Reactive Attachment Disorder
by Sharon Cipriano-Galbreath, MA, LLP
Today, mental health professionals see more and more children with behavior traits characteristic of Reactive Attachment Disorder. These traits include:
- Unmanageable anger
- An inability to soothe themselves
- An inability to wait their turn
- A need to control people as well as their environment
- An inability to accept direction, including caring protection from authority figures
These traits frequently become more intense as the child grows. Intervention and treatment are possible. Treatment with both the mother and the child, and many times the family unit, is recommended. Children from toddlerhood to eight years of age have the highest potential for benefiting from intervention that incorporates specific work with the primary caregiver, usually the mother, and the child. All youngsters have the potential for some improvement with treatment if consistent parental boundaries and firm family structure are present.
In Reactive Attachment Disorder, which is diagnosed in early childhood, the child fails to attach to the primary care provider. Parents bond to their children while children attach to their parents. The difference is more than conceptual. In parental bonding, the parent experiences tender, warm and protective feelings for the unborn infant, or in cases of adoption, for the unknown child coming in the future. For children in general, and for infants in particular, the process of attachment is dependent upon the loving response of the care provider and the trust that naturally follows from being responded to adequately.
The infant makes a demand, and depending upon the response received from those in his or her environment, begins to assess what the outer world is like. When the responses are loving, or at the least adequate, the infant/child begins to trust that his or her needs will be met, forming an attachment with the primary caregiver. When the infant or child experiences the world as cold or uncaring, it is believed by experts that the child fears for his or her life, or in other words, experiences abandonment, and the child is unable to attach to the primary caregiver. Abandonment is like a fear of death for infants, and they feel lost and cannot count on the caregiver or the outside world. This produces great inner rage; therefore, trust is not formed, resulting in inadequate attachment. A child who is unable to trust believes that he or she must care for himself or herself. The child does not accept, even conditionally, the loving authority of caregivers, teachers, friends or peers.
Inadequate attachment may result from:
- Maternal depression or death in the family in the first year of life
- Smoking, drug or alcohol abuse during pregnancy
- Separation from the primary care giver for more than 24 hours in infancy or more than three days in toddlerhood.
- Untreated illnesses such as earaches, colitis or Attention Deficit Hyperactivity Disorder
While many such occurrences are a part of everyday life for children and their families, the children involved who are not adequately reattached to the mother or the caregiver after the occurrence are at high risk for developing Reactive Attachment Disorder. Other examples of children at high risk for this disorder are:
- Children separated from loved ones due to war or natural disaster
- Children sexually or physically abused
- Children moved from caregiver to caregiver
- Children with extremely permissive caregivers who therefore experience no boundaries
- Children with a passive parent and an explosive parent who therefore cannot count on how their requests for help will be responded to
- Children with physical or mental health issues that make adequate caregiving or pain resolution difficult
For further information regarding Reactive Attachment Disorder, please contact Sharon Cipriano-Galbreath, MA, LLP.
Articles by Sharon Cipriano-Galbreath, MA, LLP