Reactive Attachment Disorder and Borderline Personality Disorder - RAD and BPD

Reactive Attachment Disorder and Borderline Personality Disorder

Complex Borderline Personality Disorder: How Coexisting Conditions Affect Your BPD and How You Can Gain Emotional Balance. Available at:

Order The Borderline Personality Disorder Workbook by Dr. Fox:

Attachment is a critical component to successful BPD treatment. In this video we’re going to explore Reactive Attachment Disorder (RAD) and BPD. The presence and overlap of BPD and RAD symptoms make sense based upon common history of those with BPD and how these individuals learn to approach others in relationships. In this video, we do a deep dive into BPD and RAD and what you can do about it to help gain insight into your attachment to others.

Reactive attachment disorder is consider a trauma and stress related disorder.

It is often identified and seen in infancy or early childhood and is characterized by a pattern of noticeably distressed and developmentally inappropriate attachment behaviors, in which the child rarely or minimally turns to an attachment figure for comfort, support, protection, and nurturance.

The essential feature of RAD is absent or poorly developed attachment between the child and supposed caregiving adults. However, Children with RAD are believed to have the capacity to form selective attachments, but due to limited opportunities during early development, they fail to learn and show the behavioral manifestations of selective attachments.

An important note is that a diagnosis of RAD should not be made in children who are developmentally unable to form selective attachments, such as those along the ASD spectrum.

What about in adults? Well, attachment in childhood can change over time based upon experiences and personal growth, but it can also stay the same, particularly if left unaddressed or neglected. We know that those with BPD are at a heightened probability to have attachment issues, and fall into either preoccupied, avoidant, or dismissing attachment styles.

This is one reason why treatment takes so long and is often a push-pull type relationship between client and therapist. For example, getting close with your therapist, feeling fear of rejection or abandonment, pulling back but wanting to be close, so you distance yourself, then agitated because your distant then want to be close but still afraid.

Attachment is scary for those with BPD, and understandably so. The individual with BPD hopefully has a relationship with a therapist that is consistent, caring, and has their best interest in mind. It can be hard to have this and see it clearly when aspects of RAD are present.

For those with RAD and/or BPD, treatment challenges typically arise also when unlearning maladaptive patterns that were developed to manage disorder symptoms like RAD. The maladaptive patterns can include missing sessions, becoming easily frightened, and intense fear of rejection or abandonment by your therapist.

You can change your attachment pattern and therapy is an ideal relationship in which to do it. I want to encourage you to be open and honest about your fears and thoughts with your therapist about these issues. Exploring them and shining a light on them will help you growth and develop a more secure attachment style.

Daniel J. Fox, Ph.D. has published several articles in these areas and is the author of:

Complex Borderline Personality Disorder: How Coexisting Conditions Affect Your BPD and How You Can Gain Emotional Balance. Available at:

[cosmicfoxglove]

I absolutely have the push-pull relationship with my therapist. Today he forgot something I had told him about my life, and I had an extreme reaction, I felt that the safety net (my therapist) suddenly disappeared from underneath me and there was just a huge black hole there instead and I was falling into it. It was frightening and felt like I was going to die. I told him I wanted to quit the session like I had done in the past, but instead I stayed with it and managed to make it to the end of the session without leaving. This is my feedback, don't walk out of a session no matter how hard it gets, stay until the end.

[jacalynndingemans]

About a year ago, I made an appointment with a therapist I found online. I’ve never been to one, but knew I needed one. I had a brief but pleasant conversation with her over the phone just a few days prior to the appointment and was genuinely looking forward to meeting her. I showed up 15m early for the appointment, waited in the lobby for over an hour, and after the guy at the front desk paged her several times, found out that somehow the time slot was double booked and she was meeting with someone else. I was so upset I couldn’t hold back tears. I didn’t cause a scene, I just said thank you and left. Inside I felt forgotten, unimportant, and untrusting of someone who could make such a stupid mistake. Rational part of my brain knew my emotions were an overreaction, but it’s like my brain is disconnected and the sensible part of my brain doesn’t regulate my emotions. She left me a VM later apologizing and asking to reschedule, but my feelings were hurt and I never called her back. I haven’t had it in me to try again. I’ve always had the BPD symptoms (quiet) however a recent marriage/divorce with a narcissist has had me spiraling, genuinely questioning everything about myself, high stress, dissociative episodes, extreme paranoia in regards to others intentions, and codependency. Also feel like I can’t trust anyone to love my authentic self, and I don’t even know what my authentic self looks like. My entire existence is based on how others may perceive me. It feels like I’m being manipulative and manipulated at the same time. If someone perceives me as xyz negative trait, I believe it to be true. I’m so insecure, it annoys even me. It’s a horrible way to live. God help me.

[Persephonova]

This is exactly the video I needed this week! I just talked to my therapist about how hard it is TO bring my big feelings to the table in my sessions and it has taken a lot of me dipping my toes in with her in telling her about bigger things to gain that trust but over a year and things are starting to really pick up!

[lindaburlison]

Hi Dr fox! I just wanted to let you know that I made a big step forward for myself recently - and I heard you in my head the entire time. Without your videos I would not have behaved how I did. So Thankyou so much! You are amazing!
To share what happened - my boyfriend booked a trip with his kids without me and without telling me.
I felt like I’d been kicked in the stomach - and told him so though not in a mean way (progress!).
I went to bed with this major impulse to just dump him that night by text and call it quits. It was a 10/10 urge.
But instead I said (to me) “dumping him by text tonight is SELF-destructive. He may deserve that, and I may break up with him, in an adult way, in person, in the future. But — I am making a promise to myself not to do that right now because I know I’m massively triggered right now. I owe it to MYSELF to not act impulsively no matter how much my brain is telling me to do this. I will not react that way as a gift to ME.”
That was the only way I could not take that action. In the past I would have done that for sure 1000% but I
I woke up the next morning and that impulse was not there and I am SO GLAD I didn’t act on it.
For me this was a major turning point in how I handle destructive impulses. And I only did that because of what I have learned from you.
I MAY break up with him in the future, but that will be done in a well-thought out, adult, non-impulsive manner that I can be proud of.
Thankyou so much Dr Fox.

[lilafeldman]

Thank you so much. Same roots to RAD and BPD. Abandonment, attachment issues, trust and emotional regulation.

[courtneymissinne]

I can only hope someday, I find a therapist. That knows anything about youth, and adult relationships. What effects you as a child, leads to adulthood. Watching every video!! Finally. Someone that is talking, and I understand completely, and he gets it!!!
Peace to all watching and much happiness to come…, 💕

[inspiretoinspire]

I have RAD, and I always wondered how this affected me exactly. After going through therapy, I am much better now! Thank you, Dr. Fox!

[hasanalmazni]

Once I feel miserable (everyday), instantly I come to Dr fox channel, it’s like a security blanket ❤️🙏

[KpopManiacLife]

I found my therapist 5 years ago and it's the best thing that has ever happened to me. I honestly wudnt be here today if it weren't for her and I'm eternally grateful to her.

She makes me feel safe, validated, heard and understood and I don't feel any judgyness by her, she's v professional and tries to be neutral and give a 3rd party's pov while always remaining respectful.

I rly like that lady cause she reminds me a lot of my best friends haha.

[TheGreatGanksby]

This has been the hardest month of my life.

I've been questioning my own sanity, but watching your videos has given me the peace and understanding needed to forego of responsibilities that aren't mine.

Thank you, for shining a light on us the psychoanalisis iliterate.

[hunnybSue]

You have explained me, I had a very abusive childhood. My parents basically did the bare minimum, I was never praised or hugged etc. I was constantly ignored and watched my younger siblings put ahead of me. I was smacked for showing anger. I'm also a survivor of sexual abuse. As an adult I went on to marry a narcissist. I have since been diagnosed with social anxiety and PTSD. My therapist also thinks reactive attachment disorder. It all fits. I don't like being angry and I withdraw. Your explanation was like turning on a light.

[teena]

This video was very informative and important for me to see. I often change therapists because it very difficult for me to form a cohesive attachment. Most times I am turned off by how often they want to drug me up or just chit chat. I have never been able to get to my core issues before with any therapist. As a result I am 51 year old woman who finds it difficult to make lasting connections that are beyond surface. I am always alone

[ShadowMaiden]

Dr. Fox (I had a pediatrician by the same name growing up in Douglas Georgia!!) thank you!!! Thank you for your kindness, your intellect, your insight, your time, your energy, THANK YOU! This is the channel I didn’t know I needed. I’m a 25 yr old female, I have my MS in clinical psychology. I believe I have BPD. I have no formal diagnosis, but every single criterion fits. I have been formally diagnosed with ADHD since age 6- I know these two disorders have a high comorbidity rate, and I have to say, I love this channel. Thank you for making me feel human and like I’m able to be better.

[tiphaniecopeland]

omgeeee.... finally someone talking about this connection! Dr. Fox you're such a badass!!!! thank you! looking forward the video.

[laceduplolita]

I first found it difficult when I found the right therapist after searching for so long. It was difficult for me because although I felt attached to this particular therapist, I felt guilt and sadness because I never found that from a caregiver or parental figure. I was afraid to get closer to my therapist because she subsequently fulfilled a position in my life in a maternal way and I did not understand the difference between that and a therapist/patient relationship. It has been over a year now and I still struggle with it to this day.

[SarahLB]

This has been my diagnosis. Very interested to see how I can work on this aspect of my life.

[kendistromberg]

I forwarded this to my new therapist. It very clearly describes what I was trying to explain about relationships with previous therapists.

[learntobake]

I appreciate the term "supposed caregivers" it definitely applies in this case, as sad as it is.

[stainedshieldsstolenhistor]

i am truly, truly forever grateful for you. No one seems to understand how my brain is but you... so i trust u and i shared this video with my therapist/mentor. thank u

[juliatysiacnaja]

Thank you for your work. I have just started studying psychology and was able to self-diagnose after participating in research on personality development. Prior to applying to university, I had analysis paralysis that affected my overall well-being, and meditation and yoga were my only tools. On a path to self-healing in order to be able to help others eventually.