The mother was diagnosed a few years ago. The sons behavior was so extreme to me and I knew nothing about BPD. I started reading about it and to me it was clear. It took awhile to convince the dad to seek help. We live in Costa Rica and finally found someone who treats children! He hasn’t been seen yet.
Hey again, thanks for filling in some of the back story. OK, so your fiance's son's mom has a diagnosis, and as you did more research and learned about the constellation of BPD behaviors, you looked at S13's actions and thought, Gee, that would make sense of a lot. Yes?
What are some of his more challenging behaviors?
As far as I've understood, professionals (at least in the USA) are reticent to diagnose the under-18 set with BPD, mostly because the brain is still developing so much in that age range. That being said, other professionals suggest that there is a difference that can be see between "teen" acting out behaviors, and "BPD" acting out behaviors in teens. Have you read anything by Blaise Aguirre? He wrote a book called "BPD in Adolescents" (
https://bpdfamily.com/message_board/index.php?topic=65571.0 ) -- could be a good resource for you.
Some members here discuss the non-official concept of "fleas" -- you know how your cat can have fleas, and is the source of fleas, but then if it's really bad, the fleas jump on to other pets, and then those pets have fleas? It can be like that with children around a BPD adult/parent. The child isn't necessarily the "source" of the BPD type behaviors (i.e. the child doesn't necessarily have BPD), but those behaviors from the adult rub off on the child (that's what the adult models to them), so the kids start doing that stuff: blaming, raging, yelling, defiance, lying, tantrums, etc.
All that to say, good idea to find someone who treats children (I'm assuming for BPD, and not ED's?) -- any chance you and your fiance can meet with the person first, before bringing S13? Could give you an idea of whether it's a helpful road to pursue. Understandable that S13 could be resistant/angry... so, finding out ahead of time if the practitioner is a good one, by meeting in person, could help.
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Eating disorders...
I definitely see the selective eating disorder thing. I didn’t know it had a name! He is putting on weight since being with us. He is not in danger of dying. You can see his ribs but he surfs and skates.
Yes, SED could be a fit, as could something called ARFID (Avoidant/Restrictive Food Intake Disorder). My non-professional understanding of the distinction is that SED-ers are about "sure, I'll eat, it's just only these 6 things", while ARFID-er's have more of the "classic" ED food refusal/food intake restriction behaviors. SED is maybe more about what the kid WILL eat and ARFID may be about what the kid WON'T eat. Again, a professional hearing a history of S13 will know better. Could even be something else... but these options give you something to discuss with a doctor. Here's a link to a Kartini Clinic blog post about SED:
https://kartiniclinic.com/blog/post/selective-eating1/ -- you can see if it rings true.
I don’t know the best way of handling it.
Are you guys able to be in touch with his primary care doctor? Or has his mom co-opted that? At least here in our state in the USA, even the non-custodial parent has rights to medical records. And, even as a stepmom, I was pretty darn close to talking my way into making dentist appointments for the kids. So, you both may have more leverage than you think to get an assessment from his doctor.
Does S13's mom think he has a problem?
In terms of what to do, big picture... don't hesitate to reach out to clinics (here's the Kartini Clinic contact info link:
https://kartiniclinic.com/about-kartini-clinic/contact-us/ ), even not in Costa Rica, and just describe your situation. Each child is different so you might get feedback anywhere from "have his doctor check him out, and if he's not losing weight, you guys are fine" to "that is more serious than it seems, and he needs to go to the hospital".
In terms of what to do in the day-to-day, like you asked about complete control versus you managing food -- again, it's a tough one, that depends on each individual situation. Are there any other food-related behaviors that you notice or suspect from S13 -- hiding food, skipping meals, obsessions with cookbooks/cooking shows, making food but not eating it, going to the bathroom after meals, not using butter... anything where you've been like "huh, that's... odd"? Overexercising, any verbiage related to "I have to do more sit-ups/I need to do my workout"? Obsession with muscle, shape, fitness? Negative description of own body?
I think it really boils down to -- is he still growing? Weight loss is not normal in kids, so that's where I'd start, as that's the most "emergency" of all the indicators. But, even if he is still growing, it's possible to have an ED at the same time, so you're doing a good job having your "radar" up. Having him not lose weight buys you some time to look into any other food/exercise behaviors and seek help if needed. If he does have an ED that requires help, yeah, he's going to be mad -- I was when I had to go get treatment as a teen. But his anger/insistence level wouldn't be an indication that he's OK.
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Lots to process! I'll wrap up for now...
kells76
