My hands hover over the computer keyboard. They are trembling. I hold down the shift key and type the words with intention, saying each letter aloud: “R-e-a-c-t-i-v-e A-t-t-a-c-h-m-e-n-t D-i-s-o-r-d-e-r.” The words “reactive attachment disorder” are memory beads I gather into a pile and attempt to string along on a necklace.
I think back to when Judith, my neighbor who is a psychiatrist, offhandedly threw out the term the first time she met Julia. We were talking about babies who start their lives in orphanages, and she mentioned the disorder. She wasn't suggesting that my daughter Julia showed any signs, but she’d said it was a well-known problem with children who’d been adopted from Romanian orphanages in the '80s and '90s. I remember nodding my head and thinking, Shut up, Judith. We got Julia young. It shouldn't be an issue.
Then, when I raised concerns with Dr. Traister about Julia’s elusive but controlling behavior when she was a toddler, he also mentioned reactive attachment disorder. Did I want a referral to a therapist, he wanted to know.
No, I wanted to be like the other mothers sitting in his waiting room, worrying about a sniffle.
Now I remember something he said: The signs of reactive attachment disorder usually reveal themselves fully when a child reaches five- or six-years-old and they start having trouble in school settings. But when is it too late for a relationship to establish or to reestablish? My daughter was cut off at birth from nurturing and love. There was no one there to soothe her. Just because I want to love her doesn’t mean she’ll let me—or let anyone.
I retrain my eyes on the computer screen. There are scores of hits on “reactive attachment disorder.” I could scroll for days and there would still be things to read. I click through to the Mayo Clinic website. It says:
Reactive attachment disorder is a rare but serious condition in which infants and young children don’t establish healthy bonds with parents or caregivers.
A child with reactive attachment disorder is typically neglected, abused, or orphaned. Reactive attachment disorder develops because the child’s basic needs for comfort, affection, and nurturing aren't met, and loving, caring attachments with others are never established. This may permanently change the child’s growing brain, hurting the ability to establish future relationships.
Another source says, "The core feature [of reactive attachment disorder] is severely inappropriate social relating, which can manifest in two ways: 1. Indiscriminate and excessive attempts to receive comfort and affection from any available adult, even relative strangers. 2. Extreme reluctance to initiate or accept comfort and affection, even from familiar adults, especially when distressed."
Bingo. I've often seen this behavior in Julia: She wants to be in control, and she’s more interested in manipulating than in truly relating. In public, Julia is the waving beauty queen, the mayor of wherever, the cheerful, friendly, squeezable, adorable mascot. She runs to adult strangers, hugs them, works the room. She solicits their attention and wraps them around her tiny, agile fingers. She’s good at it. As for children, she shows little interest in them.
Strangers or fleeting caretakers tell me I have the most adorable, delicious, precocious, confident child. Some say she’s the most adorable, delicious, precocious, confident child they've ever encountered. I nod and smile and pretend to share their sentiment, but I keep my thoughts to myself. How can I explain to a stranger that at home this child is distant, elusive, emotionally closed off, and defiant? What stranger will not say, or at least think silently, Really? I don’t see that. It must be you because she’s not like that with me.
But the list I’m looking at is uncanny. If I had been asked to describe Julia, this is the list I would have come up with independently. The child is “superficially charming and engaging, particularly among strangers she feels she can manipulate.” Next, the lists say the child “doesn't have close friends.”
One day, my husband Ricky saw I was trying to play “dolls” with Julia, but I couldn't get her to role-play. He’d casually said, “Maybe she doesn't know how to play with someone else.” At the time I thought it must be me. Maybe I didn't have my heart in it and Julia sensed it. I realize now Ricky’s was a brilliant observation. Julia can keep herself entertained, perhaps longer than a “normal” four-year-old, but the only way she can “play” with someone else is to direct or orchestrate. It is never give-and-take, never back-and-forth.
“Doesn't make eye contact. Has a severe need to control everything and everyone. Is hypervigilant. Is hyperactive. Is lazy performing tasks. Has trouble understanding cause and effect. Has poor impulse control. Chatters incessantly.” Uncanny.
I’m often asked by a teacher or babysitter, “Does she ever stop talking?” I smile because they think Julia is simply a chatty, precocious child. But it’s not like that. She chatters from the moment she wakes to the moment sleep steals her from her worn-out vocal chords. She chatters incessantly at the table, in the car, while she’s playing. She escalates the chatter when Ricky and I start to have a conversation or when the phone rings and I answer it. She uses the chatter to control her environment.
Ricky has a theory about it. He thinks Julia chatters constantly to soothe herself, to make herself feel present. He thinks silence and stillness scare her because she’s afraid of her internal thoughts. Afraid to be, not by herself, but with herself. She manufactures noise because she fears her inner world. Then, when Ricky and I try to have a pointed conversation with Julia, she will say “What? What?” and avert her eyes. She pretends not to hear the question. She turns the exchange into a power play.
I return to the list on my screen. So far, the first 18 traits are a perfect match. But then I see other characteristics that absolutely don’t describe Julia. She is not “cruel to animals.” She has not shown any “fascination with fire, blood, and gore or an interest in weapons.” She is not “self-destructive,” and even though she does not take care of her possessions herself, nor shows any affection or pride of ownership for a favorite toy or teddy bear, she’s not intentionally destructive in our house. Nobody has suspected she has any “developmental or learning delays” and she doesn't “steal or lie.”
Some psychologists believe that reactive attachment disorder is a legitimate dysfunction that affects children whose maternal bonds were severed or grossly compromised early on. Others debunk it and say it’s a made-up diagnosis. But those who treat it as a viable disorder say a child’s brain gets rewired when her basic needs have not been met or are screwed with. They say the brain actually changes physiologically when children suffer this kind of deprivation.
Parents going through the adoption process are warned that a child who has begun life in an orphanage may be delayed. Ricky and I had steeled ourselves for the likelihood that Julia would need extra time to sit, crawl, walk, speak, potty train. But Julia, a Lilliputian Olympian, hasn't missed a cue. She sat up on her own days after we brought her home. She crawled shortly after that. She walked at 12 months, ran a minute later. She started making words at one year.
She potty trained herself—and I mean herself—within a week of her second birthday. Her teeth grew in before many of the other toddlers’ teeth did in her playgroup, though the front ones were rotten from decay and lack of calcium. She has never been challenged in motor skills or coordination or cognitive ability. Julia’s been on the fast track. The only “delay” she had was growing in her silky, wheat-colored mop. She was bald until 18 months, but I wasn't too worried. I bought her cute hats.
At every turn, I told myself that this child is okay—she must be okay. She’s met every milestone. At the same time, she was detached. When I’m sick like the dickens, Julia shows no concern or empathy. As she got older, she showed constant opposition to everything, anything. She has a dire need to be in control. If I ask Julia to bring me something, say a book, she makes me wait and wait. She enjoys hearing a second request and then a third, more impatient one. When I lose patience and get up and get the book myself, she smirks.
Now I understand. Kids with RAD are extremely challenged when it comes to connecting cause and effect, but there’s another explanation, too. Julia has a history of hurt we can’t erase.
She’s been with us for three years and four months, but she subconsciously knows what it’s like to slip permanently from her mother’s arms. She understands the dizzying tumble from warmth and security. She remembers, no doubt, what it’s like to lie in a crib and wonder who, if anyone, will attend to her needs and when.
Then, one day, a man and a woman showed up, put her in a yellow snowsuit, spirited her away in the dark night, and then took her on something called a plane. And although these people who took her away had the very best intentions and thought this little child must realize how lucky she is to have escaped life in an orphanage, she must have been lying in that unfamiliar crib contemplating, What will happen next?
Julia knows she’s dependent on these strangers with their unfamiliar hands and foreign sounds and odd smells to feed her and change her diaper. She tolerates it, subconsciously waiting for something she remembers in her heart to return to her. And it doesn't. Over time, indifference morphs into anger. Her resolve hardens. I won’t let you love me. I won’t love you. At four, she’s a vessel of resentment, seething because I deign to call myself her mother.
There is a lot of advice for raising kids with RAD. Some of it seems extreme—and controversial. Something called “holding therapy,” which forces children who resist intimacy to be held against their will, seems wrong. Instead, we’re focused on parenting techniques that anyone would agree seem counterintuitive. Imagine having to say to your child, “I know it’s scary to love Mommy. But Mommy loves you and she always will.” Not something most birth mothers ever think to say to their kids.
The basic idea behind the parenting techniques is to “rewire” the child’s mind. When you shift, they do too, the theory goes. For example, children like Julia don’t feel punished during a time-out—they are relieved. It vindicates their belief that they are alone in this world. Being alone is a RAD child’s best solace. It gives them the emotional space they crave. Instead of reprimanding the child with time-outs that send them to their room or isolate them, the books say to do the exact opposite. Give them “time-ins.” Keep them close. Force them to communicate. Keep the bond solid, even if you are mad and the child is unglued.
This post is adapted from Tina Traster's Rescuing Julia Twice: A Mother's Tale of Russian Adoption and Overcoming Reactive Attachment Disorder.