COMPARISON: Reactive Attachment Disorder vs BPD

[BPDFamily.com]

Holly,

What would you say are the biggest differences?  My daughter is grown and not diagnosed.  I believe

her to have RAD, not sure about BPD, leaning more towards NPD or HPD.

[Bijou]

Holly,

What would you say are the biggest differences?  My daughter is grown and not diagnosed.  I believe

her to have RAD, not sure about BPD, leaning more towards NPD or HPD.

[qcarolr]

Here is a good book my GD's T suggested I read. It is a new paradigm ?, anyway it is certainly a loving way to deal with RAD type issues. I have used some of it's suggestions with my gd already.

"beyond consequences, Logic and control: a love-based approach to healping attchemtn-chanllenged children with severe behaviors" by Heather T Forbes. I got it at Amazon for $10.

gotta go -gd is yelling bath time

[Jemima]

Basically with RAD it is not so much a difference in symptoms (remember that with BPD, there are 9 possible symptoms and you only have to have 5 symptoms to be diagnosed with BPD, so that equals over 300 possible different ways of "having" BPD) ... .with RAD you have to know that in the first five years of life, the person had either severe neglect or multiple changes in caregiver that resulted in damage to the person's ability to bond. It is a diagnosis based in the root cause of the disturbing behaviors.

BPD, by contrast, is a disorder you define by the symptoms themselves. I have already read several different threads on this message board where people discuss the possible root causes of BPD --- and although the current professional belief is that you have to have both a genetic vulnerability AND an "invalidating" environment, some people on this board have said they noticed radical differences in their children almost from birth, others noticed radical and inexplicable changes starting at puberty, and still others didn't notice any real problems until their child was grown or almost grown ... .suggesting several different pathways to BPD.

Personally I don't think that knowing the differences is all that important, but that's just me. I am finding it helpful to read how people deal with BPD behaviors even if my daughter "really" qualifies for RAD rather than BPD.

[momofrage]

Jemima, thanks for the explanation about RAD. I am trying to focus my efforts on dealing with the behaviors I dislike, whether they stem from BPD or bipolar or alcohol/drug use. They seem to all create similar behaviors.

[qcarolr]

Here is a good book my GD's T suggested I read. It is a new paradigm ?, anyway it is certainly a loving way to deal with RAD type issues. I have used some of it's suggestions with my gd already.

"beyond consequences, Logic and control: a love-based approach to healping attchemtn-chanllenged children with severe behaviors" by Heather T Forbes. I got it at Amazon for $10.

gotta go -gd is yelling bath time

Update on this - I finished the book last night and was puzzling all day about how it connected to something else in my experience. Tonight I read a summary article from the authors website, www.ebeyondconsequences.com, and it hit me. Her theories really are very similar to DBT for teens and adults.  Mindfulness, interpersonal effectiveness, emotion regualtion, distress tolerance.

So I am trying some of her ideas of how to "regulate" or use my own calmness to calm my gd, then she is better able to deal with whatever transistion or situation we are struggling with. It is so very intuitive for me at this point in my life - I was much less regulated myself when my DD was a preschooler! So how do I use this to find a pathway to reconnecting with my daughter in a healthy way. That is my big question.

[lbjnltx]

dear qcarol,

there are many books on the market i'll bet that are written from the same basic principles of dbt. i am studying a book by Rosenfeld on Non violent communication.  basically the same concepts as dbt.  i am hoping that they are going to continue to help my relationship with my BPD13.  so far so good!

lbjnltx

[qcarolr]

Psychology, as any other science, is really an evolutionary process. And the benefits are gained from the process as our "puny human brains" will most likely never get to the "absolute answers". When a new self-help book comes out claiming to be the "new way" or "new View" as if the underlying concepts, ideas, theories have never been seen or heard before I almost want to laugh. Of course every theory has not choice but to build on everyting that has come before.

I am a knowledge seeking person. I have struggled with the purpose of my life, and for this moment, it seems to be taking in knowledge, all that I can absorb, letting it bubble around in my head a little, the putting it back out in the world in a slightly different formulation to be absorbed by someone else's knowledge seeking joruney. Then they do the same, and some of it will come back to me again later. This gift is what makes us humans so uniquie in our world, and allows us to gain ever increasing understanding of our world.

And along the way this sponge effect hopefully will increase my ability to cope with whatever challenges face me each day in my relationshipes to other people.

I have been trying to say all this for the past few days - don't know why it came together at this moment, but here it is for what it is worth to any who read it.

[momofrage]

qcarolr, what you have to say is worth a lot!

I am in much the same place as you. I am trying to read and learn and synthesize and make sense of it all. I have flashes of clarity, and increasing periods of serenity and self-discovery, as I go along this path.

I can say that I have grown emotionally and spiritually as a result of the last three months spent walking through BPD hell. I would never wish BPD on anyone, but I am becoming a calmer and more serene person due to what I have endured. Today I read something to the effect of God's plan is always good, it is us who choose to put the labels "good" or "bad" on events.

Hugs,

momof(less)rage

[Jemima]

I can relate to what each of you is saying. Right now, I am trying to learn not to respond to my uBPD/dRAD daughter's passive aggression. She will do anything to get any kind of attention, seems to thrive on upsetting others (especially me). Then when she succeeds in getting someone upset, she disrespects them by looking/acting bored when she is confronted. You can't win in this game ... .the social interactions that should be a collaborative effort, she turns into a competition or combat. She doesn't try to get along, she tries to provoke, and if she can provoke you and fool others into thinking that you are the one with the problem, then she has really succeeded. Somebody said recently that the only way to win in a game of one-upmanship is not to play. I agree. I am trying to learn how not to play. Any suggestions on taking myself out of this absurd and draining game?

[momofrage]

Jemima, for me, when I see that flash of anger and panic in my BPDDD's eyes, I brace myself, take several deep breaths, and try not to say anything right away. The book "The Essential Family Guide to BPD", teaches a silly little song to remember what to do in such a situation. Sung to the tune of "Row, Row, Row Your Boat", it goes like this:

Breathe, breathe, safety first,

Acknowledge what you hear,

Don't defend, delay instead,

Distract, defuse, or DEAR

(DEAR is an acronym for another set of coping techniques that I won't go into here.)

It sounds silly and simplistic, but if you read the chapter, it makes a great deal of sense. I tend to not think well on my feet, and I panic when I am confronted or raged at, so this gives me a framework on which to focus.

After a while, I learned more about detachment with love, and now I can usually stay pretty calm, tell myself that it is the disease speaking and not my DD, not say much but mostly listen, and validate what I can.

Ironically, by doing all of this, my DD's rages have lessened, our relationship has gotten a lot better, my stress levels are way down and my serenity is way up, and my marriage is better too.

Alanon and therapy also help me a lot.

It does really all boil down to refusing to play their game. It is impossible to have an argument with just one person participating!

[Jemima]

Thank you! I am going to practice that little song. Songs are kinda my way of coping anyway ... .I am one of the few adults that has "Elmo's Song" and "C is for Cookie" on my ipod ... .they are cheery and make me smile. I would like to hear what DEAR stands for too.

I think now that I realize that my daughter has the BPD pattern of behavior (whether or not she would qualify for a diagnosis --- although I think she does qualify) ... .now I have been able to see the "borderline turn" that Christine Lawson wrote about in her book (Understanding the BORderline Mother). For example, about 3 weeks ago, I took my daughter on a trip with me, and we had a really nice four days. SHe had my undivided attention and I didn't really have to cross her about anything. ALmost as soon as we got home she "turned" --- I crossed her or disappointed her or said no to her about something, and she turned on me. Has spent three weeks or so giving me the cold shoulder, arguing with me, doing the eye-roll and the passive-aggressive provoking, claiming we promised her things we did not, using insanity instead of reason, etc. etc. etc. ... .then when I left Sunday afternoon to return to my training (which is 5 days a week all this month), suddenly she turned back and hugged me goodbye. So maybe my recognizing that will make a difference. I think I get sucked into thinking that she has "improved" when she is in "normal mode", and then I crash whenever she goes back into her angry/oppositional mode. If I can keep it in mind that "normal mode" is not likely an indication of a permanent change, maybe I can learn to deal with it better.

I panic too --- for example, my daughter wanted to stop by Target this Sunday afternoon. My husband and I were noncommittal --- we were both exhausted trying to get our house ready to put on the market. I am in training all week for a month, he is working AND being a single dad, and we are working weekends to try to sell the house. So we didn't say absolutely not, but kind of said "maybe, but probably not" to her request to go to Target. Later on during SUnday lunch she started talking about it as if she DEFINITELY was going to Target. I think it is a type of panic reaction I have --- I had to immediately call her on it, where did she get the idea she could promise her brother something based on her having a trip to Target? I have always had a terrible aversion to promising a child something and then not following through --- it just goes against my grain. So when she fantasizes she's been promised something that isn't true, it's like I kind of panic. I HAVE to set her straight. My husband is just philosophical: We didn't promise her, she can't make us take her, it's a non-issue. But ... .he has also been known to promise kids things and then forget to follow through ... .it's just not an issue with him.

Also, I put a great deal of stock in nonverbal communication ... .my daughter's nonverbal disrespect and insolence really hurts me and gets to me. I really have a hard time not making a big deal out of it. Yet somewhere in my brain I know that I am just playing into her need for negative attention. So, that is a kind of panic too, like if I don't TAKE CARE of this situation it will escalate (when she was little, it WOULD escalate, you could never ignore her disobedience or pretend you didn't see). Now the situation has evolved into she seems to get some kind of sick joy out of starting a fight, and somehow I have to learn to quit playing this sick game.

[momofrage]

I got a lot of those situations with my DD too, where she thought we had agreed to take her somewhere or promised to do something. It's like she couldn't see the ambiguity in the answer - it was either yes or no in her mind.

I found it worked better for us if I said something like, "I don't know if we're going to go today. I'll decide later and let you know."

I also discovered that I really hated shopping when I was tired or stressed, and those outings usually didn't go well for either one of us.

[Jemima]

That makes sense --- that an ambiguous answer has to mean either "no" or "yes" to my daughter, she can't see that it means you don't yet know or the outcome has not yet been decided. It also explains why she sometimes takes an ambiguous answer as "yes" (somewhere else I posted that she had become convinced she was getting a car for her 16th birthday and went around telling people so ... .and she is NOT and has NEVER been promised a car) ... .and sometimes she says she "knows" how something will turn out (usually but not always in a negative way --- like she refuses to try something because she "knows" it will turn out badly).

Some people might think it is just the way she choose to say things, but I know her well enough to know that she is REALLY convinced she already knows outcomes in the future. For example, when she says, "No, I won't try that because it will turn out badly," I know her well enough that to her she really already knows the outcome. Also, when she says, "I am going to be XYZ someday," I know her well enough to know that she REALLY thinks it is DEFINITELY going to happen. For example, she went around telling her grandmas that she was getting a car for her birthday, and we asked her why, and instead of her explaining it was just wishful thinking or her hope, she got mad at us because she really was expecting a car. It's like she doesn't get the difference between what you THINK might happen and KNOWING FOR SURE what WILL happen.

If she wants to do something we think is not safe, she will assure us "nothing will happen." Most kids will do that but they do get that they don't really KNOW nothing will happen. She on the other hand really thinks we are just being mean by saying no, because she thinks she actually KNOWS that nothing will happen.

I just can't bend my mind enough to understand this non-logic.

[lbjnltx]

jemima,

in the mind of a typical BPD... .they cannot hold opposing thoughts at the same time.  everything is black or white... .yes or no... .they struggle with the grey matter in the middle.  dbt stresses choosing the middle path... .looking at pros and cons... .and considering other possibilities.  they have to be taught to seek the "middle path". 

my BPD13 cannot hold the thought in her mind that when i say "no" to her and "i love you"  that i really do.  this is what she believes:  if mom says "no" to me about something i want that would make me happy then she is also saying "i don't want you to be happy" therefore she must not love me.

once us non's can grasp how their thinking processes work then we are one step closer to a better relationship with the BPDs in our lives.

it is not necessary to agree with another person to understand them.  once again this is the grey matter in the middle!  if it is difficult for us... .try to imagine how hard it is for a BPD.


lbjnltx

[momofrage]

Last night during DD's rage, when she accused us of not loving her and not caring about her, all because we confronted her about sneaking a boy in overnight, I tried to reason with her. Stupid, I know, but I did it anyway. It went something like this, "Not care about you? Did we not care about you during the 6 times we took you to the ER? No wait, it was only 5 times, the other time we drove 7 hours in the middle of the night to get to the hospital where you were. Did we not care about you during the dozens of visits to the hospital and doctors and therapists? Did we not care about you while spending $40,000 in the last year on college tuition and medical bills? Did we not care about you when we were concerned about you riding in a car with a drunk driver?" Etc.

I don't know if any of it got through to her or not. Her logical brain was probably not hooked up at that moment. But it made me feel better at least.

[Jemima]

lbjnltx and m.o.r., it helps SO much to hear you describe your experiences (I CAN hold in my mind at the same time that it is a relief to me to hear your stories AND that I am sorry you also have to go through this ... .).  I read (on bpdfamily.com somewhere) about the "victim triangle" ... .realized that my husband, my daughter, and I have been playing that triangle scenario out for a long time. I experience myself as a victim (first of my uBPD mother and now of my uBPD daughter), and turn into a persecutor because I get so tired of being beat up that I lash out with my sarcastic mouth and with my power to say "no" to my minor child. I try to be consistent as a parent, but all too frequently find myself relenting on some punishment I have doled out because after the anger has passed I realize I was being too harsh. I don't like this waffle thing --- it's not good for our relationship or for my daughter's trust in me. But I also don't think that I should stick to punishments I stated in the heat of frustration and realized with a cooler head were over the top. I just wish I could stop getting so mad. That is my goal, to quit feeling/seeing myself as a victim so that I don't flip into persecutor mode.

I know by self-examination that I have plenty of fleas by being sandwiched between my mother and my daughter. They both can suck me into over-the-top emotional reactions, in ways nobody else can. I sometimes feel it is a just a cruel joke that my adopted-from-a-foreign-orphanage daughter has similar problems to my (bio) mother. Other times I think that the one common denominator in this situation is me ... .and those thoughts make me mad, because I spent my young life learning excruciating sensitivity to my mother's moods so that I could stay out of the line of fire, and now that excruciating sensitivity means that it is almost impossible to ignore my daughter's moods. Still other times I feel really defiant --- I defy anybody else to have mothered this child with severe attachment problems and have her come out as a decent human being (which she is to everybody else in the world except me, with the possible exceptions of her brothers).

[momofrage]

I've been trying to wait until I calm down to announce any punishment. It's fine to tell her that "I'll let you know your punishment after I've had some time to calm down and think about it".

I watched a show on TLC about Russian orphans with attachment disorder. It was heartbreaking. I really feel for you.

[GameGirl]

Has she been officialy dxd with RAD?  I am wondering because if you got her before age 3 she should have still been able to bond with you, which you indicated she has to a certain extent.  The symptoms you are describing could be do to cognitive defecits in her frontal lobes that she suffered aas a result of neglect in the first year of life.  What does her doctor think?

[Jemima]

She has been officially diagnosed with RAD (12 years ago). But in my opinion, there is no separating out the attachment problems/emotional problems from the cognitive problems.

[Jemima]

gamegirl, also, the state of knowledge when we adopted DD in 1995 was that if you got them under the age of 3, they would be fine (with regards to bonding). Now we know that 6 months is the critical point for maintaining their ability to bond in a healthy way ... .and that might change too as we look at how poor maternal diet, high maternal stress, etc. in utero affects people, and how varying levels of care/neglect during those first six months changes the picture.

In my opinion, they DO bond with you, but their ability to EXPRESS their attachment to you is broken. So that it is either difficult or impossible to develop a reciprocal relationship. They take, take, take. They depend on you almost to the extreme ... .but don't "recharge your batteries" by reciprocal social behavior. This is what families go through when their child is on the autism spectrum ... .except that a RAD kid isn't obviously impaired (they usually have OK facial expressions, tone of voice; they are interested in social things; they can read people well enough to manipulate them but not well enough to empathize much). The combination of impairments on the inside while maintaining a facade of normality equals high stress for both the individual and for their family.

Even with empathy ... .I think that impaired empathy (at least in my daughter's case) is not a lack of feeling for others. If she can wrap her mind around another person's situation, she does feel empathy. But the problem is she has a hard time understanding other people's perspectives ... .when you can't put yourself in another person's shoes, you have a hard time feeling with them.

[momofrage]

Gee, that sounds a lot like my DD, even though no one ever mentioned RAD.

[lbjnltx]

dear jemima,

here is a brief list of some resources i found that have helped me on my journey towards inner peace and personal mental/emotional health:

Radical Acceptance  on the Articles board by Marsha Lineham

The Man on the Bridge also on the Articles board

Letting Go  on the Spiritual Aspects board  a thread started by Cindy

1st Corithians Chapter 13  (if you are a Christian)

100% fully and completely accepting this fact:  I am only responsible for what I can control which is myself.  I cannot control the thoughts, feelings, behaviors, values of anyone else.period!

I hope that you find some strength and wisdom from these resources.

x

lbjnltx

[Jemima]

mom of rage, I wouldn't read too much into the similarities. Remember, you can't have "reactive" attachment disorder (RAD) unless there was a very early poor environment to "react" to. It's just words, I know, and probably not much different from your experience with your BPD daughter ... .but the difference to me is --- to suggest that a child from your family has RAD is to suggest you didn't provide anywhere near proper care during the first five years of life. I suspect if you were that out of it or indifferent you would not be posting on this board now, trying to figure out how to help her.

So, the symptoms may be the same, the response to the person may be the same, but what a difference a name makes. You don't need the extra guilt that comes from the RAD label! I don't feel guilty that my daughter has a RAD label because I couldn't help that she had horrible neglect during that first year of life.

lbjnltx, thank you for listing all those resources. I am absorbing as much as possible to help get myself to a place where I can deal positively with my daughter ... .and actually, with the other females in my family (mother is difficult and possibly uBPD herself; estranged DIL and her mother are probably uBPD as well ... .etc. etc. etc.). And I have got all kinds of FLEAS from years spent rubbing elbows with these problems.

I am a Christian --- so I do appreciate resources coming from that perspective. In fact, I believe it is my faith that has kept me sane all these years, dealing with such craziness. Prayer, worship, participation in my church have all recharged my batteries when my disordered kid couldn't give anything back. Of course, some people in every church think that if you're having problems, you just aren't spiritual enough ... .but if I looked hard enough, I could always find somebody who understood. The first time I ever heard about RAD was when I was pouring my heart out to a woman in my church who was a CPS social worker. That's when I decided to get professional help. And then later, a foster mom and I commiserated, and then a mom who took in her husband's much younger brother. And I found a psychologist who was also a Christian and was able to support me in my faith ... .a tremendous help when I got to feeling hopeless.

I don't regret adopting her. I can understand why some people regret the adoption, when their kid is real fragile, brittle, out of control with drugs/alcohol/criminal behavior/having babies too early/STDs/etc. But as we know from this forum alone, there aren't even guarantees with your biological kids. And even if she does turn out to have BPD, we still made a difference in her life. It's the biggest faith commitment I ever made, to take on a baby orphan to raise as my own. But they say that whatever doesn't kill you makes you stronger. I would never have figured out  my own mother's problems if I hadn't had to dig deep to figure out my daughter's ... .I would have just gone on thinking that I was the one with the problem in our mother-daughter relationship.

I have a dear friend whose first child, a daughter, was born "floppy" --- turned out to have autism, is MR, and has some kind of physical condition that left her with poor muscle tone, crossed eyes, etc. I learned a huge lesson from her when she said, "I finally quit worrying about her diagnoses. I said oh well, no matter what she's my baby and I'll love her and that's what matters." I admit I have not gotten to that point even 15 years later with my daughter ... .I still worry and fret ... .but of course I am just now coming to the conclusion that I've done all I can and I have to leave the rest up to God. That sounds like both my friend and I are/were giving up, but I don't mean it that way. I mean it in the sense of radical acceptance ... .I don't like it but that's the way it is and the way it has to be for now.

Right now I have a little bit of objectivity because I've been away from home in training for 3 1/2 days. At the end of the weekend I could possibly be a nervous wreck again. But I am NOT giving up on this "detachment", "radical acceptance" thing. I guess I'll just have to keep on picking myself up after I give in to my anger and frustration, start over, practice harder.

[momofrage]

Jemima, thanks for sharing. I didn't think my DD has RAD, I was just astonished at the similarities. I think I did a good job parenting in her early years. The problems, if they had to do with me, were probably around ages 9 to 11, and largely due to my own mental and physical ailments that were totally beyond my control.

[GameGirl]

gamegirl, also, the state of knowledge when we adopted DD in 1995 was that if you got them under the age of 3, they would be fine (with regards to bonding). Now we know that 6 months is the critical point for maintaining their ability to bond in a healthy way ... .and that might change too as we look at how poor maternal diet, high maternal stress, etc. in utero affects people, and how varying levels of care/neglect during those first six months changes the picture.

In my opinion, they DO bond with you, but their ability to EXPRESS their attachment to you is broken. So that it is either difficult or impossible to develop a reciprocal relationship. They take, take, take. They depend on you almost to the extreme ... .but don't "recharge your batteries" by reciprocal social behavior. This is what families go through when their child is on the autism spectrum ... .except that a RAD kid isn't obviously impaired (they usually have OK facial expressions, tone of voice; they are interested in social things; they can read people well enough to manipulate them but not well enough to empathize much). The combination of impairments on the inside while maintaining a facade of normality equals high stress for both the individual and for their family.

Even with empathy ... .I think that impaired empathy (at least in my daughter's case) is not a lack of feeling for others. If she can wrap her mind around another person's situation, she does feel empathy. But the problem is she has a hard time understanding other people's perspectives ... .when you can't put yourself in another person's shoes, you have a hard time feeling with them.

I am just curious as to where you are getting the six month number from.  A child has not even developed a sense of object permanence at six months.  To my understanding, the number still is 3 years.  That is not to say that a child younger than 3 can't develop RAD as a result of dusruption in the maternal bond.  However, neglect, poor prenatal care, not being picked up and cuddled etc., can definately cause brain defecits that are permanent as well.  You make a good point there. 

It sounds like your daughter got a good diagnosis and that you are doing everything you can to help her.

[Jemima]

I am getting it from the latest research on when children begin to develop selective attachments. I don't think there's any reason to distinguish the symptoms of reactive attachment disorder from the functional deficits that happen because of the neglect. They are all intertwined. Look at the work of Charles Zeanah and his colleagues at Tulane.

[Jemima]

Also, my daughter was NOT neglected after we got her at 14 months, so obviously you can develop RAD before the age of 3. She is not by a long shot the only child I know that was attachment-disordered despite being adopted well before the age of 3.

[lbjnltx]

dear jemima,

i can't help but see how God has worked through the people He has placed in your pathway.  i am always amazed at how much good can come our way when we allow Him to work through us to help others and be an answer to their prayers.

may you never run out of His servants on your journey!

x

lbjnltx

[Jemima]

lbjnltx, Many thanks! You are one of those helpers, you know  .

[lbjnltx]

jemima,

thank you for the affirmation and validation!

lbjnltx