When we went through “crisis planning” with our son’s therapist, the counselor at residential treatment, or the wraparound team afterward, I could feel my stomach clench. It was just one more time I had to sit through “experts” “helping” us make a plan that was totally unrealistic and doomed to fail.
We may as well have said, “When we reach our next crisis brought on by reactive attachment disorder, we will all jump aboard our Pegasus unicorns and ride rainbows to the pots of gold!”
But alas, we went through the motions. Our son claimed he would “use his coping mechanisms.” He would take deep breaths, go for a walk, or journal. Ha! We would not be triggered and would stay calm. Ha!
Can you stop the wind from blowing during a hurricane?
Once our kids are triggered, they are not in a rational state of mind. They are in their primal brains. And if we are traumatized enough, then we the parents are too. We are not going to think logically and calmly. We’re all going to react. That’s why we need a real crisis plan that takes the disorder — a disorder that impacts the entire family — into account with a focus on safety.
Amy VanTine, founder of RAD Advocates, helps members develop crisis plans and walks us through some of the main areas that need to be addressed in a realistic plan. RAD Advocates also does so during their annual event, the Navigating RAD experience, coming up this October in Kansas City. It’s imperative that this plan be made in advance of an actual crisis.
Keeping your other children safe during a reactive attachment disorder crisis
If you have other children in the home, they are an important part of your crisis plan. They need to be kept safe and experience as little stress and trauma as possible. This is not a one-size-fits-all approach but must take into account their ages and individual needs.
“If they’re younger children, then assign a safe place for them such as the parent’s room where they can lock the door if needed,” VanTine suggests. This plan could also include your pets if they are stressed or in danger.
“The main thing is to think ahead of time, what are those children’s needs?” VanTine advises.
“We need to recognize reactive attachment disorder as a family disorder. Traditional safety plans miss this. Everyone is triggering everyone because everyone is traumatized. Identify everyone’s triggers in your safety plan and have discussions around that.”
For example, door slamming was a trigger for one of her non-RAD children, while screaming was a personal trigger for VanTine. If the door slamming wasn’t addressed, then her two children may start screaming at each other, and suddenly three members of the family would be triggered. So part of their plan was that the child triggered by the door slamming could play video games with his headphones on if the child with reactive attachment disorder started slamming doors.
Next, make a coping box for each of the other children that can be kept in the safe room.
“Help each child make a coping box with items to help them feel safe in a moment of crisis,” VanTine says. “We recommend tapping into all of their senses: something to plug their ears or music, a game they can play, some gum or candy they can suck on or a snack, something they can rub or squeeze (like fidget toys), maybe bubbles to blow to help with their breathing. Also, things that will distract them from what’s going on.”
She continues: “Depending on the level of crisis and age of the child, we may recommend having a timer. You want to be aware of how long your children are being isolated in their safe place. If the timer goes off, they can be instructed ahead of time to either come out, or if the parent hasn’t gotten them yet, to call 911.”
Once our kids are triggered, they are not in a rational state of mind. They are in their primal brains. And if we are traumatized enough, then we the parents are too. We are not going to think logically and calmly. We’re all going to react.
If the children are old enough to call 911, talk through with them ahead of time what scenarios warrant a call and what they should say, such as, “My brother has a mental health sickness. He’s acting out and being unsafe. My mom needs your help.”
It can also be an option for your other children to leave the house during a crisis. If they’re old enough, perhaps they can leave on their own. If they’re younger, then maybe you can talk to a neighbor ahead of time, and the kids can go there. Or, maybe one parent can leave with the non-RAD kids while the other parent stays with the raging child.
Calling 911 in a reactive attachment disorder crisis
Most of us raising children with reactive attachment disorder have developed a high threshold for drama and a high tolerance for behaviors. However, calling 911 during a crisis is often an important step and is a “must” if anyone’s safety is at risk.
When we do call 911, and the police or emergency room aren’t able to help, we may be dissuaded from calling next time. However, having that documentation can be important down the line in getting the help you need or an out-of-home placement. So even if it’s unlikely to provide a solution in the moment, when in doubt, call for help. Leave a paper trail.
When the police are called, calm yourself before they arrive. First responders will want to talk to whoever is most rational. Because our children with reactive attachment disorder may instantly calm down when strangers are present, you want to appear level-headed so that you can convey to the officers what is happening.
"We need to recognize reactive attachment disorder as a family disorder. Traditional safety plans miss this," says RAD Advocates CEO Amy VanTine. "Everyone is triggering everyone because everyone is traumatized. Identify everyone’s triggers in your safety plan and have discussions around that."
Don’t give them your child’s or family’s entire story. Keep it short. Let them know your child has mental health issues and emphasize any safety concerns. Also, don’t water down your language. Don’t say “dysregulated” when you mean “raging,” for example.
However you go about it, put something in place now before you need to call 911. For example, RAD Advocate members receive a letter that can be presented to first responders and provides additional information.
Keeping yourself and your spouse safe during a reactive attachment disorder crisis
Even if your physical safety isn’t in danger, your emotional safety may be. If whoever is interacting with the raging child is being triggered, things are bound to escalate. In these cases, step back and monitor from afar or tap your spouse in if they are less triggered at that moment.
If it’s safe to do so or another adult can be in charge, then take yourself out of the equation and use whatever methods help you get re-centered. For example, my therapist would instruct me to retreat to my room, identify where in my body I was feeling the emotion, and acknowledge the emotion with kindness, as you would talking to a friend.
If I recognized that I was triggered from something in my past that the current crisis reminded me of, then I would realize that and assure myself, “That was then, this is now.” I would try to ground myself with deep breathing and visualizing my safe place in the woods with my feet in a cool stream.
What we tell ourselves in a moment of crisis can help us calm down or make it worse. Mind your inner voice.
Additional considerations during a reactive attachment disorder crisis
Other things to consider in your crisis plan include reducing safety risks, such as locking up knives or other potential weapons if these are items your child with reactive attachment disorder may grab.
“Have a safety plan for the car as well,” VanTine adds.
Make sure no objects are in reach for throwing or using as weapons. Have the child with reactive attachment disorder sit in the backseat opposite you so they can’t reach the steering wheel and you can see them.
“Have a coping box in the car with things like snacks and water,” VanTine says. “If they’re refusing to put on their seatbelt or calm down, pull over somewhere safe. You can look at your magazine, have a snack and drink some water outside the car while the child is raging. If the child gets out and does something unsafe, call 911. Know where the closest emergency rooms are, especially if you’re taking a road trip.”
If you’re out and about in the community when a rage comes on, you can calmly try and make some suggestions or defuse the situation, but if things escalate, don’t hesitate to call for help. Bystanders likely won’t understand the disorder and may judge you harshly, so it’s best to call 911 if needed.
Developing real-world reactive attachment disorder crisis plans that take into account the nature of the disorder and its impacts on the entire family is well worth the time and effort. It may not be a ride on a Pegasus unicorn, but it may very well keep everyone safe.
*name changed to protect identity