Monday, May 12, 2014

Reactive Attachment Disorder (Part One)


Throughout my life I've encountered some hard knocks which have, in a lot of ways, left me cynical. Consequently, over the years, you might have heard me repeat the old adage:  "A leopard can't change it's spots".  Simply put, I have never bought into the idea that people change.  I now recant that statement and admit I was wrong, foolishly wrong, because I now know a leopard who DID change her spots. My teenage daughter, Natalie, is that person.  What once was a child who wanted to die, is a young woman who is eager to live. The rage has been replaced with peace, and the heartache with joy. I see the change, Praise God!  It is real.  

We adopted Natalie when she was three years old from a run-down neglectful Russian orphanage.  What we didn't know at the time was that we were bringing home a special needs child, one who had never been held or called by her name, one who had not been bathed or cared for, and one who, as a result of all of this, lacked the ability to attach.  The connection that is made inside the brains of babes when their mommas meet their needs with diaper changes, milk, and cuddles was never made with Natalie.  Instead, there is a something missing, and she has felt it every day of her life. The medical community has given the empty space a name:  Reactive Attachment Disorder.  This is our story:

"Does my child have Reactive Attachment Disorder?"  If you have ever asked the question, she probably does.  Let that sink in.  Your child likely has RAD, which means you are parenting a special needs child.  As more research is being done, conservative studies now project 30-35% of children who are adopted from other countries as well as children who have had experience being bounced around in the foster care system in our own country WILL struggle with some degree of attachment issues.  I believe, however, the number is actually much higher.  Like all other mental illnesses, the numbers gathered are based only on reported cases.  As I am finding out from the many messages I continue to receive from parents who have children showing signs of RAD, many cases are not being reported at all.     

Most parents are probably a lot like me.  They see warning signs, conduct that is not "typical", but because the behavior is sporadic instead of constant, those parents don't seek help until the behavior is close to full crisis mode.  Looking back, Natalie showed symptoms of RAD early on;  but because she came from a Russian orphanage, didn't speak our language, and had no idea how to belong to a family, my expectations of her were poles apart from the expectations I had for the children I'd birthed.  I made the decision to accept her as she came to us and to allow her to blend into our family in her own way and on her own time frame.  She was three, how hard would that be, right?  (Insert a gigantic gulp)

Bringing up Natalie, from the beginning, proved to be one of the most difficult tasks of my life.  Daily, the brand new little three year old who didn't speak my language gathered up small objects and hid them under her bed, in her closet, and in all kinds of other strange places.  At one time, our guest bathtub was filled with silverware, every baking pan I owned, Q-tips, Bandaids, and her brother's Pokemon underwear.  Uhhhm, talk about random.  Nothing was off limits.  Even when we visited the homes of friends and family members, I'd have to check her pockets to rescue little treasures she'd picked up to take home for her collection.  Ok, I told myself, I would probably hoard everything too if I'd never possessed anything in my life.  How could she understand, after all?  Well, when a child is still hoarding at the age of thirteen, developing an ingenious craft out of stealing while at the same time finding brilliant locations to horde (including cutting a hole into the seams of winter coats and hiding the goods beneath the lining of the coats), you know you've got a problem.     

Another big warning sign included mood changes.  She'd go from a happy giggling little girl at home to very sad and withdrawn when going out to a public place.  Being uneducated on RAD and mental disorders in general, I believed she simply didn't like to leave home and that she would eventually grow out of it.  I imagined her mood swings being brought on by a possible fear that we would leave home and take her to live with another family or even back to the orphanage, but it was deeper than that.  Natalie learned at a very early age that she could control her surroundings and the behavior of others through her own actions.  Her orphanage was rough.  Indescribable.  When there, my husband and I noticed whenever the workers were around, Natalie would hold her head down and stand perfectly still.  But as soon as they were out of the room, and she was safe in our care, she would morph into an animated, playful, charming little girl.  We falsely attributed it to a bizarre survival tactic, even laughed about it when we were in Russia, but it was actually so much more than that.  Natalie had learned to control her surroundings through behavior, and in doing so, thought she had learned to control her own life.  

This behavior continued into adolescence and carried into her teenage years.  As time passed, though, I no longer paid attention to it as much.  My mom would comment on how she always seemed to have a little dark cloud following her around whenever we went out, but I'd answer:  "That's just Natalie".  I remember, at one point, receiving an email from a concerned youth leader at church.  She informed me that Natalie always stood off by herself during the youth service, with her head down, weekly telling the leaders her heart felt very sad.  It was when Lydia and Caleb, her older siblings, began to report to me how Natalie had a group of adult leaders at church gathered around her week after week that I finally put two and two together.  I thought back on the many years of her showing the same behavior at the grocery store, at a social gathering, or at a restaurant....and sure enough, most times when we were out, and when she was acting all sad and blue, an adult (typically a woman) would seek her out and give her a word of encouragement or a compliment.  The little rascal was working her environment all along, even at the age of three in the orphanage.  The hole in her heart needed to be filled, and the attention of others filled that hole even if only for short spurts of time.

Two other behaviors that stick out to me as I look back are that she lied often and lacked impulse control.  Both were tied together like a redneck and his dually truck.  (If you are from the south, you totally know what I'm talking about).  For instance, when Natalie was eight years old, she developed a curiosity with my cold cream.    That's right, my beauty secret is Pond's Cold Cream, what of it?  Anyway, she would stand and watch me slathering it all over my face each night, rubbing my eyes until they looked like those of a raccoon, and then carefully wiping it clean.  She wanted to smell it, touch it, and asked me to put it on her face.  "I'll put a little bit on your face, but it might be too strong for your skin, so we'll have to be careful,"  I recall telling her one evening.  A few days later, I noticed she had very quietly disappeared, which was usually not a good sign. After searching the house in a panic, I found her in my bathroom with a towel, attempting to wipe up the white cold cream that was now coating every square inch of the carpet, the countertop, Natalie's body, and the cat.  As soon as she saw me, she pointed to the poor cat and said:  "Cassie did it and I was cleaning it up so she wouldn't get in trouble."  If this had been in the days of Facebook or Instagram, I would've posted it.  It is still a vivid picture in my mind.  And I can actually laugh about it now.

Another example was during a time when we were visiting my mom's house.  Not remembering to avoid candles at all cost when children are around,  especially Natalie, my mom had one lit in her bathroom when we arrived.  The scent of vanilla drew Natalie and her sister right to it.  And once again, after noticing they had quietly disappeared, I rushed to find them standing over the candle, sniffing in the aroma and filling their lungs with smoke (or so I feared at the time).  My mom asked Lydia to bend down and blow out the candle.  I believe she actually said it like this:  "Lydia, your mom is in a tizzy over that candle, so will you lean over and blow it out so she'll hush?"  I actually played out what was going to happen before Lydia had time to pucker her lips to blow.  Just as I was screaming "NOOOOOOO!", Natalie quickly bent her head down and blew that candle with all the air she could muster, blowing hot wax all over Lydia's face and hair.  Then, without hesitation and without a sign of guilt, she stood and said:  "Oh, I thought GiGi said for me to blow it out.  I'm sorry."  OK, Mom, do you now see why I was in such a "tizzy"?  Such is the life with RAD.

Natalie's symptom list is long, and with each one, I made an excuse:

1.  Wrestling with school work = Probably a learning delay
2.  Temper tantrum = She is high spirited, that's all
3.  Wanting her own way = The classic strong willed child
4.  Stubborn = Give her credit, the girl knows what she wants
5.  Obsessive Compulsive = She likes things orderly
6.  Lies = Lot's of kids tell lies, but they grow out of it
7.  Binging on food = Her body is growing
8.  No impulse control = She's just immature for her age
9.  Unusual speech patterns = Her first three years were spent in an orphanage where no one spoke to her, so I shouldn't expect too much.  

I am the mom of five children, and the two youngest have Down syndrome. Because their disability was diagnosed pre-birth and is something I can daily see with my eyes, I accept it and am eager to give them the help they need.  Natalie, on the other hand, didn't have a diagnosis and her appearance is that of a very healthy, typical girl.  So I denied it.  I totally missed it.  RAD stared me in the face every day, bearing nearly every symptom on the list, and I didn't recognize it.  THIS is the reason I believe it is much more prevalent than statistical data suggests.  If I didn't see RAD in my daughter, it's likely others don't see it in their families either. 

We adopted Natalie in 2001, making us one of those families who caught the awesome "save the orphan" tidal wave just as it was beginning.  Since that time, thousands of orphans have been saved and now have forever families in the land of the free and the home of the brave.  Many of those children have RAD, some more pronounced than others, but all of them are in need of early intervention.  If I had caught Natalie's RAD sooner, I think we could have avoided the long term treatment center route.  And that is why it is vital to consider and identify RAD early.  Know the signs, be willing to recognize symptoms of RAD in your own child, and then implement early intervention techniques.   

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