Understanding Reactive Attachment Disorder
by Alexandra Lütz
Symptoms
Children detach as a psychological defense mechanism, protecting themselves from emotional and physical harm. That part is logical, but a mother cannot grasp why her child seems capable of affection toward the father, but not toward her. A teacher can’t figure out where the endearing child went, and from where this angry monster came. The behavior of a child with Reactive Attachment Disorder (RAD) can appear confusing and unpredictable until you understand the underlying intention.
Unattached children keep all relationships on their own conditions to avoid rejection.
You cannot be let down by someone you never loved, and you cannot be abandoned by someone you never allowed to love you. By controlling the environment, unattached children keep all relationships on their own conditions, and thereby avoid disappointment and rejection.
Children with RAD manipulate strangers with charm and even inappropriate affection, but react aggressively as soon as an adult gets too close emotionally. Among people who know them well, they pick and choose whom they will love in order to show their control of the situation.
Most children will, at some point, display a few of the following symptoms, but unattached children show most or all of them. In infants, the behaviors are subtle. Most distinctly, they don’t cry much. Yet they startle easily and are difficult to calm once irritated. These abnormal crying patterns may be one of the most significant indicators of an attachment problem in children under age 1. It may be that the baby rarely cries, or he cries with rage not typically displayed in newborns.
Other than the angry cries, the infant will rarely verbalize with babbling or giggling, and he will not respond when adults coo, smile and baby talk. In fact, he will often avoid eye contact and will not show recognition of the caregiver’s face. Babies with RAD will often be limber until an adult tries to cuddle with them. Then they will stiffen, try to wrestle away or arch their backs. As they draw close to their first birthday, they may not be interested in any sort of play (although they may “entertain” themselves by inflicting pain — pinching themselves, pulling their own hair, etc.).
Toddlers with RAD show the same types of symptoms. They are difficult to console once upset, frequently throwing wild tantrums. Minor irritations become major events demanding everyone’s attention. These children –– even though they’re accident-prone –– have high thresholds of pain, making spanking an ineffective discipline technique. They alternate between being excessively clingy (especially when mothers leave them with a sitter) and being unreceptive to affection, or even being aggressively hostile. No longer passive, depressed infants, these toddlers may be hyperactive, demanding constant attention because they are unable to entertain themselves.
These characteristics make consistent daycare difficult, but the problem is exacerbated by frequent changes in daycare. One of the most serious symptoms may seem like the least of a parent’s worry: the inability to recognize cause and effect.
By the time a severely unattached child enters school, his problems become everyone else’s problems. Instead of just hurting himself, he inflicts harm on siblings, pets, classmates and property. More troubling is that he seems to lack any remorse for his actions, and he is often fascinated with anything that repulses or shocks people in authority. He may lie (about the only time he will look you in the eye), cheat and steal without a second thought. When confronted about his behavior, he will make quite a scene in an intense control battle.
A child with RAD will often chat incessantly in an attempt to control the classroom in which he is falling farther and farther behind. Also, an unattached child typically has poor hygiene. These behaviors make him stand apart from his peers who now want nothing to do with him, reinforcing his belief that he is not capable of being loved. Still, this child will show unbridled affection to strangers, having perfected the art of manipulation to a point where he recognizes that this attention makes other people think his parents are crazy for having any trouble with him.
As time passes with no improvement, his parents become frustrated and angry about the situation. If he is not biologically related, his parents may feel as though they made a huge mistake. This parental attitude usually manifests itself in the relationship, advancing the notions already embedded in the child’s heart. Already hostile toward their mothers, unattached children intentionally create division between their parents.
If all of this seems like too much to handle, there is light at the end of the tunnel. Families can overcome RAD, but the longer the problem is allowed to develop, the more difficult it becomes for the child –– and the more likely that the parents will need to receive treatment. The entire family may need to “reprogram.” As soon as you recognize a potential problem in your family, seek help immediately from someone experienced specifically in attachment disorders, who can also rule out a diagnosis of bipolar disorder. (In older children, the symptoms of bipolar disorder can be confused with RAD, especially if the child is considered high-risk for RAD.)
Interaction Tips
Communicating with a severely unattached child requires understanding, patience and determination, as these children are manipulative and controlling but unresponsive to traditional discipline techniques. They do not trust that anyone has their best interests in mind, but you cannot get close enough to them to convince them otherwise. It is difficult to remember that these children are not simply naughty or undisciplined. They are, in their minds, fighting for their lives. It may be necessary to take older children back through earlier developmental stages to establish the level of trust and commitment required to move forward.
Your goal is to convince him that you are committed to his well-being.
When parenting a child who displays symptoms of Reactive Attachment Disorder (RAD), the immediate challenge is to create an emotional bond, allowing your child to attach first to you — the primary caregiver. When together, hold your child in your arms or lap, facing you, until he stops struggling. Respond immediately to all cries (even those that don’t seem to have a cause), giving affection any time it is asked for.
Turn off the television for good, or for at least a year, and give your child all possible attention. Remember that your child is special. You are not going to spoil him or make him self-centered. He has learned too well that adults won’t cater to him. Your goal is to help your child unlearn this negative stereotype and to convince him that you are committed to his well-being.
If your child is sick and hospitalized, seize the opportunity to lavish attention on him. Address all medical concerns but, if possible, put off any painful treatments. Consider sleeping in the hospital room with your child until he is comfortable with the environment.
Educate yourself about developmentally appropriate skills so you can recognize both lags and precocity. It is sometimes good to force your child to regress, allowing him to be a baby again and enjoy the comfort of your attention and provision.
When punishment is necessary, never use separation as a discipline method — such as time-out. Work together with your spouse to create a stable, consistent home with strict, firmly enforced boundaries, preventing situations that escalate. All adults invested in a child with RAD — including teachers and grandparents — can benefit from understanding the common symptoms and predicting the manipulations he may attempt.
Keep these tips in mind:
- Be aware that the unattached child wants to be in control. Calmly remind your child that you are the boss (even to the point of requiring him to verbalize it to you), but be painstakingly fair and consistent. Require him to follow precise directions, not allowing him to choose an option of discipline over doing what you have asked.
- Offer constructive choices rather than give direct demands. (“Would you rather use this yellow pencil to do your work or this pencil with soccer balls on it?” is better than “Do your work!”) Do not allow your child to select a third option.
- Make your child look you in the eye, but do not succumb to a staring match.
- Help your child learn cause and effect and the ability to reason. Point out the good decisions he makes and require him to “fix” the bad ones. Allow natural consequences to occur, pointing out the choices and irresponsibility that led to them.
- Ask for help from people experienced with unattached children. Keep in mind, though, that advice from well-meaning but untrained people is rarely applicable to a child with RAD.
- Recognize that unattached children crave sincere affection but don’t know how to receive it. Avoid placing your child in a situation he perceives as threatening.
- Families, teachers and other involved parties may benefit by keeping a record of your child’s progress, regress and general behavior. This can sometimes be therapeutic, especially for parents. Though parents and teachers want to assume and aim for the best, individuals with RAD tend to be manipulative. Because of this, it’s important to regularly and thoroughly document your child’s behavior, comments and interactions with you or others. RAD children often claim they have been physically abused. Though it may sometimes be true, it is more commonly a false report made after a self-inflicted injury. Objective, detailed documentation on a nonemergency basis can make these high-alert circumstances much easier to sort out.