What causes attachment disorder if there was no trauma?

[NumberEight]

Posting here for traffic.

My DD(9) has some quite severe difficulties. She has crippling low self esteem and anxiety which manifests as violent meltdowns, suicidal thoughts and self harm attempts. She had some other issues such as sensory issues.

After many years trying to seek help, we finally got CAMHS to see us and had 8 sessions with a psychologist. They are about to discharge her from the service and are saying it's an attachment disorder.

I have read around the subject and note that it is usually caused by early trauma or detached parenting (obviously simplifying there). However, I do not recognise any of this from her early life. I was a totally devoted mother. I co-slept, breast fed, made all organic baby food. I was a SAHM at the time and took her to endless baby groups and played with her constantly. I was only 15 when I had my first child so when DD came along in my 20's, I enjoyed motherhood so much more as I had none of those first time mother anxieties and was much older and able to cope. I totally devoted myself to her.

Things are more difficult now as I have a chronic illness and our circumstances have changed but her issues manifested before this came about. So why has this happened to my DD? I feel like I've gone badly wrong somewhere but can't pinpoint exactly what or where this happened.

Has anyone got an insight into ADs that could explain it to me please?

[Lovingmybear2]

Didn't want to ignore you op and much clever posters will b along soon with great advice but you sound like a wonderful mother and sometimes kids do struggle despite the best parenting

[CockacidalManiac]

I have BPD, which involves a form of attachment disorder. There was no trauma that I remember, although my mum was in hospital for quite a long time when I was a toddler, so I appear to have developed this through nobody's fault.
However, I'm led to believe that there are genetic factors too.

[CockacidalManiac]

And I think genetic factors should never be minimised; don't blame yourself for the inherited aspects though, as people sometimes do.
Any genetic disposition didn't start with you or your child's father; you inherited it too.

[CloudPerson]

Attachment disorder is a CAMHS favourite at the moment!
In absence of early neglect/abuse/trauma it shouldn't be diagnosed, according to the diagnostic manuals.
Children with autism (and other Neuro conditions) can show behaviour in line with attachment disorder, but it's root isn't neglect.
Clinicians often use something called the Coventry grid, which is a tick box chart looking at various behaviours. It's very easily misinterpreted and allows for personal judgement and isn't helped by a vast lack of understanding of autism within camhs.

Autism can be difficult to identify in girls as they can present less obviously. Have you ever looked anything up?
If you're on FB you could have a look at the girl with the curly hair, she posts short cartoony captions that give insights into autism.

[CloudPerson]

Also autistic people can display attachments differently to NT (neurotypical - non autistic) people, which can throw professionals, as they seem to expect everyone to develop attachments in the same way.

[B1rdonawire]

Hmm, I think like PPs that you might want to treat this CAMHS view with caution, if your child's early experiences were as bonded and secure as you describe and there has been no major trauma / separation either.

There is a brilliant support group on facebook called "Therapeutic Parents" - it's a closed group but just ask to join. It's the one with approx 10k members. There are some extremely wise and experienced people on there who can advise and explore it further with you. Members are sometimes birth parents whose children have an attachment disorder, sometimes adopters, foster carers or special guardians. There are a lot of aspects of therapeutic parenting that will help children with attachment needs as well as children with sensory needs or autism - but that doesn't mean it's not important to get the right diagnosis.

I hope you and your DD get the right support very soon.

[DancingLedge]

I would echo that 'attachment' is the 'in thing'. Whilst it's a genuine thing, it's also talked up in a way that's quite disproportionate to it's incidence.
Sounds unlikely, given what you've written.
Regardless of diagnosis, unless they've helped your DD, and helped you with ways you can help her, maybe you should oppose her discharge. Tell them that's not ok, tell them you want to complain.
Although in the end, Camhs may not , sadly, be where you find useful help.

Sounds so hard for you, best wishes to you and DD.

[demirose87]

My DD aged 3.5 is going through a CAHMS assessment at the moment due to challenging behaviour. Also has Global Development Delay and hypermobile syndrome. The psychiatrist wanted to exclude attachment disorder before diagnosing ASD even though she said she had seen in her behaviour signs of ASD. I think because they don't like to over diagnose autism these days they try to blame it on other things. I was told she also has sensory processing disorder but I feel as though they know she has something but putting it down to other things. Some of the questions they asked were quite intrusive and I felt they were looking for problems at home, or to do with me, which obviously they have to exclude first, but I still found quite irrelevant.

[ToddlersAndCoffee]

I had attachment disorder as a young child and still now... chams involved all through childhood ect... so I'll just tell you my personal reasons that I believe I have it and see if you can relate to any of them (I'm sure you won't - but just incase)
-my mum had twins when I was 18mo
-i was sent to stay with my grandparents for 3 weeks when they were born and consistently from a young age

• never had cuddles or kisses
  

-mum was a stay at home mum however she was always 'to busy' to play and when she did play it was always very structured like a jigsaw never just play...
-i was never listened to because I was a child and THEY were the adults, this continued until I left home (even though my eldest son is only 3 I have always made a point of listening to him and taking his opinions into account (hence he NEVER has tantrums not ever)

• we were just too different in personality. We clashed all the time!
  

-smacking, I ALWAYS resented them for it every single time. It made me so angry even from a tiny age (2+)
-no clear boundaries

[TammySwansonTwo]

Oh bless you, I wish I could give you a hug. My twins birth involved a lot of trauma and separation, one was in hospital for two months and then back in, and I have been genuinely worried about this happening as I don't feel he's ever really bonded very well to me, but things seem to be turning around now. I imagine this must be really distressing for you. There's a great movement called Therapeutic Parenting and a wonderful group on Facebook - many of them have adopted or foster children, many with attachment disorders, and although their situations are different I am sure they could give lots of advice on how to get through this x

[ShiveryTimbers]

@CockacidalManiac I wonder whether the separation from your mother, while she was in hospital, was in fact the trauma?

[maxthemartian]

If your child has had a loving, secure upbringing then I would think that ASD is a far more likely cause for her difficulties.

[BarbarianMum]

Misdiagnosed autism springs to mind.

[ConciseandNice]

I'm posting because my DD (also 9) is having the same difficulties and I am now at my wits' end. I don't know what to do anymore. I tried the gp and school to no avail. We had a camhs appointment a couple of years ago and they said she was perfectly 'normal ' and not to worry. My daughter wets herself too so there's something not right there. I am pretty desperate. I worry constantly. I am so sorry, I just wanted to say you're not alone. At 9, a lot of people are saying to me that it's hormones etc and just to be expected so you may get that too.

[EssentialHummus]

Nothing hugely relevant to add but please be kind to yourself . You've correctly identified the usual reasons for the usual kind of attachment disorders, there's no indication that either the former or the latter applies here, and you won't be the first person mis-diagnosed. (NB this was my field of study not of practice so please treat accordingly)

[RaspberryIce]

I agree with max and barbarian that they may have misdiagnosed.

[picklemepopcorn]

A few more possible triggers for attachment disorder- hospital stays for baby or adult, depression in the main carer, a traumatic health incident, pre natal extreme stress, DV.

Also, if the child has a disability or is very prem and unable to 'feel' the care they are given, that can trigger it too.

[SeaEagleFeather]

pickleme ... have you got a background in studying/treating attachment problems? (Not asking in a snarky way) I'm zeroing in on the pre-natal extreme stress comment you made. Is there firm evidence of this, or a good body of respected opinion on it?

[picklemepopcorn]

I was a foster carer, so read widely and went on lots of training. I can't remember sources though. I thought it was recognised that flooding the unborn child with stress hormones can have an impact at particular points in the pregnancy.

[picklemepopcorn]

Sustained though, not a one off like an accident. It's the sustained extreme stress which was indicated.

[Shouldnotwouldnot]

I though that had been mainly disproved now pickleme you may be out of date

From my understanding of attachment disorder doesn't this form only prior to 6 months?

[NumberEight]

Thank you for the responses everyone.

There was definitely no trauma or abuse involved. I was never away from DD for longer than a few hours (always when she was asleep until she was older). I'm confused about the traumatic pregnancy though - I discovered I was pregnant the day after I discovered XH was having an affair with a 16 year old girl. We were very on and off during this time and naturally it was extremely upsetting. I remember having a bleed and couldn't get hold of him, went to his house and found them together . However, when DD was born, I decided to break off our relationship and left him and the girl to it. I was on antidepressants but I remember it as one of the happiest times of my life - I adored DD and threw myself into parenting. Could my pregnancy have caused it or has this now been debunked?

I don't know if DD has been formally diagnosed, they are just telling me she presents as having an attachment disorder. The Coventry grid is one of the tools they used (they went through it with me).

I've considered that she may have ASD. She has hypermobility which I believe is an associated condition? But I'm just too tired to argue with them. They won't send her for an assessment and they haven't offered any therapy or strategies at CAMHS. Like a pp mentioned, their lines of questioning have been quite personal and whilst I've fully engaged, I have felt very judged at times. I'll be glad not to have to go to the sessions anymore. I've looked into private assessment and have been quoted £3000 which I simply don't have. I feel like I'm just going to have to go along with their current assessment.

Thank you for the therapeutic parenting suggestion. I will request to join their Facebook group. I do find things very difficult but it's much harder second guessing all the time what is causing this. I just want to know so I can help my DD.

[captainfunderpants]

OP have you tried going back to your GP? I'm sorry if you've done that and not got anywhere, but you could always try and explain that you are unhappy with the diagnosis, that you suspect autism and would like to have it explored? You say you have had many years of trying to get answers, so you may have tried and exhausted the GP route already. Alternatively call the National Autistic Society helpline for advice.

[corythatwas]

If she has hypermobility syndrome, then there is a strong co-morbidity with anxiety. And that's before you even start thinking about the ASD and the effects that may have.

My dd does not have ASD but has HMS and very strongly marked anxiety with very much the same symptoms; my mother has the same combo (minus the self-harming). Both brought up in very loving families, close to both parents, no separation, no other trauma than that caused by the hypermobility.

Even so, the NHS spent a LOT of time trying to delve into our past to find explanations in our parenting. Those we saw over a long period eventually retracted their statements but every time we saw a new doctor it was a new journey to establish our credentials.

Recently, dd (now a young adult) tried to access adult MH services. She was discharged after the first appointment during which a doctor told her again and again that her symptoms were typical of young women with abusive boyfriends. Dd stated repeatedly a) that she does not have a boyfriend b) that her symptoms started long before she'd ever had a boyfriend c) that all the boys she had gone out with were perfectly pleasant lads. He just kept coming back to the abusive boyfriend.