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Reactive Attachment Disorder

January 15, 2018

Recent scientific studies have revealed the importance of ‘memory updating’ in the treatment of trauma. This finding suggests that sub-cortical based interventions such as RESET Therapy, could have a profound impact in the treatment of Reactive Attachment Disorder (RAD). This condition is thought to be produced by gross negligent care which produces faulty emotional attachment with the primary caregivers. Indeed, “. . . it is only in the last 20 years that we recognize that infants need to be held and touched. We know that they cannot grow--they literally fail to thrive unless they experience physical and emotional closeness with another human being. What we often don't realize is that that need for connection never goes away.” (“Intimacy,” 2016)

 

Developmental specialists have long thought that inadequate attachment during the bonding phase resulted in a permanent loss that affects the individual throughout the lifetime. My view is different in that I perceive that RESET Therapy can unlock windows of opportunity creating the possibility of altering the failure to adequately bond early in life. This perspective is based on the rather astonishing transformative changes that have occurred consequent to the treatment of combat-veterans with PTSD through the use of an amazing intervention I’ve called RESET Therapy.

 

 

 

In essence, RESET Therapy appears to be able to induce neuronal plasticity for a brief period of time (five hours) during which trauma reactivity can be altered by dropping out the emotional component of the experience. With RAD, the idea is to both drop out negative aspects such as distrust of others as well as facilitating positive emotional experience that were missed earlier in life. Through this means, I believe that it becomes possible to bridge the void created in the first critical psychosocial stage as described by Eric Erickson.

 

Dr. Erickson’s eight psychosocial stages are perceived of as socialization building blocks with the first being: Trust vs. Mistrust. “The infant’s first social achievement then, is the willingness to let his mother out of his sight without undue anxiety or rage, because she has become an inner certainty as well as an outer predictability.” (Verheij, 2008) It is now known that that cortical development can be dramatically altered by the effects of extended stress with negative impact extending to all domains over the course of a life time. “. . . if the stress response is extreme, long-lasting, and buffering relationships are unavailable to the child, the result can be toxic stress, leading to damaged, weakened bodily systems and brain architecture, with lifelong repercussions. . . The neural circuits for dealing with stress are particularly malleable (or “plastic”) during the fetal and early childhood periods.” (“Stress_Disrupts_ Architecture_Developing_Brain-1.pdf,” 2014)

 

In the above literature, the insinuation forthcoming is that once the trust/bonding period has elapsed, the window of opportunity closes permanently.  When trauma is added to the mix, extensive problems with emotional attachment to others may ensue. RAD typically appears in infancy but may also present in a child up to the age of 5. “In DSM IV, reactive attachment disorder belongs to a group of conditions called disorders of infancy, childhood, or adolescence.” DSM V removed the disorder from this category and placed it in a new complex of conditions known as trauma and stressor related disorders. Other conditions in this group include PTSD. “The American Psychiatric Association created this category in order to emphasize similarities in the underlying causes of these conditions, namely some sort of exposure to singular traumatic events or stresses that occur gradually over time.” (“Recent Changes in the Definition of Reactive Attachment Disorder,” 2013)

 

We know from brain map imaging of combat veterans with PTSD that RESET Therapy works directly to reduce hyperarousal in the amygdala. We also know that the neural connections for emotions such as anxiety and anger actually intertwine in the amygdala/hippocampal circuitry. According to Dr. Joseph Ledoux, “the drugs available to treat anxiety disorders fall short because they address only our overactive neural response, not the underlying associations. What we need, he argues, is a multipronged approach that can recondition our response to triggers.” (Ossola & Ossola 2015) Others suggest that: 

 

“The reactivation of a stored memory in the brain can make the memory transiently labile. . . The change in memory expression is related to changes in the brain correlates of long-term memory. Many have suggested that such retrieval-induced plasticity is ideally placed to enable memories to be updated with new information. This hypothesis has been tested experimentally, with a translational perspective, by attempts to update maladaptive memories to reduce their problematic impact. . . . Evidence for memory updating is accumulating across memory systems, developmental stages, and clinical populations, pointing to possible non-invasive techniques for permanent modification of maladaptive memories.” (“An Update on Memory Reconsolidation Updating: Trends in Cognitive Sciences,” 2017)

 

Let us assume that ‘memory updating’ is a distinct possibility given these recent scientific findings. Might we then apply an alternative, non-invasive intervention such as RESET Therapy to unlock the child’s or adult’s trust potential? What impact might this have on those children who are unable to emotionally bond to others? As a former child and family psychologist trained in Systems Family Therapy, I believe that the ramifications of this possibility are profound. I plan to clinically explore ‘memory updating’ in adults with profound trust issues. With success, I will then look into application with children. Indeed, we live in exciting times!  For more information about RESET Therapy, please visit my webpage at www.drlindenfeldresettherapy.com.

 

References:

An Update on Memory Reconsolidation Updating: Trends in Cognitive Sciences. http://www.cell.com/trends/cognitive-sciences/fulltext/S1364-6613(17)30078-5

 

Intimacy: The Art of Relationships. http://www.psychologytoday.com/articles /196912/intimacy-the-art-relationships

 

Ossola, A., & Ossola, A. Scientific American MIND Reviews Anxious. https://doi.org /10.1038/scientificamericanmind1115-71a

 

Recent Changes in the Definition of Reactive Attachment Disorder. (2013, July 8). https://www.promises.com/articles/ptsd/recent-changes-in-the-definition-of-reactive-attachment-disorder/

 

Stress_Disrupts_Architecture_Developing_Brain-1.pdf. https://46y5eh11fhgw3ve3ytp wxt9r-wpengine.netdna-ssl.com/wp-content/uploads/2005/05/Stress_ Disrupts_Architecture_Developing_Brain-1.pdf

 

Verheij, F. (2008). Klassiekers van de kinder- en jeugdpsychiatrie II. Uitgeverij Van Gorcum.

 

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