My 8 year old adopted daughter has had 4 different therapists including neurotherapy. She has yet to have someone really diagnose or help us with exactly her problems. She was adopted at 2 years old and spent the first 2 years of her life being seriously neglected and abused.

Up to this point we have treated each behavior problem individually but recently my husband and I realized they are ALL connected. She exhibits a disconnected behavior from her mind/body. In that she doesn’t seem to care if she is uncomfortable or in pain. She urinates herself at night but also daily. She doesn’t seem to care and yesterday even walked around with feces in her panties. She will wear her pants backwards and will not tell an adult if she is hurt. She will not wipe her face or complain of bad smells. She would sit in the bath and burn herself if the water was too hot rather than complain or try to get out of the bath. She seems to have very little conscience when it comes to other people’s feelings.

One therapist diagnosed her with RAD and another with ADD. She is very manipulative and passive aggressive. My question is without knowing all the other details what type of mental disorder(s) would cause a mind/body disconnect? She seems to not feel pain physically or mentally. She can feel physical pain but does not react to it in a normal way. Please help!

A: How very, very sad. I agree that everything you are observing is connected. What concerns me beyond the lack of reaction to pain is the apparent regression to very primitive behavior.

It is indeed possible that she has reactive attachment disorder. When a child doesn’t have the nurturing and care they need when very little, the child doesn’t have a model for caring, for self-care and for socially normative behavior.

Unfortunately, it’s also possible that your daughter has another mental disorder. Autism, intellectual disability, childhood disintegrative disorder and childhood schizophrenia all include some of the symptoms you describe. That’s just to hazard a few guesses.

Without a clear diagnosis, therapy can’t be helpful. The therapist doesn’t know what should be treated. I urge you to take your daughter to a medical facility that specializes in childhood psychiatric problems. First, she should be thoroughly checked for any medical condition that may be contributing to her behavior. Then she needs to be screened by specialists in childhood psychiatry.

Having a chronically ill or mentally ill child is as stressful as it gets. I hope you and your husband are also getting help for yourselves. Ask your doctor for information about support groups for parents. Often other parents are the best source of information, support and practical help.

I wish you well.
Dr. Marie

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Last reviewed: By John M. Grohol, Psy.D. on 30 Apr 2013

APA Reference
Hartwell-Walker, D. (2013). Adopted Daughter May Have Reactive Attachment Disorder. Psych Central. Retrieved on August 29, 2014, from http://psychcentral.com/ask-the-therapist/2013/04/30/adopted-daughter-may-have-reactive-attachment-disorder/