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The Reactive Attachment Disorder and How to Treat It

February 22, 2017 By TodaysTherapist

Reactive attachment disorder is a rare and serious condition characterized by an infant’s lack of a healthy attachment to a parent or caregiver. It can develop if an infant’s basic needs for comfort, affection, and nurturing are not met. Not having a stable, loving relationship with others can also trigger it.

We’ll be covering:

  • What the disorder is;
  • Symptoms associated with it;
  • Causes of reactive attachment disorder;
  • Other issues related to the disorder;
  • Treatment options;
  • Examples of the disorder.

This is not a definitive source on the topic. Always seek medical care. Contact a local therapist, healthcare provider, or primary doctor for more in-depth information on the topic.

sad girl disinterested in couple

What Is Reactive Attachment Disorder?

This disorder is present in children that have been severely neglected and haven’t formed a healthy emotional attachment with a primary caregiver, particularly the mother, by the age of 5.

An attachment forms when a child is consistently cared for, soothed, and comforted when needed. Through developing an attachment with caregivers, children learn to love and trust others, be aware of another’s needs and feelings, regulate their emotions, and develop healthy relationships along with a positive self-image.

The absence of a healthy attachment during the first few years of life can have a negative impact on the child’s entire life.

Symptoms of Reactive Attachment Disorder

People that develop this disorder can be bossy, distrustful, manipulative, and controlling. They can also exhibit behavior that is destructive, impulsive, or violent. They can be sad, moody, fearful, anxious, or depressed.

There are two forms of RAD: inhibited and dis-inhibited. Someone can develop one or both types, exhibiting symptoms from each side.

Symptoms of inhibited RAD include:

  • Detached;
  • Unresponsive/resistant to comfort;
  • Excessively inhibited (holding back emotion);
  • Withdrawn.

Symptoms of dis-inhibited RAD include:

  • Indiscriminate sociability;
  • Inappropriately familiar/selective with choice of attachment figures;
  • Seeks attention from anyone;
  • Inappropriate childish behavior.

Causes of Reactive Attachment Disorder

Children are born naturally resilient. Even those neglected or left in orphanages can still develop healthy relationships with others. Because of this, there is not a thorough understanding of why some develop RAD and others don’t. Scientists hypothesize that it’s a physical contact issue.

When the child’s needs are ignored or met with physically abusive responses from the caregiver, the child learns to expect hostility and rejection. This causes the child to become distrustful and avoid social contact. Such interactions can have a negative impact on brain development and cause attachment, personality, and relationship problems throughout life.

Other Issues that Relate to Reactive Attachment Disorder

Other disorders and conditions that are associated with neglect can co-occur with reactive attachment disorder. These disorders and conditions include:

  • Cognitive delays;
  • Language delays;
  • Severe malnutrition;
  • Depression;
  • Anxiety disorders;
  • ADHD.

Reactive Attachment Disorder Treatment Options

There are two goals to keep in mind when treating reactive attachment disorder. The first goal is to make sure the child is in a safe environment. This is especially important if the child has been abused or neglected. The second goal is to help the child develop a healthy relationship with the appropriate caregiver.

Treatment primarily focuses on the caregiver. Counseling can address issues affecting the caregiver’s relationship with the child. Parenting skills can also improve the relationship between the child and develop an attachment. Play therapy could be used to let the caregiver and the child express their thoughts, fears, and needs in a safe and friendly environment.

There is no medication that specifically treats RAD, but the doctor may use medication to treat other issues that are caused by RAD, like explosive outbursts or issues with sleep.

Holding therapies and “re-birthing” techniques are very controversial, and there’s no scientific evidence to show that either technique works.

Reactive Attachment Disorder Examples

In 2014, reactive attachment disorder forced a father to give up custody of his adopted daughter. As previously stated, reactive attachment disorder can develop in adopted children.

Eric Kinzel found this out firsthand when he adopted a little girl by the name of Alani and had to give her back to the adoption agency due to her dangerous behavior. Alani and her older brother Julian were completely neglected by their mother. This serves as a precursor to RAD, abandonment issues that can cause destructive instincts.

Kinzel adopted Alani at the age of 4, but even then he noticed Alani’s “level of manipulation” that allowed her to turn those in her life against each other. The final straw for Kinzel was when Alani used a knife to gouge out the eyes of everyone in a family photo except herself. After exhausting every option for treatment, he decided to give her back to foster care.

Statistics for reactive attachment disorder are abysmal. 8 out of 10 children that are raised in an environment filled with trauma during their early years could develop RAD. Of these children, 1 out of 10 will not be able to function normally as far as emotion is concerned.

People who work in agencies that handle adopted children have noticed a rise in the portion of children affected by attachment disorders. 3 million cases of maltreatment are investigated by Child Protective Services every year, and this is only reported cases. There could be millions of other cases that go unchecked as well.

Sad girl not having fun with friends

Conclusion

Reactive attachment disorder can be prevented. The main cause of RAD is severe neglect by a caregiver as a child. If symptoms are caught in time, the child can go on to live a productive life. But if not caught in time, there are still options. Counseling, learning parenting skills, and play therapy can help a child with RAD.

Please leave a comment if there’s advice not offered above on how to deal with RAD. If someone around has tried any of the above remedies, be it on themselves or someone else, feel free to tell us about it. Take care.

Images from depositphotos.com.

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