Occasionally it takes some time for things to rattle around in my head before they can gel into a coherent thought. Reading the the wonderful post by dsdebow and its accompanying link was no exception. Immediately on its face I loved the article as it was a heartfelt yet accurate presentation of issues that do occur in adoptions even in the youngest of adoptees. We like to think that the younger a child is the easier it will be to adjust to a new environment but that is not always true.
I felt the article gave a wonderful representation of some bonding issues and I was originally satisfied to stop there. However as time passed I could not get it out of my head. Partly I am sure because it was such an unexpected reminder of our early time with our Katie as well as another preemie infant we fostered for nearly a year that we were hoping to adopt also.
Finally, I think the other reason that I could not get that article out of my head was I was searching for the signs or symptoms of attachment issues in the Mathews household. Other than the refusal to drink that blasted milk we have not heard one peep from them or anyone who knew them that alluded to attachment issues but I would have been nearly impossible for there not to have been. So, I started going through my hoarders stash and looking at pictures.
Then I googled Sherin and looked through all of the images that were there. After gotcha day at the orphanage I found 1, ONE picture of Sherin being held, hugged, holding hands with, or otherwise making affectionate physical contact with an adult. I do not include giving five on the run affectionate. The one image I found was not with Sini or WM and she looks tortured in that image. (See picture below) There is absolutely
NO question in my mind that they were having attachment issues in that home.
Perhaps because they were older well situated professional people when they began parenting made it more difficult for them to reach out for support and assistance with Sherins bomding/attachment issues. Coupled with Sinis nursing profession and experience and pride they tried to go it alone. I also think because they began parenting at a little older than average it also made change harder for them.
The UK has studies attachment disorders particularly RAD (Reactive Attachment Disorder) more than we have in the US. Since my first dealings with RAD back in the early 90s much has been learned and discussed or reclassified but still enough is not known. I personally am amazed at how much has changed in the symptoms and new classifications yet little has been done to follow the long term effects.
Originally, studies in the U.K. show RAD in children who otherwise would not fit the precipitating factors but were placed in day care before the age of two and that info seems to have been pushed to the wayside. One thing we do know is that trust is necessary to our survival and it is developed or not in early childhood. Babies come in to this world with little but a warning siren, a cry if you will. Immediately after birth when a baby cries someone responds, meets the babies needs and the baby stops crying. That is the beginning of trust. If every time a baby cries the caretaker responds quickly and fulfills the current need be it a clean diaper, a bottle or being held, trust builds. This is how bonding and attachment begin. In the situations where the caretaker fails to respond in a timely fashion, sporadically or not at all, distrust is formed. After a period of time the babies stop crying because it does not yield the desired results and the baby develops no attachment or bond with the caretaker that fails them.
In orphanages there are more babies than workers so it would be impossible to respond promptly to every cry, also limiting the one on one cuddle time which delays the start of the process required for learning to love. The longer the period of irregularity or failure the more difficult for the child to bond or attach with anyone. Possibly leading to a lifelong issue. If the failure continues beyond the cessation of crying, failure to thrive is almost certain. There is a point where the child may restart crying but it becomes a cry of rage not need.
I have no way of knowing if Sherin suffered with RAD but the odds are high. In the early stages of research in the U.K. it was believed that children not treated effectively by the age of 12 had little to no chance of moving past RAD and being able to create normal bonds and attachments in adulthood.(often leading to being unable to bond with their future children) Thankfully I dont see that line in the sand in current literature but early diagnosis and treatment (therapy) is undoubtedly more effective than delay. In the beginning hug therapy was the prime method of choice but I see although it is still widely used other methods are currently in use. We utilized a scaled down version of hug therapy at home by requiring everyone recieved a bedtime hug and kiss no exceptions. This gave a child notice of exact when that nasty hug was coming so they could prepare for it but also gave the an immediate escape path to collect themselves afterward. Much like going to get their braces adjusted or immunizations it was initially unpleasant but they were able to deal with it in small doses. I will never forget the feelings the first time my RAD girl relaxed and actually hugged me back. My cold grouchy heart nearly burst as I began to sob uncontrollably. It was a good thing she made a hasty retreat or my sobbing may have set her back a bit.
One of the newer methods recommends time in. Instead of giving a child time outs for missteps which rewards a child with RAD with the alone time they are comfortable with, perpetuating the issue and delaying attachment/bonding giving them time in requiring them to stay with and interact with the caretaker. (I recall a pleading to please just send her to her room because she couldnt stand another talk. LOL) Thus alleviating the fear of abandonment. From personal experience I think a combination of both is more successful in the long term. Teaching a child who has no experience with attachment or bonding takes long term dedication, patience and constant reassessment. A child with RAD can make a new parent(s) (new to them) who has not been properly prepared for the realities of attachment disorders or issues feeling like a failure, embarrassed and hurt that this child would go anywhere with a perfect stranger but continuously pushes the parent(s) away. The child may choose one parent they need to have present at all times and panics when they are not but ignores them when they are. These children stiffen when confronted with hugs or displays of affection. An action that can devastate a poorly prepared parent(s) as I can seem so personal. All the while completely ignoring the second parent.
We have heard the chatter that Sherin was cared for predominately by WM and that would fit in with RAD. He would most likely have been chosen by Sherin due to the early language barrier and perhaps because he was not female and every female in her life thus far had disappeared. One of the risks involved when parents are not properly prepared for attachment/bonding issues comes when 1 or both parents become offended by the childs treatment of them only, shutting down and withdrawing from the child emotionally exacerbating the problems.
I believe this is what occurred with Sini. I believe Sherin was the sweet, independent, precocious, tiny angel in public and the temperamental, autonomous, rebellious, non-compliant child at home, even playing the social role if and when visitors came to the home. Typical of a child with RAD or many other attachment issues. That is not an excuse but perhaps an explanation of the circumstances that led to the frustrations, emotional detachment, and behavior that led to the actions that ended her life. There has been no mention of therapy for Sherin or the family. Perhaps they tried it perhaps or they didnt, unless it comes out in trial we will probably never know. The worst part of this theory is
the end was totally avoidable. Had they been better prepared, more willing to ask for or seek help or less concerned about image and control they could have overcome these issues. I can sympathize with them regarding the stress and feelings that would have occurred during this time however it is not a justification of their behavior, they were supposed to be the adults, the responsible, caring loving parents who should have gone to the ends of the earth to get for her instead of waging battle with her. They were supposed to be her protectors to give her a better life full of love and giggles. Not fights and isolation. A life not death.
[FONT="]In a study by Zeanah, (Zeanah [/FONT]et al.[FONT="], 2004) on reactive attachment disorder in maltreated toddlers, the criteria for DSM-IV [/FONT]disinhibited[FONT="] RAD (i.e. disinhibited attachment disorder) were:[/FONT]
- not having a discriminated, preferred attachment figure,(she could still have that one parent she needed to have present especially in public more of a security blanket than an attachment)
- not checking back after venturing away from the caregiver,
- lack of reticence with unfamiliar adults,
- a willingness to go off with relative strangers.
[FONT="]
For comparison, the criteria for DSM-IV inhibited RAD were:[/FONT]
- absence of a discriminated, preferred adult,(she could still have that one parent she needed to have present especially in public more of a security blanket than an attachment)
- lack of comfort seeking for distress,
- failure to respond to comfort when offered,
- lack of social and emotional reciprocity, and
- emotion regulation difficulties.
[FONT="]The authors found that these two disorders were not completely independent; a few children may exhibit symptoms of both types of the disorder.[/FONT]
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https://en.m.wikipedia.org/wiki/Reactive_attachment_disorder
SYMPTOMS OF REACTIVE ATTACHMENT DISORDER Symptoms of Reactive Attachment Disorder in toddlers and preschoolers include toddler behaviors that are more intense and persistent than in normal toddlers:
- frequent, out-of-control tantrums. Unusually defiant and disobedient. Flies into a rage for the least little thing. Deliberately soils in inappropriate places. Destructive of property. Normal methods of discipline are ineffective.
- the velcro kid, unwilling to be separated from Mom(Dad)for any time at all. Cries incessantly when parted, insists on keeping Mom(Dad) in sight at all times. Scared to go to sleep alone at night, and wakes in the night to check on whether Mom(Dad) is there.
- needs to control Mom(Dad) at all times.This can be achieved in many ways:
- abnormally active toddler, constantly on the go. This risk-taking hyperactivity is intended to keep her constantly vigilant and at his side. A nightmare to take shopping, to a restaurant etc
- disruptive when Mom(Dad) is on the phone or talking to other adults, very jealous of attention to other siblings. Will whine, cling, hit, chatter, to monopolize Mom's(Dads) attention - again, insecure or anxious attachment.
- refuses to cooperate or excessively demanding with eating, going to the toilet, dressing etc. Refuses to eat meals or most foods. Demands food or drink frequently, wants Mom(Dad) to accompany bathroom visits, wipe and wash hands, etc.
- inability to play alone, insists that mother or other family member plays or interacts with him or her at all times
- demands affection on his or her terms - asks repeatedly for hugs, tells Mom(Dad), I love you endlessly.
- persistent nonsense chatter
All of these behaviors eventually result in the parents' limiting or curtailing any outings or social contact involving the child. Other behaviors that parents of normally-attached children would find worrisome are:
- dislikes being cuddled and kissed, refuses to give eye contact, wriggles and gets down from Mom's(Dads) lap when held
- inappropriately affectionate and trusting behavior towards visitors and strangers.
- excessive, intense hostility, jealousy and violence towards siblings and pets, especially when competing for Mom's(Dads) attention.
- lack of affect - remote and detached, with flat emotions.
WHY DO THESE CHILDREN BEHAVE LIKE THIS?
They feel shame, that they were unwanted by their birthmothers, and believe they must have been bad or defective to be rejected and abandoned. The lack of loving attention in the orphanage only reinforces that shame. They remain convinced that they will eventually be thrown out again, for being bad. These children usually feel anger towards their birthmother and birth family, for abandoning them. Their anger towards their adoptive mothers is actually directed at their birthmothers: they have not differentiated them. They may also feel anger towards the orphanage caregivers for the neglect and abuse they endured, and towards the adoptive parents for not rescuing them sooner. They may even feel anger about being removed from their country of origin. They are not convinced that they are really loved, and that they are permanently part of the family. To protect themselves from being hurt again by the loss of love, they may reject parents' attempts to attach, and use distancing behaviors, refusing to interact or communicate with parents. Children with insecure or anxious attachment often believe that if Mom did not give her full attention, she does not love them. If she is absent, or paying someone else attention, she has stopped loving them. Deprived in the orphanages of the constant care they needed, these children do not trust adults to meet their needs; they felt responsible for their own survival. So these children lack trust, and need to be in control at all times.
https://www.rainbowkids.com/adoption-stories/reactive-attachment-disorder-in-adoptees-513
JMHO