New and Trying to Figure This All Out

[hobbster]

I've spent quite a bit of time reading about BPD, because my son has a lot of the characteristics of it.  He has been diagnosed with ADHD, ODD, and Mood Disorder-NOS.  He sounds like a lot of the other children who have been mentioned on this site.  Do any of your kids have obsessions with this and that?  At this time, my son will try to manipulate us, lie, drive us CRAZY…anything to get us to buy him coffee or Starbucks type drinks.  It's to the point that we're fed up with any mention of it.  Asking to get coffee is the first thing he asks us every day when picked up from school.  He doesn't just ask but demands it.  He is barely 13.  The ironic thing is that his dad and I don't even drink it.  If you can give me any insight into this mystery, I'd really appreciate it. 

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[Kwamina]

Hi hobbster

Welcome to bpdfamily

Having a child with BPD (traits) can be difficult to deal with as a family. Since when have you been seeing what you now believe are BPD characteristics in your son?

He has been officially diagnosed with several other disorders. When did that happen and is he being treated for them?

Do you know when and how his obsession with coffee started? Did he perhaps drink it somewhere or see someone drink it, for instance at school? Perhaps even on television, the internet etc.?

I can imagine how this constant need for coffee could make you as parents feel uncomfortable. What happens when he demands coffee? Do you ever give it to him?

[hobbster]

Thank you for the welcome.  Our son has been in our home since he was four days old.  He is adopted.  Our ds was a very happy baby, but we started noticing intense anger beginning around three or four.  I am a teacher and started talking to our school counselor before he started school.  He was diagnosed with ADHD in the second grade followed by the other diagnoses a year or two later.  He takes several meds…Quillivant for ADHD, Abilify, Lithium, and Prozac.  The first couple of months that he started Abilify, I believed it to be a miracle drug.  It then stopped being affective but has put a lot of weight on him.   

He first had coffee a few years ago when he was visiting with my brother and SIL.  This is simply his obsession of choice at this time.  In the past it has been new expensive shoes, costly guitars, etc.  Yes, in the past we have treated him to coffee trying to work with him and hopefully get his mind off of it.  He has an insatiable sweet tooth. 

i have about made myself crazy trying to figure out what challenges face my son.  Does he have RAD, bipolar, BPD, etc?  I feel it's important to figure his diagnosis out to get the specific treatment he needs.  The p and t-doc just want to treat the symptoms. 

[livednlearned]

Hi hobbster,

Welcome to bpdfamily! I identify so much with what you're going through -- sometimes it feels like acronym soup trying to figure out what might explain the behavior. My son has been diagnosed ADHD/ADD combined type, ODD, depression, generalized anxiety. He goes to a social skills class, and the social worker has raised the possibility of sensory processing disorder (SPD), as well as highly sensitive person (HSP). SPD often goes with ADHD.

I also see signs of OCD, and my son's father has moderate OCD, plus a family history of bipolar. During a custody battle, he a forensic psychiatrist wrote "a personality disorder cannot be ruled out."    He has BPD traits and a strong streak of narcissism, a very invalidating man with many problems that made for a difficult childhood for S13.

S13's current psychiatrist is wonderful -- we are trying an approach that does not include medication. Once a week S13 sees his psychiatrist, and also has a social skills class each week. The approach being used is called metacognitive therapy and I'm seeing very early signs of improvement. I'm also learning that when things get better, that triggers anxiety in my son, and so it's always a delicate balancing act.

It's exhausting to try and figure out what all of these diagnoses are about, and then how to treat them. One thing I have realized over the years is that the pdocs and therapists really do not address us. The parents. What skills we need to help our kids. It isn't the business that they're in, so I don't blame them. But it took me a few years to realize that the doctors and therapists are not going to "fix" my son. They may disagree about what is going on with him, or how to treat him. So the part that really matters to me -- being able to live with my son -- is going to have to come from me, in partnership with them, and only if my son is willing to do the work. The docs are part of the team, but it's me who has to take care of the environment. This was a big   for me and it has made things much better for me and for my son.  

The most important skill I've learned to help deal with S13 is validation. It takes a while for this to become an effective skill, but it's also something I noticed working right away. Hallelujah! The positive feedback was so encouraging. My son was 8 when he started to talk about not wanting to live. I would say things like, "I love you so much and so many people would be sad without you" or "But you are so loved... ." And that wouldn't make him feel better. It would often make things worse.

With validation, I learned to say, "You must feel so sad to say that. Did something happen today that made you feel sad?" There are a couple of excellent books to help explain how validation works, like Power of Validation (specifically for parents) or "I Don't Have to Make Things All Better" which connects validation to boundaries, the other important skill.

We have an article about validating teens that might be helpful.

Setting boundaries is a difficult skill to master. Especially if your son has OCD or sensory processing disorder on top of BPD. They are in a constant state of stress trying to self-soothe what is ultimately an overwhelming environment -- their number one job is to get their needs met. Our number one job is to make sure that getting their needs met does not become abusive or traumatizing. I have had to learn to have strong boundaries, but to also figure out where to bend rules, especially ones that the school imposes on him.

Your son's obsession with coffee is interesting. Could he be trying to self-medicate, to maybe counter-balance some of the effects of the drugs he takes. How do you manage his insistence on drinking expensive coffees from Starbucks? It sounds like he may also be focused on status goods -- things that are expensive and "cool" to help him feel better, and he has a lot of drive to get his needs met. Has he learned that if he applies full pressure, he will eventually get what he wants?

[hobbster]

Thank you for the reply, Livednlearned….

We try to work with our son on the coffee thing, and buy it for him at least once a week.  He says he wants to be a barista someday and spends (too much) time looking up recipes on the internet.  I think he surprises the workers at Starbucks when he is very detailed about his order.  However, the once a week thing doesn't seem to appease him.  He continues to ask for it every day.  The other day, I'd just bought a drink for him, and he turned right around and asked for another. 

The therapist thought it would be a good idea for us to start giving our ds an allowance, which would help take some of the pressure off of us.  When ds asked for things, we could ask him if he had his money with him.  The t-doc also thought the allowance would foster delayed gratification for expensive things he could save for and teach him about responsibilities to earn the money.  This is all a work in progress.  He would spend every cent on coffee if we would cooperate and stop the car at his favorite coffee shop.  He recently asked for pedals for his guitar, and we encouraged him to save his allowance pointing out that he could have already bought several if he hadn't spent his $ on coffee.  He sneaks off and gets coffee anywhere we are that serves it…grocery store, mall, church. 

Because I'm an educator and well versed in the discipline management system of Love and Logic, I believe I understand what you mean by validation.  I will definitely look into it more.  It is ironic that we stopped going to a therapist, because I felt she was too soft and that her advice would make our son even more entitled than he already is.  Now I understand that she might have just been using validation.  I remember telling her a story about my son being upset because we wouldn't buy him popcorn from a specialty store one evening.  Never mind that he had already gotten a trinket from a store that he wanted, got to choose the place we were eating (it was his turn to decide), and got a cupcake for dessert.  Anyway, he was having a meltdown, because we wouldn't buy him popcorn, stomped his foot, and said, "What do you not understand about me wanting popcorn?"  I replied, "What do you not understand about the word NO?"  The therapist told me that I said the wrong thing…that my reply should have been, "Now P, I understand that you want popcorn.  if you calm down, I'll make sure that you get popcorn in a few days."  Maybe she was right, but at the time I thought she was way off! 

I have wondered in the past if my son has sensory processing issues.  He often gets annoyed when my husband or I wipe our fingers on a paper napkin.  He says he hates the sound.  Seriously?  What sound?  We don't even notice anything, but he's screamed at us several time over it.  In addition, he hates the smell of my cereal (Cheerios) and can smell them when I'm eating my breakfast way across the room.  We are not perfect parents, so I'm not going to say that we don't ever raise our voices, but there have been many times that we might be speaking sternly not yelling.  P comments that we are yelling.  When younger, he would say "Ouch" when I barely held his arm trying to guide him out of the bathtub. 

Thank you for the book and article suggestions.  I will definitely look into reading them.  I'm very interested in doing everything I can to help my son and make our home a more peaceful place to live. 

[livednlearned]

I have wondered in the past if my son has sensory processing issues.  He often gets annoyed when my husband or I wipe our fingers on a paper napkin.  He says he hates the sound.  Seriously?  What sound?  We don't even notice anything, but he's screamed at us several time over it.  In addition, he hates the smell of my cereal (Cheerios) and can smell them when I'm eating my breakfast way across the room.  

Hi hobbster,

I remember reading that adopted children can have sensory processing disorder, that it's something to watch for (and it appears in kids who are ADHD and autistic). There is also some thinking that heightened nervous system and heightened emotions can present as BPD.

I read as much as I could about SPD to try and understand my son, and that has helped. Sometimes it feels like everything eventually comes down to validation, so that's convenient! I believe my son genuinely experiences the quirky things he complains about -- I used to think he was somatizing, which I believe he does do to some extent. But I also think he experiences these things,  and reading about SPD gave me an understanding of what it might be like to be him. When he was kindergarten, first grade, he complained about how writing hurt his hand. He has been saying it his whole life, but no one believed him. Then I was reading in SPD literature about similar complaints, and so much of it applied to my son. Not just his writing grip, but other things. He doesn't like to be touched without warning, he is sensitive to light and sound. His sensory processing issues are mild, and I do make some accommodations for him because they are easy for me to do. The key has been validating that his experiences are real, and that his feelings are real. I wasn't sure how to help him beyond that and so he's seeing his psychiatrist to get help with some higher order coping mechanisms. He has become much better at advocating for himself (telling teachers that he can do better work if he is allowed to type, for example).

I know what you mean about therapists being too soft. I can see from your example that you felt it made more sense to go straight to the boundary, whereas your therapist was adding an extra step, where you acknowledge how your son feels. Do you notice a difference in his reaction when you validate him feelings? It works well with my son, but I have to admit it's a challenge to keep the irritation out of my voice. I do not want to fall into a martyr role with him (how dare he do xyz when the whole reason we are here is for him etc. etc. and I would rather be doing abc!) because it makes me feel worse, and he feels bad too.

I try to focus on small things, one challenge at a time. Even if I nail it one time, I forgive myself if 10 minutes later we're back to the drawing board. Over time, the small gains have become habitual, and I'm even seeing my son internalize them, as though he invented all this healthy resilience