Monday, February 24, 2014

Watching Trust Grow: An Example of a RAD Child Attaching

Hi Friends, We are re-running this "classic" from 2012... We think you'll find it helpful and "evergreen." 

by John and Diane.

RAD stands for Reactive Attachment Disorder and is otherwise referred to as trust disorder, attachment disorder and a number of other names, but basically refers to kids (in this example) who have had a trauma in early childhood and are therefore unable to form attachments or trust others.  They have a lot of very predictable behaviors, including manipulating others, lying, anger issues and social issues (not making friends.)

I have worked with many, many children who have had attachment disorders of various degrees. If I have gotten them very young (before 5 or 6,) I have been able to make good progress with building trust.  After that age, trust building and attachment is still possible, but it is a lot more work.

I wanted to share with you a case as an example of how some of the things I have talked about in other blog posts about building safety zones and layers of trust work. (See: The RAD Child: Situational Trust and Safety Zones:Part 1. The Bedroom    and Working with Foster Kids and RAD Kids: Part 2: Building on Situational Trust: Bartering for Goods

This example revolves around a boy we will call Steve.  I got him from a hospital setting. My home was his last hope, as he was deemed very hard to deal with due to highly manipulative behavior, demanding, refusing to participate in therapies and school lessons. He was unable to go to school. He was 12. He had been abandoned as an infant and adopted as a younger child.  He had ADD, RAD and Obsessive Compulsive Disorders. Because of violent outbursts his “parents” had put in a treatment center.

When Steve moved in he had his own room (each child must) and had his own separate bathroom. Normally children might have to share a bathroom, but my other kids shared a bathroom on another floor, so Steve had a bathroom on the main floor, which he could use, as well as any guests and visitors.  Steve was an obsessive cleaner and enjoyed decorating. This is how he comforted himself, and made himself feel safe. It lessened his anxiety.  He decorated his bedroom, and then I allowed him to decorate the bathroom as well.  He put fountains and other things in there that really wouldn’t be my tastes, but I allowed him to do it, to advance his feeling of being part of the family and make him feel safe. He was enlarging his safety zone from his room now to include the bathroom as well, which would eliminate any potential peeing issues in his room, as many kids will do that out of anxiety. (See the blog post:  Why is My Foster or Adopted Kid Urinating in The Closet (in a Jar, Towel, Hamper, Soda Can): The Red (or Yellow in this Case) Flag and How to Deal with It.

Next I wanted to expand his “safe zones” to include the living, kitchen and dining room.  I allowed him to help out by cleaning and decorating those areas as well, since he enjoyed these activities.

He would move things around, exerting some controls on these environments. Again, these were not things I appreciated, per se, but I allowed it for the time being to give him a feeling of ownership and make him feel safe and secure. He would put trinkets and decorations around the house that were childish, but they made him want to spend more time in the common areas, so I allowed it.

This also gave me more control over him in the kitchen, for example. If he was getting out of hand, I could suggest that I take the room back from him, meaning he would have to clean all his stuff out of the kitchen.

This would usually be enough to turn his behavior around because he would want to keep his stuff where it was, because it made him feel comfortable.  Just by telling him we might take the room back, he would be able to calm himself down and we could work through his behavioral issues.

Of course, he was still hypersensitive, had anger issues, yelling, all the regular symptoms, so anything I could use to control him I would use.   Allowing him to spread his roots by decorating the house had duo purposes.  

Allowing him to create an environment that he is going to attach to means allowing him to take some ownership by decorating and assisting in the cleaning of the space. This helps foster the increased feelings of safety and security in the home and in you, and is the foundation for personal trusting relationships.

 Slowly, as he felt more confident, I could begin to take back my common spaces and reduce the amount of “control” he had in those areas without making him feel anxiety.  I  found that he began to remove items and return them to his room on his own and that the importance of having his decorations distributed throughout the house diminished over time. This is a great indicator of growing attachment.

This was only one attachment “string” or method we used with this child in the home. I hope that by seeing an example of how this works in the "real world" you'll see how you can use it with your older RAD or foster kids to help build your foundations of safety and security.

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