Reactive attachment Disorder

rd                                                        By Maryam Riaz

To understand reactive attachment disorder, first have to understand attachment. Attachment is defined as the affectional tie between two people. It begins with the bond between the infant and mother.  Bowlby stated “the initial relationship between self and others serves as blueprints for all future relationships.” (Bowlby, 1975).   Attachment Disorder is defined as the condition in which individuals have difficulty forming lasting relationships. They often show nearly a complete lack of ability to be genuinely affectionate with others. 

Reactive attachment disorder (RAD) is one possible psychological consequence of child abuse and neglect for very young children, younger than 5 years of age. RAD is described as markedly disturbed and developmentally inappropriate social relatedness usually beginning before age 5 years. These behavioral manifestations are the direct result of and come after pathogenic care. Child abuse and neglect affects the lives of many children and can result in physical injury and disability as well as psychological trauma.

Clinicians and researchers agree that children who – have experienced abuse, neglect, or frequent disruptions in primary caregivers often exhibit varying degrees of cognitive, physical, and social-emotional delays (Aber and Allen, 1987\

Reactive attachment disorder is a rare but serious condition in which an infant or young child doesn’t establish healthy attachments with parents or caregivers. Reactive attachment disorder may develop if the child’s basic needs for comfort, affection and nurturing aren’t met and loving, caring, stable attachments with others are not established. Any of the following conditions occurring to a child during the first 36 months of life puts them at risk: unwanted pregnancy, pre-birth exposure to trauma, drugs or alcohol, abuse (physical, emotional, sexual), neglect (not answering the baby’s cries for help), separation from primary caregiver (i.e. illness or death of mother, or severe illness or hospitalization of the baby, or adoption), moms with chronic depression, etc.

Most children are naturally resilient, and even those who’ve been neglected, lived in orphanages or had multiple caregivers can develop healthy relationships.

With treatment, children with reactive attachment disorder may develop more stable and healthy relationships with caregivers and others. Treatments for reactive attachment disorder include positive child and caregiver interactions, a stable, nurturing environment, psychological counseling, and parent or caregiver education.

Various theories about reactive attachment disorder and its causes exist, and more research is needed to develop a better understanding and improve diagnosis and treatment options.

Maryam Riaz
Clinical Psychologist
Willing Ways, Islamabad

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