What Are the Signs & Symptoms of Reactive Attachment Disorder?

Dr Daniel Amen and Tana Amen BSN RN On The Brain Warrior's Way Podcast

When Reactive Attachment Disorder (RAD) occurs in children, it becomes very difficult for a parent to establish a meaningful bond with their child, which often leads to more problems for the child down the road. In this episode of The Brain Warrior’s Way Podcast, Dr. Daniel Amen and Tana Amen describe what RAD is, and tell you how to identify the signs and symptoms.


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Dr. Daniel Amen: Welcome to the Brain Warrior's Way podcast. I'm Dr. Daniel Amen.

Tana Amen: And I'm Tana Amen. Here we teach you how to win the fight for your brain to defeat anxiety, depression, memory loss, ADHD and addictions.

Dr. Daniel Amen: The Brain Warrior's Way podcast is brought to you by Amen Clinics, where we've transformed lives for three decades using Brain SPECT imaging to better target treatment and natural ways to heal the brain. For more information, visit amenclinics.com.

Tana Amen: The Brain Warrior's Way podcast is also brought to you by BrainMD, where we produce the highest quality nutraceutical products to support the health of your brain and body. For more information, visit brainmdhealth.com.

Welcome to the Brain Warrior's Way podcast. We are back with attachment week and we're going to talk about reactive attachment disorder. In a second I'm going to have you talk about that. But you, when I first met you, you kept saying I had attachment issues, which are not true. I'm heavily attached, till death do us part. I'm very clear about that. It took me a while to get attached, but now you have what you want.

Dr. Daniel Amen: Yeah. You kept running away and breaking my heart for like 18 months. I used to call her the black widow.

Tana Amen: I'm not a black widow.

Dr. Daniel Amen: Then finally ... she is. But then when I-

Tana Amen: I'm not. Try and go away and you'll find out.

Dr. Daniel Amen: ... got her attached, I called myself the widow tamer.

Tana Amen: I am clear, till death do us part, my love.

Dr. Daniel Amen: Right, she says the only way she's running is if she's chasing me.

Tana Amen: Yeah, you're not going anywhere.

Dr. Daniel Amen: I love that, but it took a lot of work, and part of that came from your sort of anxious attachments.

Tana Amen: Well part of it came from, let's just be really honest, a really hard divorce, and not wanting to do it again. But when I talked to you, you were like, well, you may have issues from anxious attachment. So-

Dr. Daniel Amen: So, what happened when you were a child that might have contributed to that?

Tana Amen: Okay, so according to you, 'cause I think I was fine ... and then all of a sudden he's asking me these questions, I'm like, oh wait, maybe there's something here.

So, we were really poor, and I know my mom did the best she could. She worked a lot. My mom worked a lot. She worked three jobs, she was never home, I mean like, never home. So she was gone all the time, and I would wake up in the middle of the night, she wouldn't be there, she was supposed to be there, she'd be working overtime, she'd be doing whatever she was doing. I would wake up in a panic, I mean like freaking out panic. I'd end up being hysterical.

I used to go through the phone book. This is terrible, but I used to go through the phone book, this was back before we had cellphones, and I would go through the phone book calling 24 hour diners and having them page my mom. I was thinking maybe she went out and got something to eat after work. I was so scared that something happened to her.

And then all of a sudden, I mean, this really sounds morbid, this sounds terrible, but there was a point where I couldn't keep doing that. I'd miss school 'cause I'd be up all night worrying about her. She'd come in, she's like, "Honey, I was working. I was working late. I didn't want to call you and wake you up." I'm like, "You didn't want to call me and wake me up? Are you kidding me right now?"

So I'd end up missing school because of all of this, and this happened over and over. And you'd think that I eventually would start to realize, but you don't because she was all I had. My mom was all I had. So I would get so scared.

So eventually though, I did start to change that. The sad thing is is that eventually it does change. And so probably around 11 or 12, I started to literally ... it's really morbid, but I started to think to myself, okay, so if something happens to my mom, what do I do? I would literally visualize what am I gonna do, step by step. Someone comes to the door and tells me something happened to my mom, what's next. I would visualize every single step in detail. Is my mom dead? And I'd visualize that happening. And then what's gonna happen next? Like who am I gonna go live with? What's going to happen? What am I going to do? Where am I going to stay? What's my room gonna look like?

I would go through this whole process, and I would do that almost daily, until I could tolerate it. That's what I would do until I could actually tolerate the thought of it. So, it's really weird, but I don't know if other people have done that. But that's what I would do until I could actually stand the thought of it.

Dr. Daniel Amen: And you had a very ambivalent relationship with your dad, which we've talked about before.

Tana Amen: Ambivalent's one word. Telling him not to ever talk to me again is probably not ambivalent, so-

Dr. Daniel Amen: Well, then he died in your arms-

Tana Amen: He did, but that was many, many years later-

Dr. Daniel Amen: ... and that was beautiful.

Tana Amen: As a teenager, I told him not to talk to me again.

Dr. Daniel Amen: So that's a little bit different than reactive attachment disorders. That is an anxious attachment, which I think is why you threaten my life constantly.

Tana Amen: You can't say that on the air.

Dr. Daniel Amen: I always tell people, if I'm dead, I didn't do it.

Tana Amen: But it means he deserved it. But it means he deserved it.

Dr. Daniel Amen: Reactive attachment disorder happens when children don't get the nurturing that they need, and they then don't connect properly. So for example, a baby cries and no one responds or offers comfort. A baby is hungry or wet and they're not attended to for hours. No one looks at, talks at, or smiles at the baby. A young child gets attention only by acting out. A young child is mistreated or abused. Sometimes the child's needs are met and sometimes they're not, so it's unpredictable.

Tana Amen: I have a question. So when you're reading this list, my mom was actually very loving, she was amazing, but she wasn't there, and I was left with people who actually were not nice people sometimes, that did many of those things on that list. So could that create it?

Dr. Daniel Amen: Absolutely. It doesn't have to be a parent, it just has to be a consistent, loving-

Tana Amen: I had terrible babysitters, terrible.

Dr. Daniel Amen: ... adult. But because she's gone, and you had terrible babysitters, that's gonna set you up for attachment issues. Now, you don't have this, you have what we would call an anxious attachment, that's so much better. I mean, you're better than I think you've ever been.

Early signs of an attachment disorder, child avoids eye contact, never smiles, doesn't reach out to be picked up, rejects effort to calm, soothe or connect, doesn't seem to notice or care when you leave them alone, 'cause it's this thing we call learned helplessness. They try and it doesn't work, they try and it doesn't work, they try and it doesn't work, and then they say to hell with it and stop trying.

Later on, what we see is they have an aversion to touch or physical affection, control issues. They'll go to great lengths to remain in control and avoid feeling helpless. Anger problems, difficulty showing genuine care and affection for others, and they have an undeveloped conscience because our connections often help our frontal lobes to develop. And so I have seen many, many kids over the years with reactive attachment disorder-

Tana Amen: So this sounds pretty severe. So I'm assuming there are categories of attachment disorders and like which are worse.

Dr. Daniel Amen: Right, like mild, moderate, severe-

Tana Amen: And types that are worse than others.

Dr. Daniel Amen: ... and types like anxious attachment-

Tana Amen: Which doesn't sound as quite as extreme as this.

Dr. Daniel Amen: It's not as extreme. And you know, I first started seeing it after the crisis in Romania, where-

Tana Amen: All the orphans?

Dr. Daniel Amen: ... there were just thousands of orphans who'd been neglected and they ended up getting adopted by Americans-

Tana Amen: But they're a mess.

Dr. Daniel Amen: ... and then the children were just a mess.

Tana Amen: So when you were in medical school, I'm assuming you had to watch some of the same videos I did about monkeys when they put them in cages and they don't attend to them, and how they start ripping their own hair out and slamming their heads into cages. I mean, it's terrible. They'll die, but they'll often do things to harm themselves. They create self-harm if you take a baby monkey and you isolate it and you don't cuddle it, you don't nurture it. Even if you feed it, but you don't nurture the baby monkey, what they do to themselves, they'll cut themselves and hit their heads on the walls. It's really horrible.

Dr. Daniel Amen: Did you hear about the study, there was an emperor who wanted to know what's the natural language ... it was an emperor in Europe, so he wouldn't allow anyone to be around the babies because he wanted to know what the natural language ... if children didn't have input from others. And he never found the answer to the question because they all died.

That we require attachment in order for our brains to properly develop. The good news is there's treatment. What I often find is their brains are just so busy and so-

Tana Amen: So it's like extreme trauma.

Dr. Daniel Amen: ... as they've been malnourished, malnourished emotionally, they're often malnourished physically as well. So feeding them right, getting them to exercise, time can really help. And you have to work hard on the relationship. When you have a child that's difficult, so I think, well one, you should scan them to go ... 'cause often with this kind of neglect also comes abuse, and with abuse comes-

Tana Amen: Well that is abuse.

Dr. Daniel Amen: ... traumatic brain injuries as well. And so-

Tana Amen: But I want to clarify, that is abuse.

Dr. Daniel Amen: Of course it is. But I mean, traumatic brain injury kind of abuse too. And virtually no one talks about, well we have to put their brain in a healing environment. So the food they eat matters, the boundaries that you give them in a loving way matters, so it's really optimizing the physical functioning of their brain, and then going back to time, physical time, so that you can become important to them-

Tana Amen: But have you seen when someone has suffered that severe of an issue as an infant, have you seen them ever be able to reverse to have a pretty normal life?

Dr. Daniel Amen: Yes.

Tana Amen: Wow.

Dr. Daniel Amen: But it requires a lot of effort in our four circles. So you've heard us talk about the four circles. We have to optimize the biology of their brain and their body, we then have to actually help them develop empathy, and there are ways to do that. Connect them with social skills, and then with their purpose in life.

And so it really requires all four of those circles in order to help heal reactive attachment disorder. So, know their brain, optimize your ability to relate with them, and then supervise the environment that they're in. Those are some of the big pillars that we work on here at Amen Clinics. Stay with us.

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