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Dr John B
Dr John B, Psychologist
Category: Mental Health
Satisfied Customers: 557
Experience:  PhD in Clinical Psychology, registered clinical psychologist.
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My daughter shows signs of being a sociopath. When she was

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My daughter shows signs of being a sociopath. When she was 10 years old her father and I separated and she was forced to visit him twice a week and every other weekend. He mentally and emotionally severly abused her for 10 years. She was a very caring and fragile child..sweeter and kinder than most up until she was 16 years old. It took 6 years of abuse and her feeling helpless and alone until she stopped crying over it and told me that she'd discovered a way not to care anymore..so she wouldn't get hurt. I noticed the changes in her almost immediatly and I knew something was really wrong but she was getting older and her visits would soon end. My hands were tied and there was nothing I could do..no one but me was concerned. I didn't know the signs of this disease until now. Since she wasn't born that way and she's only been like this for about 10 years (she's 27) I need to know what to do to reverse it. I can't give up on her like everyone else has. I will do anything in the world to help my daughter. Please be honest with me. I even take a long shot.
Submitted: 2 years ago.
Category: Mental Health
Expert:  Dr John B replied 2 years ago.

Hi,

I'm very sorry to hear of the situation. Before we talk about potential treatment let's try to clarify what it is you are seeing in her and whether it is indeed Antisocial Personality Disorder (ASPD - the clinical term for being a sociopath).

What is it you are noticing that leads you to suspect ASPD?

Customer: replied 2 years ago.

She doesn't care about anyones feelings. She sleeps around with different men frequently. She can't keep a relationship going.. no friends or boyfriends for long. She finds fault in them whether it's her or the other person who breaks it off. Nothing is ever her fault. She'll try and turn her roommates against each other by telling each that the other one talks badly behind their back.

She'll talk to me about her sister.. saying nasty things that she's mean and often mentions that her sister hates me (the mom). She most often does this after her sister and I have spent time together. She'll hurry and call right away complaining that her sister is horrible. Makes no sense when she explains things and if caught making a mistake regarding another human being.. will always justify it by making up horrible things they've done to her. She can only hold a job for a short while and the last 4 she's had she left because she hated all the people because they're stupid or rude. Do you need more? She went to a psychiatrist a couple of years ago..because she knows there is something wrong..but told her sister they guy was an idiot..she lied through her teeth. My younger daughter lives with her and said she can't deal with it anymore. She stares at nothing and drinks a lot...gets paranoid if you're silent for too long and her mood changes drastically. There's probably more.. if you want it.

Expert:  Dr John B replied 2 years ago.

Ok, thanks for the extra information.

 

Based on your description I would be more inclined to suspect Borderline Personality Disorder (BPD) than ASPD. BPD is far more common than ASPD, often develops in young women who experience an abusive childhood, often involves 'splitting' (manipulating people against each other) and a pattern of intense and unstable relationships. Also, ASPD usually manifests during the early teens and BPD manifests in the late teens.

 

To put it bluntly: it's much better to be dealing with BPD than ASPD, so this is a good thing.

 

I'll post a fairly lengthy description of BPD here and wait for you to read through and let me know if you think it relates to what you are seeing.


Borderline Personality Disorder


Description


The main feature of borderline personality disorder (BPD) is a pervasive
pattern of instability in interpersonal relationships, self-image and emotions.
People with borderline personality disorder are also usually very impulsive.
This disorder occurs in most by early adulthood. The unstable pattern of
interacting with others has persisted for years and is usually closely related
to the person's self-image and early social interactions. The pattern is
present in a variety of settings (e.g., not just at work or home) and often is
accompanied by a similar lability (fluctuating back and forth, sometimes in a
quick manner) in a person's emotions and feelings. Relationships and the person's
emotion may often be characterized as being shallow.

A person with this disorder will also often exhibit impulsive behaviors and
have a majority of the following symptoms:



  • Frantic efforts to avoid real or imagined abandonment
  • A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation
  • Identity disturbance, such as a significant and persistent unstable self-image or sense of self
  • Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating)
  • Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior
  • Emotional instability due to significant reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)
  • Chronic feelings of emptiness
  • Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)
  • Transient, stress-related paranoid thoughts or severe dissociative symptoms


Key Features in Detail


Frantic efforts to avoid real or imagined abandonment

 

The perception of impending separation or rejection, or the loss of
external structure, can lead to profound changes in self-image, emotion,
thinking and behavior. Someone with borderline personality disorder will be
very sensitive to things happening around them in their environment. They experience intense abandonment fears and inappropriate anger, even when faced with a realistic separation or when there are unavoidable changes in plans. For
instance, becoming very angry with someone for being a few minutes late or
having to cancel a lunch date. People with borderline personality disorder may
believe that this abandonment implies that they are "bad." These
abandonment fears are related to an intolerance of being alone and a need to
have other people with them. Their frantic efforts to avoid abandonment may
include impulsive actions such as self-mutilating or suicidal behaviors.


Unstable and intense relationships

 

People with borderline personality disorder may idealize potential
caregivers or lovers at the first or second meeting, demand to spend a lot of
time together, and share the most intimate details early in a relationship.
However, they may switch quickly from idealizing other people to devaluing
them, feeling that the other person does not care enough, does not give enough,
is not "there" enough. These individuals can empathize with and
nurture other people, but only with the expectation that the other person will
"be there" in return to meet their own needs on demand. These
individuals are prone to sudden and dramatic shifts in their view of others,
who may alternately be seen as beneficent supports or as cruelly punitive. Such
shifts often reflect disillusionment with a caregiver whose nurturing qualities
had been idealized or whose rejection or abandonment is expected.


Identity disturbance

 

There are sudden and dramatic shifts in self-image, characterized by
shifting goals, values and vocational aspirations. There may be sudden changes
in opinions and plans about career, sexual identity, values and types of
friends. These individuals may suddenly change from the role of a needy
supplicant for help to a righteous avenger of past mistreatment. Although they
usually have a self-image that is based on being bad or evil, individuals with
borderline personality disorder may at times have feelings that they do not
exist at all. Such experiences usually occur in situations in which the
individual feels a lack of a meaningful relationship, nurturing and support.
These individuals may show worse performance in unstructured work or school
situations.

Customer: replied 2 years ago.
Is it treatable?
Expert:  Dr John B replied 2 years ago.

Absolutely....and ASPD usually isn't which is why I commented that it is a good thing for it to be BPD and not ASPD.

BPD is actually rather common. The treatment generally regarded as the best approach is Dialectical Behavior Therapy (DBT). DBT is a system of therapy developed specifically to treat persons with borderline personality disorder. DBT combines standard cognitive-behavioral techniques for emotion regulation and reality-testing with concepts of distress tolerance, acceptance, and mindful awareness largely derived from Buddhist meditative practice. DBT is the first therapy that has
been experimentally demonstrated to be effective for treating BPD.

DBT is usually offered by Clinical Psychologists (although not exclusively) and she contact the American Psychology Association for assistance with finding one near her. She can take a look at the American Psychology Association's locator service - here . She can use this to find Psychologists in your area and there is a phone number you can contact if she wants want a referral arranged. Also, she can take a look at an article published by the APA here . It's an interview with a senior Psychologist and covers some of the things she should consider when looking for a Psychologist.


There are a number of books that can assist people to learn Dialectical skills at home and to generally manage typical Borderline behaviors. If she is interested in doing some reading I can recommend both this book here and this book here .

It can be really difficult dealing with a family member who has developed BPD and I would recommend that yourself (and anyone else in your family that is struggling to cope with her at the moment) to read this book here http://www.amazon.com/Borderline-Personality-Disorder-Survival-Guide/dp/1572245077/ref=sr_1_7?ie=UTF8&qid=1322625500&sr=8-7 for guidance on how best to handle her behavior.


I would also like to emphasize that DBT is generally very effective in treating BPD when the individual wants to change and is willing to participate in therapy. While individuals with BPD are usually quite reluctant to participate in therapy initially over time they usually decide to accept assistance as they find their own experience of the disorder too distressing and realize they need help.

I hope this has been of sóme help. Please let me know if you have further questions or would like me to clarify any part of my answer.

Customer: replied 2 years ago.
Honestly, I read more about BPD online and only a couple of the symptoms fit. She hasn't shown any destructive behavior and I don't see anything about her disregard for human feelings. She tells me that she loves her ex-husband because that's what she thinks I want to hear but will tell her sister that she hates him but wants to keep him in her back pocket in case she doesn't meet anyone better. When she speaks to him she tells him she want to come back to him..so he's waiting for her..and she's sleeping around in the meantime, knowing that the guy would be crushed and broken hearted if he found out. She says she doesn't care.
Expert:  Dr John B replied 2 years ago.

You know your daughter and I don't so I wouldn't want to suggest I know better than you.

However, there are two things I'd like to point out. Firstly, the destructive behavior can manifest solely as infidelity or 'sleeping around' when in a relationship. Secondly, people with BPD often claim not to care when in fact the complete opposite is true. If you look at your second post in this thread you'll see a range of behaviors that all occur because a person is experiencing intense emotion (anger, jealousy, sadness, fear) not because a person is void of emotional reaction.

I completely respect the detailed knowledge you have of your daughter and would therefore just like to suggest that you don't disregard the possibility that it is BPD while you keep looking for an answer. I understand that my answer is perhaps not one you agree with and if you would like me to opt and open the question up to other experts please let me know.

I hope this has been of some help.

Dr John B, Psychologist
Category: Mental Health
Satisfied Customers: 557
Experience: PhD in Clinical Psychology, registered clinical psychologist.
Dr John B and 2 other Mental Health Specialists are ready to help you
Customer: replied 2 years ago.
I would like you to bring it up to other professionals. please
Expert:  Dr John B replied 2 years ago.
No problem. I'll opt out now.

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