Adult RAD Rehab
Search "What is Reactive Attachment Disorder?" and you will find links that focus on the child, with very little mention that adults would have this condition. It has been established that the majority of patients being treated for RAD are adoptees. Imagine just how many adults in the United States have been adopted, and abused, and have the symptoms documented as RAD behaviors.
IN INFANTS:
Weak Crying Response.
Rage.
Constant Whining.
Sensitivity to Touch/Cuddling.
Poor Sucking Response.
Poor Eye Contact.
No Reciprocal Smile Response.
Indifference to Others.
IN CHILDREN:
Lack of Conscience Development.
Superficially Charming.
Lack of Eye Contact (except when lying).
Inability to give and Receive Affection.
Extreme Control Issues.
Destructive to Self, Others, Animals and Property.
No Impulse Control.
Unusual Eating Patterns (hoarding, gorging, or refusal to eat).
Unsuccessful Peer Relationships.
Incessant Chatter in Order to Control.
Very Demanding.
Unusual speech patterns, mumbling, robotic speech, talking very softly except when raging.
Associated Features
Learning Delays and Disorders.
Depressed I.Q. scores. http://www.psychnet-uk.com/dsm_iv/attachment_disorder.htm
My understanding and study of Reaction Attachment Disorder leads me to believe this “mental illness” is a conditioned thought process rooted in anger, fear and betrayal. The depth and scope of these negative feelings depend on three major factors: the type and duration of offensive treatment a child has experienced, the anatomical and biological structure of the brain, and the level of heart-felt feelings of resentment an individual feels towards those influencing their environment. RAD is a crime of passion all of it’s own, leaving the victims terrified to trust the words of others, ever again.
It’s been suggested that neurofeedback has been successful in the treatment of behavioral problems linked to RAD, but I personally question the use of electricity to manipulate brain activity.
"Neurofeedback is being used as an addition to many psychotherapists' practices as a boost to a sagging 'talk-therapy' practice Since in most states there are no licensing requirements, therapists who have little knowledge of physiology or computer technology can use the equipment with little oversight. The client can be hooked up and the computer program does the training with little effort on the therapist's part. It adds a high-tech effect to the session and makes the whole procedure seem more credible.
In the Gravelle case in Huron, Ohio, 11 adoptive children were given thousands of hours of neurofeedback training at a great cost to the county with seemingly little improvement in their conditions. The criticism is that neurotherapy was given to them for an array of different problems simply because the funds were so easily available. http://en.wikipedia.org/wiki/Neurofeedback
The clear message in this statement is talk-therapy needs a boost because it does not work for certain types of patients. Most RAD patients are people who have been used and manipulated by people in position’s of authority. How does this problem get managed by many mental-health practitioners? Medication or artificial manipulation of brain waves.
Until therapists understand RAD’s have difficulty maintaining emotional connections with others because honesty hurts, little progress will be made in teaching them how to trust and love with feeling.
RAD’s need to be taught how to re-parent themselves in ways that are positive and nurturing because they were denied their natural parents and proper protection during critical times of brain development. This requires time and patience and ideally, scientific diagnostic evaluation, not random, artificial manipulation.
In my next post, I will discuss how and why the goal in treatment should be focused on the need for client control and effective communication during the course of mental re-training.
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Comments
control
I can very much related to the need for client control as you mentioned in your last sentence. Over the years I've seen two therapists. The first one would sit in her chair with a serious look on her face and I felt she weighed every word I said. For obvious reasons this didn't work out. The second therapist I had, would receive me in his office, then get out to get coffee (which I always love having and he made good coffee too). The key point for me was, I could in my mind take ownership of his office while he was getting coffee. I could go through the books he had and even borrowed some to read. During the therapy, which lasted for eight months, one session a week, I had the feeling I was in control of what was happening. Of course the therapist would give certain directions and make suggestions, but I never had the feeling I was pushed in directions I didn't feel like taking.
Rules to RAD
Stress, and how it gets relieved is a huge issue that needs to be factored-in the relationship with the adult with RAD. This adult is no longer a child with developing coping skills. These skills have been used, tested and perfected. What is relief to one may be a source of stress for another. (Is it any wonder why many adults with RAD turn to drugs, sex or personal injury for physical and emotional release?) I believe how a person reacts to stress reflects how that person distracts (or detaches) himself from physical pain and emotional tension.
I found the following description from http://www.attachmentparenting.org/pdf/taskforcepaper.pdf. It reflects the reasons why adults have difficulty finding effective attachment treatments and therapies:
According to the DSM, the core feature of RAD is
severely inappropriate social relating that begins
before age 5 years. The style of social relating among
children with RAD typically occurs in one of two extremes:
(a) indiscriminate and excessive attempts to
receive comfort and affection from any available
adult, even relative strangers (older children and adolescents
may also aim attempts at peers) or (b)
extreme reluctance to initiate or accept comfort and
affection, even from familiar adults and especially
when distressed (APA, 1994). RAD is one of the least
researched and most poorly understood disorders in
the DSM. There is very little systematically gathered
epidemiologic information on RAD. In its absence,
much of what is believed about RAD is based on theory,
clinical anecdotes, case studies, and extrapolated
from laboratory research on humans and animals.
Similarly, the course of RAD is not well established.
Long-term longitudinal data on the outcomes of children
diagnosed with RAD have not been gathered
(Hanson & Spratt, 2000).
It appears difficult to diagnose RAD accurately. No
generally accepted standardized tools for assessing
RAD exist, and several interview procedures in the literature
misdiagnose inappropriately high numbers
of children as having RAD who, in fact, appear to have
only mild to moderate symptoms (O’Connor, Rutter,
Beckett, Keaveney, & Kreppner, 2000). In addition,
several other disorders share substantial symptom
overlap with RAD and, consequently, are often
comorbid with or confused with RAD. For example,
disorders such as conduct disorder, oppositional defiant
disorder, and some of the anxiety disorders, including
posttraumatic stress disorder (PTSD) and
social phobia, all share some features with RAD.
Symptom overlap can lead to a failure to diagnose
RAD correctly when it is present, and to overdiagnose
RAD when it is not present.
RAD also is distinct from, but may be confused
with, several other neuropsychiatric disorders involving
severe and pervasive problems with social relatedness,
such as autism spectrum disorders, pervasive
developmental disorder, childhood schizophrenia,
and some genetic syndromes. In addition, some children
simply have temperamental dispositions toward
either rapid social engagement on one hand or shyness
and social avoidance on the other, and neither of
these normal variants in social behavior should be
confused with an attachment disorder. Some children
simply learn odd social habits because of living
in institutions or other unnatural environments, and
these behaviors may mimic psychiatric disorders. Because
of these diagnostic complexities, careful diagnostic
evaluation by a trained mental health expert
with particular expertise in differential diagnosis is a
must (Hanson & Spratt, 2000; Wilson, 2001).
Without the scientific study of the brain's structure, function and it's ability to learn how to love and trust another human, evaluations and treatments for those with attachment disorders are subjective and varied.
I personally believe the adult who suffers with a disdain and mistrust of others, especially when stressed or hurt, must learn to parent himself the way he believes it should have been done, originally. Can this be done alone? No. There needs to be a safe source outside of his inner-self where positive and encouraging feedback is given, and acceptable means of physical or emotional comfort can be received.
Because each person's life-experience is different, I think there needs to be simple rules established for the relationship with an adult RAD.
I'm curious how many adoptees or adult victims of child abuse/neglect have met with therapists who understand the power of pre-verbal grief and parental rejection? Perhaps the better question to ask is, what therapists DO appreciate and acknowledge the needs of those broken with mistrust?
Just stop it...
I don't know a lot about these things. So, I am learning from all of you and I it only reinforces my opinion that we should support families and not take children away from them. And if, for serious reasons, it is better for the child to grow up elsewhere, to do it in an honest manner. Respectful. No secrets. And no change in identity, ever.
PeoPLe are who they are. For good or for bad. But we should not mess up the basics of life.