RAD – Reactive Attachment Disorder: Coping with the Effects in Adopted and Foster Teenagers
by Sue Scheff on Oct 24, 2011
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Reactive Attachment Disorder is increasingly being recognized as a trauma-based diagnosis in children who have insecure or disrupted early bonding relationships with their biological mother. In the 1980’s RAD as it is commonly known became a formal diagnosis based on the recognition that deviant forms of attachment led to marked behavioral and emotional difficulties in children (1) and are caused primarily by maternal deprivation and severe abuse and/neglect.
So why do children develop RAD, can it be prevented, or is it as one caller asked me over the radio – CAUSED by foster care placement? Very thought provoking!
RAD develops from the primary loss of the mother-infant/child bond. The key deficits lie in two areas. These are in terms of capacities to socialize effectively, and to form stable relationships over time.
Characteristics of RAD Children:
- Severe neglect and/or abuse by biological mother prior to the age of five years
- Difficulties in developing meaningful social relationships with others
- Easily attaches to complete strangers who become caregivers and treats every caregiver as if they share a very close and intimate bond or will be detached from any caregiver and move from one to another without any distress.
Effects of RAD in Teenagers:
In teenagers, the ongoing symptoms of detachment remain. What is different is the presentation. The hormonal mood changes along with the feelings that they are not loved enough, not wanted, and feeling abandoned and rejected worsen their fragile self-confidence and they can become very affectionate one moment and violent and aggressive the next. Foster/adoptive teens can express these emotional and behavioral changes with symptoms of running away, impulsively breaking things, punching, kicking, fighting, crying, and screaming and cursing. These behaviors are often misdiagnosed as Bipolar Disorder and the young teen is placed on mood stabilizers that work as temporary Band-Aids. Meanwhile, parents are bewildered, fearful of getting hurt or seeing the child hurt, and in efforts to get help use behavioral methods to enforce discipline. Most of these techniques fail hopelessly and in severe cases, the teen’s condition worsens to the point that residential treatment and hospitalization become the new homes for these teens. Later, untreated severely RAD teens experience homelessness as young adults, engage in substance abuse, crime, and unstable, high risk relationships. All of these factors lead these teens into severe depression, suicide attempts, abusive relationships, and hospitalizations.
Treatment of RAD:
The good news is that surprisingly RAD treatment is astonishingly simple. Major inroads into the workings of the human brain have identified the locations for traumatic emotions that are responsible for 99% of the teen’s behavioral and emotional imbalances. The primary area is located deep within the brain and cannot be accessed through talk therapy. Various forms of RAD therapy are successful. These are:
- Attachment Therapy: Based on the premise that RAD children do not know how to give or receive love
- Holding Therapy: Based on the idea that the teen has suppressed rage from the lack of maternal love as a child and needs to re-experience it. In one study (2) foster children between 5-14 years old were held down and restrained while being prodded, poked, tickled, and yelled at until the child finally stopped fighting back. When that happened, the child was released to the foster parent to attach to and be held. Criticism of this technique is of the trauma of being confined and tied up.
- Attachment and Bio-behavioral Catch-Up Therapy
- Parent-Child Interactional Therapy (PCIT)
- Behavior Management Therapy (BMT)
- EMDR: Eye Movement Desensitization Reprocessing
Further information and education regarding RAD and treatment for forms of RAD can be found in “The Supportive Foster Parent” www.thesupportivefosterparent.com and on Amazon. Or the author can be contacted at 219-736-1000/drgbook@gmail.com.
References:
- Volkar, Fred (1997). DSM IV ® Sourcebook. Chapter 15. http://books.google.com/books?hl=en&lr=&id=Q6xkh3QdyGEC&oi=fnd&pg=PA255&dq=reactive+attachment+disorder&ots=tBr0Z9U3kp&sig=soQ2z0up4zF4CFjk–30e1VUTPg#v=onepage&q=reactive%20attachment%20disorder&f=false
- http://www.ncbi.nlm.nih.gov/pubmed/10422354
About the author and contributor Dr. Kalyani Gopa:
I am a licensed clinical psychologist with over 25 years of experience in diverse clinical settings. I was trained as a clinical psychologist at the National Institute of Mental Health and Neurosciences in India, began my doctoral training in clinical psychology in Vanderbilt University and completed my training at Alliant University. My areas of interest are in parenting, becoming a foster parent, child and adolescent psychopathology, attachment issues, foster care assessment, adjustment, and training, child forensic assessments and treatment, juvenile delinquency, child sexual abuse expert witness testimony, long term sequelae of child sexual abuse, media relations, and immigrant experiences. I am fortunate to be on the Lake County Child Protection Team and provide consultation in handling complex foster care issues. And, on the Lake County Child Fatality Team. In 2002, I was the recipient of the Outstanding Service to Lake County award. Currently, I hold the position as President/Clinical Director, Mid-America Psychological and Counseling Services in Merrillville, Indiana and supervise three outpatient clinics in Indiana and Illinois. Currently, I also play the role of President-Elect, Clinical Psychology of Women, APA, Division 12, Section IV and the Statewide Liason for Public Health for the Illinois Psychological Association.
Tags: Adopted Teens, Foster parents, Parenting, parenting advice, Parenting Blogs, Parenting Books, Parenting Teens, Parenting Tips, RAD, RAD in Teenagers, Reactive Attachment Disorder
Sue Scheff: Reactive Attachment Disorder (RAD) Internet Addiction and the Risk Factors for Adopted Teens
by Sue Scheff on Jan 08, 2009
Internet addiction afflictions rising each year
The internet is an incredible resource for information and entertainment, but it does have drawbacks. Besides creating an avenue for dangerous child predators to flourish, the internet has also caused a recent and misunderstood sickness to sweep across the nation. This dangerous new disease is known as Teenage Internet Addiction.
The idea of “internet addiction” began in the 1990’s to explain an unhealthy reliance on the internet that parents noticed their teens developing. Since then, the internet’s popularity explosion and use of sites like Myspace™ and Facebook™ have ushered in a new age of teenage internet addiction.
Sue Scheff™ and other parent advocates realize the danger of teenage internet addiction, and adopted teens are highly susceptible because they often experience Reactive Attachment Disorder, or RAD. RAD develops when a teen is unable to attach trust and development in interpersonal relationships. RAD is caused by the confusion and pain of a child’s separation from their birth mother. Even a child adopted early in life can experience dramatic RAD separation anxiety in their teenage years.
Sue Scheff™ has found that internet addiction increases feelings of anti-social tendencies and the inability to interact with others, much like RAD. Adoptive teens struggle to overcome RAD increases their vulnerability to internet addiction.
Teenagers should not be fearful of the internet, it is an attractive and exciting way to gather information and communicate with others, but parents must be aware of their adopted teen’s internet usage levels. Parents should never spy on their kids; instead they should focus on maintaining open lines of communication, much like they would when dealing with Primal Wound or other adopted teen issues. Parents should ask their kids about their internet habits and ask to look at their Myspace or other profile sites. Parent should never look at teenage pages or pursue web history behind teen’s backs; this can alienate your teenager even more, amplifying feelings of anxiety or RAD.
There are some signs of teenage addiction associated with internet use that Sue Scheff believes parents should be especially aware of. Some of these warning signs are very closely related to teenage depression, another condition that many adopted teens face.
When exploring the possibility of internet addiction, check if your adopted teen experiences powerful euphoric feelings while on the internet and extreme anxiety while away from it. Also check if the teen has intense cravings for the internet, always wanting to return to it. Other warning sings include adopted teens lying about their internet usage and withdrawing from past activities in favor of increased internet usage. Internet addiction’s physical effects include dry eyes, drastic changes in eating habits, increased headache or backaches from focusing on the screen, as well as sleeping problems.
Placing the family computer in an easily monitored area is a good way to prevent internet misuse. Never ban the internet, but work on a time schedule that will be fair for both you and your adopted teen. Also work to encourage non internet activity, which means forcing other family members to reduce internet usage while encouraging outdoor activities.
Adopted teens are at a high risk for internet addiction because of their problems with RAD, but if parents foster healthy family communication practices, do an honest job of trying to understand their teenagers internet needs, and let their teens know they are ready to help them if they need it, than internet addiction and its side effects can be prevented.
Tags: Adopted Teens, Cyber Addiction, Internet Addiction, Parenting Teens, RAD, Reative Attachment Disorder, Sue Scheff
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