I received the following Comment from Dr. Mercer. Since it requires a more elaborated response than I can provide in the Comment section of this blog, I decided to respond as a post.
Here is the Comment from Dr. Mercer:
Can you tell me what was the age of the youngest child you have ever treated? Can you tell me how you ascertain whether or not there is a “good reason” for the child’s rejection? Can you tell me how often you find that you must tell a rejected parent that there seems to have been a reason for the child’s rejection, so you cannot use your treatment to address the problem?
I don’t have a treatment to suggest, and if I did that fact would be irrelevant to the empirical questions I’m asking. As I said to one of your advocates, the burden of proof is on you, not on me. But right now I’m not asking for proof, I’m just asking for a couple of details that I would think would be easy for you to supply. If you prefer not to answer, please just say so and save time for both of us.
My goodness, Dr. Mercer. I apologize. I thought you were interested in having a professional dialogue about a very serious form of psychopathology involving the child’s triangulation into the spousal conflict through a cross-generational coalition with a narcissistic/borderline parent that is inducing severe developmental, personality, and psychiatric psychopathology in the child. I’m sorry, I didn’t realize you just wanted a “couple of details” that you believe would be easy for me to supply.
Oh, by the way, have you read my book,
I devote all of Chapter 9 to Diagnosis.
You know, Dr. Mercer, I’m beginning to suspect that you don’t want to actually address the pathologies that affect children and families, but that you may have some sort of personal agenda you want to advance.
I’ve tried to address your questions at a well-balanced professional level of discussion, citing references for my statements and my concerns. You have not responded to any of this content material, but have become fixated on how early a narcissistic/borderline parent can distort a child’s functioning. Not only that, you have personalized it as to what is the youngest child I’ve ever treated. What’s it matter to the issues we’re discussing?
And you haven’t even read Foundations. I’m not sure at this point that you actually want a professional level discussion.
So I apologize, I didn’t realize that you just wanted answers to a few specific “details” rather than a discussion of the broader constructs relevant to the pathology.
So here are my answers:
Detail 1: “What was the age of the youngest child you have ever treated?”
Actually, I was the Clinical Director for an early childhood assessment and treatment center (ages 0-5) working primarily with children in the foster care system. So the youngest child I’ve personally treated was about 2 ½ years old, although I’ve supervised the treatment of a wide variety of ages, from infancy to five years old at the clinic.
In the area of early childhood, my specialty area is the preschool age range, from three to five years old.
I’m trained to clinical competence in the relationship-based interventions of Watch, Wait, and Wonder (used to improve the infant-mother bond) and Circle of Security (used to improve attachment bonding in preschool-age children).
I’m also trained to clinical competence in the DC-03 diagnostic system (an early childhood alternative to the DSM diagnositic system) and the ICDL-DMIC diagnostic system dealing with the assessment, diagnosis, and intervention for developmental and emotional disorders, autistic spectrum disorders, multisystem developmental disorders, regulatory disorders involving attention, learning and behavioral problems, cognitive, language, motor, and sensory disturbances.
Before developing my sub-specialty expertise in early childhood mental health, my primary focus was ADHD in school-age children and adolescents. One of the reasons I went into early childhood was to increase my professional understanding for the early childhood development of emotional-behavioral regulatory disorders (ADHD). My work with ADHD-spectrum issues spans the school-age and adolescent periods of child development.
My work with school-age kids and adolescents has involved extensive work with Oppositional Defiant Disorder (a co-morbid disorder with ADHD) and severe parent-child conflict. So I am well-familiar with “normal-range,” and by that I mean clinically “normal-range,” parent-child conflict (i.e., severe expressions of parent-child conflict associated with Oppositional Defiant Disorder).
My work in high-conflict divorce began in 2008 with a 10 year old child who had been rejecting a relationship with his mother for two years. The reason he offered for his rejection of his mother was that two years prior she was playing with him on the bed and she playfully held his feet over his head which compressed his diaphragm. He told his mom of his discomfort and she dropped his feet. That’s why he doesn’t want to have anything to do with his mother for the rest of his life. And nothing she can do will alter that. —— Yeah. Doesn’t make any sense does it? Didn’t make any sense to me either.
As I worked it out, it became evident the child was being triangulated into the spousal conflict by the father through the formation of a cross-generational coalition with the child against the mother. Standard family systems stuff.
Through a series of meetings with the father, it became evident that the father had prominent narcissistic personality traits with histrionic overtones. The father was angry at the mother for having rejected his self-perceived magnificence and he was using the child’s rejection of the mother as his weapon of revenge. The family process had domestic violence overtones, except instead of using his fists to beat the mother for leaving him, he was using the child.
The child was compliant, because the father would psychologically torment the child with irrational rages if the child deviated from the parentally desired behavior. If the child showed any signs of bonding to the mother, in fact, if the child did not make sufficient displays of rejecting his mother, then the father would subject the child to withering psychological torment. By rejecting his mother, the child kept the father in a regulated emotional state and avoided the father’s rageful retaliation.
At the time I had never heard of “parental alienation.” But I immediately recognized the nature and severity of the pathology from within standard and established types of pathology; i.e., the child’s triangulation into the spousal conflict by the father through the formation of a cross-generational coalition with the father against the mother in which the child was being used as a regulatory object to stabilize the father’s pathology. When I started to treat the cross-generational coalition rather than validating the child’s rejection of his mother, the father terminated therapy. I decided to look into this more and discovered the construct of Parental Alienation Syndrome and the controversy surrounding it. This pathology is not a new “syndrome.” It is a manifestation of standard and established forms of pathology.
So I set about working out the pathology at a high-level of analysis. I anticipated that the narcissistic and borderline personality pathology with which we are dealing would attack any effort to disrupt the pathology with great vitriol and irrationally based accusations characteristic of the narcissistic/borderline process of splitting. So I needed to make sure that the theoretical foundations for the explanation of this pathology were rock solid. For seven years I’ve been uncovering the linkages within this pathology.
All the while I’ve been posting to my website and blog to make information available as quickly as possible to the parents and children suffering from this form of pathology. In my book, An Attachment-Based Model of Parental Alienation: Foundations, I describe the complexity of this pathology within three separate and distinct levels of analysis, the family systems level, the personality disorder level, and the attachment-trauma level, AND I integrate the analysis across all three levels, explaining how the childhood attachment trauma creates the narcissistic/borderline personality structure, and how the narcissistic/borderline personality structure creates the family systems pathology. No model of a pathology could explain the pathology both within and across three distinct levels of analysis unless it was accurate. The description of the pathology in Foundations is accurate.
You feel I have a “burden of proof,” Dr. Mercer? Foundations is my answer. I suggest you read it before developing opinions about my work.
Detail 2: “Can you tell me how you ascertain whether or not there is a “good reason” for the child’s rejection?”
This is a complex question. As the Clinical Director for an early childhood assessment and treatment center working with children in the foster care system I saw trauma and child abuse up close and personal. I know what authentic child abuse and trauma look like. Because of this, I also know what authentic child abuse trauma doesn’t look like.
This up close and personal experience with treating the sequelae of authentic child abuse trauma helps with the differential diagnosis of the child’s role-reversal relationship with a narcissistic/borderline parent who is using the child as a “regulatory object” to stabilize the parent’s pathology. There is a distinctive difference from the symptom presentation with authentic child abuse trauma.
Among a wide variety of indicators (differential diagnosis is not about any single puzzle piece, it is about the entire picture created by ALL the puzzle pieces) children exposed to authentic child abuse do not display five specific narcissistic/borderline personality symptoms in their symptom display, 1) grandiosity, 2) entitlement, 3) absence of empathy, 4) a haughty and arrogant attitude, and 5) splitting.
On the other hand, children who are in an enmeshed cross-generational coaltion with a narcissistic/borderline parent against the other parent do display all five of these specific narcissistic personalty traits. The only way a child acquires five specific a-priori predicted narcissistic/borderline personality symptoms is through an enmeshed psychological relationship with a narcissistic/borderline parent. Do you disagree? Do authentically abused children display a haughty and arrogant attitude of grandiose entitlement toward their abuser? Of course not. They’re afraid of their abuser.
But differential diagnosis is not about any single indicator, it’s about the entire picture created by the symptoms and family processes. Another important indicator of authentic versus inauthentic parent-child conflict is the locus of “stimulus control” over the child’s behavior. The construct of “stimulus control” is a behavioral (learning theory) construct regarding the cueing of behavior. It is best understood by way of analogy:
Our driving behavior is under the “stimulus control” of traffic lights. When the light is green, we go. When the light is red, we stop. Yellow is a transitional warning. Our driving behavior is under the “control” of the “stimulus” of the traffic light.
In authentic parent-child conflict, the child’s behavior is under the stimulus control of the parent’s behavior.
In inauthentic parent-child conflict the child’s behavior is NOT under the stimulus control of the parent’s behavior.
Since our driving behavior is under the stimulus control of the traffic light, when we change the color of the traffic light we see a corresponding change in the driving behavior. If the child’s behavior is under the stimulus control of the parent’s behavior, then when we change the parent’s behavior we should see a corresponding change in the child’s behavior.
In inauthentic parent-child conflict, however, if we change the parent’s behavior we see no change in the child’s behavior. That’s because the stimulus control for the child’s behavior is in the behavior of the allied narcissistic/borderline parent and the role-reversal, “regulatory object” role of the child in stabilizing the parent’s pathology.
But this is still only another single puzzle piece of the entire puzzle picture. The puzzle “cats in the garden” isn’t this puzzle because of just a few specific pieces. The puzzle is “cats in the garden” because when we put ALL of the puzzle pieces together they display a picture of three cats, one orange cat, one grey cat, and one black and white cat, frolicking among flowers. There is a watering can over here and a fence post in this location. There is a butterfly above these yellow flowers. That’s what makes the puzzle “cats in the garden.”
Authentic trauma, which I diagnosed and treated while serving as the Clinical Director for an early childhood assessment and treatment center treating children in the foster care system, creates a puzzle picture of “boats on a lake.” Both puzzles contain blue pieces and red pieces and yellow pieces. But when we put ALL the puzzle pieces together, one creates a picture of cats frolicking in the garden, and the other creates a picture of boats on a lake.
I would also refer you to my blog post on parent-child conflict, Parenting and Protest Behavior.
Detail 3: “Can you tell me how often you find that you must tell a rejected parent that there seems to have been a reason for the child’s rejection, so you cannot use your treatment to address the problem?”
First let me correct something, it’s not “my treatment,” it’s family systems therapy.
Because of my expertise in the pathology of attachment-based “parental alienation” I am sometimes sought out by the targeted-rejected parent for help in resolving this pathology. In about 20% to 30% of these cases I have declined treatment or altered the treatment goal to address the pathology of the supposedly targeted parent because the narcissistic parent actually turned out to be the supposedly targeted-rejected parent. However, my personal experience should not be considered representative of the frequency of this in the general population because I am getting a self-selected sample of clientele in my private practice because of my expertise with this form of pathology.
Once we move beyond the current professional impasse of recognizing that both cats (personality disorder pathology) and dogs (authentic child abuse) exist, we can then begin to conduct research on this exact question. But before we reach that point we first have to recognize that both cats and dogs exist. The existence of cats does not nullify the existence of dogs; and not all animals are dogs. Cats exist.
So hopefully, I’ve addressed your “couple of details” that you think would be easy for me to supply an answer for.
And to you, Dr. Mercer, thank you for answering my previous question. It’s unfortunate that you don’t have any idea how to treat the pathology of a child’s cross-generational coalition with a narcissistic/borderline personality parent in which the child is used as a regulatory object to stabilize the parent’s pathology.
Are you aware that the premier family systems therapist Jay Haley refers to this type of pathology as a “perverse triangle”? Do you know why he calls it “perverse”?
So I guess if you have no idea how to treat the pathology, then you don’t really have much of relevance to add to the discussion of the treatment for this type of pathology. That’s unfortunate. I guess you’ll just have to defer opinions regarding the treatment of this type of pathology to those of us who know what we’re doing.
Since I’ve addressed your “couple of details,” perhaps you could answer just one question for me. You suggest that I have some sort of “burden of proof.” What I’m wondering is how did you become the arbiter for truth in this? Was it posted on Craigslist, “Wanted: Arbiter of Truth” – or is it just a role you’ve assigned yourself?
Craig Childress, Psy.D.
Clinical Psychologist, PSY 18857