Reactive attachment disorder (RAD) is a diagnosis for infants and small children and must be evident between the ages of 9 months and 5 years. Although RAD is a diagnosis of infancy and childhood, the symptoms can have long-term effects, even into adulthood. 

What is reactive attachment disorder?

Attachment issues are when a person is not able to maintain healthy attachments to other people. There are other forms of unhealthy attachment issues that can lead a person to be either distant, obsessive, anxious of loss or passive toward relationships. Attachment issues development during childhood and often relate to a mismatch between what the child needs and what the child’s caregivers provide. At times, attachment issues can emerge from abuse and neglect, but they also can develop in individuals with very loving caregivers. RAD is a severe form of attachment issues in which a child has experienced extremes of insufficient care with at least one of the following:

• Social neglect or deprivation in the form of persistent lack of having basic emotional needs for comfort, stimulation, and affection met by caring adults
• Repeated changes of primary caregivers that limit opportunities to form stable attachments (e.g., frequent changes in foster care)
• Rearing in unusual settings that severely limit opportunities to form selective attachments (e.g., institutions with high child-to-caregiver ratios)

As a result of insufficient care, the child demonstrates inhibited withdrawn behavior and emotional disturbance. With reactive attachment disorder, a child may have uncontrollable emotions and be unable to receive or give affection to others.

This disorder is categorized because of its effect on relationships and mood. If left untreated, it can lead to lifelong issues and behaviors that make connections difficult. This attachment disorder often stems from early childhood trauma or abuse. The traumatic experience disrupts the child’s trust and ability to make connections with others. Then the child becomes distant to people they are supposed to trust. Without getting the right help, a person’s point of view on trust can be warped and damage their abilities to maintain relationships and healthy boundaries into adulthood. Without understanding their trauma, an adult can continue to internalize their emotions. This can lead to either detached feelings or delayed outbursts.

RAD and the challenges of gender stereotypes

RAD symptoms that persist into adulthood may also be left unchecked due to gender stereotypes or neglect. In women, the most common RAD behaviors are that they are emotionally withdrawn and inhibited emotionally. However, in men, they display behaviors of disinhibition or an inability to control their impulses. These behaviors can be exacerbated by harmful gender stereotypes if the reactive attachment disorder goes unrecognized and isn’t addressed.

Some gender stereotypes that can make recognizing and seeking help for RAD harder include: 

• Men don’t talk about their emotions.
• Men are more disorderly.
• Women sulk.
• Women (or men) are more prideful.

All these stereotypes can be harmful for many reasons. In this case, they can be harmful because they may make it easier to ignore key signals of reactive attachment disorder . Adults who are still undiagnosed for RAD may never get the help they need to overcome trauma if these stereotypes persist. 

Common signs and behaviors linked to reactive attachment disorder

It is important to recognize the signs and behaviors of RAD in order to help yourself or others seek help. By understanding the signs or behaviors, you can reckon with your experiences. Even by just identifying these behaviors in yourself, you can better recognize and handle the behaviors. Whether you seek a therapist’s help with RAD or not, understanding the roots of this condition can help you better understand yourself.

Common signs that RAD has persisted into adulthood include but are not limited to:

• Avoiding eye contact
• Crying uncontrollably
• Not responding to affection
• Feeling uncomfortable when others show you affection
• Not knowing how to give others affection
• Feeling disinterested in social activities
• Having an inability to maintain relationships, romantic or platonic
• Not showing visible signs of happiness, like smiling
• Performing self-comforting or self-soothing actions
• Having angry outbursts
• Being argumentative or abrasive
• Being passive-aggressive
• Displaying avoidant behavior
• Communicating your emotions poorly
• Having a fear of being alone
• Minimizing your own feelings of being hurt or sad

It can be difficult for a person with reactive attachment disorder to seek help. As they often minimize their own pain and sabotage relationships, they can find it extremely difficult to seek help. However, knowing the indicators of RAD can help family, friends, co-workers, others or even the person better understand themselves. It is important to recognize these signs because it can indicate whether a person has a history of abuse or trauma that they need help dealing with. Having this information is important for communities to help those who are struggling. 

Lightfully can help individuals who have reactive attachment disorder symptoms that persist into adulthood

Although RAD’s behaviors may make approaching a person difficult, it can make a huge difference in their life. Instead of assuming a person exhibiting these behaviors is inherently explosive or distant, look further and try to understand why they may be exhibiting these behaviors. That can help you understand why that person is acting that way but also help that person better understand themselves and build connections.

Therapy can be the entry point to understanding why you or someone you care about may feel this way. Lightfully’s personalized adult mental health treatment programs can offer this and so much more. They allow you to seek help from a highly trained clinician who will create a treatment program that’s personalized to your needs. 

Change is possible. When you or your loved one is ready to seek treatment for reactive attachment disorder, reach out to our Admissions Concierge Team. We’ll take the next steps together, toward the fullest, brightest version of you.