The Scope of Attachment Disorder, By Marc Deprey

Back in 2000, my wife and I adopted two siblings, a boy, 19 months old, and a girl eight months old. After the heartache of infertility and multiple adoption attempts falling through disastrously, we thought we had finally hit the jackpot—a healthy boy and girl, eleven months apart—“insta-family!” Well, we did hit the jackpot all right. Our children are now the center of our lives, but it has not been the kind of prize we thought it would be at all.

Both our kids suffer from some form of attachment disorder. Before we got them, they both had been severely neglected and had not naturally bonded with their birth mother. Attachment disorder happens when children at this crucial age cannot trust they will be taken care of, or they fear they are in danger of dying, or they are in extreme pain they cannot express. Whatever the source of the trauma, these children react to it with a primal need to control the world by keeping people away. They are fundamentally committed to never being vulnerable again. Their behavior is very difficult to manage, as it ranges daily from overly controlling violent rages to forced, and very strained, attempts at closeness. They are very confused about what constitutes a relationship between people. Needless to say, it is not at all easy being a parent of a kid with attachment disorder—let alone two of them.

It took us five years to finally realize what we were confronting. During those five years, we went through every imaginable negative feeling about ourselves as parents—that we were incompetent “bad” parents, unable to meet our kids’ most basic needs, that we were the ones who were creating these behaviors in our kids. We felt like unadulterated failures and our newly formed family seemed doomed because of us. But after a long time, we finally realized that we were not failures. Basically, we found other parents facing the very same thing and feeling just as bad as we did. We were not alone!

There are only a few national support groups that focus on attachment and trauma issues. They vary in size but share the same commitment to help members overcome, or should I say, survive what is an epic challenge. Knowing we are not alone has been a great source of relief for us, but I’ve often wondered how ‘not-alone’ are we?

In attempting to answer this question, one must first survey the larger playing field of society itself. Common sense says that there must be families out there who’ve had nothing but attachment problems throughout their history and, because it is so familiar in their own conditioning, they don’t even know they have it. One generation emotionally neglects the next one, and on and on. Counting these families would be next to impossible since identifying them would require outside evaluation. Also, since attachment theory touches on so many aspects of a person’s development, pretty much everyone probably has some kind of attachment-related issue(s) in their past. So “normal” is going to be hard to define.

However, the kids we are trying to count have been affected by a pretty fundamental transgression and/or trauma. So affected, in fact, that they cannot go through a day without raging, aren’t flexible enough to adjust to the most minor inconvenience, and who are so filled with anxiety that they see nothing but threats all around them. This certainly doesn’t describe the majority of people in the world. So, although everyone might have attachment issues of some kind, not everyone is afflicted with an attachment disorder based on early childhood trauma.

Besides those who are unconscious of their attachment issues, like those who come from families who have known nothing else, or those with lower-grade attachment-related issues, there is a population that is more likely to consciously experience the reality of attachment disorder. This population is adoptive parents. (I’m not saying that attachment disorder only happens to adoptive families. Many biological children who experience early childhood trauma by way of painful medical treatments or severely neglectful parenting can exhibit these behaviors later on.) It is adoptive parents who are more apt to consciously experience the culture clash of differing familial histories, or the results of institutional neglect and abuse from orphanages in other countries, because they are reaching out to adopt children who are more likely to have this kind of developmental history than the average adoptive parent population—hence the clashing overlap.

Although the damage done to our kids was pretty profound, I don’t think their birth mother was a mean, or hateful person. She was doing what she was taught and, having met my kids’ other birth relatives, they all describe a long family history of not connecting at a base level. My wife and I came from families that weren’t like that. Though not perfect, our families did provide us at least enough security so that trust developed and relationships thrived. Our kids have a very different orientation. It is not from lack of trying on our part, but our kids still have a very hard time trusting that they will be okay. But at such a young age, if the need to be safe is not met, the opportunity seems closed forever. I hope that’s not really true, but my fellow parents of children with attachment disorders would probably agree with me that on many days it sure seems that way. However, there are some success stories.

If given enough time and support, some parents have been able to help these disturbed kids heal in a way that they have become productive citizens. But these success stories are too few, because support is so rare, understanding so lacking. This is a treatable condition, but it is a very long and painful treatment road—even with outside support. But it can be done and is being attempted by many committed parents throughout this country today. One thing about these parents—they may not like what happened to their kids, but they are nevertheless committed to them.

So getting back to this question of the scope of attachment disorder in the US today—we should focus our analysis on adoptive families, all the while knowing that there are probably many more cases of attachment disorder that we just can’t access. The Evan B. Donaldson Adoption Institute recently published a major study on post-adoption services (http://www.adoptioninstitute.org/research/2010_10_promises.php). The study presents some revealing statistics—

Of the approximately 135,000 adoptions per year, 52,000 are through the child welfare system. Around 45% of child welfare adoptions are cases where the child’s behavior is equivalent to children receiving mental health treatment; and about 12% of these children have severe behavioral problems with significant attachment issues. For internationally adopted children, the Donaldson Institute concludes, about 35% would fall at the level of behavioral/emotional problems requiring mental health treatment. So, since all these numbers are annual and we know the annual number of adoptions vary—international adoptions have been trending downward—we can conservatively assume that these annual totals are close enough to average. Also assuming that extremely challenging behaviors reveal themselves at about age 6–8 and 18 has been chosen as the age of majority (although attachment issues don’t end at 18), we can say with some confidence that a range of 13 years easily comprises the population we are concerned with here. So a conservative estimate of the number of adopted children (and their families) who are facing severe trauma-based issues today is over 100,000, with another 200,000 or so raising children with significant behavioral/emotional problems. This does not include the over 400,000 children still in foster care who run a very high risk of trauma-related issues.[1]

A 2005–2006 Center for Disease Control Study is even more jarring—1 in 50 infants under 12 months old were victims of abuse. This is from Child Protective Services data, so it represents only reported cases of abuse. How many of these children will experience long-term effects from their abuse? [2] Trauma professionals would say a significant number of them. But out of the 905,000 abused and neglected infants from this study, even if only 10% were traumatized in a way that created severe behaviors later on, we’d be talking about approximately 995,500 children between the ages of 7–18 who are severely affected in our country today.

In the end, our attempt to determine the number of trauma-afflicted kids will not be conclusive. But we can say with confidence that it is certainly a significant number. The real disconnect is in how we are responding to it.

At a recent international conference on attachment and trauma, held in Omaha, NE, attended by attachment therapists and parents of children with attachment disorder from all over the world, 272 people attended (75 were parents). A survey of attachment-disorder parent support networks reveals total memberships at less than 5,000. That means there are many, many parents out there thinking they are alone, thinking they are bad parents, thinking they are failures—thinking that because of them, their families are headed for a brick wall. This is a horrible place to be, and something must be done. We as a society need to do our part in helping these brave people help their troubled kids.

I want to lay down a challenge to the national parent support groups, attachment therapists, social workers, educators, mental health providers, law-enforcement professionals, child welfare workers, and policy makers—recognize these desperate families and reach out to them, point them toward real support. Break their isolation and most important of all, help them recognize that they are a large enough population to advocate for support and services. Tell them that although they do face a very hard struggle, they don’t have to face it alone without outside help.

To attachment and trauma-focused groups: I challenge you to work together to form a coalition of like-minded individuals and organizations dedicated to reaching out to these families. Issues of attachment disorder are still somewhat new to many. A sizable number of people do not understand what attachment-disorder means let alone what to do about it. There was a time when Autism and ADHD were not understood either. People got together and advocated and pushed the issue forward. We as parents of these special kids know about attachment disorder. It’s time that we attach ourselves to one another, and teach the world about this tragic—yet healable—condition.

National Parent Networks—

1. The Attachment & Trauma Network—www.attachtrauma.org

2. Attach-China—www.attach-china.org

3. Association for the Teaching and Training of Attachment in Children—www.attach.org

4. Families for Russian and Ukrainian Adoption: FRUA—www.frua.org

5. “Reactive Attachment Disorder” on Facebook