I was hit over the head with childhood trauma issues today and I am exhausted. This was certainly productive but still made me tired. I started to compare the two cases I met about today. They each have one of the above diagnosis. In one very successful meeting between providers and other community stakeholders we were able to (make our best attempt to) break down the treatment and service silos to get him the treatment that he needs. It was a very trauma-informed brainstorming session. This was for the client with PTSD. We reviewed his history and how we ended up where we are today and what we could do differently. We were all concerned about his ability to safely regulate his emotions and conflicts with others.
Fast forward to a parent I met with for the first time whose child is diagnosed with Reactive Attachment Disorder. She had heard so many things about RAD her head was spinning. She started talking about this young persons history. I am thinking how traumatic, he NEVER LEARNED to attach to others and does not know how to engage social relationships. I gave this parent this feedback and that this should be the direction of treatment. She seemed relieved.
Fast forward to tonight where my 20 month old son randomly just hugged me. After the day I had this almost brought me to tears. My two clients, rarely if ever, got these opportunities. I was able to engage with my son because he knew how to engage with me. Prior to tonight I honestly did not look at what changes the DSM 5 was making for RAD. I was surprised that the DSM-5 is going to be calling it Disinhibited social engagement disorder. Children who experience early childhood trauma are not taught to engage with others. We need to teach severely traumatized children new skills to engage. Whether it is PTSD or RAD, let’s not lose sight that it is indeed a disorder about engaging with others.