Reactive Attachment Disorder

When he was hired by the World Health Organization to find out why the children from the orphanages after WWII were out of control, John Bowlby’s research revealed what he termed “affectionless thieves”. He wrote: “ Attachment is defined as the affectional tie between two people. It begins with the bond between the infant and mother. This bond becomes internally representative of how the child will form relationships with the world. “There is an inability to love or feel guilty. There is no conscience. Their inability to enter into any relationship makes treatment or even education impossible.” (Bowlby 1955).” Bowlby later stated “the initial relationship between self and others serves as blueprints for all future relationships.” (Bowlby, 1975)

Reactive Attachment Disorder (RAD) is a complex psychiatric illness that can affect young children. It is characterized by serious problems in emotional attachments to others. RAD usually presents by age 5, but a parent, caregiver or physician may notice that a child has problems with emotional attachment by their first birthday. Symptoms of RAD include:

• detached and unresponsive behavior
• difficulty being comforted
• preoccupied and/or defiant behavior
• disinhibition or inappropriate familiarity or closeness with strangers.

“Attachment Disorder is defined as the condition in which individuals have difficulty forming lasting relationships. They often show nearly a complete lack of ability to be genuinely affectionate with others. They typically fail to develop a conscience and do not learn to trust. They do not allow people to be in control of them due to this trust issue. This damage is done by being abused or physically or emotionally separated from one primary caregiver during the first 3 years of life. If a child is not attached – does not form a loving bond with the mother – he does not develop an attachment to the rest of mankind. The unattached child literally does not have a stake in humanity” (Magid & McKelvey 1988).

“Some infamous people with Attachment Disorder that did not get help in time:  Saddam Hussein, Edgar Allen Poe, Jeffrey Dahmer, and Ted Bundy. One famous person with Attachment Disorder who did get help in time (in 1887!) and became one of the greatest humanitarians the US has ever produced is Helen Keller.” (Ken Magid 1990)

• Superficially engaging & charming
• Lack of eye contact on parents’ terms
• Indiscriminately affectionate with strangers
• Not affectionate on parents’ terms (not ‘cuddly’)
• Destructive to self, others and material things (‘accident prone’)
• Cruelty to animals
• Lying about the obvious (‘crazy’ lying)
• Stealing
• No impulse controls (frequently acts hyperactive)
• Learning Lags
• Lack of cause-and-effect thinking
• Lack of conscience
• Abnormal eating patterns
• Poor peer relationships
• Preoccupation with fire
• Preoccupation with blood & gore
• Persistent nonsense questions & chatter
• Inappropriately demanding & clingy
• Abnormal speech patterns
• Triangulation of adults
• False allegations of abuse
• Presumptive entitlement issues
• Parents appear hostile and angry

Any of the following conditions occurring to a child during the first 36 months of life puts them at risk:

• Unwanted pregnancy
• Pre-birth exposure to trauma, drugs or alcohol
• Abuse (physical, emotional, sexual)
• Neglect (not answering the baby’s cries for help)
• Separation from primary caregiver (i.e. illness or death of mother, or severe illness or hospitalization of the baby, or adoption)
• On-going pain such as colic, hernia or many ear infections
• Changing day cares or using providers who don’t do bonding
• Moms with chronic depression
• Several moves or placements (foster care, failed adoptions)
• Caring for baby on a timed schedule or other self-centered parenting