After years of violent tantrums from their son with reactive attachment disorder (RAD), Cindy and Brian were accustomed to calling the police and taking him to the emergency room. Their son stayed in psychiatric hospitals eight times by the age of 12. Cindy and Brian now understand, after their time with professionals at the Institute for Attachment and Child Development, that their son wanted to stay in those hospitals. They realize that violence is their son’s way to control his surroundings and, in his mind, to keep himself safe. It is a dynamic that, as Cindy says, “is not what a typical parent is going to understand.” Reactive attachment disorder is an extremely complex and tricky issue. In fact, many professionals don’t really comprehend it, including hospital staff.
The desire for ultimate control comes from the brain
Children with RAD seek control to avoid vulnerability and alleviate their brains wired for fear. Reactive attachment disorder primarily occurs due to abuse and neglect before the age of five. As we know from internationally acclaimed clinician, educator, and researcher Dr. Bessel van der Kolk, child neglect and abuse shapes children’s malleable brains. The brains of children who experience persistent danger and fear look differently from the brains of children who do not. Even after children are removed from abusive and neglectful homes, their brains remain “stuck” in the fight, flight, or freeze modes and at much younger ages than they are chronologically.
Much of the bewildering behaviors from a child with RAD stems from their need for control. Children with RAD will control their environments at all costs, even when it is to their own detriment—from refusing to eat their favorite foods prepared by their mothers to intentionally harming themselves to visit emergency rooms. As Brian says in the interview, his son preferred going to the hospital rather than with his parents on fun outings, such as to the park. This is because the fun outings were his parents’ plans and not his. He decided to go to the hospital and made it so to gain control.
This is the second in a new video series called Parent Talk about RAD. Please watch the next clip here.
But why hospitals?
Brian and Cindy’s son indeed controlled his surroundings to the point that he stayed at most of the psychiatric children’s units in the Denver area. He was violent to the point that his parents had no other options. But why hospitals?
Children with RAD seek environments where they can avoid authentic attachments. As Cindy chuckles in her interview, her son liked the food at some of the hospitals. Yet, there’s more than the food and lack of chores that attract children with reactive attachment disorder to institutions.
Brain and Cindy’s son desired to stay in hospitals, rather than in the comfort of his own home with parents who love him, because of the artificial environments institutions lend. Children with RAD often appear to do “well” in institutions because they don’t have to live real life or attach to anyone. They have nothing to lose.
The artificial environments of institutions include:
- The schools within them, if any, exist to serve the purposes of the institution, not primarily to serve the educational needs of individuals.
- Institutions do not include permanent live-in parent figures who truly know the children with RAD, want to get to know them, or desire to attain genuine relationships with them. The children don’t need to trust anyone and no one needs to trust them. The staff members rotate in and out, coming and going from the “real world” and their homes.
- Behavior modification plans present a series of hoops for patients to jump through without any real life consequences or benefits.
While the children have nothing to lose in these environments, they also have nothing to truly gain—no real failures from which to grow, no real feelings for and from others, no real achievements to celebrate, no real life to live. While some children with RAD appear to thrive in such environments, they are actually merely existing. When they return to their homes with parents who want so desperately to attach to them, the difficult behaviors pick right up where they left off.
When institutions make sense
If parents understand when hospitals are helpful as well as how they are not, institutions can serve a short-term purpose. Institutional care won’t help children with RAD to learn how to attach and have healthy relationships. Sometimes, however, institutions provide safety for the children and their families. Other times, the only way parents of children with RAD can find a much-needed break is through residential treatment centers. These are both extremely important reasons.
Parents of children with RAD often spend many years and resources going down the wrong path. It is important for parents to know the reality of their situation, what is effective, and what is not. If you’re a parent, continue to educate those around you about RAD. If you’re a professional, continue to educate yourself. Those raising children with RAD need strong support systems to keep going, which is the very thing they often lack.
Watch the whole Parent Talk about RAD series: