Monday, March 30, 2009

R.A.D.-Reactive Attachment Disorder

I feel like I don't know much about Reactive Attachment Disorder, but then again, I realize that I must because I have been living with it for 15 months. I really don't like labels, and I think they are over-used. I noticed this when I worked in Detroit Public School and every child was labeled ADHD. In addition, at the residential treatment facility, every girl was medicated for some "mental health" disorder.

However, in my opinion, RAD is not a "disorder" that an adopted child either gets or does not get diagnosed with. I think that the symptoms descriptive of RAD are a REACTION that every adopted child has to some degree. Now, some obviously have RAD to a greater degree than others. But honestly, can a child go through what an adoptive child goes through and not have signs and symptoms of RAD--I am clearly not referring to those children adopted from birth.

I read and re-read the criteria for RAD and didn't think Ruthie displayed any of symptoms. She is affectionate and makes great eye-contact. She had never tantrumed, screamed, hurt others or animals, or been defiant. I really just thought she was a child who was developmentally delayed, needed to learn to follow rules, and that she was just really forgetful. I have since learned that her "developmental delays" are an act, that "forgetfulness" IS a symptom of RAD, and both of these things lead to behaviors which she does ON PURPOSE to push me away, make me angry, and try to make me push HER away. It is almost as if she knows what my buttons are and she enjoys pushing them.

Here is a classic example: Ruthie has been taught to buckle her seat belt, which she has done wonderfully for months. Then one day, we are out grocery shopping and the kids did a great job. I had a pack of gum and told them that once they were all buckled in they could get their piece of gum. Guess what?? Ruthie can't buckle herself in. She is actually turning the buckle perpendicular to the metal piece into which the buckle inserts. Cameron and I look at each other in confusion and wait patiently. I began to encourage her. The time ticks by as we wait, smiling, knowing she can do it. She begins to panic and cry. I remind her that a piece of gum is waiting. I begin to really think she can't do it. She is upset and cannot figure it out, but I am confused, knowing she has done it for MONTHS with no problems. I finally buckle her in and hand her the gum. Since that day, she has not had a problem. Cameron and I wonder what was going on? Why couldn't she do it? She must NOT have been able to do it. But guess what? Later, much later--like weeks later, Ruthie confesses she did it on purpose. WHAT?! WHY? WHY? WHY? I want to ask. But, if you do ask, you will get this answer, "I don't know," and you know what, I am beginning to believe her. I don't know if she knows why. She risked not getting a piece of gum. She even cried in her panic of not being able to do it, but the thing is SHE DID IT ON PURPOSE!

That is RAD. That is jut one of HUNDREDS of examples of what we go through on a daily basis. I am not exaggerating. For a year, I thought Ruthie was learning disabled. I thought something was wrong with her memory. I thought she needed to be tested for IQ. My eyes have been opened to the reality of what is going on and it scares me more than having a child who is "slow" because instead of putting her in a special class or something, I am in the midst of a battle for control. These defenses are in place to keep me away. It works, though. It does want you to give up. It is hard.

I have heard other adoptive parents say that they are having a difficult time attaching to their adopted child. They think something is wrong with them that they don't like their child. They hate themselves and think they are the most evil person. You know what? That is a sign of RAD. It is the child working to make you not like them, to make themselves unlovable, to make you angry, and to push you away so that you WON'T attach to them. It really works. They are experts at it.

So, how do you fight this? How do you attach to a child who does not want you to attach? To a child who enjoys--for some reason I can't understand or explain--seeing you get upset, angry, have a negative reaction? By not giving it to them! You fight it with the MOST POWERFUL thing in the world: LOVE. If Ruthie didn't do her chore before, I would give her an extra one. She would take FOREVER--literally hours to do one little thing. I thought this was her. Now, I just say to her, "It looks like you don't want to do your chore today (as she sweeps the same spot for the 10th time). Okay, why don't you go play? I will do it for you because I love you so much!", and then I grab the broom and do it for her--without anger and with a smile. Do you know what Ruthie does? Not every time, but most times, she cries. Sometimes she will now even come and confess to me she lied that she did things on purpose--like "forgetting" to close the rabbit cage overnight, putting her shoes on the wrong feet, etc. When she "can't" zip her coat when she could for the past 3 months, I no longer say, "Come outside when you zip your coat. We are all going to play," because that doesn't work. She will sit inside for over an hour and cry "trying" to zip her coat. And then I used to second-guess myself and think "What if she can't zip her coat and I am letting her sit there and cry?" or feel myself get angry as I think, "This is a game, you do zip it all the time!" Instead, I take the battle away, kneel down and smile and say, "I will zip it for you, because I love you SO much." Battle done. Now, honestly, usually she will pick a battle right away again--leave the door open, the light on, make her shoe fall off, etc. and I have to patiently take away the battle by doing it for her and telling her I love her. It makes her cry real tears as she sees my love, feels my love, as she loses the battle to push me away and make me angry.

RAD is about a battle--the battle is what the child uses to push you away. Some children uses toileting, food, lying, school, clothing, medical complaints. One thing Ruthie did was complain about every little tiny cut, but then she broke her collar bone and didn't tell anyone for 2 days! That is not normal! Some children are attached to food so much and are constantly "hungry". Control. It is a fight for control. You HAVE to take control back in a loving way, in such a way that there is NO battle. It is not a battle for obedience, it is a battle to win a place in their hearts, their trust. Now, what adopted child wouldn't do this on some level? Tell me who wouldn't have RAD if they had gone through abandonment and rejection? What child comes out of that "normal"? I wouldn't! I would test that love, that parent, to make sure that they were "for real". Wouldn't you? But, you HAVE to be in control--it may seem "mean" that you have such a tight-fist of control over a child when your biological children have more choices, but that comes with time. Until attachment happens, you have to almost FORCE them to know that they CAN trust you--that you hold all the cards, but you aren't a tyrant. You make all the decisions, but you are the most loving person in the whole world even when you are spit at in the face. Just like Jesus.

RAD? A disorder? I don't think of it that way--it is not as if something "went wrong" in that child. No, they are acting in a "normal" way for what they have been through. It is not a disorder, it is a REACTION that is normal for a child who has been rejected, unloved, abandoned, unwanted, and abused. Think you won't have any "attachment" issues when you adopt? I would say EXPECT it because what child WOULDN'T react when they have been through so much?? What child would fall into your arms and say "Thank you for adopting me and rescuing me! I love you so much!" I just don't think there are very many kids who do that. I think most are scared, angry, hurt and lonely and they are going to test to make sure the branch of the new family tree they are sitting on is not going to break, but can really hold their weight.

I am telling you, adoption is a ministry. It is awesome. It is the most difficult thing I have ever done, but man, as I have said so many times before: It is worth it. You may be in the midst of attachment issues now and you are weary: I say persevere. Cry out to God. Pray. You may be considering adoption: I say go for it, but expect it to be difficult. You may be scared to adopt after reading about all these attachment issues: I say don't be scared--what God calls you to He will equip you for. You will grow, stretch, be pruned, sanctified. It hurts. It is SO stinkin' hard to die to yourself as you look into the face of a child who you know is lying to you bold-faced and say "It's okay. I love you SO much." But, isn't that the goal of this life-to become more like Christ? Who said becoming like Jesus would be easy?

In Christ, Laura


Donna said...

Both of my adopted kids (now 6 and 8, home for 3 1/2 years) are exactly the same way. I agree it is hard, mostly because it hurts to be pushed away. But it is so worth the effort. Praying God will heal little Ruthies heart, along with so many little hearts that are suffering from rejection.

staci said...

great post - I love how you describe your reactions to her "reactions" - very smart and definitely not common sense

Marty said...

How do your biological children react to your treatment of Ruthie? Do they notice that its different? Do you explain anything to them, if so, what?

Your adoption issues are so fascinating to me. Thanks for being so vulnerable!

laura mouro said...

Marty, that is a great question!

My youngest 3 are too young to notice anything different. However, this has TOTALLY helped my older two children. Ruthie does things to make them angry too and they used to tattle, get angry, cry and have had a difficult time attaching to her and playing with her. I have taught them to love her, overlooking offenses, and have told them WHY we are doing things differently. It is really starting to help them to accept her, to not react in anger, to be able to play with her. They are much more sympathetic to her now and do not see her as being disobedient, but hurting. They "get it" now and I have seen God working in their little hearts through this. It is still hard for them and they often have "conferences" with me to ask me how they should handle a specific situation. It is amazing to me that Ruthie even pushes them away.


paige said...

All I can say is WOW, have you been living in my home? I have 2 adopted children and 5 biological. You sound very wise and I wish I could talk to you. I have been praying for help! When I read your last few posts, I am convinced that God is using you to speak to me (and others too). I have a question. Food. What do you do when the child uses food and will dawdle at the table and not eat and hold food in their mouth when you know they are hungry?


Wife to the Rockstar said...

GREAT post Laura.

You are surely going to help so many parents!

Tanya said...

Thank you so much for once again being real about this very difficult issue.

Joni said...

Hi Laura, a friend referred me to your blog as I have a sibling with RAD. You are exactly right - that it's all about REACTION to what happened to them. I have three adopted siblings, but only one has RAD. She came to the family when she was 10 and is now 15. Unfortunately for her she had a long, long time learning that people who were supposed to care for her didn't and she had to push them away. I applaud your love and care of Ruthie! It makes all the difference too if you and your husband are both seeing the same thing and are dealing with things the same way.

The thing about the brain is we don't know everything about how it develops. But it is so crucial for healthy development to have that loving touch and someone who comes when you have a need.

Does anyone do RAD counseling in your area? Regular counseling may be helpful, but if the counselor doesn't understand or know about RAD issues can be mistaken - esp since the manipulation/control can be so subtle. You are right on that it's totally easy to second guess yourself because the child can seem to REALLY be struggling. It speaks powerfully that she can later come and admit to you that she'd done that - even if it is much later. My sister never willingly admits anything.

Oh, and one more thing - a friend's dd came to her at 18 months and she did have RAD. But she is now a healthy 20 year old who loves her mom and can show it. :)

Luke said...

Totally brought tears to my eyes. In all of our classes about RAD, this is the first thing that I nod my head and thing, 'Yes, I could see that working.'

And becoming more like Christ is hard. So very hard. Thankfully, God's grace is sufficient for the times when I'm not like Him.

Wonderful post!


laura mouro said...

Thank you for all your comments--it really encourages me to keep going.

Paige--food. Ah, yes, food. That has been an area of struggle for us. I think I can either email your or do a post on it.

I will try to do a post, but if you could send me your email ( I would love to correspond!


The Ballengers said...

I came across your blog last week. You are so sweetly open about your adoption issues. We, too, have an adopted daughter. She is from China and is #3 in our family of 6 children. The way you describe all your dealings with Ruthie has opened my eyes and heart to deal with Hanna in a new way. I can't believe how this is really a common thread among adopted children! Amazes me, but you are SO, SO right in all you say. It really IS the battle, and showing that child love in a way that won't engage in the battle sounds like it will work. Hanna turns 7 next week, and her 6-yr-old sister is passing her up in schoolwork. I have been saying, We'll she's just a little slower....knowing all the time that she is really almost a genius! Oh, your posts have been helping me so much. You have no idea. This revolutionizes my thinking and how I will deal w/Hanna. She is so loving and sweet and yet there are subtle issues we still need to work through. We have often said "She's just different than the other girls"...but I see that really we have work to do. Thank you for being so open w/ your thoughts. You are helping change my well as Hanna's. On the lighter side, yes, those crazy issues of "Can't get my seatbelt on" and "forgetting" to feed one dog, and giving the other only a few pieces of dog food.....and all sorts of other stuff really does happen on a daily basis....and now I see where we're going with this. Funny, but frustrating if you don't know WHY it's happening...and HOW to combat it. Love you even though I don't know you. Do you live here in AL?

Carey said...

I've started to question Peter's attachment. Our first year was a breeze but year 2 was another story. It seems to me the attachment between him & I is OK but not sure with the rest of the family. He wants to be "babied" by the other kids and then he's fine. He's now six and we'd like to see him "act his age" when it comes to chores and taking care of himself. What do you think?

Laurel said...

I am sooo... glad I found your blog. You have described just what we are going through.

We have 10 bio. kids, and brought 3 siblings home from Ghana a year ago. They are nice, sweet, pretty compliant, ... but manipulative beyond belief.

I look forward to reading more of your family story.


mama of 13

Vicki said...

I wish I had read about this type of response to the "pushing away" much earlier. Our son is 14 now and quite possibly has other issues...but is it possible for him to have RAD even though we adopted him at 10 weeks? He is currently in a mental health treatment center because of violence toward me (in particular) and his dad and siblings. I feel we have lost any possibility of effective "because I love you"...but it seemed to be the only way to keep us all safe. (He had also expressed suicidal thoughts.) Please pray for us as I am praying for your family.

Anonymous said...

Depending upon where you adopted him from, he could have FASD, more likely than RAD. If he was adopted domestically or through foster-adopt it is more likely FASD.
Hope that helps point you in a new vein of researching how to help your son.

Anonymous said...

Your blog keeps getting better and better! Your older articles are not as good as newer ones you have a lot more creativity and originality now keep it up!

Anonymous said...

We adopted a sibling group 16 years ago.

As I read about your Ruthie, I am reminded of so much of our daughter's RAD behaviors.

She was referred for psychiatric evaluation by the state-provided counselor. The psychiatrist MD diagnosed her RAD about a year after we finalized the adoption.

I originally thought of RAD of less of a "diagnosis", and more of an explanation of our daughter's behaviors. I considered her intense behaviors very different from that of "normal children". (I studied Early Child Development in College. All those behavior modification techniques I was taught worked beautifully on every child in the world it seemed, except her!!!!!! I had never before seen a child repeatedly react so badly to positive reinforcement!)

After the diagnosis, even though our daughter's behaviors were strange, they seemed to make sense as a "natural" response to the rough first years of her life, prenatally exposed to drugs and alcohol, years of bouncing around in the foster system "from house to house" because of encopresis, adoptive placements disrupted before finalization.

I'm a firm believer in believing the best about your kids!

I know the Lord is a healer!

I continue to pray for healing and wholeness for our adoptees!

I have also learned the hard way there is danger in discounting a child's valid mental illness.

There was NOTHING available to us about RAD at the time of diagnosis. No books, no internet.

We are so thankful God provided a Christian counselor through the state adoption agency.

Our family did remarkably well considering how little we knew about her condition.

When the counselor said our family was doing beautifully and our daughter didn't seem to need ongoing therapy, we believed her! We truly thought we were living our "happily ever after!"

We began homeschooling all of our children because our 3rd grade child was ruling the school with misbehavior and pitting authority against authority. Only recently, in 20/20 hindsight, we recognize that behavior as the RAD symptom of "triangulization".

Homeschooling was such a tremendous blessing to our family! We had 10 Beautiful years!

By the third year we had our daughter, we truly thought our she had "outgrown" RAD. (As I research on the web, it seems books about RAD just started being published that year)

We know differently now. We learned what we know the VERY hard way!

It seems the age-appropriate detachment from her loving family (going off to college out of state) stirred up some of the "old ugly" RAD behaviors.

Don't get me wrong... I recognize also in hindsight that many of our daughter's RAD behaviors never fully went away... we just didn't have a definition for the condition or behavior list of what RAD symptoms are.

We chalked up our daughter's slightly strange behaviors to her "personality quirks"

I'd encourage all parents of RAD kids to keep several copies of documentation of their child's RAD mental illness. Keep a couple filed away at home, in a lock box with birth certificates and even keep copies available when you are traveling!!!

We found out the hard way that a "common" RAD symptom is "false allegations of abuse against their parents."

I'm sure having a written diagnosis from an MD and a description of RAD symptoms would have been tremendously helpful when the police came knocking on our door!

The Lord is faithfully encouraging us and carrying us through the legal nightmare brought on by our RAD Kid.

We are rejoicing and trusting that nothing is wasted in God's economy.

What a blessing it has been to hear my dad tell my husband that his walk of faith through this horrendous ordeal inspires my dad to deeper faith! There are many more amazing testimonies... We're still praying for our "now adult" prodigals.