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Adoption and Reactive Attachment Disorder in the Teen Years
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The Adoptive Family and Reactive Attachment DisorderWhen parents welcome a child into the family, it is often accompanied by feelings of elation, pride, and overwhelming joy. There have been months of planning and preparing for the arrival of this little one, and there is great elation when he or she makes a grand entrance into the world. However, for some adoptive parents, those joyous feelings can be overshadowed when their child fails to make a strong attachment to them and struggle with what is known as Reactive Attachment Disorder (RAD). When an adopted child struggles with RAD, parents may feel overwhelmed by the challenge of loving and raising a child who struggles to connect with them. Without proper diagnosis, care, and treatment, the issues related to RAD can become even more complex as these children enter the teenage years, which can be a turbulent time even when there are no outside complicating factors.
What is Reactive Attachment Disorder?
An online article published by Psychology Today (2018) describes RAD as "a rare condition of emotional dysfunction, in which a baby or child cannot form a bond with its parents or caregivers due to early neglect or mistreatment" ("Definition," para.1). Reactive Attachment Disorder is not something that develops during the teen years; instead, the Mayo Clinic (2017) is among those who note that symptoms of RAD start before a child is five years of age ("Diagnostic and statistic," para. 1). Referenced in an article on Mayo Clinic's website are the criteria published by the American Psychiatric Association to determine a RAD diagnosis:
As a child gets older, there are two ways in which RAD seems to manifest itself. According to HelpGuide.org (2018), there are both inhibited and disinhibited symptoms of RAD:
- A consistent pattern of emotionally withdrawn behavior toward caregivers, shown by rarely seeking or not responding to comfort when distressed
- Persistent social and emotional problems that include minimal responsiveness to others, no positive response to interactions, or unexplained irritability, sadness or fearfulness during interactions with caregivers
- Persistent lack of having emotional needs for comfort, stimulation and affection met by caregivers, or repeated changes of primary caregivers that limit opportunities to form stable attachments, or care in a setting that severely limits opportunities to form attachments (such as an institution)
- No diagnosis of autism spectrum disorder ("Diagnostic and statistic," para.2).
The Teen Years
- Inhibited symptoms of RAD. The child is extremely withdrawn, emotionally detached, and resistant to comforting. The child is aware of what's going on around them - hypervigilant even - but doesn't react or respond. They may push others away, ignore them, or even act out in aggression when others try to get close.
- Disinhibited symptoms of RAD. The child doesn't seem to prefer their parents over other people, even strangers. The child seeks comfort and attention from virtually anyone, without distinction. They are extremely dependent, act much younger than their age, and may appear chronically anxious ("Signs and symptoms," para. 6).
Even under ideal circumstances, parenting teens can be a challenge. The teen years is a life stage that tends to get complicated. The pressures of life are greater. The stakes are higher. The options for finding and getting into trouble are more significant. And, yes, the hormones are raging inside. All of this can make for greater volatility and challenges in the home. At a time when young people are solidifying aspects of their identity, autonomy, values systems, and future dreams and goals, they need their parents to ride the roller coaster and be committed to the parenting process through the ups and downs. This can be even more challenging when the teenager is already resistant to emotional connections and struggles with trust issues. It takes a great deal of patience and perseverance. These virtues are often put to the test by the incredible emotional demands of raising a child with whom there may be a pattern of conflict.
Parents of RAD Teens
For those who are parents of RAD teens, the struggle is real. There are few things more painful than to experience the rejection of someone you love, and for RAD parents, this can be a common occurrence. Loving a child and being a solid, stable rock in their lives in these circumstances is not an easy task. Writing out of her own parenting experiences, mother and author, Nancy Thomas (2016), shares some of the challenges that parents navigate, including dealing with a RAD child's tendency to be impulsive, to manipulate in order to gain control, to have extreme control issues, to exhibit destructive behaviors, and to lie (para. 390-438).
Another adoptive mother, Shannon Guerra (2014), has also given written expression to the challenges of parenting adopted children with RAD. In her book, she notes the tendency of her RAD children to be delightful around those outside of the home, while saving their outbursts and acting out episodes in the context of the home (para. 125). Because the public and private behaviors are not congruent, it is difficult to appreciate the depth of the struggle that is taking place between parents and the children. Some parents struggle to share their experiences because they do not sense that they will be understood or believed (para. 170). It is important to remember the special need of RAD children to feel safe and secure in their relationships, and to learn that they are, in fact, able to trust and rely on their parents in the good and bad times. To provide greater safety and security, HelpGuide.com (2018) offers some suggestions to implement in the home:
- Set limits and boundaries.
- Take charge, but remain calm when your child is upset or misbehaving.
- Be immediately available to reconnect following conflict.
- Own up to your mistakes and initiate repair.
- Try to maintain predictable routines and schedules ("Tips for making," para. 2-6).
Is There Hope?
If you are a parent who feels alone in this journey, there are other families who have walked through similar experiences and can relate to the challenges you are facing. The journey toward healing is not easy, but there is hope. There are resources and referrals on this site that may be of interest as you help your kids take the next steps.
References:
Guerra, S. (2014) Upside down: understanding and supporting a
Mayo Clinic Staff. (2017, July). Reactive attachment disorder. Retrieved March 5, 2018, from https://www.mayoclinic.org/diseases-conditions/reactive-attachment-disorder/diagnosis-treatment/drc-20352945
Psychology Today. (2018, March). Reactive attachment disorder. Retrieved March 5, 2018, from https://www.psychologytoday.com/conditions/reactive-attachment-disorder
Thomas, N. (2016). When love is not enough: a guide to parenting children with RAD- reactive attachment disorder [E-book Kindle Edition]. Families by Design, Inc.