History as a diagnostic aid

An account of how I learned to be a helping professional – not an instruction manual, but a prompt for you to explore your own story .

Somewhat later, I began to read Bowlby’s work on attachment theory, and some of the studies that built on that work. Here I found a theoretical account of this issue of history that made immediate sense to me. What researchers into attachment theory observed was that people developed a more describable history as their attachments became more secure. It would be difficult to be sure how far this was a question of more secure attachments producing more trust which in turn would allow people to share what they recalled of their own history; or how far memories that had not previously been available to them, now could be recalled. Probably a mixture of both processes is at work but either way, this observation puts personal history as a diagnostic symptom of the state of a person’s emotional health, and its recovery as a reinforcement of a recovery in emotional health.

This seemed a much more valuable way of considering the issue of history and it fitted with my experience in those early professional days. It was quickly obvious in preparing social inquiry reports, that some people could give much more detailed and articulate accounts of their earlier lives than could others. At first, I saw this as a matter of relative trust but that seemed over-simplistic as some less articulate clients showed signs of trust and more articulate clients might show evasions or manipulations. Particularly common for a probation officer were clients who could give little account of themselves at all – who showed the characteristics of what attachment theorists described as ‘insecure – avoidant’ attachment patterns. I will come back to this later on, but at this stage, the inability apparently to recall anything of significance in their childhood was often a characteristic of these individuals.

Oliver Sacks writes interestingly about memory. He tells the moving story of Mrs O’C, who was orphaned by the age of 5 years and had now reached advanced old age. She had no memory of her life before the age of 5 and had always felt this as an absence in the centre of her being, as a painful sadness.

One night, Mrs O’C dreamt vividly of her childhood and particularly of the songs they danced to and sang. When she awoke, the music continued. It was so loud and vivid that she imagined a radio had been left on. Eventually, it was diagnosed as a consequence of a stroke, as temporal lobe seizures.

Associated with these songs were profound feelings of being back in her childhood, and an overwhelming emotion of nostalgic content. Sacks describes it as “a trembling, profound and poignant joy”. As she recovered from the stroke, the music gradually faded but she was left with a new sense of completeness and serenity.

Instead of looking at memories for what they reveal about the past and any explanatory role in relation to current behaviour, Sacks is interested in the impact of memory on current experience, and he sees serenity as dependant on possession of a ‘true past’, irrespective of the nature of that past.  This fits well with the findings from attachment studies.

We can be sure that one feature of the lives of offenders is a lack of ‘serenity of spirit’. The agency of change for Mrs O’C was the stroke, the physical disturbance in the temporal lobe, not the memory itself. In attachment studies, the change agency is the experience of a relationship(s) characterised by secure attachment. Increased access to memories is then a symptom of change, and a reinforcer of a greater degree of content.

Whatever the factors that drive criminal behaviour, we can also be sure that there is a profound striving or struggling. We also observe what are termed ‘cognitive deficits’, or decision making based on incomplete grasp of the world they inhabit. For many, relationships are typically insecure, substantially limiting the resources available to them that would help survive sadness, failure, inadequacy and disappointment, and similar challenges of normal real life.


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