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Having manipulative behavior with ovarian cancer. Are these treatable?

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I am writing on behalf of my sister who lives in Australia. She and I talk regularly on Skype and I am very concerned for her.She has a daughter named XXXXXXX( who lives about 2 hours away by car) who seems to have some very serious mental problems. She is very controlling and manipulative and has alienated many of her friends and family, particularly her mother who is completely devastated by her behaviour. XXXXXXX is obsessed with sexual abuse and has accused her brother of grooming his own daughter for sex. She has also accused him of sexually abusing his step sister when he was 12/13 years of age. (The only evidence of this is what she says she saw in a vision. She has questioned members of her family asking if she was abused as a baby. She is obsessed with serious illness saying she had ovarian cancer with very guarded details, refusing any help and support from her mother and telling her not to discuss the matter with any of her family, and saying that her husband could not talk about it as it was out of his comfort zone. She had a brain tumour (pituitary).
Her son had Aspergers, Dyslexia and Autism. She is very critical and threatening towards her mother and very critical of her in-laws. She is very manipulative and gives the impression of being a very caring, level headed loving and friendly person. She has made very damaging remarks about her once close friends. She has worked as a carer in the past and is very clever. When she claimed she had ovarian cancer she told her mother she was having chimotherapy and wore long sleeved blouses while she was working to cover up the canula in her wrist.She has turned her son, sister and all the grandchildren against her mother. There are a lot more details I could tell you, but I hope you can help for my sisters sake. Many thanks.
Posted Sun, 24 Feb 2013 in Mental Health
Answered by Dr. Jonas Sundarakumar 3 hours later
Hello and welcome to Healthcare Magic. Thanks for your query.

I appreciate your concern for your sister. I can understand that it is difficult for any mother to see her daughter in this situation.

From what you have described about your neice's problems, there are two clusters of symptoms which are obvious:
1) One cluster which probably indicates unhealthy personality characteristics such as:
- manipulative behaviour
- beligerent / accusatory attitude
- frequent lying
- mistrust
- attention-seeking behavior
Now, all these seem to indicate that she may be having a personality disorder, probably a illness, like a psychotic disorder.

Since, she seems to be putting both herself and others around her under distress and suffering, I think she needs professional help. In order to arrive at an exact diagnosis, she will need a detailed evaluation and psychological assessment. Further treatment will depend upon the diagnosis. But, whatever be the diagnosis, there are good treatment options available - both in the form of medication and psychological therapies. She may also need counselling to cope up with her own problems in life, like the stress of handling a child with psychological problems, dealing with her own insecurities, etc. So, my advise would be to take her to a psychiatrist for a detailed evaluation and further treatment.

It may be challenging to take her to a psychiatrist, as she may bluntly refuse. This can be handled in two ways - one is to gently convince her that she is quite stressed out and will benefit from some counselling; the other way is to take her to a doctor under the pretext of seeking medical attention for some other medical problem, maybe for her problem of "ovarian cancer", etc. In some cases, where the family members suspect that the person is suffering from a serious mental illness which may put the person or others around at risk of harm, then the person can even be taken involuntarily for treatment. You will have to discuss this with her husband also and decide which approach would be appropriate in her case.

Wish you all the best.

Dr. Jonas Sundarakumar
Consultant Psychiatrist
Above answer was peer-reviewed by
Follow-up: Having manipulative behavior with ovarian cancer. Are these treatable? 15 hours later
Hello and thank you for your advice.
I would like to clarify a few points and add some more information if I may.
XXXXXXX is 43 years old and her son XXXXXXX is 18.
She has never had ovarian cancer or a brain tumour and her son does not have aspergers or autism. He is a little withdrawn and quiet but that could be down to his father verbally bullying him as a child.
XXXXXXX has completely blocked all contact with her mother so there is no way of contact. My sister had an emotional breakdown as a result of this and is afraid of confrontation with XXXXXXX in case she suffers the same again.
There was a situation at the start of all this that started it all off.
XXXXXXX older brother XXXXXXX had an affair many years ago. About sixteen years later XXXXXXX sister XXXXXXX who lives in England got a phone call from a girl claiming to be Gary's daughter XXXXXXX XXXXXXX immediately phoned XXXXXXX in Australia instead of her brother. XXXXXXX instantly took control of the situation and welcomed XXXXXXX into the family without any proof of identity. XXXXXXX and my sister both refused to accept XXXXXXX into the family without a DNA test (which has been refused) and XXXXXXX has ruthlessly sought her revenge ever since.
My sister wants to get family relations back to normal one day but is at a loss as to how to go about it. Any advice you can give will be much appreciated. Thank you.
Answered by Dr. Jonas Sundarakumar 17 hours later
Hello again,

In light of the additional information which you have provided, my opinion regarding XXXXXXX tends to sway more in favour of a personality-related problem rather than any particular psychiatric disease.

It appears that XXXXXXX exhibits personality traits of being manipulative, mistrusting, vengeful, controlling, dishonest and with little regard for the feelings of other people. Though there could have been stressful situations and events which could have resulted in her completely cutting off herself, still, I feel that her unhealthy personality qualities have a major role to play in determining her attitude.

Unfortunately, persons with personality problems are very difficult to handle, because refuse to realize that their attitude is unhealthy and is causing hurt or difficulty to othres. This is probably the reason why Suzzane has completely cut off her mother or anyone else who may have tried to reason with her.

In this situation, especially since your sister has already suffered an emotional breakdown, it may not be a wise idea for your sister to try to initiate contact or reason out things with her. It may only be met with blunt hostility, which may hurt your sister even more. Very often, in such situations when there is a tense situation prevailing between family relationships, the best way forward is for a neutral (preferably, non-family member) to mediate things. This is because if it is a family member, there can be biases, finding faults, taking sides, etc. and it can become messy once again. So, my suggestion would be to approach a family friend or a well-wisher who is known to the family, to gently open up this discussion with her, and in a non-confrontative way, try to ease the tension.

Wish you all the best.

Dr. Jonas Sundarakumar
Consultant Psychiatrist
Above answer was peer-reviewed by
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