Attachment disorder is a complicated diagnosis that can leave families at a loss on where and how to help.

What is Attachment Disorder?

Attachment disorder is a behavioral or mood disorder that affects a person’s ability to form and maintain close relationships. While directly affecting the individual suffering from the disorder, attachment disorder also can make life at home complicated and painful. According to the Association for Training on Trauma and Attachment in Children (ATTACh), attachment trauma occurs when there is a significant disruption in the bonding between a baby or child and the primary caregiver. It can be due to a traumatic experience such as abuse, neglect, divorce, serious illness, disruption in the home due to catastrophe or war, or death.

There are two kinds of attachment disorders: reactive attachment disorder and disinhibited social engagement disorder. Both present unique challenges and require different types of care.

Reactive Attachment Disorder (RAD)

RAD typically stems from early childhood neglect or maltreatment. It’s characterized by a lack of emotion, particularly during social interactions, difficulty calming down when upset or stressed, and low levels of social interaction with others. Mood issues such as anger, unhappiness, sadness, irritation, or fear when engaging in everyday tasks are also common. 

The disorder does not go away on its own, and it can persist into adulthood if not treated effectively. Adults living with RAD sometimes demonstrate:

  • A resistance to affection
  • Low levels of trust
  • A negative self-image
  • Difficulty reading emotions in others
  • Impulsivity
  • Fear of abandonment
  • Fear of rejection
  • Feeling of shame
  • Anger issues
  • Detachment
Disinhibited Social Engagement Disorder (DSED)

DSED is sometimes a response to social neglect or a lack of consistent caregiver attachment during the first two years of life. Children with DSED usually exhibit hyperactivity, extreme social ability, minimal social boundaries, and readiness to engage with and approach strangers. 

Like RAD, children who do not receive adequate treatment can live with DSED into adulthood. Common symptoms of the disorder in adults include:

  • Hyperactivity
  • A lack of social boundaries
  • A general lack of inhibition
  • The extreme trust of strangers or acquaintances
Treatment and Placement Options

Helping a child through healing will require therapeutic intervention for both the child and current caregivers ( Strategies to help your child learn improved relationship skills and trust require nurturing, responsive caring, consistent, and stable support from family, professionals, and educators ( A positive, interactive environment that makes the child feel safe, is stable, and meets all medical and safety requirements is a must.

Therapy should be provided together as a family and separately ( Often special education services are necessary to help the child academically, and parent training is recommended to support the family as they navigate how to help their child effectively.

On October 2, 2021, Gail Curran will present with a former client and the client’s mom at the ATTACh National Conference in Minneapolis. The session, “Fight and Flight: An Adoptee’s Journey to Healing,” will feature the young woman and her family’s trials and tribulations from her adoption from a Russian orphanage at six months of age to mental health and physical injury.

By Gail Curran, MS, MBA, CEP, IECA (AZ)

Gail Curran, Optimal Edu Options, can be reached at [email protected]