Attachment Disorders And Reactive Attachment Disorder

Attachment Disorders And Reactive Attachment Disorder
posted by Dr. Hood
Sunday, August 8, 2010

Symptoms, Treatment & Hope for Children with Insecure Attachment
If you are the parent of a child with an attachment disorder, such as reactive attachment disorder, you may be physically and emotionally exhausted from trying to connect with your child, only to be met with opposition, defiance, or, maybe hardest of all, indifference. A child with insecure attachment or an attachment disorder doesn’t have the skills necessary to build meaningful relationships. Although it is never too late to treat and repair attachment difficulties, the earlier attachment issues are recognized, the easier they are to resolve. With the right tools, and a healthy dose of time, effort, patience, and love, attachment repair can and does happen.
Children with attachment disorders or other attachment problems have difficulty connecting to others and managing their own emotions. This results in a lack of trust and self-worth, a fear of getting close to anyone, anger, and a need to be in control. A child with an attachment disorder feels unsafe and alone.
So why do some children develop attachment disorders while others don’t? The answer has to do with the attachment process, which relies on the interaction of both parent and child.
Attachment disorders are the result of negative experiences in this early relationship. If young children feel repeatedly abandoned, isolated, powerless, or uncared for—for whatever reason—they will learn that they can’t depend on others and the world is a dangerous and frightening place.
Reactive attachment disorder and other attachment problems occur when children have been unable to consistently connect with a parent or primary caregiver. 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 his or her parents.
A baby or young child is moved from one caregiver to another (can be the result of adoption, foster care, or the loss of a parent).
The parent is emotionally unavailable because of depression, an illness, or a substance abuse problem.
As the examples show, sometimes the circumstances that cause the attachment problems are unavoidable. But the child is too young to understand what has happened and why. To a young child, it just feels like no one cares and they lose trust in others and the world becomes an unsafe place.
Attachment problems fall on a spectrum, from mild problems that are easily addressed to the most serious form, known as reactive attachment disorder.
The earlier you spot the symptoms of insecure attachment and take steps to repair them, the better. With early detection, you can avoid a more serious problem. Caught in infancy, attachment problems are often easy to correct with the right help and support.
Avoids eye contact
Doesn’t smile
Doesn’t reach out to be picked up
Rejects your efforts to calm, soothe, and connect
Doesn’t seem to notice or care when you leave them alone
Cries inconsolably
Doesn’t coo or make sounds
Doesn’t follow you with his or her eyes
Isn’t interested in playing interactive games or playing with toys
Spend a lot of time rocking or comforting themselves
It’s important to note that the early symptoms of insecure attachment are similar to the early symptoms of other issues such as ADHD and autism. If you spot any of these warning signs, make an appointment with your pediatrician to determine what the problem may be.
It’s common to feel frustration, anxiety, and even anger when faced with a crying baby—especially if your baby wails for hours on end and won’t calm down. Equally frustrating is a baby who seems indifferent, who won’t cuddle or make eye contact with you. In these situations, you need to find ways to get your own stress into balance. When you’re calm and centered, you’ll be better able to figure out what’s going on with your child and soothe his or her cries.
Read: When Baby Won’t Stop Crying: How to Comfort and Soothe an Upset Baby
Children with reactive attachment disorder have been so disrupted in early life that their future relationships are also impaired. They have difficulty relating to others and are often developmentally delayed. Reactive attachment disorder is common in children who have been abused, bounced around in foster care, lived in orphanages, or taken away from their primary caregiver after establishing a bond.
An aversion to touch and physical affection. Children with reactive attachment disorder often flinch, laugh, or even say “Ouch” when touched. Rather than producing positive feelings, touch and affection are perceived as a threat.
Control issues. Most children with reactive attachment disorder go to great lengths to prevent feeling helpless and remain in control. They are often disobedient, defiant, and argumentative.
Anger problems. Anger may be expressed directly, in tantrums or acting out, or through manipulative, passive-aggressive behavior. Children with reactive attachment disorder may hide their anger in socially acceptable actions, like giving a high five that hurts or hugging someone too hard.
Difficulty showing genuine care and affection. For example, children with reactive attachment disorder may act inappropriately affectionate with strangers while displaying little or no affection towards their parents.
An underdeveloped conscience. Children with reactive attachment disorder may act like they don’t have a conscience and fail to show guilt, regret, or remorse after behaving badly.
As children with reactive attachment disorder grow older, they often develop either an inhibited or a disinhibited pattern of symptoms:
Inhibited symptoms of reactive attachment disorder. The child is extremely withdrawn, emotionally detached, and resistant to comforting. The child is aware of what’s going on around him or her—hypervigilant even—but doesn’t react or respond. He or she may push others away, ignore them, or even act out in aggression when others try to get close.
Disinhibited symptoms of reactive attachment disorder. The child doesn’t seem to prefer his or her parents over other people, even strangers. The child seeks comfort and attention from virtually anyone, without distinction. He or she is extremely dependent, acts much younger than his or her age, and may appear chronically anxious.
Parenting a child with insecure attachment or reactive attachment disorder can be exhausting, frustrating, and emotionally trying. It is hard to put your best parenting foot forward without the reassurance of a loving connection with your child. Sometimes you may wonder if your efforts are worth it, but be assured that they are. With time, patience, and concerted effort, attachment disorders can be repaired. The key is to remain calm, yet firm as you interact with your child. This will teach your child that he or she is safe and can trust you.
Have realistic expectations. Helping your child with an attachment disorder may be a long road. Focus on making small steps forward and celebrate every sign of success.
Patience is essential. The process may not be as rapid as you like, and you can expect bumps along the way. But by remaining patient and focusing on small improvements, you create an atmosphere of safety for your child.
Foster a sense of humor and joy. Joy and humor go a long way toward repairing attachment problems and energizing you even in the midst of hard work. Find at least a couple of people or activities that help you laugh and feel good.
Take care of yourself and manage stress. Reduce other demands on your time and make time for yourself. Rest, good nutrition, and parenting breaks help you relax and recharge your batteries so you can give your attention to your child.
Find support and ask for help. Rely on friends, family, community resources, and respite care (if available). Try to ask for help before you really need it to avoid getting stressed to a breaking point. You may also want to consider joining a support group for parents.
Stay positive and hopeful. Be sensitive to the fact that children pick up on feelings. If they sense you’re discouraged, it will be discouraging to them. When you are feeling down, turn to others for reassurance.
If you have adopted a child, you may not have been aware of reactive attachment disorder. Anger or unresponsiveness from your new child can be heartbreaking and difficult to understand. Try to remember that your adopted child isn’t acting out because of lack of love for you. Their experience hasn’t prepared them to bond with you, and they can’t yet recognize you as a source of love and comfort. Your efforts to love them will have an impact—it just may take some time.
Safety is the core issue for children with reactive attachment disorder and other attachment problems. They are distant and distrustful because they feel unsafe in the world. They keep their guard up to protect themselves, but it also prevents them from accepting love and support. So before anything else, it is essential to build up your child’s sense of security. You can accomplish this by establishing clear expectations and rules of behavior, and by responding consistently so your child knows what to expect when he or she acts a certain way and—even more importantly—knows that no matter what happens, you can be counted on.
Set limits and boundaries. Consistent, loving boundaries make the world seem more predictable and less scary to children with attachment problems such as reactive attachment disorder. It’s important that they understand what behavior is expected of them, what is and isn’t acceptable, and what the consequences will be if they disregard the rules. This also teaches them that they have more control over what happens to them than they think.
Take charge, yet remain calm when your child is upset or misbehaving. Remember that “bad” behavior means that your child doesn’t know how to handle what he or she is feeling and needs your help. By staying calm, you show your child that the feeling is manageable. If he or she is being purposefully defiant, follow through with the pre-established consequences in a cool, matter-of-fact manner. But never discipline a child with an attachment disorder when you’re in an emotionally-charged state. This makes the child feel more unsafe and may even reinforce the bad behavior, since it’s clear it pushes your buttons.
Be immediately available to reconnect following a conflict. For children with insecure attachment and attachment disorders, conflict can be especially disturbing. After a conflict or tantrum where you’ve had to discipline your child, be ready to reconnect as soon as he or she is ready. This reinforces your consistency and love, and will help your child develop a trust that you’ll be there through thick and thin.
Own up to mistakes and initiate repair. When you let frustration or anger get the best of you or you do something you realize is insensitive, quickly address the mistake. Your willingness to take responsibility and make amends can strengthen the attachment bond. Children with reactive attachment disorder or other attachment problems need to learn that although you may not be perfect, they will be loved, no matter what.
Try to maintain predictable routines and schedules. A child with an attachment disorder won’t instinctively rely on loved ones, and may feel threatened by transition and inconsistency—for example when traveling or during school vacations. A familiar routine or schedule can provide comfort during times of change.

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