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Oakland Reactive Attachment Disorder (RAD) Therapist

Foster and adoptive parents find help for kids with reactive attachment disorder (RAD) from Matthew Lindgren, an Oakland child therapist.

Caring for a Foster Child can be HARD

Caring for a child with reactive attachment disorder, or RAD, can be extremely challenging for even mental health professionals. These kids have been through so much that they just don't know how to relate to caretakers or other people. If you're reading this, chances are you're somone who is caring for a child with reactive attachment disorder, which probably means you're a very important person who can help that child recover.

Reactive attachment disorder happens when a child endures a great deal of neglect and abandonment. While it usually develops from severe neglect in early childhood, it also develops when children are shifted among caretakers, as commonly happens in foster care or sometimes after the death of caregivers. Without anyone stable in their lives, these children never have what most of us take for granted, a childhood in which they can depend on at least one adult to always care for their needs - physical and emotional, including the need for love.

There is help for reactive attachment disorder through my practice in Oakland.

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Symptoms of Reactive Attachment Disorder

Because these children never "attach" to one stable person who remains in their lives, they behave in quite perplexing ways. They end up choosing one of two strategies in order to meet their emotional needs:

  • Inhibition - in which they essentially "give up" on attempts to receive emotional soothing from others, or in which they are so mistrustful of others that their attempts to connect with others are often obscured by self-protective behavior and fear.

  • Disinhition - in which the child attempts to have their emotional needs met by anyone and everyone they encounter. In a way, this strategy suggests a great deal of hope for the child as he or she has not "given up" on finding someone who will love them.

Most kids with reactive attachment disorder display a host of disruptive behaviors. They are commonly diagnosed with hyperactivity disorders because they cannot sit still, and they often have a tremendous problem focusing their attention. Most of us were lucky enough to learn how to direct our attention and regulate our emotions because we had caretakers who interacted with us, played with us, and showed us love and attention as infants and young children. These children have always had to depend upon themselves to learn how to behave and regulate themselves, and unfortunately, there are many essential psychological skills we must learn from caregivers that they do not know.

Many of these children also have severe posttraumatic stress disorder, or PTSD, as result of abuse and neglect, that further complicates their behavior. Many of them have been severely abused by adults, and as a result, have a fear of adults that probably helped them survive. Unfortunately this fear often continues even after the children are living with safe adults.

It is quite common for kids with reactive attachment disorder to not follow rules. They often end up with a diagnosis of "oppositional and defiant disorder" or even "conduct disorder". You have to realize that most of these kids have never been around adults who themselves followed rules. For many of these kids, the adults in their lives were far more unsafe and unruly than the kids themselves. Not only do these children not want to follow adult rules, they don't even trust that adults are capable of following or implementing rules. If they followed adult rules, it might have been extremely unsafe for them, so they sure don't want to do so now.

It is also common for kids with reactive attachment disorder to hoard food and valuable items, as well as to steal and lie. Some of these behaviors, like hoarding, result from previous fears of having to do without. Stealing and lying are often a result of having to live by their own rules, which were usually far more human and compassionate than the rules of their adult caregivers.

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Oakland Therapy for Reactive Attachment Disorder

Make no mistake about it, caring for a kid with reactive attachment disorder can be very hard. The most effective therapies are those that carefully help build a stong and healthy bond with safe and patient caregivers. While there are some techniques that can help along the way, like EMDR, this is hard work that will probably take years.

As a caregiver, you have to both "reparent" the child - offer them the love, nurturing, and play that was absent in their early years, while also holding very firm boundaries with a child who may very well require and demand excessive attention around discipline. As difficult as these children may be, it is important to realize how incredibly vulnerable they are inside, and to know that even as they might rage against you, a harsh word or angry look could devastate them. As much as this child may annoy and frustrate you, you cannot lash out in a cruel way or you risk losing whatever small amount of love they might be able to accept from you.

There is a lot controversy about therapies for reactive attachment disorder. Some therapists recommend forcefully restraining children, and some believe in elaborate rituals of "rebirthing". I want to make very clear that I do not endorse any form of therapy that forcefully restrains children as a way of confronting them, for compliance, to elicit a response, or for shame. I also do not believe in "rebirthing" therapy, though I do believe in the principle of performing nurturing actions that compensate for developmental deficits.

I do encourage caregivers and children to voluntarily touch and hold each other as a way of expressing care and love. I do create opportunities through play for children to accept nurturing touch from caregivers through actitivities I sometimes call "the baby game". I never use therapy or touch as a mean of establishing dominance or power.

When I work with reactive attachment disorder, I always treat both the child and the caregiver. The therapy is about creating and maintaing a bond between you. I use conjoint family therapy, as well as narrative EMDR family therapy to help treat children with reactive attachment disorder. I teach caregivers behavioral parenting techniques to provide the consistency, structure, and positive rewards that a child with reactive attachment disorder needs.

I work with reactive attachment disorder through my practice in Oakland. I know caring for a child with reactive attachment disorder may be the hardest thing you'll ever do, but it will be totally worth it. If you're up for the hard work ahead of you as a caregiver, I am happy to be there with you to give you the support and guidance you need.

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Call 415-820-1487 for a free phone consultation.