Reactive attachment disorder (RAD) is a mental health diagnosis listed in the Diagnostic and Statistical Manual of Mental Disorders (DSMIVTR) under disorders usually first diagnosed in infancy, childhood, or adolescence. RAD was initially introduced to the mental health community some 20 years ago. Since that time, much of the information regarding this disorder has painted a dismal and often dangerous picture of these children. Books and articles have compared children with RAD to serial killers, rapists, and hardcore criminals. Intensive and often physically aggressive therapies have been developed to treat these children. Additionally, unconventional parenting techniques have been taught to parents in order to control these children—children referred to as “disturbed” or “unattached.”

The main premise of RAD is that the child cannot socially connect or attach to others in interpersonal relationships. Behaviors inhibiting attachment to caretakers are often demonstrated by children diagnosed with RAD. Some of the behavioral symptoms published in literature include the following: oppositional; frequent and intense anger outbursts, manipulative or controlling; little or no conscience; destructive to self, others, and property; cruelty to animals or killing animals; gorging or hoarding food; and preoccupation with fire, blood, or violence.

Wow! Read that list again. Many of these behaviors sound downright frightening. It is hard to imagine that a child can do these things. Yet, while these behaviors certainly appear abnormal for anyone, especially a child, they are actually quite reasonable reactions to the experiences these children have endured. Read on….

There are many life events that can cause attachment trauma between the primary caretaker (usually the mother) and the child. These include an unwanted pregnancy, separation from the birth mother due to adoption, death of a parent, premature birth, inconsistent caretakers, abuse, neglect, chronic pain, long term hospitalizations with separations from the mother, and parental depression. Such life events interrupt a child’s ability to learn to self regulate through the relationship with the parent.

Typically, when a baby or small child is in a state of stress, he cries and the parent attends to the child’s needs, whether by feeding, rocking, or simply holding him. Each and every one of these interactions with the parent plays a critical part in assisting the development of the child’s neuropsychological control system—the system that allows the child to return back to a calm state. It is truly through this parent-child relationship that we as humans learn how to self regulate in order to stay balanced and easily shift from a state of stress back to a state of calm. This regulatory mechanism within us is not “online” at birth, and brain research has shown that it takes up to thirty months before this part of the brain is fully developed. Within this thirty month timeframe, a well attuned parent has connected with this child to calm his stress response system thousands, if not millions, of times. How critical these first thirty months are to a baby! It is through the parent-child relationship that a child’s self regulatory ability becomes engaged. This internal regulatory system then sets the foundation for the child’s neurological, physical, emotional, behavioral, cognitive, and social development.

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