Subjective Reality of the Narcissistic/(Borderline) Parent

Preface:

Equivalence of Core Narcissistic and Borderline Personality Dynamics

Narcissistic and borderline personalities are variants of the same underlying core dynamics.  While their superficial presentations differ, both the narcissistic and the borderline personality have the same underlying core structures.

Narcissistic and borderline personality structures represent the coalesced product of the “internal working models,” or “schemas,” of the attachment system. 

The attachment system creates “internal working models” regarding expectations for self-in-relationship and other-in-relationship.  Within the attachment system for both the narcissistic and borderline personality structures, the internal working model for self-in-relationship is “I am fundamentally inadequate as a person” and the other-in-relationship expectation is that “I will be abandoned by the other because of my fundamental inadequacy.”

The difference between the narcissistic and borderline personalities is that the borderline personality experiences these core beliefs directly and continually, resulting in continually disorganized emotions and relationships, whereas the narcissistic personality is able to develop a psychological defense of narcissistic self-inflation that prevents the direct experience of self-inadequacy and fears of abandonment.  Instead, the narcissistic personality projects the self-inadequacy onto others, who the narcissist then devalues and rejects for their inadequacy.  Puncture the narcissistic defense, however, and the underlying borderline emotional disorganization becomes evident in hostile tirades of venom and vitriol.

Kernberg, O.F. (1975). Borderline conditions and pathological narcissism.. New York: Aronson.

“One subgroup of borderline patients, namely, the narcissistic personalities… seem to have a defensive organization similar to borderline conditions, and yet many of them function on a much better psychosocial level.” (p. xiii)

Subjective Reality

For the narcissistic-borderline personality structure, truth and reality are fluid constructs that are subject to the ever changing emotional needs of the moment.

For both the narcissistic and borderline personality structure, regulating their intense emotional distress originating from their core sense of primal self-inadequacy and fear of abandonment takes precedence over external restrictions, even the external restrictions placed on them by truth and reality.  If they need truth or reality to be different in order to regulate their emotions, then they simply assert a different truth, a different reality.

“Narcissists are neither disposed to stick to objective facts or to restrict their actions within the boundaries of social custom or cooperative living… Free to wander in their private world of fiction, narcissists may lose touch with reality, lose their sense of proportion, and begin to think along peculiar and deviant lines.” (Millon, 2011, p. 415)

For the narcissistic/borderline personality, there is no objectivity to reality or truth. Reality and truth are subjective experiences that can change as the subjectivity of the narcissistic or borderline personality requires.  If the narcissistic/borderline personality requires the sky to be red, they simply assert the sky is red, and that becomes reality. If 10 minutes later they need the sky to be green,  they simply assert that the sky is green and that becomes reality.

For the narcissistic and borderline personality structure, “truth and reality are what I assert them to be.”

If we try to hold them accountable to a set and verifiable reality, the narcissistic/borderline personality will unleash a hostile assault of accusations, creating communication chaos with unrelated accusations, fabricated distortions, and flat denial of reality that follow so rapidly upon one another that the factual accuracy of any accusation or denial can’t be addressed.

The ability to assert whatever truth and reality is required in the moment thrives in chaos and dies in clarity. As long as chaos reigns, the narcissistic/borderline personality is free to assert and change reality and truth as needed.

Theodore Millon, one of the premier experts in personality disorders, describes the narcissistic propensity to dissolve into idiosyncratic thinking that is unconnected to reality,

“Were narcissists able to respect others, allow themselves to value others’ opinions, or see the world through others’ eyes, their tendency toward illusion and unreality might be checked or curtailed. Unfortunately, narcissists have learned to devalue others, not to trust their judgments, and to think of them as naïve and simpleminded. Thus, rather than question the correctness of their own beliefs they assume that the views of others are at fault. Hence, the more disagreement they have with others, the more convinced they are of their own superiority and the more isolated and alienated they are likely to become. These ideational difficulties are magnified further by their inability to participate skillfully in the give-and-take of shared social life… They are increasingly unable to assess situations objectively, thereby failing further to grasp why they have been rebuffed and misunderstood. Distressed by these repeated and perplexing social failures, they’re likely, at first, to become depressed and morose. However, true to their fashion, they will begin to elaborate new and fantastic rationales to account for their fate. But the more they conjecture and ruminate, the more they lose touch, distort, and perceive things that are not there. They may begin to be suspicious of others, to question their intentions, and to criticize them for ostensive deceptions…

“Deficient in social controls and self-discipline, the tendency of CEN narcissists to fantasize and distort may speed up. The air of grandiosity may become more flagrant. They may find hidden and deprecatory meanings in the incidental behavior of others, becoming convinced of others malicious motives, claims upon them, and attempts to undo them. As their behaviors and thoughts transgress the line of reality, their alienation will mount, and they may seek to protect their phantom image of superiority more vigorously and vigilantly than ever. Trapped by the consequences of their own actions, they may become bewildered and frightened as the downward spiral progresses through its inexorable course. No longer in touch with reality, they begin to accuse others and hold them responsible for their own shame and failures. They may build a “logic” based on the irrelevant and entirely circumstantial evidence and ultimately construct a delusion system to protect themselves from unbearable reality.” (p. 415)

Yet the narcissistic/borderline personality can superficially present well, so that the extent of their psychopathology goes unnoticed, even by mental health professionals.  According to Cohen (1998),

“The perception [of narcissism in a patient] is hampered by the fact that narcissistic individuals may well be intelligent, charming, and sometimes creative people who function effectively in their professional lives and in a range of social situations (Akhtar, 1992; Hendler, 1975)… While narcissism is recognized as a serious mental disorder, its manifestations may not be immediately recognized as pathological, even by persons in the helping professions, and its implications may remain unattended to. (p. 197)

Beck et al., (2004) note that narcissists can display “a deceptively warm demeanor” (p. 241) and Millon (2011) describes that “when not faced with humiliating or stressful situations, CENs [confident-egoistic-narcissists] convey a calm and self-assured quality in their social behavior. Their untroubled and self-satisfied air is viewed by some as a sign of confident equanimity” (p. 388-389).

The borderline personality can also present well superficially. The borderline style will present as a victim of cruelty from others that elicits a nurturing/protective response from unsophisticated mental health professionals.  As long as these mental health professionals do not challenge the constructed “reality” presented by the borderline personality, then these mental health professionals will be co-opted into becoming allies within the splitting dynamic of the borderline personality, and will be rewarded with displays of gratitude as the all-good wonderfully understanding and protective other within the borderline’s splitting dynamic. 

Being the idealized, all-wonderful, perfectly understanding and protective other can be quite seductive for the naive and unsophisticated mental health professional, who is by nature a helpng person.  But it represents a failure of professional knowledge and understanding in favor of the personal ego-gratification of the mental health professional.

The borderline personality is quite adept at presenting in the victim role to elicit protective nuturance from others.  A leading figure in personality disorders, Aaron Beck, notes that is is often difficult even in his own clinic to recognize the borderline personality presentation,

“Underdiagnosis constitutes a big problem that results in insufficient treatment. In many cases we saw, it took years of fruitless attempts to treat these patients before it became clear they were in fact suffering from BPD [borderline personality disorder].” (Beck et al., 2004, p. 196)

Special Population

The children and families evidencing attachment-based “parental alienation” represent a “special population” requiring specialized professional knowledge, training, and expertise to professionally diagnose and treat. 

Among the domains of knowledge necessary is a professional level of expertise regarding the presentation features and underlying dynamics of narcissistic and borderline personality structures.  Expertise in narcissistic and borderline personalities is not typical for most child and family therapists since personality disorders are an extremely rare presentation in children, and a rare presentation in parents. 

Child and family therapists tend to focus on the common disorders of childhood, child oppositional-defiant behavior, attention deficits and hyperactivity, autism-spectrum problems.  A professional level of expertise in narcissistic and borderline personality characteristic presentations and dynamics is typically not something most child and family mental health professionals possess. 

In most, if not nearly all, cases of typical child and family issues the therapist can trust that the reports of parents are within an acceptable range of truth and reality.  This assumption is not necessarily accurate when interacting with narcissistic and borderline personalities.  Mental health professionals working with this “special population” of children and families require specialized professional knowledge, training, and expertise related to narcissistic and borderline personality characteristics and dynamics so that they may be alert for the profound distortions of truth and reality associated with narcissistic/borderline personality processes.

In addition, narcissistic and borderline personality dynamics are not necessarily easily recognizable.  However, narcissistic and borderline personality dynamics are DIRECTLY RELEVANT to the diagnosis and treatment of attachment-based “parental alienation” so that these personality dynamics are directly relevant to professional competence with this “special population” of children and families.

Professionals who are diagnosing and treating attachment-based “parental alienation” require specialized professional knowledge, training, and expertise for professional competence with this “special population” of children and families, and one of the most important domains of specialized expertise is in the recognition of narcissistic and borderline personality dynamics within the family.

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

References

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

Cohen, O. (1998). Parental narcissism and the disengagement of the non-custodial father after divorce. Clinical Social Work Journal, 26, 195-215

Millon. T. (2011). Disorders of personality: introducing a DSM/ICD spectrum from normal to abnormal. Hoboken: Wiley.

The Regulatory Other

This post will discuss the concept of the “regulatory other,” which is an important parent-child relationship construct from early childhood mental health. The concept of the “regulatory other” will become a key construct in understanding how the “alienation” is created with the child.

A common misconception is that the “alienation” is produced by the narcissistic/(borderline) parent making disparaging criticisms of the other parent in front of the child.  This is not true.  This is not how the “alienation” occurs.  There are a variety of factors involved in creating the “alienation” of the child, but one of the primary constructs is the concept of the “regulating other.”

However, before directly addressing the construct of the “regulating other” I am going to lay some foundational context for the construct in the scientific evidence emerging from research in child development and the neuro-development of the brain during childhood.  I ask your patience with this foundational material.  I think the payoff in understanding the construct of the regulatory other will reward your patience.

Key Construct: Regulation

The constructs of “regulation” and “dysregulation” have become primary concepts regarding the organized functioning of brain systems and their expression in emotional and behavioral displays.

The concepts of “regulation” and “dysregulation” of brain systems, behavioral systems, and emotional systems can best be understood through an analogy to a thermostat that “regulates” a room’s temperature. If the room temperature becomes too warm, the thermostat registers this change and automatically turns on the air-conditioner to bring the room temperature back into a comfortable mid-range. If the room temperature becomes too cold, the thermostat picks this up and automatically turns on the heater to bring the room temperature back into a comfortable mid-range. The thermostat “regulates” the room’s temperature, keeping the temperature within the optimal range of comfort.

As an aside, thermostats regulate the room temperature around a “set-point” which is the desired room temperature around which the actual room temperature fluctuates. There is evidence of “set-points” in the regulatory systems of the brain that differ from person to person. For example, people vary in their “set-points” for social regulation. Some people are highly social and gregarious (a high-set point for regulating social interaction) while other people are reserved and shy (i.e., a low set-point for regulating social interaction).  Our regulatory systems keep our behavioral, social, emotional, and brain functioning in an integrated optimal range for adaptive functioning around various set-points.

Basic Brain Principles

1. Behavior is a symptom. The brain is the cause.

The disorganized and dysregulated functioning and integration of various brain systems produce disorganized and dysregulated behavior and emotional displays.  

Because dysregulated child behavioral and emotional displays are annoying to us, we used to call these displays “problem behaviors.”

However, as we have learned more about how the brain works we have come to recognize that these child displays of dysregulated behavior play an important role in healthy child development, and we have shifted the term we use to describe these behaviors from “problem behaviors” because they annoy us, to “protest behaviors”  that are designed to elicit the involvement of the caregiver… by annoying us so that we intervene to make these behaviors stop.

What the brain wants is for us to intervene.  It accomplishes this by making “protest behaviors” annoying.

Understanding the neuro-developmental role of child protest behavior is one of the major advancements in our understanding of child development during the past 50 years.  Unfortunately, most mental health professionals are not aware of the conceptual shift because of their ignorance regarding the scientific advances made in the neuro-developmental research regarding child development.

The qualities and patterns of the child’s disorganized and dysregulated behavior and emotions reveal what features of the underlying brain systems are not properly integrated in their functioning. This is diagnosis.

Diagnosis involves using the features of the child’s emotional and behavioral dysregulation to understand what features of the child’s underlying brain systems are problematic. In some cases the problem is inherent to the maturation of the child’s brain systems, in other cases the problem lay in the parent’s responses to the child. In some cases it’s both. The features of the child’s behavioral and emotional displays will answer the causal-origin question for us.

Mental health professionals who are knowledgeable in a neuro-social approach can become pretty good at reading the underlying state of the integrated or non-integrated functioning of brain systems based on the external behavioral and emotional displays of the child. The first step in this process is to understand what the various brain systems are, how they function, and also how they interact with each other to create regulated and organized behavior. The second step is to understand the various patterns indicating dysfunction in the separate brain systems and in their integrated organization.

Most mental health professionals, however, never learn about brain development. In my experience, this sort of advanced training only occurs in the early childhood specialty, and those mental health professionals that enter early childhood mental health usually do so because they like working with infants, so that they typically don’t return to working with older children and adolescents. They like infant mental health and they stay in early childhood mental health.  So you’ll likely not find many therapists working with older children or adolescents who understand brain development in childhood.

The mental health professionals currently working with older children and families have typically never received training on brain processes in child development, and are still using outmoded and archaic models of behaviorism from the 1940s-50s or humanistic “play therapy” models from the 1950s-60s, models that were created well before the major advances in the scientific research on brain and child development that have occurred since the mid-1980s.

The current state of “child therapy” generally is appallingly inadequate. But that’s a topic for another time.

In response to child “protest behaviors” the intervention of the parent acts as a “regulatory other” for the child by helping to restore the organized and regulated functioning and integration of the child’s brain systems, which then restores the organized and regulated behavioral and emotional displays of the child. This pattern represents a healthy parent-child relationship.

Teaching parents how to respond effectively as a “regulatory other” for their child is therapy.  Or at least this is what therapy should be. It is not what most therapists do since most therapists don’t know how the brain works and develops during childhood.  When I work with children and families, I’m actually monitoring and intervening on the underlying brain systems, whereas most mental health professionals are simply intervening on the level of behavior.

Behavior is the symptom. The brain is the cause.

If we simply seek to suppress the symptom then we continually need to engage in symptom suppression efforts since we have never resolved the underlying cause of the symptom. If, however, we use the symptom to diagnose the cause, then we treat the cause, resolve the cause, and the symptom goes away, often without our ever having to directly address the actual symptom itself.

Imagine if we had an infection that caused a fever.  We could treat the fever, the symptom, with Tylenol or aspirin but we would continually need to suppress the fever because we haven’t addressed the underlying cause, the infection.  Now imagine if we used the symptom of the fever to diagnose an infection so that we then treat the infection with antibiotics, cure the infection, and the fever goes away without ever having to directly address it.

Behavior is the symptom, the brain is the cause.  We need to read the symptom of the behavior for what it says about the underlying integrated or non-integrated functioning of the underlying brain systems.

However, outside of early childhood mental health, very few therapists possess the knowledge of brain systems and their integrated functioning necessary to work at an neuro-systemic level, so that very few therapists operate from this type of scientifically based neuro-social approach. This approach, however, is common in early childhood diagnosis and treatment, which has a heavy focus on relationship-based diagnosis and treatment relative to the functioning of the various brain systems involved.

The Primary Brain Systems:

There are six primary brain systems and three overarching brain systems.  The six primary brain systems are:

  1. Physical sensory-motor systems
  2. Emotion systems
  3. Language and communication systems
  4. Relationship systems (attachment and intersubjectivity)
  5. Cognitive/executive function systems
  6. Three motivational systems

Active exploratory learning: Traditionally called “play,” this motivational system is primarily embedded in the sensory-motor and emotional networks, it is an early activating motivational system during childhood that has a basic agenda of “seek pleasure and avoid pain.”

Goal-directed motivating system: Traditionally called “work,” this motivating system is embedded in the executive function networks and involves a sequencing of three phases. First, establishing an overarching goal that organizes attention and behavior; second, applying effort toward achieving the goal; and third, accomplishing the goal, at which point the brain produces a burst of positive brain chemical that tells the neural networks used in achieving the goal to keep whatever changes were made because they were successful in achieving the goal. The more effort is applied toward achieving a goal, the larger the burst of positive brain chemical released upon achieving the goal.

Relationship motivating systems: The relationship systems of attachment and intersubjectivity are primary motivational systems at the same level as the other primary motivational systems for food and reproduction. There is an inhibitory network from the two relationship systems back to the play-based and goal-directed motivational systems, so that the relationship motivating systems always take precedence. Only if the two relationship systems are satisfied and quiescent will the play-based or goal-directed motivating systems be allowed to fully organize and direct activity. If either of the two relationship motivating systems are active, then the child’s primary motivational agenda will be to satisfy the relationship needs, and the activated relationship needs will inhibit the ability of the child to achieve a full activation of either the play-based or goal-directed motivational networks.

The three (interrelated) overarching brain systems are:

  1. The Self-system
  2. Memory systems
  3. Meaning Attribution systems

2. Brain Principles: “We build what we use”

Brain systems develop interconnections based on the principle of “we build what we use.” The renowned neuroscientist, Donald Hebb, referred to this as “neurons that fire together, wire together.” In the scientific literature, this process is called the “canalization” of brain networks (like building “canals” or channels in the brain).

In explaining this to parents, I’ll often use the metaphor of raindrops falling on a dirt hillside. The first raindrop can go any direction, but whatever path it takes it will remove a little dirt with it as it glides down the hillside. Gradually, as more and more raindrops fall, channels or “canals” begin to be grooved into the hillside directing the flow of subsequent raindrops.

Whenever we use a brain pathway or system, changes take place along the neural pathway that create structural and chemical channels or “canals” in the brain that make it more likely that this neural pathway or set of brain cells will be used in the same interconnected pattern in the future. “Neurons that fire together, wire together.”

Two of the primary neural processes involved in the “canalization” of brain pathways (i.e., “we build what we use”) are called “long-term potentiation” and “synaptogenesis.” There is some very interesting work on the neuro-structural and chemical underpinnings of the canalization process done with sea slugs because their neural networks are simple and their neural cells are relatively large, making their study easier. The neural-structural processes of canalization actually involve triggering and altering genetic code, and are quite complex involving neuro-modulators and secondary and tertiary feedback systems (Kandel, 2007). The brain is a very interesting place.

The canalization of neural pathways is called the “use-dependent” development of the brain, and the role of the parent in facilitating the child’s use of particular neural pathways in response to different child behaviors is called “scaffolding,” like building a supportive scaffold around a structure as its being constructed.

Child development isn’t about rewards and punishments, these are mechanisms of social control. Child development is about the scaffolding support provided by parental relationship and communication qualities for the integrated functioning of the various brain systems. Current “behavioral” and “play therapy” approaches to child therapy are woefully out of touch with the scientific advances that have occurred in the past 50 years. In the domain of child therapy, the level of professional ignorance regarding child development and the development of the brain during childhood is disturbing.

The brain possesses a variety of regulatory networks that seek to maintain the brain’s integrated functioning in the optimal range for organized and adaptive functioning. When system elements begin to become too active or inactive, various regulatory systems will activate to turn up or down the levels of various brain systems seeking to keep the overall functioning of the brain in an organized and regulated state for optimal adaptive functioning.

During childhood, the immature development of the child’s brain means that the integrated functioning of the child’s various brain systems will often become dysregulated by maturation challenges that the child cannot independently master. This disorganization in the integrated functioning of the various brain systems will produce disorganized displays of behavior and emotions (behavior is a symptom, the brain is the cause). 

These displays of disorganized and dyregulated emotions and behavior are called “protest behaviors”  whose developmental purpose is to elicit the involvement of the parent (i.e., of a more mature nervous system) to act as a “regulatory other” for the child. The parent then responds to the child’s protest behavior by “scaffolding” the child’s transition back into an organized and regulated brain state reflected in organized and regulated behavior.

In the process of “scaffolding” the child’s state transition from a disorganized and dysregulated brain state (and behavior) back into an organized and regulated brain state (and behavior), all of the brain pathways that were used as part of this state-transition become “canalized” through “use-dependent” neural processes, thereby making this state-transition more likely to occur in the future.

Gradually, over repeated “scaffolding” by the “regulatory other” of the parent for the child’s state transitions from disorganized and dysregulated brain states to organized and regulated brain states, the child’s brain develops (“canalizes”) the neural pathways for this state transition through use-dependent structural and chemical processes, so that eventually the child is able to make this transition from an impending dysregulated brain state/behavior into a regulated brain state/behavior independently of the need for scaffolding support from the “regulatory other” of the parent. This is called the child’s development of “self-regulation.”

One type of this self-regulation development that the general public may be familiar with is called “frustration tolerance” which occurs through the repeated exposure and successful processing of minor and gradually increasing frustration experiences.

All brain systems are subject to this use-dependent development of self-regulation capacities. This is the current science on child development.

Shore (1997), for example, identifies the shift from the behaviorist paradigm to a neuro-developmental paradigm,

“The basic unit of analysis of the process of human development is not changes in behavior, cognition, or even affect, but rather the ontogenetic appearance of more and more complex psychobiological states that underlie these state-dependent emergent functions.” (Shore, 1997, p. 595).

Shore, A.N. (1997). Early organization of the nonlinear right brain and development of a predisposition to psychiatric disorders. Development and Psychopathology, 9, 595-631.

Sroufe (2000) describes the development of self-regulation through parental scaffolding,

“In the typical course of events, caregivers quickly learn to “read” the infant and to provide care that keeps distress and arousal within reasonable limits.” (Childress comment: the parent is acting as a “regulatory other.”)

“And they do more. By effectively engaging the infant and leading him or her to ever longer bouts of emotionally charged, but organized behavior, they provide the infant with critical training in regulation.”

“The movement toward self-regulation continues throughout the childhood years, as does a vital, though changing, role for caregivers. During the toddler period, the child acquires beginning capacities for self-control, tolerance of moderate frustration, and a widening range of emotional reactions, including shame and, ultimately, pride and guilt. Practicing self-regulation in a supportive context is crucial. Emerging capacities are easily overwhelmed. The caregiver must both allow the child to master those circumstances within their capacity and yet anticipate circumstances beyond the child’s ability, and help to restore equilibrium when the child is over-taxed. Such “guided self-regulation” is the foundation for the genuine regulation that will follow.” (Sroufe, 2000, p. 71)

3. Brain Principles: Protest Behavior

The following principles regarding the developmental role of “protest behavior” are important for understanding the child’s anger and rejection that is being expressed toward the targeted parent in attachment-based “parental alienation.”  Children’s authentic protest behavior is designed to elicit greater involvement from the parent who acts as a “regulatory other” for the child’s protest behavior, helping the child transition from a dsyregulated state (evidenced by the protest behavior) back into an organized and regulated state (evidenced by a pleasant attitude of cooperation).

Authentic protest behavior is never designed to sever the parent-child relationship. From the perspective of evolution, severing of the parent-child relationship exposed children to predation and other environmental dangers. Genes allowing the severing of the parent-child bond were selectively removed from the gene pool throughout millions of years of evolution.

Furthermore, regarding the authentic functioning of the brain, when children are dealing with parental behaviors that are unresponsive and problematic, this problematic parental behavior dysregulates the integrated functioning of the child’s brain systems so that the child produces disregulated emotional and behavioral displays (i.e., protest behavior) designed to elicit the involvement of the parent to serve as a “regulating other” for the child in providing scaffolding support for the child’s transition back into a regulated state, thereby building all of the neural networks associated with the developmental challenge that the child had difficulty independently mastering.

That’s how the brain works.

Sometimes the child may seek to limit involvement with a problematic parent, but this is always a regulatory strategy arising from the disorganized functioning and integration of the underlying brain systems. It is not the product of a motivated desire to sever the parent-child bond.

One of the often prominent features of the child’s anger and hostility toward the targeted parent in attachment-based “parental alienation” is that the child’s anger emerges from an organized and well-regulated child brain state. When this occurs, it means that the anger and hostility directed toward the targeted parent is not authentic to the parent-child interaction but represents a conscious choice by the child.

Authentic protest behavior is a product of a disorganized/dysregulated brain.  Behavior is a symptom, the brain is the cause.

Dysregulated behavior and a regulated brain are incompatible, and so are not authentic. Dysregulated behavior is caused by a dysregulated brain.

A regulated brain means that the child is making a conscious choice to display the apparently dsyregulated behavior of engaging in the parent-child conflict with the targeted parent, which is very different from an authentic parent-child conflict that results from an underlying disorganized and dysregulated integration of brain systems.

Important Concept:

Authentic problematic parenting dysregulates the child’s brain systems, thereby producing dysregulated child behavior, i.e., the child’s protest behavior.

If the child’s brain state is well-regulated as the child is emitting protest behavior, then the emitted protest behavior is NOT being caused by problematic parenting.

Behavior is a symptom. The brain is the cause.

The more that mental health professionals understand about the neurodevelopment of the brain during childhood, the easier it becomes to differentiate authentic from inauthentic parent-child conflict.

With my background in early childhood mental health and the neurodevelopment of the brain during childhood, spotting inauthentic displays of parent-child conflict associated with attachment-based “parental alienation” is extraordinarily easy. Might as well put up a neon sign saying, “Parental Alienation Here.”

This also means that I am able to spot with equal clarity false allegations of “parental alienation” in which the child’s conflicts with the targeted parent represent authentic responses to the problematic parenting behavior of the targeted parent.

Not everything is “parental alienation,” and the goal of all mental health professionals should be to follow the clinical data into an accurate diagnosis, not to promote an agenda or confirm pre-existing ideas.

My client is the child.  The child is displaying symptoms.  My job is to read the symptoms to accurately identify their causal origin so that we can intervene to restore the healthy development of the child.

If the problem is the parenting practices of the targeted parent (i.e., authentic parent-child conflict), that’s pretty easy to solve. We simply instruct the targeted parent in the appropriate parental responses that will act as a “regulatory other” for the child’s dysregulated behavior and emotional displays (the child’s protest behavior).  As soon as the parental responses are appropriate to the parental role as a “regulatory other” for the child’s displays of dysregulated brain states, the child’s protest behavior resolves.

Differentiating authentic versus inauthentic parent-child conflict is not about identifying specific child behaviors, although the differences are evident in certain features of behavior, it’s more about identifying the underlying brain states producing those behaviors. To do this, however, requires a professional level understanding for the socially-mediated neurodevelopment of the brain during childhood. Most mental health professionals do not possess this knowledge. They should. But they don’t.

Knowing what I know about the socially mediated neurodevelopment of the brain during childhood and its implications for child and family therapy, I am strongly of the opinion that we should require that all mental health professionals who are diagnosing and treating children possess the current scientific knowledge regarding child development and the development of the brain during childhood.

It is deeply disturbing to me that we don’t require more advanced knowledge from child and family therapists, and that we accept professional ignorance when it comes to diagnosing and treating our children. Our children and their healthy development are too important and should be paramount in determining the educational curriculum and training of therapists. Our child and family therapists should be the most exceptional of professionals in mental health. It’s too important.

The Regulatory Other in “Parental Alienation”

One of the central concepts in the neurodevelopment of self-regulatory abilities in childhood is the role of the parent as a “regulatory other” for the child. When the child begins to enter a disorganized and dsyregulated state, the parent responds in a way that restores the child’s regulated functioning. The child is using the parent as a “regulatory other” for the child’s own internal state.

Shore (1997) describes the specific relationship features of the parental “regulatory other” role function,

“The mother must monitor the infant’s state as well as her own and then resonate not with the child’s overt behavior but with certain qualities of its internal state, such as contour, intensity, and temporal features.” (Shore, 1997, p. 600)

Tronick (2003) also describes the relationship features of the “regulatory other” parent-child relationship,

“In response to their partner’s relational moves each individual attempts to adjust their behavior to maintain a coordinated dyadic state or to repair a mismatch (Tronick & Cohn, 1989). When mutual regulation is particularly successful, that is when the age-appropriate forms of meaning (e.g., affects, relational intentions, representations; see Tronick 2002c, d) from one individual’s state of consciousness are coordinated with the meanings of another’s state of consciousness — I have hypothesized that a dyadic state of consciousness emerges.” (Tronick, 2003, p. 475)

“A dyadic state of consciousness has dynamic effects. It increases the coherence of the infant’s state of consciousness and expands the infant’s (and the partner’s) state of consciousness (Tronick et al., 1998; Tronick 2002b, c.)” (Tronick, 2003,p. 475)

“Thus, dyadic states of consciousness are critical, perhaps even necessary for development” (Tronick and Wienberg, 1997),” (Tronick, 2003, p. 475)

In severely pathological parent-child relationships, however, this role-relationship of the parent and child is reversed, so that it is the parent who uses the child as a “regulatory other” to regulate the parent’s own pathology.

This is called a “role-reversal” relationship in which the child is being used as a “regulatory other” for the parent, instead of a healthy and developmentally vital parent-child relationship in which the child is using the parent as “regulatory other.”

In the Journal of Emotional Abuse, Kerig discusses the problematic development created by role-reversal relationships involving parent-child boundary violations such as the parent using the child as a “regulatory other” for the parent’s emotional state,

“The breakdown of appropriate generational boundaries between parents and children significantly increases the risk for emotional abuse.” (Kerig, 2005, p. 6)

“In the throes of their own insecurity, troubled parents may rely on the child to meet the parent’s emotional needs, turning to the child to provide the parent with support, nurturance, or comforting (Zeanah & Klitzke, 1991).” (Kerig, 2005, p. 6)

(Childress comment: the parent is using the child as a “regulatory other” for the parent’s emotional state.)

Ultimately, preoccupation with the parents’ needs threatens to interfere with the child’s ability to develop autonomy, initiative, self-reliance, and a secure internal working model of the self and others (Carlson & Sroufe, 1995; Leon & Rudy, this volume).” (Kerig, 2005, p. 6)

“When parent-child boundaries are violated, the implications for developmental psychopathology are significant (Cicchetti & Howes, 1991). Poor boundaries interfere with the child’s capacity to progress through development which, as Anna Freud (1965) suggested, is the defining feature of childhood psychopathology.” (Kerig, 2005, p. 7)

“Examination of the theoretical and empirical literatures suggests that there are four distinguishable dimensions to the phenomenon of boundary dissolution: role reversal, intrusiveness, enmeshment, and spousification. (Kerig, 2005, p. 8)

Enmeshment in one parent-child relationship is often counterbalanced by disengagement between the child and the other parent (Cowan & Cowan, 1990; Jacobvitz, Riggs, & Johnson, 1999). (Kerig, 2005, p. 10)

“However, an emotionally needy parent who is threatened by the child’s emergent sense of individuality may act in ways so as to prolong this sense of parent-infant oneness (Masterson & Rinsley, 1975). By binding the child in an overly close and dependent relationship, the enmeshed parent creates a psychologically unhealthy childrearing environment that interferes with the child’s development of an autonomous self.” (Kerig, 2005, p. 10)

“Barber (2002) defines psychological control as comprising “parental behaviors that are intrusive and manipulative of children’s thoughts, feelings, and attachments to parents, and are associated with disturbances in the boundaries between the child and the parent” (p. 15) (see also Bradford & Barber, this issue).” (Kerig, 2005, p. 12)

“As Ogden (1979) phrased it, “It is as if the parent says to the child, if you are not what I need you to be, you do not exist for me” (p. 16).” (Kerig, 2005, p. 12)

“Rather than telling the child directly what to do or think, as does the behaviorally controlling parent, the psychologically controlling parent uses indirect hints and responds with guilt induction or withdrawal of love if the child refuses to comply. In short, an intrusive parent strives to manipulate the child’s thoughts and feelings in such a way that the child’s psyche will conform to the parent’s wishes.” (Kerig, 2005, p. 12)

“In order to carve out an island of safety and responsivity in an unpredictable, harsh, and depriving parent-child relationship, children of highly maladaptive parents may become precocious caretakers who are adept at reading the cues and meeting the needs of those around them. The ensuing preoccupied attachment with the parent interferes with the child’s development of important ego functions, such as self organization, affect regulation, and emotional object constancy.” (Kerig, 2005, p. 14)

“There is evidence for the intergenerational transmission of boundary dissolution within the family. Adults who experienced boundary dissolution in their relationships with their own parents are more likely to violate boundaries with their children (Hazen, Jacobvitz, & McFarland, this volume; Shaffer & Sroufe, this volume).” (Kerig, 2005, p. 22)

Kerig, P.K. (2005). Revisiting the construct of boundary dissolution: A multidimensional perspective. Journal of Emotional Abuse, 5, 5-42.

The seduction of the child into the role as a “regulatory other” for the pathological parent is a result of the disorganized and intense emotional displays by the pathological parent. In response to the parent’s unpredictable displays of intense anxiety, sadness, or anger, the child learns to become hyper-vigilant regarding the parent’s internal state so that the child can respond in ways that prevent the parent from collapsing into a disorganized emotional state of excessive anxiety, sadness, or anger.

The child becomes the “regulatory other” for the parent, so that the child becomes adept at responding to the pathological parent in ways that keep the pathological parent in an organized and regulated state. Once the child becomes the “regulatory other” for the pathological parent, the parent simply needs to provide the child with subtle emotional and communicative cues as to how to maintain the parent’s regulated emotional state and the child will actively become what the parent needs the child to be.

In healthy parent-child relationships, the parent acts as the “regulatory other” for the child.

In the psychopathology of the “role-reversal” relationship, the child acts as the “regulatory other” for the parent.

A role-reversal relationship is extremely destructive to the healthy emotional and psychological development of the child.

Role-reversal relationships are associated with the “disorganized” category of attachment (Lyons-Ruth, Bronfman, & Parsons, 1999), which is considered to be the most severely pathological attachment category, and disorganized attachment, in turn, is associated with the development of borderline personality processes (Beck, 2004).

In attachment-based “parental alienation” the narcissistic/(borderline) parent’s attachment classification is likely to be “disorganized,” which in adults is called “unresolved trauma.” As a manifestation of the internal working models of relationship contained within the narcissistic/(borderline) parent’s attachment networks, the narcissistic/(borderline) parent forms a role-reversal relationship with the child, using the child as a “regulatory other” for the narcissistic/(borderline) parent’s own emotional regulation.

Parental Anxiety Regulation

For the narcissistic/(borderline) parent, the interpersonal rejection inherent to the divorce represents a “narcissistic injury” that threatens to collapse the narcissistic defense against the experience of primal self-inadequacy.  

The interpersonal rejection of the divorce also activates an intense fear of abandonment associated with borderline personality processes.

At the attachment system level, the attachment system forms “internal working models,” also called “schemas,” for expectations of self-in-relationship and other-in-relationship. For the “disorganized” category of attachment, the self-in-relationship expectation is that “I’m inadequate,” while the expectation of the other-in-relationship is that “I will be abandoned by the other because I’m inadequate.”

These “internal working models” within the attachment system coalesce during later childhood and adolescence into stable personality structures, with the “I’m inadequate” self-in-relationship schema reflected in narcissistic personality processes, while the abandoning other-in relationship expectation becomes reflected in borderline personality processes of an intense fear of abandonment.

Both the narcissistic and the borderline personality processes have the same underlying attachment schemas of “I’m inadequate” and “I will be abandoned because of my inadequacy.” The difference between the borderline and narcissistic personality processes is that the borderline personality experiences these internal core attachment beliefs directly, which leads to overtly disorganized behavior, emotions, and relationships, whereas the narcissistic personality has adopted a defensive veneer of narcissistic self-inflation against the direct experience of these internal core attachment schemas. However, if the narcissistic defensive veneer is threatened, the narcissistic personality responds with a disorganized tirade of intense anger consistent with the underlying borderline personality organization.

“Most of these [narcissistic] patients present an underlying borderline personality organization.” (Kernberg, 1975, p. 16)

In response to the interpersonal rejection inherent to the divorce (i.e., narcissistic injury and abandonment), the narcissistic/(borderline) parent engages the child in a role-reversal relationship as a “regulatory other” in order to regulate the intense anxiety experienced by the narcissistic/(borderline) parent associated with the threatened collapse of the narcissistic defense against the experience of primal inadequacy and a tremendous fear of abandonment.

As the child adopts the role as the “regulatory other” for the narcissistic/(borderline) parent’s pathology in order to avoid the emotional collapse of the narcissistic/(borderline) parent into chaotic and unpredictable displays of intense parental anxiety, sadness, or anger it becomes relatively easy for the narcissistic/(borderline) parent to then communicate to the child through clear but subtle “emotional signals” and “relational moves” that the parent’s emotional regulation is dependent on the child adopting the “victimized child” role in the narcissistic/(borderline) parent’s trauma reenactment narrative.

In the role as a “regulating other” for the narcissistic/(borderline) parent, the child readily adopts the parentally-desired role as the “victimized child” of the other “abusive parent” in order to keep the narcissistic/(borderline) parent from collapsing into intense emotional states of anxiety, sadness, or anger.

The induction of child symptoms is NOT accomplished by the narcissistic/(borderline) parent overtly “alienating” the child by saying derogatory things about the other parent. The induction process is much more insidious and complex.

The child is induced into becoming the “regulatory other” for the narcissistic/(borderline) parent in order to avoid parental displays of anger and rejection (or in some cases parental displays of intense sadness or anxiety), and the child is seduced into psychologically surrendering to the influence of the narcissistic/(borderline) parent through parental displays of affection and narcissistic indulgence provided to the child for cooperating as the “regulatory other” for the narcissistic/(borderline) parent.

In response to the intense and unpredictable emotional displays by the narcissistic/(borderline) parent, the child becomes hyper-vigilant regarding the emotional and psychological state of the narcissistic/(borderline) parent in order to prevent the parent’s collapse into intense, dysregulated emotional displays of anxiety, sadness, or anger, and the child becomes what the parent needs (i.e., the “regulatory other” for the parent) in order to keep the parent in a regulated emotional state.

The child enters a role-reversal relationship to become a “regulatory other” for the narcissistic/(borderline) parent’s emotional state.

The narcissistic/(borderline) parent then communicates non-verbally to the child that what the parent needs from the child in order for the parent to remain emotionally regulated is that the child adopt the role of the “victimized child” relative to the other “abusive parent.”

The moment the child adopts the “victimized child” role within the trauma reenactment narrative of the narcissistic/(borderline) parent (see Trauma Reenactment in Parental Alienation post), this immediately imposes on the targeted parent the trauma reenactment role as the “abusive parent,” and allows the narcissistic/(borderline) parent to adopt and prominently display the coveted role as the all-wonderful “protective parent” within the trauma reenactment narrative.

Inducing the child into accepting the “victimized child” role is relatively easy. The narcissistic/(borderline) parent simply seeks a child criticism of the other parent through motivated and directive questioning by the narcissistic/(borderline) parent, and the child will readily comply in offering this parentally-desired criticism of the other parent in the child’s role as a “regulating other” for the narcissistic/(borderline) parent’s emotional state.

Once the narcissistic/(borderline) parent has elicited a child criticism of the other parent, the narcissistic/(borderline) parent then distorts, exaggerates, and inflames this elicited child criticism of the other parent into supposed evidence of the “abusive” parenting of the other parent. In the process the narcissistic/(borderline) parent supplies to the “regulating other” of the child the appropriate themes for denigrating the other parent.

Narcissistic/(borderline) parent: “How were things at your mother’s house?”

Child: Pretty good, we had pizza.” <The child responds authentically>

N/(b) parent: “Oh, I guess you like the food better better over there. Does she have better food over there than we have? <The father’s sharply hostile tone signals to the child that the child provided the wrong answer, and that the narcissistic/(borderline) parent is threatening to dysregulate into anger and rejection.>

Child: “No, I actually didn’t like it. It had pepperoni on it and I hate pepperoni.” <The child reads the parental cues and quickly corrects the response to one of criticism of the other parent to keep the narcissistic/(borderline) parent in an emotionally regulated state. The child actually likes pepperoni and liked the pizza he had at his mom’s house, but truth and accuracy are sacrificed in the service of keeping the narcissistic/(borderline) parent in a regulated emotional state.>

N/(b) parent: “Yeah, that’s just like her. She never considers what other people want, it’s always what she wants. She’s so selfish and inconsiderate. Hey, how about a snack. If she didn’t feed you well over there why don’t you grab some chips from the pantry and have a snack.” <The father’s return to a normal emotional tone signals to the child that the criticism was the correct response to keep the narcissistic/(borderline) parent emotionally regulated. The narcissistic/(borderline) parent then provides the child with the acceptable theme to use in criticizing the other parent (i.e., that his mom is selfish and self-centered) and the father provides the child with a narcissistic indulgence for providing the proper response of criticizing the mother.  All the while it APPEARS as if it is the child who is criticizing the other parent and that the narcissistic/(borderline) parent is simply being the “wonderfully nurturing and understanding” parent, i.e., the coveted “protective parent” role in the trauma reenactment narrative.)

N/(b) parent: “Did you and your mom do anything?” <The father isn’t satisfied, he’s seeking another criticism from the child. Perhaps the father wants to more firmly establish the interaction pattern since the child initially said everything was okay with his mom>

Child: “Yeah, she took me over to her parents’ house, but I didn’t have any fun over there.” <The child actually likes going to his grandparents’ house. He loves his grandparents and they dote on him.  But as a “regulatory other” for the narcissistic/(borderline) parent the child is hyper-vigilant for cues regarding how to keep the narcissistic/(borderline) parent in a regulated emotional state. The child recognizes that the parent wants the child to criticize the mother, so the child provides the father with the parentally-desired response that he didn’t have fun going to his grandparents house, So that while the child actually likes seeing his grandparents and actually had a good time over at their house, truth and accuracy are sacrificed at the moment in order to keep the narcissistic/(borderline) parent regulated. The only relevant consideration for the child is how to keep the narcissistic/(borderline) parent out of an angry retaliatory state that the father earlier signaled was imminent if the child did not provide the correct responses.>

N/(b) parent: “Oh God, I’m so sorry she dragged you over there. Her parents are just awful. They just drone on and on. It’s so boring. I’m sorry you had to endure that. Hey, why don’t we go buy you a new video game.” <The father inflames the child’s elicited criticism and in doing so he provides the theme for criticizing the grandparents in the future, so that later the child will report to the therapist, “I hate going over to my grandparents, it’s awful, they just talk on and on about stuff, I hate going over there.” And the therapist will never suspect that this criticism and theme were co-created with the allied and seemingly favored narcissistic/(borderline) parent. The father provides the child with another narcissistic indulgence for the child’s cooperation in psychologically surrendering to the narcissistic/(borderline) parent by adopting the “victimized child” role.>

N/(b) parent: “So, did you and you mom get along okay?  Did you have any arguments about anything?” <The father is still not satisfied.  He wants a more direct criticism of the mother so he asks the child directly for this criticism, first in general terms but then provides a specific prompt for the child.  The criticism of the other parent is elicited by directive and motivated questioning.  The child, as a regulatory other feels obligated to provide the father with the sought-for response, and the child realizes from previous interactions with the father that if he doesn’t get the desired criticism of the mother then he will be in an angry, hostile, and punitive mood. The child wants to avoid his father’s dysregulation into anger so the child needs to provide the parentally-desired response.  The problem is that the child and his mother had a good time together.  There were no arguments.  But the child needs to come up with something.>

Child:She got upset at me for leaving my stuff in the living room.” <Actually, the mother was simply annoyed that the child left his shoes and jacket in the living room and asked him to take his stuff to his room. But truth and accuracy are sacrificed in order to provide the narcissistic/(borderline) parent with the desired response to avoid the intense and unpredictable emotional displays that can result from a frustrated narcissistic/(borderline) parent.

N/(b) parent: “Oh my god! Really? She got angry at you for that?  She’s so controlling.  Everything has to be her way or she flies off into her rages.  I swear, she has anger management issues.  It was just like that in our marriage.  I know exactly what you’re talking about.  I can’t believe how controlling she is.  I’m sorry you have to put up with that  I wish she wouldn’t get so angry about the littlest thing. Come here and give me a hug.  I’m sorry she does that.” <It doesn’t take much of a criticism, the narcissistic/(borderline) parent will take even the smallest of criticism as the seed for distortion and exaggeration into supposed evidence of the other parent’s “abusive” parenting.  Notice how the child’s characterization of the mother as being “upset” is distorted and inflamed by the father into “angry” and ultimately into “rages.” The father also provides the child with the desired and acceptable themes for criticizing the mother, that she is “controlling” and has “anger management issues.” Notice too, the loss of boundaries, “I know exactly what you’re talking about,” as the father brings the marital relationship into the discussion, “she was just like that in our marriage.”  Finally, the father signals his approval of the child for criticizing his mother..>

As these parent-child interactions are continually repeated, the child comes to understand his role in the drama, to provide a criticism of the mother, the more extreme the criticism the better, until eventually when the child returns from a visitation with the mother and receives the father’s invitation for the criticism, the child responds with a full measure of antagonism for his mother,

N/(b) parent: “How were things at your mom’s house?” <the parental invitation for the criticism>

Child: “Horrible, I hate it over there. She’s so controlling. It always has to be what she wants or she gets so angry.  She gets angry over the littlest things. I hate it over there.”

N/(b) parent: “I’m so sorry she’s like that. Come here and give me a hug. I hate when she gets like that.  I wish she cared more about how you feel instead of her own stuff.  I’m sorry your mom is like that.  Well you’re home now, so you can relax.  How about a bowl of ice cream to help to get over being with your mom.”

And if anyone asks the child, does your dad say bad things about your mother in front of you, the child says, “No” because from the child’s immature perspective it appears as if it is the child who is offering the criticism of the mother, and that the father is just being “supportive” and “understanding” of the child. 

Also note how truth and accuracy are left behind in the “regulatory other” role of the child. In the psychological world of the narcissistic/(borderline) parent, “Truth and reality are what I assert them to be,” This is a hallmark of the narcissistic and borderline thinking process that the child is acquiring. 

In the moment, while the child is interacting with the unpredictable and emotionally dangerous narcissistic/(borderline) parent, the primary motivation of the child is to keep the narcissistic/(borderline) parent in a regulated emotional state and so avoid the parent’s collapse into hostile-angry-rejecting, overly sad and depressed, or hyper-anxious emotional displays.  If truth is bent or distorted, that’s a small price to pay. 

Gradually through repeated distorting interactions with the psychopathology of the narcissistic/(borderline) parent in which the child psychologically surrenders to the role as the “regulating other” for the narcissistic/(borderline) parent, the child acquires the same psychological characteristics of the narcissistic/(borderline) parent that the child is reflecting for the regulation of the narcissistic/(borderline) parent. 

The child’s acquisition of these parental narcissistic and borderline characteristics through the child’s role as the “regulatory other” for a narcissistic/(borderline) parent represent Diagnostic Indicator 2 for an attachment based model of “parental alienation” (see Diagnostic Indicators and Associated Clinical Signs post). 

These acquired characteristics include the narcissistic/(borderline) characteristic that “truth and reality are what I assert them to be.”  The presence in the child’s symptom display of this characteristic thought process, that “truth and reality are what I assert them to be,” is a particularly distinctive sign of attachment-based “parental alienation” that evidences the influence of a narcissistic/(borderline) parent on the child’s psychological processes.

In the vignette described above, the authentic child hurts at having criticized his mother. The authentic child feels like he betrayed his mother by cooperating in the “mom-bashing” exchange with his father. The child feels guilty. While the child had to criticize the mother in order to keep the narcissistic/(borderline) parent emotionally regulated, the child doesn’t realize this. The role as the “regulatory other” is too subtle and complicated a role-relationship for the immaturity of the child to recognize.

So the child just knows something hurts (i.e., guilt at betraying his mother), but he doesn’t know why he hurts.  All he knows is that his hurt has something to do with his mother.

As this dynamic progresses, the child will come to misinterpret this hurt surrounding his mother (i.e., his guilt at betraying her and his grief at losing a relationship with his beloved mother once the rejection is underway), as being something “bad” about his mother.  In trying to understand what hurts about his mother, the child comes to misinterpret an authentic hurt as meaning that there must be something bad about who his mother is as a person.

Since she’s not actually doing anything bad that he can specifically identify, it must be her very “personhood” that’s bad.   And his father is more than willing to support this misinterpretation that the very personhood of the mother is bad, malicious, and inadequate (i.e., a manifestation of the “splitting” dynamic of the father’s psychopathology; (see Key Concept: Splitting post), so that the mother “deserves” to be rejected by the child.

“If others fail to satisfy the narcissist’s “needs,” including the need to look good, or be free from inconvenience, then others “deserve to be punished”… Even when punishing others out of intolerance or entitlement, the narcissist sees this as “a lesson they need, for their own good” (Beck, et al., 2004, p. 252).

The child’s presentation of a “deserves to be rejected” theme regarding the targeted-rejected parent is another very distinctive and characteristic diagnostic feature of attachment-based “parental alienation.”

Over time, the narcissistic/(borderline) parent will provide the child with an array of “acceptable” themes for why the child hurts relative to the other parent, e.g., the other parent is self-centered and selfish, is insensitive to the child’s needs, that the other parent broke up the family by seeking the divorce, or has a really irritating way of saying things, etc.

Regulating the Psychopathology

This whole process is controlled and directed by the narcissistic/(borderline) parent as a means to regulate the psychopathology of the narcissistic/(borderline) parent.

In the vignette described above, once the trauma reenactment narrative is in place, the father is no longer the inadequate parent (person), the mother is. The father’s threatened exposure of core-self inadequacy is protected by projectively displacing it onto the mother by means of the child’s induced symptomatic rejection of her.she’s the inadequate parent (person), not me.

The father on the other hand, becomes the “all-wonderful” parent, and the father is allowed to display the “wonderfulness” of his “nurturing and protective parenting” to the “bystanders” in the trauma reenactment who are represented by the array of therapists, parent coordinators, teachers, and attorneys who become involved.

“Reenactments of the traumatic past are common in the treatment of this population and frequently represent either explicit or coded repetitions of the unprocessed trauma in an attempt at mastery. Reenactments can be expressed psychologically, relationally, and somatically and may occur with conscious intent or with little awareness. One primary transference-countertransference dynamic involves reenactment of familiar roles of victim, perpetrator-rescuer-bystander in the therapy relationship. Therapist and client play out these roles, often in complementary fashion with one another, as they relive various aspects of the client’s early attachment relationships. (Perlman & Courtois, 2005, p. 455)

This narcissistically based “wonderfully perfect nurturing and protective parent” presentation to the “bystanders” in the trauma reenactment is sometimes explicitly expressed by the narcissistic/(borderline) parent in the sentence, “I only want what’s best for the child.” What a wonderful parent, right? Totally unlike the other parent who only cares about his or her selfish desire to have a relationship with the child.  If the other parent really cared about the child they would let the child reject them and never see the child again.  What a selfish parent.

Therapist radar should always be alerted whenever a parent says, “I only want what’s best for the child.”  We all want what’s best for the child.  Normal-range parents almost never make this statement because it is so self-evident.  But the narcissistic/(borderline) parent doesn’t recognize this statement as being self-evident for normal-range parents, and thinks it represents a “wonderful parent” presentation.  It’s not a definitive sign, but it should raise therapist alertness for the presence of the all-wonderful “protective parent” role.

The child’s rejection of the mother also allows the father to psychologically expel his abandonment fears onto the mother – she becomes the entirely abandoned parent (person) – whereas the father becomes the ideal and perfect never-to-be-abandoned parent.

The narcissistic/(borderline) father also gains possession of “the prize,” the child, who represents a “narcissistic object” symbolizing the father’s victory over the mother, and validating the father as being the “good parent.”

“[For the narcissistic personality] instead of learning to accept and master normal and transient feelings of inferiority, these experiences are cast as threats to be defeated, primarily by acquiring external symbols or validation.” (Beck et al., 2006, p. 247)

“[For the narcissistic personality] the need to control the idealized objects, to use them in attempts to manipulate and exploit the environment and to “destroy potential enemies,” is linked with inordinate pride in the “possession” of these perfect objects totally dedicated to the patient. (Kernberg, 1975, p. 33)

Childress commment: “totally dedicated to the patient” represents the “regulating other” role of the child for the narcissistic/(borderline) parent.

And through the child’s rejection of the mother, the father is able to exact revenge on the the mother for the narcissistic injury she inflicted upon him by not recognizing his “wonderfulness.” How dare she not recognize his narcissistic wonderfulness. Well, she’s paying for it now.

“If others fail to satisfy the narcissist’s “needs,” including the need to look good, or be free from inconvenience, then others “deserve to be punished”… Even when punishing others out of intolerance or entitlement, the narcissist sees this as “a lesson they need, for their own good” (Beck, et al., 2004, p. 252).

Court orders and therapist directives for parents to “not talk badly about the other parent in front of the child” are totally irrelevant. Talking badly about the other parent is NOT how the child’s symptomatic rejection of the other parent occurs.

The child is first induced into being a “regulatory other” for the pathology of the narcissistic/(borderline) parent.

From there, the child is induced into adopting the “victimized child” role in the trauma reenactment narrative of the narcissistic/(borderline) parent, which immediately creates and defines the other two trauma reenactment roles of “abusive parent” and “protective parent.”

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

* Regarding the vignette, I used the father as representing the narcissistic/(borderline) parent and the mother as the targeted parent, but these genders could easily be reversed.  There is no gender bias in attachment-based “parental alienation.”  It affects males and females in roughly equal proportions.

References

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

Kandel, E. R. (2007), In Search of Memory: The Emergence of a New Science of Mind, New York: W. W. Norton & Company.

Kerig, P.K. (2005). Revisiting the construct of boundary dissolution: A multidimensional perspective. Journal of Emotional Abuse, 5, 5-42.

Kernberg, O.F. (1975). Borderline conditions and pathological narcissism.. New York: Aronson.

Lyons-Ruth, K., Bronfman, E. & Parsons, E. (1999). Maternal frightened, frightening, or atypical behavior and disorganized infant attachment patterns. In J. Vondra & D. Barnett (Eds.) Atypical patterns of infant attachment: Theory, research, and current directions. Monographs of the Society for Research in Child Development, 64, (3, Serial No. 258).

Pearlman, C.A., Courtois, C.A. (2005). Clinical Applications of the Attachment Framework: Relational Treatment of Complex Trauma. Journal of Traumatic Stress, 18, 449-459.

Shore, A.N. (1997). Early organization of the nonlinear right brain and development of a predisposition to psychiatric disorders. Development and Psychopathology, 9, 595-631.

Sroufe, L.A. (2000). Early relationships and the development of children. Infant Mental Health Journal, 21(1-2), 67-74.

Tronick, E.Z. (2003). Of course all relationships are unique: How co-creative processes generate unique mother-infant and patient-therapist relationships and change other relationships. Psychoanalytic Inquiry, 23, 473-491.

Trauma Reenactment in Parental Alienation

At its foundational core, the family processes of attachment-based “parental alienation” represent the manifestation of a trauma reenactment narrative of a narcissistic/(borderline) parent that is embedded in the distorted “internal working models,” or “schemas,” of the narcissistic/(borderline) parent’s attachment networks.

The narcissistic/(borderline) parent is psychologically decompensating into persecutory delusional beliefs due to the activation of excessive anxiety surrounding the perceived interpersonal rejection and perceived abandonment associated with the divorce (sometimes the triggering of this perceived rejection and abandonment is delayed until the spouse remarries).

One of the foremost experts in personality disorders, Theodore Millon, describes the propensity for the narcissistic personality structure to decompensate into persecutory delusional beliefs under stress,

“Under conditions of unrelieved adversity and failure, narcissists may decompensate into paranoid disorders. Owing to their excessive use of fantasy mechanisms, they are disposed to misinterpret events and to construct delusional beliefs. Unwilling to accept constraints on their independence and unable to accept the viewpoints of others, narcissists may isolate themselves from the corrective effects of shared thinking. Alone, they may ruminate and weave their beliefs into a network of fanciful and totally invalid suspicions. Among narcissists, delusions often take form after a serious challenge or setback has upset their image of superiority and omnipotence. They tend to exhibit compensatory grandiosity and jealousy delusions in which they reconstruct reality to match the image they are unable or unwilling to give up. Delusional systems may also develop as a result of having felt betrayed and humiliated. Here we may see the rapid unfolding of persecutory delusions and an arrogant grandiosity characterized by verbal attacks and bombast.”

The reenactment of attachment trauma is also documented in the clinical treatment literature,

“Reenactments of the traumatic past are common in the treatment of this population and frequently represent either explicit or coded repetitions of the unprocessed trauma in an attempt at mastery. Reenactments can be expressed psychologically, relationally, and somatically and may occur with conscious intent or with little awareness. One primary transference-countertransference dynamic involves reenactment of familiar roles of victim, perpetratorrescuer-bystander in the therapy relationship. Therapist and client play out these roles, often in complementary fashion with one another, as they relive various aspects of the client’s early attachment relationships. (Perlman & Courtois, 2005, p. 455)

In response to three separate but interrelated psychological stresses associated with the divorce, 1) the threatened collapse of the narcissistic defenses against the experience of primal inadequacy that is triggered by the perceived interpersonal rejection inherent to the divorce (i.e., narcissistic personality processes), 2) the activation of immense anxiety from severe abandonment fears triggered by the divorce (i.e., borderline personality processes), and 3) the reactivation of attachment trauma networks when the attachment system becomes active to mediate the loss experience associated with the divorce (trauma processes), the narcissistic/(borderline) personality decompensates into persecutory delusional beliefs centering on the other parent’s “abuse” potential relative to the child.

This decompensation into persecutory delusional beliefs is centered around the pattern contained in the internal working models (schemas) of the narcissistic/(borderline) parent’s traumatized attachment networks of 1) victimized child, 2) abusive parent, 3) protective parent. The split representation for the parent role in the attachment trauma networks is the product of the “splitting” dynamic that originated in the relationship trauma involving a parent (i.e, the parent of the narcissistic/(borderline) parent as a child) who simultaneously triggers attachment bonding and avoidance motivations.

“Various studies have found that patients with BPD [borderline personality disorder] are characterized by disorganized attachment representations (Fonagy et al., 1996; Patrick et al, 1994). Such attachment representations appear to be typical for persons with unresolved childhood traumas, especially when parental figures were involved, with direct, frightening behavior by the parent. Disorganized attachment is considered to result from an unresolvable situation for the child when “the parent is at the same time the source of fright as well as the potential haven of safety(van IJzendoorn, Schuengel, & Bakermans-Kranburg, 1999, p. 226).” (Beck et al., 2004, p. 191)

The family processes of attachment-based “parental alienation” are the product of the narcissistic/(borderline) parent creating a reenactment in the current family relationships of the narcissistic/(borderline) parent’s own attachment trauma patterns, or “schemas,” by inducing the child into adopting the “victimized child” role within the trauma reenactment narrative. The moment the child is induced into adopting the “victimized child” role, then this automatically IMPOSES upon, and DEFINES, the targeted parent into the role as the “abusive parent” in the trauma reenactment narrative. The definitions of these two trauma reenactment roles (which are created the moment the child adopts the “victimized child” role) then allows the narcissistic/(borderline) parent to adopt the coveted role in the trauma reenactment narrative as the wonderful and nurturing “protective parent,” in direct contrast to the role being imposed on the other parent as the all-bad “abusive parent.”

This artificially created reenactment of “various aspects” of the narcissistic/(borderline) parent’s own “early attachment relationships” (Perlman & Courtois, 2005, p. 455) represents a false drama in which the present is distorted into a re-creation of the past.

This is psychotic. The narcissistic/(borderline) parent is no longer in touch with actual reality, but is reliving and recreating early attachment relationships that do not reflect actual events in the current world.

The very term “borderline” to describe this type of personality process reflects the recognition of the psychotic core to this type of personality structure,

“The diagnosis of “borderline” was introduced in the 1930s to label patients with problems that seemed to fall somewhere in between neurosis and psychosis. (Beck et al, 2004, p. 189)

Narcissistic and borderline personality structures are simply variants of the same core processes.

“One subgroup of borderline patients, namely, the narcissistic personalities… seem to have a defensive organization similar to borderline conditions, and yet many of them function on a much better psychosocial level.” (Kernberg, 1975, p. xiii)

Delusions and Psychotic Processes

Many people in the general public, and many mental health professionals, have the mistaken belief that psychotic and delusional processes will manifest as overtly “crazy” and bizarre.  That’s not true.

Prior to obtaining my doctorate degree I first obtained a Master’s degree in Community/Clinical psychology and I worked for 15 years on a clinical research project at UCLA on schizophreria.  During my time with this project I was trained to clinical competence on a symptom rating scale called the Brief Psychiatric Rating Scale (BPRS) on which a variety of patient symptoms are rated, including psychotic symptoms, along a 7-point scale from mild to severe.

Psychotic symptoms can manifest along a continuum of severity, and are not always overtly bizarre.  This is especially true for a diagnosis of Delusional Disorder in which the only manifestation of the psychotic process is the presence of an intransigently held, fixed and false belief that is maintained despite contrary evidence.

The diagnostic criteria for the DSM-5 diagnosis of a Delusional Disorder specifically requires that that person’s general functioning is “not markedly impaired” or “obviously odd or bizarre.”

DSM-5 Delusional Disorder

Criterion C: “Apart from the impact of the delusion(s) or its ramifications, functioning is not markedly impaired and behavior is not obviously odd or bizarre.

The delusional belief of the narcissistic/(borderline) parent in attachment-based “parental alienation” would be considered a nonbizarre “encapsulated” delusion.

Nonbizarre delusions express content that is within the realm of possibility, such as a fixed and false belief that the person’s spouse is having an extramarital affair. It’s possible that the person’s spouse is having an affair, extramarital affairs are not a bizarre occurrence, but it’s simply not true that the person’s spouse is having an extramarital affair.  Yet no amount of contrary evidence will convince the person that his or her belief in the spouse’s infidelity is wrong. The false belief is maintained despite contrary evidence.

An encapsulated delusion is limited and contained in its scope.  The jealousy delusion noted above would be an encapsulated delusion.  It’s presence and impact would not generally be evident.  Unless you asked the person specifically about the martial relationship you might never know of the existence of this delusional belief.

A bizarre delusion on the other hand, might be that people were inserting thoughts into the person’s mind (called “a delusion of control”). This false belief is outside the realm of plausibility.  This would also not be an encapsulated delusion since it affects a broad spectrum of the person’s perceptions and functioning.

The narcissistic/(borderline) parent’s delusional belief in attachment-based “parental alienation” stems from the trauma reenactment narrative and is the false belief that the other parent represents an abusive threat to the child.  It is delusional because this belief in the threat potential of the targeted parent is false and yet is maintained despite contrary evidence, it is a nonbizarre delusional belief because it is within the domain of possibility that a parent is abusive of a child, and it is an encapsulated delusion because this fixed and false belief is limited to only a narrow and contained domain of distortion, the perception of the other parent, and is not a false belief that affects a broad spectrum of the person’s perception.

At a deeper level, the delusional belief of the narcissistic/(borderline) parent in the abusive parenting threat posed to the child by the targeted parent represents a component of a trauma reenactment in which the narcissistic/(borderline) parent distorts current reality into creating and reliving a reenactment of the narcissistic/(borderline) parent’s own childhood attachment trauma patterns.

Remember what Millon said about the decompensation of the narcissistic personality under stress,

“Unwilling to accept constraints on their independence and unable to accept the viewpoints of others, narcissists may isolate themselves from the corrective effects of shared thinking. Alone, they may ruminate and weave their beliefs into a network of fanciful and totally invalid suspicions.

The rumination and weaving of the narcissistic/(borderline) parent in which they “reconstruct reality” is guided by the attachment patterns embedded in the internal working models, or schemas, of the narcissistic/(borderline) parent’s attachment system.  The distorted beliefs take on the pattern of the attachment trauma, abusive parent – victimized child – protective parent.  It is the trauma reenactment narrative that is the fundamental psychotic process, of which the narcissistic/(borderline) parent’s delusional belief in the abusive threat posed by the other parent is a surface manifestation.

The psychological processes associated with attachment-based “parental alienation” represent the interwoven expression within the family relationships of 1) personality disorder processes, 2) trauma-related processes, and 3) psychotic processes (i.e., the decompensation of narcissistic/(borderline) personality structures into delusional belief systems).

The presence of a delusional belief DOES NOT mean the person will act in an overtly abnormal way, and in the case of a narcissistic/(borderline) personality the person’s nonbizarre persecutory delusional belief may go entirely unrecognized by other people, including mental health professionals, who may mistakenly accept the plausible assertions of the narcissistic/(borderline) parent as valid. 

After all, the story offered by the narcissistic/(borderline) parent is not abnormal or bizarre, it’s not uncommon for a parent to be a bad parent who presents a risk of emotional abuse for a child, especially when the child is backing up this storyline, the narrative of the trauma reenactment, by adopting the role as the “victimized child,”  And the narcissistic/(borderline) parent presents so well, as articulate and self-assured, and as being so protective and caring for the child’s well-being.  Who suspects a delusional reenactment of childhood trauma when presented with this storyline.

A nonbizarre delusional belief is not always evident.

Professional Competence

The presence of psychotic processes is an extremely serious expression of psychopathology. That many mental health professionals are simply not recognizing and diagnosing the extreme psychopathology involved represents a highly disturbing reflection of the inadequate professional competence of these mental health professionals.

Personality disorders, the attachment system, trauma disorders, and delusional disorders are ALL established DSM constructs. There is absolutely no reason whatsoever for mental health professionals to be missing the level of severe psychopathology involved. 

It doesn’t matter what their opinions are about the construct of “parental alienation,” they are required by professional practice standards to be knowledgeable about DSM disorders, particularly if they are treating that type of DSM disorder.

If a mental health professional is diagnosing and treating the family sequelae of trauma-related reenactments of a narcissistic/(borderline) parent’s psychological decompensation into delusional belief systems, in which the child is enacting the “victimized child” role within the reenactment narrative of the narcissistic/(borderline) parent’s traumatized attachment networks, then the diagnosing and treating mental health professional better know about trauma reenactments,  narcissistic and borderline personality presentations and processes, and the nature of “internal working models” of the attachment system.

If a plastic surgeon decides to diagnose and treat cancer without possessing the requisite knowledge, training, and background necessary for professional competence, and the patient dies because of the lack of professional knowledge and competence of the plastic surgeon in diagnosing and treating cancer, this would likely be considered malpractice.

If a podiatrist suddenly decided to do brain surgery on a patient’s brain tumor, and the patient dies as a result of the podiatrist’s lack of professional knowledge and competence regarding brain surgery, this would likely be considered malpractice.

Why is it considered malpractice in the medical profession for a doctor to practice beyond the boundaries of his or her professional knowledge and competence but it’s not considered malpractice in mental health?  Oh wait, it is considered malpractice in mental health too.

Ethical Principles of Psychologists and Code of Conduct of the American Psychological Association (2002)

Standard 2.02 Boundaries of Competence

“Psychologists provide services, teach and conduct research with populations and in areas only within the boundaries of their competence, based on their education, training, supervised experience, consultation, study or professional experience.”

It doesn’t matter what they may think about the Gardnerian construct of “Parental Alienation Syndrome” or if they are familiar with the attachment-based model of “parental alienation” described in my writings and in my Master Lecture Series seminars.  Because all of the constructs I describe in an attachment-based model of “parental alienation” are established and accepted psychological constructs within the DSM diagnostic system, AND all of the constructs have a solid and established foundation in the research base of professional psychology.

It doesn’t matter if the plastic surgeon says that he doesn’t believe in this so-callled cancer disease (or never heard of cancer).  If a physician is going to diagnose and treat cancer then it is incumbent upon the physician to ensure that he or she has the necessary professional knowledge and expertise to diagnose and treat cancer. 

“Whoops, my mistake. Didn’t know what I was doing. Sorry.” is NOT an acceptable answer if the patient dies as a result of the professional’s lack of appropriate knowledge and professional competence.

It doesn’t matter if the podiatrist THINKS she can do brain surgery because she went to medical school.  To do brain surgery requires specialized professional knowledge and expertise.  Just because a physician went to medical school does not necessarily mean the physician is competent to do brain surgery without first taking steps to acquire the specialized professional knowledge and training necessary for brain surgery.

There is nothing “NEW” regarding an attachment-based model of “parental alienation” except that these established psychological constructs are being applied to the family processes traditionally called “parental alienation.” ALL of the psychological principles and constructs discussed in an attachment-based model of “parental alienation” are firmly established and accepted psychological principles and constructs that should be part of the professional competence for ALL mental health professionals generally, and particularly for mental health professionals who are diagnosing and treating this set of psychological issues.

If you don’t know what you’re diagnosing and treating, you should probably stay away from diagnosing and treating it.

Notice that in all of my writings, I put the term “parental alienation” in quotes. That’s because the term “parental alienation” represents a popularized lay term for the psychopathology involved.

The correct clinical term is pathogenic parenting (i.e., patho=pathological; genic=genesis, creation). The term pathogenic parenting refers to the creation of psychopathology in a child through aberrant and distorted parenting practices, and the actual clinical psychopathology involved is the psychological decompensation of a narcissistic/(borderline) parent into delusional belief systems that are manifesting through a reenactment of attachment trauma patterns into current family relationships.

When I first entered private practice from my position as the Clinical Director for a children’s assessment and treatment center I knew nothing about the construct of “parental alienation.”  My areas of specialty are ADHD, parent-child conflict, and marital and family therapy, and I have a secondary expertise in early childhood mental health and the neuro-development of the brain during childhood. 

When I ran across my first case of “parental alienation,” however, I was able to recognize the personality disorder processes, the delusional belief systems, and the trauma reenactment.  In my early writings on “parental alienation” I was discussing this clinical phenomenon as warranting the DSM-IV TR diagnosis of a Shared Psychotic Disorder and I was noting the descriptions contained within the DSM-IV TR regarding a Shared Psychotic Disorder diagnosis and the family processes traditionally described as “parental alienation,”

DSM-IV TR – Shared Psychotic Disorder:

“The essential features of Shared Psychotic Disorder (Folie a Deux) is a delusion that develops in an individual who is involved in a close relationship with another person (sometimes termed the “inducer” or “the primary case”) who already has a Psychotic Disorder with prominent delusions (Criteria A).” (American Psychiatric Association, DSM-IV TR, 2000,p. 332)

“Usually the primary case in Shared Psychotic Disorder is dominant in the relationship and gradually imposes the delusional system on the more passive and initially healthy second person. Individuals who come to share delusional beliefs are often related by blood or marriage and have lived together for a long time, sometimes in relative isolation. If the relationship with the primary case is interrupted, the delusional beliefs of the other individual usually diminish or disappear. Although most commonly seen in relationships of only two people, Shared Psychotic Disorder can occur in larger number of individuals, especially in family situations in which the parent is the primary case and the children, sometimes to varying degrees, adopt the parent’s delusional beliefs.” (American Psychiatric Association, DSM-IV TR, 2000,p. 333)

Aside from the delusional beliefs, behavior is usually not otherwise odd or unusual in Shared Psychotic Disorder.” (American Psychiatric Association, DSM-IV TR, 2000, p. 333)

With regard to the course of Shared Psychotic Disorder, the DSM-IV TR notes,

“Without intervention, the course is usually chronic, because this disorder most commonly occurs in relationships that are long-standing and resistant to change. With separation from the primary case, the individual’s delusional beliefs disappear, sometimes quickly and sometimes quite slowly.” (American Psychiatric Association, DSM-IV TR, 2000, p. 333)

When the diagnosis of Shared Psychotic Disorder was discontinued in the DSM-5 I wrote a paper currently up on my website in which I analyzed the clinical psychopathology of an attachment-based model for the construct of “parental alienation” relative to the newly revised DSM-5 diagnostic system, and I concluded that the clinical psychopathology represents a DSM-5 diagnosis of,

DSM-5 Diagnosis

309.4   Adjustment Disorder with mixed disturbance of emotions and conduct

V61.20   Parent-Child Relational Problem

V61.29   Child Affected by Parental Relationship Distress

V995.51 Child Psychological Abuse, Confirmed

Of note, is that the diagnosis of Adjustment Disorder in the DSM-5 is in the category of “Trauma– & Stressor-Related Disorders.”

The clinical psychopathology involved is all comprised of standard psychological principles and constructs.  It is beyond me why this pathology hasn’t been identified and resolved earlier, other than the possibility that the field was so distracted by the debate over the Gardnerian model of PAS that no one bothered to define the pathology from within standard and established psychological principles and constructs.

The pathology is there, and it is clearly evident to anyone with a knowledge of the relevant domains of pathology, and ALL mental health professionals should have at least a basic knowledge of these relevant domains (i.e., personality disorders, delusions, trauma, the attachment system) as part of their foundational understanding of the DSM diagnostic system, since all of these constructs are in the DSM diagnostic system . 

I want to make sure I am entirely clear on this, ALL of the psychological constructs associated with an attachment-based model for the construct of “parental alienation” are established and accepted principles and constructs currently within professional psychology and the DSM diagnostic system.  There is absolutely NO REASON why mental health professionals have not, and are not currently, making the appropriate clinical and DSM-5 diagnosis of the pathology.

  • Narcissistic and borderline personality disorders are established and recognized constructs within the DSM diagnostic system.
  • Delusional beliefs are established and recognized constructs within the DSM diagnostic system.
  • The attachment system is a recognized construct within the DSM diagnostic system, and the attachment system has a substantial research base establishing it as a primary professional construct.
  • Trauma is a recognized construct within the DSM diagnostic system, and the construct of trauma has a substantial research base establishing it as a primary professional construct, including trauma reenactment.

Trauma Reenactment

Regarding the reenactment of trauma, van der Kolk describes the impact of childhood exposure to “developmental trauma,”

“After a child is traumatized multiple times, the imprint of the trauma becomes lodged in many aspects of his or her makeup… Unless this tendency to repeat the trauma is recognized, the response of the environment is likely to replay the original traumatizing, abusive, but familiar, relationships.” (van der Kolk 2005)

The recognition of trauma reenactment also includes the association of borderline personality symptoms to trauma reenactment processes:

Trippany, R. L., Helm, H. M., & Simpson, L. (2006). Trauma reenactment: Rethinking borderline personality disorder when diagnosing sexual abuse survivors. Journal of Mental Health Counseling, 28(2), 95-110.

As is the role of attachment trauma reenactments in the treatment of trauma-related disorders:

Pearlman, C.A., Courtois, C.A. (2005). Clinical Applications of the Attachment Framework: Relational Treatment of Complex Trauma. Journal of Traumatic Stress, 18, 449-459

According to van der Kolk,

“When the trauma fails to be integrated into the totality of a person’s life experiences, the victim remains fixated on the trauma. Despite avoidance of emotional involvement, traumatic memories cannot be avoided: even when pushed out of waking consciousness, they come back in the form of reenactments, nightmares, or feelings related to the trauma… Recurrences may continue throughout life during periods of stress.” (van der Kolk, 1987, p. 5)

There is absolutely NO REASON that the pathology associated with an attachment-based model for the construct of “parental alienation” is not currently recognized and addressed within mental health OTHER than professional ignorance and incompetence.

It is NOT an issue of “parental alienation,” the pathology being expressed in the family processes involves standard, established, and accepted constructs of psychopathology.

If ANY targeted parent is in a position of educating a mental health professional regarding the nature or degree of the psychopathology involved with the construct of attachment-based “parental alienation” then this is clear evidence that a podiatrist is doing brain surgery, i.e., that the mental health professional is practicing beyond the boundaries of professional competence in likely violation of professional practice standards. 

ALL diagnosing and treating mental health professionals should be sufficiently knowledgeable so that it is the mental health professional who is educating the targeted parent regarding the personality disorder dynamics, the delusional processes, the reenactment narrative structure, and the attachment system distortions involved in attachment-based “parental alienation,” NOT the other way around.

I have two invited Master Lecture Series seminars available online through California Southern University in which I discuss at a professional level the nature and severity of the pathology.  Mental health professionals can watch these seminars to become educated and aware of the pathology involved. 

It is NOT about “parental alienation.”  All of the involved principles and constructs are established and accepted principles and constructs within the DSM diagnostic system and the established professional research base.

If you don’t know what you are diagnosing and treating, then you probably shouldn’t be diagnosing and treating it.

Podiatrists are not allowed to perform brain surgery, plastic surgeons are not allowed to treat cancer.

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

References

Personality Disorder

Millon. T. (2011). Disorders of personality: introducing a DSM/ICD spectrum from normal to abnormal. Hoboken: Wiley.

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

Kernberg, O.F. (1975). Borderline conditions and pathological narcissism.. New York: Aronson.

Trauma Reenactment

Pearlman, C.A., Courtois, C.A. (2005). Clinical Applications of the Attachment Framework: Relational Treatment of Complex Trauma. Journal of Traumatic Stress, 18, 449-459

van der Kolk, B.A. (2005). Developmental trauma disorder. Psychiatric Annals, 35(5), 401-408.

van der Kolk, B.A. (1987). The psychological consequences of overwhelming life experiences. In B.A. van der Kolk (Ed.) Psychological Trauma (1-30). Washington, D.C.: American Psychiatric Press, Inc.

Trippany, R. L., Helm, H. M., & Simpson, L. (2006). Trauma reenactment: Rethinking borderline personality disorder when diagnosing sexual abuse survivors. Journal of Mental Health Counseling, 28(2), 95-110.

Professional Standards

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (Revised 4th ed.). Washington, DC: Author.

American Psychological Association (2002). Ethical principles of psychologists and code of conduct. American Psychologist, 57, 1060-1073.

False Allegations of Parental Alienation

 Not everything is “parental alienation.”

Sometimes a child’s desire to avoid a relationship with one parent is justified by the parenting practice of that parent.

In about 25% of the cases that come to me because of my expertise in “parental alienation” the narcissistic parent turns out to be the targeted parent who is seeking my help in fostering the child’s relationship with this narcissistic parent because this parent feels entitled to possess the narcissistic object of the child.

This parent’s absence of empathic resonance for the child’s inner experience becomes clearly evident in the first few sessions with this narcissistic parent.  The child’s experience isn’t relevant to this parent, only the experience of the narcissistic parent is relevant in this parent’s perception.

Since the narcissistic parent has a fixed belief in his or her own perfection and wonderfulness, in their view there can be no other reason for the child’s reluctance to provide them with the narcissistic supply of adoration other than “parental alienation.”

In these cases, the child does NOT display the three diagnostic indicators of attachment-based “parental alienation” (Diagnostic Indicators and Associated Clinical Signs), and when I meet with the favored parent, this favored parent is entirely normal-range and does not display any narcissistic or borderline traits. 

Only the targeted parent displays narcissistic/(borderline) traits, and the child’s complaints about the absence of empathy of this parent makes total sense to me as a psychologist.  I see this narcissistic parent’s absence of empathy displayed in our sessions.  I know exactly what the child is saying.

Not everything is “parental alienation.”  Sometimes it is the targeted parent who is narcissistic.

Living with a Narcissistic Parent

In these false “parental alienation” cases, the profound absence of parental empathy of the narcissistic parent is experienced by the child as emotionally and psychologically painful.

There is interesting research by Moor and Silvern (2006) on the association of child abuse to parental empathic failure which found that parental empathic failure actually represents a form of psychological trauma for the child.

“The indication that posttraumatic symptoms were no longer associated with child abuse, across all categories, after statistically controlling for the effect of perceived parental empathy might appear surprising at first, as trauma symptoms are commonly conceived of as connected to specifically terrorizing aspects of maltreatment (e.g., Wind & Silvern, 1994).

However, this finding is, in fact, entirely consistent with both Kohut’s (1977) and Winnicott’s (1988) conception of the traumatic nature of parental empathic failure. In this view, parental failure of empathy is predicted to amount to a traumatic experience in itself over time, and subsequently to result in trauma-related stress. Interestingly, even though this theoretical conceptualization of trauma differs in substantial ways from the modern use of the term, it was still nonetheless captured by the present measures.” (Moor & Silvern, 2006, p. 197)

Moor, A. and Silvern, L. (2006). Identifying pathways linking child abuse to psychological outcome: The mediating role of perceived parental failure of empathy. Journal of Emotional Abuse, 6, 91-112.

The absence of parental empathy is painful, and severe failures of parental empathy, such as those associated with a narcissistic parent, are traumatic for the child.

When a child is exposed to chronic and severe failures of parental empathy, such as from a narcissistic parent, the child will seek to avoid the psychologically painful relationship with this parent. The child’s efforts to avoid a relationship with a narcissistic parent represent a normal-range and healthy protective response to the chronic and severe failure of parental empathy associated with narcissistic parenting practices.

A child seeking to avoid a relationship with a narcissistic parent represents an authentic response of the child to severe and chronic failures of parental empathy.

A narcissistic parent is incapable of empathy. For the narcissistic parent, the child is an object; a possession. The narcissistic parent cannot resonate with the child’s inner needs and experiences. For the narcissistic parent only the narcissistic supply that the child offers the narcissistic parent is important.

In their relationship, only one person exists, the narcissistic parent. The child’s authenticity is not acknowledged, the child’s authenticity is nullified and obliterated so that the child can serve as a narcissistic reflection of the parent’s own self-experience.

In these cases of false allegations of “parental alienation,” the child experiences a relationship with the narcissistic parent as being painful and tries to communicate this to the narcissistic parent. However, the narcissistic parent is unable to self-reflect and deflects the authentic criticism of the child as being invalid. The narcissistic parent is entirely unable to comprehend why the child wouldn’t want to adore and become the narcissistic possession of the magnificent wonderfulness of the narcissistic parent.

Over time, the child becomes discouraged that the narcissistic parent will ever be able to show empathic care and responsiveness for the child’s authenticity, so that the child begins to withdraw from a relationship with the narcissistic parent because the relationship is too painful, the relationship with the narcissistic parent is experienced as being psychologically traumatic for the child.

The narcissistic parent, however, cannot abide criticism –

“I’m not at fault. I’m perfect. You’re the problem, not me. I’m wonderful.”

So then why is the child critical of the “wonderful” narcissistic parent? Why does the child seek to avoid a relationship with the “perfect” narcissistic parent? The only answer the narcissistic parent can come up with is that it must be “parental alienation” by the other parent. What else could account for the child’s criticisms and rejection of the perfection and wonderfulness of the narcissistic parent?

Not everything is “parental alienation.”

Sometimes the narcissistic parent is the targeted parent and the child’s avoidance of a relationship with this parent is an authentic child response to the profound failure of parental empathy associated with a narcissistic parent. So that in these cases, the allegation of “parental alienation” made by one parent toward the other is actually a false allegation.

Differentiating True “Parental Alienation” from False Allegations of “Parental Alienation”

How can we differentiate true “parental alienation” from false allegations of “parental alienation?”

The answer is that the full set of the three diagnostic indicators for an attachment-based model of “parental alienation” will NOT be evident in false allegations of “parental alienation,” and the full set of three diagnostic indicators will always be present in true allegations of “parental alienation.”

Attachment System Suppression

The differentiation of the attachment system differences in authentic parent-child conflict from cases of “parental alienation” is subtle but distinctive.

False Allegations of “Parental Alienation” – In authentic parent-child conflict, the child’s “protest behavior” (e.g, angry-oppositional behavior) remains an “attachment-behavior” designed to elicit GREATER parental involvement.

In authentic parent-child conflict, the child still WANTS to form a relationship with the targeted parent but is frustrated and discouraged by some element of the targeted parent’s behavior, such as the chronic failure of parental empathy associated with narcissistic parenting practices. In authentic parent-child conflict the child’s withdrawal from a relationship with the targeted parent reflects the child’s discouragement in achieving an affectionally bonded relationship rather than a rejection of a relationship with the targeted parent.

In cases of authentic parent-child conflict, since the child’s protest behavior and withdrawal from the targeted parent reflect the child’s discouragement in achieving a positive relationship rather than rejection of a relationship, if the behavior of the targeted parent is changed to allow for child bonding then the child’s motivation toward bonding with the parent will achieve completion and the parent-child conflict will resolve.

In authentic parent-child conflict the child’s protest behavior reflects an “attachment behavior” designed to elicit GREATER parental involvement, and the child’s withdrawal from a relationship with the parent reflects DISCOURAGEMENT in forming an affectional bond to the parent, so that if the parenting behaviors are changed to allow an affectional bond to be established, the parent-child conflict will resolve.

True Allegations of “Parental Alienation” – Whereas when the parent-child conflict with the targeted parent is the product of attachment-based “parental alienation,” the child’s protest behavior will represent an inauthentic display as a “detachment behavior” designed to sever the child’s relationship with the parent. The authentic functioning of the attachment system DOES NOT ALLOW child detachment behaviors.

From an evolutionary perspective, children who detached in their bonding to parents fell prey to predators and other environmental dangers, so that genes allowing child detachment behaviors were selectively removed from the collective gene pool. Whereas children who bonded MORE strongly to problematic parents were more likely to acquire parental protection from predators, so that genes motivating INCREASED CHILD BONDING motivation to problematic parents were selectively increased in the gene pool because of the survival advantage that increased child bonding to the problematic parent provided..

This is important to understand about the authentic functioning of the attachment system, children are MORE STRONGLY motivated to bond to problematic parents. Children do NOT reject parents. Children who rejected parents were eaten by predators.

Authentic parent-child conflict is a product of the child’s desire TO FORM an affectional bond to the parent that is being frustrated in some way. When the barrier to the parent-child bonding is removed, the child completes his or her desire to form an affectional bond to the parent and the parent-child conflict is resolved.

In attachment-based “parental alienation,” on the other hand, the child is SEEKING TO SEVER the parent-child bond, so that the child’s protest behavior represents a “detachment behavior.” Child “detachment behaviors” represent an inauthentic display of the attachment system.

There are only a limited number of highly pathogenic circumstances that can override the survival advantage conferred by the parent-child bond so that a termination of the parent-child bond is sought.

  1. Sexual abuse/incest
  2. Prolonged and severe physical abuse of the child (years)
  3. Prolonged and severe domestic violence (years)
  4. Sometimes: chronic prolonged parental alcoholism or severe substance abuse (decades). More often, however, parental alcoholism and substance abuse produces a “parentified child” who adopts a caretaking role toward the parent

In the absence of these specific circumstances in the parent-child relationship, problematic parenting produces an INCREASED child motivation toward bonding with the problematic parent. Authentic child withdrawal from a relationship with a parent represents discouragement, NOT rejection.

Stimulus Control

The clearest way to differentiate authentic from inauthentic parent-child conflict is through the construct of “stimulus control.”

All behavior is elicited by stimuli, or cues. Our driving behavior, for example, is under the “stimulus control” of traffic lights. If the traffic light is red, we stop. If it is green, we go. Yellow is a transitional warning. In addition, our driving behavior is under the stimulus control of painted lines on the road, traffic signs, and our internalized rules for driving. All of these various stimuli control our driving behavior.

Children’s behavior in authentic parent-child conflict is under the “stimulus control” of the parent’s behavior, so that changes in the parent’s behavior will produce corresponding changes in the child’s behavior.

If, however, changes to the parent’s behavior do not produce corresponding changes to the child’s behavior, then the child’s behavior is NOT under the “stimulus control” of the parent’s behavior, meaning that the parent-child conflict is inauthentic.

In attachment-based “parental alienation,” the child’s behavior toward the targeted parent is not under the “stimulus control” of the targeted parent’s behavior.  It doesn’t matter what the targeted parent does or doesn’t do, the child rejects a relationship with this parent. 

In attachment-based “parental alienation,” the locus of “stimulus control” for the child’s behavior toward the targeted-rejected parent is to be found in the cross-generational coalition of the child with the narcissistic/(borderline) parent, and is contained in internalized “rules” the child has acquired through the distorted parenting practices of the narcissistic/(borderline) parent regarding the child’s relationship with the targeted parent, much in the same way that our internalized rules regarding driving act to control our driving behavior.

Differentiating Authentic Versus Inauthentic Conflict

One means of differentiating authentic versus inauthentic parent-child conflict is whether the child’s protest behavior represents an “attachment behavior” designed to increase parental involvement in response to barriers to the child’s ability to form an affectionally bonded relationship with the parent, or whether the child’s protest behavior represents an inauthentic display of “detachment behavior” designed to sever the parent-child relationship.

A second means of differentiating authentic versus inauthentic parent-child conflict is through the construct of “stimulus control.” The child’s behavior in authentic parent-child conflict is under the stimulus control of the parent’s behavior, so that changes in the parent’s behavior produce corresponding changes in the child’s behavior. Whereas in inauthentic parent-child conflict the child’s behavior toward the targeted parent is NOT under the stimulus control of the targeted parent, so that changes to the behavior of the targeted parent DO NOT produce corresponding changes to the child’s behavior.

Personality Disorder Symptoms

This is the clearest set of symptoms for differentiating true allegations of attachment-based “parental alienation” from false allegations of “parental alienation.”

In attachment-based “parental alienation,” the child’s symptomatic rejection of a relationship with the targeted parent is the product of pathogenic parental influence on the child by the narcissistic/(borderline) parent. In influencing the child to reject a relationship with the other parent, the narcissistic/(borderline) parent leaves telltale evidence of his or her pathogenic influence on the child through the narcissistic/borderline features of the child’s attitude toward the targeted-rejected parent.

Children to not spontaneously develop narcissistic and borderline personality traits. The development of narcissistic and borderline personality traits in children can ONLY be produced by the pathogenic parenting practices of a narcissistic or borderline parent. The psychological influence on a child by a narcissistic/(borderline) parent will leave “psychological fingerprint” evidence of this pathogenic influence in the child’s symptom display toward the targeted parent.

The “psychological fingerprint” evidence of distorting pathogenic influence on the child by a narcissistic/(borderline) parent is the presence in the child’s symptom display of five specific narcissistic and borderline features.

In authentic parent-child conflict in which a false allegation of “parental alienation” is made, the child’s symptom display toward the targeted parent WILL NOT display narcissistic and borderline personality features. In particular, the child will not evidence a sense of entitlement relative to the targeted-rejected parent, nor will the child evidence an attitude of haughty and arrogant contempt for the targeted-rejected parent.

In authentic parent-child conflict the child will also typically continue to evidence normal-range empathy for the emotional experience of the targeted parent, although this capacity for empathy may periodically disappear during periods of open anger toward the targeted parent. In authentic parent-child conflict, the child’s capacity for normal-range empathy for the targeted parent will typically be evident during inter-episode periods that occur between openly angry exchanges the child has with the targeted parent.

Also, in authentic parent-child conflicts the psychological dynamic of splitting will not be evident in the child’s symptom display. Spitting is the characteristic tendency for polarized black-and-white thinking in which people and relationships are seen as entirely good and wonderful, or as entirely bad and evil. In authentic parent-child conflict the child will express anger and frustration with the targeted parent, but will not characterize the targeted parent as a polarized extreme of all bad. Instead, during periods when the parent and child are not openly fighting, the child will be able to maintain a nuanced, shades-of-gray, perception of both positive and negative qualities possessed by the targeted parent, even though the child may find some parental qualities frustrating and provoking.

In order for attachment-based “parental alienation” to be diagnosed as being present, ALL FIVE narcissistic and borderline traits MUST be present in the child’s symptom display. The presence of all five narcissistic and borderline traits in the child’s symptom display represents the “psychological fingerprint” evidence for the distorting pathogenic influence on the child by a narcissistic/(borderline) parent.

Since the child is rejecting a relationship with the targeted parent, the psychological influence on the child that is evidenced in the child’s display of narcissistic and borderline personality traits CANNOT be emanating from the targeted parent, since the child is rejecting the influence of this parent. Since narcissistic and borderline personality traits can ONLY emerge as a result of distorting pathogenic parenting practices by a narcissistic/borderline parent, the only possible source for the child’s symptom display of narcissistic and borderline personality traits is the distorted pathogenic parenting practices of the allied and supposedly favored parent.

Sub-Threshold Display

If the child’s symptoms display some but not all of the five narcissistic and borderline personality traits predicted by an attachment-based model of “parental alienation,” then the diagnosis of attachment-based “parental alienation” cannot be made.

In sub-threshold cases in which some but not all of the diagnostic indicators of attachment-based “parental alienation” are present, a 6-month “Response-to-Intervention” (RTI) trial can be initiated, treating the parent-child conflict as if it was authentic. This 6-month RTI trial can clarify diagnostic features in one or the other direction.

If the parent-child conflict is authentic, then six months of treatment should produce substantial improvements in the relationship. If the parent-child conflict is the result of attachment-based “parental alienation,” then six months of treatment will produce no gains, and during the six month RTI trial the additional confirmatory diagnostic indicators should become evident during the course of treatment.

The presence of additional clinical signs (Diagnostic Indicators and Associated Clinical Signs) indicative of attachment-based “parental alienation” may also help confirm diagnostic impressions.

Delusional Beliefs

The third diagnostic indicator of attachment-based “parental alienation,” an intransigently held, fixed and false belief (i.e., a delusion) regarding the supposedly abusive parental inadequacy of the targeted rejected parent, will not be present in authentic parent-child conflicts.

The foundational source of this delusional belief is the reenactment narrative involving attachment trauma networks in the “internal working models,” or “schemas,” of the alienating parent’s attachment system. This process is explained more fully in my online Master Lecture Series seminars on theory and treatment (7/18/14: Theoretical Foundations11/21/14: Diagnosis and Treatment) through California Southern University. The child’s delusional belief represents the child’s adopting the “victimized child” role within the trauma reenactment narrative.

This type of trauma reenactment is familiar within the treatment literature related to trauma,

“Reenactments of the traumatic past are common in the treatment of this population and frequently represent either explicit or coded repetitions of the unprocessed trauma in an attempt at mastery. Reenactments can be expressed psychologically, relationally, and somatically and may occur with conscious intent or with little awareness.” (Perlman & Courtois, 2005, p. 455)

“One primary transference-countertransference dynamic involves reenactment of familiar roles of victim, perpetratorrescuer-bystander in the therapy relationship. Therapist and client play out these roles, often in complementary fashion with one another, as they relive various aspects of the client’s early attachment relationships. (Perlman & Courtois, 2005, p. 455)

Pearlman, C.A., Courtois, C.A. (2005). Clinical Applications of the Attachment Framework: Relational Treatment of Complex Trauma. Journal of Traumatic Stress, 18, 449-459.

In the case of attachment-based “parental alienation” it is the family members who are enacting the various roles of the narcissistic/(borderline) parent’s attachment trauma history, in which the child is enacting the role as the “victimized child,” the targeted parent is enacting the role as the “abusive parent,” and the narcissistic/(borderline) parent is adopting and enacting the coveted role as the “rescuing/protective parent.”

But none of this trauma reenactment narrative is true. The child is not a victim, the targeted parent is not abusive, and the narcissistic/(borderline) parent is not protective. It is a false drama created in the trauma contained in the narcissistic/(borderline) parent’s attachment system.

The child’s delusional belief represented by Diagnostic Indicator 3 is a manifestation of the child having been induced through the distorted pathogenic parenting practices of the narcissistic/(borderline) parent into adopting the “victimized child” role within the false trauma reenactment narrative of the narcissistic/(borderline) parent’s attachment trauma.

So that expert clinical diagnosticians, which should be a requirement for all mental health professionals working with this “special population” of children and families, should look beyond the mere surface features of the child’s delusional beliefs into the surrounding context for signs of the trauma reenactment narrative of which the child’s false belief in the “victimization role” is but one feature.

In authentic parent-child conflict involving false allegations of “parental alienation,” the child’s beliefs regarding the parenting practices of the targeted parent are not delusional. If, for example, the child asserts that the parent is physically abusive, the evidence presented by the child for this belief will be consistent with the child’s expressed belief. So that a child who asserts that the targeted parent is physically abusive should report that this belief is based on repeated incidents of being hit with a belt, or with a fist, or with an electrical cord.

Whether or not these child reports can be substantiated is another matter, but the reports of the child regarding the parenting practices of the parent should be consistent with the child’s beliefs that the parent is physically abusive (in the case of allegations of physically abusive parenting).

This is in contrast to a child who alleges the targeted parent is “emotionally abusive” because the parent took the child’s iphone away as punishment for the child’s hostile and negative attitude and display of disrespect. This is not considered “abusive” parenting, this is considered “discipline” and is entirely within normal-range parenting practices.

In this case, if the child maintains the position that the parent taking the child’s iphone away for a period of time as discipline for inappropriate child behavior represents “emotional abuse” rather than normal-range parenting practice (i.e., “discipline”), then this would suggest the presence of an intransigently held, fixed and false belief in the supposedly abusive parenting practices of a normal range and affectionally available parent, which would be consistent with the child adopting a “victimized child” role.

In authentic parent-child conflicts, such as when the targeted parent is the parent with the narcissistic personality, or in cases of authentically abusive parenting, the child’s beliefs regarding the parenting practices of the targeted parent are not delusional, they are accurate.

Furthermore, in cases where it is the targeted parent who has the narcissistic personality and is making a false allegation of “parental alienation” from an inability to self-reflect and from a charcterological propensity to externalize blame and responsibility, professional clinical interviews with the targeted parent should reveal the presence of narcissistic personality traits.

Prominent among the distinctive clinical indicators of narcissistic personality is the absence of empathy. So in cases of authentic parent-child conflict in which the narcissistic parent is the targeted parent, clinical interviews with the narcissistic targeted parent should be able to reveal this parent’s profound absence of empathy, which then supports the beliefs of the child regarding the problematic parenting practices of the narcissistic targeted parent, so the child’s beliefs again are not delusional but are supported by direct clinical observation.

Diagnosis of Attachment-Based “Parental Alienation”

Not everything is “parental alienation.”

Sometimes the targeted parent is the narcissistic parent and the child’s withdrawal from a relationship with this narcissistic parent is an understandable and reasonable response to the profound absence of parental empathy emanating from the narcissistic parent. Sometimes the allegation of “parental alienation” by a narcissistic parent represents the inability of the narcissistic parent to self-reflect and the narcissistic tendency to externalize blame and responsibility.

Sometimes the child’s withdrawal from a relationship with a parent is the product of actual physical or sexual abuse of the child, or is the product of prolonged and severe domestic violence. In these cases the child’s belief in the abusive parenting practices of the physically or sexually abusive parent are not delusional, they’re true.

However, in these circumstances the child will not display narcissistic personality traits toward the abusive parent. In particular, the child will not display an attitude of haughty and arrogant disrespect and contemptuous disdain toward the physically or sexually abusive parent, nor will the child display a sense of entitlement relative to the abusive parent, in which the child feels entitled to have every desire immediately met by the physically or sexually abusive parent.

Instead, physically and sexually abused children tend to present as timid and submissive in their relationship with the abusive parent, and they may display as angry and aggressive in other settings, such as in peer relationships at school.

Sometimes, however, a narcissistic/(borderline) parent has formed a cross-generational coalition with the child against the other parent, in which the child has been induced into adopting the “victimized child” role in the trauma reenactment narrative of the narcissistic/(borderline) parent, so that the child is induced through the distorted pathogenic parenting practices of the narcissistic/(borderline) parent into rejecting a relationship with a normal-range and affectionally available parent so that the child can be used by the narcissistic/(borderline) parent as a “regulatory object” for this parent’s own emotional and psychological needs.

This process is explained more fully in my online Master Lecture Series seminars on theory and treatment (7/18/14: Theoretical Foundations11/21/14: Diagnosis and Treatment) through California Southern University.

So that sometimes the child’s rejection of a relationship with a parent is the product of attachment-based “parental alienation.”

When ALL THREE diagnostic indicators of attachment-based “parental alienation” are present in the child’s symptom display, then a clinical diagnosis of attachment-based “parental alienation” is warranted since NO OTHER PROCESS can produce THIS SPECIFIC SET of child symptoms other than an attachment-based model of “parental alienation.”

Authentic parent-child conflict will not produce this specific symptom set. Authentic child abuse will not produce this specific symptom set. ONLY the processes of an attachment-based model for the construct of “parental alienation” will produce this specific symptom set of three diagnostic indicators (Diagnostic Indicators and Associated Clinical Signs)

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

References

Moor, A. and Silvern, L. (2006). Identifying pathways linking child abuse to psychological outcome: The mediating role of perceived parental failure of empathy. Journal of Emotional Abuse, 6, 91-112.

Pearlman, C.A., Courtois, C.A. (2005). Clinical Applications of the Attachment Framework: Relational Treatment of Complex Trauma. Journal of Traumatic Stress, 18, 449-459.

Online Seminar: The Diagnosis & Treatment of Attachment-Based Parental Alienation

My 11/21/14 online seminar regarding the Diagnosis and Treatment of Attachment-Based “Parental Alienation” through the Master Lecture Series of California Southern University is now available online for the general public at:

https://vimeo.com/calsouthern/review/113572265/8d0b48de77

A handout of the Powerpoint slides for this seminar is available on my website: www.drcachildress.org

I believe this seminar is significant in several primary areas:

Standards of Practice: This seminar describes clearly defined standards for professional competence in the diagnosis and treatment of this “special population” of children and families experiencing attachment-based “parental alienation.”

Psychological Child Abuse: It establishes the theoretical foundations and support for identifying attachment-based “parental alienation” as psychological child abuse that warrants the DSM-5 diagnosis of V995.51 Child Psychological Abuse, Confirmed.

Diagnostic Criteria: It defines a set of clear diagnostic criteria based in established and accepted psychological principles and constructs that can reliably identify attachment-based “parental alienation” in every case, and that can reliably differentiate attachment-based “parental alienation” from other forms of parent-child conflict, including false allegations of “parental alienation.”

Protective Separation: It defines the structure necessary for treatment that begins with a protective separation of the child from the pathogenic parenting practices of the narcissistic/(borderline) parent during the active phase of the child’s treatment and recovery.

This online seminar is now available for review by therapists, child custody evaluators, attorneys, judges, and the general media, and so can serve as a referral resource for targeted parents trying to increase general public awareness and the understanding of legal and mental health professionals regarding the issues surrounding an attachment-based model of “parental alienation” and the mental health needs of children and families experiencing this type of tragic family process.

With the proper professional understanding that leads to an appropriate legal and mental health response, the solution to attachment-based “parental alienation” in any individual family circumstance is likely to be achievable within a relatively short period of active treatment intervention.

The family tragedy of “parental alienation” needs to end.  Today.

Every day that passes that we do not enact the required solution is another day that we tolerate the profoundly destructive psychological abuse of the child.

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

High Road to Family Reunification

My blog posts have been somewhat quiet recently because I’ve been focused on writing a book regarding the Theory and Diagnosis of an Attachment-Based Model of “Parental Alienation,” and I had to prepare for my recent Master Series seminar through California Southern University regarding the Diagnosis and Treatment of Attachment-Based Parental Alienation.” I was also focused on a Court case in Hawaii that was operating under time pressures.  This case was referred to me through Ms. Dorcy Pruter, a co-parenting and reunification coach at the Conscious Co-Parenting Institute (www.consciouscoparentinginstitute.com)

The Court case had a successful outcome for the targeted-rejected parent, and Ms. Pruter is now handling the mother-daughter reunification process.

I have been aware of Ms. Pruter’s work in this area for a while, but through our work together on this case I have had the opportunity to review Ms. Pruter’s reunification protocol and have also been able to engage her in extensive dialogue regarding her approach and an attachment-based model for the construct of “parental alienation.”

I would like to take this opportunity to provide Ms. Pruter with my unequivocal, full and complete support for her model of family reunification (“High Road to Family Reunification”).  Based on my review of her reunification protocol, it is theoretically sound for addressing the issues surrounding an attachment-based model of “parental alienation.” I would anticipate that her reunification protocol will be highly effective in resolving the family issues surrounding an attachment-based model of “parental alienation.”

One of the primary issues regarding enacting Ms. Pruter’s reunification protocol is that it FIRST requires the child’s protective separation from the distorted parenting practices of the narcissistic/(borderline) allied (and supposedly “favored”) parent. This is, however, not a limitation of her protocol but instead represents an authentic treatment-related need of addressing the pathogenic parenting of the narcissistic/(borderline) parent that is inducing the very serious child psychopathology evidenced in attachment-based “parental alienation.”

In my private practice I will no longer treat cases of attachment-based “parental alienation” without first obtaining the child’s protective separation from the pathogenic parenting of the narcissistic/(borderline) parent because I have become convinced that to do so places the child at risk of psychological harm as a result of being turned into a “psychological battleground” between the efforts of therapy to restore the child’s normal-range, balanced and healthy psychological functioning and the unrelenting efforts of the narcissistic/(borderline) parent to maintain the child’s symptomatic rejection of a relationship with the normal-range and healthy targeted parent.

Turning the child into a psychological battleground between the goals of therapy to restore healthy child development and the pathogenic goals of the narcissistic/(borderline) parent to maintain the child’s symptomatic state runs the considerable risk of harming the child-client’s emotional and psychological development.  So unless the necessary treatment-related conditions exist to allow effective therapy to restore the child’s healthy functioning without risking psychological harm to the child in the process, then I will decline treatment.

In my professional view, based on my professional experience and expertise in this area, professionally responsible and competent treatment of an attachment-based model of “parental alienation” (i.e., the presence in the child’s symptom display of the three Diagnostic Indicators of attachment-based “parental alienation”) REQUIRES that the child FIRST be protectively separated from the pathogenic parenting of the narcissistic/(borderline) parent during the active phase of the child’s treatment and recovery.

Once the child’s healthy and normal-range functioning has been restored and the child’s healthy and normal-range relationship with the formerly targeted-rejected parent has been recovered, then the pathogenic parenting of the narcissistic/(borderline) parent can be reintroduced under appropriate therapeutic monitoring of the child’s symptoms that ensures that the child’s symptoms do not return upon the reintroduction of the pathogenic parenting of the narcissistic/(borderline) parent (there are treatment-related steps that can be taken to reduce this risk).

In first requiring the child’s protective separation from the pathogenic parenting of the narcissistic/(borderline) parent, Ms. Pruter’s protocol (the “High Road to Family Reunification”) demonstrates its accurate understanding for the family dynamics involved.

Furthermore, Ms. Pruter’s reunification protocol is solution-focused and avoids criticism of the narcissistic/(borderline) parent, thereby respecting the child’s love for BOTH parents, even for the narcissistic/(borderline) parent.  The fundamental issue for the child is his or her TRIANGULATION into the spousal conflict through the efforts of the narcissistic/(borderline) parent that enlist the child in a cross-generational coalition against the other parent.

In avoiding criticism of the narcissistic/(borderline) parent, Ms. Pruter’s reunification protocol represents an appropriate response to the child’s triangulation into the spousal conflict by allowing the child to be de-triangulated from the spousal conflict.  The child does not need to take sides.  I’m sure this is a great relief to the child.

In addition, her protocol is psycho-educational in focus, so that it effectively brings cognitive mediation to emotional processes, thereby lessening the child’s hyper-inflamed emotional distortions toward the targeted parent.  The educational material also provides the child with a healthy and balanced narrative for understanding the family experience without blame for anyone, including without guilt for the child stemming from the child’s prior distorted-hostile-rejecting behavior toward the targeted parent.

Ms. Pruter’s reunification protocol elegantly provides the child with a narrative road out of the hostile-rejecting behavior toward the targeted-rejected parent while simultaneously de-triangulating the child from the spousal conflict.

Ms. Pruter claims she has experienced substantial (universal) success with her protocol in reunifying parent-child relationships, and after my review of her protocol I would similarly expect it to be fully successful based upon its structure and approach.

Ms. Pruter’s protocol also has a component for the participation of the narcissistic/(borderline) parent in learning the skills needed to avoid triangulating the child into the spousal conflict, which also recommends this protocol as a complete family intervention.  Although Ms. Pruter notes from her experience that participation by the narcissistic/(borderline) parent is irregular at best.

One of the limitations of Ms. Pruter’s reunification protocol is that it is offered in an intensive four-day initial intervention with subsequent follow-up to stabilize the reunited parent-child relationship, which places this protocol beyond the reach of many families that live in other parts of the country or who may have limited financial resources.  I am currently in discussion with Ms. Pruter on ways to possibly make training in this reunification protocol available to mental health therapists via online training seminars so as to make this approach more broadly available to targeted-rejected parents and their children.

Another limitation is that the protocol (appropriately) requires that the child be protectively separated from the pathogenic parenting of the narcissistic/(borderline) parent during the active phase of the child’s treatment and recovery.  While this is both a necessary and professionally responsible requirement, it will require the cooperation of the Court, which is a hurdle that targeted-rejected parents will need to address and overcome before this protocol becomes available for restoring their relationships with their children that have been so severely damaged by the pathogenic parenting of the narcissistic/(borderline) parent.

Yet even with these barriers to enacting the protocol, I am heartened and optimistic in reviewing a reunification protocol that is both thoughtfully integrated and elegant in its formulation, and that is theoretically sound for addressing and resolving the family dynamics associated with an attachment-based model of “parental alienation.”

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