Reactive Attachment Disorder

What is it?

Reactive Attachment Disorder (RAD) is a relationship disorder. Children with RAD fail to develop secure attachments to caregivers and are unable to love and to be loved. They have experienced trauma and neglect in their first few years of life, and thus do not trust anyone. To ensure that they do not get hurt again, children with RAD manipulate each family member to maintain a sense of control. Often, these children are found in foster or adoptive homes.

Causes:

RAD is a result of trauma within the first two years of life. The following are common causes of trauma in infancy:

Sudden separation from primary caretaker (through death, illness of caretaker, or removal of child)
Physical, emotional, or sexual abuse
Illness or pain not alleviated by caretaker
Neglect (in holding, talking, nurturing, and meeting basic physical needs)

Characteristics:

Children with RAD exhibit a variety of characteristics, mainly relating to the need to be in control of situations. Listed are common symptoms:

Superficially charming (using cuteness to get his/her own way)
Cruel to animals
Manipulative of adults
Difficulty with eye contact (unless lying)
Overly affectionate with strangers
Has no friends, or just for short while
Enjoys being sneaky
Crazy lying (lying when it would have been just as easy to tell the truth, or lying when they know the other person know the truth)
Incessant chattering and nonsense question asking
Excessively bossy
Fails to re-establish interaction after separation (poor reunion response in infancy)
Lacks compassion and remorse
Overall developmental delays

Treatment:

Treatment for RAD is still unclear and very controversial at this point in time. However, psychologists have been able to draw some conclusions about what does and does not work with RAD children. First, traditional therapy has been found not to be a viable option. It is predicated on the idea that a child can build trust with someone. These children are unable to trust adults and relax enough to give adults any power over them. What psychologists have found is that alternatives to traditional therapies are needed to help these children. One prospect that has been used is “holding therapy.” Advocates for this technique profess that holding therapy provides the ultimate corrective emotional experience because it repairs a child’s disturbed development more fully than any other therapy. The process is designed to provoke youngster’s infantile emotions, including rage, frustration, anger and need for nurturing. The child lies across the laps of two adults usually the therapist and a primary caregiver. This is designed to let the child relinquish control. Throughout the holding, the therapist looks softly into the child’s eyes and holds the child gently but firmly. The technique is meant to build a new foundation for a healthier attachment between parent and child. This therapy has received much criticism and stirred controversy due to its physical nature. One thing that most all parents, psychologist, therapists, and social workers agree on, however, is that new therapies must include a family model where issues of trust and care are addressed instead of working with the child alone.

Source: “Mental Health Sensitivity Curriculum: Understanding Brain Disorders”
By Kentucky Partnership for Families and Children, Inc

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