fbpx A Family's Journey with Reactive Attachment Disorder
Authored by Nexus Family Healing on February 8, 2024

*A disclaimer before reading: I reference a county social worker in this article. Our Nexus workers have always been advocates of our family and each child. Similarly, most county workers we have worked with have been much more thorough. This is more of an anomaly, not the norm. But it does happen.

Our son was placed in our home after we had done respite care for him twice. He was 12 at the time, and very much in that awkward-yet-adorable adolescent phase. His smile was charming, and his eyes seemed sincere. I felt attached to him pretty quickly. 

When we were told by his social worker that he was being put on an adoption website if a family was not soon found for him, my husband and I began to pray. We got along with him very well, and our other kids seemed to enjoy having him around, too. We thought maybe we were the family meant to be matched with him (we still believe in God’s plan in this).

We barely knew him, except that we knew he had been adopted as a toddler and left at a residential facility eight years later when he was 11 years old. We did not know why, and we did not have a clear picture of what had happened. There was a county worker who demonized the other adoptive parents, and said our family was his hope and what he deserved. Honestly, we felt pretty special, and we felt like we had a genuine connection with him. We started processing pre-adoptive papers two months after meeting him (about one month after him moving in), at the prompting of the county worker.

We met our son in May of 2019, and he was adopted by December 2019. Anyone who knows adoption knows this is extremely fast. It should have been our first red flag about something deeper we did not yet know. In hindsight, I wonder why I didn’t ask more questions… and not because we wouldn’t have him in our family either way, but to set up support and to understand the extreme needs he would have. I wish I would have had the experience to push back and demand more information from the county.

I would ask: 

  • What really happened with his first adoptive family? Why would they do such a desperate thing, knowing the harm it would cause? What did life look like for them, and what sorts of help did they seek before this decision?
  • What are all of the diagnoses? What do they mean? To whom can I talk about the day-in and day-out needs of a person with these diagnoses? 
  • Why is the county worker telling him that we are his only chance?
  • How does insurance work with or against us as we seek help for his upcoming needs? 
  • Does he need an only-child situation, or are siblings a good thing for him?

I now know you can’t ask all the right questions if information is withheld from you. The county held the information, providing only some, and other information was also missing because our son was previously adopted and those records remained with the first adoptive family. Despite our thorough and caring licensing worker asking for this, we were told we could not get those records.

After a couple years of extremely bizarre behavior, a never-ending game of tug-of-war, and anguished cries of desperation from yours truly, I requested a new diagnostic assessment, and it revealed Reactive Attachment Disorder - RAD. Previously, we knew about the diagnoses of ODD (oppositional defiant disorder) and IED (intermittent explosive disorder), uncovered by assessments done while he was in his previous foster home, but RAD is something entirely different. RAD feels like a bomb dropped on your life, especially the longer you went without knowing. Trying to force attachment and family on a child/youth with RAD can do a lot of harm to him and the entire family.

Reactive Attachment Disorder

Reactive attachment disorder develops from early trauma, especially the trauma of neglect as an infant. Attachment is formed in early infancy: a baby gets its needs met and connects with the nurturer, a baby learns to trust. When this does not occur, the brain wires differently, and attachment to caregivers is more than difficult to make. Nurturers and caregivers are seen as the enemy, as a child/youth with RAD will try to become autonomous to minimize the subconscious threat in their brain. The resulting behaviors can be alarming.

For us, RAD has looked like:

  • Chronic theft of random items in the home, including our daughter’s hair ties, an iPad, cleaning supplies, Legos, and other items that don’t always make sense/would have no value to him
  • Spying on me in the shower 
  • Urinating in bottles, vases, and cups, and keeping them in his room
  • Charming personality with a lot of deceit or manipulation behind it
  • Triangulation between us (parents) and therapists, teachers, etc.
  • Explosive episodes when we are getting “closer” or having good days
  • Risky behavior, including drugs
  • Lack of remorse
  • Cutting off his (adoptive) sisters and brothers, acting as though they don’t exist
  • Dangerous operation of a car at high speeds, resulting in three police cars pulling him over (he then appeared very calm and remorseful and received no charges)
  • Failing multiple classes in school every semester, despite having no IEP or extra educational needs
  • Charming teachers, administration, and even law enforcement out of disciplinary action
  • Quitting all sports, one by one, despite excelling at every single sport
  • General self-sabotage: when things are going well, it’s time to tear it down
  • Rage episodes that result in damaged property and relationships

All of this is difficult to manage and live with, but I hear a quiet whisper from above reminding me that my son is still human, and that there’s hope for a future if we can get the help he needs and deserves. My next logical question is: How can we get him the help he needs? And what does that look like? 

Long-Term Outcomes for RAD

All of my research about RAD hasn’t revealed a lot about the healing process or the long-term outcome. This is hard, too. As a parent, I’m desperate for answers. The one common fact I’ve found is that many kids with RAD benefit from residential treatment because the “threat” of family and nurturing is not there. They can learn to do a lot of things necessary for everyday living from a treatment center that they will not accept from family, simply because family (especially the more nurturing caregiver) feels threatening to them.

Had I known this early on, I do believe residential treatment, specifically a place for kids with RAD, would have benefitted him and given our family more resources. He would come home with skills he needs, and we would have time to separate ourselves from the hardship in order to do the deep work necessary to parent and mentor him in a way that is actually beneficial to him. The way I loved him and cared for him was actually working backwards in his life, and this is something I had no way of knowing. I’m still learning.

We are in limbo right now. We are seeking more help and more treatment, but the logistics are daunting and there are blocks around every corner (and we feel rushed! He is 17 now!). To get insurance to help, you need a mental health case worker. We are in the works of establishing one, but we are on a waiting list since he had the required interview to even establish a case worker. Though recommendations were made based off of his interview, we still wait on the steps that are in everyone else’s hands. I am the squeaky wheel every week, calling the county and the mental health workers; I am relentless in pursuit of getting him help. This is how you must be if you are a foster or adoptive parent, but double down if you are parenting a child with RAD, especially if that child has dangerous and/or explosive behavior. I used to feel bad about it, like I should feel guilty for making our/his needs known. However, my advice to all parents is to keep putting yourself at the front of their minds. Be kind and considerate when communicating with them because their jobs are so hard… and so is yours.

Living with RAD

Our son has therapy twice a week, but it’s a constant battle to work around his triangulation between his therapist and us. He is at a supportive school, but his endurance fades fast, and a good first quarter usually means a bad/failing second quarter as that endurance fades. We have a prayerful and uplifting community around our family and our son, and that’s a gift, but it can be hard for them to know what to do to help us tangibly. We often don’t even know how to begin asking for help because, unless a person is trained in this, it feels irresponsible to place our son in their care, especially if they have children.

We are actively trying to figure out how to help our son have a hopeful future. We have fight in us, even when he’s lost his internal battle for his own well-being. We are damaged as a family, but we will not let it all destroy us or him.

So, I don’t know much about how to help yet, but my promise to other parents of children with RAD is that when I find out more, I will share. I will share the process, the things I wish I had known, ways to advocate, and how to take care of yourself and your family through it all. When I know more, I will share more because I am in the trenches with you right now, and you are not alone at all. You’re not crazy. You’re not cruel. You’re not hopeless. You’re not weak. You are doing some of the most challenging work on this planet, and we can’t predict if that will yield fruit in the future or not. However, we can know for sure that our efforts aren’t for nothing, even if the outcome is not what we hope for, now or ever.

On the worst of days and best of days, consider these questions: How is this experience making me stronger? How am I becoming a person of integrity as I work for the best without the expectation of something in return? How am I learning to love/care for my child differently than my instincts, and how does this help me be more considerate in general? 

And – in my last days of this life, will I regret trying to help someone, even someone who may not love me back? I don’t think I will. 

Nexus Family Healing is a national nonprofit mental health organization that restores hope for thousands of children and families who come to us for outpatient/community mental health servicesfoster care and adoption, and residential treatment. For over 50 years, our network of agencies has used innovative, personalized approaches to heal trauma, break cycles of harm, and reshape futures. We believe every child is worth it — and every family matters. Learn more at nexusfamilyhealing.org