Uniting in a Scientific Foundation

I received a Comment from Michelle Jones, LCSW to my blog post Bringing the Era of Gardnerian PAS to a Close.

I found her Comment so articulate and spot-on accurate that I decided to repost it here as a blog.  In my view, her description of the situation is exactly correct.

As preface let me say that the only thing I care about is bringing an end to the family tragedy of “parental alienation.”  And we can accomplish that.  We can bring this family nightmare to an end.  Today.  This instant.  The pathology of “parental alienation” is not some type of new and unique pathology. It is a manifestation of established, well-defined, and well-understood forms of psychopathology that ALL mental health professionals should ALREADY be knowledgeable in, especially if they are working with this type of pathology.

An attachment-based model of “parental alienation” is NOT me… it’s Kernberg, it’s Millon, it’s Beck, it’s Bowlby, it’s Ainsworth, it’s Haley, it’s Minuchin,… it is the work of the preeminent figures in all of psychology. 

All I did was bring this work together and apply it to the pathology commonly referred to as “parental alienation.”  It’s not “my theory.”  It is the fundamental principles within established forms of psychopathology.  Read Kernberg, read Millon, read Beck, read, Bowlby, read… it’s all there.

There is NOTHING new in Foundations.  It is all established and well-defined forms of pathology.

Here is the comment of Michelle Jones, LCSW.  I am in 100% agreement with her.  Solving the pathology of “parental alienation” is the central issue, and it is the ONLY issue.

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From Michelle Jones, LCSW:

As a mental health therapist, I am making this reply directed to mental health therapists. It is difficult for most people to rise above their current situation and see the bigger view of themselves within the context of their own era of history.  Looking back, it’s much easier to see.  As they say, “Hindsight is 20/20.”

When Joseph Lister proved that using antiseptics in surgery could reduce the number of post op infections, you would think the people at that time of history would have shouted for joy that such progress could be made.  Instead it challenged their paradigms and actually caused insult to many of the professionals at the time.  Looking back, we see the ignorance and the extreme shortsightedness of the accepted thinking of that day.  And of course today we all believe in the reality of microbiology and the need for sterile technique, but historically, the idea took some getting used to.  It actually took about a decade for people to start taking Lister seriously.  Further, without Lister’s clear and accurate assessment that “germs” caused infections (and not bad air), there was no way to justify or standardize the use of antiseptics.

We are now in a critical time of change in the history of parental alienation treatment.  I believe it is mandatory to accurately define the pathology of parental alienation in an indisputable, scientifically-based manner, as you have done Dr. Childress–so that we can justify and prescribe the necessary treatments.  We, as mental health therapists should know that our interventions are only as good as our assessments. If we do not accurately identify the pathology, then we cannot justify the necessary and appropriate interventions.

This should not be a debate about whose opinion or construct is better than whose, this should be an objective, scientific and moral endeavor to raise the professional standard of practice across the field of mental health.  If we as professionals truly believe in “doing no harm,” and our focus is truly on helping children and families, who are the foundation of our society, then we need to lay down our egos, and our outdated paradigms, and with integrity and humility, seek truth, even if it challenges us personally.

I am not criticizing Gardner, nor those who have supported the PAS model.  You have all done so much good in the world, and I sincerely appreciate your efforts.  I own and have read most of your books.  What I am asking is, “Is the PAS paradigm really working to the extent that it justifies and allows the needed solutions?”  Gardner did a lot of good to raise awareness, and at great personal expense.  His behavioral observations were accurate, but his theoretical constructs were not complete.  That’s okay.  If he were alive today, I believe he would shout, “That’s okay, just do something that works and stops the abuse!”  After reading many of his articles and books, I truly believe his motives were pure.  But his character and his contributions are not under question and we shouldn’t allow ourselves to be distracted by whether or not we should be loyal to Richard Gardner.  Adopting the constructs of an attachment-based model of parental alienation has nothing to do with being loyal or disloyal to Gardner or the groundwork he laid, it’s about the next step in history and addressing the urgency of bringing about solutions to the devastating problem of parental alienation.

As you have stated, Dr. Childress, staff splitting is a symptom of what happens to the treatment team when working with patients with personality disorders.  Divide and conquer is their MO.  I have spent years working with patients in residential treatment centers (many with personality disorders) and the clinicians would meet once or twice a week in treatment team to collaborate so that we could unite and do effective therapy.  The patients could not be helped without unified treatment interventions.

If we are going to effectively treat parental alienation or pathogenic parenting, it will require the same thing, uniting as a treatment team and implementing appropriate interventions with strict boundaries so that change can actually happen.  How do we determine the needed boundaries and interventions?  Only by first properly and accurately identifying the pathology.  Dr. Childress has painstakingly done this for us in Foundations.  I urge all mental health professionals to read Foundations and see if it fits with the established and accepted therapeutic theories we were trained in. Let’s unite in the spirit of peace and cooperation and reach consensus on the best treatment standards for parental alienation.  And then, let’s unitedly take action.

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I agree 100% with everything Ms. Jones said.

This is only about a scientifically-based description of the pathology so we can move forward in its diagnosis and treatment.  The pathology is NOT a new and unique syndrome, it is a manifestation of entirely understandable and defined forms of psychopathology. 

It is time to end the unnecessary and paralyzing debate in professional psychology and come together in the service of children and families caught in this particular form of pathology.

The focal goal of our efforts needs to be a change in the APA Position Statement on Parental Alienation so that it,

1.)  Acknowledges that the pathology exists, using whatever name establishment mental health wishes to use (“parental alienation,” “pathogenic parenting,” “attachment-trauma reenactment pathology” – or some other label for the pathology).

The pathology of “parental alienation” exists.

2.)  Formally recognize the children and families evidencing this type of pathology as representing a “special population” who require specialized professional knowledge and expertise (in attachment theory, personality disorder pathology, and family systems theory) in order to competently assess, diagnose and treat.

The complex nature of the pathology defines these children and families as a special population who require specialized professional knowledge and expertise to competently assess, diagnose, and treat.

I believe this to be a reasonable and temperate demand on our part.  All we are asking for is professional competence in established domains of professional psychology.

In order to achieve professional competence in established domains of professional psychology, we must first be able to define the pathology within established and existing forms of psychopathology.

That’s what Foundations does.  It establishes the foundations for professional competence. 

It is time to end the divisive and damaging debate within professional psychology and come together, all of us, to meet the very real needs of the children and families experiencing this type of tragic psychopathology.

Thank you for your support Michelle.  Your banner is on the battlefield in support of the children and families who need us.

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

Foundations is not “my theory.”  Here is the source material:

Central References:  Books

Bowlby, J. (1969). Attachment and Loss: Vol. 1. Attachment. NY: Basic Books.

Bowlby, J. (1973). Attachment and Loss: Vol. 2. Separation: Anxiety and Anger. NY: Basic Books.

Bowlby, J. (1980). Attachment and Loss: Vol. 3. Loss: Sadness and Depression. NY: Basic Books.

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., and Associates (2004). Cognitive Therapy of Personality Disorders. (2nd edition). New York: Guilford.

Kernberg, O.F. (1975). Borderline Conditions and Pathological Narcissism. New York: Aronson.

Minuchin, S. (1974). Families and Family Therapy. Harvard University Press.

• If a mental heath professional is assessing, diagnosing, or treating this population of children and families and has not read these texts by the most preeminent figures in attachment theory, personality disorder pathology, and family systems theory, then the mental health professional is very likely to be practicing beyond the boundaries of his or her professional competence in violation of Standard 2.01 of the Ethical Principles of Psychologists and Code of Conduct of the American Psychological Association.

Additional Central References: Research

Fonagy, P., Luyten, P., and Strathearn, L. (2011). Borderline personality disorder, mentalization, and the neurobiology of attachment. Infant Mental Health Journal, 32, 47-69.

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.

Fonagy, P., Target, M., Gergely, G., Allen, J.G., and Bateman, A. W. (2003). The developmental roots of Borderline Personality Disorder in early attachment relationships: A theory and some evidence. Psychoanalytic Inquiry, 23, 412-459.

van Ijzendoorn, M.H. (1992) Intergenerational transmission of parenting: A review of studies in nonclinical populations. Developmental Review, 12, 76-99

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

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

Macfie, J., McElwain, N.L., Houts, R.M., and Cox, M.J. (2005) Intergenerational transmission of role reversal between parent and child: Dyadic and family systems internal working models. Attachment & Human Development, 7, 51-65.

Lyons-Ruth, K., Bronfman, E. and 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).

Main, M. and Hesse, E. (1990). Parents’ unresolved traumatic experiences are related to infant disorganized attachment status: Is frightened and/or frightening parental behavior the linking mechanism? In M.T. Greenberg, D. Cicchetti, & E.M. Cummings (Eds.), Attachment in the preschool years: Theory, research, and intervention (pp. 161–182). Chicago: University of Chicago Press.

van der Kolk, B.A. (1989). The compulsion to repeat the trauma: Re-enactment, revictimization, and masochism. Psychiatric Clinics of North America, 12, 389-411

Pearlman, C.A. and Courtois, C.A. (2005). Clinical applications of the attachment framework: Relational treatment of complex trauma. Journal of Traumatic Stress, 18, 449-459.

Prager, J. (2003). Lost childhood, lost generations: the intergenerational transmission of trauma. Journal of Human Rights, 2, 173-181.

Shaffer, A., and Sroufe, L. A. (2005). The developmental and adaptational implications of generational boundary dissolution: Findings from a prospective, longitudinal study. Journal of Emotional Abuse. 5(2/3), 67-84.

van Ijzendoorn, M.H. (1992) Intergenerational transmission of parenting: A review of studies in nonclinical populations. Developmental Review, 12, 76-99

Brennan, K.A. and Shaver, P.R. (1998). Attachment styles and personality disorders: Their connections to each other and to parental divorce, parental death, and perceptions of parental caregiving. Journal of Personality 66, 835-878.

Dutton, D. G., Denny-Keys, M. K., and Sells, J. R. (2011). Parental personality disorder and its effects on children: A review of current literature. Journal of Child Custody, 8, 268-283.

Sable, P. (1997). Attachment, detachment and borderline personality disorder. Psychotherapy: Theory, Research, Practice, Training, 34(2), 171-181.

Holmes, J. (2004). Disorganized attachment and borderline personality disorder: a clinical perspective. Attachment & Human Development, 6(2), 181-190.

Lopez, F. G., Fuendeling, J., Thomas, K., and Sagula, D. (1997). An attachment-theoretical perspective on the use of splitting defenses. Counseling Psychology Quarterly, 10, 461-472.

Juni, S. (1995). Triangulation as splitting in the service of ambivalence. Current Psychology: Research and Reviews, 14, 91-111.

Mikulincer, M., Gillath, O., and Shaver, P.R. (2002). Activation of the attachment system in adulthood: Threat-related primes increase the accessibility of mental representations of attachment figures. Journal of Personality and Social Psychology, 83, 881-895.

Garety, P. A. and Freeman D. (1999) Cognitive approaches to delusions: A critical review of theories and evidence. The British Journal of Clinical Psychology; 38, 113-154.

Rappoport, A. (2005). Co-narcissism: How we accommodate to narcissistic parents. The Therapist.

Hodges, S. (2003). Borderline personality disorder and posttraumatic stress disorder: Time for integration? Journal of Counseling and Development, 81, 409-417.

Levy, K.N. (2005). The implications of attachment theory and research for understanding borderline personality disorder. Development and Psychopathology, 17, p. 959-986.

Additional Supporting Research

Fonagy P. and Target M. (2005). Bridging the transmission gap: An end to an important mystery in attachment research? Attachment and Human Development, 7, 333-343.

van IJzendoorn, M.H., Schuengel, C., and Bakermans-Kranenburg, M.J. (1999). Disorganized attachment in early childhood: Meta-analysis of precursors, concomitants, and sequelae. Development and Psychopathology, 11, 225–249.

Macfie, J. Fitzpatrick, K.L., Rivas, E.M. and Cox, M.J. (2008). Independent influences upon mother-toddler role-reversal: Infant-mother attachment disorganization and role reversal in mother’s childhood. Attachment and Human Development, 10, 29-39

Sroufe, L. A. (2005). Attachment and development:  A prospective, longitudinal study from birth to adulthood, Attachment and Human Development, 7, 349-367.

Bacciagaluppi, M. (1985). Inversion of parent-child relationships: A contribution to attachment theory. British Journal of Medical Psychology, 58, 369-373.

Benoit, D. and Parker, K.C.H. (1994). Stability and transmission of attachment across three generations. Child Development, 65, 1444-1456

Bretherton, I. (1990). Communication patterns, internal working models, and the intergenerational transmission of attachment relationships. Infant Mental Health Journal, 11, 237-252.

Cassidy, J., and Berlin, L. J. (1994). The insecure/ambivalent pattern of attachment: Theory and research. Child Development, 65, 971−991.

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.

van der Kolk, B.A. (1987). The separation cry and the trauma response: Developmental issues in the psychobiology of attachment and separation. In B.A. van der Kolk (Ed.) Psychological Trauma (31-62). Washington, D.C.: American Psychiatric Press, Inc.

Raineki, C., Moriceau, S., and Sullivan, R.M. (2010). Developing a neurobehavioral animal model of infant attachment to an abusive caregiver. Biological Psychiatry, 67, 1137-1145.

Kaplan, J. T., and Iacoboni, M. (2006). Getting a grip on other minds: Mirror neurons, intention understanding, and cognitive empathy. Social Neuroscience, 1(3/4), 175-183.

Iacoboni, M., Molnar-Szakacs, I., Gallese, V., Buccino, G., Mazziotta, J., and Rizzolatti, G. (2005). Grasping the intentions of others with one’s own mirror neuron system. Plos Biology, 3(3), e79.

Fraiberg, S., Adelson, E., and Shapiro, V. (1975). Ghosts in the nursery. Journal of the American Academy of Child and Adolescent Psychiatry, 14, 387–421.

Barnow, S. Aldinger, M., Arens, E.A., Ulrich, I., Spitzer, C., Grabe, H., Stopsack, M. (2013). Maternal transmission of borderline personality disorder symptoms in the community-based Griefswald Family Study. Journal of Personality Disorders, 27, 806-819,

Carlson, E.A., Edgeland, B., and Sroufe, L.A. (2009). A prospective investigation of the development of borderline personality symptoms. Development and Psychopathology, 21, 1311-1334.

Fruzzetti, A.E., Shenk, C. and Hoffman, P. (2005). Family interaction and the development of borderline personality disorder: A transactional model. Development and Psychopathology, 17, 1007-1030.

Stepp, S. D., Whalen, D. J., Pilkonis, P. A., Hipwell, A. E., and Levine, M. D. (2011). Children of mothers with Borderline Personality Disorder: Identifying parenting behaviors as potential targets for intervention. Personality Disorders: Theory, Research, and Treatment. 1-16.

Svrakic, D.M. (1990). Functional dynamics of the narcissistic personality. American Journal of Psychiatry. 44, 189-203.

Widiger, T.A. and Trull, T.J. (2007). Plate tectonics in the classification of personality disorder: Shifting to a dimensional model. American Psychologist, 62, 71-83.

Additional Supporting Books

Cozolino, L. (2006): The neuroscience of human relationships: Attachment and the developing social brain. WW Norton & Company, New York.

Siegel, D. (1999). The developing mind: Toward a neurobiology of interpersonal experience (New York: Guilford Press, 1999)