The first eighteen months of life is filled with rapid changes for parents and infants across every aspect of human development. At the stage of infancy the influence of a positive attachment can enrich an infant’s behavioural development (Peterson 2010, pp.140-150). Erikson (1968 cited in Peterson 2010, p.51) theorises that to mould a positive attachment an infant must achieve a balance of the psychosocial stage of ‘trust versus mistrust’. The achievement of this stage combined with the infant’s environment, social arena, and how infants see themselves as individuals is dependent on a positive attachment. With an understanding of Erikson’s theory and knowledge of attachment principles a nurse can help parents achieve this stage of infancy. This essay will concentrate on how having an understanding of Erikson’s theory can help nurses when advising positive attachment strategies to parents. And also reflect on how parents can achieve a positive attachment with a nurse’s intervention.

Erikson assembled eight stages of human development that ‘remain within the proper rate and proper sequence which govern the growth of personality’ (Erikson 1959, p. 52). In other words, a person cannot advance to the next stage of development without achieving a resolution of conflict with the one before. The first stage of ‘trust versus mistrust’ (Peterson 2010, p. 51) is between birth to eighteen months and is described as a time of potential ‘crisis’ for an infant (Erikson 1959, p, 50). During this stage an infant battles with inner conflict which is slowly developed into a balance between sense of self and trust in others. Caregivers have the responsibility to guide infants toward a successful resolution of conflict so they are competent to advance to Erikson’s next stage of ‘autonomy versus shame and doubt’ (Peterson 2010, p. 51).

It is important to also define positive attachment; as the trusting relationship that forms during infancy, usually with the primary caregiver. It is a time when an infant develops a secure attachment with a caregiver that prepares the infant for positive relationships on an intimate and social level that is carried on throughout the stages of life (Peterson 2010, p. 141). After birth an infant is dependent on others to fulfil his/her every need. The focus is on the ‘quality of the maternal relationship’ as suggested by Erikson (1965 cited in Candlin 2008, p. 131). This significant stage is the maternal bond, usually between the primary caregiver and infant, that grows through a sense of connection. The primary caregiver develops an internal sense of what the infants needs are, and the infant can sense the mother is confident and secure in her actions knowing that all his/her needs will be met (Erikson 1963, p. 76). The infant is reliant on this emotional security to help guide him/her on the right path to establish trust, in preparation for a positive attachment. If the infant has inability to grow through attachment he/she may display signs of constant crying, inability to self soothe and withdrawal, possibly due to the caregiver struggling to connect and understand the infant’s needs (Children, Youth and Women’s Health Service). By aiming to support the primary caregiver and encourage positive attachment a nurse could recommend the Maskan approach of learning to ‘interpret and respond’ to soothe the infant as suggested by Cianco (2001, p. 6). Also, using Eriksons (1963, p. 237) observation and theory of the Sioux Indians to swaddle and restrict the limbs of an infant to calm him/her may be useful to alleviate the negative behaviour.

The relationship of attachment is developed over time, but an infant’s environment is also vital for their psychosocial growth. The primary caregiver needs to provide a kind, warm and stimulating environment that is safe and secure (Peterson 2010, p. 124). The infant needs to trust that this is a good place to be and have the desire to develop emotionally and explore his/her surroundings. Having a desire to develop his/her ‘mental vitality’ in this environment as described by Erikson (1968, p. 95) is one gain of mastering positive growth. However, an unattached infant could develop an imbalance of trust showing anger and bad tempered behaviour that could lead to ‘rage’ (Erikson 1968, p. 82). A nurse would have to consider what is contributing to the infant’s negative behaviour. It could be that the caregiver may have financial pressures or be from a lower socio-economic circumstance with no history of healthy development. Caregiver’s background and lifestyle is important to understand so that nurses can determine what positive strategy methods will benefit the infant. (Crisp & Taylor 2005, p. 103). Caregiver’s would benefit in understanding how an infant uses visual and physical cues to communicate (Cianco 2001, p. 3) and knowledge of Piaget’s (1970 cited in Peterson, pp. 122 – 123) stages of sensory and cognitive motor skills could be useful in achieving a healthy level of development. To do this a nurse could suggest simply spending quality time with the infant, establishing a daily routine and involving the infant in simple activities benefiting both caregiver and infant in developing his/her sense of self and positive attachment (Children, Youth and Women’s Health Service).

Evaluating an infant needs can be a difficult task for nurses. Nurses would need to develop a sensitive out-look towards caregivers and their needs in promoting healthy development for infants. Depending on caregiver’s circumstance a nurse may question whether the method used by Sioux Indians (Erikson 1963, p. 137) is too aggressive to adapt to but suggesting the Maskan (Cianco 2001, p. 6) approach may be a better option. Thus having a theoretical background in an evaluation ensures that a nurse will implement the correct balance of positive development needed for caregiver and infant.

This essay has demonstrated that in the nursing profession using the understanding of Eriksons’ theory of ‘Trust versus mistrust’ as a base of reflection along with the principles of attachment can be beneficial. This provides an excellent setting for nurses to be capable of assessing an infants needs (Crisp & Taylor 2005, p. 283). Simultaneously a nurse can offer adaptive methods to encourage positive attachment and strengthen coping skills to overcome disparities during the stage of infancy. A nurse can be a continual base of resource for the caregiver helping to establish healthy environments and good maternal relationships. In return the infant develops a healthy positive attachment with caregiver a sense of self and a resolution of conflict. The infant is then competent to move onto Erikson’s next stage of ‘Autonomy versus shame and doubt’ (Peterson 2010, p. 51).