Reactive attachment disorder: symptoms, causes and treatment

Conflicts and lack of affection in childhood can feed this disorder.

A kiss, a hug, a caress... They all have something in common: in most cases they are carried out with affection.and most of them awaken feelings of warmth and affection in most of us. Let's imagine for a moment that we have never received any in childhood. Or that we have done so, but without any affection or emotion being manifested in it. Let us also imagine that we have always felt secondary, unimportant to those close to us. How would we feel? How would we relate to others?

It would not be rare that this would cause us severe limitations, which would mark and hinder our development as people and our social relationships. This is what happens to people with reactive attachment disorder.. Let's see what it consists of.

Reactive attachment disorder: main symptoms

Reactive attachment disorder is one of the one of the disorders related to trauma and stressors.. It is also a new disorder included in the latest version of the reference manual of clinical psychology and psychiatry, the DSM 5.

Reactive attachment disorder is characterized by the presence in children over nine months of age of a behavioral pattern in which high emotional and affective inhibition towards their caregivers, not seeking or even avoiding contact with them.The infant does not seek and even avoids contact and comfort from them even when there is a stimulus or situation that frightens him or her or causes him or her Pain or anxiety. In general, the subject feels unimportant and undervalued, and does not have a strong emotional bond with them.

This pattern of inhibition is maintained not only with their caregivers but also at the social level, expressing difficulties in reacting emotionally to the social environment and frequently expressing irritability, sadness or fear of caregivers even in non-threatening situations. They frequently express few positive feelings or emotions in social interaction..

The symptoms described above can be observed before five years of age, and it is important to keep in mind that a diagnosis can only be made if the diagnostic criteria for autism are not met. In this sense, it is easy to In this sense, it is easy to observe a certain similarity between some aspects of the symptomatology of both disorders, but there are major differences.but there are major differences. One of them is its cause, which in the case of reactive attachment disorder has been identified and is in fact part of its diagnostic criteria.

Causes

The causes of reactive attachment disorder, a de facto requirement for it to be diagnosed, are mainly found in insufficient care during the first years of life. The subject has not received enough affection and has not had his or her emotional and care, affection and protection needs care, affection and protection and/or basic physiological needs.

It is more frequent in families in which parents have poor parenting skills, or in those who tend not to express feelings. It is common in dysfunctional families, which do not provide or meet the basic needs of the child.

It is also possible that there has been intrafamilial violence, whether physical or not, or whether or not it is directed at the child in question, or sexual abuse. However, this does not mean that it cannot occur in families without great difficulties at the socioeconomic level, the defining factor being that they have not satisfied or have not known how to sufficiently satisfy the needs for affection, or have been excessively ambivalent in the expression of affection. excessively ambivalent in the expression of affectivity towards the towards the subject in question.

This disorder can also occur in children who have gone through several changes of primary caregivers (due to custody issues), or those who have been educated in institutions and contexts such as orphanages or foster homes where they have not been given enough time and their affective needs have not been sufficiently attended to. It should be kept in mind that the experience of these circumstances does not have to cause a disorder..

Treatments

The treatment of the disorder of the reactive attachment is complex and requires a multidisciplinary approach professionals from the fields of psychology, medicine, social work, education and the field can come together.

It is necessary that the subject can establish a strong bond with a caregiver a caregiver to provide emotional support.. For this reason, individuals with this type of disorder will often benefit from the use of family therapy, not only to treat the subject but also to establish appropriate educational guidelines in cases where there are deficits in parenting skills.

It is essential to work on the emotional component with the child. In this sense it will be very useful the use of therapies aimed at strengthening the subject's self-esteem, as well as training in social skills.as well as training in social skills. Cognitive restructuring will allow changing the dysfunctional cognitions that the subject may have regarding social bonding.

It should also be taken into account that some cases occur in a context of severe neglect of the child's needs, with circumstances that may even pose a danger to the subject's life, such as the existence of drug dependence on the part of the parents. In this aspect may require the removal of guardianship or custody by a judge, either temporarily or permanently. either temporarily or permanently.