Sunday, September 21, 2008

how reactive attachment disorder consumed my thoughts this weekend

as a student teacher i had a little one in my class diagnosed with reactive attachment disorder. she had been adopted from a romanian orphanage at the age of 3 by a caring, well-meaning family who quickly became torn apart by this little one. they went to family therapy and the little one went to foster care until the grandparents of her original family agreed to raise her, which is what brought her to our tiny town.
she arrived in the class not long before i did. when i began my stint as a student teacher everyone was still walking around wide-eyed, wondering how to approach this charming, beautiful, yet thoroughly puzzling little one who could become violent or manipulative at the drop of a hat.
during my independent teaching she held scissors to a clump of my hair when i leaned down to help her with her work, threatening to chop it all off. there were pencil-dart throwing incidents, as well as some chair and desk shoving. i absolutely fell in love with her, yet also fully acknowledged that i had no way to help her. when my student-teaching time was over i was left with one final 6 weeks of my senior year (my college was on a trimester system). instead of taking a class that would have allowed me to join my fellow seniors at the river 4 days a week, i convinced my education advisor to let me do an independent study on reactive attachment disorder.
i talked to the professors in the psych department, ordered text-books for attachment-disorder graduate classes, and got busy trying to understand exactly what RAD is, and what it meant for the little one who had just consumed my senior year of college.
her 3 years in the romanian orphanage were to blame, according to my research, as the neurological connections had not been made to allow her to ever believe adults would provide and care for her needs. we were there to be controlled and manipulated, but not to help her. her perspective of relationships was that people controlled one another, she had no understanding of love or empathy as an emotion.
but what do you do about it? i found a list of books recommended to use with children diagnosed with RAD, such as the velveteen rabbit. i made a packet the little one could work through that went back and looked at her childhood memories. i am still haunted by her responses. throughout these interactions she drew herself as a baby hatching out of an egg, because, while others may have come from mommies, she knew she had not. she had no mommy. when i asked her to show me how to take care of a baby when it's crying she yelled, "shut up you stupid baby!"
then there was the day the class was writing about where they would go if they were flat stanley. she wrote that she would go to romania to feed the babies, because there were too many babies there. and she began drawing the babies on her paper. the more she drew the harder the lines became. it was watching a child in a trance, as she just whispered, "too many babies, too many babies". the paper was covered, front and back, with circles representing the babies where she was born.
all of this research was interesting but i was, and still am, acutely aware that i wasn't sure how much good any of it did. i am not a therapist, but a student who read a few books. she became better at explaining her emotions, and better at relating with her classmates, but i couldn't help wonder if i had only helped her learn to manipulate others through emotions, or if i was really helping her to understand herself.

this year i am working with a little one who reminds me so much of my original romanian baby. her hair hangs the same way down her face, her body language, her demeanor, her attempts at pushing people away all bring me back. yet this little one was not like this last year. last year she was happy, a bit shy, a bit sad, but overall a typically developing kindergartner. i feel like we are watching a train wreck and have no way of stopping it. she is slipping from the 'typically developing' side of the attachment chart to the 'attachment disorder' side.

i'm reading, rereading, and rethinking, everything i did back then. those old text books are out, i'm taking new notes, remembering old ones, desperate for some clue. part of what i've read has been reaffirming. we're doing the right things, we're on the right track. we react to her violent behavior in the right ways. part of the reading makes me frustrated because i am not a therapist, and if i was, the chances i would work with a child whose family does not have insurance to pay for mental health would be very slim. i'd rather work with her everyday in school, yet that means we're limited by our role as "teacher" instead of "therapist". some of the reading gives me hope, but much just scares me. unlike my other little one whose neurological brain map had been formed years ahead, i fear we are watching the re-mapping. we're watching her working internal model of herself change from positive to negative. how do we jump on the tracks and stop the coming wreck?


**************************** said...

I stumbled upon this post somehow and it broke my heart. I am a therapist (individual and couples therapy) and don't have direct experience with RAD but see the impact of attachment disruptions in some of the adults I see who struggle with connection with others. I've always been fascinated in a horrified way about RAD. I empathize with you in your response to these children.

Lisa Brookes Kift, MFT

Anonymous said...

Please make sure your textbooks are current. The attachment field has progressed rapidly especially in the last five years.

C said...

As a mom to two RADishes, I will say that there is nothing that anyone can do to bring healing to a child with RAD, unless they are a therapist that is working directly with child and Mom. Until everything is backed up, and that child bonds to mom ... the RAD exists. It all starts at home. That child simply cannot, and will not, ever trust you until they heal enough to trust mom.

Sounds depressing, I know. Actually, the role of teachers can be vital, as long as what they do does not interfere with the bonding that has to happen at home.

It's so strange and difficult for many people to comprehend, because it is so backward from most of the things that people deal with. Traditional therapy makes many of these kids worse. Any therapy that doesn't involve Mom (aka: primary caregiver) will be futile.

I think you should sit and latch on to the parents and make sure that you are working in conjunction with everything they are doing at home - they may kiss you right on the mouth. :)

Some things that you CAN do in the classroom are to get a little mini trampoline, and have them do 50-100 jumps 2-3 times during the day (every child in the class can do this, too - a quick jumpstart to the brain and gives the therapeutic quick up-and-down motion). Strong sitting is another great tool (do a google search on "strong sitting" for lots of info - my YouTube link will also come up on the first page). Taking a deep breath and holding for 10 seconds give the brain a big dose of oxygen when they are in that back stressed part of the brain.

I could go on for days. I've been entrenched in RAD for the last six months. There is hope. There is hope for every child, but it takes SO MUCH WORK!

Many educators don't really and honestly learn about RAD. I meet parents all the time who bring material in to help the schools understand. They get a little nod and nothing changes. Some RAD kids will not allow their teacher to see their negative behaviors for months (still in the charming stage with them). So, there are many who question whether the parents are even being truthful.

It's an uphill climb every day. To read how much YOU are researching and caring ... WOW!

Go rub off on EVERYONE!! :)

Anonymous said...

If you aren't familiar with Nancy Thomas, you should definately read some of her books. She is the RAD pro! Also, you as a teacher have a very important job when it comes to working with a RAD kid. There is nothing worse than not having a teacher believe in the disorder or believe that they know the cure. So kuddos to you for working so hard.