book review: When Love is Not enough by Nancy Thomas

I finished reading a great guide to parenting children with special emotional needs. Specifically those with Reactive Attachmenmt disorder RAD and other mental illness.

Nancy Thomas is not a psychologist. But has spent years helping children and learning from others who are psychologists/ therapists and very respected. I did review sometime ago the book dandelion on my Pillow Butcher Knife Beneath which is her and her family’s autobiography.

This book outlines the princeples she teaches and what was clearly shown in her other book.

Basically children with RAD have tragically never bonded in the way a newborn baby bonds with it’s parents in the first year of life. The first year of life is about all the baby’s needs being met and them trusting it will happen. Them feeling safe. Only then can they develop properly.

Many things can cause this to break down or not happen. The most obvious are things like fetal alcohol syndrome (though kids can have FASD and not necessarily have RAD) emotional, physical or sexual abuse. Several caregivers, an unwanted pregnancy(a developing baby in the womb can sense this), and hospitalizations or illnesses.

So basically any trauma in that first year that prevents the baby from being cared for in the appropriate loving way.

As abuse is prominent with this diagnosis many of the children are in the foster care system for years, multiple caregivers/ moves making it worse. Though as I’ve read more I’ve read stories of parents adopting or fostering an infant only a few weeks old and somehow the foundation of RAD was already set in their brains. So despite all efforts at a solid first year of life the child from the get go displays these symptoms. I didn’t know that could happen and it truly is sad.

RAD has the following symptoms: Attachment Disorder Symptoms

• Superficially engaging & charming

• Lack of eye contact on parents’ terms

• Indiscriminately affectionate with strangers

• Not affectionate on parents’ terms (not ‘cuddly’)

• Destructive to self, others and material things (‘accident prone’)

• Cruelty to animals

• Lying about the obvious (‘crazy’ lying)

• Stealing

• No impulse controls (frequently acts hyperactive)

• Learning Lags

• Lack of cause-and-effect thinking

• Lack of conscience

• Abnormal eating patterns

• Poor peer relationships

• Preoccupation with fire

• Preoccupation with blood & gore

• Persistent nonsense questions & chatter

• Inappropriately demanding & clingy

• Abnormal speech patterns

• Triangulation of adults

• False allegations of abuse

• Presumptive entitlement issues

• Parents appear hostile and angryFrom the Nancy Thomas Parenting site, link at end of post

You can imagine that having a child with these symptoms is not easy! Because parents often are emotionally mentally and physically exhausted by trying typical parenting techniques, Nancy Thomas and coleagues developed a system of creative and counterintuitive but effective stratagies.

The basis of tjheraputic parenting is about giving high structure along with high nurture. The child needs very firm boundaries, basically to be brought back to the parenting level of a baby/ toddler. Where the parent decides everything and the child has to respectfully ask for everything including a drink of water or to use the bathroom.

Safety is the first concern with installing an alarm on the bedroom door being a top priority. These children have often been abused at night. So often don’t feel safe in their own rooms. It also stops a common problem which is children getting up at night and wandering the house and likely stealing destroying things and having the chance to hurt others. Nancy emphasizes that anytime a child is able to display these different behaviors, they’re not just hurtful to those around them they make the child worse be cause the child continues to see themselves as unlovable in need of no one yet absolutely in control a super bad combination!

The door alarm insures safety for everyone. The basis for interacting with the child is to have loving eye contact and physically being close not shouting across a room. Interestingly Nancy recommends not coming down to a child’s level but having the child sit and you stand. I’m not sure about this and feel that could be an intimidating stance especially to an emotionally out of sync child. She recommends keeping instructions to only a few sentences as that’s all the child can process at first and it avoids arguments.

In correcting a child she emphasizes lots of pizzaz(what Karen Purvis calls playful engagement) and to have consequences be natural rather than planned out punishments. For example if a child starts to act up outside the limits of playtime (in the beginning only books, coloring, legos and other construction, Mini tramp are allowed) playtime is over with no discussion. If a child sets off the alarm at night they have to spend quiet time in their room the next day to give the family a chance to rest. Sorry having a really hard time thinking up examples! Anyway the point is that yelling doesn’t accomplish anything and actually makes the sick part of the child’s brain go into high gear because they want the parent to be angry to push them away.

Chores are a big part of the program. But not like making them do endless chores. Working together as part of the family is really emphasized and activities like cleaning up being good bonding situations. Strong sitting is another helpful idea. This is basically like meditation. The child sits legs crossed back straight facing the wall, for no visual distraction. Hands in their lap. This is supposed to be a time to collect one’s thoughts reflect on their feelings, and often as a transition. The child will also do this after a chore before the parent checks it. Obveously this is very hard for even healthy young children to do so it’s important to start small. Exercise is also emphasized and no computer or TV time for the first year.

For all behaviors listed she gives creative practical ways to work with them most envolving humor and always love. The importance of self-care is highly emphasized as having a good attachment therapist, and support team including doctors, teachers, and respite care providers hopefully on the same page.

I recommend this book for anyone considering foster care or adoption of special needs children. Many thought certainly not all children come from troubledpasts where aspects or all of this disorder is possible. The recommendation she gives is to start out with the basics of theraputic parenting to be on the safe side and then adjust to fit the needs of the child. I’ve read many posts by these parents and it’s truly heartbreaking how the child’s mind by a very young age is totally turned against anything loving or kind and instead cold manipulative and rejecting. Like all mental illness it’s obviously not conscious either. Yes especially as the child gets older knowing they have a problem and that it’s their job to work on it is important. But even then. Many adults with this disorder don’t know unless they happen to find something about it online. Though some say the adult version of RAD is borderline personality disorder. There are some amazing stories of very wise adults who have healed and truly are grateful for parents that stuck with them.

I might want to work with children with disabilities someday though I doubt I could ever raise a child foster or otherwise, and this subject really interests me. As I said before her autobiography is a more in depth approach that illustrates what she’s saying. I’d love to see her with kids live and see how it works first hand.

For more information go to her website:

On a funny note: I misspelled attachment with one t and was brought to the American Trade association for Canabis and hemp LOL!

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