Attachment Disorder Treatment

Attachment disorders are almost always caused by some sort of trauma experienced in early childhood. Risk factors may include:

• Physical or emotional abuse.
• Neglect.
• Loss of a parent or caregiver.
• Many changes in caregivers or extended breaks from the primary caregiver.
• A large number of medical procedures.
• Lack of care in institutional settings or out-of-home placements like foster care.
• Adoption.

There are different types of attachment disorders, and not all children or adolescents with attachment disorders have gone through severe trauma. Some may have ongoing issues with their parents or caregivers that cause the relationship to be permeated by fear or mistrust. For instance, when a parent or caregiver yells or places blame when a child cries or seeks comfort, the child may develop an insecure or disorganized attachment (more information on these kinds of attachment below).

It is estimated that up to 50% of children may have some sort of attachment disorder or insecure attachment.[1] This number includes those who have severe disorders as well as milder forms of insecure or disorganized attachments.

Anyone who goes through the kinds of trauma listed above can develop an attachment disorder. Attachments start forming shortly after birth and are more noticeable by the time a young child is six to nine months old.

Children who come from backgrounds where poverty is an issue are more likely to develop attachment disorders. Likewise, children of parents who have a mental illness are more at risk for attachment disorders.

There are many different symptoms of attachment disorders. Some parents or caregivers may not realize their child has an attachment disorder, or they may think the child’s symptoms are related to other (often medical) issues.

Symptoms of Attachment Disorders in Babies

Some common symptoms in young babies include:

• Colic or trouble feeding.
• Trouble gaining weight.
• Inability to be comforted.
• Seeming detached or unresponsive.
• Being overly comfortable with strangers (for older babies).

Symptoms of Attachment Disorders in Children

Children with attachment disorders might display different symptoms, such as:

• Defiant or disinterested behavior.
• Preoccupation with certain toys or behaviors.
• Not seeking or accepting comfort when distressed or upset.
• Feeling disproportionately sad or down even in safe situations.
• Hyperactivity.

Symptoms of Attachment Disorders in Adults

Attachment disorders can also affect adults. These adults usually experienced trauma in very young childhood that they may or may not be aware of. Symptoms of attachment disorders in adults include:

• Lack of understanding of social interactions and boundaries.
• Lack of inhibition.
• A willingness to trust strangers.
• Difficulty forming relationships and trusting others.
• Difficulty showing affection.
• Anger issues.

There are two main types of attachment disorders: Reactive Attachment Disorder (RAD) and Disinhibited Social Engagement Disorder (DSED). There are also different forms of attachment.

Reactive Attachment Disorder (RAD)

Children with RAD tend to avoid people. Symptoms of RAD include difficulty calming down when they become upset, and not seeking comfort from their caregivers. These children tend to be closed off and may feel sad or hopeless, even when they are with trustworthy caregivers.

Disinhibited Social Engagement Disorder (DSED)

Children with DSED are those who are too comfortable with strangers and who seem unaware of social boundaries. These children tend to be too open with people they don’t know and are willing to accept things from strangers, be held by them, or go off with them when asked.

Insecure Avoidant Attachment

Children who are insecurely attached to their caregivers seem as if they don’t care when their caregivers leave, but in reality, they are quite upset. When the caregivers return, the children don’t come back to them, or they ignore them.

Resistant Attachment

Children with insecure resistant attachment cling to their caregivers. They are fearful of abandonment and stay close to their caregivers. If their caregiver leaves, they have difficulty being calmed when the caregiver returns.

Disorganized Attachment

Disorganized Attachment refers to behaviors that are difficult to categorize. Children with disorganized attachment may display some behaviors that seem like they have healthy attachment, but others that show an insecure attachment.

Like other mood and behavioral disorders, attachment disorders are diagnosed when a doctor or mental health professional asks questions of the parent and child about their symptoms, medical history, and behavioral health history. The provider might also observe interactions between parents and the child.

Diagnosis for attachment disorder is typically not given before nine months old. To be diagnosed, a child must display a pattern of behavior corresponding to the symptoms above, and the provider will rule out other issues like autism spectrum disorder.

Attachment disorder interventions usually include therapy and parental education. In rare cases, medication might be warranted to address a child’s needs.

Therapy

Several different types of therapy might be used to help parents and children cope with attachment disorders. Cognitive Behavior Therapy, which aims at changing a person’s thought processes, is a common type of treatment. Play therapy and Attachment-based therapy are also useful.

Parenting Classes

Educating parents or caretakers about secure attachments and giving them the skills to parent their children in safe, healthy, and healing ways is extremely important when treating attachment disorders.

Medication

Medication is usually used to help children or parents who have parallel disorders, like anxiety or depression, as medication itself cannot solve an attachment disorder. However, managing a child’s or a parent’s other disorders will make it easier for them to bond.