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Question
Posted by: Maria | 2012-02-24

Mental health issues - nature vs nurture

Hey CS

My daughter is turning 10 in June. He biological mother (deceased) was diagnosed with histrionic personality disorder and possible Munchausen syndrome. I believe her biological grandmother (mother''s mother) has Borderline Personality disorder.

To what extent are these disorders genetic and are there specific things we need to watch out for and strategies we should follow to handle her? We do have problems with her telling lies, and sometimes fantasising about things and then getting upset if we don''t go along with the fantasy. I think she is getting too old for that now. She uses her considerable intelligence to tell very believable lies and I wonder how often she gets away with things that we never pick up on.

We are working with a child psychologist at the moment and I will also discuss this with her.

Adding my own depression and anxiety issues into the mix makes for an " interesting"  dynamic. I''ve changed p-docs and am now on Venlor. It''s only been 18 days so far but I''m less irritable and more patient, so I''m hoping this might be the solution.

Scratches to kitty!

Regards

Maria

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Our expert says:
Expert ImageCyberShrink

I have studied the fascinating Munchausen syndrome, and actually had a couple of cases in treatment at one time, which is exceedingly rare. Not much is known about its causes, partly because they are so rare, so evasive, and so insistent that the only problems they have are the problems they obviously do not have. I would not see it as inheritable, though, and nobody on earth has described cases in mother and child. There have been cases described of a mother who induced illness symptoms in her child in order to get attention for herself, but this is still Munchausen behaviopur by the mother, and the child, once free from the mother's influence, has never been described as developing such behaviours herself.
Histrionic and Bordeline Personality Disorders are also exceedinly difficult to treat, but not generally regarded as inherited, and if so, then only weakly so.
A main problem, I'd think, with such a background, is that it would be harder for you to assess the ordinary significance of lying and other tedious child and teenage behaviours, without worrying that these may be more sinister signals of mom or grandmom breaking through, which is actually highly unlikely to be so.
Tantasising can remain a part of life for many people ; what one expects her top recognize with increasing clarity is the distinction between fantasy and reality, and to relinquish the expectation that other people will play along as though her fantasies were real.
Discuss with her the classic story of the Boy Who Cried Wolf ; the point that if one becomes recognized as a liar, its hard or impossible to convince people you're telling the truth when you really need them to believe you. And explore gently what she gets out of the lies - is it an enhanced sense of self-worth ( looking back at her true biological background won't provide that !) oe importance ? Does she realize that her genuine self is interesting and important, and the invented self very much less so ?
Hope the Venlor continues to work well. Kitty is grateful, After a couple of weeks on heat has returned to normal. I think she has only a dim memory of her scratchy lust in those periods, but she does look vaguely apologetic and embarrassed.

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Our users say:
Posted by: cybershrink | 2012-02-25

I have studied the fascinating Munchausen syndrome, and actually had a couple of cases in treatment at one time, which is exceedingly rare. Not much is known about its causes, partly because they are so rare, so evasive, and so insistent that the only problems they have are the problems they obviously do not have. I would not see it as inheritable, though, and nobody on earth has described cases in mother and child. There have been cases described of a mother who induced illness symptoms in her child in order to get attention for herself, but this is still Munchausen behaviopur by the mother, and the child, once free from the mother's influence, has never been described as developing such behaviours herself.
Histrionic and Bordeline Personality Disorders are also exceedinly difficult to treat, but not generally regarded as inherited, and if so, then only weakly so.
A main problem, I'd think, with such a background, is that it would be harder for you to assess the ordinary significance of lying and other tedious child and teenage behaviours, without worrying that these may be more sinister signals of mom or grandmom breaking through, which is actually highly unlikely to be so.
Tantasising can remain a part of life for many people ; what one expects her top recognize with increasing clarity is the distinction between fantasy and reality, and to relinquish the expectation that other people will play along as though her fantasies were real.
Discuss with her the classic story of the Boy Who Cried Wolf ; the point that if one becomes recognized as a liar, its hard or impossible to convince people you're telling the truth when you really need them to believe you. And explore gently what she gets out of the lies - is it an enhanced sense of self-worth ( looking back at her true biological background won't provide that !) oe importance ? Does she realize that her genuine self is interesting and important, and the invented self very much less so ?
Hope the Venlor continues to work well. Kitty is grateful, After a couple of weeks on heat has returned to normal. I think she has only a dim memory of her scratchy lust in those periods, but she does look vaguely apologetic and embarrassed.

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