Attachment Counter-Transference Scale

Social interactions have a feature of a call-and-response sequence.  Two of the most common call-and-response sequences are for social politeness, the “thank  you – you’re welcome”  gracious display and the “sorry – no problem” forgiveness call-and-response.

A call-and-response I recommend for targeted parents is the bonding call-and-response of “I love you – love you too.”  In the attachment pathology of AB-PA, the child will not provide the called for response.   However, that doesn’t matter.  For a fraction of a moment, that response was in the child’s brain, “love you too.”  The child then blusters and flusters to remove it… but it was there for a moment…

“Love you – love you too; uh, no I don’t, I hate you, I hate you so much you can’t even imagine how much I hate you.”

“I know.  Love you – love you too.  Stop it!  Don’t say that.  Stop telling me that.  You don’t love me, and I hate you.  So stop.”

“Okay.  Love you – love you… uggghhhhh, stop it.  I’m out of here, I hate you.  That’s all I have to say.  Hate, hate, hate.”

“Okay.  Bye.  Love you.”

The call-and-response puts the response in the other person’s brain whether they want it there or not. 

Counter-Transference

The first six questions of the Attachment Counter-Transference Scale use this quality of call-and-response.  They are simple and direct… calls.

“As a child, did you love your mother?”

Simple and direct.  It’s a call.  It will receive a response.  Pop, yes, no, kinda will enter the person’s brain.  The defenses may then kick in, but for a moment the authentic response is in this person’s brain. 

But no one is listening to their response but them.  They can use all sorts of defenses, but they know.  They know the truth.  They know what that first response is, they were there during their childhood, they know what the truth is.  And that truth is the first response, “did you love your mother?” – “did your mother love you” – now there is an interesting question.  Pop.  There it is, there’s the answer.

Does their answer matter?  No.  The question’s direct simplicity is triggering the authenticity of response  – and in the social isolation of the person’s own self-awareness, this is all within the person’s own head – between them and themselves.  They know the truth.  What they say and what they know to be the truth may be two different things, but we’ll deal with that shortly.  The question pops the answer, and they know the truth.

What the question does is prompt their self-realization of the truth to each of these questions, whether this truth quickly becomes layered with defenses is secondary.

“did you love your mother?”  “did your mother love you?”

“did you love your father?” – “ did your father love you?

There they are.  Those are the four counter-transference questions.  To a simple-direct question, each one is answered honestly for a moment in the mind of the respondent.  Defenses may come in reporting, in social exposure, but the person knows.

Then opens the second phase of the counter-transference assessment, does the person respond honestly or does the person lie?

People who authentically answer yes to all four questions are of minimal to no risk for negative counter-transference issues.  It’s the people who answer no or somewhat to one of those four questions who are of concern.  Still, we all have our various childhood traumas and we recover… we recover by acknowledging the truth of our trauma and dealing with it.  Hiding our trauma is a sign of our not having dealt with and processed the trauma experience – we’re still working it through.

So the actual answer to the first six questions isn’t about the actual answer, it’s about whether problems are concealed or admitted.  That is the counter-transference scale.

If the person tells the truth and acknowledges potential counter-transference issues, great.  Go speak with a professional colleague for a bit to make sure you understand the issues you may bring from your own childhood background.  That’s a good thing.  We’ve highlighted an important issue in the treatment of attachment-related family pathology, and we’ve got it taken care of in a simple and efficient manner.

But if the person lies, then we will never know.  They’ll say everything in their childhood was fine, when it wasn’t.

Yes, that is true.  And that’s okay too.  Because they will know.  If you lie on the Attachment Counter-Transference Scale, you 100% have counter-transference issues.  Ta-da.  Exposed.

Yes, granted, it’s only exposed to the mental health professional’s self-secrecy… but they know.  They know their first response to the questions.  They know they deceived, they hid their trauma.  They know.

And that’s the point of the Attachment Counter-Transference Scale.  People can deceive the scale by lying.  But then, they have their answer.  They know they have prominent counter-transference bias and unresolved childhood trauma, and they know that their work is fraudulent, that they are swindlers and charlatans, they have lied and they are not truthful.

We may not know… but they do. And that’s the point of the Attachment Counter-Transference Scale.  Asking six questions, simply and directly – call-and-response for the authentic response, and then… do you disclose or deceive?

Why hugs?  Why hugs for questions 5 and 6?

Affection.  Questions 5 and 6 trigger affection (call-and-response).

But lots of people may not be very huggy.  I know.  But it’s affection none the less.   I’m a clinical psychologist, things are never quite as they appear.  The question triggers affection.  Call and response.  I don’t care what the actual response is, I’m triggering affection and then looking how the person decides to disclose.  The person remembers their childhood hugs, or the absence of childhood affection, it’s a call and response.  And then, do they disclose or deceive?

Therapist:  “I never got hugs from my dad, he was never around.  But that’s okay.  I didn’t really need affection from my dad.  A dad’s love isn’t really important. I’m okay.”

Dr. C:  Of course you are.  and perhaps you may want to look at your relationship with your dad a little bit, perhaps there’s some sadness there that you haven’t noticed, perhaps wanting to bond more to him than maybe you did or could?  Maybe you’ll want to take a look at that a bit more, especially if you want to start working with children’s attachment pathology surrounding parents and divorce.  Wouldn’t want things with your own family of origin influencing how you see stuff with the current families you’re treating.

My goodness gracious, you’re a mental health professional, this isn’t a game.  This family needs your help, answer the questions honestly.  If you’ve got crazy-nutty in your childhood, no worries, trauma happens, we attend to it, we resolve it.  No worries.  Just acknowledge it so we know that you’ve dealt with it.

But if you’re hiding and not disclosing your childhood emotional traumas, then your childhood emotional traumas are going to come back through unconscious counter-transference issues when working with attachment pathology in families.  So this is a self-assessment for all mental health professionals… complete the Attachment Counter-Transference Scale.

First six questions, deceptively powerful. 

If you acknowledge issues in your childhood family of origin, go check in with a professional colleague for 4 to 6 sessions to clarify the issues and their possible influence on perceptions.  And then you’re good to go.

Don’t lie.  Tell the truth.  Deal with stuff if you’ve got stuff.

Simple as that.  Professional standards of practice for all mental health professionals working with attachment-related family pathology surrounding divorce.  Have you dealt with your stuff?  Show us.  Complete the Attachment Counter-Transference Scale.

Question 7

Question 7 of the Attachment Counter-Transference Scale is another deceptively revealing question.  Question 7 is qualitatively scored and interpreted.  The stem of the question rules out the three domains of child abuse, physical, sexual, and neglect.  The question then asks about rejection of a parent, are there justified reasons to reject a parent other than abuse?

There are a variety of answers that can be offered to this question.  It is a projective question designed to elicit counter-transference relevant schemas.  There are potential yes answers that can be supported, but what is the support offered?  That’s the schema.  This question will retrieve the schemas of the mental health professional surrounding parent-child relationships, and potentially discipline, loyalty, and affection issues.  This is a schema search question.

Importance of Relationship Questions

Next on the Attachment Counter-Transference Scale are four 0-100 rating scales for the importance of each of the four types of primary parent-child bond; mother-son, mother-daughter, father-son, father-daughter.  Scoring indicates that all four scales should be rated as 100, and that any lesser rating requires professional justification and research support.

And there may be times when one relationship might be given preferential treatment, such as the mother-child bond in the first 12 months of infancy.  Cite the research, make the case.  I’m good with that.  But default is 100 for all parent-child bonds; father-son, father-daughter, mother-son, mother-daughter.  Each of these relationships is unique, each type of bond is incredibly important to the child’s healthy development, and none of them are expendable – 100 for each relationship type, or make the case with research.

What these four questions do is get the mental health professional on record – documented.  All four are equal in importance.  Right?  Or no,… which then reveals the counter-transference, which relationship type is valued, which devalued – or make your case by the research.

Family of Origin

The structure of the family of origin is less important than the degree of conflict in the family of origin.  High conflict families of origin can undermine the person’s ability to recognize and use effective problem-solving skills for conflict resolution because this person never had these problem resolution skills modeled by parents during childhood development.

The person may have subsequently acquired knowledge of effective problem-solving and communication skills for conflict resolution, we simply want to be reassured of this, what skills have they learned, where and how, and what skills are they teaching families and applying in therapy?

The primary issue of concern is the ability to resolve conflict (the “repair” in the breach-and-repair sequence).  High conflict families are unable to resolve conflict. 

Moderate conflict families may or may not effectively resolve conflict, and resolution may be more intermittent.  Moderate conflict families of origin can go either way in terms of concern for counter-transference issues in the child who is now grown to adulthood and who is now occupying the role of therapist or evaluator for a client family.

The Curriculum Knowledge Scale

This is the curriculum for knowledge required to assess, diagnose, and treat attachment-related family pathology surrounding divorce.  This also exists as a stand alone scale:

Curriculum Knowledge Scale

There is no “acceptable” level of professional ignorance.  Attachment theory, personality disorder pathology, and family systems therapy are all established domains of knowledge and are all relevant to resolving attachment-related family pathology surrounding divorce.

An attachment-based model of “parental alienation” (AB-PA; Foundations) is a scaffolding support to knowledge, it is not the knowledge itself.  The Curriculum Knowledge Scale identifies the information from professional psychology required for professionally competent practice with attachment-related family pathology surrounding divorce.

Legal System

I think all family law attorneys should ask for a Curriculum Knowledge Scale from all child custody evaluators along with submission of their reports.  I think it’s kind of important to know what the mental health professional knows as a basis for their opinions.

I think all “reunification therapists” (there’s no such thing as “reunification therapy”; it doesn’t exist) should also be required to complete the Curriculum Knowledge Scale, providing a copy to parents as part of the informed consent process for each family they treat. 

I think family law attorneys working for their clients, should ask the court to formally request a copy of a Curriculum Knowledge Scale for each mental health professional working with the family, including the children’s individual therapists.  Might as well find out what they know… or don’t know.

Personally, I’d just ask for the more complete Attachment Counter-Transference Scale.  It contains the Curriculum Knowledge Scale as part of it, so it’s like a two-fer.

Conclusion

All mental health professionals working with attachment-related family pathology surrounding divorce should complete the Attachment Counter-Transference Scale as a standard of practice.  Document family of origin concerns, address family of origin concerns… or lie… and become a charlatan and fraud. 

We know the counter-transference bias is out there.  We want to put the pressure of exposure on it.  We want to identify it – to itself, so the person has the opportunity to do the right thing and deal with their childhood trauma issues, so that their own childhood stuff won’t affect their work with current families.  That’s the right thing to do. 

The Attachment Counter-Transference Scale puts pressure on them to do the right thing, we know you, even if you hide… and we know that you know you.  Tell the truth.  Do the right thing, be authentic, acknowledge childhood trauma, deal with whatever needs to be dealt with.

counter-transference

From Aaron Beck on schemas:

“Evaluation of the particular demands of a situation precedes and triggers an adaptive (or maladaptive) strategy.  How a situation is evaluated depends in part, at least, on the relevant underlying beliefs.  These beliefs are embedded in more or less stable structures, labeled “schemas,” that select and synthesize incoming data.” (Beck et al., 2004, p. 17)

“The content of the schemas may deal with personal relationships, such as attitudes toward the self or others, or impersonal categories.” (Beck et al., 2004, p. 27)

“When schemas are latent, there are not participating in information processing; when activated they channel cognitive processing from the earliest to the final stages” (Beck et al., 2004, p. 27)

“When hypervalent, these idiosyncratic schemas displace and probably inhibit other schemas that may be more adaptive or more appropriate for a given situation.  They consequently introduce a systematic bias into information processing.” (Beck et al., 2004, p. 27)

Craig Childress, Psy.D.
Clinical Psychologist, PSY 18857

Beck, A.T., Freeman, A., Davis, D.D., & Associates (2004). Cognitive therapy of personality disorders. (2nd edition). New York: Guilford.

 

 

The Shame of the APA: Cruelty and Contempt Shown to Grieving Parents

Over 20,000 parents are asking the American Psychological Association to affirm its support for Standard 2.01a of its ethics code requiring professional competence… and they are met with silence… nothing… no dignity, no respect for their suffering… just silence, contempt, and disrespect.

You don’t matter.  You don’t even merit a response.  Cruelty, contempt, and disrespect.

No answer.  Just silence.

Petition to the APA – 2018 (online)

Petition to the APA – 2018 (booklet)

The ethics code of the American Psychological Association is hollow and without meaning.  It means nothing if the APA does not support it… and the APA will not support it’s own ethics code.  The APA cares that it looks good with it’s nice words, but will not back those hollow words when needed.  The APA ethics code is vacuous, empty words without meaning.

Over 20,000 parents reaching out to the American Psychological Association, asking the APA for a simple press release affirming the APA’s support for Standard 2.01a of the APA ethics code requiring professional knowledge and competence…

Silence.  Nothing.  The APA does not even show these 20,000 parents the dignity and respect of a reply.  Just contempt.  Contempt and disrespect for 20,000 parents seeking professional knowledge and competence with their children and families.  Shame to the APA for its contempt and cruelty.  Shame to the APA for its complicity in tolerating ignorance and professional incompetence.  Silence.  Nothing.

APA: Complicity with Child Abuse

If a psychologist is treating families, that psychologist should know how family systems function – Minuchin, Bowen, Haley. 

Question to the APA: Is it reasonable for parents to expect that the psychologists who are working with their families know about family systems constructs; triangles, cross-generational coalitions, and emotional cutoffs – Salvador Minuchin, Jay Haley, Murray Bowen?

Silence.  No response from the APA.  Contempt and disrespect.  These parents don’t even merit a response; “You don’t matter.  Your pain and suffering doesn’t even merit a response.”

So apparently psychologists working with your families don’t need to know anything about families.  The APA is silent.  The APA ethics code is hollow.  Empty words without meaning.  You are alone, the APA has abandoned you and your children.  The APA will not support you in your efforts to acquire professional knowledge and competence in the psychologists treating your families.

If a psychologist is treating attachment-related pathology, that psychologist should know about the attachment system; Bowlby, Ainsworth, Mains and the research literature. 

Question to the APA: Is it reasonable for parents to expect that psychologists who are working with their children and families to resolve parent-child attachment pathology know about the attachment system, how the attachment system functions and how it dysfunctions?

Apparently that is not necessary.  The APA is silent.  So apparently it is not necessary for psychologists to know about the attachment system when assessing, diagnosing, and treating attachment-related pathology in the family; Bowlby, Ainsworth, the attachment research literature… not necessary to know when treating attachment-related pathology.

The APA ethics code is hollow and without meaning, Standard 2.01a is hollow and without meaning, because the American Psychological Association is silent when 20,000 parents ask for support from the APA for Standard 2.01a. 

Silence is complicity, and in this case silence is also cruelty.  Twenty thousand parents deserve a response.  Say something.  They deserve a response.  They are people who are suffering, they are parents who are suffering the loss of their children.  They are not invisible.  See them.  At least acknowledge them.  Respond to their Petition.  But silence is cruelty.  Silence is contempt.

Wendy Perry: wendyarcher@rocketmail.com is your contact.  Not me.  Talk to Wendy.  She speaks for these parents.  She is your contact.

Silence from the APA is abandoning these parents to their emotional and psychological abuse.  Abuse from the sadistic cruelty of their narcissistic-borderline ex-spouse, corrupting and taking the children away from the beloved and loving parent in revenge and retaliation for the divorce, and from a failed family court system that does not diagnose pathology.  Family courts are matters of law, not of diagnosing pathology.

To the APA:  Your silence communicates your contempt and disrespect for the suffering of these parents, that these people do not even merit a response from you.  That they are of no value.  That they don’t matter.  Their immense suffering from the loss of their children means nothing to you, – silence, not even a response.  Nothing. 

That is cruel.  Contempt and cruelty.

Twenty thousand parents come to you in their pain, and you treat them with contempt and disrespect – with cruelty for their suffering.  They have lost their children.  At least say something. 

Nothing.  Silence.  Contempt, cruelty, and disrespect.

Shame is on the APA.  This is to your shame.

The ethics code of the APA is hollow and without meaning when it is not supported by the APA.  These parents are simply asking that the APA release a statement of support for Standard 2.01a of their ethics code requiring professional knowledge and competence, these parents can take it from there.  That is all they are asking… for the APA to simply voice its support for Standard 2.01a of its own ethics code.

Silence.  Nothing.  Not even a reply to say why they won’t issue a statement supporting Standard 2.01a.

To the APA:  Your silence to these parents tells them, “You are of no value.  Your suffering and the loss of your children means nothing.  You are not even worth a reply.  You are invisible.  You don’t exist.  Your suffering doesn’t matter, your suffering doesn’t exist.”

Shame to the APA.  Cruelty to trauma.  Contempt.  Disrespect to suffering.  You mean nothing, not even a response.

Complicity in the cruelty, trauma, and abuse.  Shame to the APA.

Complicity with Abuse

Silence is complicity.  The APA knows that personality disorder pathology exists.  the APA knows that the narcissistic-borderline personality will collapse in response to the rejection and perceived abandonment surrounding divorce.  The APA knows that the narcissistic-borderline pathology is high-conflict, manipulative, and exploits others.  The APA knows all of this.

And yet, when the parent-spouses of these collapsing, high-conflict, psychologically abusive narcissistic-borderline parents come to the APA for support of professional knowledge and competence… silence… nothing.  You don’t matter enough to even give a reply.  You mean nothing to us.

The APA is complicit in the psychological abuse of children by the pathology of a narcissistic-borderline parent surrounding divorce.  They know.  And their silence is complicity.

An estimated 6% of the population is diagnosable with narcissistic personality pathology; an estimated 6% of the population is diagnosable with borderline personality pathology:

  • “Prevalence of lifetime NPD was 6.2%”

Stinson, et al., (2008). Prevalence, correlates, disability, and comorbidity of DSM-IV narcissistic personality disorder. Journal of Clinical Psychiatry. 1033-1045.

  • “Prevalence of lifetime BPD was 5.9%”

Grant, et al., (2008). Prevalence, correlates, disability and comorbidity of DSM-IV borderline personality disorder. Journal of Clinical Psychiatry. 533—545

Narcissistic and borderline personality pathology exists.  We know this. 

The narcissistic personality is vulnerable to collapse in response to rejection, the borderline personality is vulnerable to collapse in response to abandonment.  We know this. 

Divorce represents both rejection and abandonment by the spousal attachment figure.  We know this. 

We should therefore anticipate that approximately 10-15% of all divorces should evidence collapsing parental/(spousal) narcissistic-borderline pathology.  We know this.

The narcissistic-borderline personality is high-conflict.  We know this.

The 10-15% of all divorces that contain a narcissistic-borderline parent will comprise 80-100% of the high-conflict divorces, because the narcissistic-borderline personality will definitely collapse in response to divorce and the narcissistic-borderline personality is high-conflict.  We know this.

Now… the spouses divorcing the high-conflict pathology of a narcissistic-borderline spouse are seeking professional competence in personality disorder pathology from the psychologists who are assessing, diagnosing, and treating their families and the children’s attachment pathology surrounding the divorce.  They are asking that the psychologists working with their families know about personality disorder pathology: Beck, Kernberg, Millon, and Linehan.

Question to the APA: Is it reasonable for these parents who are exposed to the narcissistic and borderline personality pathology of their ex-spouse surrounding the divorce to expect that the psychologists working with their families know about personality disorder pathology; Beck, Kernberg, Millon, and Linehan?

Apparently not.   The APA is silent.  It is not necessary for psychologists working with personality disorder pathology to know about personality disorder pathology. 

Twenty thousand parents asked the APA to affirm its support for Standard 2.01a that would require professional knowledge and competence.  Silence.

APA: Complicity with Child Abuse

Nothing.  No response.  Contempt and cruelty.

Shame to the APA.

Two full years before the current Petition to the APA, in February of 2016, these parents came to you with their first petition. 

Parent’s First Petition to the APA – 2016

Do you remember what you told them?  I do.  I was watching as these parents organized their petition seeking  your help in solving the suffering in their families.  I was listening when you answered them.  You told them that you would form a committee to “look at the research.”  Do you remember that?  I do.  I can get the emails from these parents if you’d like. 

You told them that you’d form a committee to look at the research.  They waited.  They aren’t seeing their children the entire time they’re waiting for you to form your committee.  All of 2017 they waited for you.

Nothing.  In 2018, I wrote the second Petition to the APA using my knowledge of professional psychology, and my understanding of the rampant and unchecked professional ignorance and incompetence these families are facing from professional psychology.  It’s now nearly three years later, it’s approaching three years since these parents first approached you… where is this committee you promised them in 2017?  Nothing.  Disrespect.  Contempt.

Empty words. 

Cruelty.  Contempt.  Disrespect.

In 2016 these parents came to you with their first petition seeking your help.  All they want is professional knowledge and competence from the psychologists treating their families – basic knowledge; Bowlby, Minuchin, Beck, Linehan, Bowen.  That’s all they want, just basic knowledge and competence from the psychologists treating their families.

These parents are suffering the loss of their children.  Some haven’t seen their children in years… two years, five years, ten years, they haven’t even seen their own beloved children.  They are normal people, loving parents, they did nothing – their only crime was marrying a narcissistic-borderline personality spouse who used the child viciously and cruelly as a weapon of revenge in the divorce.  No one’s protecting their beloved child from the psychological cruelty of the narcissistic-borderline personality parent.

These parents are grieving the loss of their children.  They are traumatized.   They have lost their beloved children.  Their grief is immeasurable.

The response of the APA to their suffering? 

Silence. 

Contempt.  Cruelty. 

APA: “Your suffering is not our concern.  We abandon you.  You are invisible.  You don’t matter.”

Shame to the APA.  Parents seeking knowledge and competence from their treatment providers.  Just asking for a statement from the APA supporting Standard 2.01a of the APA ethics code… and getting no response.  Silence.  Contempt.  Cruelty.

No reply.  These parents do not even deserve a reply.  Nothing.  They don’t matter. Their suffering doesn’t matter. 

Shame to the APA.  Cruelty.  Disrespect.  Contempt shown to suffering and grief.

Hollow Ethics

The APA ethics code is hollow.  Why should any psychologist affirm the APA’s ethics code when the APA won’t even affirm the APA’s ethics code?

Parents are left with no choice.  They have been abandoned by professional psychology and by the APA.  Their only choice for acquiring professional knowledge and competence is to file individual licensing board complaints on a case-by-case basis against violating psychologists who do not possess the required knowledge and competence, thereby compelling the acquisition of knowledge and competence: Bowlby, Minuchin, Beck, Millon, Kernberg, Bowen, Ainsworth, Haley…

Will licensing boards enforce Standard 2.01a requiring professional knowledge and competence?  No.  Why should they?  The APA doesn’t even affirm its support for Standard 2.01a requiring professional competence.  The APA ethics code is hollow and without meaning.  So, no, the licensing boards are not likely to enforce standards for professional competence without the APA indicating its support for Standard 2.01a.  As long as the APA does not support Standard 2.01a, the licensing boards will not support enforcement of Standard 2.01a.

To Psychologists: The APA ethics code is hollow and without meaning.  No need to abide by it.  A few select features are relevant, no sex with clients, maintain confidentiality, no dual relationships.  But the rest of it is pretty much empty words and without real meaning, especially that part about knowing what your doing, Standard 2.01a, no need to abide by that.

Principle E: Respect and Dignity

APA Ethics Code: “Principle E: Respect for People’s Rights and Dignity: Psychologists respect the dignity and worth of all people.”

To the APA:

Twenty thousand parents come to you seeking help in acquiring professional knowledge and professional competence in the treatment of their families, and your response?   Silence.  Nothing.  Their suffering doesn’t even merit a response. 

Is that treating these parents with respect, dignity, and worth?  No, it’s not.  These parents at least deserve a response from the APA, and they deserve the support of the APA in seeking professional knowledge and competence.

Are you honestly going to take the position that psychologists working with families don’t need to know Minuchin, Bowen, and Haley (family systems)? 

Are you honestly going to take the position that psychologists working with attachment pathology don’t need to know Bowlby, Ainsworth, and the research literature on attachment (attachment theory)? 

Are you honestly going to take the position that psychologists working with personality disorder pathology in the family don’t need to know Beck, Millon, Kernberg, and Linehan?

If so, then Standard 2.01a is hollow and without meaning.

You will eventually issue a statement in support of your own ethics code Standard 2.01a, because these parents are asking you to do so.  It will help them attain professional knowledge and competence with their children and families.

Or you can abandon these parents and children.  Silence.  Complicity in their suffering and abuse.

These parents are suffering daily.  They need the knowledge of professional competence in family systems, personality disorder pathology, and the attachment system, now… today.  Each day is one more lost day without their child, and a child deprived of a mother or father by the cruelty of a narcissistic-borderline parent.

They came to you in 2016.  Nothing.  Two years later, they came to you again in 2018.  Nothing.  Cruelty, contempt, and disrespect for their suffering.  The APA knows the truth of their suffering, and the APA is silent.  Not even showing these parents the dignity of a response.

I am not your contact.  Don’t speak to me.  Speak to the parents who are suffering.  Speak to the parents that need your help.

Wendy Perry: wendyarcher@rocketmail.com
parent-child advocate

Silence is cruelty.  Speak.  Say something.  These parents deserve a response.

Silence is shame.  Silence cruelty and contempt for suffering.  Silence is complicity with abuse.

Craig Childress, Psy.D.
Clinical Psychologist, PSY 18857

The Parenting Practices Rating Scale

The Parenting Practices Rating Scale is designed to document the clinical assessment of parenting by the targeted parent.  The scale contains four primary items:

1.)  Category Level of Parenting:

Item 1, the Category Level of Parenting, identifies deviant-abusive parenting relative to broadly normal-range parenting. 

The Level of parenting is rated on a 4-point Likert scale (abusive, severely problematic, normal-range problematic, normal-range healthy), anchored by descriptive categories of parenting.  Identifying the category of parenting locates the parenting in the corresponding Level of the rating scale. 

The 4-point Likert scale is then brought together into two broad categories of parenting; deviant-abusive (Levels 1 and 2) and normal-range (Levels 3 and 4).  It is this dichotomous classification that is used for diagnostic indicator 1 by the Diagnostic Checklist for Pathogenic Parenting to define a “normal-range parent” (Levels 3 and 4)

Ratings on Item 1: Category Levels should offer parenting examples to support the category rating.

2.)  Permissive-Authoritarian Rating

Item 2, the Permissive-Authoritarian Rating, is a 0-100 dimensional rating along the continuum of lax and permissive parenting to over-controlling and authoritarian parenting, with normal-range parenting represented by the mid-range scores.  This clinical rating represents the clinical judgement of the assessing mental health professional based on identified features of parental attitude and approach.  Ratings on Item 2: Permissive-Authoritarian Rating should be supported with examples.

A heuristic for clinical rating is that scores in the upper and lower 20% (0-20 and 80-100) should be considered sufficiently extreme to raise child protection considerations (for neglect at the lower extremes and for hostile-aggressive parenting at the upper extremes).

Normal-range parenting should be considered ratings between 25-75, with allowances provided for the cultural values, religious values, and personal values of the parent.  Clinical psychology typically recommends a mid-range balance along this dimension that incorporates flexible dialogue and negotiation with clearly defined rules, structure, and expectations (preferred rage of 40-60). 

However, some parents tend to be more lax, negotiable, and permissive (building relationship at the expense of child maturity; 30s), while other parents tend to be more rule-oriented, authoritarian, and structured (building child maturity at the expense of relationship; 60s).  These are value laden decisions for each parent, and as long as the parenting is broadly normal-range (25-75), parents should be allowed the right and discretion to form their families consistent with their cultural, religious, and personal value systems.

3.)  Empathy

The nature of parental empathy is not a decisional factor, but is an important descriptive feature for treatment-related considerations.  Throughout the professional literature, authentic parental empathy for the child is identified as the most important factor in parenting.  Highly lax and permissive parenting (30s) can be entirely healthy for the child with the addition of authentic parental empathy for the child’s autonomous experience, and can be damaging for the child’s development in the absence of authentic parental empathy.  Similarly, highly structured and authoritarian parenting (60s) can be entirely healthy for the child with the addition of authentic parental empathy, and can be damaging to the child’s development in the absence of authentic parental empathy.

The Empathy item is rated along a 5-point Likert scale, extending from narcissistic-style parenting evidencing an absence of authentic empathy for the child (emotional indifference or psychologically dominating projective identification), to borderline-style parenting of intrusive psychological over-involvement (psychologically anxious-intrusive parenting and projective identification).

Normal-range parental empathy is rated as a 3.  Narcissistic absence of empathy is rated as 1.  Borderline over-intrusive projective identification is rated a 5.  The mid-range scores of 2 (absent of parental psychological involvement) and 4 (anxious over-intrusive parenting) are indicators of normal-range parenting of concern, while the more extreme scores of 1 or 5 would represent prominent clinical concerns for the child’s development. 

Children flourish emotionally and psychologically from authentic parental empathy that is not projective of the parent’s own emotional and psychological needs and history (a normal-range rating of 3).

4.)  Issues of Clinical Concern

Item 4 identifies parenting behaviors of potential clinical concern, such as psychiatric issues, substance use issues, and trauma history issues.  These clinical concerns are modified by treatment.  If the parent’s psychiatric issues are being stabilized by treatment, if the parent’s substance use issues are in substantial remission (1 year), and if the parent’s own trauma history has received treatment, then these issues are all of lesser and limited clinical concern.  On the other hand, untreated major psychiatric pathology in a parent, active parental substance abuse, or unresolved parental trauma are all domains of prominent professional concern regarding the emotional and psychological well-being of the child.

Item 4, Issues of Clinical Concern, is a nominal rating scale of six categories of parental factors that would trigger treatment-related considerations.

Craig Childress, Psy.D.
Clinical Psychologist, PSY 18857

 

Two Diagnostic Models: Your Choice

You need to be an informed consumer of mental health services. These are your children and it is your family.  Which diagnostic model is used with your children and with your family is your choice.

So let’s compare.

There are currently two diagnostic models for determining the cause of a child’s rejection toward a parent surrounding divorce, the 8-symptom Gardnerian PAS diagnostic model, and the three-symptom AB-PA diagnostic model. They are assessed in different ways, and they lead to different outcomes.

The 8-symptom Gardnerian PAS diagnostic model has been applied for the past 35 years. It is the current diagnostic model being used. It is responsible for the current situation. If you want to see what the Gardnerian 8-symptom diagnostic model leads to, just look around… we’ve been using the 8-symptom Gardnerian PAS diagnostic model for 35 years, and it is currently the most prevalent diagnostic model being used to assess the pathology of “parental alienation” (attachment-related family pathology surrounding divorce).

AB-PA: The AB-PA diagnostic model was first described by Childress in Foundations (2015). It is mostly unknown in professional psychology, but it is rapidly gaining awareness in professional psychology.

As evidence of this increasing awareness, Dr. Childress has already conducted a six-session treatment focused assessment by court order (conducted across three consecutive days of clinical assessment sessions with the family; and a turn-around time for the treatment focused assessment report to the court in less than two weeks). An AB-PA pilot program for the family courts is also currently available in Houston, Texas; with 15 AB-PA knowledgeable mental health professionals trained to administer the six-session treatment focused assessment protocol, trained to manage the Strategic family systems intervention of a Contingent Visitation Schedule, and knowledgeable in solution-focused family therapy (Minuchin, Bowen, Berg) for stabilizing the post-divorce separated-family structure, along with 10 AB-PA knowledgeable amicus attorneys to coordinate family treatment with court orders and court support.

The three-symptom AB-PA diagnostic model represents change.

The AB-PA diagnostic model represents the application of the highest caliber of professional knowledge (Bowlby, Minuchin, Beck) and standards of practice to the assessment, diagnosis, and treatment of attachment-related family pathology surrounding divorce.

The 8-symptom Gardnerian PAS diagnostic model is based on the proposals of one man, a psychiatrist in the 1980s, that there exists a “new form of pathology” unique in all of metal health, so unique that this “new form of pathology” needs its own unique new set of symptoms unlike any other symptoms for any other pathology in all of mental health, eight symptoms made up 35 years ago, in the 1980s, by this one psychiatrist .

The three diagnostic indicators of AB-PA are based in the standard and established constructs and principles of professional psychology; Bowlby, Minuchin, Beck; the attachment system, personality disorder pathology, family systems therapy.

The 8-symptom Gardnerian diagnostic model is assessed using a six to nine month child custody evaluation costing $20,000 to $40,000.

The three diagnostic indicators of AB-PA (an attachment-based model for the pathology) are assessed in six sessions for around $2,500.  All three symptoms of AB-PA are standard symptoms fully within the existing scope of practice for all mental health professionals to identify.

When the three diagnostic indicators of AB-PA are present in the child’ symptom display, the DSM-5 diagnosis is V995.51 Child PsychologicaL Abuse, Confirmed.

When the 8-symptom Gardnerian PAS diagnostic model is used, this does NOT lead to a DSM-5 diagnosis of Child Psychological Abuse. The 8-symptom Gardnerian PAS diagnostic model does NOT result in a DSM-5 diagnosis of Child Psychological Abuse.

The 8-symptom Gardnerian PAS diagnostic model requires that targeted parents prove “parental alienation” through a court trial. It is in the two year run-up period to the trial that the child custody evaluation is typically ordered.

Since child custody evaluations take six to nine months to complete, this typically extends the time needed to obtain the court trial that’s needed to prove “parental alienation” using the 8-symptom Gardnerian PAS diagnostic model to about two years, or longer, from the start of the pathology (six months to get the court order for the custody evaluation, nine months for the custody evaluation to be completed, and three to six months to schedule the trial).  Assuming there aren’t court scheduling delays or delay tactics used by the allied narcissistic-borderline parent, the minimum anticipated time before trial is two years, and it often takes closer to three to five years before trial due when court delays and delay tactics by the allied narcissistic-borderline parent are factored in.

With the three diagnostic indicators of AB-PA, the pathology can be assessed by a mental health professional in six sessions.  This means that the time frame for an assessment and report to the court can be as short as two weeks, and typically not longer than 8 weeks.  Because the AB-PA diagnostic model returns a confirmed DSM-5 diagnosis of V995.51 Child Psychological Abuse, the start of treatment, including a possible protective separation of the child from the pathogenic parenting of the allied narcissistic-borderline parent, can begin within months of the start of the pathology.

With the 8-symptom Gardnerian PAS model (the one currently being used throughout psychology), it typically takes at least two years and over $100,000 in legal costs before even reaching the point where a decision is made by the court… and who knows what the custody evaluator will decide and then what the court will decide.

Typically the initial custody report returns a vague “both parents are contributing” analysis and conclusion (it’s a safe middle-of-the road position), with a recommendation for no change in the current de facto sole custody to the allied parent that is created by the child’s rejection of the targeted parent, and a recommendation for “reunification therapy” between the child and targeted parent to rehabilitate their relationship (that’s being damaged by the allied parent).

After a year of utterly failed “reunification therapy” in which the severity of the child’s rejection of the targeted parent has become more severe and more fully entrenched, a second “follow-up” custody report is usually ordered, typically with the same evaluator because it’s assumed the prior knowledge of the evaluator with this family will be useful. However, this assumption is usually not warranted. If the mental health professional doesn’t have the knowledge needed to correctly identify the pathology the first time, then the second time is probably not going to be all that different.

The time frame using the 8-symptom Gardnerian PAS diagnostic model becomes:

  • Initial order for a custody evaluation: six months to a year from the start of the pathology (cost: $20,000 to $40,000 per evaluation).
  • Completed custody evaluation: Six to nine months to complete the custody evaluation, typically recommending no-change in the de facto sole custody to the allied parent, and usually recommending “reunification therapy.”
  • “Reunification Therapy”: One year of failed “reunification therapy.”
  • Update custody evaluation: Six months to complete the follow-up custody evaluation, and three months to schedule the court date.

So by the time the trial arrives, it has typically been at least three years since the start of the pathology.

No matter what the outcome at trial, three entire years of the parent-child relationship is lost with the targeted parent. That time can never be recovered no matter what decision is ultimately reached at trial.

In addition, if an ultimate decision is made at trial of “parental alienation,” this means that the child has been abandoned to the pathological parenting of a narcissistic-borderline parent for three entire years of development without the compensating healthy influence of the normal-range targeted parent.  Using the 8-symptom diagnostic model of Gardnerian PAS, the damage and pathology is allowed to continue for three to five years before it is addressed.  The damage is done, and three years of parent-child time with the normal-range, loving and beloved parent, is lost, and can never be recovered.

Because the 8-symptom Gardnerian PAS diagnostic model is assessed using a child custody evaluation and proving “parental alienation” in a court trial, legal costs can often run in excess of $100,000, and often closer to $150,000 through three years of litigation and trial before action is taken to solve the pathology (typically three to five years of litigation is needed before reaching trial).

Dr. Childress: In my view as a clinical psychologist, every cent of this money should go to the child’s college education fund, not to attorneys and child custody evaluators.  In my view as a clinical psychologist, it is both unethical and immoral practice for any psychologist to actively collude with and participate in a process that is known to abandon a child for up to three years with a pathological parent, and that will knowingly drain the family’s money needed for the college education of the child, to pay for the legal and therapy costs imposed by the diagnostic model of the pathology.  When there is a more efficient, successful, and better way, it is the ethical obligation of all psychologists to take this route.

The three diagnostic indicators of AB-PA are made by a mental health professional within six to eight weeks of the initial identification of the pathology, and it is the DSM-5 diagnosis of V995.51 Child Psychological Abuse from this assessment by a mental health professional that is provided to the court to support the targeted parent’s requests for orders from the court.

With the AB-PA diagnostic model, a confirmed DSM-5 diagnosis for the pathology can be made in six-sessions ($2,500) and the targeted parent, whether represented by an attorney or self-representing pro se, begins the litigation process with a confirmed DSM-5 diagnosis of Child Psychological Abuse for the parenting practices of the allied narcissistic-borderline parent.

Dr. Childress: In my professional view as a clinical psychologist, this is a lock-down reason for selecting the AB-PA diagnostic model. The AB-PA diagnostic model provides (in six assessment sessions) a confirmed DSM-5 diagnosis of Child Psychological Abuse for the pathology.

The 8-symptom Gardnerian PAS diagnostic model does not result in a DSM-5 diagnosis of Child Psychological Abuse (in six to nine months of assessment; $20,000 to $40,000 for just the assessment).

If you use the 8-symptom Gardnerian PAS diagnostic model, the differential diagnosis in the assessment process is a pathology that’s been made up in forensic psychology to coincide with their construct of “parental alienation,” called “justified estrangement.” If targeted use the 8-symptom Gardnerian PAS diagnostic model, they will need to defend themselves against the allegation that the pathology is “justified estrangement,” meaning that the targeted parent “deserves” to be rejected for past parental failures.  When the 8-symptom Gardnerian PAS diagnostic model is used, targeted parents must defend their prior parenting, that they do not “deserve” to be rejected because of their prior problematic parenting (“justified estrangement”)

Since there are no criteria for “justified estrangement,” the mental health professionals assessing for the 8-symptom Gardnerian PAS diagnostic model can find a blend (a “hybrid”) of both “parental alienation” and “justified estrangement” – typically leading to no treatment for the “parental alienation” because the targeted parent is deemed to be partially contributing to their “justified estrangement.”

In the AB-PA diagnostic model, the presence of the three diagnostic indicators of AB-PA is a confirmed DSM-5 diagnosis of V995.51 Child Psychological Abuse. Period, end of story.  In AB-PA, there is no such thing as “justified estrangement.”

In AB-PA, the construct of “justified estrangement” is called physical and sexual abuse of the child by the targeted parent, and the rule-out diagnosis for the targeted parent is that there is no physical or sexual abuse of the child by the targeted parent, that the parenting practices of the targeted parent are broadly normal-range.

These are not differences of opinion regarding the two diagnostic models, these are the facts surrounding the use of each diagnostic model. You are the parent.  These are your children, and this is your family.  You should be an informed consumer of mental health services.

You are the parent.  The choice as to which diagnostic model you want to ask be applied with your children and with your family is up to you.

Craig Childress, Psy.D.
Clinical Psychologist, PSY 8857

 

The Scientific Method: AB-PA

In my 2008-2010 analysis of the pathology,  I saw how the Gardnerian PAS diagnostic model was attacked as “junk science.”  I knew the pathogen would attack an attachment-based model with the same attack, so an attachment-based model needed to be solidly grounded in the scientific method, and it is.

The good thing about being a scientist is that we can have conversations with science.  She’s really quite helpful and supportive once you get to know her.

I’m a psychologist.  I’m a social scientist.  I’ve had extensive conversations with science over the years.   The key thing with science, is she always wants you to make a prediction that can be verified… or disproven. 

Here is my conversation with science regarding the AB-PA diagnostic model:


Dr. Childress: Science, I need your help.

Science:  What is it?

Dr. Childress: I have information that needs to be grounded in the scientific method, so I want to walk the information through you.

Science: That’s what I’m here for.  What’s the information?

Dr. Childress:  It’s a diagnostic model of pathology.

Science: What is the prediction that the diagnostic model makes?

Dr. Childress: It makes the prediction that a specific constellation of three highly unusual symptoms will be displayed in the child’s symptoms.

Science:  Okay. The null hypothesis (H0) is that there will not be a specific pattern of symptoms in the child’s symptom display, and the research hypothesis (H1) is that there will be a specific pattern of symptoms in the child’s symptom display.  The dependent variable are the three symptoms predicted by the diagnostic model.  How are you operationalizing the dependent variable, the three symptoms?

Dr. Childress: The criteria for the diagnosis is the presence of three specific symptoms in the child’s symptom display, 1) attachment system suppression toward a normal-range parent, 2) narcissistic personality traits in the child’s symptom display, and 3) an encapsulated persecutory delusion in the child’s symptom display.

Dr. Childress: For the first diagnostic indicator, the operational definition for “attachment system suppression” is a child evidencing a desire to sever the parent-child attachment bond.  The specific evidence are verbal statements by the child indicating a desire to sever the attachment bond to the parent, child behavior indicating a desire to sever the parent-child attachment bond (hostile-rejection or anxious-avoidance), and refusal of opportunities to spend time with the rejected parent.

Dr. Childress: Also for the first diagnostic indicator, the operational definition for “normal-range parent” is a category rating of Level 3 or Level 4 on the Parenting Practices Rating Scale.  This category rating is a clinical judgement by the mental health professional based on the clinical data from the family.

Science: Those are fine.

Dr. Childress: For the second diagnostic indicator, the narcissistic personality traits, the diagnostic model predicts five specific narcissistic personality disorder traits in the child’s symptom display, 1) grandiosity, 2) absence of empathy, 3) entitlement, 4) haughty arrogance, and 5) splitting.  The operational definitions for these symptoms is provided by the American Psychiatric Association in their diagnostic criteria.

Science:  Those are fine.

Dr. Childress: The operational definition for the third criteria of an encapsulated persecutory delusion is provided by the American Psychiatric Association in their diagnostic criteria.  On the Brief Psychiatric Rating Scale, the child’s delusion belief would be rated a 4 or a 5.

Science.  That’s fine.  Your structure is grounded.  Your operational definitions are grounded. 

Science: Describe the research hypothesis, (H1), why does the diagnostic model predict this set of symptoms, and why does this set of symptoms support this diagnostic model?

Dr. Childress:  The diagnostic model is grounded in the work of Bowlby (attachment), Minuchin (family systems), and Beck (personality disorder), as well as the entire professional literature from these domains of professional knowledge.  The diagnostic model is described in the book Foundations, which describes the pathology at three separate and integrated levels of analysis, 1) family systems level, 2) personality disorder level, 3) attachment trauma level.  Beyond describing these three independent levels of analysis for the pathology, the description of the pathology is integrated across all three levels, explaining all of the interactions of these three factors. The diagnostic model explains:

  • How the attachment pathology creates the personality disorder pathology;
  • How the personality disorder pathology then creates the family systems pathology;
  • How the attachment pathology creates the family systems pathology;
  • How the family systems pathology creates the attachment pathology;
  • How the personality pathology creates the attachment pathology;
  • How the family systems pathology triggers the personality pathology.

Dr. Childress: The three symptoms predicted from the diagnostic model are each highly unusual individually;

1.) Attachment Suppression: Suppression of a child’s attachment bonding motivations toward a parent is extremely rare (associated only with sexual and physical child abuse), and is an impossible symptom toward a normal-range parent.

2.) Personality Disorder Traits: The presence of five narcissistic personality traits in a child’s symptom display is rare. Children typically do not display personality disorder pathology. This symptom indicator is strengthened within the diagnostic model by requiring multiple narcissistic symptoms (5; the threshold for a DSM-5 diagnosis of a personality disorder) and by specifically identifying which five narcissistic symptoms will be evidenced.  There is only one plausible explanation for the presence of narcissistic personality traits in the child’s symptom display, i.e., the psychological influence and psychological control of the child by a narcissistic parent, that it is the parent’s narcissistic traits toward the other spouse-and-parent that the child is acquiring and expressing.

3.) Persecutory Delusion: This is an impossible symptom. It is impossible for a child to develop a persecutory delusion toward a normal-range parent.  Yet the diagnostic model predicts that this impossible symptom will be present in the child’s symptom display.  Children never spontaneously develop an encapsulated persecutory delusion toward a normal-range parent; it is impossible for a normal-range parent to create an encapsulated persecutory delusion in the child.

Science: The structure of the design is a three-way interaction of independent variables. The independent variables are correlated; statistical analysis considerations apply regarding correlated independent variables.  The levels of the independent variables are outside of experimental manipulation, so the design is a quasi-experimental, natural groups design.

Dr. Childress: Since this is a diagnostic model not a research design, do I need to measure the levels of the independent variables?

Science: No.  The presence of the three diagnostic indicators will confirm the diagnostic model that predicted the presence of these symptoms.

Dr. Childress: What is the scientific strength of this diagnostic protocol?

Science: Confirmation of predictions made by a three-way interaction of variables represent extremely strong confirmation of the diagnostic model making the prediction (H1). If the three a priori predicted symptoms from a three-way interaction are found, this data would confirm the causal attributions of the model.  A three-way interaction of variables means developing alternative explanatory models is extremely unlikely.

Dr. Childress: So, science… is everything good to go?

Science: Yes. The diagnostic model is structurally sound.  The scientific hypothesis (H1) is that a pattern of three symptoms will be found in the child’s symptom display.  The null hypothesis (H0) is that the three predicted symptoms in the child’s symptom display will not be present. The independent variables are three nominal data categories, family systems pathology, personality disorder pathology, and attachment pathology in the family. The dependent variables are the three symptoms in the child’s symptom display, attachment suppression, specified personality disorder traits, and an encapsulated persecutory delusion.

Science: Since you are not manipulating or measuring levels of the independent variables, this is not a research protocol.  It is a scientifically grounded diagnostic protocol.  The diagnostic model makes predictions that are confirmed or disconfirmed on an individual basis.

Science: Statistical cautions will emerge if the scientific basis of the diagnostic protocol is changed into a research protocol because the three independent variables of the diagnostic protocol are conceptually entangled and correlated with each other.  For a diagnostic protocol, the entanglement of the independent variables is not a relevant issue because the outcome dependent variable (the predicted symptom pattern) provides confirmation for the diagnostic model as a whole.  For a research protocol that examines the relative influence of each independent variable (IV) on the dependent variable (DV), disentangling the constructs for the IV and operationalizing their definition would be required.

Science: The scientific methodology for the diagnostic protocol of the three diagnostic indicators (H1) allows causal statements regarding the origin of the three symptoms when they are present in the child’s symptom display.  The presence of these three symptoms in the child’s symptom display would represent scientifically grounded proof for the causal associations described in the model that predicted these symptoms.

Science: Of note, there are simpler diagnostic models that would be grounded in the scientific method and allow causal diagnostic statements for the child’s symptoms. If attachment system suppression is impossible toward a normal-range parent except in cases of child abuse, then the presence of this single symptom alone, in the absence of child abuse, would represent confirmation for the diagnostic model that predicted this symptom.

Science: Alternatively, if an encapsulated persecutory delusion toward a normal-range parent is impossible, then the presence of this symptom alone in the child’s symptom display would represent confirmation for the diagnostic model that predicted this symptom.

Science:  It is notable that the diagnostic model makes a prediction of all three symptoms being present, and that two of the predicted symptoms are impossible.  Prediction of two impossible child symptoms and one improbable symptom that are then found in the child’s symptom display is solid confirmation for the diagnostic model that made the prediction.

Dr. Childress: What are the limitations to the diagnostic protocol?

Science: First, that the null hypothesis (H0) will be confirmed and the three child symptoms will not be evident in the child’s symptom display. Since two of the diagnostic indicators are impossible (attachment system suppression toward a normal-range parent and an encapsulated persecutory delusion toward a normal-range parent), the likelihood of the null hypothesis is 100%.   These three symptoms should never be found in a child’s symptom display.

Science: If, however, the three symptoms of the diagnostic model are found, then this represents complete confirmation for the diagnostic model that predicted these symptoms, and there exists one method for creating the previously impossible symptoms, the method described by the diagnostic model.

Science: The second limitation is that there may be alternative models that describe the presence of the three symptoms found in the child’s symptom display.  Since the predicted symptoms are the product of a three-way interaction of independent variables, the possibility of an alternative explanatory model are incredibly remote, with a likelihood next to non-existent.

Science: Within the scientific method, when a model has had its predictions confirmed by evidence, it is the responsibility of critics to propose alternative explanations.  Therefore, if the three diagnostic indicators are present in the child’s symptom display, this confirms the diagnostic model that made the prediction of these symptoms and it becomes the responsibility of critics to develop alternative explanatory models (if this is possible). That represents the advancement of knowledge through the scientific method. If alternate explanatory models are proposed, then examination of differing predictions made by the two models can differentiate which one represents an accurate description of the child’s symptoms.

Science: Third, this scientific model is diagnostic, meaning that it is applied one person at a time.  If it is true in one person, that doesn’t mean it exists anywhere else in the world, until the second case, and the third case are found, each having the same pattern of diagnostic indicators.  The prevalence of the pathology is unknown by the diagnostic protocol itself and would require further epidemiological research relative to public health concerns.  A diagnostic protocol only provides information about pathology on a case-by-case basis.

Dr. Childress:  Science, are there additional advantages to the diagnostic protocol.

Science: If the diagnostic model confirmed by the three diagnostic indicators remains undisputed by opposing evidence (an alternative explanation for the three symptoms being present in the child’s symptom display), then the diagnostic model and it’s three operationally defined diagnostic indicators represent an exceptionally good diagnostic independent variable (IV) to include in future research protocols.  Dependent variables (DV) of the investigator’s choice could be examined relative to two groups (2 levels of the IV), those with the three symptoms of the diagnostic model, and those without the three symptoms of the diagnostic model (a 1×2 natural groups design).  Alternatively, differing comparison groups could be selected from families in the foster care system, and families seeking services for school-related child behavior problems (a 1×3 design).  The diagnostic framework itself could be broken down into categories of independent variable (IV), such as families meeting all the criteria (high), families meeting some of the criteria (medium), and families meeting none of the criteria (low).  If a second factor was considered in the research design, such as the gender of the child, that would create a factorial design.  If two levels of the diagnostic category are used (presence-absence of the three symptoms) and two levels of child gender are used, that would create a 2×2 factorial natural groups design.  If three categories of the diagnosis IV were used, such as children in high-conflict divorce, children in the foster care system, and children with school behavior problems, and four levels of a second IV for parent-child relationship type (father-son, mother-son, father-daughter, mother-daughter) the design becomes a 3×4 factorial design.  The increasing number of cells in the factorial design would require larger numbers (N) of research participants for statistical purposes.  Because subjects are not being randomized to conditions, it would not be an experimental design, but would be a quasi-experimental design using naturally occurring groups. Since the diagnostic model is being used in the construction of the independent variable (IV), the nature of the dependent variable (DV) is entirely at the discretion of the investigators.  The DV might be a child characteristic, such as depression or anxiety as measured on various rating scales, or self-esteem as measured by a rating scale, or the child’s emotional and psychological functioning as measured by scores on a standardized projective test (like the Robert’s Apperception Test for Children).  Or the DV might be a quality of the parent’s pathology, such as the degree of splitting or a history of childhood trauma as measured by the Adult Attachment Interview.  Or the DV might be an aspect of the spousal-relationship, as measured by ratings on attachment compatibility and personality scales.  Multiple dependent variables can be included in any design structure, with the increasing number of independent and dependent variables impacting statistical analysis and increasing the number (N) of research participants required and recommended for statistical analysis. The diagnostic model of the three symptoms is a tool in structuring the independent variable (IV) of a research protocol.  How it is used to structure the independent variable (IV) and what dependent variables (DV) are examined are the choice of the investigator.

Science: The diagnostic model can also structure single-case research designs.  For example, treatment protocols using the single-case design could examine response to treatment or alternative treatments. The inclusion criteria into the single-case research would be the three symptom indicators of the diagnostic model.  ABA single case protocols are easily constructed for treatment (baseline data – intervention data – removal of intervention data).  When dealing with the treatment of pathology, the simple ABA protocol that leaves the child in a no-intervention condition is not recommended for ethical reasons.  In treatment related research using the single-case design, the ABAB reversal design is used (baseline-intervention-baseline-intervention; ABAB). 

Dr. Childress: Thank you. So am I good to go?

Science: You’re good to go.


Craig Childress, Psy.D.
Clinical Psychologist, PSY 18857

AB-PA and Forensic Psychology: Four Statements

Statement 1: The standards of practice in forensic psychology are substantially below the standards of practice in clinical psychology.

I suspect this statement will draw the ire of my colleagues in forensic psychology.  That’s not important.  The statement is true and needs professional focus and resolution.

Statement 2: The practice of child custody evaluations violates every professional standard of practice for the construction of an assessment procedure.

I suspect this statement will draw the ire of my colleagues who conduct custody evaluations.  That’s not important.  The statement is true and needs professional focus and resolution.

Statement 3: There is no such thing as “reunification therapy.”  It an undefined term for a snake-oil therapy of unknown and undetermined content.

I suspect this statement will draw the ire of my colleagues who conduct court-ordered “reunification therapy.”  That’s not important. The statement is true and needs professional focus and resolution.

Statement 4: The construct of “parental alienation” is disabling the mental health response to the pathology and is beneath professional standards of practice for defining and describing pathology.

I suspect this statement will draw the ire of my colleagues who use the construct of “parental alienation” to guide their practice.  That’s not important.  The statement is true and needs professional focus and attention.

A professional-level description of “parental alienation” depends on which information sets from professional psychology are applied to the clinical data, information sets from family systems therapy or information sets from attachment trauma and personality disorder pathology.

Family Systems Clinical Description of the Pathology: 

The child is being triangulated into the spousal conflict through the formation of a cross-generational coalition with the allied parent against the targeted parent, resulting in an emotional cutoff in the child’s relationship to the targeted parent (Minuchin, Haley, Bowen).

Attachment System Clinical Description of the Pathology:

The child’s rejection of a parent surrounding divorce represents the trans-generational transmission of attachment trauma from the childhood of the narcissistic/(borderline) parent to the current family relationships, mediated by the personality pathology of the parent that is itself a product of this parent’s childhood attachment trauma (Bowlby, Beck, Millon, van der Kolk).

An attachment-based description of attachment-related family pathology surrounding divorce, (attachment-based “parental alienation”; AB-PA) represents the return of clinical psychology to court involved consultation, court-involved assessment of pathology, and court-involved treatment of pathology. 

Nothing about AB-PA is new.  AB-PA represents the application of established constructs and principles of professional psychology to a set of symptoms (Bowlby, Minuchin, Beck, Bowen, Millon, Kernberg, Ainsworth, Linehan…).

An attachment-based description of the pathology is grounded entirely within the standard and established constructs and principles of professional psychology; the attachment system, personality disorder pathology, family systems therapy, and complex trauma.

Professional psychology has the obligation to provide the highest caliber of professional knowledge and standards of practice for all clients and for the court.  Forensic psychology is currently failing in this obligation.

An attachment-based model of “parental alienation” (attachment-related family pathology surrounding divorce) represents the return of clinical psychology to court-involved consultation, court-involved assessment of pathology, and court-involved treatment of pathology.

Craig Childress, Psy.D.
Clinical Psychologist, PSY 18857

Diagnostic Indicator 2: Personality Pathology

Diagnostic Indicator 2: The child’s symptoms evidence five specific narcissistic personality traits:

  • Grandiosity:  The child displays a grandiose perception of occupying an inappropriately elevated status in the family hierarchy that is above the targeted-rejected parent, from which the child feels empowered to sit in judgment of the targeted-rejected parent as both a parent and as a person.

  • Absence of Empathy:  The child displays a complete absence of empathy for the emotional pain being inflicted on the targeted-rejected parent by the child’s hostility and rejection of this parent.

  • Entitlement:  The child displays an over-empowered sense of entitlement in which the child expects that his or her desires will be met by the targeted-rejected parent to the child’s satisfaction, and if the rejected parent fails to meet the child’s entitled expectations to the child’s satisfaction then the child feels entitled to exact a retaliatory punishment on the rejected parent for the child’s judgment of parental failures.

  • Haughty and Arrogant Attitude:  The child displays an attitude of haughty arrogance and contemptuous disdain for the targeted-rejected parent.

  • Splitting:  The child evidences polarized extremes of attitude toward the parents and a rigid inflexibility in which the supposedly “favored” parent is idealized while the rejected parent is devalued and demonized as an all-bad and entirely inadequate parent.

The child’s emotional response and behavior toward the targeted parent is dysregulated (chronically hostile, angry, and rejecting).  The child is rude, defiant, and disrespectful toward the targeted parent.  While the child’s behavior toward the targeted parent is oppositional and defiant, the child’s emotional and behavioral dysregulation is not Oppositional Defiant Disorder (although it will meet diagnostic criteria for Oppositional Defiant Disorder), it is instead a reflection of narcissitic personality traits of haughty arrogance and contempt for the parent.  The child intentionally says hurtful things to the parent without apparent empathy or compassion for how the child’s cruelty affects the parent.  The child is harshly judgemental of the parent, and feels empowered and entitled to judge the parent.  The child’s harshly judgemental attitude toward the parent is rigidly fixed and uncompromising, it is not open to change.

The child, however, does not have a personality disorder.  The child displays this attitude only toward the targeted-rejected parent.  With teachers and the general public, the child is well-behaved and well-regulated.  The child is cooperative with teachers in the classroom, presenting no behavior problems, and is reportedly well-behaved and respectful with the allied parent. 

The selective display of narcissistic traits is only toward one target.  Personality disorder pathology affects all relationships.  This means that the child does not have a personality disorder.

Q:  How does a child acquire multiple narcissistic personality traits of haughty arrogant judgement, entitlement, an absence of empathy, and splitting, directed only toward the specific target of the other parent? 

A:  Through the psychological control (Barber) of the child by a narcissistic-borderline personality parent, who is transferring this parent’s own narcissistic attitudes of harshly critical judgement, arrogant contempt, absence of empathy, and inflexibly negative polarized perceptions toward the other parent to the child.

It’s not the child who has these beliefs toward the other parent, it’s the allied narcissistic-borderline parent who has these attitudes toward the other spouse, and the child is acquiring these narcissistic personality traits displayed selectively toward the targeted parent through the psychological control and influence of the child by the allied narcissistic-borderline parent.

A parent cannot psychologically control and distort a child without leaving “psychological fingerprint” evidence of the control in the child’s symptom display.  The five narcissistic personality traits displayed in the child’s symptoms represents the “psychological fingerprint” evidence of the child’s psychological control by an allied narcissistic-borderline parent.

The psychological control and influence of the child to hold the same attitudes as the parent is the only conceivable process that creates five selectively displayed narcissistic personality traits toward a single target, the other parent-and-spouse.  The child and allied parent have formed a cross-generational coaliton against the targeted parent, and the child is acquiring the allied parent’s contemptuous, judgemental, blaming, critical, and harsh attitudes and beliefs about the targeted parent-spouse.

Narcissistic personality disorder pathology in a child is an extremely rare symptom.  It is almost never seen in juveniles (only in cases of juvenile delinquency and conduct disorder, and only rarely even in these cases). Narcissistic personality pathology is just not something that’s seen in childhood disorders, and yet five specific narcissistic personality disorder features are clearly evident in the child’s symptom display.  This is incredibly unusual, and this is predicted by an attachment-based model for the construct of “parental alienation.”

The child’s narcissistic personality traits are not endogenous to the child, because they are displayed selectively only toward a specific target, the other parent. The a priori prediction of five specific narcissistic personality traits in the child’s symptoms, which are then evidenced in the child’s symptom display, represents extremely strong confirmatory evidence for the diagnostic model that predicts these symptoms.

The narcissistic personality traits displayed by the child toward the targeted parent represent the “psychological fingerprint” evidence of the psychological control of the child by a narcissistic-borderline parent who has formed a cross-generational coalition with the child against the other parent.

Psychological Control of the Child

The manipulative psychological control of the child by a parent is a scientifically established family relationship pattern in dysfunctional family systems. 

In his book regarding parental psychological control of children, Intrusive Parenting: How Psychological Control Affects Children and Adolescents, published by the American Psychological Association, Brian Barber and his colleague, Elizabeth Harmon, identify over 30 empirically validated scientific studies that have established the construct of parental psychological control of children (studies referenced by Barber and Harmon).  In Chapter 2 of Intrusive Parenting: How Psychological Control Affects Children and Adolescents, Barber and Harmon define the construct of parental psychological control of the child:

“Psychological control refers to parental behaviors that are intrusive and manipulative of children’s thoughts, feelings, and attachment to parents.  These behaviors appear to be associated with disturbances in the psychoemotional boundaries between the child and parent, and hence with the development of an independent sense of self and identity.” (Barber & Harmon, 2002, p. 15)

According to Stone, Bueler, and Barber:

“The central elements of psychological control are intrusion into the child’s psychological world and self-definition and parental attempts to manipulate the child’s thoughts and feelings through invoking guilt, shame, and anxiety.  Psychological control is distinguished from behavioral control in that the parent attempts to control, through the use of criticism, dominance, and anxiety or guilt induction, the youth’s thoughts and feelings rather than the youth’s behavior.” (Stone, Buehler, & Barber, 2002, p. 57)

Soenens and Vansteenkiste (2010) describe the various methods used to achieve parental psychological control of the child:

“Psychological control can be expressed through a variety of parental tactics, including (a) guilt-induction, which refers to the use of guilt inducing strategies to pressure children to comply with a parental request; (b) contingent love or love withdrawal, where parents make their attention, interest, care, and love contingent upon the children’s attainment of parental standards; (c) instilling anxiety, which refers to the induction of anxiety to make children comply with parental requests; and (d) invalidation of the child’s perspective, which pertains to parental constraining of the child’s spontaneous expression of thoughts and feelings.” (Soenens & Vansteenkiste, 2010, p. 75)

Research by Stone, Buehler, and Barber establishes the link between parental psychological control of children and marital conflict:

“This study was conducted using two different samples of youth.  The first sample consisted of youth living in Knox County, Tennessee.  The second sample consisted of youth living in Ogden, Utah.” (Stone, Buehler, & Barber, 2002, p. 62)

“The analyses reveal that variability in psychological control used by parents is not random but it is linked to interparental conflict, particularly covert conflict.  Higher levels of covert conflict in the marital relationship heighten the likelihood that parents would use psychological control with their children.” (Stone, Buehler, & Barber, 2002, p. 86)

Stone, Buehler, and Barber offer an explanation for their finding that intrusive parental psychological control of children is related to high inter-spousal conflict:

“The concept of triangles “describes the way any three people relate to each other and involve others in emotional issues between them” (Bowen, 1989, p. 306).  In the anxiety-filled environment of conflict, a third person is triangulated, either temporarily or permanently, to ease the anxious feelings of the conflicting partners.  By default, that third person is exposed to an anxiety-provoking and disturbing atmosphere.  For example, a child might become the scapegoat or focus of attention, thereby transferring the tension from the marital dyad to the parent-child dyad.  Unresolved tension in the marital relationship might spill over to the parent-child relationship through parents’ use of psychological control as a way of securing and maintaining a strong emotional alliance and level of support from the child.  As a consequence, the triangulated youth might feel pressured or obliged to listen to or agree with one parents’ complaints against the other.  The resulting enmeshment and cross-generational coalition would exemplify parents’ use of psychological control to coerce and maintain a parent-youth emotional alliance against the other parent (Haley, 1976; Minuchin, 1974).” (Stone, Buehler, & Barber, 2002, p. 86-87)

Cross-Generational Coalition:

The construct of a cross-generational coalition within the family is described by both Salvador Minuchin and Jay Haley, preeminent theorists in family systems therapy.  Jay Haley provides a definition the cross-generational coalition:

“The people responding to each other in the triangle are not peers, but one of them is of a different generation from the other two… In the process of their interaction together, the person of one generation forms a coalition with the person of the other generation against his peer.  By ‘coalition’ is meant a process of joint action which is against the third person… The coalition between the two persons is denied.  That is, there is certain behavior which indicates a coalition which, when it is queried, will be denied as a coalition… In essence, the perverse triangle is one in which the separation of generations is breached in a covert way.  When this occurs as a repetitive pattern, the system will be pathological.” (Haley, 1977, p. 37)

Salvador Minuchin, provides a clinical description of the impact of a cross-generational coalition on family relationships following divorce:

“An inappropriately rigid cross-generational subsystem of mother and son versus father appears, and the boundary around this coalition of mother and son excludes the father.  A cross-generational dysfunctional transactional pattern has developed… The parents were divorced six months earlier and the father is now living alone… Two of the children who were very attached to their father, now refuse any contact with him. The younger children visit their father but express great unhappiness with the situation.” (Minuchin, 1974, p. 61-62; 101)

On page 42 of their book, Family Healing, Salvador Minuchin and his co-author Michael Nichols provide a structural family diagram for the inverted family hierarchy created by minuchin cross-gen slidean over-involved (enmeshed) relationship of a father and the child that excludes the mother.  The three lines between the father and child in this diagram indicate an enmeshed relationship of psychological over-involvement, and the child has replaced the mother atop the hierarchy with the father, holding an elevated position with him in which they are entitled to judge the mother. 

The structural family systems diagram provided by Minuchin and Nichols graphically illustrates that the cross-generational coalition of the child with the father creates both an inverted family hierarchy in which the child is elevated into a position of judgement above the mother, from which the child feels entitled to judge the adequacy of the mother as a parent, and also creates an emotional cutoff in which the mother is rejected by the alliance of the father and child (emotional cutoff: Murray Bowen; Titelman). 

Conclusion

Diagnostic Indicator 2: Personality Disorder Pathology is the result of the child acquiring the narcissistic attitudes of contempt, absence of empathy, harsh and critical judgement, and inflexible polarized attitudes of demonization toward the targeted parent from the pathogenic parenting of the allied narcissistic-borderline parent through processes of psychological control and the formation of a cross-generational coalition against the targeted-rejected parent-and-spouse.

The presence in the child’s symptom display of five a priori predicted narcissistic personality disorder traits represents definitive diagnostic evidence for the child’s cross-generational coalition with an allied narcissistic-borderline parent against the targeted parent-spouse. 

However, in the diagnostic identification of an attachment-based model of “parental alienation” (AB-PA), the presence of five narcissistic personality traits in the child’s symptom display is only one of three diagnostic indicators that must all be present; attachment system suppression toward a normal range parent (Diagnostic Indicator 1), five specific narcissistic personality traits in the child’s symptom display (Diagnostic indicator 2), and an encapsulated persucutory delusion displayed by the child regarding the child’s supposed “victimization” by the normal-range parenting of the targeted parent (Diagnostic Indicator 3).

Craig Childress, Psy.D.
Clinical Psychologist, PSY 18857

References

Barber, B. K. (Ed.) (2002). Intrusive parenting: How psychological control affects children and adolescents. Washington, DC: American Psychological Association.

Barber, B. K. and Harmon, E. L. (2002). Violating the self: Parenting psychological control of children and adolescents. In B. K. Barber (Ed.), Intrusive parenting (pp. 15-52). Washington, DC: American Psychological Association.

Stone, G., Buehler, C., & Barber, B. K.. (2002) Interparental conflict, parental psychological control, and youth problem behaviors. In B. K. Barber (Ed.), Intrusive parenting: How psychological control affects children and adolescents. Washington, DC: American Psychological Association.

Soenens, B., & Vansteenkiste, M. (2010). A theoretical upgrade of the concept of parental psychological control: Proposing new insights on the basis of self-determination theory. Developmental Review, 30, 74–99.

Haley, J. (1977). Toward a theory of pathological systems. In P. Watzlawick & J. Weakland (Eds.), The interactional view (pp. 31-48). New York: Norton.

Minuchin. S. & Nichols, M.P. (1993). Family healing: Strategies for hope and understanding. New York: Touchstone.

Bowen, M. (1978). Family therapy in clinical practice. New York: Jason Aronson.

Titelman, P. (2003). Emotional cutoff in Bowen family systems theory: An Overview.  In Emotional cutoff: Bowen family systems theory perspectives, P. Titelman (ed). New York: Haworth Press.