Reactive Attachment Disorder, what is it?

Reactive Attachment Disorder, what is it?

Reactive attachment disorder in children is presented as a condition in which their emotional development is limited, their social interactions seem inappropriate for the stage of development, some have difficulties in relating or do so in a very uninhibited way, the bonds that they establish in their life build them in a confusing way, due to a pathological upbringing, in which their basic and / or psycho-affective needs were not adequately coveredIt also happens when there is a traumatic rupture between the affective child-mother bond from the early stages of life.


  • 1 Why Reactive Attachment Disorder occurs
  • 2 Subtypes of Reactive Attachment
  • 3 Symptoms and causes
  • 4 The work that separates us
  • 5 Between love and hate: “ambivalent attachment”
  • 6 Psychotherapeutic intervention through art
  • 7 Strategies to raise happier children

Why Reactive Attachment Disorder Occurs

Affection, support and emotional containment, all are important in the healthy development of children, when they lack them or receive them inconsistently, their emotional development is affected. In reactive attachment disorder, the child shows difficulties or is unable to initiate and maintain social relationships in a manner relevant to its evolutionary phase and context, being aggressive-avoidant or very emotional, so much so that they do not discriminate against strangers

The human being, unlike other mammals, would not survive without the care of another person, so that this feeling of innate attachment contributes to our survival. The link is the emotional relationship established between the child and the person who raises or takes care of him, it is expressed by the way in which the child establishes certain behaviors in order to stay physically close to their caregivers, these behaviors may be evident from the first months of life.

During pregnancy, the child begins to develop the bond of attachment with his mother, around eight months of age, begins to develop separation anguish, which is something natural in its development, because until then it begins to see the mother as something separate from her, Margaret Mahler said that all children go through a separation and individuation stage, "Where the infant faces the termination of symbiosis with the mother."

Mahler affirms that, due to all the changes of his development, they naturally generate intense anxiety: the disharmony between the acquired motor skills and the emotional maturity available to the child, among others, can be triggers of anxiety. Also, Melanie Klein talked about the early object relationship, which includes anguish and defenses present in the baby's bond with his mother.

Winnicott also considered fundamental the role of the mother, in the primary situation of the child, since it is she, who plays the physiological and emotional function of holding company or bra, at that stage the mother works as the "auxiliary self" of the child: “Thus, a space of illusion is created between them. At a later stage, the mother must progressively disappoint the child, so that he can have contact with reality and develop the true self”.

A dysfunctional or broken affective bond, predisposes the child to be insecure and fearful of their present and future circumstances, they present so much pain in the face of separation that they experience anxiety states until they reach the degree of anguish.

The mother's task is to provide adequate support for innate conditions to achieve optimal development." Hartmann

The child with reactive attachment disorder (RAD) may have difficulties in creating bonds or relationships of trust with adults or with their peers, because in their upbringing they developed pathological links with parents or primary caregivers, especially with the mother.

The little or no parental ability to raise a child by transmitting affection, containment and care necessary for their healthy development, have a profound impact on the child and the relationships he will form throughout his life. Children with reactive attachment disorder may manifest avoidant behaviors Y refuse care of adults, for not feeling safe, comfortable or content In their presence, they often do not feel valued by their primary caregivers.

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Subtypes of Reactive Attachment

There are two subtypes of reactive attachment disorder:

Inhibited Type

  • The boy shows emotionally repressed, inhibited and distrustful, usually watches over people around him.
  • It can often be shown aggressive and afflicted, manifesting resistance to the rewards offered, often showing no affection or emotions, may experience inability to initiate conversations or develop normal social interactions.
  • They present a lot distrust of strangers and the people around them since they have never been able to experience a relationship of trust in childhood.
  • In severe cases they may become injured or injure others, showing hostility and disproportionate reactions.
  • The psychological disorder they suffer, in most cases, physically impact, causing delays in development in general or lack of physical growth.
  • When children cannot establish a healthy attachment relationship with a constant caregiver, they become children who exhibit hostile behaviors and may have aggressive outbursts, be cruel to people, animals and their environment, as well as have little or no empathy, as she normally learns from the mother.

Uninhibited type

  • In this subtype, the child has a lack of selectivity when choosing the linking figures, that is, they do not have appropriate social discrimination, so they can be overly confident with the people around them, looking for the affection they did not receive adequately during their first years of life, they usually manifest excessive affection with people who have just met, is unable to discriminate against their caregivers.
  • They are children that when come to a stranger have a lot of physical closeness with him, they can hug him and have an inappropriate confidence, since he doesn't know the person, which represents a risk factor for his safety. As a protective factor against abuse, abuse and other violations of their most serious rights, children need to learn to distinguish themselves (family members, caregivers and "trusted" people) from strangers.

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Symptoms and causes

The manifestations of reactive attachment disorder can range from extreme shyness to problematic behaviors with pictures of hyperactivity, lack of attention, impulsivity or aggressiveness, among other. This happens, in part, because these small ones show high levels in the segregation of cortisol and adrenaline, thus affecting their development.

Children with reactive attachment disorder can generate changes in your immunology and body weight. Some of them, have difficulties in their physical development and appear malnourished. These children consume a lot of energy in being alert and in trying to capture the attention of the mother, father or caregivers, that way they are establishing pathological patterns of attachment throughout life.

Affective communication between parents and children, the love of caregivers, especially the mother, allows the child to develop empathy: love and nonverbal cues with your mother such as looks, caresses and hugs, are typical signs of attachment, necessary among the family For a healthy development.

Risk factor's

When the child receives a pathological upbringing, it can generate the reactive attachment disorder. Some other causes that include this type of upbringing can be: not meeting your needs, depriving you of well-being, neglecting basic physical needs of the child, lack of affection and / or security, abuse, speaking to him abusively, physical or psychological violence, continuous changes of the child's primary caregiver, which prevents him from establishing stable emotional bonds, when there is abandonment of the child, divorces and / or separation of parents or when their caregivers do not adequately express their feelings and for this reason, they do not transmit love and affection properly, when their rights are violated.

The work that separates us

There are situations in which due to labor issues the mother or father cannot be with the child to meet their needs, either for long periods of time or for hours in the day; It is advisable that parents who are in this situation try to give their children quality time, since this is scarce and nourish not only with food, but with positive caresses for children. What are the positive caresses? Smiles, affectionate looks, do the everyday trying to meet their biopsychosocial and emotional needs.

Resilience protective factor

There are children who have more resilience than others, so that not all children develop reactive attachment disorder despite having suffered difficult circumstances, there are those who suffered greatly due to dysfunctional attachment ties with their primary caregivers, however, they tend to establish emotional bonds with other people, being covered in this way, some socio-affective needs.

The Breastfeeding, is considered as an optimal way to meet the nutritional needs of the baby, both physically and psycho-affectively, since the mother-child bond is strengthened, while both increase their health.

Between love and hate: "ambivalent attachment"

When the habitual caregiver elaborates an inconsistent, anxious or ambivalent attachment, that is, extremely affective and then avoidant or hostile with the child, until reaching the degree of physically and verbally mistreating it, given so much instability and constant uncertainty, the child develops a anxious attachmentIt also occurs when the caregiver has other serious personality disorders or emotional lability. In severe cases, the child may not be certain that at least his basic needs will be met, since he has no security, he generates separation anxiety, reaching levels of anguish.

The limits we learn and set from childhood, in turn, the type of attachment we develop will largely determine the kind of relationships we will have in our lives... Have you had a couple that does not stop sending you text messages, under any pretext? Or maybe he gets "folk" because you didn't answer his dozens of messages during the day? Do you know people who need to constantly know where and what their "loved one" is doing? The attachment in the relationships is also reflected, a typical example of anxious attachment is when one of the two or both are constantly sending texts and calling the couple, in anguish when they are not answered, sometimes for fear of abandonment , to deceit or simply feel that they need to be constantly "connected", which can be so strenuous for the other, that it can make it possible to fulfill their fears of abandonment by acting in this way: a self-fulfilling prophecy, as many end up "suffocating" emotionally to the couple.

Children who develop a ambivalent attachment they relate to others through aggression or inappropriate behavior, since the child has become accustomed to receiving attention only when he behaves in that way. People who develop an ambivalent attachment, when they grow up and have a partner, usually need constant conflict, they can be violent people with their partner at a physical and / or psychological level, after abuse, in reconciliation, they can be very affectionate, establishing and thus reinforcing the circle of violence and abuse.

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Psychotherapeutic intervention through art

Reactive attachment disorder, both in its inhibited and deshinibide form requires psychotherapeutic support for the child and the primary caregivers. Interventions are important to get the child to recover or develop confidence in adults, the psychologist serves as a figure with which you can establish a bond of trust, support and containment.

Children with reactive attachment disorder respond well to therapies that involve activities playful and artistic, such as music therapy, psychodrama, small plays or the winky theater, since they have powerful cathartic effects on them, so that they benefit greatly from this type of therapy, even children who have the avoidant subtype, those who show states of evident anxiety or hostility, usually show acceptance for this type of therapy, because the link is given through art and play.

It is possible to modify the avoidance behaviors, aggressiveness, hostility or those that include the lack of social discrimination, especially when treatment is initiated in early stages and the relevant changes in family dynamics are made, according to special psychoeducational suggestions for The family provided by the therapist.

Strategies to raise happier children

  1. Human development begins from gestation. Nourish your child with essential care and positive caresses consistently.
  2. Provide quality time to children, as much as possible, respecting that magical space in which they will strengthen their emotional bond, dedicate a few minutes to listen to it, far from any distraction: “disconnect a few moments from the networks and connect with your child”.
  3. When there have been conflicts, it is possible to restore the emotional bond, with simple daily actions, when the will to change family dynamics is not enough, the help of a psychologist is required.
  4. Do not physically or verbally abuse your child for making mistakes, when there is insistence on hostile or inappropriate behavior, other more appropriate psychoeducational strategies can be used, psychologists can guide you.
  5. Point out or label the behaviors and not the child.
  6. Sowing emotional ties with your children that include physical contact: distribute kisses, hugs, send messages of love and remind him that he is loved and important to the family.
  7. When you execute positive behaviors and efforts, congratulate and motivate you to achieve your goals.
  8. Limits are also necessary, when you specify them to the child do it with love.
  9. Listen and accompany the child in their emotions.

Items that may be of interest to you

  1. Child psychology, education, development and disorders
  2. Separation anxiety disorder, what is it?
  3. On adoption and attachment
  4. Anxiety disorders in childhood
  5. Cognitive Development in childhood: Language and Emotions

Bibliographic references

  1. American Psychiatric Association (2014). Reference guide for the diagnostic criteria of the DSM-5. Washington, D.C .: American Psychiatric Publishing.
  2. Bleichmar, N. M .; Lieberman, C. and Cols. (1989). Psychoanalysis after Freud. Mexico: Eleia Editores.