One word has been used more than any other over 20 years to describe my children’s behavior.
It’s direct – by creating a perception of the problem. It’s convenient – by placing blame entirely on my kids. And it’s easy – by removing any sense of responsibility from the adults in charge.
Yet manipulation doesn’t adequately tell their whole life stories.
The dictionary defines manipulate: to influence or control artfully or deceptively. Sounds like the unscrupulous used car salesman with a well-defined scheme for personal gain – rather than my kids who live in the moment and act impulsively.
For many children with early trauma, mental health challenges or ongoing, severe stress (Adverse Childhood Experiences), their outward behaviors – that appear as manipulation on the surface – are typically far more complex. In my opinion, the book Stop Walking on Eggshells hits the nail on the head.
The behavior is not intentionally manipulative but a desperate attempt to cope with painful feelings or get their needs met without the aim of harming others.
A desperate attempt to cope with painful feelings of the past
In other words, you cannot simply force people to want to change their behaviors. “After all, they aren’t just ‘behaviors’ to the person suffering from a mental health disorder. They are coping mechanisms that the individuals have used all their lives.” says John D. Grohol, Psy.D.
The spontaneous rage that erupts into verbal and physical aggression is an act of desperation.
The deeply embedded shame that arouses self-harm is an act of desperation.
Whereas some individuals gravitate to one extreme, others cycle between both – depending upon the situational triggers.
Nonetheless, the desperation is real – something that most people and many parents cannot fully comprehend. Nor fully appreciate, much less empathize. Me included.
Until I forever changed my perspective.
So what is the right mental health diagnosis? PTSD? Depression? Bipolar Disorder? A secondary disability of Fetal Alcohol Spectrum Disorder? Are there co-existing conditions?
Interestingly, many tweens, teens and young adults display “traits” of Borderline Personality Disorder (BPD) – including all six of my children, even though each displayed varying degrees of attachments to me. Three healthy, two relatively stable, one underdeveloped. As adults three of my six received a full BPD diagnosis.
Sadly, most previously had been given the highly negative labels of Oppositional Defiant Disorder, Conduct Disorder, Reactive Attachment Disorder and Anti-Social Personality Disorder – which brought nothing but negative professional reactions and gross assumptions.
About my children.
About my parenting.
With no explanations of the underlying behavior. Only willful disobedience. No offers of evidence-based treatment. Just blame and shame.
In the first half of the 19th century, BPD was coined with the belief that patients lived on the “border” between neurosis (inner struggles) and psychosis (delusions). Although the psychiatric community abandoned that theory in the 1970s, the name remained.
Today the prevailing mindset is people with BPD feel the same emotions as everyone else.
However, there is difference – as described in Stop Walking on Eggshells.
They feel things more intensely.
They act in ways that are more extreme.
They struggle constantly to regulate emotions and behavior.
And their glass is always half full with black and white perceptions, minimal self-worth and unrealistic social expectations.
– people are either flawless or evil
– they are completely for or against them
– they are totally right or absolutely wrong
– abandoned at slightest provocation
– distrustful or suspicious much of the time
– unfulfilled even with love, affection and attention
Displaying challenging behaviors:
– difficulty observing personal limits of others
– changing their expectations so no one can fulfill
– acting impulsively without regard to dangers
Emotion – not rational thought – ruled my children’s lives.
Dialectical Behavior Therapy continues to be gold standard in treatment which I described in this past blog. It saved two of my young adult children from “desperation” – and with the recent introduction of age-appropriate DBT programs for teens, I have hope for struggling families. A residential treatment center that failed my two oldest children years ago has a DBT unit today.
That’s real progress. Not just more of the same. Since many community mental health centers throughout the country offer DBT groups too, access has never been greater. Nearly all take Medicaid, and most have sliding payment scales.
With DBT a highly-trained facilitator teaches specific skills in a group setting over three to six months with individual follow-up. The focus is on the future with respect of the past. More rational thinking. Less emotional reactions – and drama. Lots of boundaries. No excuses.
No doubt, DBT (or another therapy rooted in mindfulness) might just be the treatment that desperate – not solely manipulative – children need. They will acknowledge, understand and process their personal pain.
Hopefully your options are clearer.
The time to treat is now. DCP
Essential features of Borderline Personality Disorder (BPD) are impairments in personality (self and interpersonal) functioning and the presence of pathological personality traits. To diagnose BPD, the following criteria must be met:
1. Impairments in self functioning (a or b):
- Identity: Markedly impoverished, poorly developed, or unstable self-image, often associated with excessive self-criticism; chronic feelings of emptiness; dissociative states under stress.
- Self-direction: Instability in goals, aspirations, values, or career plans.
2. Impairments in interpersonal functioning (a or b):
- Empathy: Compromised ability to recognize the feelings and needs of others associated with interpersonal hypersensitivity (i.e., prone to feel slighted or insulted); perceptions of others selectively biased toward negative attributes or vulnerabilities.
- Intimacy: Intense, unstable, and conflicted close relationships, marked by mistrust, neediness, and anxious preoccupation with real or imagined abandonment; close relationships often viewed in extremes of idealization and devaluation and alternating between over involvement and withdrawal.
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