Psychiatric Disorder? Hmmm.

[emotionallybankrupt]

I have a HUGE struggle with the concept of whether my difficult child is REALLY mentally ill, or just plain mean. It's easy for me to see depression, bipolar, and so many challenges in this way--chemical imbalances, no choice in the matter. But the lack of remorse? The seeming lack of a normal conscience? No empathy? I really wish I could see this as an illness, because I think it would help me be a lot more tolerant and would help me LIKE my difficult child a lot more. But...I believe my difficult child has CHOSEN these behaviors, and I think of illness as lacking that component of choice.

I have trouble with the fact that medications are so ineffective with this crowd. We have had many periods of time when my difficult child has been compliant with the medication regimens, and I think so many options and combinations have been tried, that it is not reasonable to continue that route. That's maybe the only factor my difficult child and I agree upon. She doesn't want any more medications, and I don't want her to put these powerful chemicals in her body when there is no positive result. I also see in my own difficult child the capacity to control her behaviors when it benefits her in some way; it seems to be a willful, manipulative thing.

As for the pay-off for her? I don't think she has wanted the negative consequences that have come her way. I sure don't think she wanted me to call the police when I have done that; I think she underestimated me and thought she could get by with her behavior and get the better of me. Back to making her own rules, thinking she is somehow entitled to special treatment, and believing that with persistence she could take over control of my house. Is that illness? I think it would be a lot less painful if I could find a way to see it as illness.

In researching "personality disorder" I found that, in an earlier time, the DSM termed it "character disorder." Have we just tried to make it sound nicer? Some personality disorders make sense to me to be termed that way, but I have a big problem getting past the manipulative, dishonest, warped view of right and wrong, especially central to antisocial personality disorder. I really do want to see my child as ill rather than mean, but I just can't get there. How have you reconciled this?

 

[Lori4ever]

Read up on anti social personality. The sociopath next door is an awesome read that explains things in plain terms. Frightingly so, in my humble opinion. I have a similar issue with mine in that respect, I do know it's hard to deal with. Hope it gets easier soon.

 

[flutterby]

My daughter has a personality disorder - Borderline Personality Disorder. The old thinking was that it was caused by abuse. While I agree that abuse can cause the disorder, I think there has to be a predisposition to it.

My daughter has not been abused. From the moment she was born, she was different. Exceptionally needy, to the point of never being able to fulfill that need. She's been in therapy on and off since she was 5. I've seen this diagnosis coming since she was 7. therapist first brought it up as something that may be diagnosis'd down the road when she was 10.

The thing is, there is so much more about the brain that we don't know than we do.

There is definite faulty thinking going on. The fact that with therapy, people with this disorder can get better tells me that it is a psychiatric disorder. But, I have never had a problem seeing it that way.

Most - if not all - of personality disorders carry with them some degree of emotional dysregulation. They don't *want* to be that way. No one wants to be miserable (even though it may seem like they do). They just don't know how to make it better. The result of the tumultuous emotions, impulsivity, and faulty thinking is the behavior; that tends to be only what most people see. However, there is a lot of internal struggle going on with these patients.

Janet can probably better explain it.

 

[witzend]

I started to type something out, and got quite far. Then I blipped it into the ether.

I think it helps if you don't question the "why" of it. Maybe they're born with it, and maybe they grow into it with repetitive episodes throughout their lives. But the "personality" part is just that. It is in fact a part of their personality, the very stuff that they are. They're not likely going to want to change it any more than a person who is cheerful will want to change their personality. That would invalidate them. Unfortunately, it's also a "disorder". I think of it moreso in the lines of a disordered (unwanted, unpleasat, etc.) personality rather than a personality disorder.

I guess what I'm saying is that maybe your daughter has chosen these behaviors, but she's not choosing anymore. It's part of what she is.

 

[BusynMember]

I have borderline. I was a lot worse when I was younger. I always had remorse though. Lots of us. But it didn't stop me from lashing out at those I loved the most when I felt they were rejecting me or criticizing me or abandoning me. In the end, many did abandon me, although I feel they have borderline as well...so you can imagine the fun.

Substance abuse makes even non-personality disordered people mean.

(((Hugs))) I hope she finds the motivation to go into DBT therapy (it's great, but takes a lot of work). If she truly doesn't have remorse, I don't believe it's always a choice. I did have lots of remorse and empathy, but some people are born more empathy-challenged, as my p-doctor put it.

 

[CrazyinVA]

The seeming lack of a normal conscience? No empathy? I really wish I could see this as an illness, because I think it would help me be a lot more tolerant and would help me LIKE my difficult child a lot more. But...I believe my difficult child has CHOSEN these behaviors, and I think of illness as lacking that component of choice

Seeing it as an illness doesn't always help me like my difficult child more. It also doesn't make me more tolerant. Educating myself about, in my Oldest's case, borderline personality disorder, simply helps me understand my Oldest better. I don't use it to excuse her behavior. As a doctor once said to me, "if she has a personality disorder, you have to understand, this is who she is." I can't change that. I can only accept it, and learn to deal with it.. or *not* deal with it, as the case may be. I can change how I react, or don't react, to her behavior. The more I read about and understand the disorder, the more I can help myself deal with it. It's not about helping her, or even hoping she'll change, it's about helping myself.

 

[DammitJanet]

Like Crazy, knowing whether something is an illness or not doesnt really make me like or not like my kid more or less. It does give me somewhat more of an understanding of some of the reasons he may be doing what he does but it doesnt give him an excuse. Or a "get out of jail free" card. Gosh he wishes he had one of those...lol.

I understand personality disorders because I have one. My son has a different one which is really a mix of several put together. Each of our problems are different. He is more like your daughter in some ways. While he loves me dearly, I clearly dont come first to him most of the time. There are a few times when I hit the top of his list but most of the time I only register when he needs me. I know this. In this way he is very narcissitic. But he would also give someone the shirt off his back, let anyone live with him, feed a crowd, and loves deeply. He would never hurt anyone unless they were hurting him or his family. He is very connected to his family. He is only now starting to respect authority and obeying the law..(except when it comes to driving without a license...sigh). That came about because I had him charged with three felony counts of forged checks. Had to do it. He left me no choice but to bring him up short.

Do I love him? God yes. Do I always like what he does. No. Can I separate the two. Yes.

 

[witzend]

I agree that there are a lot of co-morbidity issues with the Personality Disorders.

 

[emotionallybankrupt]

To get to the center of my problem, I think it would have to be the personal abuse my younger daughter and I have absorbed for the past four years. I can't figure out what kind of confused thinking, internal struggle, or inherited predisposition would have made that unable for her to control, and that leaves me with a lot of blame and resentment to do something with.

I loved her dearly, did for her the very best I knew to do in every situation--and I've been lied to, cursed with more obscene language than I knew existed, and much more. Yes, I still love her, but I'm stuck in a big emotional tangle that pulls me in different directions every day. The pain over the absolute betrayal is huge, and I can't figure out yet how to reconcile all that with the, "She's ill," or "She has a brain disorder," argument.

How have you worked through the resentment and betrayal issues?

 

[Hound dog]

Nichole is diagnosed both borderline and bipolar. And the years when she was unstable were nitemarish.

She could be sweet, loving and so darned kind one minute, the next she was going for your throat. No warning, just WHAM! Afterwards she would behave as if nothing had happened.

We often thought she never felt remorse for her behavior, cuz she certainly didn't act like it most of the time. But talking with her when she was finally working her treatment program trying to get better.......she would sob with remorse over things long past even.

In Nichole's words, not acting like she had regrets or remorse for her actions was like pretending they never happened, that nothing was wrong. When in fact she felt like she had control over absolutely nothing.

It had become a defense mechanism sort of for behaviors/moods triggered by her disorders. Once family members started calling her on it.....pointing it out to her.....she learned to react differently. Because after so many years it had become automatic.

We really worked hard on this because it was such an issue. A huge issue. We're a close knit family. And this was pulling Nichole away from everyone.

I mean, c'mon. It's hard to have someone rip your head off with vicious and cruelty one second and then smile at you and ask you to do something for them. Or want to just plain act like nothing happened and be offended when your emotions are still in an uproar from it.

Nichole is tons better. But every now and again she'll slip up...and if one of us are around, we still call her on it. And make her think thru better responses ect. lol

 

[DammitJanet]

Im thinking that if your problems really started in just the last 4 years that maybe it wasnt an abuse problem. The theory is that especially in borderline that it can be triggered by a childhood that is invalidating to the childs emotional needs. Now that can be caused by anything. A parents death or a divorce, a working mom who leaves a kid in daycare and the daycare provider doesnt provide the emotional support the kid needs, kids in the neighborhood that the child believe shun the child...anything that the child perceives as an emotional let down. Its a combination of the way the child was wired and the environment.

 

[emotionallybankrupt]

Im thinking that if your problems really started in just the last 4 years that maybe it wasnt an abuse problem.

There was always an underlying disrespect there, which I couldn't find a reason for. Even other people mentioned it to me, for example the disrespectful way she would speak to me in public places at times. It was quite embarrassing. We'd talk it through forever afterwards, and she'd never admit she saw anything wrong with anything she said or did.

The catalyst for trouble is, and has always been, being denied her way.

The full-blown abuse, however, began right at four years ago, not because the potential had just arrived, but because I finally had found out about some of the "behind my back behaviors" that had been going on a LONG TIME. I think I'm an intelligent woman with good instincts and fairly perceptive, but I never saw it coming. As things would happen, she would present the most convincing arguments and explanations anybody ever heard, and there was never a thing to give her away. I bought it every time.

It was a tip-off from another parent that finally gave me reason to get very sneaky and make some moves that, under normal circumstances, I'd consider to be underhanded. I still think that was the only way I would ever have found out what a huge problem I had, though, and it was high time for me to get a reality check. She's simply that good. And...I was making a fool out of myself, defending her at every turn. She did an absolutely awesome job of presenting herself as the poor victim of horrible rumors, mistaken identity, and quirky misunderstandings. This is still a big part of my betrayal issue.

So, absolutely she's had problems much longer than four years, but as long as she was so successfully "playing" me, the real abuse stayed underground, because she didn't need it yet. We moved into the authority war because I would not allow her to make her own rules. As long as she had me fooled into thinking she was following the rules, we had a fairly peaceful place here, even though still there were some inappropriate attitudes from near the beginning.

 

[JJJ]

This is a very interesting thread to me. Kanga consistently tests with "features of personality disorder" but due to her age, they won't diagnosis her with it yet. She completely lacks remorse. Her therapist says she feels that Kanga has remorse for the abuse she heaped on Tigger but not on me. I don't think she feels remorse at all. I think she figured out that people were looking down on her for abusing a small child and she expresses remorse because it gets her something.

I do forgive Kanga for what she did. She had a horrible start in life through no fault of her own. When we got her at 6, she was already so damaged but hid it well.

I don't think I will ever forget what she did nor ever trust her again. Love her -- I don't know, maybe one day...

 

[emotionallybankrupt]

This is a very interesting thread to me. Kanga consistently tests with "features of personality disorder" but due to her age, they won't diagnosis her with it yet. She completely lacks remorse. Her therapist says she feels that Kanga has remorse for the abuse she heaped on Tigger but not on me. I don't think she feels remorse at all. I think she figured out that people were looking down on her for abusing a small child and she expresses remorse because it gets her something.

I really consider it a kindness that the personality disorders are not diagnosed until the age of 18. I think the diagnosis brings a social stigma, a complication in qualifying for insurance benefits, and a reluctance for many counselors to take on the challenge. The prognosis is not good, patient compliance is frequently a problem, and I think a lot of counselors burn out with these patients. People like success, and I don't think the counselor of an antisocial patient is likely to find a lot of success. DBT seems to show a lot of promise with borderline, for those patients who are willing to make the commitment to do the work, but what is there for the antisocial--or for that matter, what is there for ANY patient who denies any responsibility for the problem? Or that they have a problem?

In also makes sense, I think, to hold out as long as possible before dropping such a heavy diagnosis, in hopes that maybe the symptoms will ease as the patient gets to the other side of the teenage years and all the natural rebellion that goes along with that phase of life.

In my case, I think difficult child MAY at some point feel remorse for the abuse to her younger sister, because while she found her to be an aggravation, she was not an authority figure, and therefore not an obstacle. For the time being, however, difficult child maintains that her younger sister says she is scared when she is not, complains over nothing, etc.--just to get attention and to get difficult child in trouble. As long as she can justify/deny her behavior in this way, there is really no room for remorse. Ironic to me that she is calling her SISTER a liar!

The situation with me is different. She feels no remorse for what she has done to me, because she believes I deserve what I got, for standing in her way. difficult child in fact stated the gist of that from time to time, and I believe in those cases, she was telling the truth.

By the way, it's also interesting to me that substance abuse has never been an issue in the case of my difficult child. She had a brief period of very limited experimentation--probably of a fairly typical sort among teens--and that was that. Finished. I am VERY thankful, of course, but it seems strange to me that, in the middle of all the other outrageous behavior, this is apparently one standard she has set for herself and held to. Yes, I have praised her for that over and over.

 

[witzend]

She's only 16, she may one day feel remorse. Or perhaps regret. I would be surprised if she showed or felt either emotion now. She's only 16 years old. I think that 16 year olds tend to be selfish by nature. I'm not saying that I think you should hold your breath, it's miserable living with this type of child. But they do eventually move out of your house, and you won't have to live with their antics every day. And as that happens, you will be less and less angry with her. And she will have less and less opportunity to treat you badly and/or blame you for her shortcomings. One way or another, they all grow up. And at some point in their lives, people figure out that they're way too old to be giving their parents grief and get any sympathy out of it. I know it's cold comfort for now, but even if you can't look forward to her changing, you can look forward to it not being the dominating feature of your life.

 

[CrazyinVA]

How have you worked through the resentment and betrayal issues?

I still deal with some of this, to an extent. But the short answer is: my own therapy, support groups, educating myself about the disorder, keeping boundaries, workign on detachment skills, taking care of myself. In fact, the same skills I learned in Al-Anon for coping with my alcoholic ex spouse and mother, can be used to deal with my children's mental disorders. I can't change who they are, and I can't change the things I may or may not have done to help/hinder them in the past. It took years of practice. All I can say is to keep at it. It will get easier. The behavior won't necessarily get better, mind you, but your ability to cope with it will, if you work at it.

The situation with me is different. She feels no remorse for what she has done to me, because she believes I deserve what I got, for standing in her way. difficult child in fact stated the gist of that from time to time, and I believe in those cases, she was telling the truth.

Some of this is her being a teenager, as Witz said. Take the typical teen "not my fault" behavior and add a personality disorder to the mix? Bam.. lethal combination. I will say that this got better as my Oldest got older. She's 25 now, but at 16, nothing was EVER her fault. She was never, ever sorry for any outburst, physical or emotional aggression towards me.. it was always MY fault. ("if you had just let me do such and such, I wouldn't have had to throw that chair at you.") I was the worst mother in the world. Yada yada yada. It's hard to take, I know.. but again, learning the coping skills above helps with this as well, eventually.

Hugs. It's not an easy road.

 

[flutterby]

There are a couple of articles I had previously posted on the News forum of this board.

 

[rejectedmom]

My difficult child 1 has a personality disorder and her treatment of me and her siblings is similar to your daughter's. I had to put her up in an apartment at age 21 just to get her out of my house. I was called obsenities everyday for years. Do I love her..yes. Do I like her..sometimes. How do I resolve the abusive side of her? I take care of myself. It serves me no purpose to dwell on it so I just stay away when she is in a "mood" and if on the phone I end the conversation if she becomes abusive. Then I do something for me. Whether it be meditate or a movie or a walk through an antique store I refuse to let it getme down and I refuse to internalize it or even carry it. Some times I do need to talk to husband about it just to vent but I find I do not loose much of my life over it anymore. It takes diliberate practice but does become easier over time. I have learned not to ever expect an apology nor for her to see how she hurts others. She is who she is and I feel it is genetic as she is no different than her paternal grandmother and my father. Controlling, manipulative, self absorbed, frequently abusive, never at fault and horribly unhappy with her live. All her therapy has only helped her to rationalize her behavior and villify everyone else. Instead of working on herself she goes around diagnosing everyone else. I hope she will change. I figure there is a 50/50 chance. I say that because my mother in law didn't but my Father did after he got cancer.

That said, she and I have our good times too and I try to just focus on them. Of course it is easier to do that when they are not under your roof. -RM

 

[emotionallybankrupt]

Thank you for all the responses and for the articles. I'm getting there, doing a better job of setting boundaries and taking care of myself and my other daughter, and yes, it makes a big difference to get a little distance on it with her out of the house. As far as putting her up in an apartment, I don't have the means to do that, but would honestly have to say I don't know if I'd be willing to do that if I had the means. I don't know if that's a good or bad thing. I think the only chance she has for any change is to hit "rock bottom," but I don't know what "rock bottom" is for her, and I don't want her to hit so hard that she completely self-destructs.

I know there is a strong genetic component, but I don't think she has even tried to overcome it. She sure has had a lot of the "nurture" component from a lot of people who love her very much, ahd she has simply walked away from every one of them. Hopefully something will make her turn the corner eventually, but I just can't let her back in my house. I don't know if I'll ever feel able to have a relationship with her again, but right now it's too soon.

The e-mails of "I know I did some horrible things, and I'm sorry, but now I need you Mom...I need your advice, Mom," have just started in the last couple of days. (Translate I need something from you, Mom, and I'm hoping a token apology will be good enough for me to get it.) I knew it would be coming, and I figured the upcoming holidays would be a trigger, as well as just feeling the absence of her mother for the first time. I'm sure she's out of money too and is just now learning it doesn't magically appear. She's hating to hear me say that the daily explosions in our home have been unhealthy for each of us, and that her sister and I are doing better now without all that conflict. Misery loves company, I guess.

Gut feeling is that I need to let her feel the natural consequences of fighting me so hard until she finally got out of the house. Also that--for now at least--I can't take care of her sister and myself unless I let her stay at a distance and see that this independent "adulthood" she was wanting so badly isn't all it's cracked up to be. I'm just telling her that she's in exactly the situation she chose for herself and that I'm sure she wouldn't have fouight so hard to trade her childhood and teenage years for early adulthood unless she had a plan to make it work to her advantage. I know she must have hated that response from me, and so far that's been the end of the exchange. I'm sure it's far from over, though. She's had only since last night to think it over.

 

[katya02]

This thread resonates for me in many ways with respect to several relatives including difficult child. EB, I think you're absolutely accurate in your assessment of the reason for the current contact (suddenly has needs, wants something from you, thinks a token quasi-apology will set everything back to 'normal', i.e. you doing things for her). Your response is wonderful. Sounds like you've reached the point where you're able to detach - just not willing to take the abuse anymore. I'm glad you're recovering some peace in your household and in your life.

Even though your difficult child will be angry that you don't rescue her now, and may cut off contact for a time, believe me, she'll be back. Long ago I worried that saying or doing the wrong thing would have permanent consequences that I'd regret down the road. The only 'wrong' thing is to continue to let someone with a personality disorder use you. I've gone no-contact with certain relatives for prolonged periods of time and they always manage to re-establish contact. At least I've learned to keep my boundaries high and unyielding.

So, be firm, do what you and your younger daughter need, and don't feel bad about it. Not that your letter sounds like you are, but as time goes by it's easy for doubts to creep in. Protecting yourself and your daughter is Job 1; and you'll still know what your difficult child is up to. Best wishes ...