Reactive attachment disorder (RAD) is often a result of an inability to form close attachment bonds with a primary caregiver (often a parent) during childhood. This lack of attachment is often caused by a neglectful or dysfunctional relationship between the infant/child and the parent. The child can often feel abandoned or ignored. Children with RAD are presumed to have grossly disturbed internal working models of relationships that may lead to interpersonal and behavioural difficulties in later life.
As a result of the negative early relationships, Reactive Attachment Disorder always involves issues with social relationships.
The core feature is severely inappropriate social relating by affected children. This can manifest itself in three ways:
- Indiscriminate and excessive attempts to receive comfort and affection from any available adult, even relative strangers (older children and adolescents may also aim attempts at peers). This may often times appear as denial of comfort from anyone as well.
- Extreme reluctance to initiate or accept comfort and affection, even from familiar adults, especially when distressed.
- Actions that otherwise would be classified as Conduct disorder such as abusing animals, harming siblings or other, family, or self harm.
The individual believes that everyone leaves them so they act out. At least this way they feel they can have someone leave on their terms. It would be far worse to be an easy going person and still get rejected. Their thinking: “At least if I am rejected for being bad, there’s a reason.”
These limiting self beliefs can play havoc with relationships. The first attachment relationship is important in paving the way for future relationships. Without forming a bond with a caregiving adult, the person often has great difficulty forming and/or maintaining future social and intimate relationships.
Child learn they can’t count on anybody and learn defense mechanisms (like being badly behaved or unruly) as a way to cope.
This can happen for many reasons:
- A baby cries and no one responds or offers comfort.
- A baby is hungry or wet, and they aren’t attended to for hours.
- No one looks at, talks to, or smiles at the baby, so the baby feels alone.
- A young child gets attention only by acting out or displaying other extreme behaviors.
- A young child or baby is mistreated or abused.
- Sometimes the child’s needs are met and sometimes they aren’t. The child never knows what to expect.
- The infant or young child is hospitalized or separated from their parents.
- A baby or young child is moved from one caregiver to another (the result of adoption, foster care, or the loss of a parent, for example).
- The parent is emotionally unavailable because of depression, illness, or substance abuse.
While according to the American Psychiatric Association’s (2013) Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), reactive attachment disorder must be diagnosed between the developmental ages of nine months and five years, its effects are long-lasting, often extending into adulthood. Reactive attachment disorder in adults can involve significant psychopathology – dysfunction in thoughts, feelings, and behaviors.
Signs and Symptoms of Reactive Attachment Disorder in Adults
Certain behaviors, as well as inner emotional experiences, indicate reactive attachment disorder in adults. These signs and symptoms include:
- Withdrawal from connections
- Inability to develop and maintain significant relationships, romantic or otherwise
- Inability to show affection
- Resistance to giving and receiving love despite craving it
- Control issues
- Anger problems
- Sense of distrust
- Inability to fully grasp emotions
- Feelings of loneliness and emptiness
- Lack of a sense of belonging
Reactive Attachment Disorder can be dealt with through therapy – such as Cognitive Behavioural Therapy. Disorders that begin in childhood often require more intensive therapy but it’s not impossible to improve a person’s interpretation of the world around them.