When Dr. Madrid and his wife Whanda adopted their daughter, whom we’ll call “Lily,” they were hopeful about growing their family. However, they couldn’t have anticipated the challenges they would face. They didn’t fully understand the complexities of raising a child who had experienced early trauma — an impact that can lead to reactive attachment disorder (RAD), also known as developmental trauma. It wasn’t until Lily was diagnosed that they had even heard of RAD.
For Whanda, the responsibility of managing Lily’s care quickly became her primary focus. As the family’s main caregiver, she was the one to research therapies, seek out professionals and try to navigate the unpredictable behaviors that Lily exhibited. She soon realized that not only was there very little understanding of reactive attachment disorder in the medical community, but her husband, despite being a physician, also lacked information and resources.
The Nurturing Enemy: Why One Parent Often Takes the Lead in Navigating Reactive Attachment Disorder
One of the most difficult dynamics of reactive attachment disorder is the way it can manipulate family relationships, often leaving one parent in an incredibly challenging role. In the Madrid household, Whanda found herself navigating what is commonly referred to as the nurturing enemy. This occurs when a child with RAD pushes away their primary caregiver — the one providing the most structure, nurture, and stability — while manipulating others in the family to create division.
Whanda became the primary advocate for Lily, taking on the bulk of the research, managing her care and attending therapy sessions with her daughter. Dr. Madrid, a busy physician working 40 to 50 hours a week, wasn’t involved in the same way. He admits that he struggled to understand the severity of the behaviors Whanda described. At times, Lily would manipulate situations by telling lies to gain favor or redirect blame, which exacerbated the already strained family dynamic. She would lie to get Whanda’s biological sons in trouble, something Whanda didn’t notice until she witnessed an incident firsthand.
Whanda struggled to communicate these types of behaviors to Dr. Madrid, and for a while, neither of them understood the full scope of the manipulation. Over time, however, she realized that Lily was intentionally creating distance in the family, using the nurturing enemy dynamic to further isolate Whanda. “I didn’t see it for a long time. It wasn’t until I spoke to a counselor that I realized what was happening — how Lily was creating division between us,” she explains. This revelation was key to Whanda’s understanding of the disorder, but it also left her feeling alone in her struggle. Lily’s behaviors were insidious and complex, and Dr. Madrid was still learning about RAD as well.
A Gap in Awareness Among Professionals
As a physician, Dr. Madrid was taken aback to realize how little he knew about reactive attachment disorder — and he wasn’t alone. The disorder is poorly defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM), and professionals across the board, including pediatricians, psychologists, and social workers, often lack the training to recognize it. “It’s not that every doctor needs to be an expert in RAD,” he says, “but there needs to be a general understanding that it exists. At the very least, primary care physicians and other healthcare providers should be trained to recognize the signs of reactive attachment disorder and point families in the right direction — toward resources like RAD Advocates and qualified clinicians who can help. This is crucial for families to get the right support.”
The lack of education available is exacerbated by the nature of manipulation and triangulation of RAD. Because the primary caregiver is often the only person who sees the child's symptoms, others often point fingers at the parent as the problem which only isolates the parent more. Even when a clinician does not see the symptoms, they need training to interview and believe the primary caregiver.
This lack of awareness left Whanda searching for support in an already exhausting journey. Although they were initially referred to a therapist by their daughter’s former foster parent, those services didn’t help. The therapist told Whanda that they were wasting their money because their daughter was only telling her what she wanted to hear rather than working through her issues. Whanda was grateful that the therapist understood enough about RAD to know when her services weren’t helping. Yet, she couldn’t find anyone else who could. Whanda explained, "I couldn’t find anyone else with experience in RAD. Even when I did, they didn’t fully understand it or couldn’t relate to what we were going through.”
Finding a Community and Taking Action
It wasn’t until Whanda discovered RAD Advocates that she began to feel less alone. Through the organization, she found a community of parents who understood her struggles. Recognizing the importance of spreading awareness, Whanda led the effort to support RAD Advocates through their family’s nonprofit, the Madrid Family Foundation.
One of the most difficult dynamics of reactive attachment disorder is the way it can manipulate family relationships, often leaving one parent in an incredibly challenging role. In the Madrid household, Whanda found herself navigating what is commonly referred to as the nurturing enemy.
"For me, it’s important to help families going through what we went through," Whanda said. "I didn’t have the resources or support, and I felt so alone. I hope to help others to avoid that experience."
Dr. Madrid agrees with the importance of supporting families and raising awareness. "Organizations like RAD Advocates provide critical education and connection for families. The more professionals know about RAD, the more we can help struggling families.”
Moving Forward as Advocates for Others Navigating Reactive Attachment Disorder
Despite their challenges, the Madrids remain committed to making a difference. Their donation to RAD Advocates reflects their belief in the power of community and advocacy. By sharing their story, the Madrids hope to shed light on the complexities of reactive attachment disorder and encourage others to seek out the support they need. Their journey serves as a reminder that while reactive attachment disorder presents unique challenges, families don’t have to face them alone.
*pseudonym used to protect identity