Types of Attachment Disorders

An attachment disorder is the result of a broken attachment in early childhood. In children, this is known as reactive attachment disorder, or RAD. Some infants and young children do not have a secure attachment to a primary caregiver (be it a parent or other stable source of care). This may look like neglect, such as not having basic needs met: food, warmth, physical affection. A broken attachment may also occur if the child develops in an environment where the child feels unsafe and frightened or when there are repeated changes in primary caregivers (such as multiple moves through foster care). Babies and young children are entirely reliant on caregivers to meet physical and emotional needs. When those needs are repeatedly ignored, symptoms of attachment disorders may develop.

There are two types of reactive attachment disorder in children: inhibited reactive attachment disorder and disinhibited reactive attachment disorder. These have very different symptoms. A baby who cries and rarely receives comfort or food may eventually stop crying when it learns that its needs will not be met. Some children will have difficulty bonding with caregivers. Other children may cling to any possible source of care in an indiscriminate manner. Inhibited RAD displays symptoms such as lack of affect, difficulty displaying emotions/minimal emotional expression, withdrawn behavior, and a lack of interest in physical affection or being comforted. Children I have worked with who have inhibited RAD may show a lack of interest in play and prefer to play alone, smile little, have few facial expressions, and not react when their caregiver leaves from or returns to a therapy session. Children with disinhibited RAD show markedly different behaviors. They will often try and befriend others indiscriminately, people please, hug and be physically affectionate with strangers, and frequently show some signs of regression such as acting younger than their age by “baby talking” or behaving like a younger child. They may demonstrate anxiety over how much others like and want to be with them.

Both types of reactive attachment disorder have clear connections to the neglect experienced in early childhood. While some children no longer are receptive to or seemingly dependent on caregivers due to their needs being denied prior, some work overly hard to win over others and make up for that lost attachment. Both types may also be difficult to treat without professional help. There are often long-lasting impacts through later childhood and adulthood, including lack of relationships with others (romantic, familial, or platonic) or unstable relationships and over dependence on others. Child Therapists can work on the process of helping rebuild attachment between child and caregiver and work to heal old wounds. In my work, building attachment is often a process that takes a great deal of time and effort from the caregiver. The results, however, can be life changing.

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