As parents of children with reactive attachment disorder – a developmental trauma disorder – we hear a lot of advice and opinions from our friends, family, professionals, and the general public. When people who have not raised a child with reactive attachment disorder (RAD) offer these opinions, they are often based on myth or a lack of understanding.
Common myths about reactive attachment disorder hurt those of us who are in the trenches, already feeling isolated and misunderstood. RAD Advocates surveyed parents to come up with the most common things we collectively hear as a RAD family community.
If you’re a fellow parent, you’re not alone in hearing these misconceptions. If you’re a professional, friend, or family member, read on to learn more.
Myth #1: “Reactive attachment disorder isn’t real” or “RAD is rare”
There’s a prevailing myth, even among many professionals, that reactive attachment disorder isn’t real or is rare. Reactive attachment disorder first appeared in the Diagnostics and Statistics Manual of Mental Disorders in 1980. Even though the entry carries a narrow definition, and many feel “developmental trauma disorder” would be a better name for several reasons, the behaviors and symptoms our kids display are real.
The symptoms of reactive attachment disorder are often confused with other disorders like post-traumatic stress disorder, anxiety, depression, and attention deficit hyperactivity disorder (ADHD). Talking to other parents raising kids with reactive attachment disorder, we find that our kids have many things in common that are not explained by other diagnoses.
Reactive attachment disorder does appear on a spectrum but is not rare. Forty percent of the general population is categorized as having an insecure attachment style, and a study showed 38-40% of toddlers in foster care who had been maltreated met the diagnostic criteria for the disorder (See Reactive Attachment Disorder: The “Rare” Culprit that Stifles Traumatized Kids and Their Parents ). I can only imagine how that statistic would soar if the criteria were more accurate and if they studied older children in foster care as well.
Myth #2: “They’re a total sweetheart, maybe the parent is the problem” (otherwise known as, “They’re not that way with me”)
Reactive attachment disorder typically looks much different outside the home than it does in the home. It can even look much different in how the child treats their mom versus dad. This is because the symptoms of reactive attachment disorder are typically expressed outwardly with the mom or other primary caregiver. This person becomes the nurturing enemy.
The symptoms of reactive attachment disorder are often confused with other disorders like post-traumatic stress disorder, anxiety, depression, and attention deficit hyperactivity disorder (ADHD).
Most children with reactive attachment disorder experienced some form of abuse, neglect, inconsistent caregiving and/or a painful separation prior to the age of 3. Because of this, they unconsciously do not trust their primary caregiver to take care of them or be there for them.
Kids with reactive attachment disorder only feel safe when they are in control. Therefore, they reject the primary caregiver, or nurturing enemy, pushing that parent (or both parents) away and doing everything in their power to stay in control. It is an innate means of survival.
Rather than getting their needs met in a healthy way – through loving and close relationships with their parents – children with the disorder rely on triangulation and manipulation to get others to do what they want without genuine closeness. Therefore, they are often superficially charming to teachers, relatives, and friends of the family. These folks see a much different child than mom does. “In retrospect, I think the severity of my grandson’s attachment issues was masked by a ready smile, a willingness to give and receive hugs, and by certain thoughtful moments that would surprise you,” my mom says.
It’s important for people to listen to the primary caregiver. You may never see the child they see, but by dismissing their reality, you are making them feel misunderstood and alone.
Myth #3: “Only children from foster care or orphanages get reactive attachment disorder”
Many children with reactive attachment disorder have experienced abuse or neglect, which is why it’s associated with foster care adoption or adoption from orphanages. However, even children adopted at birth or biological children can develop the disorder. These children get misdiagnosed when clinicians dismiss the possibility of reactive attachment disorder simply because the child wasn’t adopted or in the foster care system or an orphanage.
It’s important for people to listen to the primary caregiver. You may never see the child they see, but by dismissing their reality, you are making them feel misunderstood and alone.
When I attended the first Navigating RAD conference, I met parents who adopted children at 10 days old and 6 months old who had severe reactive attachment disorder. There are many factors that can influence whether a child develops reactive attachment disorder. Perhaps the infant had medical issues and had to be separated from his or her mother and endure traumatizing treatments prior to the age of 3. Other traumatic separations, even consensual infant adoption, leave a “primal wound.” If the child was left to cry hungry in a dirty diaper for their first 10 days, that can impact their attachments. Alcohol, drug or cigarette use during pregnancy impacts development. Domestic abuse during pregnancy is a factor, as is the mental health of biological parents and any disorders they suffer from.
Myth #4: “But he’s not violent; it can’t be reactive attachment disorder.”
As mentioned above, reactive attachment disorder is a spectrum. Not all children with reactive attachment disorder are violent, hurt animals, or set fires. Because of this, many of us – and the professionals we see – fail to diagnose reactive attachment disorder early enough in cases that are not so blatant or severe.
Children get misdiagnosed when clinicians dismiss the possibility of reactive attachment disorder simply because the child wasn’t adopted or in the foster care system or an orphanage.
No matter the level of severity, symptoms of reactive attachment disorder disrupt relationships and require support for families. Most children with RAD push against attachment figures, need control, triangulate, manipulate, lie, and steal in ways that are far from neurotypical. Other behaviors, including violence to oneself or others, may or may not occur depending on the severity of the child's disorder.
Myth #5: “All they need is love”
We are taught – and the general public believes – that all children need is love and a stable home. Sadly, it’s not that easy. Children with reactive attachment disorder unconsciously fear attachment and are threatened by love. Forcing attachment before the child feels safe or has learned to give up control and let their parents parent them usually backfires and makes the problem worse (see "Myth #7: All they need is some therapy" below).
Reactive attachment disorder is a complicated disorder that is difficult to treat, even by experienced professionals. Everyday parents don’t stand a chance on their own, no matter how much love they have to give.
Myth #6: “You just need to parent them XYZ way”
Parents raising children with reactive attachment disorder are often judged as too rigid and strict because our children need high structure and supervision typical of younger children. On the other hand, others may judge us as spoiling our children if they witness tantrums or yelling from the child.
In the four years between when we adopted our son and when we got the reactive attachment disorder diagnosis and discovered RAD Advocates, I bought book after book and attended conference after conference. I was convinced that if I just parented him “right,” he’d get better.
Reactive attachment disorder is a complicated disorder that is difficult to treat, even by experienced professionals. Everyday parents don’t stand a chance on their own, no matter how much love they have to give.
There is no magic parenting style that will heal our children. Yes, parents are part of the puzzle, but our parenting alone is not the fault or the cure. Judging us when you haven’t walked in our shoes is extremely hurtful and isolating for us.
“There is a myth that proper parenting will change the child's behavior,” one parent who took the survey says. “RAD results from trauma that impacts the development and physiology of the brain. No one would go to a child's oncology ward and tell the parents that if they just did a better job their child would not have this condition. Yet, this is the message I hear all the time. It is cruel."
Myth #7: “All they need is some therapy (or medications)”
Many think talk therapy and maybe some medications are magic bullets for troubled children. Both can be helpful, but finding practitioners experienced in dealing with reactive attachment disorder who know the right approaches is extremely difficult.
For therapy to be effective, the child must want to change, and the therapist must understand the disorder. “Children with moderate to severe RAD typically need to be outside the home for treatment because everyone in the home is suffering,” says Forrest Lien, LCSW, a counselor who spent the last three decades of his career working with children with developmental trauma and their families. “A lot of attachment folks will push the attachment relationship with the mom rather than looking at the whole breakdown of the family system.
"No one would go to a child's oncology ward and tell the parents that if they just did a better job their child would not have this condition," a mom of a child with reactive attachment disorder says. "Yet, this is the message I hear all the time. It is cruel."
“With effective RAD therapy, the clinician works with the child to give up trying to take control and to allow themselves to feel vulnerable with their attachment figures and to count on their parents to guide them and direct them,” he continues. “That’s like saying to these kids, ‘Give up all your survival tools and trust me.’ To them that feels like dying.”
This is why severe cases must be treated outside the home first. However, children with more mild reactive attachment disorder may be treated with the right strategies in an outpatient setting, Lien says.
Meanwhile, children seeing a psychiatrist are often misdiagnosed with things like ADHD and treated with the wrong medications, which you can read more about here.
Myth #8: “Reactive attachment disorder is incurable”
Reactive attachment disorder is difficult to treat, there’s no doubt about it. That’s one of the many reasons RAD Advocates was founded – to help connect families with guidance, support, and the right resources.
While many children don’t get the help they need or are not yet to the place where they want to change, there are success stories. Of course, success looks different for each person and family. Still, there is hope.
Myth #9: “But he loves you (or is attached to you) so it can’t be reactive attachment disorder”
There are many attachment styles, including a number of insecure attachment styles. Because of this and the fact that reactive attachment disorder is a spectrum, not all cases look the same.
Our son, as my mom states above, would give hugs – but on his terms or as a manipulation tactic. Same with saying “I love you.” Because he didn’t recoil to touch or would give eye contact, his RAD diagnosis was missed for years. “They can have a disordered attachment and still have reactive attachment disorder,” one parent notes. They can seem attached because they have separation anxiety or seem well adjusted to those outside the home, another parent adds.
Myth #10: “My kid does that, too”
One of my biggest pet peeves is when parents of biological children say, “That’s typical kid behavior,” or “My child does that too.” Of course, in the extreme cases of reactive attachment disorder, where children literally try and kill their parents, siblings, or pets, or set the house on fire, their parents are less likely to hear this. However, our son was not violent. Therefore, I heard this a lot.
While many children don’t get the help they need or are not yet to the place where they want to change, there are success stories. Of course, success looks different for each person and family.
How I finally came to explain reactive attachment disorder parenting to others was that it’s the difference between a drip of water out of the faucet every now and then vs. a nonstop firehose. Yes, a neurotypical kid may lie every now and then, while a child with RAD usually lies chronically. A neurotypical kid may get in trouble at school a few times in their life, while parents of children with reactive attachment disorder usually hear from the school several times a week. Almost every minute spent with our son felt like a struggle. This is not typical.
We can dispel myths and protect families, together.
We all hope for the same thing – that troubled kids can grow up with stable families. It’s sad that it doesn’t always happen. But when the opportunities arise, whether through adoption, kinship or otherwise, we need to protect that foundation with every support possible.
These myths prevent families from getting the help they so desperately require and deserve. They consistently poke tiny holes in the family foundation we want for kids, ultimately leaving gigantic holes in its stability. These myths leave families, and kids, extremely vulnerable to disruption. It’s not their fault when that happens, it’s “ours.” It’s our collective responsibility to protect kids and families. They can’t do it alone.
RAD Advocates is working tirelessly to combat these myths and share accurate information so that families dealing with reactive attachment disorder can find understanding, help, and hope. Remember, we all want the same thing. Let’s work together to make it possible.
About the Author:
Micaela Myers and her husband adopted a pair of siblings from foster care in 2015, when the children were 9 and 13. Since then, she has become an advocate for foster care reform and the support and education of adoptive parents. She was a member and is a supporter of RAD Advocates. Micaela earned her MFA in writing from Vermont College of Fine Arts and works as a professional writer and editor in Colorado.
Photo by Andrea De Santis on Unsplash