Therapy: Initial Considerations (1)

I received the following question regarding therapy and I thought I’d reply through my blog.

Caveat:  Without conducting an independent assessment of family relationships, I cannot offer advice on any specific situation.  I can, however, offer general commentary regarding the issues and factors to be considered in treating an attachment-based model of “parental alienation.”

Here is the question I received:

“I am currently in a position where our therapist is asking the courts to remove our children from the alienating parent and have them placed back in my custody.  Do you have any general suggestions for reunification for an alienated parent?  The expectation in our situation is that our 14 year old will be very resistant and our 12 year old will be receptive, based on what the therapist has learned in the last 90 days of sessions.”

An aside: The therapist needs to be careful in the phrasing of this recommendation because treatment providers are prohibited from offering child custody recommendations.  With regard to “parental alienation” this becomes more complex because the pathogenic parenting of the narcissistic/(borderline) parent shifts the clinical concerns from child custody to child protection.  Yet caution still needs to be exercised by treatment providers relative to child custody considerations.

As a clinical psychologist I can discuss treatment-related issues, but I cannot offer an opinion on custody.  This becomes somewhat convoluted when the treatment issue is one of child protection, and therapy requires the child’s protective separation from the pathogenic parenting of the narcissistic/(borderline) parent that is inducing the child’s symptoms, in order to protect the child from harm associated with being turned into a “psychological battleground” by the continuing pathogenic influence of the narcissistic/(borderline) parent who is pressuring the child to maintain the child’s symptomatic rejection of the other parent even as therapy is trying to restore this parent-child relationship.

In my view, my only option since I cannot offer recommendations for child custody considerations is for me to decline therapy until such time as the child’s protection during the active phase of treatment can be guaranteed by a protective separation of the child from the pathogenic influence of the narcissistic/borderline) parent whose distorted parenting practices are inducing the child’s symptomatic state.

However, there are currently many less-than-competent therapists who would be more that willing to pick up any cases that I decline, so that essentially those who are knowledgeable must decline to conduct therapy, leaving treatment to those therapists who have little to no idea what they’re doing.  This is unfortunate.

Initial Comments:

The stages, focal areas, and processes by which we treat and resolve the child’s symptoms that are created by the pathogenic parenting of the narcissistic/(borderline) parent, and by which we also restore the child’s authenticity rather than simply replacing the child’s psychological domination by the narcissistic/(borderline) parent with our own psychological domination of the child, go beyond my ability to describe in a single weblog essay.

So I will begin to describe these therapeutic processes and interventions in this response, beginning with the overall structural goals of the therapeutic process, and then I will follow up on these initial considerations in future blog essays focusing on the various specific components of the therapy process.

The Symptomatic Eldest Child

It is not unusual for the eldest child to be the initial focus of the narcissistic/(borderline) parent for distortion and alliance, while the younger children are left relatively unattended to by the distorting psychopathology of the narcissistic/(borderline) parent. Over time, however, once the eldest child has psychologically surrendered to the psychopathology of the narcissistic/(borderline) parent, the focus of both the narcissistic/(borderline) parent and the eldest child then becomes turned toward inducing the same pathology in the younger siblings, until eventually all the children are induced into cutting off their relationships with the targeted parent.

So if the eldest child is fully symptomatic but the younger child isn’t, this means that the psychopathology of the “alienation” process has not yet achieved full completion. Under these circumstances, I would estimate that the psychopathology has achieved 3/4 to 2/3 completion, which provides us with some degree of healthy to work from. My preference would be to catch the psychopathology early, at about the 1/4 to 1/3 point, no later than 1/2 completion, but that’s not always possible (seldom possible in today’s climate relative to treating “parental alienation”).

The strategy of the narcissistic/(borderline) parent is to delay therapy and buy time for the pathology to become established in the child. The longer effective therapy is delayed, the more entrenched the child’s symptomatology becomes. Time is on the side of the narcissistic/(borderline) parent and the psychopathology.

When the youngest child retains some degree of healthy, then there are ways to use the youngest child’s continued healthy as a formative seed around which to reconstitute healthy parent-child and sibling relationships throughout the family, in which the remaining healthy of the youngest child can serve as a source of “social referencing” within therapy sessions for what constitutes “normal-range” and balanced.

This is particularly true if normal-range child grievances and “breach-and-repair” sequences between the targeted parent and the youngest child can be elaborated in therapy to achieve an effective and successful resolution, then this provides a model for the eldest child of how conflict and conflict resolution is handled in a healthy and productive way.

Protective Separation

Reunification therapy requires the child’s protective separation from the pathogenic parenting practices of the narcissistic/(borderline) parent during the active phase of the child’s treatment and recovery.

From a therapeutic perspective, the protective separation is needed in order to protect the child from being turned into a “psychological battleground” by the continuing psychological pressures applied to the child by the narcissistic/(borderline) parent designed to maintain the child’s symptomatic rejection of the other parent even while therapy is trying to restore the child’s affectionally bonded relationship with the targeted parent.

The analogy is to an infectious disease process (or more accurately, to a computer virus infecting the “files” of the child’s attachment system). The first step in treating an infectious disease is to isolate the child from the source of the pathogenic agent. If, for example, we try to treat the child with antibiotics while the child is continually re-exposed to the pathogenic agent (i.e., the germs or virus in the infection analogy; and the distorted parenting practices of the narcissistic/(borderline) parent in the “alienation” process), the child will simply become continually re-infected even as we try to treat the disease process, leading to the creation of a highly treatment resistant strain of the pathogenic agent.

The first step in treating attachment-based “parental alienation” is to protectively separate the child from the source of the pathogenic parenting during the active phase of the child’s treatment and recovery. Once we have restored the child’s normal-range and balanced psychological functioning, then we can boost the child’s natural “immune response” to the pathogenic agent and reintroduce the child to the psychopathology of the narcissistic/(borderline) parent.

Children love both parents. That is simply the way the attachment system works. We want the child to have healthy and positive relationships with both parents, and we also want to protect the child from the distorting influence of “corrupt files” contained within the attachment system of the narcissistic/(borderline) parent.

The Goal of Therapy

If we can obtain the child’s protective separation from the pathogenic psychopathology of the narcissistic/(borderline) parent during the active phase of treatment, then we can initiate the restoration of healthy and balanced child authenticity. A subtle point of therapy is that the goal is not to restore the parent-child relationship, the goal of therapy is to restore a healthy and balanced authentic child. If we are able to achieve this goal, then a healthy and positive parent-child relationship with the targeted parent will also be achieved.

Children love their parents. Restore the healthy and authentic child and we will restore a healthy and balanced parent-child relationship.

Of note is that normal-range children are sometimes annoying to their parents. This is an important part of the children’s healthy development in which they are expressing their own authenticity and individuation into the parent-child relationship.  We are not seeking “perfect children,” we are seeking psychologically, emotionally, and socially healthy children. Low-level episodes of child protest behavior and minor “breach-and-repair” sequences are not only normal, they are developmentally vital to the child’s healthy development of autonomous self-structure.

In addition, parents are often annoying to their children. Parents set limits, establish and enforce household rules, and have expectations for appropriate child social behavior. All of these parenting functions are normal-range and healthy, and all of these parental functions can, at times, provoke episodes of normal-range child protest behavior. Children can sometimes be annoying to parents. Parents can sometimes be annoying to children. This is normal-range and healthy.

Correcting Child Pathology

However, in attachment-based “parental alienation,” the child is expressing pathological narcissistic and borderline personality disorder traits acquired from the pathogenic parenting of the narcissistic/(borderline) parent. One of the primary interventions toward restoring the authentic child is to eliminate this expression of psychopathology by the child.

The treatment approach toward the psychopathology is to adopt a stance of relentless kindness, gentleness, understanding, and a relaxed-pleasant emotional tone within the simultaneous context of directly and steadfastly challenging the child’s expressions of narcissistic and borderline psychopathology (i.e., entitlement, a haughty and arrogant attitude of contempt, an absence of empathy, polarized black-and-white thinking, emotional tirades of verbal abuse, etc.).

Gandhi said, “the antidote is the opposite.” Think of the child’s hostile over-angry symptoms as a muscle spasm of the emotional system. We want to relax the spasming anger system. The emotion of relaxed pleasant-happy relaxes emotional spasms in the brain.

“No worries. It’s all good. Everything is going to be okay. I love you very much.”

At the same time, we want to provide the child with clear social feedback that the psychopathology is a distorted symptom of pathology and that it is not acceptable, not because of who the targeted parent is, but because of who the child is. We are kind and compassionate because of our values, because of our character. We expect the child to display normal-range social behavior as a reflection of the child’s healthy and positive character.

We cannot force someone to be nice, we can only force them to be submissive. Kindness is a choice. Kindness is a mater of character. Using force with another person is a violation of the other person’s autonomy. The other person has a right to be who they are. We want to try to avoid discipline responses and instead shift to guidance based strategies of dialogue and communication that seek the child’s cooperation, not merely the child’s obedience (think Gandhi, who was relentlessly challenging, but who did so with gentle kindness and a willingness to dialogue).

At the same time, we have the right to reject the child’s angry, contemptuous, disrespectful attitude and behavior. That attitude and behavior is not acceptable. However, we also approach the child with an understanding that the symptomatic expressions are not emanating from the authentic child, but from the pathogen that has infected the child. The child has been held as a psychological hostage by a narcissistic/(borderline) parent (see “The Hostage Metaphor” article on my website; http://www.cachildress.org), and in that context the child has had to completely surrender psychologically to the psychopathology of the narcissistic/(borderline) parent in order to survive.

How would we respond to the child having a fever as a result of an pathogenic virus? The child has acquired a “computer virus” from the psychopathology of the narcissistic/(borderline) parent that is infecting the child’s emotional and relationship systems (primarily the attachment system, but also the empathy system). This pathogenic “computer virus” is crashing the child’s social and emotional functioning, which represents the symptom induced by the pathogen, the “fever” if you will.

We want to respond with calm and relaxed confidence in the healthy authenticity of the child, while also gently and relentlessly challenging the child’s current symptomatic pathology.

Harmonic Resonance: When we pluck the middle C string on a harp, the other two C strings an octave above and below also begin to vibrate in “harmonic resonance.” We want to do the same thing. We want to respond to the child’s authentic self, that is buried within the child, underneath the child’s symptomatic psychopathology, to reawaken the authenticity of the child through our “harmonic resonance” with it, through our fundamental confidence in the child’s inherent goodness of character.

The therapist can play an important role is this by offering the child a balanced third perspective on the child’s self-authenticity. The child has received one perspective of truth from the narcissistic/(borderline) parent, another perspective of truth from the targeted parent (which the child has been induced to reject). The therapist is in a position to offer a balancing and normal-range third perspective that calls forth and validates the child’s inherent goodness of character.

The Misattribution of Grief

This is a critical component of therapy (see “Reunification Therapy” article on my website; http://www.drcachildress.org). The child authentically feels hurt and pain as a product of the child’s relationship with the targeted parent. The origins of the child’s authentic hurt and pain is initially the result of the child’s grief response at the loss of the intact family structure that occurred with the divorce. But once the child is induced by the pathogenic parenting of the narcissistic/(borderline) parent to reject the other parent, who is actually deeply loved by the child, the child experiences a second and more profound grief response over the loss of an affectionally bonded relationship with the beloved but now rejected targeted parent.

However, under the distorting influence of the narcissistic/(borderline) parent, the child is led into a misinterpretation of this authentic experience of sadness and hurt as falsely representing an emotional signal that something the targeted-rejected parent is doing, or something about the mere personhood of the targeted parent, is so bad, so “abusive” of the child, that it is this quality of the targeted-rejected parent that is creating the child’s authentic experience of immense sadness and suffering associated with the targeted-rejected parent.

This attribution of meaning by the child, created under the distorting influence of the narcissistic/(borderline) parent, is not true, but in the absence of an accurate attribution of meaning the child comes to accept and believe the distorted meaning construction of the narcissistic/(borderline) parent for the child’s authentic experience of sadness and suffering associated with the targeted-rejected parent.

The accurate attribution of meaning is that the child actually loves the targeted parent very much, and very much wants and misses having an affectionally bonded relationship with this parent, but the child’s inability to establish this affectionally bonded relationship with the targeted-rejected parent is producing a tremendous grief response of sadness and suffering. It is as if the child’s beloved parent has died.

This is vitally important for the therapy process to understand. The child authentically experiences a deep sadness and hurt associated with the targeted-rejected parent, which the child is falsely attributing to the “abusive” parenting or personhood of the targeted-rejected parent (under the distorting pathogenic influence of the narcissistic/(borderline) parent).

Therapy needs to reorient the child to the child’s authentic grief response, and provide a balanced and accurate attribution to the child’s authentic experience. Once the child receives and recognizes an accurate attribution of meaning for the child’s sadness and pain, i.e., that the child actually loves the targeted parent and wants an affectionate bond with this parent, then the “computer virus” will be cleansed from the child’s emotional and relationship systems and the child can fulfill and complete the normal-range functioning of these brain systems.

However, while the child is in the parental care of the narcissistic/(borderline) parent, the child is in a psychological hostage situation and does not have permission from the hostage taker to form an affectionally bonded relationship with the beloved but rejected targeted parent, and the child is instead required by the hostage taker to actively reject the beloved other parent (see “The Hostage Metaphor” article on my website; http://www.cachildress.org). If the child shows any bonding motivations with the targeted parent, or even fails to adequately display overt rejection of the targeted parent, then the child faces a withering psychological retaliation from the psychopathology of the narcissistic/(borderline) parent.

Unless we can first protect the child from psychological retaliation from the psychopathology of the narcissistic/(borderline) parent for any child display of affectionate bonding or failure to display adequate rejection of the other parent, we cannot ask the child to bond with the targeted parent because to do so will only expose the child to psychological retaliation from the narcissistic/(borderline) parent.

We must first secure the child’s protection. Only then can we proceed with therapy.

(end Part I of Therapy)

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