Reactive Attachment Disorder: A Reflection

 *Helpful Links at Bottom*

Dan Heymann of Bright Blue created the music to  "Weeping" after the Apartheid regime drafted him into service. He later added lyrics which echoed his thoughts on the  State of Emergency announced by the South African white regime. Josh Groben helps further the recent awakening of people who realize the horrors of unjust and oppressive forces of the past, present, and possible future through his revival of the song "Weeping," bringing the issues to life for all who hear the song's powerful lyrics.

You may be wondering how I plan to relate this to the topic at hand, which is something called Reactive Attachment Disorder (RAD). You'll see the reason behind this as I thread the lyrics through this article.

The staff at Mayo Clinic describes RAD as "...a rare but serious condition in which infants and young children don't establish  healthy bonds with parents or caregivers." This disorder most often occurs in children who have experienced trauma through the death of a loved one, neglect, abuse, multiple home placements, and other situations that prevent the child from forming a long-term bond with a safe, loving adult or become part of a situation that breaks such a bond. The child comes to believe they must fend for themselves emotionally and physically or attach inappropriately to strangers. They may exhibit behaviors such as stealing, pointless lying, poor life choices, hoarding, sexual promiscuity, self-abuse, abusing others, and a host of other undesirable behaviors.

My two stepchildren once lived with their biological mother and father. Their mother developed breast cancer when they were toddlers. This meant both children went through a host of caregivers while their father worked to support the family and help their mother fight the breast cancer monster. As the fight neared its close and their mother's health took a sudden downward spiral, the children were sent out of state to a relative's home while their parents got things in order before moving to the same area of the state so their mother could spend her last days with them. 

These kids learned early on that life is  painful and  unstable. They seemed to take solace in toys, food, and power. The death of their mother only exacerbated these issues. They already knew that their demands would be met by well-meaning people who felt sorry for their loss and felt bad saying no to a single whim or demand.

When I married their father, I quickly realized the problems these children suffer from go deeper than kids who needed a stable environment and some extra love. They quickly taught me about themselves through behaviors such as theft, lying, manipulation, inappropriate acts, and destroying items around the house. One of the first things they did was set their clocks nightly for midnight or 2 am, at which time they would go to the kitchen and eat handfuls of sugar or whatever they could get their hands on, pour dish-soap in the dish-washing machine, and clog the toilets. All actions were vehemently denied and there seemed to be no signs of a conscience with either of them. I'll spare details on other behavior for the sake of propriety.

This went far beyond  behaviors expected in a child who suffered loss. We took them to a therapist expecting to find help, but the therapist seemed to believe that the problem was our parenting. She also believed every lie she was told by the children, despite being told that they would lie and say the sky was purple and to always confirm answers with us. Since I managed to raise three other children and spend a good amount of time working with children and adults with mental disorders, her answers struck me as those of someone without much experience. At one point I had to control a rising giggle at the therapist's utter shock when my stepdaughter defied the therapist's request to stop playing with the items on her shelf. She had asked the child to stop, explained calmly how it made her feel to have someone else playing with her personal items without permission asked my stepdaughter if she understood. My stepdaughter said yes, and the therapist gave us a look as if to see "See how easy this is?" Ten seconds later, the child was at it again and the therapist looked very upset and confused." As tempting as it was to say "See what we meant when we said normal logic doesn't work with her?" I didn't say so, but we did started the search for a therapist with a clue.

I hit the books and the internet and finally came across the term "Reactive Attachment Disorder." We went through a few more therapists and the children chewed them up and spit them out. Finally we ran into one familiar with RAD and the children finally had a diagnosis. RAD along with OCD tendencies. Both exhibit some very different symptoms and some identical ones, yet they both fit the diagnosis perfectly.For example, the OCD tendencies manifest themselves in my stepson through counting dishes, hyper-organization of toys and obsessing over an upcoming event or flier for a program he will be attending. With my stepdaughter, the OCD tendencies show themselves through obsessive skin-picking when stressed and hoarding what other people would toss in the garbage, such as massive amounts of ripped paper and tags from clothing.

What does this diagnosis mean for them and us?

Nothing. We simply have a name for something we already figured out for ouselves and for behaviors we were using suggested RAD coping methods to treat. When our youngest child, a girl, seemed to be the most physically aggressive and acted out most, we made the mistake of assuming the squeaky wheel needed the most grease. It turned out we were wrong. While we diverted much of our attention to helping her, it turned out that her acting out was actually a good sign since it showed us she wasn't internalizing her emotions as much. We continue to see her grow, heal and show more signs of emerging from the cocoon she wrapped herself in for protection. While the road ahead still looms for miles and RAD is often a life-long fight, we now have high hopes that she will fully emerge from her cocoon strong, beautiful, and with wings that will take her straight down the path of freedom that leads to becoming the wonderful young lady she was born to become.

My stepson is a couple years older and more set in his ways. His quietness doesn't coincide with his inner storm.

"I knew a man who lived in fear
It was huge, it was angry, it was drawing near
Behind his house, a secret place
Was the shadow of the demon he could never face
He built a wall of steel and flame
And men with guns, to keep it tame
Then standing back, he made it plain
That the nightmare would never ever rise again
But the fear and the fire and the guns remain"

This RAD child appears to be very hostile inside. His publicly calm demeanor and superficial charm are attractive to others, who don't realize he's simply assessing them and figuring out how they may be manipulated at a later date. The violent tendencies at home, destruction of property, and outrageous behaviors gave us cause to install a security camera, alarm all windows, keep our doors locked at night, alarm his bedroom door at night, and provide 24 hour supervision for the safety of others.

People might wonder why a child with reactive disorder would do such a thing when they have love, attention, and a decent home. Well, he's making sure he's in control. He had no control when he was being moved from caregiver to caregiver. He had no control over whether his mother lived or died, and that meant that she died. That is a scary thing for a child to go through. That was his nightmare, and he's making sure that it doesn't happen again. He protects himself with a lack of empathy for others and a wall around himself. Anger protects people from pain. Most humans can understand that to a degree. Nobody wants to feel pain.  It hurts. However, children with RAD take that concept to ridiculously high levels, often without realizing what they are doing or that it is detrimental to their own well-being. If a child with RAD is in control, he only feels the emotions he wants to feel. Typically, that means refusing to express any emotion towards others except anger,  so he desperately clings to any tiny bit of control he manages to grasp. Children with RAD frequently use false charm to imitate love, but the adults in their lives quickly learn it is a ploy to obtain something the child wants or to cover for a wrong. He is coping with life by doing what he believes is keeping him safe and keeping the nightmare from rising again.

Inexperience with RAD leads to false hopes. With the help of studying, weekly therapy sessions, and interaction online with other parents of RAD children, we learned how to regain quite a bit more control with my stepson. His behavior improved with our constant vigilance and frequent discussions. We mistakenly interpreted it as progress. He picked up quite a lot of psychological terminology from his multiple visits to therapists and learned to use them appropriately, convincing us that he was truly becoming an attached child who wanted nothing more than to be a typical kid and have good times with his family. 

"It doesn't matter now it's over anyhow
He tells the world that it's sleeping"

We sure wanted to believe him. No parent wants to feel like a failure, but almost every adult caring for a child with RAD begins to doubt him/her self at some point in time. I soon came to believe the RAD demon still roared inside him, cloaked in a mask of invisibility and only coming out when we were at our most vulnerable. For parents of kids with RAD, our most vulnerable time is when we let our guard down and allow ourselves to believe that all is well. As parents, we want our children to be happy and healthy. We buy them gifts, provide for their needs, and try to take them out when we can for fun activities. So often this backfires. A child with RAD may enjoy the attention and the outings, but we soon learned that anything good we do for our RADical children results in an explosion of bad behavior.

This goes against typical parenting. To help our children heal, we often must deny them the typical things of childhood until they can handle those things appropriately, then we introduce them into their lives at a slow pace. To an outsider, the family with a RAD child appears to be dysfunctional. I've yet to meet a family who didn't eventually become the target of an investigation by the Children's Services. When I first learned of this I wasn't sure what to think. Surely it would never happen to us! We do all we can for these children. When we first realized they had Reactive Attachment Disorder, we basically started them back from infancy, teaching them from the ground up. They learned the basics of life such as proper toileting habits, how to dress, matters of hygiene, the correct way to ask for and thank a person for an item, and how to discern between right and wrong. We work on teaching them how a healthy person responds to different situations.

My stepson learned the routines and how to appear to be responding appropriately, but we recently realized that none of it comes from his heart. I was so angry and frustrated at the wasted years and exhaustion we went through trying to reach him that I couldn't help but wonder if the child was simply a spoiled little brat with anger issues that might get resolved one day by a school-ground bully. Since he is small for his age and bullies others, there is no doubt in my mind that one day he will pick on someone who will not stand for it. I spent the next 1 1/2 weeks stomping about with my own anger issues, ready to give him up to someone who might be able to make a difference. We called numerous agencies and found that while all agree he needs in-patient care, none were willing to accept him and those that did refuse to take the insurance the military gives us. With costs nearing $1,000 per day of treatment, placing him in care became a non-option.

We couldn't think of what to do. We didn't want to continue living this way. I was too angry to be useful and simply avoided dealing with him. Then one day I sat down and tried to think it out. Why would he behave so poorly when he knew the consequences would not benefit him? The thought grew in my mind. As I worked to process that thought, we received another nasty surprise. My stepson told people we weren't feeding him. We quickly became initiated into the club of RAD induced investigations by Children's Services. Any concerns were quickly eliminated and the case was shut immediately.

Our stepson admitted he lied to about not being fed because "I felt like causing some trouble for you guys. I thought she [the social worker] would feel sorry for me."

Again, no conscience. He felt that causing others problems would be worth whatever hassle it may have caused him. He admitted he didn't think about what would happen apart from people feeling sorry for him, an emotion he loves to elicit from others. In fact, he pulled a similar stunt during Christmas. We took him to see Santa Clause and the child sat on his lap, put on a pitiful face, and told Santa "All I want for Christmas is a pair of jeans because these holey ones I'm wearing are my warmest ones and I'm cold." Talk about dirty Santa looks! We took the child home, threw away the jeans with holes, and he no longer could complain. He had three brand new pairs tucked away and never worn, because he wanted to convince people to feel sorry for him because "I like brand-name clothes." With him, nothing is enough. If he has three new pairs of jeans, he feels he deserved five. If he has five, he feels he deserves ten. Good grief, the child even decided he deserved a big house and we were being unfair by not owning a large house for him.

Lying. Destroying stuff. Hurting people and things. Writing hate letters and making up games with "I hate my stepmom" themes. Obsessed with the idea of weapons.

It SOUNDS like anger, doesn't it? It sounds like he's possessed by a huge, angry RAD demon.

"But as the night came round
I heard its lonely sound
It wasn't roaring, it was weeping
It wasn't roaring, it was weeping."

Is what he is experiencing true anger? I'm no longer convinced that this is anger. I'm convinced he feels anger and expresses what he feels as anger because it's easy and makes him feel as if he's in control when he is being cruel and angry, but the root of that anger is fear that took root in sorrow. This is his way of weeping, how he copes with sorrow born of fear.

That seed of fear became planted when his birth mother's cancer diagnosis took place. The multiple caregivers and lessening ability of his mother to care for him watered that seed and it blossomed.

Then she died and that fear became fertilized, branching out to become so overwhelming that to avoid being overcome by it, he put up his walls. He decided to do what it took to be in control of his pain...by any means necessary.

It's not working out too well for him.

We've learned to stand back. This is his own demon. All we can do as his parents is teach him he has the tools to fight this and then pray he chooses to engage those tools. We've had people tell us that we can "love this away." You cannot love RAD away. In fact, overwhelming a RAD diagnosed child with love may very well drive them to simply build higher walls to avoid having to deal with the emotions love brings. It goes against the natural feelings of foster parents, adoptive parents, stepparents and other caregivers who dedicate their lives to raising children with RAD to become independent adults with the ability to love others, themselves and survive in the world on their own and hopefully become assets to their future communities. Love must be demonstrated in small amounts and controlled environments in order for the child to feel safe accepting it. It may take weeks. It may take months. It may take years. It may never take at all.

Love also may mean needing to let go and allow that child to live in a home that is more suitable to their individual needs. Sometimes a child with RAD needs to be part of a home where they are the only child for their own safety and the safety of others they may lash out towards. Sometimes they will need to be in a group setting rather than a private home. This should not be viewed as a reflection on the family that placed them, but rather as an act of love. The rigorous attention and high level of need required for a child with RAD should be acknowledged, appreciaed, and supported.

Unfortunately, those on the outside without experience with Reactive Attachment Disorder have a tendency to become judgmental and suspicious when they see a child being raised in what appears to be a style different from the norm.

"And then one day the neighbors came
They were curious to know about the smoke and flame
They stood around outside the wall
But of course there was nothing to be heard at all"

The judgmental attitude and concern is understandable to a point, as many children with RAD appear well-adjusted and may often behave like angels in public settings such as church, parks and around acquaintances. Families like ours desperately need the support and understanding of others as often we are exhausted physically, emotionally and mentally by the intensive needs we must meet on a daily basis to provide balance and a semblance of normalcy into our home lives.

That is RAD. It is an unfair battle thrust on our children and thus upon us. Those on the outside peek in our windows and wonder who messed up. Our kids are in a moment-to-moment fight for emotional survival. The caregiveers are in a constant fight to not only help their children and families, but to defend themselves against outside forces that fail to take the time to understand the monster we're battling and wonder why these children aren't healing if they're honestly being provided with love and care. The answer is this: it's their choice to heal, not ours. It can be helped along, but never forced. When judgmental people choose to ask me why my stepson isn't healing, this part of "Weeping" comes to mind:

"I’ll be d*mned if I can see a reason to explain
Why the fear and the fire and the guns remain"

Nobody questions when a child with RAD heals, but some do demand explanations for those that don't. Since we have one healing and one not healing, the questions continue. Unless one is familiar with RAD, such questions are inappropriate when coupled with judgment. Nobody would dream of asking the parent of a child with a gaping wound from a car accident why they didn't manage to heal the wound and get rid of the scar as soon as it came about. Just as a physical wound takes time to heal, so do mental ones. Unfortunately, the mental wounds usually took years to build up, so it may very well be a lifetime before full healing takes place.

The Bible tells us in 1 John 4:18 (Darby Version) There is no fear in love, but perfect love casts out fear; for fear has torment, and he that fears has not been made perfect in love.

No human loves perfectly. I am convinced that the only way for this child to become "perfect in love" and have his fears cast away will be through God, and that may not even happen in this lifetime. The physical changes brought to the brain by mental disorders is real and there is no promise of physical healing in this lifetime, not by doctors, not by parents, not even by God himself. There is solace in knowing that our time on this earth is brief in comparison to eternity, so even if our children of RAD do not heal in this lifetime, one day God's perfect love will cast out that fear and our eternal Father's hand will wipe away their tears. As much as we may wish we had that power, we can only go so far. The rest is between the person suffering from RAD and God. 

For those of you dealing with Reactive Attachment disorder in your family or who simply wish to learn more, here are some resources that may help you in that quest.

Mayo Clinic: Reactive Attachment Disorder Information
http://www.mayoclinic.com/health/reactive-attachment-disorder/DS00988

Support forum for RAD Caregivers: This forum is mainly dedicated to parents sharing information, venting and helping each other learn how to deal with the issues RAD brings into our lives:
http://www.adsg.org/forum/index.php

*HIGHLY RECOMMENDED*  FFCMH: Scroll down a bit and look on the right to enter your state to find the nearest place to contact. This organization will help you advocate for your child, help you find resources, and help you build a strong support system:
http://www.ffcmh.org/

Recommended Reading: Parenting with Love and Logic. I found this book helpful for dealing with all of my children, whether RAD, regular, or in the classroom.
http://www.loveandlogic.com/ecom/c-79-featured-selections.aspx


Weeping: The Story Behind the Song http://www.weeping.info/index.html
Weeping: Josh Groban with Vusi Mahlasela
http://www.youtube.com/watch?v=4LnB2fZkLAI

I will be ordering the following book. If anyone else read it or does read it, feel free to share your thoughts on it:
http://www.amazon.com/dp/0970352522?tag=kasoftsoftware0c&camp=14573&creative=327641&linkCode=as1&creativeASIN=0970352522&adid=1VG4H6X1TG04HWFB3W6V&

©2011 Gina Locke