Reactive Attachment Disorder:

[MHz]

A Disorder of Attachment or of Temperament?

Reactive Attachment Disorder
(in part)

Reactive attachment disorder (RAD) is one of the few disorders listed in the DSM-IV that can be applied to infants. It is a disorder caused by a lack of attachment to any specific caregiver at an early age, and results in an inability for the child to form normal, loving relationships with others. This paper gives a review of the disorder as it is currently understood, including explanation of attachment theory, groups commonly affected by the disorder, and symptoms characterizing RAD. Finally, a critique of the current stance on the conceptualization of RAD is given, with some exploration into whether this disorder is really the result of disturbance in attachment or due to responses and reactions both on the part of the caregiver and the child due to temperament.
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Reactive attachment disorder (RAD) is one of the few disorders listed in the DSM-IV that can be applied to infants. It is a disorder caused by a lack of attachment to any specific caregiver at an early age, and it results in an inability for the child to form normal, loving relationships with others. In order to understand RAD as it is viewed currently, it is necessary to briefly explain attachment theory and describe groups commonly affected by RAD and the symptoms characterizing RAD. Due to the relative newness of reactive attachment disorder as an accepted clinical diagnosis, there are a variety of criticisms of the current conceptualization of RAD. These criticisms are given, with some exploration into whether this disorder is really the result of disturbance in attachment or due to responses and reactions both on the part of the caregiver and the child due to temperament. Stafford, Zeanah, and Scheeringa (2003) point out that the DSM-IV focuses more on a child's aberrant social behavior rather than on a child's disturbed attachment behavior, deemphasizing the significance of attachment in RAD. Also, pathogenic care is described as the etiology for RAD, with little attention given to a biological predisposition to developing the disorder. Although no research has been conducted on the influence of temperament on the development of RAD, current knowledge suggests that temperament may play an important role in the etiology of RAD, and its impact should be investigated further (Zeanah & Fox, 2004).


Reactive attachment disorder - Mayo Clinic


Definition

By Mayo Clinic Staff

Reactive attachment disorder is a rare but serious condition in which an infant or young child doesn't establish healthy attachments with parents or caregivers. Reactive attachment disorder may develop if the child's basic needs for comfort, affection and nurturing aren't met and loving, caring, stable attachments with others are not established.
With treatment, children with reactive attachment disorder may develop more stable and healthy relationships with caregivers and others. Treatments for reactive attachment disorder include positive child and caregiver interactions, a stable, nurturing environment, psychological counseling, and parent or caregiver education.


Symptoms

By Mayo Clinic Staff

Reactive attachment disorder can start in infancy. There's little research on signs and symptoms of reactive attachment disorder beyond early childhood, and it remains uncertain whether it occurs in children older than 5 years.
Signs and symptoms may include:

• Withdrawal, fear, sadness or irritability that is not readily explained
• Sad and listless appearance
• Not seeking comfort or showing no response when comfort is given
• Failure to smile
• Watching others closely but not engaging in social interaction
• Failing to ask for support or assistance
• Failure to reach out when picked up
• No interest in playing peekaboo or other interactive games

Reactive attachment disorder is rare. Signs and symptoms can occur in children who don't have reactive attachment disorder or who have another disorder such as autism spectrum disorder. It's important to have your child evaluated by a psychiatrist who can tell whether such behaviors indicate a more serious problem.


Causes

Risk factors

The risk of developing reactive attachment disorder from serious social and emotional neglect or the lack of opportunity to develop stable attachments may increase in children who:

• Live in a children's home or other institution
• Frequently change foster homes or caregivers
• Have inexperienced parents
• Have prolonged separation from parents or other caregivers due to hospitalization
• Have a mother with postpartum depression
• Are part of an unusually large family, such that parental time is scarce or available unequally or rarely

However, most children who are severely neglected don't develop reactive attachment disorder.


Complications



Treatments and drugs

Children with reactive attachment disorder are believed to have the capacity to form attachments, but this ability has been compromised by their experiences. The best treatment for a child with reactive detachment disorder is a positive, loving, stable, caring environment and caregiver.
There's no standard treatment for reactive attachment disorder, but it should involve both the child and parents or primary caregivers. Early intervention appears to improve outcomes. Goals of treatment are to help ensure that the child:


As usual their solutions tend to be a patch instead of a fix. The last bit above should include the child who is now an adult. The solution is the same across the board and each individual has a unique delay factor that needs to be found before getting past the effect is as far as initial reaction to a new idea by somebody who is in the wrong with the patient. Bad parenting by decision or by accident end up with the same results, distrust in a relationship that is a trusting one based on the two people involved.
That also means the child that didn't get treated can be reached in adulthood by people who know how to manipulate the issues in a positive way that lessens the incidents of 'needless tension'.


For myself when I am asked to do something for somebody I like the condition doesn't allow me to react properly in real time. It takes me 1/2 hour to go from a flat, 'No.' with no 'reasonable' explanation to the 'Yes.' that should have been available in real time if I did not still suffer from reactions I developed when I was an infant. If the incident can't be remembered then it is classified as 'gut instinct' but with results that are not close to being the correct choice most of the time. If the subject is left alone I can filter all the stuff I need to reply with a reasonable answer that does have a rational explanation. With a loved one the reply is often a change from no to yes, with strangers the change might be fewer times due to the problem when dealing with strangers is that I might answer, 'Yes.' automatically and 30 minutes later start to regret that commitment as strangers should get a, 'No.' reply more often than they get a 'Yes.' reply, the exact opposite of what is done with requests from 'trustworthy friends' who will f*ck up every now and then. The difference is a friend will make sure it isn't repeated, if a stranger isn't pushed away that is the beginning of an advantage for him in a relationship that calls for them to have very little influence over you decision making process.


My T-shirt would be. 'How am I feeling? Ask me again in 30 minutes, until then, kindly f*ck off.'

 

[Twila]

I knew a single dad who's youngest daughter was diagnosed with this. She was a difficult teenager, to say the least.

 

[MHz]

I'm promoting that everybody suffers from it to one degree or another. You get it during your infant years but it stays with you your whole life. Currently there is no cure and I say that is crap. The only thing needed is to let the person have some quiet time between being given a question and when they want to answer the same question.

Based on the 'you can lead a horse to water but you can't make him drink' has time injected that starts when you first get to the well and when the horse finally takes a drink. That amount of time is for that horse alone, any other horse will have a different time but all that are brought there eventually take a drink using their own free will that tells them when the right time is.

In childhood and after 6 it can start to be that friends are trusted more than parents or brothers or sisters. High School would be the time the 'rebel child' appears and sometimes the good advise that does come from reasonable parents or friends is rejected for all the wrong reasons.

In marriage it would be when one partner starts taking advice from a 'new friend' rather than a husband who is right rather than wrong in a certain situation. The solution used on couples is the same one that should be applied to infants experiencing the same symptoms. That being said not all relationships are going to end up being healthy ones so they have to be left behind and hopefully the next ones will be healthier ones.

One of the reasons that teens can't be helped is because the parents are in denial that they could be the root cause of the problem. Single parents pretty much says something went wrong in the child's past already. Adults are the ones with skeletons in their closets rather than the kids coming with a full closet at birth. They pass that onto their kids rather than the child being born a problem child.

 

[Twila]

I agree with you there MHz.

I've always found it weird that parents forget what it was like to be a child. They rarely take into account the things they disliked about how their parents parented.

I've heard some of the most ridiculous things come from parents mouths.

"grow up" - which is exactly what the child is doing. why hurry it?

asking a child to do something when the parent has no intention of allowing the child the right to decide.

Putting food on a childs plate and expecting them to eat it all

Demanding to know what a child/teen is thinking and then expecting that child/teen to feel comfortable telling the truth.

so many more. These are just the ones that come to mind first.

 

[MHz]

When the abused or neglected become parents how can there be any other outcome. If there are specific acts that can cause that disorder there should be another action that can break it down. Along with parents who are in denial they are the cause (presently) rather than the solution there is a medical industry that is chomping at the bits for new patients with new illnesses and (unfortunately) the treatments last a lifetime and they are an experiment by themselves in most cases.

In the cases you mentioned and the solution I suggested had been implemented do you think it would have made a difference. Most of the times a reactionary 'no' was not followed by silence and an argument then took over and that killed the mood. I'm quite sure it would have made a difference as I use that on people I know will react in that specific way. Abused people are naturally a bit over possessive and while they do think they qualify for extra help or some freebie that should be denied to abusers. The one person they never see as a possible abuser is their new best friend, one in a long line of self professed people. That is how a wolf in sheep's clothing works and when the scam is over the one that gets the blame is the friend the person became rather than the stranger being accepted too quickly.

The last time I manipulated somebody like that is Chance's mom. She and her friend are in Chance's old room and I gave them my spare computer tower as it will run the TV and their laptop won't. I was going to lend it to the girl downstairs that went into rehap because she missed chance so much. To give her some entertainment when she was alone I was going to hook that up and just run it off my broadband so it didn't add an expense to her limited income.
Rather than take the desktop I suggested I borrow the laptop and then lend it to Sue, problem solved right. Well the argument was on and it went so far she was going to order her own cable and a string of other shit all over that suggestion. Two days later she took it down to Sue herself as a homecoming gift. If it needs something fixed I do that part but that situation would have gotten the same reaction no matter what the request was. The delay Chance's mom should impose herself would be some portion of the two days or perhaps the full time was needed. It worked out the way it should of if normal people had covered the topic the night Sue was to be at home. I'm not sure about Sue but I see no reason not to use the same method as often as I can, Open the subject, refuse to do more than that for a 'few days' (or until she opens the topic) and then it is a rational chat rather than a reactionary fight.

As a side note I appreciate your input and to tell you the truth the condition does exist but dies the solution seem too easy? Where is LudLowLife we should try this new pill out on him.
.

 

[Curious Cdn]

I agree with you there MHz.

I've always found it weird that parents forget what it was like to be a child. They rarely take into account the things they disliked about how their parents parented.

I've heard some of the most ridiculous things come from parents mouths.

"grow up" - which is exactly what the child is doing. why hurry it?

asking a child to do something when the parent has no intention of allowing the child the right to decide.

Putting food on a childs plate and expecting them to eat it all

Demanding to know what a child/teen is thinking and then expecting that child/teen to feel comfortable telling the truth.

so many more. These are just the ones that come to mind first.

Imagine when generations of British Imperialists were raised by their aunties because the parents were off in injah and wanted nothing to do with children, anyway.

That would explain their generally sunny dispositions in that culture.

 

[MHz]

Reactions can be broken down into a series on interacting elements that have one thing in common. Real events the witness has experienced in the past and full control belonged with the other person and those moments were never resolved so they are reacted to when anybody else repeats something that happened the first time long ago.

The disorder is in place before childhood is over and in all likely-hood it is there by the time an infant becomes a child. Trauma and that is emotional trauma so physical abuse is not mandatory but it is there more often than not. If it was severe enough somebody would have (hopefully) intervened. Since the 'disorder' is just being mentioned it is a show-in that no treatments have been developed, let alone effective ones.

In this lab everybody from the age of 3 and older has the disorder to one degree or another. Chance and I both had it and I am a witness to how it evolved and how he even recognized it at a much, much earlier age than I did in myself (35-40) It showed in our single parent relationship by him approaching me with a new idea that probably involved spending more than his allowance would cover. When you take my reaction and examine it it some things were part of the equation. Recognition of the person and with Chance that would always have been a 'positive' factor. The denial for the request was automatic, it did not take one word of his request into consideration and the rest of the interaction was based (by both of us) that I had filtered it out logically (like in the past) and this was the final answer. Since our relationship lasted all the way to the end we eventually found out that it took me 30 minutes to evaluate the request and reply with what an reasonable parent would. (okay but the extra comes off your next 3 allowances)
He didn't have that same condition until well into our stay in a toxic environment, that manifested itself in my initial request being denied and then a short argument and that was followed by an apology at about the 30 minute mark after the argument ended. We didn't get that solved until about the last year he was alive and our conditions might have improved slightly but even at that level we solved the bickering that should not have been part of out interaction. I'm going to stress that Chance and I were very close and anybody else would have been tossed to the curb long ago.
He often said I taught him that and back thenI didn't have an arguments as why it didn't happen that way as that is just what I used to do. No, argue for a varied amount of time, 30 minutes alone to think, apologize for the argument, take steps to begin request's eventual completion.

That being said Chance also suffered some events in the past that put him into my custody in the first place. That would make me the 'parent/loved one' who is no longer trusted 100% and that would be justified rather than imaginary.

Next is how he greeted strangers, . . . .

 

[Twila]

Imagine when generations of British Imperialists were raised by their aunties because the parents were off in injah and wanted nothing to do with children, anyway.

That would explain their generally sunny dispositions in that culture.

wouldn't it just?

what we do to our kids...

I remember being berated by my parents for not talking to them about stuff. I remember being very well aware that if I did try and talk about stuff I'd be getting lectured in no time flat, so why would I talk to them about stuff?

It's too bad parents forget what it's like to be a child. They don't forget they're childhood just what it's like to be a child.

 

[MHz]

What parent doesn't think they have overcome the past and they are the best parent on the block? Too bad about that awful kid they have eh??

If you knew you parents had a reaction problem to said topics and by utilizing the delay factor you could have brought up the subjects and got a reasonable reply would you have?? I think the last time I asked my parents for anything and got the standard 'no' was 'Why in the hell did you even have kids for?' By the time I was 20 I was sure I wasn't going to have kids just because I saw my own childhood as not being all that much fun really. I wasn't sad and there were lots of single people around to take up the slack.
Basically party your face off and then die. Something obviously went wrong and that is a good thing because Chance and I had a great deal of fun in the time he was here. . . . not so much since he left.

 

[MHz]

I'm going to label that a good relationship just because we found a short delay was very helpful in long term but the period to when that process began didn't start until the chatting stopped. At the worst there was just the argument and the hour that was needed was most likely not acted on at all let alone as soon as it could have.

Chance's natural family was a fractured one without a doubt and it wasn't unusual for the sisters and mother to ban their children from seeing each other just because they were in another part of a constant fight/argument.Chance was acting as a peacemaker just by ignoring that rule and he went and visited whomever he wanted to whenever he to and that was allowed because inside they knew the 6 year old knew more about relationships than the 'adults' who are perfects examples of untreated people with a RAD condition themselves.
Later another relationship can be looked at as working even better than the one we had as it was in a stage where reactions were spontaneous (like they always are in everybody all the time, good or bad) and there was no negative emotion just by seeing the person unless that is where it was at when they saw each other the last time. That is part of a healthy relationship if there is no filtering done between the two times. In me it would bring out the emotion I was feeling the last time we were together. As I left I would have parked that emotion as the input was no longer in the vicinity. Something else was though and that was a return to something I was doing previously so that emotion is triggered. If I drove to a meeting it would have been an emotional drive for the better or worse and at the meeting that emotion would have been parked and it was un-parked as soon as I saw the vehicle again the emotions I had when I closed the door returns.
That particular time caused me to also laugh out loud and that is more than rare for me because in the meeting I was asked 2x if I ever felt I was being watched and both times drew a blank until I saw my vehicle and then I remembered I had mentioned I hit so many red lights it feels like somebody is watching my particular vehicle and making the light red as the conclusion of the exercise. I made sure I mentioned that as the first topic the next time I saw this 'stranger in my life'. One of the reasons I mentioned it at all is between the two meetings that popped into my thought process a few times and mentioning it ended it and this is the first time I have thought about it. This gives you a bit of an idea of what those pills are doing to my mind. There can't be much left as I have been giving people a piece of it for years.
Because I claim to have a very good memory it may/may not be helpful to know why I don't need to do any lists. Shopping would be the longest one in a month. If I remember something I missed I stop what I'm doing and go and get it'. The bigger the inconvenience the better as that means I am not likely to make the same mistake again. Since the lesson ends up being put into a 'general' directory the lesson can apply to many individual events that a similar in nature. I tend not to lie at all so the speed of my recall is instant for most topics. That being said, I had to look at my address and new phone number for a month or so starting just a few years ago. Sentences get less breaks than they used to so I'm under the impression I am getting better with age at the moment. I'm not expecting balance and hearing to improve but 7tsp of a borax solution 2x a day (1 level tsp in 1 liter of tap water is the solution's strength) x28 days seems to have helped my lower back aches and pains. The strength I used is for a fungus infection of the lungs and sinuses. Chance and I were in the same house with him getting the strongest exposure.In the ICU they found a cyst about a foot long at the top of his back.That would have first appeared after being in the house for a few of the 14 years. In my case what is taken to be a worn out lower back could be a cyst and the solution I was adding to my drinking water reduced the size and that lowered the pressure and that lowered the discomfort I feel while out walking the dog. Walking back from the grocery store with two bags is it if I choose the nearest one so I might try that for another month sometime this year.

Chance was also very honest with everybody and with me it was total until he was over 18 and even then he said it was better he say nothing than lie and I was fine with that as our own relationship was still based on real shit. Most of his relatives have a very poor memory and they are not very honest with me or with anybody and for me that is usually enough to end a friendship but there were Chance's relatives rather than being mine. I call it being between a rock and a hard place to be quite honest. Label my relationship with the stepdaughters as fractured and unresolved to even a small degree.
Zero contact except for Chance's mom and that didn't last very long after Chance died as that was the only thing we had in common. I have a stronger bond with Chance's brother because of the past so a few more relationships even before the ones with strangers becomes the topic. Next post I guess.

 

[Angstrom]

wouldn't it just?

what we do to our kids...

I remember being berated by my parents for not talking to them about stuff. I remember being very well aware that if I did try and talk about stuff I'd be getting lectured in no time flat, so why would I talk to them about stuff?

It's too bad parents forget what it's like to be a child. They don't forget they're childhood just what it's like to be a child.

Like what!? Not having responsibilities?? Not having to worry about anything?

Hunans are only as responsible as they need too.

So let's bubble wrap our kids till they become completely careless

 

[MHz]

The parents are the ones that are the most resistant to change and they are often the ones creating the problems.

There is no other way to carry on with this subject without covering all of it as far as symptoms, solutions. Abuse is not always seen as abuse when it happens but it does make changes harder in adult life and that when fixes would also be harder to apply even if an action can be attributed to be a reaction to a specific event. Now try leaving specific details out and no names.

Bullshit aside, if a disfunction exists in a person today that has the person experience a flashback to another time and place and another person. The first two elements are required in a dynamic relationship as they play together in a way that keeps the level of conversation at it's highest level as that is also helpful in keeping stress at it's lowest levels while traversing a hectic social life or hermit like remoteness. Exploring the incident that is remembered is a skeleton in the closet and that needs to be taken care of as it is a relationship killer via outside influences and relationship can fail for a variety of reasons so any way of reducing 'bad choices' is going to be worth it in the long haul.
Once the distraction is in full view the connection to the present will be pretty clear and the solution will vary with the incident. In the 'I just want to get on with my life' mode or 'I want to stop falling for the same old shit time after time after time' mode then you script up what would be a legal long lasting solution is to practice that version (brainwash yourself) and there goes the ghost so when a similar incident that caused the flashback before now gets the response you programed in and the banter is a lot lighter and emotions roll on as they should. Coming and going but never overstaying their allotted time. Any other sequence seems to almost create more problems than it solves. There is a possible solution that may not be as 'unworkable' as possible for a few specific cases. A hooker who has a detachment disorder will usually be a no kisser as the customer is there for other acts. Without that first step of intimacy the hooker is now doing something that is found to be abusive to her rather than it being a shared pleasurable experience. That plays out when she wants to have a long-term relationship yet the distance created by the lack of intimacy that hooking created is still there without a just cause. If kissing is the first step then it seem somewhat logical that the rehab start there. I doubt there is a program for that so let's play doctor. Must precede anything considered to be a '2nd base' move and have a certain amount of time applied and it may or may not be restricted to the mouth portion of the woman's body (in this case) sometime down the road. Perhaps the guy can lighten the mood by wearing 20 pairs of boxers for obvious reasons as kissing might star with one quick closed mouth peck and then 20 minutes of motionless hugging. I assume cheating or breaking the rules will happen but I'll bet the ones that suffer the most at the first are the ones who don't have to come for a 2nd try.
Incidents involving traumatic events needs to be taken especially seriously as suicide rates claim them in their 20's. One girl I met in group used to have her father force her give blowjobs during mealtime if the desire came up. She was dead within two years.

If solutions to the milder cases exist where can be fixed, rather than patched over, then that knowledge should come up something for the more severe cases. Pedophile comes to mind as being a social disorder that has 'nil' as it's reversal rate.
Low self esteem probably has a 100 possible causes and 1 cure that is effective for all 100 in a lifelong cure. Under the assumption that you cannot unlearn 'things'. What you know is not written in concrete so updates are allowed when they call for it. That is if getting the person well once and for all is the goal. The one closest to them better also be prepared to do even more of the work if they are considered to be the smarter of the two.

If something is fuked at the start it is going to be just as fuked at the end, by design rather than people don't known how to live together in a thriving way that is also quite natural rather than needing a cupboard full of these. Put them in the Rec room where they belong.

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[MHz]

Talk about good timing. A short playlist does a much better job than pages and pages of paper. I would suggest the symptoms come in a range strengths and flavors and the person not affected is rare rather than RAD being very widespread. She does an excellent job of giving a list to choose from.
[youtube]bn6Rwz8SyCI&index=6&list=UU2qHhg4EQV2bDHIWPNKrvHQ[/youtube]