What happens when children with Reactive Attachment Disorder are not identified or receive the help they need before they become adults? Recently, I have been thinking about the similarities between intimacy anorexia and attachment disorders in the couples that I work with.
Do untreated attachment disorder children become intimacy anorexics? Are adult intimacy anorexics untreated reactive attachment disorder (RAD) children? Is my client, spouse or am I myself an adult that acts like a child because of attachment issues?
I am no expert in understanding RAD, as it is not a population I have worked with. But then again, maybe I have been working with the adult version in the form of intimacy anorexic clients. What happens when RAD children become adults?
There is a great deal of information online, in fact, much more than I expected. After growing up in a neglectful environment, there appears to be no known clear cause or explanation why some children develop RAD and others do not. However, there is a theme around the child not receiving their physical, emotional or relational needs appropriately by their parent or caregiver.
These children are not appropriately attaching to the caregiver and/or the caregiver to the child. There is the lack of or inappropriate emotional expression and/or facial affect exchange expressed to the caregiver toward the child. There are different severities of attachment disorders. It is often seen in children who were adopted or grew up in orphanages but not always. Children who grew up in traditional homes can also develop RAD.
Some believe untreated RAD children “grow-out-of-it.” Others believe mood disorders develop, such as anxiety, depression or bipolar disorder. Some believe and have evidence of these children developing borderline, narcissism, anti-social, avoidant, dependent, schizoid, OCD and many other adult personality disorders. Many of these personality disorder behaviors are seen in the RAD diagnostic criteria. I am not saying that I agree or disagree; however, there is more and more scientific evidence of unhealthy brain and emotional development in children. It also makes sense when humanity is designed for intimacy with God and others.
What I am learning is that there are two types of RAD. There is avoidant and anxious, our ambivalent types. I am not going to get into the specific difference, but I want to bring our attention to the behaviors that I see that are similar; and in many cases, the same behaviors we see working with adults struggling with intimacy anorexia in their marriages.
Intimacy anorexic behaviors that overlap with RAD:
- Unable to control or express anger or emotions appropriately
- Accuses, blames, and criticizes others
- Displays passive aggressive behaviors
- Has a victim mentality
- Intolerant of rules and authority
- Inability to show empathy or remorse
- Has difficulty trusting others
- Views relationships as threatening or too difficult
- May have an addiction to cope or create distance
- Has grandiose or unrealistic fantasies about themselves and others
- Has had many short-term relationships
- Views relationships as unfair and out of balance
- Views others as being difficult to understand
- May be socially awkward and have inappropriate social boundaries
- Unable to read social cues and body language
- Acts impulsively
- Uses love to reward or punish others
As I look at RAD and intimacy anorexia in adults, these are a few of the behaviors that overlap that I have noticed. I am not saying that RAD children become intimacy anorexics. However, it is something we should consider that might help our clients better understand how and why they have become intimacy anorexics.
Like most personality disorders, medication is not generally an option, as it is when treating a mood disorder. Creating a safe, loving and caring environment might work to help children with RAD; however, I have not seen this work well with adults. An adult’s brain is fully developed with beliefs and agreements that are now ingrained into the neuro network of their brain, heart and body.
Support groups, cognitive behavioral, Gestalt, trauma work, energy psychology, and mind/body techniques have helped many clients struggling with intimacy anorexia. Any or several of these might be a great treatment option for you or your spouse struggling with attachment issues from childhood.
Cory Schortzman is an author, speaker, teacher and licensed mental health professional. Since 2008, he has served as the Executive Director of Transformed Hearts Counseling Center in Colorado Springs, CO. He is the founder of SARA, the Sexual Addiction Recovery Association. Cory is passionate about helping couples and individuals overcome sex addiction. He is also passionate about bringing awareness to the public and supporting the elimination of sex and human trafficking. Cory has been married since 1998 to his beautiful wife, Kerry, and lives in Colorado with their four daughters. He and Kerry have been seen on the CBS Early Show, Inside Edition, and ABC Good Morning America, Fox 21 News, and TLC/Discovery discussing the harm of sex addiction and the joys of recovery. He has also been heard on numerous radio programs.
Cory’s books include: Out of the Darkness, Into the Light the Workbook, Into the Light the Steps, Ashes to Beauty the Steps, 301 Dating Ideas, 301 Conversational Ideas, 301 Ways to Say I Love You, 301 Ways to Love Your Children & 301 Recovery Tools & Tips.