Heinz Kohut, father of the school of self-psychology, in the last lecture of his life, when considering the most significant factor leading to mental illness, said, “The absence of the mother”.
Whilst his words could be taken literally, he was talking symbolically about the loss of a nurturing caregiver and the lack of a supportive environment and consistent parental figures. In short, the lack of a secure base.
Bowlby’s term a ‘secure base’ summarised his concept of healthy attachment . Without this, an individual lacks the capacity to integrate experience and relate with others adequately.
Psychoanalyst Donald Winnicott said, again symbolically, that the caregiver only needs to be “good enough”. In other words, childhood experience does not have to be perfect. Indeed for resilience to develop, the child and growing adult must be exercised by experience, but to a degree that is proportionate with their ability to cope.
The maintenance of a good supportive environment, a ‘secure base’, is primarily the task of the child’s caregivers who will moderate adverse experience.
Within the environment of the secure base, the child learns to relate to others. They start to recognise what others may be thinking and feeling when they receive appropriate responses within relationships with caregivers, siblings, friends, teachers, and others. They pick up clues about maternal preoccupation or distraction from subtle body language or context.
Within this environment they learn to mentalist, to interpret what other people do or say as meaningful and that others’ motivation is informed by their own feelings, beliefs, reasons, thoughts, stresses, needs or desires.
Without this learned competence, without the security of an internal secure base, the child will experience life as confusing and chaotic.
They will then respond to stresses ‘avoidantly’, withdrawing within themselves and try to sort life out on their own (much as we saw with Andrew) or ‘ambivalently’, reaching out to others for security and support which they feel they lack in themselves.
Broadly speaking, the latter was Beth’s instinctive way of dealing with difficulties in the workplace and before receiving the help and support that she did. Generally one to rely on support from friends and family, she was unable to do so at a time of exhaustion and overwork.
For both, their ways of relating and seeking help were not ‘good enough’ …
 Holmes, J. (2001) The search for the secure base: Attachment theory and psychotherapy. Hove: Routledge.
(This is an edited excerpt from my book A Lawyer’s Guide to Wellbeing and Managing Stress published by ARK Group in 2015.)