INSIDE: Understanding How Reactive Attachment Disorder Thinks and Feels
Guest Writer
As therapists, we don’t always get to pick our specialties. Sometimes they pick us. Such was the case for me with Reactive Attachment Disorder. I have more than 27 years’ experience working with teens and adults and it’s normal for any number of issues to present, all as varied as the people that sit across from me. Early on in my career there were two themes that I could not determine where they were coming from: (a) a deep inability—an incapability really—to truly trust someone else and, (b) feelings of being in a low-grade state of survival constantly, even when the external circumstances seemed to be adequate, or enough. These two themes were infused with intense reactions anytime anything—even a small thing—seemed to rock the client’s world. It was the reoccurrence of these intense reactions that ultimately landed someone in one of my blue La-Z-Boy recliners.
These two themes motivated me to gain an understanding of what I now realize is the disorder called Reactive Attachment Disorder. The primary purpose for my research was to better understand the thinking patterns behind the many outward behaviors I was seeing in my office. I have been working in this area ever since.
What is it? Simply put, Reactive Attachment Disorder (also known as RAD because it’s shorter) is an infant’s inability to attach to its primary caregiver—generally the mother—during the first 12 months of the infant’s life. There is confusion surrounding attachment, and that is the words “bonding” and “attachment” getting used interchangeably. In reality, they have very different meanings. The easiest way to describe the difference between these two concepts is this way:
Bonding is what a normal, healthy (important adjectives here) adult will unconditionally (key word) do toward an infant. Bonding is adult toward infant.
Attachment is what a normal, healthy (important words again) infant will conditionally (key issue here) do if, and when, the infant assesses its environment to be safe enough and if the primary caregiver is consistent enough to be relied upon.
The subjective measurement is the word “enough.” The actual amount of “enough” will vary from one infant to the next even when two, or more, kids are in the same home environment and encounter same or similar circumstances. Attachment is child toward adult. To further confuse, the primary caregiver may in fact bond, but the infant may still not attach.
The most widely noted circumstances causing attachment disorders are abandonment, neglect and/or abuse (physical, sexual and/or emotional). Other situations that have the potential for RAD to develop in an infant are:
Pre-mature birth with complications
Traumatic pregnancy and/or delivery
Birth mother’s use of alcohol and/or drugs during pregnancy
After birth complications or trauma for the infant
Lack of enough nurturing from mother
Lack of enough validation from father
Any number of early childhood traumas
Any combination of the above
Don’t jump to the conclusion that every adopted child or every pre-mature born infant has RAD. Obviously, that isn’t the case. However, situations like the ones listed above would account for the times RAD exists when the child is a part of an intact family structure or was adopted at birth and taken home directly from the hospital to a good nurturing family.
But a person doesn’t simply “outgrow” attachment issues with time. What happens is his/her behaviors change with age, which in turn, match a different set of collective behaviors and receives yet a different diagnostic name. And many times these other diagnosed disorders are accurate, mind you, just not comprehensive.
The problem is that underlying the other disorder(s) may be RAD. RAD may be (not always) the “starter domino” in the long domino train of destructive thinking patterns and behaviors that finally bubble to the surface in the adolescent or adult. Dealing only with the end domino (dysfunctional thinking patterns or behaviors) will have a lesser chance of generating deep, permanent change. Only when the where and why behind the behaviors are addressed can complete healing be possible.
The child, teen or adult, who behaves in ways for which they are given a continually revolving list of diagnostic labels, is more than likely acting out of their “fight” side of the “fight or flight” survival reaction of the brain. It’s what gets them noticed. The reason for the many diagnostic labels, and all the conflicting opinions for the behavior, is due to the tactics that are being identified, not the underlying issue. But if the person tends more to the “flight” side of the reactionary brain, what behaviors do you see? None. That’s the point here. The compliant—think camouflage—behaviors are acceptable for the most part and the person gets left unbothered. Still, underneath the camouflage there’s a reactive brain and a person who has attachment issues just as serious as their “fight” reactive brain counter part.
INSIDE: Understanding How Reactive Attachment Disorder Thinks and Feels is a compilation of the thoughts, reactions and belief patterns I have studied over my 27 years as a therapist. It represents what numerous clients who have RAD, or RAD dynamics, have shared with me during my time in private practice, residential treatment center and in psychiatric hospital settings. It is representative of people across the entire spectrum, male and female, teen and senior; whether officially diagnosed with a mental disorder or not. INSIDE is how they described what life is like for them as teens and adults.
I wrote INSIDE for two primary audiences. First is for the professional working as a psychologist, therapist, school teacher, youth worker, social worker, probation officer, etc. who encounters such a person in their line of work. The second is for any friend or family member of such a person, to help them gain a better understanding of the dynamics of what’s behind the behaviors they currently see in their friend and/or loved one.
INSIDE: Understanding How Reactive Attachment Disorder Thinks and Feels, is a journey inside the world of a person with RAD and how they live in it.
