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Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5106
Experience:  Dr. Mark is a PhD in psychology in private practice
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Hi, my husband and I have been together for three years. Weve

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Hi, my husband and I have been together for three years. We've been to three professional psychologists and are seeing our pastor, yet things do not improve. He has an explosive temper among other things. One psychologist suggested PTSD, another ADHD, and he got upset and didn't want to return to either...therein we're on yet another counselor. He seems to have lots of the symptoms of child RAD but is 37 years old.
• Won’t have eye contact
• Withdrawn
• Failure to smile
• Avoids/dismisses comforting comments
• Engages in self soothing behaviors
• Does not seek physical contact
• Avoids you
• Seems disinterested
• Calm when left alone

He meets all of the risk factors. Suffers with the following:
• Poor self-esteem
• Antisocial behavior
• Relationship problems
• Temper or anger problems
• Depression
Anxiety
• Unemployment or frequent job changes – not sure this is an issue because this seems to only be since marriage
• Inappropriate sexual behavior – avoidance of the love relationship and resorted to porn

but also has lack of empathy/remorse, lack of eye contact, and lies frequently. He took an online PTSD test and said it came back 'minimal effects'. Not sure what to do but when he has these angry outbursts they last for days or weeks even... outside of that it's normal for him not to have eye contact, to do his own thing, very detached emotionally, no remorse or empathy for others, completely self serving... etc. Extremely prideful and can't admit to any wrong doings... ever. He can lie to my face and will say I could have been more up front but can't say he lied... etc.
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Mark replied 1 year ago.

Hi! I'll be glad to be of help with this issue. I see that your question has been here for a little while and no one answered until I logged on. I think the reason is because there is no "happy" or "light" answer to give you. I'm so sorry for that; but I want to try to help you even so.

I can imagine how overwhelming--distressing and heartbreaking--this situation must be for you. You are clearly a loving wife. And also clearly, you're an intelligent and level headed person. You've looked at his symptoms and you've come up with RAD. I have to tell you, in my career, to have people from the general public do enough research to get to the RAD world is very rare. The list of symptoms you present are enough for me to know that I don't need to send you a checklist of RAD symptoms; you clearly know what they are. The one area you haven't discussed is his early childhood (adoption, disruption of family life, etc.) that we use to clinically diagnose RAD (or, for that matter, any attachment disorder).

But clinical diagnosis is not the issue here. It is really a side issue. Whether PTSD (often a RAD look-alike or even comorbid disorder) or ADHD (often misdiagnosed with RAD at about 10-16 years old, but also can be comorbid), or RAD (no one wants to say such a diagnosis as it's so difficult to treat at any age, but actually easier as the person gets older), the central issue is the same: you have been married for 3 years; you have been to 3 professionals in that short time; you have not gotten any further than you were when you began with the professionals.

And this is actually the key to my answer to you that you need to consider and think about. Your husband is not willing to see he has a problem, that he has a serious problem, and that nothing will get better until he is willing to try to work on his serious problem. Actually, problems. I know you know this. But really good people sometimes need to hear from objective outside people that their goodness, increasing your goodness even to the nth degree, will not change that dynamic.

And, as important: yes, he has a problem; yes, he needs help; but also yes, you have a right to a life. You also count. That you are more healthy, healthy in the "normal" way that "normal" people are healthy, does not mean that you have a responsibility to live on hope and prayer only. You have been granted a life as well; and it has importance as well.

So, I urge you to go to the pastor and give it a try. But to recognize that what I said in the paragraph above has to also be part of the conversation.

I want to offer hope in the sense of two treatment modalities that might be helpful to him if he becomes willing: DBT and EMDR. To learn how to approach life from something other than feeling, the best type of therapy is Dialectical Behavioral Therapy (DBT). At its behavioral heart, RAD is a feelings centered disorder. DBT can work in individual therapy or group therapy. I personally like when clients use both as long as the therapists doing each are different therapists so that you are establishing two relationships. I want you to learn the skills that DBT offers. So, start with the following website put together by people who aren't psychologists but who have gone through DBT themselves. Try to get him to use as many of the self-help options they have. But then see if it can get him into the therapy sphere. Here's their web address:

http://www.dbtselfhelp.com/


DBT was originally developed by Dr. Marsha Linehan for Borderline personality disorder. But it's been now accepted as a modality for many different diagnoses. EMDR is a protocol for PTSD. Here is the International Society's website:

 


http://www.emdria.org/

On the web you will find many opinions on EMDR both for and against. I am trained in it and have found it useful. Exposure therapy is also very helpful. However, I have found that he will need to combine these types of therapy with a more introspective, humanistic approach. If we actually look inside, we can find great relief and meaning.

 

So, I hope and wish the very best for you and also hope that I may have been of some help in a very difficult situation.

Okay, I wish you the very best!

My goal is for you to feel like you've gotten Great Service from me and the site. If we need to continue the discussion for that to happen, then please feel free to reply and we'll continue working on this. If the answer has given you the help you need, please remember to give a rating of 5 (Great Service) or 4 (Informative and helpful), or even 3 (Got the job done) button. This will make sure that I am credited for the answer and you are not charged anything more than the deposit you already made by pressing any of these buttons. Bonuses are always appreciated! If I can be of further help with any issue now or in the future, just put "For Dr. Mark" in the front of your new question, and I'll be the one to answer it. All the best, XXXXX XXXXX

Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5106
Experience: Dr. Mark is a PhD in psychology in private practice
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