RAD - Oppositional defiant disorder therapy

March 2, 2010 - PRLog -- On the Failure to Attach

I was three-years-old when my small family was ambushed by a band of Arabs. My father was killed, and my mother was carried away to a hospital and was not to return for years.  Having physically survived, I was sent to a nearby kibbutz for foster care and was placed with a group of children my age.  Everyone was sympathetic and kind, but I would not be consoled. My world had ended: I had lost my beloved father and mother, and nothing mattered to me.  I was alone in the world.  I mimicked the other kids as I went through the motions of day-to-day living, but, afraid and alienated, I felt estranged from everyone around me.

Three years later, when my mother came back for me, it was too late.  She too, meant nothing to me.  She was just another person with whom I obediently went to live a different, but equally meaningless, life.  I was still terrified and alone, with no one to confide in.  I tried my best to pretend I was just like other kids, but I wasn’t.  I was so handicapped by my fear and isolation that during grade school I was thought to be retarded, so after the eighth grade I was taken out of school and put to work.

As an adult, I continued to pretend normalcy. With great effort I was able to catch up on my schooling, and obtain a higher education.  I married but was unable to sustain the marriage and a few years later divorced, leaving behind two wonderful sons. In deep despair, I entered psychotherapy and overcame the terrible effects of my unfortunate past.  I remarried and, finally able to function at full capacity, have been leading a good, decent, and productive life since.

During therapy, I became fascinated by the workings of the mind.  I took the necessary training, became a therapist, and devoted the next 25 years, perhaps not surprisingly, to studying and treating the effects on the child of abandonment at infancy.  I soon discovered to my astonishment that, dramatic as my case was, I was luckier than countless millions who, with seemingly less traumatic histories, suffered from the same condition but were injured far more seriously and had no effective therapy to help them.

What made their experiences different and their prospects so hopeless?  They all were injured in their infancy.  I was already three years old at abandonment, and this was a great advantage.

Attachment Deficit
Emotional injury in the first three years can occur as a result of obvious situations.  Here are examples drawn from the early lives of some of my patients:

   * One man, as an infant, was separated from his mother and hospitalized for three weeks when he was 11 months old. His mother was allowed only at visiting time.
   * One woman was born to an alcoholic, disinterested mother
   * Another woman’s mother lost her husband just before she gave birth and, in her grief, kept her baby, emotionally, at arm’s length
   * A man was born prematurely and was placed in an incubator for several weeks
   * One woman was born to a mother overwhelmed with many other small children and a chronically ill, out-of work husband.

Not all babies necessarily become damaged because of these kinds of deprivations; we only know of the many who do.  But it doesn’t necessarily take catastrophes to cause permanent emotional injury.  As you will soon read, many suffer even when everything seems to be fine.

Researchers in human attachment who surveyed the American population have found that as many as 40 percent exhibit “insecure attachment style;” that is, they are unable to attain a secure attachment with anyone.  For the sake of convenience, I have been calling this inability “attachment deficit.”  Little known, and largely unrecognized by the therapeutic community, attachment deficit is a problem of epidemic proportion in our present culture.

More than half of those with attachment deficit have “avoidant attachment style;” that is, they are uncomfortable being close to others and find it difficult to trust them.  Their overriding world view can be summarized as:  “I don’t need anyone; I can do it all myself!”  The others exhibit “ambivalent attachment style.”  They see other people as being reluctant to get close, are worried that others don’t really care about them, and are often viewed by others as clingy and manipulative.  Their lament is, “nobody cares about me.”

A teenage girl with attachment deficit once said to me, “I don’t like depending or being beholden to anybody.  I can’t believe people enjoy me and my company. I always feel that I’m a burden.”

People with attachment deficit feel unloved and uncared for and believe they are unlovable.  By contrast, those with secure attachment are comfortable depending on others, find it easy to trust and get close to others, and have a strong sense that they belong with others and with their communities.

Adults with attachment deficit may have serious marriage problems, feel empty and lonely, have problem kids and grapple with other family troubles.  In addition, many also suffer from substance abuse, behavioral addictions, eating disorders, anxiety, and depression.  Some become antisocial: in extreme cases, they may commit violent crimes or even become serial killers.

Children with secure attachment style are motivated to belong and to cooperate because they want their parents’ approval and are willing to do what is expected of them to receive it. But those with attachment deficit, already feeling unloved and unlovable, have nothing to lose by displeasing parents and other authority figures.  They manifest their attachment deficit in disturbing behaviors, ranging from lethargy to hyperactivity or from clinginess to reclusiveness.  Many are defiant and oppositional, and some are truly uncontrollable and destructive.  These children are often diagnosed as hyperactive, manic-depressive, impulsive, oppositional, or with attention deficit disorder and are medicated to make their behaviors more manageable.  Meanwhile, their core problem attachment deficit remains unknown and goes untreated.

In spite of the enormous number of people affected by this condition and the substantial amount of available research, little is known about attachment deficit among either the general public or the therapeutic community.  Consequently, this condition is usually misdiagnosed and improperly treated.

The Detachment
Almost everyone has heard of the Rumanian Orphans Syndrome, the wasting away of infants as a result of insufficient human contact.  This syndrome was not new to researchers.  Dr. Rene Spitz, a noted European early child psychiatrist, found that many infants in orphanages, who also lacked sufficient human contact, eventually wasted away and died.  The “illness” these dying babies suffered from was called marasmus.  A later researcher, Dr. John Bowby, who dedicated his life’s work to the study of attachment in children, observed, in the 40s, toddlers in English hospitals who were left there for a week or more without their mothers.  He found that many lost all interest in people and became concentrated on sweets and toys instead.  Many of those who did seem friendly toward the medical staff barely acknowledged their mothers upon their mothers’ return--a lack of interest that too often proved permanent.

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RAD Consultancy offers a unique approach to treat Reactive Attachment Disorder(RAD), Conduct Disorder (CD), Oppositional Defiant Disorder (ODD), Attention Deficit Hyperactivity Disorder (ADHD), Bipolar Disorder (BPD), Post-Traumatic Stress Disorder (PTSD) or depression.