Oppositional defiant disorder Reactive attachment disorder
Reactive attachment disorderReactive attachment disorder

Reactive attachment disorder

Letters from Mothers

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Marta, 24

My daughter Marta's sad childhood began even before her birth. Our son was only a few months old when I accidentally became pregnant with Marta. I was very attached to my son and resented the intrusion.

When Marta was born, nursing her was emotionally wrenching for me; it made her older brother cry, and I was so attached to him. So even in the hospital, I let the nurses give Marta a bottle, which is something I never allowed with any of my other children born before or after Marta. I did not want to become attached to her.

Of course, I did not realize all this at the time. All I knew then was that Marta did not seem to like me, and I felt indifferent in return.

Marta was the only child for whom I did not have enough milk; we are a Christian family, and I have six children. In retrospect, I know this was because I did not let her nurse long enough, as I was in a rush to get back to my much-preferred oldest. I worried that he would feel neglected and unloved if I spent too much time with Marta.

When Marta was about two years old, I realized something was very wrong with our relationship, and I knew I was responsible. I had made a mess, and now I wanted to clean it up. So one day I picked her up, sat down on the rocking chair with her, and said, "Marta, let's let bygones be bygones. I love you. Would you please forgive me? Come, let's be friends from now on." I held her and rocked her and cried tears of bitter regret at how I had treated her. How terrible to be unwanted before you are even born! She, however, sat there upright and sucked her thumb. She didn't cry. Generally, she hardly ever cried. Why would she? I had not exactly been responsive to her tears. Can you blame her for not liking me, for not trusting me?

The years passed, and while I was always extremely close with our other children, the relationship between Marta and me was almost nonexistent. She bonded with her father somewhat, but he traveled a lot and was sometimes unwell, and between those two reasons, he was often not available. The interaction between Marta and me was so infrequent that when she was away, I didn't notice much of a difference in the household. We hardly spoke, though I did try much harder from the time of the rocking chair reconciliation, for whatever that was worth. Marta did not seem interested in having my attention like the other kids did.

More years passed. Marta grew up and became a miserable, sad, depressed, anxious, difficult teenager and then adult. She drank too much, starting at age fourteen. She began smoking marijuana. She put on weight. She cared very little about her appearance and was the only one of our six children to look sloppy all the time. She was diagnosed with all sorts of emotional problems, including acute anxiety disorder and OCD, but the diagnosis that fit her best was Aaron Lederer's: deficient maternal attachment. I learned from one of Aaron Lederer's workshops, the reading materials he gave me, and our subsequent telephone appointments that the nature of the attachment that a baby has with his/her mother is crucial. It is the most important attachment of his life, and it affects all future relationships, including those that a person has with his or her spouse, boss, colleagues, children, and self.

Though she was intellectually brilliant, Marta could not let herself succeed at anything, perhaps because she unconsciously believed that if her own mother could not love her, she was not lovable and deserved to fail. When asked how she felt about me, Marta was overheard to say, "I don't understand her. It's as if we speak two different languages, and neither of us can really hear what the other is saying." Marta found me, her mother, mystifying and annoying, and I found her distant and just as difficult to understand.

In her early twenties, Marta's mental disturbances grew to the extent that she was once arrested for running repeatedly up and down the stairs in an apartment building. She was tormented by recurrent, worrisome thoughts and desperately sought relief, and soon she began taking prescription drugs to combat her OCD. The drugs did not work too well, but they anesthetized her enough that she thought they were working. Soon Marta had no life; she basically slept the days and nights away.

Our other children grew up, left home, built successful careers, got married, and started families. While they lived at home, they worked or furthered their educations, took care of themselves, and helped with the household chores. But not Marta. She failed at hatever she undertook. When Marta was twenty-three but less mature and less responsible than a five-year-old, Aaron Lederer offered to teach me new ways to communicate with Marta that he said may help cure her and help our relationship. He said it would be painless and uncomplicated and would probably only take a few months, and eventually Marta would stop "shooting herself in the foot," which is how I described how she lived her life. For example, she would get a job, then do something inappropriate and get fired. She would make a friend, then act gross and lose the friend. She would make the other people in our household (her best friends, really) angry at her by leaving messes all over the house. Absolutely no one ever wanted to share a room with her because of her sloppiness.

Things also got to a point where her siblings would not lend her money because they knew she would not pay it back. My husband and I also stopped giving Marta money because all her money went toward impulse buys like donuts and coffee, never to the legitimate needs for which they were intended, like a sweater or transportation. If we bought her a new coat, for example, she was likely to lose it or forget it on the subway. She stole money from wherever she could, and when confronted, she casually admitted it. Caring for her was frustrating, to say the least.

Aaron Lederer and I began having weekly, half-hour-long telephone appointments with unlimited contact by e-mail between sessions. I told only my husband what I was doing, not Marta or anyone else in the house.

Aaron explained to me that the first step in our work would be to help Marta form the secure and affectionate attachment with me that she'd missed the first time around. He said that accomplishing this shouldn't take more than a few weeks and instructed me to simply stop giving Marta any orders or lectures whatsoever. We were always strict about chores and personal responsibility, but Marta was now exempt. In short, my first assignment was just this: do not tell her what to do. Do not rebuke her if she does something wrong. Unless there is actual physical danger, do not warn her of the consequences of her behavior/misbehavior. Just coexist. "You are bringing her back to the baby stage, when you expected nothing of her," Aaron said. In cases where it was necessary to get her to do something right away, he instructed me exactly how to do it.

The first week that I did this, my overwhelming reaction was one of vast relief. It was a relief not to feel obligated to correct Marta or to explain to her the error of her ways, even when she did blatantly stupid things like leaving the refrigerator door hanging open after taking something out. It was a relief not to have to work so hard to get through to her. With Aaron's clear instructions echoing in my head (and in my computer, because I typed them up each time as we spoke), I just smiled to myself and casually closed the refrigerator door. I acted as if it were no problem, as if I hadn't even noticed who had left it open, as if closing fridge doors after other people was just something I did all the time.

I didn't say a word when she left her clothes in middle of the hallway steps. I didn't say a word when she spilled food on the floor and didn't clean it up. I just acted like one might if a small baby did that: I cleaned up after her without comment. I truly felt no anger, since I had not been haranguing her to be neater or more responsible. Her irresponsibility no longer made me feel ignored or disrespected because I was no longer asking anything of her.

After a few days of this, I noticed something rather fantastic start to happen.

Marta seemed to start liking me and finding me interesting and worthwhile to talk to. This alone made me happy.

And I was much happier, too, for another reason: I had been busy teaching and correcting Marta because I had felt this was my parental responsibility, but I was constantly upset because she never really listened to my advice at all. I had been doing a lot of talking to the walls. Now I wasn't doing any more of that. Ignoring wrongdoing felt much more useful and right to me than pointing it out to someone who was not listening and was not able to absorb what I said.

Marta was her usual, irresponsible self, but I didn't play the all-knowing, irate mother/guidance counselor anymore. Instead, I was all-accepting. Seeing how positive and beneficial this was to our relationship, Aaron assigned us several more weeks of this.

I enjoyed these weeks more than I can describe.

Each week when we spoke and I told him about the changes in Marta, Aaron said, "Just continue doing what you have been doing. This is progress. You are starting all over again with a clean slate." And I truly felt the progress. The relationship between Marta and me was blossoming. Now that I was not correcting, not criticizing, not lecturing at all, Marta no longer avoided me. She would often sit down wherever I was just to talk with me. One time, my husband was out of town on business, and all the other kids were away. I got up my courage and asked Marta if she would like to go out to dinner with me. Why did this take courage? Because although I had been out to eat alone with all my other children countless times, I had never been out to a restaurant alone with Marta. It was unspoken but understood that we were from two different worlds; we wouldn't have anything to say to each other. I would no sooner have asked her out to dinner than I would have asked the postman in for breakfast. But now I asked, and Marta agreed.

As we drove out of the neighborhood, I asked her what kind of food she wanted to eat. She looked at me in surprise and asked, "You mean we're not picking up the other kids? We're not picking up-" and mentioned each one by name. Each time I said no, not this one, not that one, nobody, just you and me, she grew more surprised and a little bit uncomfortable, but as we drove, she seemed to get used to the idea. She had assumed I would want to take her somewhere close by, but I suggested that we drive a little, so we went to another neighborhood.

At the restaurant, conversation flowed easily between us. On the way home, there were some companionable silences when we ran out of topics, but there was no tension. Marta put on some music, and I let her change it as often as she wanted and control the volume. Aaron's words rang in my mind: no criticism.

In this first stage of therapy, the heat was off me to raise Marta into a responsible adult. Anyway, my way had not been working, so it was best dropped.

Even if this is as far as we get, it has still been a huge gift for both of us and for the whole family, as we definitely began to heal our strained relationship. With Aaron's continuing direction, with patience on my part, and with God's help, I hope this will be the first step toward a healthy future for this troubled young woman.

I have been following Aaron Lederer's instructions for about nine months now. When Aaron first told me to stop making demands on Marta so as to return her to infancy, so to speak, I was shocked, but I soon became grateful. After a few weeks of following his instructions, it became clear to me that this was the right thing to do. Marta and I were able to slowly construct a relationship. I do not say "reconstruct," because we never had one to begin with. Now we do.

When I first stopped making demands, Marta tested me, waiting for the other shoe to drop. But slowly, she saw that I was really, really not making demands. Even when there was truly a lot of work to do, she was exempt unless she wanted to help. Often, she would sit there and watch everyone else hustle and bustle but not help. Sometimes it took a lot of effort and restraint on my part not to demand her participation, but I passed these tests. Sometimes I had to explain to the other kids (especially the one who particularly resented Marta's ongoing "vacation") that we are working on something special for Marta and that that was why the rules were different for her right then. Aaron taught me to acknowledge the complainer's feelings of unfairness even while explaining that things were different for Marta.

It was fascinating to note that slowly, even the things Marta did that were "wrong" according to house rules, such as leaving a wet coat on the couch, stopped irritating me. I guess that when you really love someone, her mistakes and even her deliberate wrongdoings don't bother you so much.

Then Aaron said that the time had come to gently move Marta into and through the "terrible twos" and help her leave them behind successfully. He explained that the terrible twos is a developmental stage during which a child learns to accept that he or she is no longer the center of the universe but is "just" an ordinary member of the family, hence becoming socialized. "We will give Marta the opportunity to decide to leave her position as an infant and begin maturing. But," he added, "only she can make that decision."

In our weekly sessions, Aaron gradually gave me instructions on how to speak with Marta to accomplish this transition. For example, I learned to make gentle, carefully phrased requests: "Marta, would you do me the favor of putting your coat into the closet every night when you come home for supper?" I didn't give orders; I asked for favors. And he told me how to respond when she messed up or "forgot."

I added favor requests very slowly.

Recently, my husband and I took Marta on a trip to the doctor. We talked and sang and laughed, mostly at Marta's jokes. How different this was from our earlier trips! On those earlier trips, my husband mostly talked with Marta in the front seat, while I sat in the back and cried, knowing that we were about to deal with The Marta Problem again and that I had little hope for success. I knew I would have to explain again about that nightmare infancy and childhood. But this trip was totally different. Marta was funny and interesting, and she was honest about her OCD-style anxieties about being taped (she would not open her mouth at tollbooths because there was video surveillance). And halfway there, my husband turned to me and said, not realizing how important it would be to me, "Honey, you know, Marta told me a few times that lately she has had a real relationship with you, that ‘she and Mommy are like friends now'." I wanted it confirmed, so I said, "You mean as of recently?" And my husband said, "She feels like it's been this way for the past few months, approximately since October."

I just calmly said, "Oh, that's good. I'm glad." Outwardly I was calm, but inside I was euphoric. I knew exactly what had made the difference: it was my telephone sessions with Aaron Lederer. My husband did not make the connection, but I did.

I looked up the dates just now. We began our weekly sessions on July 20. August didn't make a visible, measurable difference, but by October, even Marta had noticed the change in our relationship. The importance of the statement "Mommy and me are like friends now" coming from Marta cannot be overstated.

I wrote an e-mail to Aaron Lederer that said, "Ahaaa …(joyous, contented sigh)!"

The biggest regret of my whole life has always been the way I treated Marta when she was in utero and then when she was a baby. It feels unbelievable to me that I have finally been given the tools to "undo" or somehow rectify that.

We are very active in our church, and Sunday dinner is a big deal in our house. On Saturday, we clean the entire, huge house from top to bottom in preparation. We change the linens and prepare the guest rooms. There are always huge pots of food and cakes, and the tables are set with china and crystal. The fact that Marta had not been helping with any of this for the past few months was extremely strange, but I was "making no demands," as instructed! The big breakthrough came on Saturday, March 4, 2006. Marta came over to me and quietly asked, "Mom, how can I help for Sunday dinner?"

This was the first time I'd ever heard these words from her. The other kids asked very often, but Marta never had. And this meant that she had had enough of total freedom from responsibility, enough of infancy. At least, enough for that day.

Aaron had taught me the proper response for this sort of situation, which was, "Such-and-such needs to be done. Is that something you would like to do?" I swallowed hard, and said, "Mrs. Watkins needs a ride over; would you like to drive over and pick her up?" Marta took the car keys and went and got Mrs. Watkins for Sunday dinner as if it were the most natural thing in the world. I just stood there watching the car disappear; I could not believe what was happening.

There has been a slow sea change in this family. Suddenly, I have become Marta's defender; I am her ally. Several of the other children have noticed it. And my husband has commented several times that Marta has been telling him how good our (Marta's and my) relationship is.

Sometimes, when my husband makes a demand of Marta that I think is unfair ("Lose weight!"), Marta glances at me, waiting for me to rise to her defense, which I do. I even prepared my husband for the fact that sometimes I might contradict him in front of the children in defense of Marta; previously, this was a cardinal sin that we never, ever did.

The children were heard to comment, "Hey, look, Marta loves Mommy!" Interesting that they did not notice the changes I made; they saw only the changes in Marta!

Recently, my husband made a joke at Marta's expense. My younger son (who likes to give us a running commentary on what is going on in the family, as if it's a baseball game) immediately said, "Now Daddy is going to look at Mommy and see if he's in trouble with her for making fun of Marta."

The kids have been remarking among themselves that Marta is happier and more relaxed. I think she feels safer. I am going to e-mail them all and ask them to describe exactly what is different. Marta makes more jokes, and they're very funny; or example, she sings an OCD song that she made up while checking to see whether the windows were locked.

I had gotten myself into a bind. I started a huge housecleaning project late Saturday night-washing all the curtains- and we were planning a big Sunday dinner for fifty people, which was to take place in the very room where the curtains were down. It was taking much longer than I expected to take them down, wash them, and put them back up. I was starting to sweat. I was panicky. My usual rescuers (the kids who always came to the rescue when there was a crisis) were not there or not available: they were at their places of employment, out of town, or busy with their babies. I was in tears, trying to hurry with the re-hanging of the wet curtains but seeing plain as day that with my skeleton crew, I would not finish without staying up all night-something I cannot do.

Suddenly, I realized that something was happening. Marta-Marta-was coming to the rescue. She set up an assembly line with two nephews, both not old enough to help on their own; one of them stuck the hooks into the curtains, and the other passed them up to Marta. Marta went up on a ladder and quickly started taking and re-hanging the curtains.

I tried not to stare. I could not believe my eyes. Marta was saving the day. She was working hard and doing it well, and it didn't look like she would leave this job halfway through, as had previously been her custom. As I started to realize that everything would get done before the guests arrived, my tears of frustration and fear and panic turned to tears of joy and relief and delight and gratitude to Aaron Lederer. "She is a different person," I told Aaron during our next telephone consultation. "She saw me suffering, and she responded. Marta saved me."

After the whole shebang was over, I decided to try verbalizing it, but Marta has never been comfortable with loving words from me. Quietly, I began by saying, "Marta, you saved me." She immediately seemed uncomfortable, so I stopped. But then, when my husband walked in, I informed him loudly enough for Marta to hear, "You don't know what this place looked like last night. Look now, look how clean and beautiful all the curtains are! Marta saved the day today. She literally saved the day. There was no way.…"

I came to understand that I could tell the story to many people, but I could not speak of it directly to Marta with too much emotion. Too much emotion from me makes her uncomfortable.

In our family, we have a few birthday customs. One of them is that at each person's birthday supper, we go around the table, and everyone says some nice things about the birthday girl/boy, tells some true stories. That Sunday, looking at the clean curtains, the thought struck me: finally, I had a personal story to tell at her birthdays. Lack of advance planning gets Mom into tight spot. Marta rescues Mom. It would have been nothing special for the other kids, but it was a milestone for this one.

My other daughters all had albums with their childhood pictures. But somehow, I had never made one for Marta. Here she was in her twenties already, and she did not have her own album. Suddenly, I had a burning desire to create one for her. And I did. Only I didn't make one for Marta that was the same as her sisters'. I custom-ordered a very high-quality one, bound in red cloth. On it were brass, embossed letters: Marta's Life. I got a calligrapher to write her name and the date of her birth inside the front cover. And then I found the negatives, printed the pictures, and put them in the album. I gave it to her. She didn't react too much (photo albums are not her thing), but I felt very good about it because I knew it had been the right thing for me to do for her.

I think I did this because Aaron showed me that it doesn't matter how many years pass, you can fix your past mistakes. Marta passed the age for collecting pictures years ago, but so what? Give her the album now. I am so glad I did. One of my other daughters was more than a little jealous of Marta's album with the brass letters and the calligraphy, but I told her, "You got yours when you were four years old. Marta waited all these years for hers. She deserves something better." She understood.

Marta is physically an adult but is still emotionally immature. She still borrows money and doesn't repay it. My daughter Lynn is upset with her right now because she lent Marta her summer clothes–shopping money, Marta did not return it, and now Lynn has no new summer clothes. (I told all the children long ago not to come to me for Marta's loan repayments. Most of them don't lend to her anymore, but tenderhearted Lynn succumbed to her begging.)

Despite the progress we have made, Marta can still be so irresponsible at times that I want to cry. If the sheet comes off her bed, she just sleeps on the bare mattress until I notice it and put it back on. She does not put covers back on food containers, and the food gets ruined. The night before she left to go on a month-long trip, I asked her to collect all her dirty laundry from all over her room and put it all on the floor of the laundry room. I wanted to wash it and dry it and fold it for her so she could pack clean clothes. I did all that but saw that she still didn't have enough clothes. So I went up to her room and found that she had missed a few piles. I had to start all over again with the laundry, and it was past midnight. I was upset and beyond exhausted, and I wondered whether this child would ever grow up. My other children did their own laundry before they had to pack for a trip. And here, this "grown woman" could not even manage to collect her dirty stuff that had been gathering in her room for heaven knows how long. (The thought of having Marta pack for her trip alone did not even enter my mind.)

Marta has emotional disorders, and she has a long way to go before she catches up with others in her age group. In our community, many others her age are married with two children or holding down responsible jobs. Marta is far from these things. She has impractical ideas and thinks very short-term. But one thing is well on the road to being fixed, and this is a major thing. The relationship we never had has finally been forming. I did not think it was possible. I thought I would take my pain and regret to my grave with me. Instead, a miracle is happening.

If the lack of a relationship with me was (at least partially) the cause of Marta's problems, then forming one now might help alleviate them, with God's help, of course. I also thank Aaron Lederer. I never would have followed the weekly instructions if I did not have full faith that he was an honorable, ethical human being who possessed real integrity and deep generosity. Many times, his instructions did not make sense to me. They flew in the face of everything I believed. Because I trusted him, I listened anyway. Now, I am so glad I did. I also appreciated his honesty even when he had to tell me painful truths about our daughter.

There is no question that Marta is becoming less self-centered. My other children, whose homes she visits, make comments to me that prove this is the objective truth. For example, they notice that she "is more chilled," "is better company and does not run away from social situations anymore," and "takes messages for me when I am out."

The most difficult task I was given by Aaron Lederer was to not ask her to help with things, and the end result is that she now offers help of her own accord. It is ironic that I was worried about following that instruction because I was afraid it would make her into a parasite and a taker, but the exact opposite has happened.

Possibly because he himself suffered as a child and was abandoned, Aaron has a sixth sense when dealing with children like Marta. Sometimes when we are talking on the phone, he gets an idea about Marta, something he just "knows," and he is often right. I have learned to trust his intuition. Sometimes he subscribes to a "tough love" philosophy. For example, he once told me to inform Marta, "From now on, I won't be doing your laundry." When she asked why, I was supposed to respond, "It is just too much for me. I have so much housework to do, plus I have my job. I need to unload some of the housework." I was not to give in and wash a single item of Marta's, even if it found its way into my laundry hamper. I collected the dirty clothes from all over the house and tossed them in front of Marta's bedroom door instead.

On the other hand, sometimes Aaron instructed me to be the exact opposite of a tough-love mom. For example, when Marta "forgot" her key repeatedly and rang the bell, I was forced to get up from sleep or from my work to open the door for her. I was sure Aaron would tell me to say, "Marta, from now on, if you forget your key, you will have to borrow one from the neighbor to get inside the house." But no. Instead, he said, "Marta wants an affectionate greeting from you; that is why she summons you to the door when she arrives home. It's not to get into the house that she rings the bell, it's to get the big hello from you."

I was shocked to hear this; a big hello, at her age? But he reminded me that emotionally, Marta was a small child. So the next time she rang the bell, instead of an angry "Why don't you have your key?" I opened the door and said, "Hi, honey, how was your day?" Her response shocked me. Firstly, she told me about her day. And second, about an hour later, she walked over to my desk and said, "Mom, when Uncle Sal was visiting last week, I gave him my key, and he never gave it back. Sorry for ringing." I replied, "It's okay if you ring the bell." She gave me that startled look that often follows one of Aaron's "communications" that doesn't fit in with the way I have always acted and walked away.

Today was my last session with Aaron Lederer. Together, we have brought Marta as far as we can. Her relationship with me, which was once somewhere between bad and nonexistent, is close and secure. She seeks me out frequently for reassurance, and I gladly provide it. Although she often helps with household chores now, she still lacks initiative when it comes to taking on responsibilities and preparing for an independent future.

At this point, Aaron has suggested that I enroll Marta in a group residence for adults with emotional disorders. I am in the process of doing so, although many of our relatives are against it. So is Marta, but she's getting used to the idea. Aaron gave me the "communication" to give Martha when I talked with her about it. I know for a fact that I would not have had the wisdom or the strength to do this if not for Aaron's encouragement and guidance throughout the process.

Interestingly to me, Aaron's whole philosophy is to counter the abandonment the child suffered with a secure maternal bond. He himself embodies this with the ways he relates to the mothers he counsels. The best example of this is our last email conversation. I e-mailed him the following: I am slowly realizing something that I don't want to realize, but if there is anything you have taught me, it is to face painful truths head-on. It doesn't really make sense for me to call you weekly anymore. Under your guidance, a miracle happened: the bond between me and Marta has been created anew, and it is strong. I know what I have to do as far as the group residence goes. I know how to talk to her and how to react to the things she says. Possibly, there is not much more you can do for me or for Marta. I love talking with you, but I feel that our work with Marta is done. What do you think?

Aaron replied: Congratulations; I couldn't agree with you more. It is my usual practice to wait for the mother to signal when the time to stop is in sight. She usually knows, as you are beginning to. Once Marta's move is complete, it will become up to her how far she is willing to go toward independent and successful living, of which I have no doubt she's fully capable. At this point, no one can make her make the decision to live as an adult. This is true for all two-year-olds; only they can decide to give up their wish to remain the entitled center of the universe in favor of becoming ordinary, cooperative members of their families and societies. What helps them decide that is their secure attachments with their mothers. Through your devotion to Marta's recovery, you've been able to help her attain such attachment. The rest is up to her now. But there is no need to rush. I suggest that we nevertheless talk next week as planned and take it from there. What do you think?-A.L.

I think I was deeply blessed to find Aaron Lederer. I hope he continues in good health to do his work with children who did not form secure, positive attachments with their mothers in infancy for whatever reasons. I am happy he is having his book published because it will spread the word that there is real hope to those who need to hear it, and I am pleased that he has been training therapists to do what he does and carry on his work. However, even when his therapists are all over the world, numbering in the hundreds, doing what he trained them to do, I will know I was one of the lucky ones who got to work with the master himself.

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