It’s Really Quite Simple

Things are changing.

I am increasingly being asked to consult within the mental health system and the legal system regarding the assessment, diagnosis, and treatment of attachment-based “parental alienation” (AB-PA). This is a good thing.  People in the mental health system and legal system are becoming educated.

The climate is shifting.  I can feel it.  Mental health and legal professionals are beginning to understand.

And it’s really quite simple actually.  I can see the lights of understanding going on as I talk to them.  They want to do the right thing, they just need guidance out of the wilderness.

Assessment leads to diagnosis… and diagnosis guides treatment.

Simple.  Simple.  Simple.

All we are asking for is that the court-involved mental health professionals – therapists and child custody evaluators – simply assess for standard and established symptomatology in the child’s symptom display:

 Developmental Pathology:  Attachment system suppression.

Personality Disorder Traits:  Specific narcissistic personality traits in the child’s symptom display.

Psychiatric-Delusional Pathology:  An encapsulated persecutory delusion regarding the child’s supposed “victimization” by the normal-range parenting practices of the targeted-rejected parent.

All of these are standard forms of mental health pathology that are fully within the scope of practice for all mental health professionals.  No new forms of pathology – no strange new types of symptoms.  Standard stuff.  Attachment system suppression, personality disorder traits, encapsulated persecutory delusions.  Simple.  Simple.  Simple.

Just assess for the symptoms.  Then document the findings of the assessment using the Diagnostic Checklist for Pathogenic Parenting.  What could possibly be simpler?

Assessment – Diagnosis – Treatment

Step by step.  Assessment.  Diagnosis.  Treatment.

The issue isn’t “parental alienation,” it’s pathogenic parenting (patho=pathology; genic=genesis, creation).  Pathogenic parenting is the creation of significant pathology in the child through aberrant and distorted parenting practices.  It is a defined term in both clinical and developmental psychology.  Fully established “standard of practice” stuff.

Pathogenic parenting.  The creation of pathology in the child through aberrant and distorted parenting practices.

What targeted parent out there doesn’t completely understand that their beloved child’s normal emotions and normal behavior have become completely twisted up and distorted by the manipulative, self-serving, and exploitative parenting practices of the allied narcissistic/(borderline) parent?

Your beautiful and beloved child is no longer recognizable; twisted with anger and venom, arrogance and lies.  Where did your beloved child go?  What happened?  That’s called pathogenic parenting, the creation of significant pathology in the child through aberrant and distorted parenting practices.

What’s been done to your precious child by the other parent, by your narcissistic/(borderline) ex-, is called pathogenic parenting.  The creation of significant pathology in the child through aberrant and distorted parenting practices.

All we’re asking is that mental health professionals assess for the symptoms of pathogenic parenting by a narcissistic/(borderline) parent who has formed a cross-generational coalition with the child against the other parent (Minuchin; Haley).  No big deal.  Simple.  Just assess for the symptoms.

Then document the findings of the assessment using the Diagnostic Checklist for Pathogenic Parenting.  Seriously… what could possibly be simpler?

Assessment Leads to Diagnosis

Step by step.  Assessment leads to diagnosis.

Pathogenic parenting that is creating significant developmental pathology in the child (diagnostic indicator 1), personality disorder pathology in the child (diagnostic indicator 2), and delusional-psychiatric pathology in the child (diagnostic indicator 3) in order to meet the parent’s own emotional and psychological needs represents a DSM-5 diagnosis of V995.51 Child Psychological Abuse Confirmed.

All we want is an assessment by a mental health professional for the symptoms of pathogenic parenting created by an allied narcissistic/(borderline) parent who has formed a cross-generational coalition with the child against the other parent (Minuchin; Haley).

That’s all.  Simple.  Just assess for the symptoms.  Are they present or not?

Assessment leads to diagnosis.  Pathogenic parenting that is creating significant psychopathology in the child represents a DSM-5 diagnosis of V995.51 Child Psychological Abuse, Confirmed.

Diagnosis guides treatment…

Simple.  Simple.  Simple.  From a mental health perspective, this is not a big deal.

Diagnosis Guides Treatment

Assessment leads to the DSM-5 diagnosis of V995.51 Child Psychological Abuse, Confirmed.

Pathogenic parenting is not a child custody issue, it is a child protection issue.

In all cases of child abuse, physical child abuse, sexual child abuse, and psychological child abuse, the appropriate professional response is to protect the child.

In all cases of child abuse, the child is first protectively separated from the abusive parent.  This is the appropriate response in cases of physical child abuse.  This is the appropriate response in cases of sexual child abuse.  This is the appropriate response in cases of psychological child abuse.

Assessment leads to diagnosis.  Diagnosis guides treatment.

In all cases of child abuse, once the child is protectively separated from the abusive parent, we then treat the child for the emotional and psychological consequences of the child abuse and we restore the child’s normal-range and healthy development.

In all cases of child abuse, once the child’s healthy and normal-range development has been recovered and restored through therapy, we then reintroduce the relationship with the formerly abusive parent with sufficient safeguards in place to ensure that the child abuse does not resume once the relationship with the formerly abusive parent is reestablished.

In all cases of child abuse, the formerly abusive parent is required to obtain collateral therapy to gain – and demonstrate – insight into the causes of the prior abusive parenting.

In all cases of child abuse, the response of the formerly abusive parent to his or her collateral treatment is used as a gauge in determining the level of safeguards needed upon reintroduction of this parent to the child.

We do this for physical child abuse, we do this for sexual child abuse, we do this for psychological child abuse.

Assessment leads to diagnosis, and diagnosis guides treatment.

Simple.

Pathogenic parenting is not a child custody issue, it is a child protection issue.

Once I get to explain this to mental health and legal professionals, the solution is really quite simple.

Assessment.  Diagnosis.  Treatment.

Craig Childress, Psy.D.
Psychologist PSY 18857

6 thoughts on “It’s Really Quite Simple”

  1. Thanks again, Dr. C! Just to be clear are you wanting to now refer to this as pathogenic parenting exclusively? No more parental alienation? I can absolutely see the point in doing that. Lead the way! Many hugs.

    1. I agree Felicia. I have been a victim of Pathogenic Parenting for 17 years – then known as PAS. I do, however, agree that Richard Gardner was right in the 8 manifestations of PA. However, for 30 plus years it has not been accepted by the APA – so a victim parent is going to get nowhere in the courts. I think the G8 (as they are known) are a very good warning signs that your child has been alienated (or should I say that the pathogen has raised its’ ugly head)? I think Dr C. has nailed it and it is Simple (to use his words). It is simple in the extreme cases but aren’t they the most important? Mine was, and my ex was a Narcissist and it is the extreme cases that need the most attention because they can cause psychosis in the child. I know that there are many mild, moderate, even hybrid cases but he just wants to solve this ONE problem which is the severe. The severe is caused by a Narcissistic Personality Disorder and this puts the child at extreme risk (for a lifetime)! and is Psychological Abuse Confirmed. End of.

    2. The term “parental alienation” is embedded in our culture as the label for this pathology. I understand that and accept that this term will continue to be used to describe the attachment-related pathology of pathological mourning surrounding divorce (with allied narcissistic/(borderline) parent as the primary case tnad the child being influenced toward disordered mourning by the aberrant and distorted parenting of the allied narcissistic/(borderline) parent.

      But it’s the mental health system I’m focused on changing. The mental health professinoals should be using standard and established constructs and principles to understand, assess, diagnose, and treat this pathology.

      The term “parental alienation” is associated with Gardnerian PAS, which is a horrible model of pathology that has led to 30 years of controversy and no solution. Gardnerian PAS allows – and indeed invites – rampant professional incompetence. We cannot hold mental health professionals accountable to Gardnerian PAS. That’s why I set about defining this form of attachment-related pathology surrounding divorce entirely from standard and established constructs and principles. Now there are two distinctly different models for describing the pathology, Gardernian PAS and an attachment-based model of “parental alienation” (AB-PA). With AB-PA we can hold mental health professionals accountable.

      The switch to the defined construct of pathogenic parenting, to the defined construct of cross-generational coalitions, and to defined construct of pathological mourning, other defined constructs in established professional psychology is meant primarily for mental health professionals. Mental health professionals need to become competent. The rampant professional competence must end.

      People will continue to use the term “parental alienation” – and that’s fine with me. I’m just trying to achieve clarity with the field of mental health about what we mean when we use the term “parental alienation.” Using the term “pathogenic parenting” provides this clarity.

  2. Dr Childress:

    My daughter is exhibiting some very disturbing behaviors, but as of this date she is (mostly) not exhibiting those behaviors in your diagnostic criteria. I’m very thankful for this, but what concerns me is that those behaviors in your ASM are almost all present. Am I in a race against the clock to win my daughter before my ex inevitably manages to turn her heart?

    1. I cannot comment on your individual situation because I haven’t interviewed everyone involved.

      Let me make some general statements about sub-threshold cases of AB-PA.

      In the future, once we have achieved professional competence in mental health therapists, sub-threshold AB-PA cases will be relatively easy to solve. However, until we achieve professional competence, this will be dicey. The important consideration is that AB-PA represents the attachment-based pathology of “disordered mourning” (Bowlby, 1980). The child’s sadness surrounding the divorce is being translated into “anger and resentment, loaded with revengeful wishes” (Kernberg, 1977) by the distorting parenting practices of the allied narcissistic/(borderline) parent. Once the child begins rejecting a relationship with the beloved-but-now-rejected targeted parent (the erased parent), then the child’s grief and sadness hugely increases.

      What is absent in the parent-child relationship with the narcissistic/(borderline) parent is empathy – authentic empathy for the child’s sadness, grief, and loss surrounding the family transitions. The narcissistic/(borderline) parent is the “primary case” of pathological mourning surrounding the divorce, since the damaged structure of the narcissistic/(borderline) personality cannot process the emotions of sadness, grief, and loss. Instead, this personality structure collapses when rejected or abandoned by the attachment figure (in this case the other spouse in the divorce), and translates sadness and mourning into “anger and resentment, loaded with revengeful wishes.” As a result, this parent cannot have empathy for the child’s experience of sadness, grief, and loss.

      The goal of the targeted-authentic parent is to help the child understand and process the child’s sadness. The targeted-authentic parent must have empathy for the child’s hurt, grief, and loss, and also empathy for how the child is being put in the middle of the spousal conflict by the allied narcissistic/(borderline) parent. Doing this – helping the child understand and process the child’s sadness and cope with being put in the middle of the spousal conflict – is really hard to do. That’s why the help of a capable and competent therapist is really valuable. However, there aren’t many capable and competent therapists out there right now.

      I will offer an hour of consultation with any mental health professional (it has to be with a mental health professional) regarding the attachment-related pathology of AB-PA. So I recommend that targeted-authentic parents locate a mental health professional who is willing to consult with me and then have them send me an email with the heading Professional Consultation. That’s the best way of locating professional competence at this point.

      For the targeted-authentic parent – empathy for your child’s difficult position is critical. Next, don’t try to parent using standard “discipline” strategies of punishment for misbehavior. This is where it also gets hard. How do you respond when your child is openly defiant or rude? Disciple (punishment) is typically not helpful. This is where empathy for the child’s sadness and being caught in the middle becomes essential. Challenge the child’s rude and disrespectful behavior, but do it from a relationship-based perspective of teaching the child appropriate pro-social values, and helping your child understand that the feeling isn’t angry… it’s sad. Outwardly, the child is angry. Inside, the child is sad. The child needs a hug.

      Oh, but they’re all prickly and angry and rejecting. I know. But they still really need a hug. Be warm. Be kind. Provide empathy. Tell them it’s not okay to be rude and mean, because they’re a good kid, and you know that. Encourage that hug. Smile. Offer warmth. Rude is not okay, but you also understand how difficult it is to be caught in the middle, and you’ll help them out of it – not by blaming the other parent – but by offering a hug when they need it but are all angry and grumpy because they don’t understand they’re hurting.

      There’s more. It’s deep. But authentic empathy is key.

      Look, the child didn’t choose that other parent for themselves. You chose that parent for them. It’s not the child’s fault. The child is trying to cope with a highly manipulative narcissistic/(borderline) parent. You escaped that person by divorcing them. But your child still has to cope with that person as a parent. And that other parent is always on the verge of emotional collapse into anger (for both the narcissist and borderline) or deep depression (for the borderline). That other parent is manipulatively twisting the child’s authentic sadness into anger and blame, seeking to manipulate the child into joining that parent’s “side” against you. If the child doesn’t join the “side” of that parent, then that parent is going to retaliate against the child. Not the child’s fault.

      So while the child’s emotions and behavior may be problematic, it’s not the child’s fault. Empathy. The child needs your empathy. Then the child needs help to work out how to process the sadness (they need a hug) and how to escape being caught in the middle.

      But again, these are just general statements, I don’t know what’s actually going on in any individual family unless I’ve interviewed everyone.

      Craig Childress, Psy.D.
      Psychologist, PSY 18857

    2. yes,turn her mind and emotional health,proffessional incompetence is why we could not save the child and the child who showed mild narsisistic behaviors had escalated until child fully became pas ,stopping all contact.It did not matter how much unconditional love u provide,they r with u a minicule of time ,u will get false hope that u are getting through to her about her rude abussive escalating behaviors,that of narsisistic pd traits and u may see change,but then they return next visit five steps backwards until they can no longer take the confussion sahame of loving you while they r to hate you ,so they succomb to the abusers and end all ties,i pray the change comes on time for the emotional health of your baby,from a parent whom lost all 4 to pas,and fought a deaf system until they were all gone xoxo

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