C
Cracklin'Rose
Guest
Hello everybody. I just found this amazing place and after reading through the posts, I'm hopeful someone can advise me on whether it would be worthwhile to have my stepdaughter difficult child assessed for a personality disorder. Here's the situation: she has been gone a week and is couch surfing, drinking, doing drugs, etc. Last night she was caught shoplifting and then let go with a citation. She will be 18 in 9 weeks and just got back from a 3 month + stay in a wilderness therapy program. On her return we placed her in an intensive outpatient dbt program, as well as AA and individual and family counseling. We have a family contract and a level system. Our other children can live with the rules, but our difficult child will not. She is not usually openly defiant, just incredibly devious.
After seeing the striking difference in outcomes between our difficult child and our 15 year old easy child/difficult child upon completion of the same wilderness program, I started to investigate the possibility that our difficult child has something more serious than the ptsd and depression she was diagnosed with. She has many antisocial traits, including a long history of recklessness, stealing, fighting, truancy, drug and alcohol abuse, promiscuity, lying, and cruelty to animals. She has also been very cruel to her siblings, especially her younger sister. She cannot maintain relationships with her peers and shows little or no empathy toward others. She has no real interest in anyone but herself. Family therapy is a joke because she will not accept responsibility for her actions; she just rationalizes, deflects and justifies.
Honestly, there is little we can do for her at this point, and we don't want her in our home a minute longer than necessary. She can't be trusted as she steals money from us as well as stealing our vehicles. Also, she has told me that when she lived with her mother and was angry with her she would spit on her plate and in her food. I shudder to think what she does here when she is angry. There is not a single rule that she will voluntarily follow as she seems to believe that rules shouldn't apply to her. Again, she isn't openly defiant, she just sneaks around and then brags to her siblings about it.
The reason I'm considering making the effort to have her assessed for a personality disorder is that the treatment she has received so far (pt, dbt) has done absolutely nothing for her. From what I know, the most effective treatment for cd or aspd involves longterm cbt. From what I have observed of her therapy sessions, she enjoys the sympathy and loves to talk about herself, but is completely unwilling to accept responsibility for her own behavior. On the other hand, if she returns home at all, she will not be here for long. Once she turns 18 she will be on her own and responsible for getting herself to treatment so is there any point to getting another diagnosis now?
It is inevitable that she will have further contact with the mental health care system in future, and also likely with the court system. Would a pd disagnosis help or hinder her? There is obviously a stigma around cd and aspd, which may explain the reluctance I have seen by mental health professionals to explore that possibility, but the treatment she is likely to receive without an accurate diagnosis is worthless and may even do more harm than good. I say this because she had a miserable childhood with her mother (also likely aspd or nd) and was raped by a neighbor of her mother's. She has only lived with us for a little over a year. When she is in any kind of trouble, she has learned to bring these things up and use them to elicit sympathy and excuse her own behavior.
I know I probably sound callous, but believe me, I was incredibly sympathetic for many months. I apologized to her over and over for what had happened, even though we had been fighting to get custody of her for years, and she had always insisted she wanted to stay with her mother. I cried and felt sick when she told us some of the things that her mother had supposedly done. I say supposedly because we later found out from her stepfather (since divorced from her mother) that our difficult child would return home from visits with us with all kinds of fantastical stories about how we mistreated her and would say nasty things about us and make fun of us. This stepfather absolutely doted on her, even after his own parents refused to allow her in their home any more because they thought she was "the devil." No kidding.
So anyhoo, thanks for letting me vent and please let me know what you think about whether I should bother trying to get an axis II diagnosis or not.
After seeing the striking difference in outcomes between our difficult child and our 15 year old easy child/difficult child upon completion of the same wilderness program, I started to investigate the possibility that our difficult child has something more serious than the ptsd and depression she was diagnosed with. She has many antisocial traits, including a long history of recklessness, stealing, fighting, truancy, drug and alcohol abuse, promiscuity, lying, and cruelty to animals. She has also been very cruel to her siblings, especially her younger sister. She cannot maintain relationships with her peers and shows little or no empathy toward others. She has no real interest in anyone but herself. Family therapy is a joke because she will not accept responsibility for her actions; she just rationalizes, deflects and justifies.
Honestly, there is little we can do for her at this point, and we don't want her in our home a minute longer than necessary. She can't be trusted as she steals money from us as well as stealing our vehicles. Also, she has told me that when she lived with her mother and was angry with her she would spit on her plate and in her food. I shudder to think what she does here when she is angry. There is not a single rule that she will voluntarily follow as she seems to believe that rules shouldn't apply to her. Again, she isn't openly defiant, she just sneaks around and then brags to her siblings about it.
The reason I'm considering making the effort to have her assessed for a personality disorder is that the treatment she has received so far (pt, dbt) has done absolutely nothing for her. From what I know, the most effective treatment for cd or aspd involves longterm cbt. From what I have observed of her therapy sessions, she enjoys the sympathy and loves to talk about herself, but is completely unwilling to accept responsibility for her own behavior. On the other hand, if she returns home at all, she will not be here for long. Once she turns 18 she will be on her own and responsible for getting herself to treatment so is there any point to getting another diagnosis now?
It is inevitable that she will have further contact with the mental health care system in future, and also likely with the court system. Would a pd disagnosis help or hinder her? There is obviously a stigma around cd and aspd, which may explain the reluctance I have seen by mental health professionals to explore that possibility, but the treatment she is likely to receive without an accurate diagnosis is worthless and may even do more harm than good. I say this because she had a miserable childhood with her mother (also likely aspd or nd) and was raped by a neighbor of her mother's. She has only lived with us for a little over a year. When she is in any kind of trouble, she has learned to bring these things up and use them to elicit sympathy and excuse her own behavior.
I know I probably sound callous, but believe me, I was incredibly sympathetic for many months. I apologized to her over and over for what had happened, even though we had been fighting to get custody of her for years, and she had always insisted she wanted to stay with her mother. I cried and felt sick when she told us some of the things that her mother had supposedly done. I say supposedly because we later found out from her stepfather (since divorced from her mother) that our difficult child would return home from visits with us with all kinds of fantastical stories about how we mistreated her and would say nasty things about us and make fun of us. This stepfather absolutely doted on her, even after his own parents refused to allow her in their home any more because they thought she was "the devil." No kidding.
So anyhoo, thanks for letting me vent and please let me know what you think about whether I should bother trying to get an axis II diagnosis or not.
Fortunately, there are a wide variety of opinions on the board and hopefully someone will be along shortly to give you a different one. Again - welcome and I'm glad you found us!
