AskHal

Steve

Steve,

I appreciate the question because it allows me to address some larger issues. I'm guessing you are having some personal experience with this diagnosis so after addressing RAD in general, I'll address the more personal side of the issue.

Reactive Attachment Disorder (RAD) is sometimes referred to as Attachment Disorder or Detachment Disorder, and it is a label applied to a group of symptoms including:

marked inability to form close relationships

intense need for physical and emotional privacy

strong distrust of parents coupled with overfriendliness with strangers

emotional outbursts with little empathy for those affected

Now reading this may alarm many folks--"that sounds just like my kid!!" But before everyone starts self-diagnosing their youngster, let's look at a few diagnostic factors. Usually children that receive this diagnosis are those who have been abused early on or shuffled between several houses and primary caregivers from the beginning of their lives.

Also, it's important to remember the nature of psychological/behavioral diagnostics. Despite amazing amounts of research, diagnosis is not an exact science. Far from it. A diagnosis like RAD is simply an attempt to help explain an otherwise unexplainable common set of behaviors. Nothing more. And what a diagnosis in the psychiatric world does is govern and direct the medication prescriptions. So never forget that behind every diagnosis is a consortium of occupations who, less than ideally, depend on such diagnoses for their existence. I’m not crying out “conspiracy!” here, I’m just putting forth my strong skepticism about the exactness of any diagnosis. You can see what else I’ve written about this topic here.

But about RAD in particular, I do not have a lot of professional experience. Like I mentioned above, it is usually discussed about children who were either abandoned or shuffled between foster homes a great deal during their first three years. Thus it has a lot to do with a child’s earliest “attachment” to caregivers and parental figures. When this process is interrupted, and then left unaddressed, then the child can begin to exhibit the behaviors described above.

I highlighted the “left unaddressed” part because that is the only part parents of RAD kids, or any kids, can play. I find discussions about attachment disorders very aggravating because they usually center on what the child didn’t get. The scientific community is usually focused on causes. But parents need solutions. And focusing on what an adopted child, for instance, didn’t get does not necessarily help the parent going forward. If anything, it can lead to another kind of reactive attachment disorder—the one we see in parents.

Here’s how it works: A couple decides to adopt a child from a foreign country, knowing that the child may have had a very rough early childhood by the time they receive her. So they read tons of literature about the need to re-attach to the child because it is likely that the child suffers from RAD. After receiving the child, therefore, the parents are hypervigilant in searching for any attachment concerns. I always find this process fascinating because hypervigilance is one of the hallmark behavioral symptoms of RAD!

So then the parents work very, very hard at making a strong attachment to this child that supposedly cannot make attachments. And, of course, their reactive efforts fail. I would argue that these hypervigilant efforts actually help create the very type of distancing behavior in the child they’re afraid of.

That’s the inevitable failure of focusing on the child and not the parent. That’s where I believe ScreamFree Parenting can be of tremendous help.

Steve, I’m guessing you’ve got a child with either the likelihood or the definite tendency to exhibit RAD behaviors. And you’re not asking how it developed, or what you should look for. You’re wanting solutions. You want to find something that “works.”

My question is always this: What is your definition of success? If your child has been diagnosed with RAD, then “success” can easily become defined by the RAD—the child begins to connect more with you, offer more eye contact, rage less, hide less, and reach out more. The problem with defining success that way is that your efforts to create such responses will only backfire. We tell these kids they cannot attach and then work our butts off trying to make them attach!

I would hope you would be open to a different definition of success. One that is governed by a question that won’t lead to backfire. What kind of parent do you want to be to this struggling child? It would seem that the absolute last thing a parent of a Reactive Attachment Disorder child would want to be is “reactive.” No matter what.

Your number one job as a parent is not to fix your child. Read that again. It works without fail—our efforts to fix our children will only create the results we fear the most.

What your child needs the most is what you need the most—calm leadership that can steer the whole family, including yourself, through the tough challenges ahead. That means that parents who take care of themselves first and foremost, exhibiting the kind of self-restraint, self-discipline, and emotional maturity they want to see from their kids. Even when the “unattached” kids don’t seem to notice, agree, or care.

What does this look like? Simple principles: take care of yourself, set very clear guidelines about household responsibilities, create activities involving the whole family as well as individual relationships, let natural consequences do the screaming (and teaching), set schedules that are firm but flexible.

Interestingly enough, a book I found on RAD seems to agree. In her recommended book, When Love Is Not Enough: A Guide to Parenting Children with RAD, Nancy Thomas states that “normal parenting” doesn’t work with these kids. She states that instead, parents of children “with” RAD should follow some other principles, such as:

1. Take Care of Yourself First

2. Establish Respect

4. Teach Self-Control

7. Expect Restitution for Damages

Take care,

Hal