How Reactive Attachment Disorder Can Fuel Addiction

Reactive attachment disorder is a relatively rare condition that can present in early childhood, and one that is associated primarily with serious childhood trauma such as abuse or neglect that is suffered during the earliest period of their life, generally before they are 8 months old. It can also be associated with changes to a primary caregiver during the same period or the traumatic loss of a caregiver.  

These factors prevent the child from forming a healthy attachment with their caregiver as most children do, which can seriously disturb the internal model of relationships that normal children eventually form. Such a child will then become unusually withdrawn and less able to form bonds and relationships with others, as evidenced by the fact that they will not seek out comfort from others and may instead react negatively to attempts that are made to comfort them or to provide them with love and care. 

On the other hand, there also exists a “disinhibited” form of reactive attachment disorder, in which children, instead of becoming withdrawn, will instead not exhibit the appropriate discrimination when it comes to their attachment figures. 

Such children may be overeager to trust unfamiliar adults, which can pose a safety issue, and they may not show a preference for their caregiver over a stranger or the developmentally appropriate behavior of checking back in with their caregiver after venturing off. To complicate matters further, some children with reactive attachment disorder may also display behavior that has features of both inhibited and disinhibited attachment. 

Along with the attachment issues that are at the core of their disease, children with reactive attachment disorder will also typically display other signs of behavioral disturbance, such as a decreased ability to regulate their emotions, unexplained sadness, fearfulness, and irritability, or disproportionate responses to change or stress. 

These symptoms will often lead children with reactive attachment disorder to struggle socially in school as well as at home and should be apparent before a child is five years old. They also should not be better explained by a pervasive developmental disorder like autism, which can cause similar symptoms but is not related to a traumatic history. 

There is no standard treatment for reactive attachment disorder, but the child should obviously first and foremost be removed from the neglectful or abusive environment. Then, caregivers can work to establish a safe environment for the child and to establish a more secure attachment with them. Therapy and treatment can focus on improving children’s social and emotional regulation skills, and on providing them with the opportunity to establish meaningful and positive social relationships. 

However, if the child is not given adequate opportunity to form these relationships, or does not adequately resolve their original trauma, symptoms of reactive attachment disorder can persist into adulthood, which is where this diagnosis can potentially intersect with issues of substance abuse. 

Though the condition is rare enough that relatively few formal studies have been done on reactive attachment disorder outcomes, adults who displayed symptoms of reactive attachment disorder may still exhibit disturbed attachment, such as a reluctance to form relationships with others or a diminished ability to establish and maintain those relationships. 

They may also continue to struggle with symptoms like hyperactivity, anxiety, depression, and feelings of loneliness or emptiness, all of which have well-documented associations with the abuse of substances as an attempt to “self-medicate” emotional distress. 

If this behavior becomes sufficiently entrenched, treatment for the substance abuse disorder may be required in the form of a residential or outpatient treatment program. There, intensive therapy can help the person to tease out the roots of their addiction and address their traumatic past, as well as to learn new coping mechanisms and other emotional regulation skills that will help them to build the healthy relationships with others that will help them to maintain their sobriety.

In extreme cases, use of the Marchman Act may be required to force someone who is struggling with substance abuse due to the aftereffects of reactive attachment disorder or any other psychological condition to undergo this intensive treatment and turn their life back around, especially if their loved ones are perceiving clear signs that the person is becoming a danger to themselves or others. 

The Marchman Act is a Florida statute that allows for the involuntary commitment of someone who poses such a danger due to their substance abuse provided certain other conditions are met. Though this extreme measure should typically only be tried after lesser measures like talking to the person have failed, it is sometimes necessary for loved ones to take this painful step to ensure their safety. 

To learn more about the Marchman Act and how one of our skilled intervention counselors can guide you through the process of obtaining your loved one the appropriate treatment, you can call us anytime at 833-497-3808 or contact us online anytime here.