Catholic Medical Quarterly Volume 74(4) Nov 2024

FAITH IN MEDICINE

The Icon of Our Lady of Perpetual Succour the ideal of mother-infant attachment behaviour

Dr Ian Johnston

Icon of Our Lady of Perpetual SuccourImage by Ruffles DeQueijo

One of the most celebrated icons in Christianity, and certainly the most recognisable, is that of Our Lady of Perpetual Succour which is kept at the Church of the Most Holy Redeemer and Sant’ Alphonsus on the Via Merulana in Rome. While it has been displayed there since 1866, tradition traces its origin from at least 1499 when it is known to have been venerated at the Church of St Matthew which was situated on the same site on the Via Merulana[1].

Strictly speaking, icons are not art – they a truth about God, being “visible representations of supernatural things”.[2] Writers of icons (icons are properly said to be “written” and not painted) will spend time praying and fasting in preparation to create more than just a picture, but to reveal a deeper, divine truth in their work. The role of the image was to help those who could not read to learn – it was the Biblia Pauperum, the “Bible of the Poor”[3].

The icon of Our Lady of Perpetual Succour is of Cretan origin[4]. The Virgin is clothed in deep ultramarine, a pigment derived from ground down lapis lazuli rock, being the most expensive pigment of the age[5]. Her red under-tunic mirrors the colour worn by virgins at the time of Christ[6]. The Virgin is pointing at the Christ Child with her right hand and holding him with her left arm supporting his weight. The Child is holding her right thumb. Unlike a traditional icon of the Virgin and Child, the Christ Child is neither looking forward nor in a pose of benediction[7] but is looking over his shoulder at Archangel Gabriel who is bearing the Cross and, on the opposite side, at Archangel Michael who bears the lance and sponge, the instruments of his death.

An interesting detail in the icon is the sandal which is falling from the Christ Child’s right foot. Various biblical interpretations have been put forward to explain this[8]. The Book of Ruth (Rt 4:7- 8) speaks of a custom of taking off a sandal and handing it to another to seal an agreement of an inheritance. St Paul, in Phil 2:6-11, describes Christ’s humility in emptying himself of divine glory to live a human life. This emptying is given expression in the icon as the falling sandal.

At a more simple, human level an interpretation of the falling sandal might be to imagine the Christ Child anxiously running in terror from the instruments of his future death, as carried by the Archangels, into the loving and protective arms of his mother. He looks over his shoulder in dread fear while trustfully holding her hand. In his anxiety to reach his mother quickly, his sandal loosens and starts to fall off. We can imagine that he gets to his mother before it falls off completely.

The icon portrays what child psychologists would recognise as attachment behaviour. The Christ Child is doing no more than any child would do when threatened or endangered – he is seeking safety and protection. The Virgin, for her part, supports and protects him, instilling a sense of safety, settling his distressed state and, by her maternal attention to his needs, calming his fears. This is not the time for imparting blessings – that can wait for later. The Christ Child needs the loving embrace of his mother. The icon is a reminder that, while Christ is fully divine, he is also fully human. He has the same need for emo- tional and physical support from his mother as any other child.

Attachment behaviour is any form of behaviour that results in a person attaining or maintaining proximity to some other clearly defined individual who is conceived to be better able to cope with the world[9]. It is most obvious when a person is frightened, sick or fatigued. It describes the safety seeking behaviour of a child when danger is perceived.

Crying is an example of attachment behaviour – it is a distress signal designed to get the care giver involved.[10] The purpose of attachment behaviour is to bring the individual (infant) into closer proximity, or to maintain proximity with his or her attachment figure, with the instinctive expectation that the attachment figure will remove the stres- sors, thus deactivating the need for attachment behaviour. [11]

An essential survival programming of infants is their attachment behaviour. Attachment behaviour draws the primary caregiver, usually the mother, to the baby at times of distress. It requires that the primary caregiver be attuned to her baby. To be attuned is to make someone able to understand or recognise something, or to make someone able to respond to something.[12] Attunement is the behaviour of sensitive, good enough parents in recognising, understanding and responding to their baby’s emotional needs, especially the negative emotional needs, which complements their response given to the baby’s physical needs. Carers who are poor readers of their infant’s emotional cues compromise the child’s healthy psychosocial development.[13]

An attuned mother allows her baby to make sense of the bewildering range of interpersonal and environmental stimuli that can provoke anxiety and distress when presented in an unregulated manner. In the words of Donald Winnicott, eminent child psychotherapist of the last century, attuned mothers “give back to the baby the baby’s own self ”.[14] Attunement promotes attachment and allows the infant to explore and develop.

Infants can be either securely or insecurely attached[15]. A securely attached child will seek safety appropriately. An insecurely attached child seeks it in an abnormal manner which can be either avoidant, ambivalent, or disordered.

For secure attachment to develop it requires that empathic parents respond appropriately to their child’s emotions, particularly the negative emotions. The infant, when distressed, then feels understood, his arousal levels fall, and he starts to make sense of his emotions. This builds a sense of competence in the infant who can then go on to develop flexible, open relationships.

On the other hand, the infant who is insecurely attached is overly concerned with the sensitivity and appropriateness of the response from their parent. [16] He lacks confidence that the attachment figure can provide safety. He may know from previous experience that the parent either does not respond, or responds only partially or inappropriately, so leading to anxiety. In some situations, this anxiety can be extreme, a state termed hypervigilance, where the infant is constantly aroused and stressed. The infant’s time is taken up with worries about his safety which leaves less time for exploration and development. Children who are physically and emotionally abused by one or both of their parents may show this pattern.

The patterns of insecure attachment are worthy of description. In avoidant attachment, an unwilling mother, perhaps a mother who resents her infant because of a relationship breakdown with the father, may resist the emotional needs of her child.[17] The infant, recognising that the mother does not provide the safety and emotional response he needs, unconsciously adapts either by minimising or exaggerating his own response to elicit a stronger maternal response. Neither approach will work to satisfy his needs and he learns to become self-sufficient and not to cause his mother distress. Such an infant may go on to have difficulties with emotional closeness in later life.

In ambivalent attachment, the unable mother, perhaps a mother who has mental illness (postnatal depression is common), is unable to give a consistent response to her child.[18] She is more concerned with her own needs and her response to the infant does not always match the child’s needs. The infant sees no predicable response from the mother and begins to distrust her. He will resist being soothed, his emotions go unregulated, and he becomes attention seeking.

The psychosocial needs of infants were first described by German-American psychoanalyst, Eric Erikson in 1950.[19] He determined that the essential psycho-developmental task in the first year of life is for the parent to meet the infant’s basic needs and for the infant to develop trust. An infant depends on the mother for sustenance and comfort. The attuned mother, by helping the infant recognise and understand his distress facilitates the development of trust in the infant. Consistency of approach by the mother is important – it builds the sense that the infant feels safe, comforted and well cared for. The infant of a neglectful or abusive parent learns that the world is unpredictable, or perhaps even, a dangerous place.

We never can be perfectly parented for there are no perfect mothers or fathers. We should be happy to settle for a parent who is good enough. For many, even this imperfect ideal does not exist. Children born to mothers who physically or emotionally abuse them, those born to mothers troubled with mental illness, or mothers who have unresolved childhood trauma, frequently have attachment disorders. Mothers addicted to drugs and alcohol often do not themselves get the emotional (and often the physical) safety and protection they need to resolve their own emotional distress and to support their infants’ emotional needs.

The Icon of Our Lady of Perpetual Succour portrayed the ideal of mother-infant attachment behaviour five centuries before academic understanding emerged. A detail of the icon confirms this – while the Virgin is pointing to her Son, she is looking sideways at us. Attuned to our needs, she is extending that trust to us. She wants us to trust in her and her Son.

Jesus entrusted each of us to the care of his Mother on the cross, “…he said to his mother, ‘Woman, behold, your son.’ 7en he said to the disciple, ‘Behold, your mother.’” ( Jn 19: 26-27).

We need only look to the maternal instincts of our Heavenly Mother as exemplified in the icon of Our Lady of Perpetual Succour to know she is there as our safe haven, the one who knows exactly what is wrong and what we need. She recognises the source of our distress, can soothe our fears, and will calm our anxieties. She will meet us with the love that our own dear parents were unable or unwilling to provide. Even those who have been blessed with responsive and attuned parents will recognise her warm and generous maternal comforting when called upon. Our Lady of Perpetual Succour is the ideal of parenting and the model of secure attachment.

Thou art clement, thou art chaste,
Mary, thou art fair;
Of all mothers sweetest, best;
None with thee compare.

St. Alphonsus Liguori

Dr Ian Johnston is a Specialty Doctor in Community Paediatrics in South London

References

  1. Korn, Daniel. Embracing the Icon of Love 2015 Liguori Publications, Missouri.
  2. Attributed to Dionysius the Areopagite, cited in: Ferrero, Fabriciano The story of An Icon 2001 p23 Redemptorist Publications, Cambridge.
  3. Wikipedia https://en.wikipedia.org/wiki/Icon
    (accessed 10 Feb 2024)
  4. Ref 2; p12.
  5. Raemers W (revised by MacNiven-Johnston, Glynn). Devotions to Our Lady of Perpetual Succour 2014 p6 The Incorporated Catholic Truth Society, London.
  6. Wadding, George. Mother of Perpetual Help – Reflections on an Icon 2014 p39 Redemptorist Communications Ireland.
  7. The Icon is of the Hodegetria style (translated from Greek: “she who shows the Way”). Traditionally, these icons show the Christ Child facing forward with the Virgin pointing to him as the source of salvation of the world. The Christ Child is typically portrayed with one arm in a benediction pose.
  8. Ref 4 above, p7.
  9. Bowlby, John. (1988) The Origins of Attachment Behaviour. In: A Secure Base, Clinical applications of attachment theory. P26, Bristol: JW Arrowsmith.
  10. Howe, David. (2005) Child Abuse and Neglect. Attachment, Development and Intervention. P16; Basingstoke: Palgrave Macmillan.
  11. Prior, V. Glaser D. (2006) Understanding Attachment and Attachment Disorders. Theory, Evidence and Practice. London; p17. Jessica Kingsley Publishers.
  12. Cambridge Dictionary.
  13. Ref 10. p14.
  14. Winnicott, D. (1971) Playing and Reality. New York: Basic Books.
  15. Prior, V. Glaser D. (2006) Understanding Attachment and Attachment Disorders. Theory, Evidence and Practice. London; p24. Jessica Kingsley Publishers.
  16. Ref 10. P32.
  17. Ref 10. p34.
  18. Ref 10. pp35-37
  19. Erikson, Erik (1950) Childhood and Society. New York: Norton.