Most children start to learn about the “stranger danger” concept before they can walk. They learn to trust their parents or caregivers. They form attachments and emotional bonds to people that surround them. However, some children lack all of these qualities. The “stranger danger” concept is blurred in their minds to the point where they feel closer and more attached to the strangers than their caregivers. These children have disinhibited social engagement disorder.
Disinhibited social engagement disorder (DSED) is one of two attachment disorders that can be found in children and teens. DSED keeps children from forming bonds with their parents and family members. Instead, they have close bonds to strangers. They are more comfortable with strangers and care for them as their primary caregivers.
Children with DSED are often children who have been institutionalized either in foster care or any other place where they had multiple caregivers. They may have lived in an orphanage most of their life so they see a high ratio of adults to children. They learn to seek attachment elsewhere, not with their caregivers. These children have most likely been exposed to new people and strangers on a regular basis. They rarely have time to form a complete bond with anyone. Therefore, they tend to give it freely to all new acquaintances. Not all orphans or children from the foster care system will develop DSED, but the system does increase the risk in a child.
Abuse or childhood trauma also increases the risks of DSED in children. These children may have witnessed the death of a parent. Perhaps their parents may have been an absentee parent or someone who abuses substances. They would have been neglected or abandoned. They may also have been sexually abused. Some sexually abused children may eventually see the act as an act of love necessary for all relationships. So, they will be uncomfortably close to strangers.
Children with DSED will have many symptoms that others can clearly see. Usually, their attitudes and attachments toward strangers will come off as uncomfortable and inappropriate to adults around them. These children will have no trouble being overly friendly and talkative to strangers. They may hug and engage in other culturally unacceptable or age-inappropriate acts with said strangers.
These children are not afraid to leave a safe place with a stranger. They will go willingly and have little thought of alerting anyone. They have no problems with any strangers touching them or talking to them since they have no fear of strangers like other children. This makes them more susceptible to harm. They can easily be kidnapped or sexually abused. However, they often lack loving bonds with adults and other children. Their attachments are very fleeting but intense.
DSED like many other non-physical illnesses are individualized. Therefore, the medical provider has to take into account both the children’s attitude and the environment before making a treatment plan. Psychotherapy can be used to help children with DSED. For the therapy to work, it has to involve both the child and the caregivers. The child may undergo play or art therapy to feel more comfortable. Depending on the child’s age, they can also have talk therapy individually or in group.
In therapy, the caregivers are given tools to improve their interactions with the child. They get to understand the child’s diagnosis better. The therapist will teach them ways to make the child feel secure and cared for so that he can develop healthy attachments. The child will be better at both emotional and social attachments. It’s important to keep up with the treatment tools while keeping a loving and comfortable relationship even if they show sign of rapid progress. Some children can regress after treatment if the environment has not improved.
Not all children that have been through abuse or the foster care will develop DSED. Many other factors will add up to it. Most of these children will usually grow out of it because DSED is not known to last through adulthood. However, it increases their risks of harm drastically while they’re still underage. Therefore, it’s important to seek treatment as early as possible.