Attachment Disorder is not really a diagnosis. You will see it labeled as Reactive Attachment Disorder but I find that it does not always fit neatly into a box. It can be seen as a personality disorder, as chemical dependency, as depression or anxiety. I see it more as a symptom of a client’s mental health. What I am talking about is a child who was separated from mother at birth and this can be for a variety of reasons. One case the mother was mentally ill and had a breakdown on the delivery table between baby one and two, the children were sent to foster homes immediately. Another case the mother was sick and the child was separated from her for a certain amount of time. The mother might be a drug addict or alcoholic. The mother might have mental health problems and are unable to bond with baby; severing the trust/mistrust stage. I am going to share a story about Bill.
Bill is a child who was born with “yellow jaundice” as they used to call it. He was left in the hospital for a week and his mother was sent home (hospitals are not attune to the effects separation will have on babies – maybe they are now but they weren’t long ago). Bill’s parents were in a Domestic Violence plagued marriage (father as batterer) and when his mother tried to escape with him, his father caught up with them and kidnapped Bill for six months. The mother did not know his whereabouts and as the parents were not divorced yet, the police could not do anything about it. The father ended up abandoning the baby and then the police brought the baby to the mother. During the divorce proceedings, however, Bill was given to the grandparents. The mother was able to see Bill once a year and tried to reunify with him without success on several occasions. Bill had lost an ability to attach to the mother and the mother was ill-equipped to understand how to recreate a bond with him. It was too late.
As an adult, Bill dropped out of school and became a drug addict for many years. During which time he had many children from various women. He did get clean but never sought out treatment. His children are all over the place and he has no ability to connect with their mothers so that he can have visitation with them. His finances are utilized on the family he did finally stabilize with – another woman who was also a drug addict like him. A woman who also never sought out treatment and came from a family of addictions, sexual abuse, and depression that never went treated. She was seriously neglected and thus probably has attachment issues as well.
I am not treating Bill but a family member shared this story with me. They were concerned about his mother who desperately wanted a relationship with her son and grandchildren. He seems to be a loving father but has never been able to connect with his mother. In fact, he appears to do whatever he can to go against the mother. Along with being a drug addict, he was reported to be a pathological liar. His mother knew this but when she would try to confront him about things he would start crying and throw a fit (as a child). As an adult, he turns the story around and tells her she is crazy and needs help. He will vehemently deny things even those which are obvious. For example: the mother reported that she tried to explain to her son that he was feeding too much candy to the children. The son, standing in the driveway with candy all around him said that he and his wife had stopped giving this to the children. When the mother pointed out the obvious, he stated that the reason it was on the ground was that the children didn’t want it anymore so they through it there. The mother continues to feel isolated and detached from her son because she can’t have conversations with her son unless it is to praise him for something. It is a relationship based on lies. She worries about the life her grandchildren are leading.
People like Bill, who were raised with a separation from their parents, have difficulties bonding with them. Often they are able to bond with the caretaker (who had them the most) but reject the mother. Even the bond that they will have with the caretaker is filled with lies and deception. As Bill was a drug addict, he stole from his caretaker. The caretaker enabled him to continue with the lies and deception because he would tell her that the money he “used” (meaning stole) was to pay for diapers or gas for his car. Even when Bill spent time behind bars, the caretakers coddled him and took him in upon his release. As Bill never spent time completing his treatment, he has never made amends to his caretakers (paid them back) and owes his mother a large sum of money for an attempt to do rehab.
Attachment is severed the minute the baby is removed from the womb. The baby needs to develop an immediate bond with the parent, thus they are given to the mother, after delivery to soothe the baby. Children are okay being in a nursery and sent to their mother’s from time to time for feeding. This is the first stage of learning individuation/separation. The longer the baby is separated from the mother, trust begins to be severed. Without trust, the baby begins to self-soothe and if they are emotionally intelligent can withstand some trauma but if not, they will collapse completely. Some adult children who talk about being separated at birth and were emotionally intelligent (good survival skills), have attachment issues but I find they are easier to work with in therapy. As I am not an expert on this, I can only go with the cases I have worked with successfully and these are survivors.
I have found that if the birth parent is reunited with the baby – early on (a week or two later) attachment can be supported, yet attachment as an adult is difficult. In these cases I do see self-soothing with an oral fixation. Early detachment from birth mother that is severed completely (adoption or long term foster care with few caretakers) can heal with the consistent caretaker as well but often there is self-soothing here too. Both of these scenarios might show obesity, or a fluctuation with weight but it also might be a smoker. More severe situations of detachment from birth mother and multiple caregivers will show Chemical Dependency and Conflict Disorder or even Reactive Attachment Disorder. This is a more extreme self-soothing and self-sabotage without the resiliency levels to repair the attachment or want to repair the attachment. Some people may get clean and sober but repel psychotherapy because then they have to attach to themselves through self-awareness. Often it can be more painful to try and attach to self than to live their lives in pain (i.e., denial). I have heard a few clients who abandoned therapy make the comment “I have lived for years with [this chaos] and have been just fine why do I need to dredge up all this history?” I suspect this is the case with Bill and probably his wife. People who seriously need psychotherapy have learned to find coping skills that they feel are appropriate but often it is isolating themselves in a cocoon to protect from others.
The wall Bill has built between he and his mother deflects any self-awareness by pushing her away with his invisible shield that spits out swords that pierce her and shut her up. This keeps the relationship under his domination. He controls and manipulates her so that if she wants a relationship with him, she must obey his clues. It is my understanding that his mother has felt afraid of her son on occasion but more specifically when he was on drugs.
As a therapist, I often wonder about the relationship between early attachment and shooters that we see, almost daily now, around the country. I can’t imagine that someone who has a healthy attachment to their mother would have this level of a lack of empathy toward their fellow human beings. I read “School Violence: Facts vs. Fiction” by Dr. Dewey Cornell, many years ago now and the main issue I took away from this was perpetrators being bullied. I don’t recall the discussion of Attachment Disorders because at that time I was not as conscious of this as an issue as I am now. Therefore, if he did mention it, I clung to the bullying instead which was more easily identifiable in my consciousness then. Now, however, we are dealing with much more than school shootings. It is adults who have taken over from the plight of teen angst and wish to have their moment of glory or retribution to those who have harmed their psyche in some perceived way.
As Narcissism and Attachment disorders or early attachment being severed are closely linked if not synonymous, it is important to make people aware of this in the field of mental health, medical fields and social work. Educators could benefit from these teachings as well but this must be handled more carefully with this professional. I find that teachers tend to play psychology professional when they learn about the mental health world. Thus, they are constantly diagnosing and even telling parents what medication a child should be on. More often than not, they are incorrect. Nonetheless, more education needs to go out to professionals dealing with children and parents and adults in general. Hospitals can benefit from learning about early attachment and find ways to keep the child and mother together as much as possible. They will be able to better detect situations when brought into pediatric care, rather than trying to quickly put into a box (assess a more holistic picture of the child). Mental health clinicians will have a better grasp of their client. Social workers will be able to better understand the placement of the foster child and detect a need for therapy earlier on – rather than waiting for the behavioral issues to begin showing itself.
Attachment between mother and child is imperative. Nine months in a womb means that once they are delivered we must, as professionals, be more prudent in assuring that early attachment is protected.