No two cases of Reactive Attachment Disorder are exactly the same.
Every child and trauma experience are unique and different.
However, there is a differentiation when it comes to specific symptoms.
There are two types of Reactive Attachment Disorder.
Both types of Reactive Attachment Disorder operate on a spectrum, meaning that some cases are far more mild or severe than others.
Understanding a child's type of Reactive Attachment Disorder can help when choosing what types of treatment may be beneficial.
So, what are the 2 types of Reactive Attachment Disorder you ask?
Let's go through all of the details!
What are the 2 Types of Reactive Attachment Disorder?
Before we dive into the two types of Reactive Attachment Disorder, it's important to understand what all children with Reactive Attachment Disorder have in common.
I can think of no better way to understand Reactive Attachment Disorder (RAD) than by reading the resource above.
Not only does it explain what happens to the brain of a child who experiences trauma early in life, but it also gives a glimpse of what family life looks like raising a child with RAD at different ages and phases.
There is a set of classic symptoms related to Reactive Attachment Disorder that all children with the diagnosis display in one form or another.
The resource above discusses those symptoms in detail and explains what the worst case scenarios may look like for all involved.
I wish I could say that symptoms of Reactive Attachment Disorder vary based on what type a child has, but that's not true.
Children with different types of RAD just go about doing things in different ways.
There are so many ways to push others away when struggling with Reactive Attachment Disorder, no matter what type a child or teen has.
The resource above gives over 150 ways caregivers may see this happen in the home and/or in the community.
So, now that you understand what Reactive Attachment Disorder is and how it plays out, no matter what type a child or teen has, let's talk about the two types of Reactive Attachment Disorder!
I'm excited to share this information with you, not just as someone who knows a lot about Reactive Attachment Disorder, but as a caregiver of two adopted daughters, each one having a different type.
Inhibited Reactive Attachment Disorder
A child or teen with inhibited Reactive Attachment Disorder tends to avoid others and social situations all together.
This is especially true when it comes to spending time with family and caregivers.
These situations cause the child or teen with Reactive Attachment Disorder to feel unsafe.
Avoiding eye contact and staying emotionally withdrawn are normal.
The emotions of a child or teen with inhibited Reactive Attachment Disorder remain hidden until they become too big. Emotional regulation is very difficult.
At times you will notice that emotions don't match situations and are inappropriate, or there's a lack of emotional expression altogether.
A child or teen with inhibited Reactive Attachment Disorder isn't one to show affection or accept affection from others, especially when it involves physical contact.
You will notice a child with inhibited Reactive Attachment Disorder watching others closely, but the child or teen will hesitate to engage or not engage at all.
The child or teen with RAD chooses to isolate and remain alone, as this feels safe.
Where other children and teens feel comforted by caregivers and other adults when distressed and consoled, a child or teen with inhibited Reactive Attachment Disorder does not.
What does Inhibited Reactive Attachment Disorder Look Like in the Home?
Our daughter Princess has inhibited Reactive Attachment Disorder.
Just as the diagnostic criteria states, she loves her alone time and is the ultimate introvert.
We've learned to respect these parts of our daughter and allow her the freedom to be alone when she desires, in order to prevent unnecessary unsafe behaviors.
There are parts of her that will try social events. These events are very scary and anxiety ridden.
When we follow her lead as to what she wants to do and where she wants to go, tagging along for extra support, some social experiences can go well.
Princess holds in her emotions as long as possible to avoid conversation and processing. This usually results in a RAD fit later on.
She does not like affection of any kind.
We've learned to respect this about our daughter and do not initiate affection.
Instead, we let her know we're here for her whenever she wants physical affection. She can initiate at any time.
While I wait for my two hugs a year, I do whatever I can to show Princess I love her in ways that she feels safe accepting.
Following Princess' lead in healing (when possible) has drastically lessened the amount of unsafe behaviors in the home.
She has chosen to to accept love from her family, and healed in significant ways.
Had she not made the choice she did, there was a definitely a chance her behaviors would escalate and become so unsafe, she would not be able to live in the home.
Disinhibited Social Engagement Disorder (DSED) or Disinhibited Reactive Attachment Disorder
A child or teen with disinhibited Reactive Attachment Disorder or Disinhibited Social Engagement Disorder is the exact opposite of a child or teen with inhibited Reactive Attachment Disorder in so many ways.
In social situations a child or teen with disinhibited Reactive Attachment Disorder is overly friendly with EVERYONE, including strangers.
There is no understanding of "stranger danger."
The child or teen with disinhibited Reactive Attachment Disorder may go with anyone, without checking in with caregivers first.
Even more concerning is the child or teen's need to seek out affection from others in unsafe ways.
This is incredibly scary for caregivers.
There is a constant need for attention or connection with anyone and everyone.
A child or teen with disinhibited Reactive Attachment Disorder often develops superficial relationships with others.
Behaviors become inappropriate and dangerous towards others when the CONSTANT need for attention or connection are not met.
A child or teen with disinhibited Reactive Attachment Disorder does not understand social boundaries.
The child often acts younger than her age, and in very inappropriate ways.
What does Disinhibited Reactive Attachment Disorder Look Like in the Home?
Our daughter Sunshine has disinhibited Reactive Attachment Disorder or Disinhibited Social Engagement Disorder, a type of Reactive Attachment Disorder.
She is a classic example of all of the the traits listed above to the point that it is unsafe for our family to have her live at home with us.
Sunshine has been in and out of multiple residential placements, and is now in long term residential care.
No matter how much attention and connection we provide, it is not enough.
She demands more in unsafe ways, attempting to hold us "hostage."
Members of our family have been victims of verbal, emotional, and physical aggression on a regular basis.
Sunshine continues to display the same behaviors in residential facilities towards peers and adults.
It's still my hope that Sunshine's brain will heal and change over a long period of time, but we do not know if that is possible.
Which Type of Reactive Attachment Disorder is Easier?
As a caregiver of two children, one with each type of Reactive Attachment Disorder, I can honestly say that both are equally hard to manage.
I attribute Princess' healing to her cognitive abilities, not to the type of Reactive Attachment Disorder she has.
Sunshine has multiple diagnoses which include developmental and intellectual delays, as well as a mood disorder. This is why I am unsure if healing is possible.
Both girls were equally difficult as toddlers and young children.
The elementary years were an incredible challenge, one exhibiting depression and suicidal behaviors while the other became homicidal.
Neither type of Reactive Attachment Disorder are easier; they're just different.
How Can Knowing What Type of Reactive Attachment Disorder My Child or Teen Has Help Me?
Knowing what type of Reactive Attachment Disorder your child or teen has can help when seeking out treatment options.
Though both of my adopted daughters have Reactive Attachment Disorder, each one has required the opposite approach in situations with behaviors in order for healing to occur.
They've required an opposite approach when parenting is concerned.
What works for one, does NOT work for the other.
Despite what professionals may say, there is no one perfect evidence based treatment that will help a child or teen heal from RAD.
If there was, all would be cured.
Just like every brain and trauma experience is unique, so is the healing process, if healing is possible.
Get to know your child or teen.
The best recommendations we have are in the resource below.
Whether you have a child or teen with inhibited Reactive Attachment Disorder or one with disinhibited Reactive Attachment Disorder, or one of each like us, healing can happen, when possible.
Remember how your child or teen ended up with Reactive Attachment Disorder.
None of it is the child's or teen's fault.
Both inhibited and disinhibited Reactive Attachment Disorder are a result of trauma experienced in utero and/or during the first 18 months of life.
Don't give up hope!
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