Foster parent of teenager with HPD/BPD symptoms

Hi everyone,

I'm new to the forum, but I felt a need to reach out. I am concerned about my 15 year old foster daughter whose given name is Stormie (so does that mean her mother wished this on her?). My husband & I are set to become legal guardians soon. I have experience working in the mental health field as a case manager, but right now, I feel I need other's input. She sees a therapist, and maybe I need one too. I don't know.

She is currently dx'd with disruptive behavior disorder NOS(not otherwise specified) and ADHD. She has a history of sexual abuse and severe neglect. Her moods are very unstable- but she's not bi-polar. She's a shallow person, likes to be the center of attention, is very loud, she is often irritable and overly dramatic, concerned with her body image to the point of a possible (suspected, but as yet unproven) bulimia. She has a history of self-mutilation, sexually acting out with boys and girls, some drinking and drug use. She is manipulative (or tries to be anyway).

I'm wondering if it's too late for her to be fixed. I was hoping with enough love, consistency, providing positive outlets that she would manage to become a healthy adult. She has made progress in the past year, but now that it's nearing guardianship she has been acting out more. Our 15 year old niece just moved in with us and there's some tension there too. All in all, we have 5 children (2 biological children 14 year old girl, 11 year old son, and another 14 year old foster son.) Her presence in the house causes tension on everyone's parts and puts everyone on edge. I don't want to give up on her. Unfortunately, her therapist appts are not regular enough and she only shows him her "good" side. We live in a very small town and mental health treatment is very limited. I welcome input from anyone who has anything at all to say, but would especially appreciate comments from anyone who has been diagnosed with HPD and can offer me some insight into thought patterns that may have started during adolescence or earlier that I can recognize and break through. Was there something lacking in your childhood? Also, if there are any other parents of HPD's out there. Would love to hear from you too.

P.S. We are getting her involved in martial arts(she wants to) and eventually plan to buy a horse (she has previous experience with them). My goal is to continue working on her inner self, but in the mean time, I'm sick of the drama!!!.

I'm sorry to hear that you're going through a lot of trouble with this girl and yeah it might not be a bad idea for you to seek out some therapy for yourself too as dealing with these people for any length of time can be really destructive and really tear a person up inside as this excerpt I found on them online shows...

"When the histrionic is angry, unhappy, disappointed, injured, or hurt - she feels unable to express her emotions sincerely and openly since to do so would be to admit her frailty, her neediness, and her weaknesses. She deplores her own humanity - her emotions, her vulnerability, her susceptibility, her gullibility, her inadequacies, and her failures. So, she makes use of other people to express her pain and her frustration, her pent up anger and her aggression.

She achieves this by mentally torturing other people to the point of madness, by driving them to violence, by reducing them to scar tissue in search of outlet, closure, and, sometimes, revenge. She forces people to lose their own character traits - and adopt her own instead. In reaction to her constant and well-targeted abuse, they become abusive, vengeful, ruthless, lacking empathy, obsessed, and aggressive. They mirror her faithfully and thus relieve her of the need to express herself directly.

Having constructed this writhing hall of human mirrors, the histrionic withdraws. The goal achieved, she lets go. As opposed to the sadist, she is not in it, indefinitely, for the pleasure of it. She abuses and traumatizes, humiliates and abandons, discards and ignores, insults and provokes - only for the purpose of purging her inner demons. By possessing others, she purifies herself, cathartically, and exorcises her demented self."

Sadly there is not really much I can tell you to help you with this girl other than if at all possible try to make her appointments with the doctor more regular.

You did say she has improved so that is at least a partial answer to your question "Is it too late for her to be fixed?"

Well if she has improved at all then the answer I take it is no its not too late.

She just needs to keep going to therapy and keep being supported.

thanks for your support. The excerpt you used described her and the way we feel pretty accurately. We'll probably stick with it for another year before we actually decide whether we'll go for guardianship or adoption.

First I want to applaud your heart to take on such a challenge, and try to help a teen who's in need. Most older kids in the system don't seem to get a second chance. Maybe this girl will find one with your family.

A personality disorder is a disorder, which means someone hard to deal with period. Honestly though, it could be worse. By reading this HPD forum you get to hear one part of the story by people who might have been in relationship with someone with HPD.

However it seems, that for therapists\psychologists who deal with many types of mental illness and disorders this is one of the more "milder" (particularly out of the Cluster B disorders). The statistics seem to show that those with HPD are more fully functioning in their everyday lives such as work etc. They aren't inclined to turn out to be psychopaths in the true sense, they aren't as violent or destructive to society as many with ASPD. The risk for suicide and other self-destructive behaviors aren't as high as for those with BPD, so there is some hope in that.

I think they greatest problems\symptoms will have to do with their close relationships like will they ever maintain any, and sexual behaviors acting out sexually (which definitely could cause major problems for you as a parent and later for herself).

With her background of heavy abuse and her self-mutilating I wonder if she may have\also may have BPD. Sometimes it takes seeing more than one professional to get the right diagnosis. It seems that the statistics seem better for those who have BPD to get treatment and continue with it, possibly getting better. However, there may be a greater chance that they may "go over the edge" in acting out such as in suicide, overdose or harming others. Some experts think HPD may be a weaker form of BPD, since these two have much in common.

I think that's a great idea of building up her other interests so she can have other healthier things to distract herself with if need be(instead of sex and drugs). It's also good to help her build up her skills\talents so she could be able to have a stable work history and career.

Whatever your decision about adopting her, I would hope you would continue to research HPD (possibly BPD) thoroughly. There aren't that many books out there on the subject. You could try Amazon. You also could try paying for research articles. You can order them online but you will have to pay. There aren't many free ones on the internet.

Here is link to a site that has a view of HPD personality traits that could possibly be fine-turned towards the positive.

http://www.ptypes.com/dramatic.html

I have more links to sites that have more information (some of it hopeful) on HPD if you would like me to PM with that list I could.
Best wishes

(KontrollerX quotes from some writing (from where he doesn't site)
"...In reaction to her constant and well-targeted abuse, they become abusive, vengeful, ruthless, lacking empathy, obsessed, and aggressive."

Now that person with HPD may have their own manipulations and abusive tendencies, but however, the person who then acts abusive, ruthless vengeful etc. is responsible for their own behavior.

They cannot say, the one with HPD made me do it etc, the person who is in relationship with them makes their own choices how to respond (unless they are a child). If they act out destructively it only shows that person themselves has their own issues\ possibly their own disorder.

"Now that person with HPD may have their own manipulations and abusive tendencies, but however, the person who then acts abusive, ruthless vengeful etc. is responsible for their own behavior.

They cannot say, the one with HPD made me do it etc, the person who is in relationship with them makes their own choices how to respond (unless they are a child). If they act out destructively it only shows that person themselves has their own issues\ possibly their own disorder."

It is indeed true that we are all responsible for our own behaviour in this life but like one teacher of mine once told me when discussing violent acts and why they happen from seemingly good people to our class he pointed out the obvious which is sometimes a person is simply pushed too far.

Responsible for their actions most definitely but for every effect there is most certainly a cause that brought about that effect.

If the cause was completely imagined then the person is projecting and is most likely mentally disordered but if the cause could reasonably make any normal person snap and they do snap then it was simply an instance of allowing anger to get out of control and regardless of wrong or right a very real cause brought about that anger produced effect.

It is indeed true that we are all responsible for our own behaviour in this life but like
one teacher of mine once told me when discussing violent acts and why they happen from seemingly good people to our class he pointed out the obvious which is sometimes a person is simply pushed too far.

Responsible for their actions most definitely but for every effect there is most certainly a cause that brought about that effect.
If the cause was completely imagined then the person is projecting and is most likely mentally disordered but if the cause could reasonably make any normal person snap and they do snap then it was simply an instance of allowing anger to get out of control and regardless of wrong or right a very real cause brought about
that anger produced effect.

KontrollerX-

Now you are getting into a deep psychological,philosophical, spiritual type topic- the degree to which people adults responsible for their behavior. This is something to do it justly would require a lengthy discussion. Nature or nurture, environmental, societal spiritual influnces. Is someone with a mental illness truly responsible, to what degree, etc. etc.?

Maybe I'll try responding to this point:

"discussing violent acts and why they happen from seemingly good people to our class he pointed out the obvious which is sometimes a person is simply pushed too far. "

Was this a sociology class or psychology class, abnormal psych?
To me it is clear that violent acts do not just "happen". They don't just pop out of nowhere from "good people" (or completely sane people).They don't just pop out of people who have no history of violence. Some people who are pushed too far won't respond violently, they may use other options like just walking out of\away from the provoking person or situation, they may choose to brood or get depressed, they may do what it takes physically to protect themselves but not take the offensive. If a violent act occurs physically, aside from that person specifically defending themselves from a violent physical attack, I don't believe that's justified.

It also depends on the degree and then degree of the response. If someone threw food at you I don't think that justifies you bludgeoning them or shooting them. If they swear at you and lie to you does that mean it's o.k. to slap them around?


A person being pushed too far might be expressed by someone getting fed up with someone's bickering that they throw their newspaper in the air. Someone stalking, harassing, striking, drawing blood and other acts aren't the sign of someone being
pushed too far they are a sign that person has issues-serious ones. They have something going on inside them that was there all along (not because of another person) another person might just bring it to light, but they have to admit the violence is coming out of them. If a person overreacts in a violent way they need to admit they have issues and they for whatever reason chose to react that way instead of choosing a less violent way.

If a person is being provoked by someone else, if the first person doesn't remove themselves from that situation either temporarily or permanently that shows something deeper is going on. They still have some kind of issue and cannot claim they just snapped.

You mentioned "seemingly good people" Many of those with NPD, ASPD or sociopaths appear like "good people" look at the BTK killer, he had a double life, it seems his wife didn't suspect a thing. You have Scott Peterson and many others, others seemingly good or normal who seem to just snap. If you dig into their lives
and past though you will find they did have issues, they were just "good" at hiding them. If they "just snap" or are provoked to an extreme reaction it shows something was going on under the surface.

Most adults can avoid, get away from, or out of a bad relationship that might "provoke" them. Now if for whatever complicated or twisted reason they don't, it's still a matter of choice. If you choose to stay because of sex, or that person is paying your bills (it's another if they are threatening to kill you or your children) or you hope to fix them, that is your choice. If they act up and you do something violent you can't put the blame on them, you chose to be in that situation where you knew you might be provoked. It isn't wise for an alcoholic to hang out at a bar, and then say it was the bartenders fault they drank again.

You mentioned a cause bringing on an effect and allowing anger to get out of control. There can be a common cause but not all people react the same way. Dealing with emotions and people isn't the same as the laws of gravity.
Allowing anger to get out of control is that persons choice. Anyone can get angry but not everyone vents anger in the same way, some do it in more destructive or violent ways. A policeman has a right to get angry dealing with thugs, but they have to keep
their anger in control and not just start shooting at everyone who looks like a thug on the street. Even they are held accountable if they respond with violence in a situation
without a life-threatening cause.

Thanks for your input. I appreciated your "positive" approach. There are good things about her. I looked at the site your recommended and it described her good qualities accurately. This is why we don't want to give up on her. Also, we are going to change therapists so she can be seen more regularly.

I found this to be really helpful even though I've only gotten two replies so far. I know most people in this forum seem to be adults and are having the kinds of relationship problems typical of the disorder. (I'm hoping we can rehabilitate her enough before she becomes an adult herself so that she can be happy.)

It would be painful to watch her as an adult and not be able to form lasting relationships and see her heart broken many times over. The thing I'm most afraid of is that she won't "have a heart" after so many times. That's one thing she's got going for her right now. She is still "workable" because she has a conscience and "little bit" of a heart still left.