A New Name for Reactive Attachment Disorder

This wasn’t the topic I’d planned for today. But the last few weeks, I’ve been seeing more and more information about a new name for Reactive Attachment Disorder. Reactive Attachment Disorder hasn’t been on the radar of psychiatrists and the DSM (the manual used for making diagnoses of medical and psychological illness) for many years. If you have a RAD kiddo, you may have found like me that a lot of mental health professionals haven’t even heard of it. 

And many times, as a lot of you have also experienced, RAD is misdiagnosed as other disorders. Sometimes it’s because they are looking at symptoms and not causes. August was diagnosed with ADHD, ODD and one therapist even suspected Asperger’s. Finally we found the psychiatrist who knew what he was talking about. Then we understood what we were dealing with.

But lately a group of psychologists have been talking. There is a new term being discussed and developed to talk about trauma-affected children. There is a group of 10 mental health professionals working to coordinate the understanding of childhood trauma. They are describing the effects it has on the brain, the long-term behaviors, the ability for normal relationships and attachments and more.

I am including the link to the article which most plainly explains this progress here.  Then this article explains what the diagnosis might look like. You will see quickly that it looks a lot like RAD. 

So is this new name and inevitable inclusion in the DSM going to finally get us some real answers to treatments which will work and trained therapists? Well, it’s not that much good news. But it does give us a simpler explanation for the real long-term effects of childhood trauma. We might be able to carry this with us to help explain our kiddos better to doctors, therapists, teachers and others. For example, here’s another article that helps simplify the new diagnosis. 

I’m not completely comfortable with it yet. I still want to hang on to RAD because emphasis on that “attachment” piece is missing in this new diagnosis. That is also what is missing in our trauma-affected children. But it is the first time in a long time that any attention has been paid to what happens to our children in those early years and what needs to be done to help them. So I’m giving a big cheer!

I’m going to be keeping an eye on this one and seeing what happens. I would suggest you talk about what your child’s official diagnosis is as the new DSM is released. This may be of particular importance for insurance coverage for residential treatment, disability insurance and other payments. 

Until next time,

Shannon

 

Early Childhood Trauma in the News

I am writing about this because I know that anyone who’s been awake over the last year and has a RAD kiddo has been thinking the same thing I have been. What is going to be the fallout of the family separations that are taking place at the Southern Border? How will this early childhood trauma show up down the road? I am not writing this as political commentary but purely from the standpoint of the psychological aspects of what the children are going through.

It is not part of their plan for these families to be separated. The children are not aware of what is happening and why. The main difference between these children and those in an orphanage overseas is that they aren’t given up willingly. However, the separation from a primary caregiver at a crucial time of bonding without knowledge of when or if they will be reunited is the same.

I found a couple of articles which discuss the short- and long-term effects of this separation on the children. I think as you read them you’ll see astonishing similarities between how the psychologists describe the children and our own RAD kiddos. The first is this one from The Washington Post. What I find most striking is the description of the pruning of the dendrites or nerves of the brain. This is almost exactly how the psychiatrist who diagnosed August with reactive attachment disorder described what the lack of bonding with a primary caregiver did to his brain. Exactly! I couldn’t believe it. So much of the description of the symptoms is spot on.

The second one I wanted to reference is this one from The New Yorker. It’s much more recent having been written just three days ago. The psychologist in this article talks about the effects on both younger and older children and how they are different.

One of the important parts of this article is how it discussed the effects not just to the brain but to all the body systems: the immune system, the cardiovascular system and others. August is small for his age and has hung on to the bottom of the growth chart most of his life. Now we don’t know his genetics so there’s no way to know if that’s just how he is or not. But his psychiatrist told me early on about a condition called psychosocial dwarfism. It’s where children are able to actually will themselves to stay small in an effort to try and keep from having to become independent or take on more responsibility. As soon as I read that part, its immediately what I remembered!

If you Google “effects of separation on immigrant children” you can read lots of other articles on the subject. I am sure you will see your RAD kiddos in the descriptions as well. I hope there will be time for these relationships to be repaired and these children to be healed.

Until next time,

Shannon

Feeling Like A Failed Parent

This was not the post I had planned for today. I started writing it Saturday after a very long week last week. Some things happened with August and I ran out of antidepressants and I wasn’t sure I’d make it out of bed. And for the first time last Thursday I said these words out loud, “My son is a psychopath.” And now I’m feeling like a failed parent

Not my proudest mom moment.

I suppose this needs some explanation. The last couple visits with August had made me uncomfortable. I know Reactive Attachment Disorder inside and out. I have read and studied it for years and I understand what it looks like. This wasn’t RAD. I talked to him about various things some of which dealt with his behavior and how it affected people in his life. He said outright he didn’t care if he hurt people. He didn’t care if he used people for what he could get from them. Maybe it was for show. Maybe it was to look cool or strong. But it seemed all too real.

He talks about life after prison. His clothing, his lifestyle, how much money he will have. It’s all the best of everything. That is what he looks forward to. Nothing is about relationships with his family or friends. Nothing is about making a better life or repairing the damage he has done. He is not missing being separated from us at all. He says, “I love you” at the end of visits and phone calls but it’s always to hard to believe. 

I am still trying to piece together what has happened but near as I can tell he’s pulled some friends and friends of other inmates into some scheme that has gotten him and them in more trouble. He obviously didn’t care that he knew what he was doing was illegal and also illegal for them because he did it. Though I’m not completely sure he knew what he was doing. And it might mean extended time for him. I don’t know. Our conversation today revolved around his anger that he was in solitary and that maybe those he got caught up with might say something that would get him in trouble. 

Here’s the thing. July 5th. On July 5th he was six months without a conduct issue and was going to be eligible to get into a program which would get him moved to another dorm with stricter regulations which would help him stay more focused, and the program completion would get him reduced time and the possibility of a sentence reduction. But here we are instead.

Psychopathy isn’t the actual psychological term. It’s actually Antisocial Personality Disorder. For information about it, you can check it out here.  It is distinguished from sociopaths by severity and contrary to made for TV movies, they are not always violent serial killers.

But now I am sitting here wondering what validity I have as a parent to be writing to you all. I know my child is wounded from harm that I didn’t cause. That his brain is physically damaged. But it is also harm I couldn’t heal. And he harms others with seemingly no concern for their well-being. I started writing because I thought I had something to give to parents to help them avoid some of the mistakes I made. To provide a resource where parents could come together and learn some tools that would help them along the road to healing their children.

But I sat in that visiting room and listened to him. And now this has happened. And now I feel like such a fraud. 

Taking care of ourselves also means knowing when we’ve done all that we can for our children. His father has been much better at that. I keep wishing and fighting and hoping. Maybe in vain. Looking for that spark of empathy that I hope will magically appear maybe when his brain fully develops. My therapist years ago said that maybe August sabotages his progress in there because he feels safe in there and he doesn’t really want to get out. In there he doesn’t have to make choices of right or wrong where he has repeatedly made the wrong ones. Maybe when he voluntarily decides to take the medications that will help his brain function better things will change. Or maybe it won’t and I will finally have to realize I’ve done all that I can. Can a mother ever do that? 

Pondering the next time,

Shannon