Robin Balbernie, Consultant Child and Adolescent Psychotherapist in Gloucestershire made links back to Emanuela’s presentation and the attachment behaviours of children from orphanages or where they have been neglected.  He introduced the interesting notion that ‘Reactive Attachment Disorder’ (RAD), when looked at through an evolutionary perspective, could be a smart survival tactic.  He looked at studies in Bucharest, where institutionalised babies had damaged and under-developed brains due to lack of stimulation.  They were diagnosed before the age of 5 with RAD, which differs from insecure attachment.  RAD is part of their personality whereas insecure attachment is part of the relationship.  With RAD, there are 2 forms of disturbance.  Inhibited, where there is no attachment and the child is emotionally withdrawn, in contrast with disinhibited behaviour, a child will indiscriminately attach themselves to anyone who is there, whether the relationship is appropriate or not.  These 2 extremes are not opposites of the same concept , but are actually 2 different concepts and can be seen to co-exist in the same child.   There is a school of thought that believes that RAD could actually be seen as a disorder of non-attachment.

An abandoned child will usually protest when separated from their main caregiver.  This can continue for some time and is a strategy to promote survival by bringing the caregiver back.  Eventually, this turns to despair as the caregiver does not return.  The child begins to disengage from everyone around them and in evolutionary terms, they are avoiding action that may attract unwanted attention from predators.  Finally, the child appears to return to normal behaviour, but becomes highly independent and detached.  It is thought that this detached state allows the child to cast off old attachments, enabling them to form new ones with caregivers who will help them to survive.  In effect they adapt to their changed environment.  Robin made the point that in Russian orphanages, a child may experience 50 to100 different caregivers in the first 2 years of life.  As a result of no preferred caregiver, the child eventually has to show an interest in everyone, as they are unable to distinguish who may become and attachment figure for them.  As a result they have no fear of strangers.

His conclusion was that RAD is not a disorder, but adaptive behaviour.  Evolution is about a child reaching reproductive age, so they will attach to any caregiver who will help them to reach this goal.  If it is accepted as ‘normal’ behaviour, then foster parents can be trained to deal with it, rather than try to change the child to fit the ‘norms’ of society.  They need to help the child release their behaviours and the focus should be on the caregiver not the child, e.g. provide a nurturing environment that the child can adapt to, rather than adapt to them.