What Is Attachment Disorder?
Reactive Attachment Disorder (RAD) - a complex, severe and relatively uncommon psychiatric disorder in which infants and young children have extreme difficulty forming lasting emotional attachments with their caregivers.
A child who has RAD has often been neglected, abused or orphaned. RAD develops because the child's basic need for comfort, nurturing and attachment haven't been met and caring bonds between the child and caregiver do not develop. This lack of attachment may permanently change the growing brain and hurt the ability for the child to develop future relationships.
Reactive attachment disorder may be a lifelong conditon, but with treatment, children may be able to develop stable and healthy relationships with caregivers.
What Is Attachment?
Attachment is the deep connection between child and caregiver encoded into a young child's brain in the first years. Attachment has profound impact upon every component of the human body.
Core Beliefs in Attachment:
Early childhood experiences are coded into our brain; those first experiences create core beliefs about ourselves, other people and the world. Core beliefs interpret the present and anticipate the future.
Concept of self: "I am good, worthwhile, lovable, wanted and competent."
Concept of Caregivers: "They respond to my needs, are sensitive and dependable, caring and worthy of trust."
Concept of Life: "My world is safe. Life is good."
Concept of Self: "I am unlovable, helpless, worthless and unwanted."
Concept of Caregivers: "They do not respond to my needs and are hurtful, insensitive and unworthy of trust."
Concept of Life: "My world is unsafe. Life is hard."
Causes Of Reactive Attachment Disorder:
Attachment disorders are most likely to develop when children are unable to form a bond with a parent or caregiver within the first three years of life. Situations which increase the likelihood of an individual developing Reactive Attachment Disorder include:
- Unwanted pregnancy
- Separation from primary caregiver early in life (i.e. death of the mother, adoption, extended hospitalization)
- Chronic maternal depression
- Frequent moves (such as changes in foster care placements)
- Self-centered parenting, such as caring for a baby on a timed schedule (i.e. ignoring the baby's cues of hunger until the "appropriate time")
Even though some causes are unavoidable, the message to the undeveloped psyche is the same: my needs don't matter.
Symptoms of Reactive Attachment Disorder:
The symptoms of Attachment Disorder vary with the individual. RAD symptoms may mimic other disorders (like autism).
According to AttachmentExperts.com, symptoms of Reactive Disorder are:
- Behavior: destructive, irresponsible, impulsive and defiant behavior. They may abuse, steal and lie, start fires, be cruel to animals or become self-destructive. An aversion to physical contact.
- Emotions: children with RAD may be sad, moody, fearful, anxious, depressed and hopeless. They may also exhibit inappropriate emotional reactions.
- Thoughts: children with reactive disorder may have negative beliefs about themselves, relationships, and life. They have no concept of cause-and-effect. They may experience inattention and learning problems.
- Relationships: a person with RAD is untrusting, bossy, manipulative and controlling. They cannot give or receive genuine affection and love and may be indiscriminately affectionate with strangers. Individuals with RAD have unstable peer relationships, often blaming others for their own mistakes or problems.
- Physical: people with RAD may have poor hygiene, often wetting the bed. They may have a high pain tolerance as well as genetic predispositions to conditions like hyperactivity and depression.
- Moral/Spiritual: people with RAD may lack faith, compassion, remorse and meaning. They often identify with the darker sides of life.
Reactive Attachment Disorder and Adoption:
It's devastating to adopt or foster a child only to find out that they're angry and unresponsive. It's not because they don't love you; they simply don't understand how to properly bond with a caregiver or see you as a source of love and comfort.
Rest assured that, in the end, your love will matter.
Reactive Attachment Disorder Treatment Options:
Treatment for Attachment Disorder is based on a multi-pronged approach. Education and parenting skills classes are offered to parents along with both individual and family therapy. Medications can be helpful in treating issues such as depression or anxiety.
Adults, too, can suffer from the fallout of attachment problems if the disorder was not addressed earlier in life. Specialized therapy is recommended to deal with maladaptive behaviors learned in childhood.
That said, The American Academy of Child and Adolescent Psychiatry (among MANY other organizations) strongly warn against the following types of treatment for reactive attachment disorder because they are DANGEROUS. DO NOT USE THE FOLLOWING TECHNIQUES:
- Tightly binding, wrapping, or holding children.
- Withholding food and water or forcing the child to eat or drink.
- Yelling or tickling, or any triggering behavior that leads to anger then submission from the child.
How To Parent A Child With Reactive Attachment Disorder:
Check with social services to see what local resources may be available.
Be realistic in your expectations and celebrate every victory, however minor.
Laugh a little. Happiness, hopefulness and a sense of humor will help you to feel better while coping with attachment disorder.
Find a support system and use it.
Be prepared to call emergency help if your child becomes violent.
Join a support group and connect with others who may be experiencing the same things you are.
Remind yourself that it's okay to be angry or frustrated sometimes.
Take care of you, too. It's hard when you have stress coming at you from every angle, but in order to properly care for anyone else, you have to care for YOU.
Try to be patient. RAD didn't develop in a day and you can't expect to fix it in one, either.
Hotlines for Reactive Attachment Disorder:
National Dissemination Center for Children With Disabilities: 1-800-695-0285
Zero to Three: (202) 638-1144
24 Hour Parent Helpline: 1-888-435-7553
Additional Resources for Reactive Attachment Disorder:
The Institute for Attachment provides information on the symptoms of attachment problems in adults.
RadKid.org is a resource for finding other parents who are living with a child with Attachment Disorder.
ATTACh (Association for Treatment and Training in the Attachment of Children) provides a parenting guide for those dealing with attachment disorders.
Adoption.com has a section of resources for adoptive parents who are looking to learn more about attachment and bonding.