Reactive Attachment Disorder: bonding with a wounded child

December 10 | Guest post by Tina Traster
Tina and her daughter.

Angelina Jolie and Brad Pitt make it look easy. They adopt kids from all corners of the world and the media broadcasts images of perfect Kodak moments. They'd have you believing families bond and blend instantaneously.

They don't. Not always. Not in my experience, or in the experience of many others. Sometimes the road to loving your adopted daughter is long and twisted and scary. You know something is wrong — but is it her? Is it you? You drown in shame and confusion, hiding your feelings from the world. It can't possibly be that you've gone to the other end of the world to get this baby and you're not bonded after a month, six months, two years.

I knew something wasn't right early on. We adopted Julia from a Siberian orphanage in February 2003. She didn't clutch to me or gaze in my eye. She never rested her head on my shoulder or relaxed into a warm embrace. She didn't respond if I sang or read to her. It was like she was there, but wasn't.

For a while, weeks, maybe months, I sank deeper and deeper into depression, thinking I'd made a terrible mistake. Maybe I wasn't cut out to be a mother?

Julia was a little more responsive with my husband, but only somewhat. For the first 10 months, I suffered guilt, shame and sadness. After traveling 10,000 miles, twice, to bring home this child, I was unwilling to let anyone know how I really felt.

Then the revelations began. I hired a day-time nanny in early 2004. Anna was 21, experienced and energetic. She'd come with a glowing review from the mother of her last charges. When she mentioned Julia was having trouble warming up to her, a ding went off in my head. Why? Why isn't Julia connecting to this lovely young lady who took her daily to the park, to play dates, to "Mommy-and-me" classes. I thought for sure that Anna might be able to give her what I couldn't.

A year later, I enrolled Julia in pre-school, and saw more of the same: a child who was not bonding with teachers or other children. She was as much an enigma to others as she was to us. Everyone agreed she was gregarious, vivacious, friendly and outgoing. Yet at the same time, she was aloof, hard to figure out. When I picked her up at the end of the day, she was always by herself, sometimes sitting under a desk.

Worried, I mentioned her odd behavior to her pediatrician. That was the first time I'd heard of Reactive Attachment Disorder (RAD). The doctor, who worked with international and foreign adoptees, explained RAD was common among institutionalized children. The early break from birth mothers causes trauma that makes it difficult for the child to trust or attach to another adult. This, he explained, is why Julia recoils when she is held. Why she doesn't have a favorite teddy. Why she won't make eye contact.

I wasn't ready to hear this. I told myself we just need more time. I stored the doctor's explanation in the back of my mind but pieces of it drifted out now when I watched Julia fight naps or wander away from me constantly. Finally, when she was four, I was ready to face her demons, our demons. It was during a nursery school recital that I broke down and sobbed because I realized how lonely and displaced and isolated my daughter was. Julia was unable to sing along with the group. Her disruptive behavior forced a teacher to take her off the stage and leave the room. This may not sound like the most unusual event for a young child — but put in context, I understood right then and there, I needed to intervene.

My husband and I banded together to read everything we could on the syndrome. We made a dogged effort and a conscious commitment to help our daughter and make ourselves into a family. It was our daily work. We learned that parenting a child who has trouble bonding requires counter-intuitive parenting instincts — some that disturbed and surprised family and friends. People could not understand that we'd respond to Julia's fussing with a passive poker face rather than indulge her. We'd laugh during her tantrums until she abandoned them, and moved on as though they'd never happened. They didn't understand that Julia wasn't willing to give hugs and we didn't ask her to do so.

With the help of research and case studies, we had a tool box. Some advice was invaluable, some failed. Some techniques worked for a while. We were living inside a laboratory. I knew how lucky I was to have a partner like Ricky because so many marriages and homes are ravaged by the challenge of adopting difficult children.

Over time, there was more engagement with Julia. It wasn't necessarily loving and warm at first but it was moving in the right direction. We were drawing her out. She became more capable of showing anger rather than indifference. As her verbal skills developed, we had the advantage of being able to explain to her that we loved her and would never leave her. That we understood how scary it was for her to be loved by an adult and that she was safe.

Progress took time — and the work of staying bonded with a wounded child is a life-time endeavor. That's okay though because Julia has stepped out of the danger zone. She's taken off her helmet and armor. She has let me become her mother. And I honor that trust by remembering, each and every day, how she struggles with subconscious demons and how mighty her battle is and will always be.

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  1. Thank you for your post. I also wanted to remind readers that "so many marriages and homes are ravaged by the challenge of [adopting] difficult children". It isn't just families that adopt that get ravaged. I understand completely that there are more obvious wild cards when you adopt, but when you chose to have a child — either through birth or through adoption — the entire process is filled with uncertainty. It is hard for me when people highlight that it is especially so for families adopting children, perhaps because I fear that often people equate that with a choice that can be backed out of.

    7 agree
    • I get what you are saying – I have a 5 month old and it has been CRAY! – but often children in foster care or adoptive homes have major emotional issues. And parents, often, have no idea what is going on.

      I say this as someone who ADORED my foster parents but was still kicked out because I didn't know how to show it, or that I needed to…showing that you cared for something, when I was growing up, was equivalent to asking for it to be taken away or destroyed.

      I wish they had known more about children with my background. Being a successful adoptive or foster parent requires counseling and psychology skills. Skills applied in a vacuum because you don't always have the full story about what happened to this child versus raising a child from birth. The good news is that if you can get a child before they are six months old, you can reverse the emotional damage! (But, if mom was a crackhead, you may still have substantial medical/developmental issues.)

      Basically, what I am saying is that YES! being a parent of any stripe is difficult but it really is important for people to know the added difficulties of being a foster/adoptive parent so they can successfully help their foster/adoptive children!

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      • I have tried to become a foster parent. I made it part-way through the certification process and had to admit to myself that I was not emotionally strong enough. I feel a lot of shame for it. Maybe someday I will have the skills. I admire those who do.

        1 agrees
        • You might want to consider doing respite if it's available in your area (if you haven't considered it already). You don't have to be a full time carer to make a difference to kid in care. We started off doing one weekend a month, for one kid. That turned into every second weekend for twins. It gave their parent a break, and we were able to mentor and encourage the kids in ways their family couldn't. It isn't as full on and emotional as being a full time carer, and some respite carers stay in touch with their kids for decades.

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        • I don't think you should feel shame at all. Admitting that you don't have the emotional strength is FAR better than believing you do and not being able to properly care for those who so badly need it. It's a form of strength in itself.

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          • I feel good about things now but spent so many years feeling shame because I didn't at first understand what was going on, and I felt like I was failing my daughter

      • What surprised us — and maybe kept us in denial — was that wegot our baby at 7-8 months, and so we were unprepared for how much damage already existed.

        1 agrees
  2. What an incredible story and I want to say THANK YOU for sticking it out and making it work. RAD happens at such a deep, primitive level – I mean, these are babies! – that it is incredibly difficult to fix.

    And RAD can show up in older kids in weird ways. For example, a child that has never been able to attach to one adult goes to school where, typically, our entire education system is based on a child trusting the adult.

    "1+1=2"
    "Why?"
    "Because it is."
    "But why?"
    "Because I said so, and because I am the teacher and I know more than you do."

    If you have never connected with a primary caregiver, then your ability to trust what people in authority say is very limited.

    Again, THANK YOU SO MUCH. I only wish that adoption/foster care agencies would be more upfront about this.

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    • Exactly. Adoptive parents need to be up on this. That's why I'm writing a book. I wish I'd known about this prior to my daugther's adoption. And maybe the burden was on me to learn it but I didn't, and that was a shame

      1 agrees
  3. I can't laud you enough for sticking it out and making it work. It gives so much hope to others. I have not walked in your shoes but I recoiled at the last line in the article:
    "(…)she struggles with subconscious demons and how mighty her battle is and will always be."
    She might just be ok. If I were you perhaps I would be afraid of hoping. But there is no objective reason for your daughter's battles to last forever.
    Again though, thank you for this piece. Julia's a lucky little girl 🙂

    • Many physical disorders can be treated and managed, but not cured. Many mental disorders are the same way. The author isn't saying that her daughter will never be functional, never live a productive, fulfilling life, or never be happy. She's acknowledging that some mental health issues will be with the patient to some degree for their whole life, and stating that if that's the case with her daughter, she won't love her any less or take it personally, and she'll continue to support her.

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      • I understand your point however psychological disorders are, at their base, physiological disorders and advances in the elucidation of the latter are galloping ahead. In fact, RAD has only relatively recently been identified and only as a disorder at that.
        Unfortunately, there's a lag between the discovery of these findings and the general public's education on the latter. The author herself said that they had to piece together a plan between advice and what research they could get their hands on in order to help their daughter. What I'm saying is that there may be hope. It is a tightrope walk, between cherishing potentially false hopes and accepting a more dire fate, one I don't envy any parent. But the research on learning processes and epigenetics leaves a lot of room for hope in the study of childhood traumas. I don't doubt for a second that an unconditional fierce love is held by the author, irrespective of outcomes. But again, (and these are relatively new findings, even if they have been known intuitively for much, much longer) there seems to be some hope that trauma-related disorders need not be life-long.

        • I think the author's point is legit. Her daughter has been struggling with this for most of her life. If something were to happen, she could easily disconnect again. Also, do you have a source for the 'physiology' comment?

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          • I kind of work on this stuff but please feel free to email me if you have specific questions and I can send you some info.

        • And what I'm saying is "there is hope" and "the patient may deal with this all her life to a certain extent" aren't mutually exclusive.

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          • Thanks for the discussion. It has made me think about this a little deeper the past week, including my own assertions and it has motivated me to finally write a firts post to an empty blog. It's on the sciencey side but if you want to read it, there's the link above.

  4. Such a beautiful story – I'm so glad that you were able to figure out that your kiddo was dealing with RAD and had the support all three of you needed to get help and stay connected to her.

    Our adoption agency did a lot with upfront training on attachment, even with prospective parents like me who weren't adopting older kids.

    I appreciate the previous poster who noted that adopting isn't the only way to find oneself parenting a "difficult" kid – but adopting a child who is older than 6 months who has been previously institutionalized is pretty much signing up for a rough ride in the beginning. I feel badly for parents who are not given the information they need to prepare for this and have nothing but respect for those who figure it out and do the work to make that bond happen.

    Thanks for sharing your story!

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    • You're the second person to mention "after six months." I've never looked into adoption or attachment, so I was wondering what it is about that six month mark that mean so much more emotional distress. Do you have some links I can research from? I would think that this emotional distress mark would be much older, like 3 or 4 years old, when the child can remember what is going on around them.

      • 3-4 years? Seriously? Children can remember things way -way earlier than that. And the attachment to caregiver begins at birth. Tiniest babies need a lot of tactile contact which just does not happen in the institutional setting.

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      • There's significant evidence to show that trauma begins in the WOMB. Severe stress, emotional instability, substance abuse — all of that can seriously compromise prenatal development. And trauma in the first few months of life can actually be far more damaging than trauma after the first few years. In fact, one of the most severe cases of RAD I've ever seen was in a girl adopted at 7 months old. She's 12 now, and has been in and out of residential treatment since she was 4.

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  5. I'm so sorry your little family have found yourselves living with RAD. It's such an awful, complicated, insidious disorder. It's so great you've been able to make progress and have found resources to help. I wish the three of you all the best and am sure with your love and support Julia will grow into an amazing young woman.

  6. Wow! I am in tears and can't explain how moved I am by this. How lucky your little girl is that it was you and your partner who adopted her…people who love her enough to understand her and give her the time, space and love so badly she needs. Thank you so much for sharing this…I applaude you not only for adopting this beautiful little girl and taking such good care of her but for also sharing a story that surely is hard to tell. It is so important that people talk about the different hurdles and challenges of parenthood (no matter how you got there) in a real and honest way. I can't thank you enough for your bravery.

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  7. The six month "time zone" is not one supported by research. Please, I take GREAT offense to the offhand comment that unless the birth mother "was a crackhead." … Comments like these continue to inflame a very emotional subject.

    The adoption industry that says "Everything is beautiful! Adoption is great!" do a disservice to adoptive parents. Yes, if knowing that adopting from a Russian orphanage will mean that parents will have to do more trauma counseling than 'traditional parenting,' turns of prospective parents, than so be it. Adoption is advertised in the US as a simple solution to a very complex problem.

    I do hope that Julia will live a happy life. I am an adoptee from the closed adoption era in the US, and I am in reunion with my first mother. This reunion changed my life, and made me realize where many of my attachment issues come from.

    Please, Tina, I hope that you will continue to educate yourself as to the issues of international adoption so you can help guide your daughter in the future. I would encourage you to check out http://www.thelostdaughters.com, a blogging project of female adoptees. It may be very helpful to understand what emotions Julia may be facing as she enters her teenage years.

    Laura

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    • My 18 month old foster brother's biomom was a crackhead – is the phrase 'user of crack' less offensive to you? No one realized that he had been having micro-seizures since before birth as a result of her using crack while pregnant with him, and that those seizures were causing brain damage every time.

      'Crackhead' is appropriately descriptive and most decidedly not offhand.

      As for the six month horizon, the foster parents that I work with as a GAL all state this. Additionally, the six month threshhold for brain plasticity related to neglect may be linked to speech development. (Often babies' first word occurs around this point.)

      From an article describing a study on 'mother love': "Moreover, new animal research reveals that without the attention of a loving caregiver early in life, some of an infant's brain cells may simply commit suicide. Although the growing brain naturally prunes cells during development–losing up to half by adulthood–the neurons in the neglected animals died at twice the rate of those in animals kept with their mothers."

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  8. Hayden, Thanks for clarifying. I just took issue with your original comment, that's all: "(But, if mom was a crackhead, you may still have substantial medical/developmental issues.)" … which did not distinguish that you were speaking from somewhat personal experience. Many first mothers, whether or not they strugle with drug addition, love their children and would like to keep them but many socio-economic factors keep them from being able to get the help and suppor they need.

    Even so, your foster brother's first mother was a drug addict. I'm just surprised you can so flippantly use such terminology about the mother of your baby sibling.

    "As for the six month horizon, the foster parents that I work with as a GAL all state this." — this is not research. The loss of the birth mother is pre-verbal, emotional damage cannot be "undone." Even if adoptees don't express this loss (because it was preverbal, and they may not even be able to FIND words for the loss once they begin speaking), they have lost their birth mother. Attachment to the adoptive mother and father is in addition to, attachment to the birth mother. Adoptees can be extremely resilient, finding coping mechanisms, as Julia did, to keep from potentially feeling that loss again.

    I don't mean to say that adoptees are damaged. No. I mean that adopted children are still adopted! They lost their biological heritage, their original name, their birth mother. That loss can't be undone, not even in reunion. Reunion, helps, but that's a whole other story!

    Hayden. I totally get you. I agree, babies need love, physical affection for their neuroglogical development. No doubt. And I also agree with your comments about forming secure attachments. I just wanted to make the note about not using demonizing language about birth mothers, who may not be "here" to defend themselves. That's all.

    Laura

    3 agree
    • Hi Laura,

      I can't speak from experience as an adoptee, but I would caution you against using such broad, sweeping language about all adoptees. I'm sure there are many who may not agree with you — our archives are evidence to that. I'm not saying that you're right or wrong, but the pieces we've run in the past just on this website seem to be to at least show that attachment to birth mothers isn't as black and white as you're saying — What I have learned about adoption, family and myself since the death of my birth mother springs to mind.

      Thank you to both of you for the discussion — it's definitely been interesting and a little intense!

      4 agree
    • You've read a lot into that comment: that it was flippant, that the term 'crackhead' is derogatory, and that I needed to clarify that it was from personal experience so that you would not be "GREATLY offended". Suffice it to say that I disagree with you on all of these points.

      As for referencing the foster parents that I work with as a GAL, that was intended to provide anecdotal evidence from people who work directly with foster and adoptive children and, as such, have an informed opinion. Granted, it is not a statistically valid sample size but still relevant to our discussion.

      I then followed this with a quote discussing research that IS applicable. Since I can only read articles and comment while pumping, it is done one handed, and I do not have the time to do a point by point refutation of your assertion that there are no studies that support that.

      No study has, as far as I am aware, directly explored this question but many provide corollary information as to what I am talking about. Since every child's development is variable, the 6 month horizon is not hard and fast, but it is a valuable tool for ensuring the best for the children that I am responsible for. Getting them into care with a single foster home, for an extended period of time, makes ALL the difference before 6 months.

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  9. I think one thing to think about is that this kind of 'attachment' disorder was actually adaptive- for the messed up situation the child was living in. That is not so much a mental problem as a normal reaction to the abnormal situation, and a reaction that helped that child survive through those circumstances. Now, in better circumstances, the child eventually might be able to re-adapt to a loving, nurturing context- i think that's part of what we see described in this post about how she's taken her armour off.

    3 agree

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