Reactive attachment disorder
The broad theoretical framework for current versions of RAD is attachment theory, based on work conducted from the 1940s to the 1980s by John Bowlby, Mary Ainsworth and René Spitz. Attachment theory is a framework that employs psychological, ethological and evolutionary concepts to explain social behaviors typical of young children. Attachment theory focuses on the tendency of infants or children to "seek proximity" to a "particular attachment figure" (familiar caregiver), in situations of alarm or distress, behavior which appears to have survival value. This is known as a discriminatory or selective attachment. Subsequently, the child begins to use the caregiver as a base of security from which to explore the environment, returning periodically to the familiar person. Attachment is not the same as love and/or affection although they are often associated. Attachment and attachment behaviors tend to develop between the ages of six months and three years. Infants become attached to adults who are sensitive and responsive in social interactions with the infant, and who remain as consistent caregivers for some time. Caregiver responses lead to the development of patterns of attachment, that in turn lead to internal working models which will guide the individual's feelings, thoughts, and expectations in later relationships. For a diagnosis of reactive attachment disorder, the child's history and atypical social behavior must suggest the absence of formation of a discriminatory or selective attachment.
Attachment therapy
Matthew Speltz of the University of Washington School of Medicine states that the roots of attachment therapy are traceable to psychologist Robert Zaslow and his "Z-process" in the 1970s. Zaslow attempted to force attachment in those suffering from autism by creating rage while holding them against their will. He believed this would lead to a breakdown in their defense mechanisms, making them more receptive to others. Zaslow thought attachment arose when an infant experienced feelings of pain, fear and rage, and then made eye contact with the carer who relieved those feelings. If an infant did not experience this cycle of events by having his fear and rage relieved, the infant would not form an attachment and would not make eye contact with other people. Zaslow believed that creating pain and rage and combining them with eye contact would cause attachment to occur, long after the normal age for such developments. Holding therapies derive from these "rage-reduction" techniques applied by Zaslow. The holding is not used for safety purposes but is initiated for the purpose of provoking strong negative emotions such as fear and anger. The child's release typically depends upon his or her compliance with the therapist's clinical agenda or goals. In 1971, Zaslow surrendered his California psychology license following an injury to a patient during rage-reduction therapy. Zaslow's ideas on the use of the Z-process and holding for autism have been dispelled by research on the
genetic/biologic causes of autism.