I’ll Explain It Just Once

Okay, listen up. I am going to explain this once. I’m not going to debate it. I’ve got a whole lot of work to do, and I need to get to that work. I’m not going to go round and round on this. So here it is. I’m going to explain it once.

The Problem

The mental health response to “parental alienation” is massively broken. The legal system response to “parental alienation” is massively broken. The solution is in first fixing the mental health system’s response. The diagnosis of pathology is a mental health issue, not a legal issue. Once we fix the mental health response, THEN we can fix the legal response. We cannot fix the legal system’s response to the pathology until we FIRST fix the mental health response.

Any solution that requires us to prove parental alienation in court is no solution at all. So whatever solution we develop (I’ve already developed it. It’s the attachment-based model) must be self-contained within the mental health response to the pathology.

The upper end of the pathology is so extreme that we will need at least the ability to protectively separate some of these children from the pathogenic parent. To accomplish this we will need the cooperation of the legal system. But we can’t get bogged down in proving “parental alienation” to the court. This means that in these extreme cases the mental health system, ALL of the mental health system, must go to the legal system with one clear and united voice to tell – not ask, we’re not going to prove it to them, they have to take our word for it – mental health needs to tell the legal system with a single clear united voice, that these children at the upper end of the pathology need to be protectively separated from the pathogenic parent in order for the mental health system to treat and restore these children’s healthy development.

So, to recap. The solution is not in the legal system’s response. The solution is in the mental health system’s response. We will need the cooperation of the legal system. When we turn to the legal system, the mental health system will need to speak with ONE clear and united voice so that the legal system can act with the decisive clarity necessary to solve this pathology (at least at the upper extremes of the pathology).

Conclusion 1.

We must unite mental health. This division within mental health must be brought to an end. To the extent that the Gardnerian PAS model contributes to continuing this division, we must jettison it. We cannot, however, jettison the divisive Gardnerian PAS model until we have something to replace it, otherwise there is simply a vacuum in our ability to diagnose and treat the pathology. Before we jettison the Gardnerian PAS model, we need a replacement model. This replacement model must be able to unite ALL of mental health into a single united voice so that when mental health goes to the legal system ALL of mental health can speak with a single voice so that the legal system can act with the decisive clarity necessary to solve the pathology (at least at the upper extremes of the pathology – I’ll address the solution to the lower end of the pathology’s spectrum later. But our solution to the upper extreme end of the pathology is key, and then we work our way down. We’re capping the pathology at its most extreme and working our way back).

Solution

So I set about solving Conclusion 1’s need for a replacement model for the pathology that can unite ALL of mental health into a single voice. So what’s causing the division?

Gardner proposed a “new syndrome” and establishment mental health is not accepting a “new syndrome.”

Plus, the Gardnerian eight symptom identifiers are poor. Their operational definitions are poor (I’m not going to debate this. They are. They are poorly defined symptom identifiers. As a professor, I’d give them a grade of D- for a variety of reasons. Primarily, too much subjectivity. Listen, we have to assume that mental health professionals are incredibly stupid. We cannot ask them to think. We have to give them diagnostic indicators that are simple and that minimize as much as is humanly possible the need for them to think – as much as possible we have to idiot-proof the diagnosis so that we can achieve the maximum amount of consistency and standardization to the diagnosis).

The replacement model needs to bring establishment mental health on board into a single unified voice. The Gardnerian PAS model is a poison pill. We need to entirely jettison this model. If we retain any component of it, this will just wrap us up in debate again and this will delay the solution. We need to bring establishment mental health a pristine model that meets their standards. This will allow us to move with the greatest efficiency and speed toward enacting the solution.

Establishment mental health does not want a “new syndrome” proposal. Okay. No “new syndrome.” Even the word “parental alienation” is part of this new syndrome. So to create a completely pristine model, I’ll shift even this term over to “pathogenic parenting.” The term “pathogenic care” was used in the DSM IV TR in reference to a Reactive Attachment Disorder. Since this new model is going to organize the description of the pathology around the attachment system, a change to the term “pathogenic care” or “pathogenic parenting” is appropriate and it will get us by establishment mental health at even this very most fundamental level of what we’re calling the pathology.

But if I switch this term out too soon, we’ll lose the Gardnerians, so I need to continue to use the term “parental alienation,” but I need to begin to also prepare everyone for the additional use of the term “pathogenic parenting” that we’ll need when we start to unite with establishment mental health. I’ll also begin to prepare everyone for this unification by always putting the term “parental alienation” in quotes, so that when we finally reach the point of uniting with establishment mental health, if establishment mental health has any problem with the use of the term “parental alienation” then I’m not tied to it, I can jettison it easily, and this term doesn’t bog us down. We simply switch it out to “pathogenic parenting” and keep moving.

But the construct of pathogenic parenting also offers us a huge, and I mean huge advantage. We don’t need to chase diagnosing the narcissistic/borderline parent down the rabbit hole of trying to get them to expose their pathology. From a clinical psychology perspective, we cannot get trapped into diagnosing the pathology of the “alienating” parent. Their manipulation is to hide behind the child. They’re using the child as a human shield. If we try to get to their pathology they just put the child in our path, “I’m just listening to the child. We need to listen to what the child wants. It’s not me it’s the child.” The pathogen hides. One of the primary defensive structures of the pathology is to remain concealed. The clinical diagnostic solution must be able to penetrate this concealment of the pathology behind the child.

How do we do that?  By not trying to penetrate the concealment.

Here’s the answer:  We cannot psychologically control a child without leaving “psychological fingerprints” of our control in the child’s symptom display. If we stay 100% diagnostically focused solely on the child’s symptom display – using the construct of pathogenic parenting – we can lift the “psychological fingerprints” of the allied narcissistic/borderline parent’s psychological control off of the child’s symptom display. Gotcha.

The “psychological fingerprints” in the child’s symptom display of the child’s psychological control by the narcissistic/borderline parent are the three diagnostic indicators of attachment-based “parental alienation”:

1.) Attachment System Display. The attachment system distorts in characteristic ways in response to problematic parenting. The normal attachment system does not ever distort in the way it displays in “parental alienation.” The display of the child’s attachment system – even if we grant problematic parenting by the targeted parent – never displays in the way it does in “parental alienation.” If you know what you’re looking for, the attachment system display in “parental alienation” reveals the psychological control of the narcissistic/borderline parent. But this is too technical a symptom. We need to idiot-proof the diagnosis. We’ll need more blatant fingerprints. This initial diagnostic indicator also puts us in the domain of “parental alienation” pathology (as opposed to ADHD or autism pathology).

2) Personality Disorder Traits: These are the most direct and obvious “psychological fingerprints” of the psychological control of the child by a narcissistic/(borderline) parent. They even carry the calling card of the parent’s personality disorder. The child is not evidencing paranoid personality traits, or obsessive-compulsive personality traits. The child is evidencing narcissistic personality traits. There’s a whole lot more here I could talk about, but I’m waiting because I don’t want to distract away from the primary focus. But this is just the tip of the iceberg. Why do I always use the linked phrase narcissistic/(borderline) and put the term borderline in parentheses? There’s a reason I do this. Later I’ll be discussing narcissistic/(narcissistic) and narcissistic/(borderline)-(hystrionic) and narcissistic/(antisocial), etc. But not just yet. We need to stay focused right now.

3.) Delusional Belief: This is the lynchpin symptom. A child’s response to authentic child abuse is not delusional. It has a basis in reality. This is going to become a key diagnostic indicator when we go up against the allies of the pathogen. The attachment system also doesn’t display the way it does in “parental alienation” in cases of authentic child abuse, but that’s a technical and sophisticated issue requiring professional expertise. For the idiot-proof diagnosis, we’ll use the delusional disorder symptom.

But the use of the word “delusion” to describe the child is initially going to be off-putting to many ignorant mental health professionals. The child doesn’t seem psychotic. The child appears totally rational. That’s where understanding the trauma reenactment narrative is critical. The delusion in this case isn’t some sort of bizarre psychosis, it’s the intransigently held, fixed and false belief of the child that the child is a “victim” of the “abusive” parenting of the targeted parent. The targeted parent’s parenting practices are entirely normal-range.  The parenting practices of the targeted parent are not “abusive.” This is a delusion.

Who is the actual source of this delusion? Who actually has the delusion? The narcissistic/borderline parent. The narcissistic/borderline parent is the primary source of the delusion (the Millon quote is golden in this regard), and the child’s expression of this delusional belief is the result of the psychological control of this child (psychological fingerprint) by the delusional narcissistic/borderline parent (once we solve “parental alienation” we’ll be taking this shared delusion back to the DSM-5.1 revision).

Once I had these three “psychological fingerprints” of the pathogenic parenting (i.e., diagnostic evidence of the psychological control of the child by the allied narcissistic/borderline parent) I then ran through every possible form of parent-child conflict and child pathology to see if any other form of pathology evidences ALL THREE of these diagnostic indicators. Nope. We’re good to go.

Gotcha. These three child symptoms expose the psychological manipulation of the child by the narcissistic/borderline parent using the construct of pathogenic parenting, which is a fully establishment construct (“pathogenic care” DSM-IV TR)

Theoretical Foundation

So in order to unite with establishment mental health we need to define the pathology entirely within standard and established psychological principles and constructs. No “new syndrome” proposal. And anything that even remotely involves Gardnerian PAS will be a poison pill and will distract us into debate and division. The alternative model needs to be pristine.

And it’s going to receive incredible scrutiny from the allies of the pathogen within mental health, looking for any little flaw in the model that will allow them to discredit it or lock it up in debate and controversy. It’s going to need to be rock solid theoretically. Not just on the surface layers, but down into its core. That’s what has taken me seven years. I had the superficial layers in two years. It’s been the core bedrock that’s taken longer. But let me tell you, there is some stuff in this model that people haven’t recognized yet that is going to ripple for decades. The pathology of “parental alienation” is about to move from the backwaters of high-conflict divorce to front and center of attachment theory. It’s just a matter of time until people start recognizing some of the profound implications (it’s like the ticking clocks on Dark Side of the Moon).

As I said in a previous post, I’m 60 years old and I’ve already had one stroke. My time here is limited. We can hope I have another 10 to 15 years, but it might be as short as 5 to 8. Who knows, maybe tomorrow. I am so far ahead in understanding this pathology than what I’m talking about now that I’m afraid the level I’m at now may be lost unless I get it out, but I don’t want to distract from the focus of solving the pathology. For example, what’s particularly interesting is if we could be talking about the actual specific “information structures” of the attachment system that are being distorted and damaged by the pathogen, there’s some amazing stuff there (the pathogen appears to attack both identity and memory information structures, leading to a loss of self-orientation, which then allows for the psychological control by the other). But I don’t want to distract focus. We need to remain entirely focused on solving this pathology as quickly as is humanly possible. Once it’s solved we’ll have the luxury of unpacking all of this.

I’ve gotten enough out already that if I die now, the solution will continue to reveal and enact itself. The solution genie is out of the bottle and can’t be put back in. So right now, it’s just a matter of how long the solution takes to be enacted, not whether it happens. It will happen.

But it’d be a shame if I die before I get some of this deep-level information out, such as what I just shared about both the construct of “information structures” in the attachment system and which information structures are attacked by the pathogen (I prefer the term “meme-structures” when talking about the structure of the pathogen – the patience is hard, wait, they’re not ready for it yet, wait, they’re still trying to wrap their heads around the solution). The pathology is like a “computer virus” in the attachment system (sorry, couldn’t resist). I’m trying to give clues and pointers in case I go suddenly then at least there are directions that people can follow for unraveling this pathology. The implications into trauma are also profound.  I come out of early childhood and the attachment system. Once the attachment people and the developmental trauma people in the citadel get ahold of this pathology, they’re going to become so excited. It’s like how brain damage can reveal what function the damaged portion of the brain served. The type of damage to the attachment system being expressed and revealed by the “parental alienation” pathology reveals so much about the nature and functioning of the attachment system and about the impact of developmental trauma in the attachment system, layers upon layers. But I can’t talk about any of this yet, because I’m waiting for people to catch up to just the basics of solving the pathology of “parental alienation.” But this is just the tip of the iceberg, people.

So I worked out the description of this pathology at a fine-grained level, so that when the time comes to integrate with establishment mental health, which is now, the time is now, the theoretical foundations of the alternative model are rock solid. I don’t want to get over-confident until the battle is fought, but I’m expecting the attachment-based model is going to fly through vetting by establishment mental health with nary a whisper of challenge. So far, there has been no challenge to the substance of the model. None.

This model can then bring us together with establishment mental health into a single unified voice. And then look what the model gives us:

An idiot-proof diagnostic model. Three diagnostic indicators. Not twelve, not eight. Three. Just three. Simple. To make it even simpler I’ve listed them as a checklist, One… check – Two… check – Three… check. Good, very good. Now when these three symptoms are present, all at the same time, in the child’s symptom display, what does that mean? Pathogenic parenting, right. Good. Oh, I’m so proud of you. And what DSM-5 diagnosis do we give to pathogenic parenting involving severe developmental pathology (Diagnostic Indicator 1), personality disorder pathology (Diagnostic Indicator 2), and psychiatric (delusional) pathology (Diagnostic Indicator 3)? That’s right, V995.51 Child Psychological Abuse. Good, very good. Oh, you’re doing so well with this. Now, is the child abuse suspected or is it confirmed? It’s confirmed, that’s right, good job. It’s confirmed because the child is displaying these symptoms, the pathogenic parenting is confirmed by the symptoms in the child’s symptom display. Good. Now, final question, so pay attention, as a mental health professional, when you’ve diagnosed child abuse what do you do? Oh my goodness, right again, you report it to Child Protective Services. Wow. You did such a good job. That was amazing. I’m so impressed.

Whew.

So now we have reports of Child Psychological Abuse starting to be made to CPS by mental health professionals based on an attachment based model of “parental alienation.” The social workers at CPS aren’t going to know what to do with these reports. They’ll interview people and come back with “inconclusive.” But they’ll start to be annoyed and curious. What’s this attachment-based model of “parental alienation” that’s creating all of these reports. Dr. Childress, can you offer a training for our social workers in an attachment-based model?

Certainly, I’d be glad to. Theory-theory-theory, narcissistic/borderline parent, attachment trauma reenactment narrative, theory-theory. Now, this pathology can always be recognized by a specific set of three diagnostic indicators. When all three of these child symptoms are present in the child’s symptom display there is no other possible explanation, other than attachment-based “parental alienation” by a narcissistic/borderline parent. Here, I’ve got this checklist right here for you of these three symptoms, can you pass these back, thank you. You’ll notice it also has some associated clinical signs listed. Now these associated clinical signs are not diagnostic, the diagnosis is made solely on the presence or absence of the three diagnostic indicators, but these associated clinical signs are some additional things you can listen for in your assessment that can help confirm and support the diagnosis. So, lets go over these indicators and associated signs. There are three definitive diagnostic indicators for this pathology. The first one is…

At that point, we’ll have CPS trained and on board.

Protective Separation

Diagnosis guides treatment. If a child has ADHD, we do treatment for ADHD. If a child has autism, we do autism treatment. If a child is being abused, we respond with a child protection response. In all cases of child abuse, we protectively separate the child from the actively abusive parent and we place the child in kinship care with a normal-range caregiver. In the case of “parental alienation” the kinship care is with the normal-range and affectionally available targeted parent.

Now, if the treatment team believes that a child protection response is not yet warranted in any specific situation, then no treatment is ever mandatory. But the focus should always be on the child’s symptoms. No symptoms, no need to protectively separate the child from the pathogenic parent. But if there are child symptoms, then we need to protect the child.

Narcissistic personalities do not understand the construct of authority. But they do understand the construct of power.

To the Narcissistic/Borderline Parent: If the child continues to evidence these symptoms directed toward the targeted parent, then the next step will be a protective separation of the child from you for at least a nine-month period, which is the required period needed to restore the child to normal-range functioning.  We’ve already discussed it fully and I’m not going to discuss it further.

See what we’re doing? We’re not placing pressure on the child to love and bond to the targeted parent, which only makes the child a “psychological battleground” between our efforts to restore normal-range functioning and the continuing efforts of the narcissistic/borderline parent to keep the child symptomatic. Instead, we’re going to the source (the actual source for the “stimulus control” of the child’s behavior), the narcissistic/borderline parent, and we’re making a very clear statement that provides the narcissistic/borderline parent with clearly structured boundaries for their (disorganized) manipulative pathology of exploiting the child: “Stop it. Release the child to love the other parent or we will remove the child from your care.”

An attachment-based model gives you the option to protectively separate the child from the psychologically abusive parent if this is what’s needed in order to treat and resolve the child’s pathology.

The solution is entirely contained within the mental health system response to the pathology, particularly once we reach the CPS level of the solution. If the court system becomes involved, the targeted parent has two independently made DSM-5 diagnoses of V995.51 Child Psychological Abuse, Confirmed, one from an expert in this form of pathology and a confirming diagnosis from Child Protective Services. When presented with a single unified voice from the mental health system, the legal system will be able to act with the decisive clarity necessary to resolve the pathology.

Correcting Gardner’s Mistake

There is a correct professional procedure to follow in professional clinical psychology. Define the pathology from entirely within standard and established psychological principles and constructs. This leads to making the correct diagnosis of the pathology. The treatment we use is based on the diagnosis.

Gardner did not follow this procedure. In his eagerness to identify the pathology, he skipped the first step. He did not define the pathology using standard and established psychological constructs and principles. Instead, he opted for a short-cut of proposing a unique “new syndrome” with unique new symptom identifiers. But then notice the problem that this creates regarding diagnosis.

Rather than having a formal diagnosis for the pathology which would have been available if Gardner had followed the correct professional procedure, a short-cut “new syndrome” proposal REQUIRES that the syndrome itself be accepted as the diagnosis. This has produced 30 years of impasse.

I’m a clinical psychologist. What I’ve done is gone back and fixed the mistake of Gardner when he used a short-cut instead of established professional clinical psychology procedures of assessment and diagnosis. What I’ve done with an attachment-based reformulation of the pathology is to go back to that initial step that was skipped by Gardner, and I’ve done a proper clinical assessment of the pathology. I’ve defined the pathology (pathogenic care) entirely within standard and established psychological principles and constructs, which then leads to the diagnosis of the pathology, which then leads to the treatment plan. That’s how things are supposed to work. What I’ve done is standard clinical psychology.

Gardner got us off on the wrong track. I’m putting us back on the correct path. I’m doing this because I’m a clinical psychologist. That’s what I do. I assess, diagnose, and treat pathology. All sorts of pathology. In this case it’s a complicated pathology, but it’s not an unsolvable pathology. We just need to follow the appropriate professional steps of defining the pathology from entirely within established psychological principles and constructs, which will lead us to the proper diagnosis, which will lead us to the necessary treatment plan. I teach this to students all the time. Standard clinical psychology.

The solution is available to us, right here, right now, if we simply return back to the standard procedures of professional clinical psychology. What was needed was to fix the step skipped by Gardner of defining the pathology from entirely within standard and established psychological principles and constructs. Because of specific features of my professional background I was able to do this. That’s what I do in my book Foundations. That’s why it’s entitled Foundations. Through establishing the necessary Foundations in defining the pathology, I return us to the proper path of professional clinical psychology.

It’s not Dr. Childress’ new theory. There is nothing “new” in Foundations. It’s all standard and established psychological constructs and principles. That’s why I didn’t call it the “Childress Theory of Parental Alienation.”  No. It’s an attachment-based model for describing the pathology. The correct clinical psychology term for the pathology is pathogenic parenting (pathogenic care that’s distorting the child’s attachment system). I am just doing what a good clinical psychologist does. I’m first defining the pathology from entirely within standard and established psychological principles and constructs, which then leads to the proper diagnosis, which then leads to the necessary treatment plan. Standard clinical psychology.

For all mental health professionals:  At this point you are now either part of the solution or you are part of the problem. The only thing that is no longer acceptable will be our abandonment of children to the psychological abuse of a narcissistic/borderline parent. That stops. If you are going to collude with child abuse because of your ignorance and professional incompetence, then you may be looking at licensing board complaints and malpractice lawsuits from targeted parents based on violations of Standards 2.01, 9.01, and 3.04 of the Ethical Principles of Psychologists and Code of Conduct of the American Psychological Association and for failure in your professional “duty to protect.”

Everyone’s gotten lost in Wonderland by thinking that we have to have the diagnosis of “parental alienation” accepted by establishment mental health and that we need to prove “parental alienation” in court. No we don’t. All we need is professionally competent clinical psychology. I’m a professionally competent clinical psychologist. I’m pulling us out of Wonderland and I’m putting us back on the right path.

Lesser Forms of the Pathology

This is easy. 

Once we solve the broken response of the mental health system to the extreme form of the pathology, then we can turn our attention to the lesser forms of the pathology and all the different variants.

And we will solve these in exactly the same way we solve the more extreme version of the pathology:  We define the nature of the pathology within standard and established psychological principles and constructs, which will lead us to the proper diagnosis, which will direct us toward the required treatment response.  No big deal. It’s called professionally competent clinical psychology. 

But first things first.  We need to solve the extreme version of the pathology first and put mental health back on the proper path of professional clinical psychology.

So. There it is. I’m going to get back to work.

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