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'As If' Personality Type
  • Garden
    Posts: 329
    Took our daughter to CAMHS (she was referred following the incident where she self-harmed and they thought she had leukaemia) - anyway, the child psychotherapist who will be assessing her met with her a few weeks ago and has had a meeting with me and he thinks she might not have PDAS. Instead, he thinks it might be this 'As If' personality, which I understand is actually sth to do with Borderling Personality Disorder (!)

    If you google 'As If Personality Type' you get some interesting information about it and it seems to come down to these people lacking authenticity - a lot of it sounds very much like my daughter. I had posted elsewhere about the information on here about PDA not exactly sounding like my daughter, though she does have a PDA diagnosis from a paediatrician. Now I am wondering if it may be this 'As If' personality type.

    Our daughter is adopted and had a very traumatic early life. I think that there is no doubt that our daughter has some very interesting ways of coping with life - she is avoidant and role-plays to a massive extent and throws mega tantrums when she can't cope. The question seems to be - is this due to a developmental condition which is intrinsic to her and unlikely to shift i.e. PDA or is it a mental health issue brought on by her response to her early life experience and possibly inherited genetic susceptibility?

    She is going to be assessed over the next few weeks and the psychotherapist hopes to find out more - basically, can therapy help her to change or not? Does she have insights and the capability to use therapy?

    I don't know if any of you have come across this one - and I remember that someone was interested in knowing what else PDA is sometimes interpreted as, so thought it would be useful to post this. I'll let you know how I get on.
  • jelv
    Posts: 185
    From what you've said it sounds like she has some elements of attachment problem, and (as in the case of our adopted daughter) there's no reason why that can't be in addition to any other problems.

    The fact sheet from OAASIS is a pretty good introduction to what RAD is about. It also has some very good links.

    Have you been talking to anyone from AdoptionUK?
  • webbwebb
    Posts: 2,569
    Hi Garden

    I know very little about "As If" or other personality disorders or attachment disorder but I am so very glad to hear that your CAMH's dept. are doing what they can ie further assessment, to get to the bottom of your daughters problems.

    I hope that after some time with the psycotherapist and others you may be closer to understanding your daughter.

    Paula
  • Lixina
    Posts: 289
    Yes, that's an interesting area of overlap.
    With me, I actually came at it the opposite way. I was sexually abused and from reading literature about sexual abuse, I found out about borderline personality (as far as I know, 'as if' personality is another name for the same thing). I identified strongly with a bunch of borderline features, but didn't actually meet the full criteria. Then I found out that PDA describes me much more completely than BP does.
  • Garden
    Posts: 329
    Jelv

    Our daughter's first ever diagnosis was of attachment difficulties (from the Post Adoption Centre). She got this diagnosis when she was four and we got funding to go to PAC for their family therapy programme. I believe that she did have some RAD symptoms and the work we did at PAC helped enormously - but there were many behaviours which persisted. She is very bonded to me and my husband and does not show the same anger and need to provoke me on a regular basis as does her sister (also adopted - they are birth siblings but had a very different experience in the birth family).

    It was because we found that the diagnosis of RAD only got us so far that we kept searching for answers and then a paediatrician diagnosed PDAS. Now the CAMHS therapist thinks it may well be sth to do with her response to her early life experience - I'm struggling though to interpret this in relation to what he's saying it could be and RAD, which of course is what early trauma is supposed to cause in children like my daughter.

    All I know is that following recommendations for RAD don't help with our daughter and she doesn't seem to need attachment strategies like theraplay - she seems happy in our family. The problem seems to be that she never acts like a 'real' person - she is always role playing and copying others. The 'as if' personality type description seems to fit her to a T - but then so does PDAS.

    We read through the birth family papers again once we had the diagnosis of PDAS and we can see a lot of signs to suggest that her birth mother, and possibly her father, have PDAS. It would explain a lot about why she neglected the children. But now I suppose you could equally say that it was a personality disorder and not PDAS there too? The thing that makes me think the birth mother had PDAS in particular is that the family went into a residential assessment centre where the social workers tried to get the birth parents to look after the children. The birth father did everything while the birth mother did practically nothing, and they noted that the more they tried to get the birth mother to comply (reminders every half hour at one point) the more she retreated and did even less. The social workers were bewildered as she kept saying she wanted to keep the children but then would do absolutely nothing about it.

    So we thought that PDAS sounded like a good explanation of what was going on in this family. Also, the birth uncle died of an epileptic fit and I read somewhere that people were investigating a possible link between epilepsy and PDAS. So that was interesting too.

    But now we've been given this other possibility. I do understand that such a lot of it comes down to who you see and what their specialism is. The people at the Post Adoption Centre for example are attachment therapists - they do not carry out developmental assessments or full psychiatric assessments. If you go to them with an adopted child and they tick the boxes for RAD then you are likely to get a diagnosis of RAD. Similarly, the paediatrician I saw was very keen to diagnose everyone she saw with a developmental condition like ADHD (she diagnosed our other daughter with ADHD) or autism. She was very dismissive of any mental health possibilities. Now the CAMHS therapist who has never heard of either PDAS or the sort of attachment therapy we got at PAC.

    So it's all a bit of a minefield for the amateur parent isn't it? I suppose I shoud be grateful that people are taking our daughter's behaviours seriously. On one level she appears absolutely fine - the CAMHS therapist commented on this too. You could try to be very positive and just see her behaviours as at the extreme end of normal - but I am pretty sure they are not.

    So, if it's 'As If', and it comes from her response to her early life experiences, I am now wondering if traditional CAMHS therapy is going to work anyway or if we need dedicated supporpt from e.g. Family Futures.

    I will keep you updated. Yes, I do know Adoption UK.

    Many thanks
  • Hope
    Posts: 23
    A very interesting discussion here. I work a lot in assessing children with attachment disorders. It is possible to see how these get confused with many other problems and I find it a fascinating topic theoretically. But I also was a foster carer and I think the practical advice for children with PDA symptoms feels much more useful than all the theories. There is also a lot of practical advice available for children with hyperactive or autistic symptoms so whichever a child is diagnosed with, I would say, use what is relevant! Find out what works for you and your child. Every child is an individual and all are different. The diagnosis is a means to an end, getting the services you need.
    Personality differences are also fascinating and may not need to be diagnosed as disorders if people are comfortable with who they are.
    It is good to see that many adoptive parents have found this site. Best wishes to you all in this difficult task of attachment. That is important for any child.
    HOPE
  • Garden
    Posts: 329
    Our daughter has now been assessed by the child psychotherapist (four sessions) and it's interesting. He looked into PDA (our daughter has a PDA diagnosis from a paediatrician but he had never heard of it) and agrees that she ticks all the boxes, but he says that's merely interesting and doesn't mean that she necessarily has PDA, though he's not discounting it either. It was an interesting conversation as he's very open to new ideas, which is refreshing - he thought that we should just use the diagnoses/labels which get us somewhere, while the professionals should use her behaviours as a starting point to try and offer help.

    He does tend to his 'As If' personality type theory. He thinks that she has this as a result of her early neglect (she is adopted) and in particular her response to a particular developmental stage which is to do with fantasy/reality. He said that traumatised children often have a problem with this developmental stage - they either become very afraid of fantasy and can't play creatively for example and are scared of everything (that's our other daughter, PDA daughter's sibling) or they retreat to fantasy as a coping mechanism. I have to say that I can tell how stressed out our daughter is by the degree to which she plays with her dolls.

    I think that his explanation makes a lot of sense for us. Our daughter does role play all the time - I think that it's this which made the paediatrician think of PDA in the first place. But many of you have children who don't role play, and I was interested to know at one point why the PDA literature doesn't focus on role play so much, when it was the one thing that got our daughter the diagnosis.

    Anyway, she is going to start therapy next month. He thinks it will help her. We'll have to wait and see. In the meantime I still see PDA as the neatest way of explaining her and what she's about. Interestingly, the paediatrician who diagnosed our daughter told us that PDA was very common in adoptees as they inherited it from their birth parents, and it explained why the birth parents weren't good at looking after them. But maybe these kids look like they have PDA because of the early trauma and the difficulties they then have in getting through the relevant developmental stages........................
  • jelv
    Posts: 185

    Garden said:

    Interestingly, the paediatrician who diagnosed our daughter told us that PDA was very common in adoptees as they inherited it from their birth parents, and it explained why the birth parents weren't good at looking after them.



    From what we know of our daughter's birth mother, I wouldn't disagree with this suggestion!
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