Treatment Discussion Response to Jean Mercer

This is my response to Dr. Mercer regarding her desire to discuss treatment.

Hello Dr. Mercer,

First, let me say it’s a pleasure to meet you and to engage you in this professional dialogue. Thank you for your response to my previous post.

Second, let me say, I am not a fan of the Gardnerian PAS model. I will in no way defend the Gardnerian PAS model. Needless to say, I suspect my criticisms of the PAS model have left me few friends among the current PAS advocates. Don’t care. The PAS model isn’t very good.

I’m a conservative clinical psychologist, and I believe we should remain within scientifically established psychological principles and constructs and work at the highest level of professional knowledge, based in the scientifically established literature.

Also, I’ve worked in the foster care system as the Clinical Director for a children’s assessment and treatment center, and I am experienced with authentic child abuse up close and personal. Whatever solutions we develop must protect 100% of children 100% of the time.

Based on your blog and Comment, I recognize your interest in moving into a discussion of treatment, but I would respectfully suggest that a discussion of treatment would be premature before we have an agreed understanding regarding the pathology we are trying to treat.

While I must plead ignorance regarding your work, I suspect you have a strong concern for protecting children from authentic child abuse and a strong reluctance to discount the reports from the children. If I’m correct in my assumptions, your position would be understandable and I would agree with it.

What I’m worried about is a very small population of children who are being parented by a narcissistic and/or borderline personality parent.

A 2008 study regarding the prevalence of Narcissistic Personality Disorder (Stinson, et al., 2008) estimates the prevalence of Narcissistic Personality Disorder at 6%.

A 2008 study regarding the prevalence of Borderline Personality Disorder (Grant, et al., 2008) estimates the prevalence of Borderline Personality Disorder at 6%.

I’m not going to quibble on numbers, but my point is it’s a small, but not insubstantial, group of families. This pathology, the narcissistic and borderline personality pathology, is also likely to be highly represented in high-conflict divorce. The association of this type of personality pathology with disorganized attachment would mean that these spouses/parents have no organized strategy for repairing relationship breaches, such as encountered in the divorce. In addition, the divorce hits dead center on the narcissistic vulnerability of primal self-inadequacy (rejection of the narcissistic personality spouse by the attachment figure of the other spouse), and dead center on the core borderline vulnerability of abandonment fears (by the attachment figure of the other spouse).

So a more florid display of narcissistic and borderline personality pathology surrounding divorce should be expected. So the clinical question becomes, what would that display look like?

In discussing the narcissistic and borderline personality structure, Otto Kernberg notes that,

“They are especially deficient in genuine feelings of sadness and mournful longing; their incapacity for experiencing depressive reactions is a basic feature of their personalities. When abandoned or disappointed by other people they may show what on the surface looks like depression, but which on further examination emerges as anger and resentment, loaded with revengeful wishes, rather than real sadness for the loss of a person whom they appreciated.” (Kernberg, 1977, p. 229)

The divorce experience is a loss, so it will produce a grief response. But if the narcissistic/borderline personality structure is characterologically unable to process sadness and grief, but instead translates it into “anger and resentment, loaded with revengeful wishes” then what we may be looking at is what Bowlby called disordered or pathological mourning.

“Disturbances of personality, which include a bias to respond to loss with disordered mourning, are seen as the outcome of one or more deviations in development that can originate or grow worse during any of the years of infancy, childhood and adolescence.” (Bowlby, 1980, p. 217)

I don’t want to go too technical in our discussion at this point, but I don’t feel I’m cherry-picking Bowlby. It think that attachment theory and personality disorder pathology can add considerably to the quality of the discussion that has thus far been dominated by a woefully inadequate proposal of PAS. Personally, I’m going to be leaving the construct of PAS behind as an interesting historical curiosity, and I intend to engage in a more scientifically and clinically anchored discussion of the pathology.

As I said in my post Cats Are Not Dogs, there is a genuine pathology, and it is linked to the pathology of a narcissistic and borderline personality parent. That’s the group of parents and their children that I am concerned about. Not all animals are cats. Not all animals are dogs. And the existence of cats does not discount the existence of dogs. Both cats and dogs have four legs, fur, and a tail. So we don’t want to get them confused. But there are also differences; cats have retractable claws, dogs don’t; dogs bark, cats meow. So once we know what we’re looking for, then we can begin to identify the specific features that clinically differentiate cats and dogs.

Recognizing that you may reasonably disagree with the order of my listing of extremely bad parenting, I would rank order my list of worst possible parents as:

  1. Sexual abuse – incest
  2. Narcissistic and borderline personality parent
  3. Physical abuse
  4. Neglect and depression
  5. Actively bipolar and schizophrenic

Reasonable people can disagree on the specific order of this list, and even trying to develop a list at this extreme level of pathology may be a fool’s errand. But my point is that narcissistic and borderline personality parents are extremely bad parents.

In this regard, you may also be interested in a wonderful study by Moor and Silvern (2006) regarding the mediating role of parental empathic failure in the subsequent outcome from various forms of childhood trauma exposure. They describe in their study that,

“Only insofar as parents fail in their capacity for empathic attunement and responsiveness can they objectify their children, consider them narcissistic extensions of themselves, and abuse them. It is the parents’ view of their children as vehicles for satisfaction of their own needs, accompanied by the simultaneous disregard for those of the child, that make the victimization possible.” (p. 104)

“An empathically responsive environment precludes abuse and objectification of children. Correspondingly, the act of child abuse by parents is viewed in itself as an outgrowth of parental failure of empathy and a narcissistic stance towards one’s own children. Deficiency of empathic responsiveness prevents such self-centered parents from comprehending the impact of their acts, and in combination with their fragility and need for self-stabilization, predisposes them to exploit children in this way.” (p. 94-95)

“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.” (p. 197)

The characterological incapacity for empathy and the role-reversal violation of psychological boundaries associated with the narcissistic/borderline personality pathology is what has me so deeply concerned for the children of these parents (Fonagy, Luyten, & Strathearn, 2011).

Splitting and Triangulation Through the Cross-Generational Coalition

Returning to the narcissistic/borderline parent’s response to divorce, what happens when the splitting pathology of the narcissistic/borderline parent is added to a role-reversal cross-generational coalition as defined by Minuchin (1974) and Haley (1977)? The pathology of splitting cannot accommodate to ambiguity (Juni, 1995). It polarizes perceptions into extremes of all-good or all-bad. This polarization does not involve an actual physical separation of brain networks, but rather a neurological cross-inhibition of these networks.

The borderline personality structure has its origins in disorganized attachment involving incompatible motivational directives for attachment bonding and avoidance. According to Aaron Beck and his colleagues (2004),

“Various studies have found that patients with BPD 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).” (p. 191)

The pathology of splitting arises to resolve the simultaneous activation of attachment bonding motivations (“haven of safety”) and avoidance motivation (“source of fright”) created by a parent who is “at the same time the source of fright and the potential haven of safety” (creating the disorganized attachment).

Splitting involves the intense neurological cross-inhibition of attachment bonding and avoidance motivations, so that a single coherent motivational directive can be achieved. When one motivating system is on, the other motivating system is entirely turned off (cross-inhibited), so that only one or the other of these motivational systems can be active at any given time, which produces the characteristic polarization of perception into extremes of idealization or devaluation, and the complete absence of ambiguity (i.e., of both networks being on simultaneously which would modulate the perception of the other person).

With the divorce, the spouse becomes an ex-spouse, i.e., the representational networks for the spouse switch from the attachment bonding motivational system to the avoidance motivating system. Since the pathology of splitting cannot accommodate to ambiguity, only one of these motivational networks can be active at any given time, and with the divorce that network for the other spouse/(parent) is the avoidance motivating system. The attachment-bonding networks are entirely turned off (neurologically inhibited). Which means that the narcissistic/borderline parent cannot perceptually register the continuing attachment bond between the child and the other parent because the attachment bonding system in the brain of the narcissistic/borderline parent is being entirely shut down (cross-inhibited by the avoidance system).

This leads to a characteristic feature of this pathology, that the narcissistic/borderline parent cannot recognize, cannot perceptually register, that a normal child’s attachment system would want a relationship with the other parent (the parent who the narcissistic/borderline parent now perceives as being the embodiment of evil because of the splitting pathology).

With the divorce, the spouse has become an ex-spouse, so they must also become an ex-parent. There is no other possibility allowed by the neural networks of the splitting pathology. The ex-husband MUST become an ex-father; the ex-wife an ex-mother. This is a neurologically imposed imperative created by the splitting pathology.

The narcissistic/borderline personality parent accomplishes this goal by engaging the child into a cross-generational coalition (i.e., a role-reversal relationship as a “regulatory object” for the parent) in which the child is induced into rejecting the other parent (actually, the child is induced into adopting a trauma reenactment role of “victimized child” but I don’t want to get too far afield; I describe the symptom induction process in Foundations).

What we’re essentially looking at in the pathology traditionally called “parental alienation” is the manifestation of narcissistic and borderline personality pathology into the family relationships as a consequence of the divorce.

This whole dynamic is much more involved and complex, and I would refer you to Foundations for a complete description of the pathology. My point is that the pathology exists. The pathology of narcissistic and borderline personality disorder exists. And it is this pathology that is creating the child’s symptom display which is traditionally called “parental alienation.” The legions of parents who are claiming that they have been completely cut off from relationships with their children because of the pathological parenting of their ex-spouse are not delusional. The pathology exists as a manifestation into the family processes of narcissistic and borderline personality disorder pathology of the allied and supposedly “favored” parent.

That’s not to say that children do not also reject relationships with parents because of authentic child abuse and domestic violence. Just because cats exist doesn’t nullify the existence of dogs. Both cats and dogs exist.

But right now, I’m discussing cats, not dogs. We can discuss dogs once we recognize the existence of cats. The existence of dogs, while actual, does not nullify the existence of cats. Cats exist. Narcissistic and borderline personality pathology exists.


So, returning to your initial desire to discuss treatment, the question becomes what is the treatment for a child’s role-reversal pathology as a regulatory object for a narcissistic/borderline parent? In this regard, my primary concerns would include both the “invalidating environment” described by Linehan (1993) and the role-reversal pathology (Kerig, 2005) in which the child is used as a regulatory object to stabilize the parent’s pathology, both of which are associated with narcissistic and borderline psychopathology.

Linehan and Koerner (1993) describe the invalidating environment,

“A defining characteristic of the invalidating environment is the tendency of the family to respond erratically or inappropriately to private experience and, in particular, to be insensitive (i.e., nonresponsive) to private experience… Invalidating environments contribute to emotional dysregulation by: 1) failing to teach the child to label and modulate arousal, 2) failing to teach the child to tolerate stress, 3) failing to teach the child to trust his or her own emotional responses as valid interpretations of events, and 4) actively teaching the child to invalidate his or her own experiences by making it necessary for the child to scan the environment for cues about how to act and feel.” (p. 111-112)

In their description of the invalidating environment, Fruzzetti, Shenk, and Hoffman, (2005) note the nullification of the child’s self-authenticity,

“In extremely invalidating environments, parents or caregivers do not teach children to discriminate effectively between what they feel and what the caregivers feel, what the child wants and what the caregiver wants (or wants the child to want), what the child thinks and what the caregiver thinks.” (p. 1021)

In the Journal of Emotional Abuse, Kerig (2005) describes the pathology of the role-reversal relationship and notes the nullification of the child’s self-authenticity,

“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.” (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.” (p. 14)

Rappoport (2005) describes the parenting of a narcissistic personality,

“To the extent that parents are narcissistic, they are controlling, blaming, self-absorbed, intolerant of others’ views, unaware of their children’s needs and of the effects of their behavior on their children, and require that the children see them as the parents wish to be seen. They may also demand certain behavior from their children because they see the children as extensions of themselves, and need the children to represent them in the world in ways that meet the parents’ emotional needs.” (p. 2)

In describing the co-narcissist’s relationship with a narcissistic personality, Rappoport (2005) describes the nullification of the other person’s self-experience,

“In a narcissistic encounter, there is, psychologically, only one person present. The co-narcissist disappears for both people, and only the narcissistic person’s experience is important.” (p. 3)

In the family systems literature, the construct would be psychological enmeshment. In the child development literature it would involve the construct of shared “intersubjectivity.”

Ultimately, the role of intersubjectivity is going to become central to understanding the pathology, and the works of Stern, Tronick, Trevarthan, Fonagy, and others is going to become prominent to understanding the pathology and important for understanding treatment.

Stern (2004), for example, describes the neurological underpinnings of shared psychological experience,

“Our nervous systems are constructed to be captured by the nervous systems of others. Our intentions are modified or born in a shifting dialogue with the felt intentions of others. Our feelings are shaped by the intentions, thoughts, and feelings of others. And our thoughts are cocreated in dialogue, even when it is only with ourselves. In short, our mental life is cocreated. This continuous cocreative dialogue with other minds is what I am calling the intersubjective matrix… The idea of a one-person psychology or of purely intrapsychic phenomena are no longer tenable in this light.” (p. 76)

Tronick (2003) refers to this shared psychological state as a “dyadic state of consciousness,”

“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.” (p. 475)

The mirror neuron network represents the neurological substrate for this shared psychological state (Iacoboni, et al, 2005; Kaplan & Iacoboni, 2006).

The concern surrounding the pathological parenting of a narcissistic/borderline parent is that the child is being used in a role-reversal relationship as a regulatory object to stabilize the pathology of the narcissistic/borderline parent, and that this role-reversal pathology has nullified the child’s self-authenticity in order to meet the needs of the narcissistic/borderline parent.

So if you wish to begin a discussion of treatment, then I would pose the question to you as to what you propose the treatment to be for the role-reversal pathology of a child’s cross-generational coalition with a narcissistic/borderline parent in which the child is being used as a regulatory object to stabilize the pathology of the narcissistic/borderline parent?

In order to engage the discussion of treatment, we need to first understand what the pathology is that we are treating.

In my view, a discussion of treatment is a bit premature, but if you want a beginning orientation to my basic views, I would refer you to my blog post, On Unicorns, the Tooth Fairy, and Reunification Therapy in which I discuss a general orientation to therapy for this type of narcissistic/borderline personality pathology within the family from multiple perspectives.

In your blog you drew from one possible idea I’ve put foward, a strategic family systems intervention, for treating the pathology of a role-reversal relationship with a narcissistic/borderline parent in which the child is being used as a regulatory object to stabilize… you know that’s an awfully long sentence to write each time I have to refer to this pathology… isn’t there some shorter label we can give to this type of pathology?

Hmmm… people in the general population appear to be calling it “parental alienation.” The problem is, if I call it “parental alienation” then everyone is going to think I’m talking about a Gardnerian model of PAS, and I’m not. But if I label this pathology something different, then people won’t realize that I’m talking about the same type of pathology they are, of a child’s induced rejection of a parent which they’re calling “parental alienation.”

Okay, how about this. I’ll use the term “parental alienation” but I’ll put it in quotes to indicate that it’s not an actually defined pathology, and then I’ll add the words attachment-based to differentiate this description of the pathology from the Gardnerian PAS model.

So that’s what I’ve done. Going forward, Dr. Mercer, if you’d like to refer to the pathology of a narcissistic/borderline parent inducing a role-reversal relationship… on and on long sentence… by some other label, I’m open to that. My preference, based on my analysis of the pathology in Foundations, would be “attachment-trauma reenactment pathology.” But if you want to call it “Bob” – that’s fine by me.

I don’t care what we call it, we just need to recognize that narcissistic and borderline personality disorders exist and that this form of pathology becomes highly activated surrounding divorce (i.e., the loss of the attachment figure and direct hits on the core vulnerabilities of the narcissistic/borderline parent), and that a narcissistic/borderline parent has an extremely devastating impact on child development. Cats exist. Dogs exist. They both exist.

Parallel Process

One of the dangerous features of working with borderline personality pathology is the parallel process of splitting that can occur among the mental health professionals working with the borderline pathology. Marsha Linehan (1993) refers to this parallel process as “staff splitting.”

“Staff splitting,” as mentioned earlier, is a much-discussed phenomenon in which professionals treating borderline patients begin arguing and fighting about a patient, the treatment plan, or the behavior of the other professionals with the patient… arguments among staff members and differences in points of view, traditionally associated with staff splitting, are seen as failures in synthesis and interpersonal process among the staff rather than as a patient’s problem… Therapist disagreements over a patient are treated as potentially equally valid poles of a dialectic. Thus, the starting point for dialogue is the recognition that a polarity has arisen, together with an implicit (if not explicit) assumption that resolution will require working toward synthesis.” (p. 432)

I am concerned that the parallel process of splitting has infected previous discussions of this pathology surrounding the Gardnerian PAS model, in which hyperbolic exaggerations have been used to characterize reasonable and responsible mental health professionals as somehow being unethical and as seeking the abuse of children.

In moving forward with professionally responsible dialogue, I would desperately want to avoid the parallel process of “staff splitting” described by Linehan. “Sides” are a manifestation of the splitting pathology. There are no sides. We all want to protect children from child abuse. 100% of children 100% of the time. The critics of Gardnerian PAS want to protect children from an authentically abusive parent (dogs exist). The supporters of the “parental alienation” construct want to protect children from the pathology of a narcissistic/borderline parent – although they have not been describing it in this way – (cats exist).

In her wisdom, Marsha Linehan has pointed to the door out from the parallel process of splitting. Each side in the dialogue represents “equally valid poles in a dialectic” and “the starting point for dialogue is the recognition that a polarity has arisen, together with an implicit (if not explicit) assumption that resolution will require working toward synthesis.”

Working toward a reasonable, professionally sound, and scientifically supported synthesis for addressing all forms of emotional, psychological, physical, and sexual abuse of children is what I seek in proposing an attachment-based reformulation for the pathology traditionally called “parental alienation.”

Best wishes,

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


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

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

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

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.

Grant, B.F., Chou, S.P., Goldstein, R.B., Huang, B., Stinson, F.S., Saha, T.D., Smith, S.M., Dawson, D.A., Pulay, A.J., Pickering, R.P., and Ruan, W.J. (2008). Prevalence, correlates, disability, and comorbidity of DSM-IV Borderline Personality Disorder: Results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry, 69, 533-545.

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

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

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

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

Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York, NY: Guilford

Linehan, M. M. & Koerner, K. (1993). Behavioral theory of borderline personality disorder. In J. Paris (Ed.), Borderline Personality Disorder: Etiology and Treatment. Washington, D.C.: American Psychiatric Press, 103-21.

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

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.

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

Stern, D. (2004). The Present Moment in Psychotherapy and Everyday Life. New York: W.W. Norton & Co.

Stinson, F.S., Dawson, D.A., Goldstein, R.B., Chou, S.P., Huang, B., Smith, S.M., Ruan, W.J., Pulay, A.J., Saha, T.D., Pickering, R.P., and Grant, B.F. (2008). Prevalence, correlates, disability, and comorbidity of DSM-IV Narcissistic Personality Disorder: Results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry, 69, 1033-1045.

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.

11 thoughts on “Treatment Discussion Response to Jean Mercer”

  1. Dr. Childress Do you really think Narcissistic/Borderline Parenting ie, parent alienation is worse than physical abuse and neglect? I know its bad but im not sure it comes b4 those two!

    Sent from my Windows Phone ________________________________

    1. It’s all bad. The issue with physical trauma is that the abused child can set up at least some types of psychological barriers to protect the core psychological self from damage, so that when we go to heal the damage and recover the authentic person through therapy we have a greater likelihood of finding areas of self that have been protected from the trauma. The narcissistic/borderline parent invades the very self-structure of the child, feeding psychologically on the child’s self-structure development to support the inadequate and damaged self-structure of the narcissistic/borderline parent. When we go to heal the damage and recover the authenticity of the person in therapy, there are absent places of core self-structure that simply haven’t been developed. Physical abuse is damage from the outside in. Narcissistic/borderline parenting (particularly borderline parenting) is damage from the inside out. They’re both exceedingly bad. Precise ranking of “exceedingly bad” is a fools errand. My point is that narcissistic/borderline parents aren’t just bad parents, they are exceedingly bad parents. Among the worst parents possible. Craig Childress, Psy.D.

    2. Dear Chaide,

      It is not Dr. Childress who knows this, it is substantiated by the best research in the world.
      You must understand this! This is the most important piece of information to have. The parenting, or any relationship with these extreme personality disorders is severe psychological abuse! And more damaging to our children than the 2 more frequently cited types of abuse. Please Google
      “Unseen Wounds: The Contribution of Psychological Maltreatment to Child and Adolescent Mental Health and Risk Outcomes.”

      This is one of the most recent and highly regarded clinical research articles authored by a host of respected experts from across the country and headed by Joseph Spinazzola and Hilary Hodgdon at The Trauma Center at Justice Resource Institute, Brookline, Massachusetts. This article verified the previously found evidence that, “Psychologically maltreated (emotionally abused and neglected) youth exhibited equivalent or greater baseline levels of behavioral problems, symptoms, and disorders compared with physically or sexually abused youth on most indicators. The co-occurrence of psychological maltreatment with physical or sexual abuse was linked to the exacerbation of most outcomes. Despite its high prevalence in the CDS, psychological maltreatment was rarely the focus of intervention for youth in this large national sample. We discuss implications for child mental health policy; educational outreach to providers, youth, and families; and the development or adaptation of evidence-based interventions that target the effects of this widespread, harmful, yet often overlooked form of maltreatment.”

      We need to help Dr. Childress bring this message to the forefront. These children are so incredibly harmed and overlooked!

      Thank you for your interest.


  2. Dr Childress, is there a cure/treatment for a narcissistic/borderline parent?

    Sent from my Windows Phone ________________________________

    1. In depends on the severity. Personality traits run along a continuum from mild to moderate to severe. In general, for Narcissistic or Borderline Personality Disorders, the prognosis for recovery is poor, at least not at our current level of treatment. Dialectic Behavior Therapy (DBT) is a strong treatment for some of the features of Borderline Personality Disorder (particularly the self-harm) and can obtain a substantial measure of recovery depending on the individual circumstances. Cure, meaning complete recovery? No. Narcissistic Personality Disorders rarely seek treatment because they cannot endure the collapse of the narcissistic defense necessary for self-observation. Schema Therapy developed by Dr. Young looks promising. The narcissistic/borderline personality is a product of their own childhood trauma. I will not abandon the child-that-once-was, so I will not abandon the parent they have become. The prognosis is poor, but we must do everything in our power to heal the trauma in all its forms and manifestations. Empathy is the key. Altering their embedded schemas is the process. Craig Childress, Psy.D.

  3. Dr. Childress,

    I have read Dr. Jean Mercer’s responses to your work and the comments from others who have posted to her blogpost. I was tempted to engage in the discussion, but ultimately declined as she consistently fixated on her desire for empirical studies to support your work. Despite Howie Denison’s repeated knowledgeable responses and extensive documentation of supportive materials, Dr. Mercer fought to cling fast to wanting to be right and denigrating your work with unsubstantiated claims. The most disappointing part of attempts to engage her in a professional communication, was her condescending verbiage about those parents and children suffering life-altering losses due to the eradication efforts by a narcissistic/(borderline) ex-spouse (and I would add sadistic to the description in my case, as he thoroughly enjoyed “taking me down”). Phrases like “There may be such a thing as PA . . .”, and “parental alienation swamp,” are indications that she herself may have a personality disorder that exhibits in her neglect to express empathy towards those suffering, in order to achieve a hierarchal sense of self.

    My simple request is to move past this ignorant roadblock and continue your mission to save all our children. I know that my and my daughter’s severely fractured lives are dependent on those like yourself, who are willing to work on the behalf of parents and children suffering from the loss of a meaningful and loving familial relationship. Dr. Jean Mercer is now on the radar of alienated parents and children who are in need of professional to avoid contact with her at all costs. She is a fine example of a mental health professional that should refrain from working with families experiencing parental alienation. If I may quote from “Foundations,”

    “To the extent that professional ignorance and practice beyond the boundaries of professional competence then causes harm to the child client and to the targeted parent, the mental health professional may become vulnerable to professional or legal actions (334-344).

    Thank you for your efforts to shine a piercingly bright light on a very dark problem.

  4. I like Dr. Childress’s work but I think it should be subject to criticism and empirical testing to the greatest degree possible. I think he has done a great job of explaining PA in terms that are well accepted and have at least some empirical testing, but further testing and prodding might reveal some errors. Finding errors is good because it gives us the ability to move past them.

    1. Dear Jim.

      You can’t help but be impressed with the confidence that Dr. Childress has in his theory to invite as much critical probing and criticism as anyone can muster. But a little more research on the part of those questioning any or all of his convictions will answer unanswered questions.

      My children and I and hundreds of thousands of families are the empirical test cases. We are the casualites because no one is willing to acknowledge that severe psychological (emotional abuse and neglect) abuse from a parent that lacks empathy and therefore can hurt their family with no thoughts of remorse, causes irreparable damage to children. And it is the most severe type of domestic abuse to coerce a parent’s children into rejecting them. You can not imagine the depth of grief I live with everyday having seen what this personality disorder has done to our children. My children, who are lost to me and to themselves.

      Dr. Childress hasn’t made this up in his head, The cruelty that this personality disordered parent can inflict is criminal. I know, my ex-husband was found to have “screwed up” our children in criminal court, but there was nothing they could do. Dr. Childress sees this tragedy in his practice daily, as do other mental health professionals it is just that he KNOWS what he is dealing with, and the others don’t. He truly wants to protect our children and their future generations.

      Test whatever you like; the high representation of this personality disorder in high conflict family court, the association of this personality disorder with disorganized attachment, the relationship of a lack of empathy with the inability to provide for the emotional needs of their children, the PTSD as a result of being psychologicall battered,, splitting, triangulation…whatever. But when you follow up with more research and you find that the empirical research has already been done, help us to rescue our children. . And please do not call his model parental alienation, His insights are without controversy or question. He has authored the model for Attachment Trauma Reenactment or the Transgenerational transmission of attachment trauma. The behaviors of the personality disordered parent parallel a slice in the chronology of abusive episodic cycle of this pathology but the picture; the chronic, severe family abuse that these very ill parents and partners are capable of is unimaginable.

      Thank you for your interest in this plight.


    2. Jim,
      this is exactly what I was going to say (more or less). Critical exposure is often better exposure, especially in Childress’s mission of awareness.

      Still there is something very familiar about her message. It feels like every dismissive avenue I’ve been down within my own case and I am sure it strikes a similar chord with many others. It looks, smells, and tastes just like every therapist, attorney, and judge.

      Jean is a dangerous voice though:
      Her blog is ranked on page one of “Dr. Childress” query on google (this is how I found her article).
      Jean’s critique has just the right balance of intellectual fortitude diluted down for a layman’s understanding. Her message may not be a white-hot rod but it glows enough to burn and I fear people like her will make it more and more difficult to advance understanding and ultimately results. I fear not for Childress, but for me and others on the front-line who have lost a child or are losing their child or children to PA.

      I’ve watched every video Childress has produced at least 20-30 times (with the exception of his most recent.) read his book, three other alienation books, as well as read/watched any videos, papers, sites I can find about Attachment theory, and personality disorders, so that I can have competence, knowledge, understanding, and leverage. It is very frustrating to me do all this work because by definition it tosses me in the wanna-be doctor category, but I’m not a doctor of anything, and I don’t want to be a doctor, or a lawyer, or an activist or a blogger. I’m a dad who wants to have his child back. Jean doesn’t understand this or she chooses not to understand it. Real people, real scenarios, and not all of us can be child abusers.

      I agree with Della’s comments, and I do think Jean’s blog mimics the taste of a personality disorder, and perhaps this why it feels so similar.

      It’s true, Jean’s observation of “Pathogen” being used as a metaphor is accurate, and it appears as though she has been infected by it. The overall message of her blog and comment responses are “Don’t be fooled” which mirrors the splitting affect we already experience. She’s clearly intelligent and I expect that she knew what she was doing when she chose the language for her headline and subsequent statements. Her message is to either incite controversy for notoriety, or to deny the existence of PA, but I do not buy for one second that she wrote her critique as a public service announcement regarding Attachment Based PA because she believes it is harmful. There’s something personal in it for her.

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