Established by the United Nations in 1948, the World Health Organization (WHO) initially prioritised the health and well-being of the many children who had been displaced, evacuated, made homeless or orphaned during the Second World War. At the time, Bowlby held a senior research and clinical position at the London Tavistock Clinic and had recently established the Separation Research Unit. The WHO commissioned Bowlby to review the care of children lacking homes or families. The resulting report is an odd amalgam. On the one hand, Bowlby’s 1951 Maternal Care and Mental Health, published by the WHO, reviews the available literature on institutional care, documenting negative consequences across many domains, including poor mental health. Bowlby was mindful that ‘all the evidence was still sketchy, it was inadequate’, ^{Reference Bowlby1} but he felt that the general indications of the effects of institutional care were clear. On the other hand, the book develops claims from Bowlby’s earlier writings about the importance of a familiar caregiver for a child’s development. Two concepts are fundamental to how Maternal Care and Mental Health brings these concerns together: ‘maternal deprivation’ and ‘continuous relationship’; neither is defined by Bowlby. The result is a lack of clarity, and sometimes outright oscillation in the text itself, between two distinct claims. Bowlby states: ‘What is believed to be essential for mental health is that the infant and young child should experience a warm, intimate, and continuous relationship with his mother (or permanent mother-substitute).’ ^{Reference Bowlby2} This much-quoted statement, exemplifying the broader predicament of the book, can be interpreted in two distinct ways.

A first claim (MCMH1) represents what was taken from Bowlby’s work by allies such as Ainsworth. Its importance as a contribution to developmental science cannot be overstated:

‘Children can be expected to develop better mental health when they have the experience of care from at least one familiar caregiver.’

The lack of such experience can be called ‘deprivation’, and its presence can be called a ‘continuous relationship’. Fed by reading in ethology, cybernetics and cognitive science, by the 1960s MCMH1 would evolve into Bowlby’s fundamental proposition that the development of attachment relationships, and the benefits for psychosocial development that may stem from these relationships, depend on experiences of availability by particular, familiar and non-abusive caregivers when a child is alarmed. ^{Reference Forslund, Granqvist, van IJzendoorn, Sagi-Schwartz, Glaser and Steele3} The ideas of deprivation and continuous care, and the priority given to warmth, were discarded by Bowlby as misleading early attempts to get at a subtler point: that a child benefits from sufficient interaction with a specific caregiver(s) to learn that this person will be available when the child is alarmed, that they offer a ‘safe haven’. This learning about help-seeking and its consequences is important for socio-emotional development because ‘the period when they are most active is also the period when patterns of control and of regulating conflict are being laid down’. ^{Reference Bowlby4} Institutional care predisposes impersonal relationships, high child–caregiver ratios and staff turnover, hindering the development of experiences of particularised and familiar relationships, and of safe haven provision. Bowlby therefore saw it as an extreme case of a broader threat to children, who might lack safe haven provision for other reasons too.

MCMH1 was a groundbreaking contribution, and one we are still fathoming. Developmental scientists are still working to draw conclusions about what form and extent of familiarity with caregivers serve to offer the benefits of safe haven provision, questions that have major implications for parenting, social policy and child welfare practice. For instance, work by van IJzendoorn and Bakermans-Kranenburg has documented that even forms of institutional care structured to resemble a family may not achieve this provision. ^{Reference Van IJzendoorn and Bakermans-Kranenburg5} There remain outstanding questions for attachment researchers about whether it is primarily the caregiver’s availability when a child is distressed or exploring that matters, rather than familiarity in itself, in offering a child felt access to a safe haven.

Nevertheless, as well as MCMH1, a second claim (MCMH2) can be implied by Bowlby’s statement about the need for a ‘warm, intimate, and continuous relationship’:

‘The development and emotional wellbeing of a child depends on his or her mother being present and attentive night and day, every day.’

This can be called a ‘continuous relationship’, and its absence is ‘deprivation’. MCMH2 is what most readers appear to have taken from Maternal Care and Mental Health. ^{Reference LeVine, Otto and Keller6} This impression was probably reinforced by Bowlby’s apparent confirmatory statements in the abridgement of the book, still in Bowlby’s name, as Child Care and the Growth of Love, published in 1953. Child Care and the Growth of Love argued that a young child needs his or her mother ‘as an ever-present companion’, conferring ‘the provision of constant attention night and day, seven days a week and 365 days in the year’. Child Care and the Growth of Love sold extremely well – nearly half a million copies in the first run. Against this punitive standard, all mothers fall short, making MCMH2 attractive to those who wish to justify surveillance and parenting-focused interventions where children are perceived as being at risk. ^{Reference Vicedo7} Although by no means entailed by MCMH1, MCMH2 excludes the role of structural factors such as poverty or racism in hindering caregiving, situating the mother and her actions as the central concern. MCMH2 has had a powerful appeal, for instance, in child protection practice. ^{Reference White, Gibson, Wastell and Walsh8} However, MCMH2 also justly received criticism, ranging from contemporary feminist commentators to Bowlby’s allies such as the developmental psychologist Mary Ainsworth. ^{Reference Ainsworth9} When friends, such as the renowned paediatrician Donald Winnicott, wrote to Bowlby asking him to disavow MCMH2, these requests appear to have gone unanswered. ^{Reference Winnicott and Rodman10} Bowlby knew that his statements were used to argue for positions by no means entailed by MCMH1, for instance against state-sponsored childcare provision, yet he made no public retraction or qualification. ^{Reference Lewis11}

The anthropologist and critic of attachment theory, Robert LeVine, has claimed that Bowlby lacked awareness of the extent to which he was fuelling caricatures of mothers and family life. ^{Reference Bowlby12,Reference Bowlby13} It may be concluded that Bowlby was a man of his time, and that the stereotypes of motherhood he drew upon were those he personally held. However, close examination of Bowlby’s private notes and publications of the period, we think, tells a different story, one of a tragic pact. Bowlby urgently wanted his basic idea of the importance of familiar care to be widely acknowledged, and he regarded demagoguery as the price of getting this idea into circulation. He had repeated experiences of colleagues and practitioners rejecting the significance of children’s actual experiences of care. To overcome this barrier, Bowlby was explicit, both in his private notes and in print, that he was appealing to the ‘pure prejudice’ of the day about children and parenting. ^{Reference Bowlby14} In his popular writings he knowingly ‘exaggerates everything’. ^{Reference Bowlby15} Bowlby’s own cultural values probably made use of such prejudices about maternal care both more appealing and difficult to repudiate. However, the Bowlby Archive held at the Wellcome Collections in London gives many indications that, especially as his thinking became more grounded in ethology, he did not agree with MCMH2. In his notes on scientific papers that attribute this perspective to him, for instance in asserting that he gave priority to care by the mother, he wrote with bafflement in the margins that the authors apparently had not read his work properly. ^{Reference Bowlby16}

However, in our research on the history of attachment research, it struck us as strange that Child Care and the Growth of Love, with its pivotal role for the interpretation of Bowlby’s position in Maternal Care and Mental Health, is much more dominated by MCMH2 than his other writings of the period. In works like ‘Should a baby be left to cry?’, for the magazine Parents, Bowlby states that children ‘certainly do need their mother’s presence and affection, or at least that of someone else whom they know and trust’. ^{Reference Jones17} Such statements use the ambiguous language of presence and attention, which could imply either MCMH1 or MCMH2. However, our impression is that popular language and assumptions are being used to draw readers towards recognition of the importance of experiences of care by familiar people who can be trusted by the child to be available. By contrast, in Child Care and the Growth of Love, MCMH2 appears to elbow out MCMH1. The text also differs stylistically from Bowlby’s other writings (e.g. the term ‘babyhood’, which appears elsewhere only when he is quoting or paraphrasing others).

No commentator at the time, or subsequently any historian, discussed the fact that Child Care and the Growth of Love was abridged by Margery Fry, the criminal justice reformer and retired principal of Somerville College Oxford. It has been tacitly assumed that Bowlby was heavily involved in the abridgement. It is difficult to offer conclusive proof based on absences, but our impression of the archival material suggests that Child Care and the Growth of Love was probably composed entirely by Fry, based on an interpretation of Maternal Care and Mental Health as claiming MCMH2, and incorporating extracts from the book that can point to this conclusion. In Fry’s biography, her work on Child Care and the Growth of Love is described very briefly:

In contrast to other records from this time, there are no letters with Bowlby in the Fry Archive at Somerville College. However, notably, the Fry archive does contain the transcript of an unpublished talk to BBC Woman’s Hour from 1947, entitled ‘The Child’s Need for Love’, written before Bowlby commenced work on Maternal Care and Mental Health. In this talk, Fry emphasises ‘the detailed care that any really good mother lavishes quite by instinct on her child’ and ‘how important they are in the development of personality’. ^{Reference Morris19} ‘The Child’s Need for Love’ urges that, where a parent does not show this instinctual care, and there are concerns about child neglect, adoption of the child is ‘very often the best solution’, although sometimes training mothers to alter their behaviour is possible.

In the Bowlby archive, and in contrast to his other works, there are no drafts of Child Care and the Growth of Love. There is also no correspondence with Fry, in contrast to the rich correspondence from the period preserved in the archive. We have also found no subsequent reference by Bowlby to Child Care and the Growth of Love, except a later remark reported by a friend that he felt it could benefit from revision. ^{Reference Bowlby20} Hopkins, Bowlby’s niece, colleague and executor, recalls that Bowlby spoke about Fry ‘with enthusiasm and, I think, gratitude’. She suspects ‘that the abridgement was achieved with minimal input from JB and that that was what delighted him’ (personal communication, April 2021). By way of context, Bowlby was extremely busy in the early 1950s, balancing a growing family, professional demands at the Tavistock Clinic and two challenging projects. First, he was intensively reading about ethology, considering how the conclusions of ethologists about animal behaviour and motivation might integrate with psychoanalytic theory. An indicator of the profundity of this challenge is that meeting it led the theory of the attachment behavioural system, a seismic shift in thinking about motivation in close relationships. Second, he was working on his research group’s studies of hospitalised children, the funding for which had been facilitated by his WHO report. An indicator of the challenge posed by this project is its ultimate failure. The quantitative study developed by Bowlby produced data that were, by his own admission, unusably poor. ^{Reference Bowlby20} Ainsworth was originally hired to analyse the findings from this work, but was unable to salvage the project. In retrospect, Bowlby had neither the skills nor time to develop an effective quantitative study of the effects of hospital care. In the midst of the attempt, one can imagine the appeal of someone else offering to abridge a scholarly report, and in doing so making a bestseller. This would not be the first time that a researcher has delegated ‘communications’ activity conducted in their name; or the first time that a man’s name is on a book predominantly ghost-written by a woman.