Category: Parenting advice

How to discipline a child with Reactive Attachment Disorder (RAD) – Part II

In case you missed it: How to discipline a child with Reactive Attachment Disorder (RAD) – Part I


  • Behavior modification isn’t effective because kids with RAD often lack cause and effect thinking and are not sufficiently motivated by rewards. Furthermore, these tactics convey to the child what is important to the parent. The child can use that information to thwart the parent and gain control of the household.
  • Punishments act to reinforce the child’s innate sense of worthlessness. The parent and child will find themselves locked in an ineffective cycle of misbehavior and punishment when the parent is punitive.
  • Multiple warnings are perceived by the child as weakness and an opportunity to continue misbehavior. These nearly always backfire.
  • Reprimanding often provokes an extreme reaction, especially when done publicly because it plays into the child’s already low self-esteem and can trigger their internalized self-loathing and anger.
  • Zero tolerance policies leave parents with little latitude when the child refuses to comply. Parents may find themselves shocked by the obstinacy of the child who continues to up the ante.
  • Focusing on “why” is counterproductive because these children typically lack analytical and abstract thinking skills. Asking why or explaining why is likely to be frustrating for both parent and child.
  • Responding emotionally to a child’s behavior is unhealthy for the parent and places the child squarely in the driver’s seat. When a parent takes a child’s behavior personally and becomes provoked to anger, the child is in control.

As you can see, “Parenting 101” simply does not work with kids who have RAD. Those strategies,

  • continuously activate your child’s fight-flight response system
  • create a tug-of-war between you and your child
  • give your child opportunities to humiliate you with non-compliance
  • give your child the opportunity to exert their (age inappropriate) control time and time again, and
  • create frustrating loops with no off ramp for you as a parent

Most importantly, traditional parenting methods and approaches will not result in behavioral changes or compliance, especially as your child gets older. Since this definitely won’t work, trauma-informed therapeutic parenting  methods can provide a meaningful way forward.


  • Give choices that allow you to maintain control as the parent, while empowering the child. For example, ask if they’d like to do their homework at the kitchen table or on a pillow on the living room floor. By approaching the child this way, you can often distract them from willful disruption and obstinacy.
  • Be discrete when discussing matters with the child. Feeling backed into a corner, publicly shamed or teased is likely to trigger a negative, possibly violent reaction.
  • Rely upon natural consequences which are best for all children including those with RAD. Always use a neutral or empathetic tone and keep it as simple as possible.
  • Side-step power struggles by showing empathy, but not engaging in endless arguments which are usually counterproductive. The child is likely to capitalize on any discussion to thwart the rules. They also may use it as an excuse to escalate the situation.
  • Be prepared to remove yourself from the situation if you cannot cope. The extreme behaviors of kids with RAD can be extremely frustrating, overwhelming, and hurtful. It’s normal to feel emotional, but when you lose your cool, the child is in control.

None of these strategies are a magic bullet, but especially for kids on the mild end of the spectrum, you may be surprised by how successful they are. And even for kids on the more severe end of the spectrum, they are a way forward.


If your child is on the more severe end of the spectrum, and especially as they move into the teen years, therapeutic parenting will not be enough. You may need to re-evaluate your priorities and goals.

To start with, you don’t need to “fix” your child’s RAD. You don’t need to teach them the consequences of their actions. You don’t need to get them into college.

For many RAD parents, getting the child to 18 while keeping everyone safe, is enough. That alone is a monumental success.

This takes a significant mindset shift, but can greatly impact how we address situations with our child.

Let’s look at an example.

“My daughter was vaping in the school bathroom. She got caught but the school isn’t suspending her!! She sweet talked the principal and is getting a second chance. I’m going to call the school and demand that she be treated like every other student. She needs consequences to learn.”

To start with, in principle, I totally agree with this parent. However, in practice, I do not. And that’s where we need to live as RAD parents—what works in practice, not in principle.

Let me ask you this, will this child actually learn from the consequence of being suspended from school? Will they stop vaping?

Very unlikely on both counts.

If anything, they’ll use this as a future way to get out of school whenever they like. The child will not care that they have been suspended. They may even be happy about it.

On the other hand, any suspension will have consequences for the rest of the family. Here’s the reality of what this suspension may actually look like:

  • You will have to take time off from work to monitor the child
  • You will spend all day absolutely miserable, tortured by their behavior
  • Your other children will be trapped in the resulting toxic home environment

If the suspension isn’t going to teach the child and it will only be a punishment for the rest of the family, it’s time to reevaluate.

How might our response be different if we have more pragmatic parenting goals? These may be some realistic, pragmatic parenting goals:

  • Help my child get their high school diploma, fairly earned or not (this will make them more likely to be successful and independent at 18)
  • Protect my other kids in the home from primary and secondary trauma
  • Protect my own mental health and stay in a place where I won’t do something I regret

With these pragmatic goals, I’d be calling the principal to thank her for not suspending my child. In fact, I’d be using my child’s IEP to contest a suspension on the basis that the behavior was related to their disability.

How about chores? If you’ve been asking your child to take out the trash for months—years—and they still refuse, it’s time to rethink that too. First, accept that they’re never going to comply. Second, realize that every time you ask, you are picking up that rope in the tug-of-war they want to engage you in. Finally, you’re creating an opportunity for them to humiliate you with non-compliance. That doesn’t make sense if there’s no real hope of the child ever complying anyway.

As a fellow parent of a child with RAD, I know this is a hard pill to swallow. I know this is bad parenting advice—bad advice if you had adequate tools and supports for caring for a child with a severe mental health condition. But parents of kids with RAD don’t have that.

You don’t have the tools to do the job. And, so, you’re going to have to hold your nose and make the best of the bad choices you’ve got available to you. You must be pragmatic about what you can do and remember that the physical and mental well-being of the whole family matters, including yours.

This is an excerpt from the book Reactive Attachment Disorder (RAD): The Essential Guide for Parents

YouTube: Do kids with RAD misbehave on purpose?

Do kids with RAD misbehave on purpose?

Great to share with family and friends who don’t “get it” and are second guessing your parenting!

For neglected and abused children who are diagnosed with Reactive Attachment Disorder (RAD), insecurity, fear, and hurt are stamped on the very core of their being—even if they only act this out unconsciously. Their brains are ‘stuck’ in survival mode and as a result everything is about control because they’re afraid, anxious, and uncertain about the world around them and their caregivers.

The child is usually not aware of why they are acting the way they are and is acting out of subconscious trauma-based feelings. Because of this, therapist say that our kids are not purposely misbehaving. But any parent of a child with RAD knows this is simply not true. These behaviors can be both subconsciously motivated and purposeful.

RAD… or just “normal” teenager stuff?

Parenting a teenager is hard. And…parenting a teenager who has RAD is even harder.

Here’s the thing—sometimes we blame RAD when our teen is actually acting on par with their peers. For example, you might be frustrated with your RAD teen’s chronically messy bedroom and unmade bed, and blame RAD. You find a pizza box in their dresser drawer with half eaten pizza and say in exasperation: “That’s RAD!”

But, no. This is totally normal teenage behavior. In fact, I once found a half eaten pizza in my kid’s dresser drawer—and it was my birth son who doesn’t have RAD.

The Baltimore Sun calls this messy bedroom issue an “age-old impasse between teens and parents.” Their parenting experts suggest that we ignore the mess whenever we can. This is often the best approach with our RAD kids too. And, it’s easier if we can recognize it for what it is: normal teenager behavior. Of course, there are cases where RAD compounds this issue; for example, when our kid is collecting feces and urine in their bedroom. That IS a RAD thing and can’t be handled in traditional ways.

RAD can exacerbate normal teenage behavior or make it harder for parents to manage. Some of the behaviors can also be more dangerous for RAD kids who are particularly vulnerable due to their poor impulse control, under developed cause and effect thinking, propensity for risk taking, and lack of close relationships with adults they can go to for help. Still, it’s important to know the difference between normal teen stuff and RAD so we don’t lose perspective and we can better temper our expectations.

Below is a list of normal  behaviors teenagers commonly engage in. I’m not condoning them or necessarily passing moral judgement. I’m not suggesting you ignore them with your RAD kids. However, very high percentages of teenagers engage in these behaviors and only a tiny percentage of teens have RAD. I’m simply pointing out that these behaviors, in themselves, are not RAD.

Having a messy bedroom – Messy bedrooms, including food in drawers, unmade beds, uncleaned bathrooms, and mountains of dirty laundry are part of the teenage lifestyle. The Baltimore Sun calls this an “age-old impasse between teens and parents.”

VapingAccording to the CDC, 1 in 5 high school students have vaped in the last month. This is easier for kids to access than other substances and easier to conceal from teachers and parents.

Having a secret phone – 95% of teens have access to a smart phone according to Pew Research Center. Teens see their phones as an extension of themselves and when they are taken away they are very clever in finding ways around the punishment or they get a secret phone.

Watching porn and sextingBy age 18, 93% of boys and 62% of girls have been exposed to porn. Even more frightening are the statistics around sexting, sending sexually explicit texts. 1 in 4 teens are receiving sexts. 1 in 10 are forwarding sexts without consent which can have serious consequences including being placed on the sex registry list.

Having no motivation – Unlike generations of the past, today’s teenagers seem unmotivated to get jobs, drive, or move out of mom and dad’s house. According to USA Today, teens aren’t eager to get their driver’s license. Thanks in part to the pandemic, it’s become socially acceptable for kids to stay longer and longer in their childhood homes (New York Times).

Self-diagnosing mental health– One of the latest fads for teens is to diagnose themselves with bipolar, depression, an eating disorder, or any other myriad of conditions. And they don’t usually want treatment. This dangerous social trend seems to have begun with TikTok videos. Teenagers are doing this for a variety of reasons ranging from being in crisis and unable to access mental health resources to seeking attention.

Grappling with gender – One recent study in Pennsylvania found that 1 in 10 teens identify as gender diverse. A Gallup poll found that 1 in 6 GenZ adults identify as LGBT and with today’s teenagers this number is on the rise. This teenage generation has embraced gender and sexual diversity like no other before it.

GamingThe highest risk for video game addiction is for males aged 18-24. Research shows that young people spend more than eight hours online for entertainment (including gaming) every day. This is such a growing problem that the World Health Organization has added Gaming Disorder to their International Classification of disorders.

Addiction to Social media – According to one academic study teens use social media apps over 7.7 hours per day and 46% of them say they are “constantly” online. TikTok, SnapChat, and Instagram are the favorite apps for teens. Being addicted to social media is not only something normal for teenagers but for our whole society.

This is an excellent article on the hallmarks of this generation: Is This Normal? My Teens’ Gen Z Characteristics & Slow Adolescent Development

Reimagining Success as a RAD Parent #NAVRAD22

I’m in Atlanta at the Navigating RAD 22 conference with RAD Advocates this weekend. For those of you who couldn’t make it, this is your place for the highlights from the amazing speakers!

Reimagining Success as a RAD Parent

Keri Williams, author and advocate

Highlights & Take Aways

  • Success begins with getting everyone’s head above water. Depending on your situation and child, this alone may be all you can do.
  • With RAD kids you’re not going to be successful if your goal is to help them live up to their potential. The disorder is too dysregulating for our kids to tap into their gifts and talents right now. And given the control symptomology of RAD, they probably don’t want to live up to their potential right now.
  • Goals as a RAD parent must encompass the whole family, not just child with RAD.
  • In the day-to-day, we need to ask ourselves, “Is this something I’m willing to sacrifice my other kids for?” Remember, consequences and rewards don’t work for RAD kids on the moderate and severe end of the spectrum.
  • For most kids with RAD, the best way forward is to keep them in school. If they sweet talk the principal out of a suspension, let it go. That suspension wouldn’t teach them anything and would only be a punishment for the rest of the family.
  • Kids with RAD aren’t going to learn from failing classes or being retained. That’s only going to make them less likely to be independent and out of your house at 18. It may feel incredibly unjust, but let the school promote them through if they will.
  • Get an IEP with a behavioral plan so your child can have modifications and legal protections against suspensions and expulsions.
  • If your goal is to keep your child in RTF, you do not want to be a “problem parent.” If you are, they’ll likely find a way to discharge your child or be suspicious of you and raise the risk of them reporting you to CPS.
  • Having felony charges will be a major barrier to your child ever being independent (felonies lead to lifelong issues with housing, employment, public assistance – all of which our kids on the severe end of the spectrum will almost certainly need). Carefully consider if pressing charges makes sense.
  • The traditional parenting goal of helping our kids live up to their potential doesn’t apply – the disorder is too dysregulating for our kids to tap into their gifts and talents and they probably don’t want to live up to their potential right now.
  • Especially if they are violent, having them view you as the enemy can literally put you and your other children in danger. Find ways to pull back and build good will with your child.

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Keri Williams, author and advocate

Keri Williams is a foster and adoptive parent who has spent over a decade navigating the mental health system on behalf of her children. She advocates for reforms in the mental health system to better serve our society’s vulnerable children and the families who care for them. She’s a passionate supporter of adoption when adoptive parents are informed and supported. Keri is the author of Reactive Attachment Disorder (RAD): The Essential Guide for Parents and But, He Spit in my Coffee: A reads-like-fiction memoir about adopting a child with Reactive Attachment Disorder(RAD). She holds the IndieReader Best First Book award for her memoir. Keri lives in North Carolina and has five children including two who are adopted out of foster care.

Glass Children: The Impact of RAD on Siblings #NAVRAD22

I’m in Atlanta at the Navigating RAD 22 conference with RAD Advocates this weekend. For those of you who couldn’t make it, this is your place for the highlights from the amazing speakers!

Glass Children: The Impact of RAD on Siblings

Monica Badgley, RAD Sibs with a panel of young people

Highlights & Take Aways

  • See Them: Help them recognize their value apart from their sibling with RAD
  • When your bonded child comes to you with a hurt, don’t listen for the facts of what happened. Trauma minds don’t always remember all the details. What they’re really saying is that they were blamed for something their RAD sibling did and the details don’t matter.
  • Bonded children who grow up with RAD siblings need to process their trauma so they don’t bring it into their own future families.
  • Bonded kids often come to have this mission to help their parents with the RAD kid. They aren’t able to rest in their role as a kid and they grow up quickly. As parents we need to be mindful that our child sees themselves as a teammate.         
  • As parents we have to learn how to set our bonded kids free. It’s not their job to protect us and to take care of their RAD sibling.
  • Bonded kids with RAD siblings also can develop amazing skills of independence, resilience, self-sufficiency, and the ability to find the silver lining.
  • A lot of bonded kids with RAD siblings use humor to cope.
  • In a household that is high pressure kids can start to shut down. Arts can help kids to express themselves, feel and heal.
  • When our kids expose how they are feeling it is their way of decompressing. Even if you feel that you have no idea what to “do,” that doesn’t matter. Just let them talk. Talking allows them to process their feelings which is the step to healing.
  • Having alarms on your RAD kids door can help your other kids cope if they are afraid at night.
  • Your bonded children can also benefit from fidget toys and a safe place.
  • After you are finished managing a rage be sure to check in on the other kids and make sure they’re okay. Let them know that they’re not a burden.

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Monica Badgley, RAD Sibs

Monica Badgley is on a mission to create a community of support for siblings of those with RAD. After several years of focusing on her children with RAD, Monica’s eyes were opened to the traumatic impact it was having on her child without RAD. To bring a platform to these often overlooked children, Monica founded RAD Sibs, an organization supporting siblings of people with RAD, helping them to feel less isolated and no longer seen through like “glass children.” RAD Sibs offers community and validation through Sib Shops, videos, interviews, and encouraging mail.

Find Monica at RADSibs

Determining What You Have Left as a Family and Ideas to Move Forward #NAVRAD22

I’m in Atlanta at the Navigating RAD 22 conference with RAD Advocates this weekend. For those of you who couldn’t make it, this is your place for the highlights from the amazing speakers!

Determining What You Have Left as a Family and Ideas to Move Forward

Carrie O’Toole, , M.A., board-certified Christian life coach

Highlights & Take Aways

Carrie is our people and we are her people. After struggling with infertility, she and her husband created a family of two adopted children and one birth child. Their youngest, Sam, they adopted from Vietnam at the age of 3 ½. Their long journey through special-ed, hospitalizations, and multiple diagnoses including RAD ended with relinquishing Sam for adoption into another family. After suffering devastating judgement from the people she thought would support her, Carrie has devoted her life to being there to support other families who find themselves grappling with these difficult situations.

  • We’re told all we need is love by churches, agencies, therapists, and our families but that’s not true. Love cannot cure trauma.
  • Some families are damaged beyond the point of recovery.
  • Moms of children with RAD do develop PTSD.
  • We all believe adoption is forever, but sometimes that’s not what is best for the child or the family.
  • When considering if your child should continue living in the home you have to think about yourself, your other kids, your marriage, etc. It’s not just your child with RAD. Consider,
    • Do you have the finances? Do you have the emotional support?
    • How traumatized is everyone in the family, especially mom? Sometimes mom can’t recover from her trauma with the child in the home. It’s very hard to heal PTSD with the child who is triggering you in the home.
    • This is true for the child too. If you’ve become the “nurturing enemy” mom, it’s very hard for them to heal in the home.
  • Living with a RAD sibling has significant impact on siblings. In partnership with RAD Sibs, Carrie offers groups, support, and curriculum for siblings.
  • Parents/former parents of kids with RAD can be amazing respite providers because they understand RAD and we know that kids with RAD won’t do it to us.

Carrie offers resources through Carrie O’Toole Ministries including a faith-based Relinquished Retreat to help parents process trauma and grief related to trauma, adoption, and relinquishment. This retreat is not only for parents who have already relinquished. It’s for anyone who has put their children in out of home care or who is considering it.

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Carrie O’Toole, M.A., board-certified Christian life coach

Carrie works as a coach, helping other struggling adoptive parents to heal from their own grief and trauma. She helps parents through coaching, her book, Relinquished: When Love Means Letting Go, documentary film, Forfeiting Sanity, the Relinquished Retreat for Parents, blogs, and podcasts.

Find Carrie at Carrie O’Toole Ministries

“Why Am I Feeling Crazy?”: The Life of RAD Parenting” #NavRAD22

I’m in Atlanta at the Navigating RAD 22 conference with RAD Advocates this weekend. For those of you who couldn’t make it, this is your place for the highlights from the amazing speakers!

“Why am I feeling crazy?”: The Life of RAD Parenting

Forrest Lien of Lifespan Trauma Consulting

Highlights & Takeaways

  • To understand RAD we need to understand Erik Erikson’s attachment cycle theory. Kids with RAD have disrupted development prior to the age of 3 and their need to survive is locked in. Our RAD kids are locked in an arousal state because they learn at a young age from abuse and/or neglect that that creates more safety for them than dissociation (neglect often can be more profound than physical abuse).
  • Bonded kids want to please you, but RAD kids don’t have that connection with you, so lying and stealing become part of their toolbox for control. “Lying and stealing” is a developmental delay in the attachment.
  • Traditional residential treatment programs don’t make kids with RAD “family kids.” When behavior modification is the model, kids are following the rules for rewards not in order to go home. Those facilities are staffed with newbie social workers and therapists and our children are exposed to other kids with similar behaviors and issues.
  • Can we “fix” a kid with RAD? It depends on how severe It is and how empty they are.
  • We can’t treat the RAD unless we treat the mental illness first (such as bipolar and mood disorders).
  • There is no pill that is going to fix RAD. Medications can regulate the brain—make kids more clear in their thinking and calm—and we can treat them. Unfortunately, it sometimes creates a more clear thinking and calm RAD kid.
  • If kids with RAD don’t want to learn, they’re not going to. Parents shouldn’t work harder than their kids on their life.
  • The cuter and smarter the RAD kid, the harder they are to treat. These children can be very sophisticated in grooming the adults around them.
  • Here’s how moms of kids with RAD get PTSD: repeated rejections from the RAD kid, relentless control battles, losing your friends/spouse, becoming isolated without support.
  • Dads need to believe their spouse. This doesn’t mean that moms don’t sometimes respond badly, but that needs to be put in context. RAD kids can make moms crazy.

I’m so thankful for Forrest, one of the few professionals who really “gets it” and is supporting and advocating for our families.

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Forrest Lien, LCSW, Lifespan Trauma Consulting founder/owner

Over his career, Forrest has avidly shared his expertise to advance the field of trauma. He has consulted with 20/20, HBO, and The Today Show and has presented at over 300 workshops internationally on the effects of early trauma including at the Mayo Clinic.

As founder and owner of Lifespan Trauma Consulting, Forrest continues his legacy of highly sought-after training, program development, and advocacy for families and their children with reactive attachment disorder.

Reactive Attachment Disorder (RAD) visualization: Restoring empathy

Here’s a meditation from Chel Hamilton created especially for RAD moms to help us recenter and return to that place where we can view our child’s challenging behaviors through the lens of their trauma. Chel walks us through a powerful visualization exercise to restore our empathy, a feeling that is so easily worn away by the daily struggles we face with our child.

Tips to survive parenting a child with RAD as an introvert

Being the the parent of a child who has Reactive Attachment Disorder (RAD) as an introvert can be incredibly challenging. Our child’s needs and the extensive interactions we have with service providers leave us drained and unable to recharge. Most days we don’t even have five minutes to ourselves and are bombarded with constant, mostly unpleasant stimuli. By understanding our strengths and needs as introverts, we can better parent our children and better care for our own mental health.

What is an introvert?

We think of the extrovert as the life of the party while the introvert curls up on their couch with a novel. In truth, the extrovert-introvert personality trait exists on a continuum.

These are some common qualities introverts share: 

  • Prefer calm, less stimulating environments
  • Introspective, reflective, and self-aware
  • Need to prepare to spend time in groups and crowds
  • Enjoy small, close circles of friends
  • Lose energy in social settings 
  • Need to spend time alone to recharge
  • Prefer to write/text instead of talking

Being an introvert is often confused with being shy or socially anxious and some introverts do have these personality traits. However, there are many introverts who are not shy and are not socially anxious. 

Playing to your strengths

First, as a fellow introvert, let me say, there is nothing wrong with being an introvert. In fact, one recent study found that introverts are more likely to be successful CEOs. That’s great news for parents of kids with RAD because we sure have our hands full!

So, let’s start by looking at 3 ways we can play to our strengths to be more successful in our role advocating for our children.

  1. Family-team meetings and therapy sessions are full of non-verbal communication and layers of context. TIME Magazine compares an introvert’s observation skills to a “superpower.” As an introvert you have the advantage of excellent observation skills and intuition to gain insight into these highly charged situations and navigate them safely and more effectively.
  2. Frustration, anger, outrage – big emotions – often lead to words we all wish we could take back. When working with service providers this is especially true. Introverts tend to think before they speak and choose their words wisely. Your introvert’s quiet nature is a huge advantage because it will help you be more cautions in your interactions and make you less likely to speak off the cuff.
  3. RAD is a nuanced disorder and untangling any situation with your child, a therapist, CPS person, or teacher can be seemingly impossible. “For an introvert, [active listening] is a natural way of being.”  As an introvert your natural listening skills are a big advantage to enable you to understand what each person is saying and better communicate.

You are your child’s best advocate, and remember that you you bring a lot to the table specifically because you are an introvert.

Tending to your needs

People with introverted personality types have two very specific needs:

  1. They need to mentally prepare for socialization
  2. They need regular alone time to recharge

Our child, their therapist, the parade of service providers, endless appointments, and dealing with extreme behaviors — make meeting these needs impossible. This leads to introverted parents quickly spiraling into depression and hopelessness. They literally have no energy left to draw from because they are running on empty. There is no silver bullet solution and in some cases you may need to consider if RTF is an option. But, there are some ways you can prioritize your needs to protect your mental health and enable you to better meet the needs of your child.

Here are a few simple ideas that worked for me:

  • Start each day with some alone time (even if it’s 5 minutes before you wake up the kids).
  • Use soothing techniques like a deep-breathing exercise or a calming meditation.
  • Pick your battles – know your limits. If letting the kids watch TV gives you some alone time, I say go for it. 
  • Create boundaries with service providers (ask that they schedule all calls ahead of time, or at least text to ask if you’re available before calling).
  • Ask for time to review any documents before you sign them – even if it’s just to buy you time to process the meeting you just had.
  • Take a coffee or soda to meetings so you can take a sip to give you a few seconds to gather your thoughts or get through an awkward moment.
  • Leverage emails. Write notes before phone calls and meetings. Practice, practice, practice.

What has worked for other parents:

“I commandeered a room in our house as ‘mine.’ I give notice before going in that they need to get what they need from me before the door closes. If I’m in there with the door closed, I’m off limits … usually doing yoga or meditating. However, it only works if they’re sleeping (i.e. 5am or 10pm) or if my husband is home.” – Thanks to Allison for this tip!

Are you an introvert? What other ideas do you have for leveraging our strengths and prioritizing our needs while parenting a child with RAD?

Remember to focus on the amazing strengths you bring to the table as an introvert and look for creative ways to meet your needs.

When suicidal ideations may not be serious

I opened the closet door to find my son Devon squatting in the shadowy darkness with a belt looped loosely around his neck. He was 9. Confident that he wasn’t actually trying to hurt himself, and was only trying to get attention, I hid my fear. I knew if I showed my alarm, he’d be more likely to do it again. And again.

“Stop being silly,” I said in as carefree of a tone as I could manage. I took the belt, which wasn’t even buckled, from him. Unfortunately, in spite of my nonplussed response, his behavior escalated until I had no choice but to bring him to the mental health emergency room.

The intake nurse explained to me that he was experiencing “suicidal ideations,” that is thoughts or plans to commit suicide. “But he’s not actually thinking of harming himself,” I insisted, surprised by her diagnosis. “He wouldn’t even know how to kill himself with a belt. He’s only nine.”

Looking down her nose at me, the nurse said, “We don’t really know that, do we?”

It’s a complicated scenario faced by many parents of children with reactive attachment disorder (RAD) – kids like Devon who are sometimes willing to up the ante sky-high, even threatening self-harm and suicide. This is because kids who have RAD are desperate to control the people and situations around them. While there are certainly some who are suicidal, it’s not uncommon for kids with RAD to use these behaviors as a coping mechanism, with no genuine intention of harming themselves. And, the payoff can be huge. They avoid consequences, side-step difficult conversations, garner sympathy and attention, and gain control of virtually any situation.

My son, now 16, routinely threatens to kill himself over the smallest of triggers – breakfast cereal he doesn’t like, being told no, having to wait his turn. He’s attempted to slit his wrists with paper cuts, tried to hang himself using a belt on a closet rod, and tried to strangle himself with his shirt. Perhaps the scariest incident was when he climbed to the top of the rail of a second floor stairwell at school and threatened to jump. During the subsequent suicide assessments, Devon always admits he was bored, mad, or frustrated – not actually wanting to kill or hurt himself. Therapists, nurses, and social workers who have witnessed these incidents agree they are motivated by a desire for attention or a desire for control. We also all agree that the attempts are inherently dangerous, regardless of his motivation.

But why?

In some cases, his behavior is deliberate and calculated. Other times, it’s caused by dysregulation, lack of cause-and-effect thinking, and poor impulse control. In these situations, it has been helpful to me to remember that my child’s innate need to control situations and people is borne of childhood trauma. I am better able to respond from a place of empathy when I keep in mind the neglect or abuse that has causes my child to go to such desperate lengths.

Though the initial incidents of suicidal ideation are alarming, parents of kids with RAD can become weary and calloused over time. Click To Tweet

What to do

Though the initial incidents of suicidal ideation are alarming, parents of kids with RAD can become weary and calloused over time. It is, after all, counterintuitive to give credence to threats that seem designed to manipulate or control, but these behaviors are simply too serious to ever be minimized or ignored. Even if you’re 1000% certain your child has no intention to kill himself, you must take suicidal ideations seriously every time, and here’s why:

    • You may be misinterpreting the situation and they may really desire to harm themselves.

    • They can accidentally hurt themselves, even if that’s not their intention.

    • These behaviors are clearly indicative of an underlying problem that needs to be addressed.

If your child is having suicidal ideations here are some steps you can take to keep them safe and find a way forward.

Plan Ahead
    1. Create a detailed safety plan

    2. Know what mental health resources are available in your area including contact information, hours, and crisis services offered.

    3. Be vigilant. What this looks like in your home will be unique to your situation, but it may include locking away knives, removing belts, or installing collapsing closet rods.

In the Moment
    1. De-escalate the situation at all costs in order to stop your child from endangering themselves.

    2. Lower your expectations – now’s not the time to quibble about tone of voice, cursing, and other unacceptable behaviors. Your only goal is to keep your child safe.

    3. Seek emergency help by calling a crisis team or taking your child to the mental health emergency room. In some cases, you can schedule an emergency session with an outpatient therapist.

After the fact
    1. Follow-through with recommendations for therapy, medication management, and other services.

    2. Identify and address underlying triggers.

    3. Update your safety plan based on the latest episode.

When our children use suicidal ideations to manipulate and control situations it can be tiresome and frustrating. It’s easy to begin reacting to these behaviors like we do any other attention-seeking behavior. But, with suicidal ideation the risks are simply too high. Always take them seriously and make safety your priority.

What it’s like being the sibling of a child with RAD

“It’s like living in a prison. We can’t go anywhere. All doors are locked. Alarms everywhere. We can’t have friends over. Stuff goes missing. We’ve all had black eyes, split lips and bite marks…we’re the ones who suffer.” – Grace, 14, on living with a sibling with reactive attachment disorder.

Grace’s experience is not uncommon for siblings of children who fall on the moderate to severe range of reactive attachment disorder (RAD). The dysregulation and other challenges of RAD restrict family activities, cause stress and chaos, and require a disproportionate amount of parental attention and energy.

Siblings are too often the overlooked victims of the disorder.

I initially thought that adopting another child would enrich the lives of my other kids. I certainly never imagined that it’d be a traumatizing situation. For years, my children were routinely exposed to scary outbursts and stressful conflicts. They were humiliated and embarrassed at school – especially after their brother who has RAD punched a teacher in the stomach. They missed out on sleepovers, birthday parties, and were late to basketball and soccer practices. Doing my best in the moment – surviving – I didn’t realize how difficult things were for them until much too late. They had internalized fear, anxiety, and anger.

Doing my best in the moment – surviving – I didn’t realize how difficult things were for them until much too late. It was only later that I realized how traumatized siblings internalize fear, anxiety, and anger.

The struggles and emotions of brothers and sisters of children with RAD—siblings like Grace—can best be understood through their own words. I put up a post on two online Facebook support groups to gather those sentiments. In those posts, I requested parents to ask their children what it’s like having a sibling with RAD. I’ve included their responses throughout this article and only edited their comments for grammar.

Living in Fear

Many siblings are trapped in a perpetual state of anxiety and vigilance, fearful for their own safety and the safety of their parents. They’re often targeted with physical aggression and witness terrifying situations.

Here’s what siblings are saying:

“I can feel her getting all angry and I get worried and feel a little sick in my stomach. When she gets really bad and is yelling and screaming and hitting you [mom] I feel upset that I can’t stop her, that I can’t protect you from her.” – Chad, 10

“Mommy, I am scared. She hurts me.” – Susie, 6

“Is the door locked?” – Jake, 15, sleeping on his parent’s bedroom floor with his 10 and 12-year-old brothers.

“I’m scared she’s going to do something to me. But I won’t let her know I’m scared.” – Mia, 11

“I wish she could live somewhere else. I don’t like her anymore. She’s never nice.” – Ava, 4, whispered to her mother afraid her sister with RAD would overhear and retaliate.

“No, Sis!” – Emma, 2, screamed in a nightmare after watching her 12-year-old sibling with RAD physically attack her mother.

“Why is she always so mean to me? She’s always hateful and yelling at me.” – Ashley, 10. A middle child, Ashley also has a brother with RAD. Of him she says, “He lies to get me in trouble. He hits me and threatens to kill me and swears at me.”

What you can do

Put alarms on sibling’s doors to help them feel safe. Give them the option of sleeping on a daybed in your bedroom. Make a concerted effort to minimize their exposure to violence and danger with an escape plan out of escalating situations. This may mean calling grandma to be picked up, going outside to play or another option that works best for your family.

Internalizing dysfunction

For many siblings, family life can be highly dysfunctional and confusing. This can lead to a warped view of normal family relationships with devastating, lifelong impacts. Siblings often struggle to differentiate the person from the disorder and come to hate their brother or sister who has RAD.

Here’s what siblings are saying:

“She always says she’s sorry and goes right back to being so happy when I’m still hurt. I can’t trust her anymore because she always says she won’t do it again and then usually does in the very same day.” – Beth, 10

“I never want children of my own. What if something goes wrong and they end up like her? I just couldn’t handle raising a child like that!” – Marie, 29

“Mom, does he have to come home? You are so much nicer when he is gone.” – Brandon, 12

“Sometimes I feel like no one can see me because my mom and dad give [my sister with RAD] constant attention.” – Honor, 6, who after having to help out with her RAD sister says she never wants to have children.

“It breaks my heart to hear my baby sister say she hates me and is going to kill me tonight! It’s not fair.” – Samantha, 15, said weeping.

“They’re always mad, sad, and don’t like their mom or dad, and lie all the time.” – Addison, 10, on why all siblings are bad.

“Don’t you get it? She is a horrible person.” – Kayla, 12, when she found her mom sobbing over something her sister with RAD said.

What you can do

Let siblings be honest about their feelings and don’t minimize their experiences. Find a good therapist who can help them process and gain some perspective. An outside person, like a therapist, can help them develop empathy and compassion while maintaining healthy boundaries.

Many people think that time apart is counterintuitive in helping a child with RAD and their family heal and attach. Yet, it’s quite the opposite with the right model.

Losing their childhood

Siblings don’t live the carefree lives of others. They miss basketball practice and piano lessons when their sibling flips into a rage. They aren’t able to go on family vacations and outings are often cut short. Their treasures and toys are broken. Their allowance is stolen. For them, growing up can be less than ideal and full of heartache and challenges.

Here’s what siblings are saying:

“I’m only 10-years-old! I’m too little to have to deal with this stuff!” – Ethan, 10, once a happy-go-lucky boy who is in therapy. ‪

“It was depressing and exhausting. I was never allowed to have fun.”  – Michael, 10, who has been in therapy for the last two years.

“It feels like living in a minefield. Looks peaceful and nice one minute, war zone the next.” Jeffrey, 8

“I never get to have friends over and I missed my best friend’s birthday party. I already had a present and had to give it to her at school on Monday.” – Abby, 11

“They have no idea what it’s been like!” Skylar, 8, cried after neighborhood kids blamed her when her sister with RAD, 11, was removed from the home. Her sister was removed because she was planning to murder Skylar and her family.

“I can’t wait to move out.” – Hunter, 17. When Hunter’s sister Ava, 10, also traumatized by their sibling with RAD heard this she said, “You can’t leave me here with her!”

“Sometimes it feels like it will never end.” – Emma, 15, who has started cutting to “release” the pain, is severely depressed, and has lost 40 pounds in the last year after witnessing the tantrums, explosions, anger, aggression, violence, and threats of a sibling with RAD.

Siblings don’t live the carefree lives of others. They miss basketball practice and piano lessons when their sibling flips into a rage. They aren’t able to go on family vacations and outings are often cut short…For them, growing up can be less than ideal and full of heartache and challenges.

What you can do

Enlist family and friends to help siblings with rides to practice, science fair projects, and other important activities. When accomodations cannot be made, acknowledge your child’s feelings and validate them. Enroll them in camps. Let them stay with grandma or auntie for long vacations to get a break and enjoy their childhood.

Collateral damage

Many parents, myself included, are so consumed with the minute-by-minute challenges of raising a child with RAD that they underestimate, or don’t fully recognize, the impact on siblings. It was only after my son was admitted to a residential treatment facility that I began to fully understand how his disorder had impacted my other children. To this day my youngest son who lived in fear of his brother for the first five years of his life is highly anxious and at age 11 is afraid to sleep alone. I often wish for a do-over.

When assessing treatment options for your child with RAD, be mindful of the needs of siblings. Many people think that time apart is counterintuitive in helping a child with RAD and their family heal and attach. Yet, it’s quite the opposite. “Time apart allows the parents and other children to heal from their own trauma while, at the same time, kids with RAD learn how to attach and to live in a family,” said Executive Director Forrest Lien. “When the children return to their own families after the Institute, everyone is stronger. They can live together safely. We’re strengthening families so they don’t fall apart forever.”

Don’t make the mistake of imagining siblings are coping and doing okay. Don’t, like me, realize only once the damage has been done. There are no perfect answers, but understanding how RAD impacts siblings is a good starting place. Don’t let them be collateral damage.

Don’t miss these posts:

What to consider before you adopt

How moms of kids with RAD get PTSD

Some names have been changed to protect the privacy of these children.

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Parents of kids with Reactive Attachment Disorder: 10 Unfortunate truths you must know

Parents of kids who have severe Reactive Attachment Disorder (RAD) often feel as if they are on the verge of a nervous breakdown. They are afraid – perhaps even terrified – of their children. They literally wonder how they’ll make it through the next day. Some are suicidal. Many are depressed, fearful, and unable to cope. Too many parents, years after their child is grown and gone, deeply regret sacrificing their other children, their marriages, and their mental health and wellbeing. 

I’ve been there.

This is straightforward advice, one parent to another that you’re not going to find anywhere else. It’s specifically for parents of children who are dangerous and violent and does not necessarily apply to children with mild or moderate RAD symptoms.

Let’s strip away the platitudes and talk about surviving. Here’s my unfiltered, pragmatic RAD-parent-to-RAD-parent advice: 

1. If your child has been diagnosed with RAD and is exhibiting extreme behaviors that you can’t safely deal with on your own, get your child into treatment as soon as possible.

Do whatever it takes. Go to the mental health ER every single time your child’s behavior is dangerous to himself and others – even if it’s every week or every other day. Your insurance company will be most likely to fund the treatment your child needs if they understand the gravity of the situation. When they are made aware of your child’s needs by regular ER visits made when your child needs intervention, they will be more likely to approve the needed treatment. 

2. If your child is violent towards you (Child on Parent Violence – CPV), you may need to press criminal charges.

Child-on-Parent Violence is quite common in homes where a child suffers from RAD. Yes, the justice system is unlikely to do them any good. But it may be the only option to keep you safe. Don’t put your safety in jeopardy by waiting too long.

3. Don’t beat yourself up for not having natural affection towards your child.

You have been the victim of trauma akin to domestic violence and no one believes a victim should naturally feel affection toward her abuser. It’s hard for us to think of children – even young grade school aged children – in these harsh terms, but it’s the reality. 

4. Be prepared for false allegations.

CPS will take seriously even the most absurd claims – despite witnesses and video footage – and you absolutely can lose ALL your children during these investigations. If the allegations are substantiated you can lose your children forever.  If your child has started making false allegations against you, consider this a huge warning – act fast to get help. 

5. Enjoy your summer break and let siblings enjoy it too.

If that means setting your child with RAD up with a TV and game system, do it. What good are parenting ideals if you sacrifice siblings to reach them? Someday you’ll look back on these years and be amazed at how you managed day to day. Be pragmatic and don’t lose yourself in a losing battle.

6. Your children are being exposed to domestic violence.

Exposure to hours of screaming, explosive rages, and physical attacks is harmful to siblings. They are being forced to live in a state of hyper-vigilance that can cause anxiety, depression, PTSD, and so much more. It would be considered child abuse or neglect for a mother to allow their children to be exposed to similar behavior spousal domestic abuse. Find a way to protect and provide time to talk with a therapist for siblings – they have rights too, and you have an obligation to them too. 

7. Some children with RAD abuse their siblings. 

They may bully younger siblings or abuse them physically, emotionally, or sexually. This is something you must keep a very close eye on. Remember children with RAD are often extremely manipulative and this can enable them to abuse their siblings right under your nose.

8. Realize that someday you may have to choose between protecting your non-RAD children and keeping your child who is exhibiting extreme, dangerous RAD behaviors at home. 

This may mean putting your child in residential programs that seem to be little more than “holding cells.” It may mean filing criminal charges against them. These are heartbreaking choices no parent should have to make, but they may be coming your way. Start mentally preparing yourself now.

9. If it is necessary for your child to receive help in a residential treatment facility, understand that the experience may aggravate your child’s behavior, possibly making it worse. 

Yes, in residential treatment facilities your child will be exposed to children with worse behaviors, and many of the “treatments” will empower your child to continue with his behaviors. Despite this, these facilities are sometimes the best, the necessary choice when you need to protect the child from himself and to keep siblings safe.

10. Your child’s therapist and treatment team are very likely to turn on you. 

As the parent, you are an easy target for therapists, and much easier to focus on than RAD. Also, providers need to show positive outcomes to continue receiving funding and some will skew the truth to do it. Always remember that this is your child’s team, not yours.

Adapted from: Reactive Attachment Disorder (RAD): The Essential Guide for Parents