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Many of us have someone in our lives who has trouble forming relationships with others. It might be a coworker, a distant cousin or a neighbor. These individuals don’t seem to have anyone close to them. And even when you’ve tried to establish a bond with them, you’ve felt pushed away. You may have wondered why some people are like this.
It could be the condition known as reactive attachment disorder (RAD). Reactive attachment disorder, also known as RAD, is a rare psychological disorder that develops when a child is unable to form proper emotional bonds to their parents or caregivers. This disorder, which is present in 1%-2% of children according to the Cleveland Clinic, is a response to extreme neglect or abuse and a lack of healthy attachments in early childhood. RAD’s effects can last through adulthood, especially if not treated. Reactive attachment disorder in children is often confused with autism due to some overlapping symptoms. Also, due to a lack of public knowledge, adults with RAD are often seen as weird, aloof, cold or introverted.
How Does Reactive Attachment Disorder Develop?
The first few years of a child’s life are crucial for all types of development. The child’s caregivers play a crucial role in their development by caring for physical and emotional needs. Aside from providing food and shelter, parents or primary caregivers are also responsible for providing comfort and a sense of safety and support, which then informs the child’s attachment style.
Reactive attachment disorder occurs when young children or infants don’t form a healthy, strong bond with their parents or caregivers. Typically, this happens because the child is neglected, mistreated or not held enough. Children with reactive attachement disorder often have trouble expressing and controlling their emotions. As these formative years are critical in shaping who a person becomes, RAD can have a long-lasting impact.
Emotionally abusive, neglectful or absent caregivers are not the only potential cause of RAD. Severe reactive attachment disorder may also develop as a result of a situation in early childhood such as unstable foster care or having an ill parent — instances when a child’s living situation or primary caregiver changes frequently or traumatically.
RAD disorder can continue into adulthood and cause problems with relationship-building. Adults with RAD have difficulty forming romantic and platonic relationships. And if they can’t create meaningful bonds with others, they don’t get to experience positive, collaborative relationships.
RAD is one of many types of attachment disorders. One study of the general population found that only about 1.4% of people have reactive attachment disorder. This rare disorder is considered a severe stress-and-trauma response condition. RAD is often misdiagnosed as other conditions, such as autism, which can delay proper treatment.
There are two main types of attachment style: secure and insecure. Children whose emotional needs are met and treated as important tend to develop a secure attachment to their caregivers. Children who are emotionally neglected or abused, on the other hand, may develop an insecure attachment style. They learn that they can’t count on their parents or caregivers to meet their emotional needs.
Relationships are a significant source of happiness and comfort in people’s lives. If left undiagnosed and untreated, RAD can continue to negatively impact a person’s ability to live a happy, fulfilled life.
Characteristics of Reactive Attachment Disorder in Children
Reactive attachment disorder may start developing in infancy. A child with RAD may often appear sad, fearful or irritable and not be comforted by adults. The child will likely not smile or laugh much and may appear disconnected from the world around them — kids with RAD are aware of what’s happening and can process situations cognitively but fail to react emotionally. They may be disinterested in interactive games like peekaboo and dislike physical touch.
Children with RAD may also grasp for a sense of control in their environment, which can manifest as frequent tantrums. When upset, they’re likely to calm down more quickly when left alone than when offered comfort. Inhibited ability to connect with others and dislike for physical touch are just a few of the symptoms that overlap with autism, which opens up the potential for misdiagnosis.
What Are Symptoms of Reactive Attachment Disorder in Adults?
The symptoms of RAD can change over time from early childhood to adulthood.
Children with RAD may display the following symptoms:
- Not turning to their parents or caregivers in times of fear or need
- Having no response at the rare times the caregiver does show nurturing
- Not having an interest in being social with others
- Displaying negative emotions (sadness, fear, anger) at inappropriate times
- Reactive abuse — lashing out at the person who’s hurting them
Adults with reactive attachment disorder can show these signs and symptoms of their condition:
- Difficulty managing their emotions
- Low self-esteem and self-worth
- Lack of empathy
- Inability to show emotions of consciousness (guilt, remorse, regret)
- Difficulty establishing and maintaining relationships
- Behavioral issues (anger, impulsivity)
- Detachment
- Difficulty showing affection
- Control issues
- Distrust of others
- Feelings of emptiness and loneliness
- Lack of a sense of belonging
What Are Causes of RAD?
Being loved and cared for at an early age teaches children how to develop relationships. Reactive attachment disorder can develop when a child doesn’t receive adequate love, attention and care. It’s seen in children who’ve lived in orphanages or moved around between foster homes. It also occurs in those who’ve been abused or removed from their primary caregiver.
Risk factors of RAD are seen in these examples of poor caretaking:
- Leaving an infant in a dirty diaper for hours
- Allowing a child to go hungry frequently
- Not comforting a child who’s in distress (e.g., allowed to cry for hours)
- Ignoring a baby for hours at a time
- Teaching a child that the only time they get attention is when they act out
- A home environment where a child is emotionally or physically neglected and abused
What Are Other Symptoms of Reactive Attachment Disorder in Adults?
The main symptom of RAD in adults is the inability to form meaningful, long-lasting relationships. At work or school, the inability to form relationships can hinder a person’s progress and ability to excel. In their personal life, a lack of close relationships can lead to depression, anxiety and poor anger management.
Typically, the individual wants to form relationships but can’t seem to make them work. Ultimately, this is due to a deep-seated feeling that they don’t deserve love and friendship since they never received it as a child.
Other signs of RAD in adults include:
- Eating disorders
- Drug and alcohol abuse
- Learning disorders
- Behavioral disorders
How Is Reactive Attachment Disorder Diagnosed?
Reactive attachment disorder in children can only be diagnosed between the ages of 9 months and 5 years, though symptoms may persist into adulthood if left untreated. It’s typically diagnosed by a pediatric psychologist or other pediatric mental health professional.
The diagnostic criteria listed in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders begins with the child’s demeanor. The child must display signs of being emotionally withdrawn and unwilling to seek comfort from others, as well as displaying abnormal responses to normal amounts of stress. Responses may include sadness, withdrawal, irritability or lashing out. The child must have a history of not having their physical or emotional needs met, and autism should be ruled out before making a diagnosis of RAD.
What Are Treatment Options for RAD?
Reactive attachment disorder in adults is highly treatable with the right therapy. In therapy, the individual has to come to terms with their childhood and understand that none of what occurred was their fault. They must acknowledge how much that childhood trauma has negatively impacted them as an adult. Individual counseling can focus on repairing broken family bonds and learning to create new healthy relationships. If a person wants to confront and restore their family relationships, they can also enroll in family therapy.
Individuals with RAD are at greater risk for substance abuse or addiction. This means they may need to seek treatment for a co-occurring disorder. Although this can complicate matters as there are two challenges to overcome, it’s vital to address both. It may even be beneficial to choose a treatment program that lets them focus on both conditions simultaneously.
FHE Health Can Help
Reactive attachment disorder in adults doesn’t have to be a lifelong condition. Treatment is possible and can bring real results that make a difference in a person’s life. If you or someone you know is struggling with RAD, the mental health specialists at FHE can help. Start your journey toward recovery today by calling (833) 596-3502.
