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Reactive Attachment Disorder in Defiant Teens

As kids with Reactive Attachment Disorder (RAD) become adolescents, the outward issues change, but the root causes are the same: inability to form intimate reciprocal relationships or to empathize, inability to trust, and lack of conscience. These traits may manifest in varying degrees and forms.

Adolescence is a time when even healthy teens are seeking approval of others. The teenager with Reactive Attachment Disorder has a great gaping hole, an intense craving for love and approval, but doesn't believe it can be genuine when it is given. Relationships are more like contracts: I give you this if you give me that (e.g., a young female will have sex in order to have the status of having a boyfriend, or a young male will be friendly in order to have privileges of sharing another's games). The RAD child may steal from her friends or mom or dad in order to get what she wants. The child will lie in order to keep receiving the benefits of a relationship. These characteristics are common in many adolescents, but with Reactive Attachment Disorder, the teenager goes to an extreme. The incidences of crime, drug abuse and early pregnancy are almost universal.

Relationships don't last long. When the time comes to become more intimate, older RAD teens and young adults find it easier to start over with someone else – or if a better option shows itself, they may switch. Rules and restraints often become intolerable as RAD teens and young adults develop individuality. Some teens run away or get arrested. Suicide and self-harm (e.g., cutting) are very common.

Grown-ups with RAD have difficulty maintaining relationships or keeping a job. By their mid-twenties, many have learned enough about social rules to imitate healthy interactions. They know what others should feel in certain circumstances, so they may try to feel that way (or claim to feel it.) They know that immoral actions usually bring objectionable outcomes. However, if they think that they can get away with it and still get what they want, they will still do whatever they want. By this time, their talent for manipulative behavior is well refined.

There is basically only one window of opportunity for changing the destructive behavior of an individual with Reactive Attachment Disorder: during adolescence. This is a time when the RAD child may open up and learn to have real relationships, and have the intense craving satisfied. Parenting a RAD adolescent is very stressful due to the constant manipulation and lying. Just when the parent thinks she is getting through, the teenager will do something to betray her. The challenge is figuring out how to show love and empathy without feeding the child’s desire to engage in manipulative behavior. But nurturing the parent-child relationship over the years often gets the message across that the RAD teen can be loved regardless of how she behaves.

Parenting Defiant Teens with RAD

Self-Test for Reactive Attachment Disorder [RAD]

How can you know if your RAD teenager needs to be placed in a residential treatment program?

Take the self-test below. If your RAD teen has 10 or more of the following symptoms/conditions, then chances are he/she is in serious need of residential treatment for RAD-related issues:

1. "I hate you," attitude
2. "You can't make me," attitude
3. Abrupt Change in Personality
4. Abusive Behavior
5. Academic Problems
6. Alcohol Abuse or Addiction
7. Anxiety
8. Argumentative
9. Attempted or Threats of Suicide
10. Attention Deficit Hyperactive Disorder
11. Authority Problems
12. Avoidant Behavior
13. Bipolar Disorder
14. Blames Others for His/Her Behavior
15. Blames Others for His/Her Mistakes
16. Blatant Disregard of Rules
17. Can't Accept "No" For an Answer
18. Can't Accept Feedback
19. Can't Keep Friends
20. Clinging Behavior
21. Conduct Disorder
22. Cutting
23. Danger to Self or Others
24. Demonstrates Poor Impulse Control
25. Depression
26. Difficulty Coping with Stress
27. Distant or Aloof Behavior
28. Drug Abuse or Addiction
29. Easily Misled
30. Eating Disorder
31. Family Conflict
32. Grades Have Fallen
33. Has a Preoccupation with Blood and Gore
34. Has a Preoccupation with Fire, blood and gore
35. Hoards or Gorges Food
36. Is "Above the Law"
37. Is Cruel to Animals
38. Is Cruel to Siblings
39. Is Developmentally Delayed
40. Lacks Motivation
41. Lazy
42. Learning Disabilities
43. Low Self-Esteem
44. Lying
45. Manipulative
46. Never at Fault
47. Oppositional Defiant Disorder
48. Peer Problems
49. Persists in Steady Nonsense Questions or Chatter
50. Pits Parents Against Each Other
51. Poor Choice of Friends
52. Poor Emotional Control
53. Poor Relationships with Others
54. Poor Self-Image
55. Resentful
56. Resists Tasks
57. Risky Behavior
58. Runs Away or AWOL
59. School Suspensions
60. Self-Harm or Mutilation
61. Sexually Active
62. Shifts Blame to Others
63. Shows Indiscriminate Affection Toward Strangers
64. Shows Poor Eye Contact
65. Skips School
66. Smoking or other Tobacco Use
67. Sneaky Behaviors
68. Stealing
69. Superficially Engaging and Charming
70. Uncontrollable Anger

Parenting Defiant RAD Teens

Control and Limit-Setting for RAD Children & Teens

Parenting a youngster with Reactive Attachment Disorder (RAD) is extremely challenging, intense and exhausting, but the rewards are equal to the difficulty of the task. Not all attachment therapists agree on the details of how to parent RAD kids, but most experts agree that “control and limit-setting” should be a primary focus.

One thing that many RAD kids have in common is their extreme need to be in control of their environment and of the people in it, especially their moms and dads. When they were young kids in the orphanage or foster care, they didn't have an opportunity to complete the bonding cycle, which is where trust develops. Perhaps the move to their new adoptive home interrupted that cycle, and therefore they don't trust grown-ups to take care of them. In addition, when the grown-ups were in charge, the youngster was abandoned, neglected or possibly hurt. So these very smart kids have figured out that to feel safe, they need to be in control. But this, unfortunately, is a no-win situation. Why?

The youngster wants to be in control to feel safe. But a youngster who is in control is, by definition, not safe, because he doesn't have the cognitive capabilities or the experience to be the care-taker. This need to control can manifest in defiant behavior (e.g., not obeying requests, talking back, arguing, constantly interrupting, demanding attention, etc.). Even refusal to eat or toilet train can be efforts at maintaining control at all costs.

RAD children need to learn that to follow a parent's direction is safe. They need to know ¬ that to yield, to cooperate, to surrender, and to follow does not signify weakness. It is only then that they will be able to learn about:

• being contained
• being directed constructively
• being nurtured
• being safe
• being valued
• cause-and-effect thinking
• reciprocity

Some moms and dads start out by setting firm limits, but the defiance of their RAD youngster may lead them to back-off so that every interaction with their youngster is not a fight (sometimes this becomes necessary just to get out of the house and get to work). Some moms and dads believe it is so important to encourage the youngster's independence that they should be very careful about forcing their will on him or her. Other parents are afraid that their RAD child will throw a temper tantrum in public and cause them embarrassment.

Unfortunately, those care-takers who have extremely kind and gentle temperaments have the most difficulty being firm “limit-setters” because they hate to see their adopted youngster unhappy – and setting a limit for a youngster is going to make that youngster unhappy, at least temporarily. Thus, moms and dads should be mindful of their temperament, and when in doubt, they can safely assume they are inclined to be overindulgent, and should therefore try to draw the line a bit more firmly.

Parents should also take into account the child’s point of view about limit setting. Moms and dads have no problem setting limits when danger is involved (e.g., a youngster running into the street). A very young child doesn't know the difference between running into the street and running into the living room. All he experiences is a mother or father preventing him from doing something he wants to do. When a youngster insists on doing anything at all - in spite of the parent’s serious opposition - the parent’s response should be consistent, regardless of the reasons, whether we're talking about eating cookies on the coach or playing with a razor blade.

Also, the adopted RAD youngster has experienced what attachment therapists refer to as the "eternal no." Birthmother said "no" by giving the youngster up for adoption. It's permanent and it's the ultimate "no." So when mom or dad sets a limit and says "no," the adopted youngster often equates that with "You don't love me" and responds with defiance. The adoptive moms and dads get the anger that rightfully belongs to the birthmother. It is therefore important for parents to lovingly enforce limits. This may require simple holding and comforting and/or consequences when the youngster acts-out.

Parenting Defiant RAD Teens