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Mar 162013

The DSM-IV is the diagnostic “Bible” of psychology. It essentially is a list of different symptoms that apply to a certain disorder or mental illness, say for example “depression” and says in effect, if the patient has 9 out of 12 of these symptoms lasting X amount of time, then their diagnosis is “Major Depression”

Unfortunately, it is hard to get a consensus of opinions from three psychologists much less hundreds about a psychological problem, and in some cases they can’t even agree on a name for a disorder.

The manual is updated periodically and it is currently in an up date process and should be out “soon.”

Also, causing more problems in diagnosing psychological and mental health issues is the fact that people have overlapping symptoms, no two people are exactly alike and there is disagreement between one mental health practitioner and the next on whether a person has X symptom or Y symptom. So in other words you may have say in a court case two PhD psychologists testifying, one for the prosecution saying that the defendant is sane, and the one hired by the defense saying he is crazy as a bessie bug.

So if your child is acting out and you take them to a psychologist for an evaluation you may be given a diagnosis that another equally qualified psychologist might say is wrong. This is quite frustrating to parents, police, teachers and other mental health professionals.

The following is a link to the Mayo Clinic website about “oppositional defiance disorder” and I think is a pretty good layman’s explanation of ODD. Keep in mind though that your child may also have other problems such as Attention Deficit Disorder, ADD, or Attention Deficit/Hyperactive Disorder. ADHD. Having one disorder or illness does not keep a person from having another one as well.


Some research now is showing that many mental illnesses and personality disorders, just like alcoholism, have a pretty heavy genetic component. That does not mean though that DNA=destiny and that if your child has a parent or grandparent with mental disorders or illness that they are doomed to also have this disorder or mental illness, but it might be a heads up to you if you start having problems with your child if they have a parent or grandparent who might have passed on some “bad” DNA..

Some mental illnesses and personality disorders do not show up until puberty or young adulthood, while other kids may be showing marked behavior problems at an early age. I have worked in psychiatric inpatient facilities with children as young as 8 or 10, that I would not have gone to sleep if that child was in my house for fear they would burn it down while I slept.

My own son, Patrick, who is officially diagnosed as Anti-social Personality Disorder (this is the DSM-IV equivalent of “Psychopath” or “sociopath.”) but prior to about 14 or 15, he was an ideal child with only one episode of serious misbehavior at age 11 but which quickly seemed to resolve itself.

My other son, Andrew, was ADHD from the day he was born, but managed to do quite well over all and is a self supporting functional adult. He required a great deal of attention and private schools for a time, but we muddled through. I did not allow him to use his ADHD diagnosis as a crutch or an excuse for bad behavior. I also chose not to medicate him with Ritalin which was the only drug available at the time. It turned him into a “zombie.”

Even if your child is diagnosed as Anti-social personality disorder that does not mean that s/he will become a serial killer as the popular media might have us believe. Many people with this disorder become doctors, lawyers, senators, judges, military generals or CEOs of Enron. They learn to function in society, though they lack a typical amount of empathy.

In my own family, my biological father would qualify as a psychopath without a doubt and I know for sure he killed at least two people, yet he was quite bright and maked the Forbes 400 richest men in America at one time in the 1970s. He was also married 6 or 7 times, estranged from all his children except one of my half brothers who is a clone of him. My son’s other grandfather was a navy chief in WWII and a career navy man, that I have no doubt would score high on the Psychopathic Check List, revised, developed by Dr. Robert Hare as the legal gold standard for distinguishing a psychopath in a court of law.

In my mother’s family, her brother I believe was a psychopath as well as a violent alcoholic and wife beater who if his crimes had been punished as they deserved, would ave spent life in prison without parole. Her maternal grandfather was also an abusive alcoholic. Unfortunately, in our family and culture and the assigned role of the women was to cover up and keep secret the evil deeds of the male offenders. Alcoholics Anonymous would call this role “enabling.” To this day, my mother plays her assigned role to the hilt by supporting my son Patrick by sending him money in prison and hiring him an attorney to try to get him out of parole, even though by so doing, her other grandsons and her only child will not speak to her as long as she does so.

I grew up not understanding the family dynamics or the assigned roles in our family drama-rama, but after I started working in mental health venues, my education slowly started to erode my denial of what the dynamics were. At first I had difficulty accepting them until eventually after I broke off all contact with Patrick, he sent an ex cell mate of his to kill me. At that point I started to truly educate myself on all forms of behavioral problems and try to find a way to heal my own wounds and to grow into an emotionally healthy adult. Better late than never.

Now that I am retired and have gained some hard won wisdom, my purpose is to help others to cope with problematic family members in a healthy way. When Patrick was arrested the first time, I felt so alone, and condemned by the psychologist that the court ordered that we attend counseling with. Patrick convinced the man that I was an abusive mother and that his main problem was his abusive home life. Then he stole my car to haul the loot he stole from our friend’s business, and when I turned him in to the law, jumped bail, stole a motorcycle and went back to Texas from the state where the family was living. He hasn’t lived in my home since then, 1989, and has only spent a total of less than 12 months on the streets as a free man. Even those months were on parole. While on parole he never made any attempt to follow the rules. Even in prison, he has made every effort to break the rules and in the first 15 years he was there was sent to solitary 19 times for serious offenses including having a knife in his cell and a cell phone.

While I kept Patrick’s crimes secret from all but my closest friends and family for decades, I have “come out of the closet” and am no longer willing to bear his shame. I raised him to the best of my ability, and though his father and I were divorced, his step father and other male family members were good role models, so he was not without good male influences or anything else a kid would have needed to succeed in life. He was blessed by God with superior intelligence and scored in the top percentile on the IQ tests, and he was given private schooling and many other advantages that other kids lack. Unfortunately, he made choices to give in to the DNA and to find his adrenaline rushes in socially unacceptable ways.

Joyce Alexander, RNP, retired

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  4 Responses to “Oppositional defiance disorder”

  1. Joyce, I appreciate this article – it is very explanatory for those of us who have experienced the “difficult” child.

    My belief is that all children have to experience the defiance of authority, at some point. Most children who are raised with a strong sense of “self” and boundaries seem to push the edge of the authoritative envelopes without slipping a cog. But, those who have their parents attempting to be their “friends” instead of a parent seem to be the ones that really go off their rails.

    I’ve seen the father of my eldest attempt to be the “buddy” to our son and foist the discipline and “rules” onto my shoulders while he was the “fun parent” that violated his own “rules” that he had set forth. So, when both parents are not on the same page and working together to be PARENTS instead of “buddies” or “friends,” a child becomes confused because there is no clear definition of what is, and is NOT, acceptable or appropriate.

    It seems to me that too many parents are trying to warehouse and befriend their children instead of being patient and waiting for friendship to develop when their children have secured their own independence. Just my general observations…..LOL

  2. Truthspeak I agree with your post entirely, but Oppositional Defiance Disorder takes the “defiance of authority” to a NEW LEVEL of behavior that borders on the dangerous to the very dangerous.

    It is a “pre-psychopathic” disorder. In fact, last night Law and Order, SVU had a GREAT show on about such a child. The little girl age 5 or 6 was having multiple “accidents” that resulted in bruises and broken bones. Her 10 yr old brother finally said the nanny pushed her down the stairs, but it turns out the kid was lying and HE had been doing the physical damage to the little girl.

    The high dollar private school and his very caring but unwise parents knew he would RAGE and strike out, but they and the school counselors were giving him time outs for VERY violent behavior and they were medicating him ILLEGALLY because the father didn’t want the kid “labeled” but the police and a psychiatrist finally convinced them to send him to some “program” and he became angry, and cut his mother with a knife—but then he stole a gun, held a retarded child hostage at gun point and ended up shooting one of the SVU team in the vest (bullet proof no major damage) but the court then took over and the BEST scene I’ve ever seen (this kid was a GREAT ACTOR) the boy was crying and saying “I love you dad, don’t let them send me away, I love you” and the camera came around behind the dad and showed the kid’s face with the “Charlie manson stare” in his eyes. ODD and pre-psychopathic kid. I’ve seen plenty of them in inpatient care and the ONLY thing they respond to is superior force.

    SOME O.D.D. kids outgrow the WORST of it, especially if they have had treatment and PARENTS who were PARENTS not friends to their kids, but some go on to become full fledged psychopaths.

    When you have a situation like you described with your X husband trying to be the “good dad” and make you the “mean mom” even a typical kid can become a horse’s behind, but if you have a kid who tends toward DEFIANCE and he gets rewards from the “friend” parent he or she will really go into defiance against the “mean parent.” Possibly defiance of all authority as well. Genes are not destiny, but they definitely direct traffic toward the pathway.

  3. I have always been the mean parent.Dad is the nice guy. All of the kids protect there Dad like he is a angle and point there finger at me when ever we have a dis agrement.None of them like to deal with there dad though when they are in trouble becauase he talks and talks and talks until the kids want to scream.They would far sooner take there consequences from me and get it over with but I am the mean one. My oldest daughter is the one that wants to be friends with her kids and wants other people like me to be the mean one. But as someone we all know stated it is my job to be the GRANDPARENT not the parent. She is right I just need to let my daughter know that. I believe she has some kind of disorder but I do not know what kind. All these disorders were not know about fourty years ago.I do believe she was ADHD as a child.She was a very busy attention deficit child. She was a hard one but no matter how hard I kept trying to parent her and still do. She just doesn’t get it.

  4. Welcome distressed grandmother! Glad to see you here!

    It is difficult to parent any child when there is a “co-parent” who undermines what we are trying to teach the child. Especially if that “co-parent” is personality disordered themselves.

    It is also a fact of biology that “personality disorders” and other mental problems are somewhat genetic, so if your “co-parent” is either mentally ill or personality disordered the child may be genetically predisposed to that problem as well as to be environmentally damaged by association with the “co-parent”

    People with personality disorders or mental illness do NOT make good parents, and the child gets the “double whammy” of being around a person who is not a good parent as well as the genetic predisposition of mental illness and/or personality disorders.

    Even when your child has “problems” whatever they be, ADHD, Personality disorder etc., they may have children and we may love those children very much and it is painful to us to see those children that we do love be poorly parented. We of course want to protect those children from poor parenting by our own offspring or the partners of our offspring, but unless it is a situation where we CAN and are WILLING to take on 100% responsibility for those grandkids and become the PARENT, like Milo has chosen to do with ONE of her Psychopath daughter’s two children, many times all we can do is to stand by and watch and weep. Milo’s daughter lost custody in court after a many-thousand dollar legal battle and Milo got custody of her grandson and is now the PARENT of that child.

    In situations where it is impossible to actually legally TAKE CUSTODY of the child, or where you are just not able mentally, financially, emotionally able to be a PARENT to a grandchild, then it is important to keep some sort of relationship with the child, in order to at least be a GRAND-parent to that child or children. And, that is not always easy when you see that the children are being poorly parented.

    A GRAND parent can still even in these situations have a wonderful relationship with those children and show them unconditional love as well as teach them healthy social, moral, and emotional functioning by associating with them. I have seen many children who were raised by disordered and dysfunctional parents who had loving GRANDparents turn out just fine because of those loving grandparents.

    Trying at this time in your daughter’s life to “correct” her problems in parenting and in her relationships with others is probably a losing proposition and may actually alienate her from you so that she won’t let you see the children, so it is probably best to “walk on eggshells” around your daughter and not offend her or “correct” her but just realize that what you are doing with her is to enable you to have contact with the kids. You can’t do anything at this point in life to “fix” your daughter, she is what she is now. Accept that, and don’t grieve over it any more. Your focus now I think should be the benefit of the kids and being able to associate with them. I know that may be very difficult but you can do it. As long as you NO LONGER EXPECT to fix your daughter, and thus irritate her by trying, hopefully she will allow you contact with the kids as a GRANDparent and through that, you can benefit the children.

    I was very close to my grandparents and I think that closeness with them was a big part of what made me who I am today. While my mother is not a spath, none the less, she was not the kind of parent she should have been, but the loving relationship I had with my GRANDparents gave me strength and a feeling of being loved for myself whether I was “good” or “bad.” That didn’t mean my grandparents didn’t correct me when I was with them, they did, but gently, and because I loved them so much I would never have wanted to disappoint them.

    Hopefully you can use the time you have with your grandchildren to foster that kind of relationship with your grandchildren and ignore your daughter’s poor parenting. Accept that you cannot change her at this point, which will make it easier for you to ignore what she does. You did the best you could at the time you were her parent, and now that she is an adult, good, bad or indifferent, you have to ACCEPT that she is what she is, but the children are still not “set in stone.”

    I strongly believe, distressed grandmother, that by being able to associate with your grandchildren as a GRANDparent that you can model and demonstrate for them healthy behavior and kindness and be of great benefit to their growth. God bless you!

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