Assessment: This is what you’re looking for…

This is what you’re looking for…

If you see that, then this is what you’re looking at…

If that is what you’re looking at, then this is what you do…

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I want to carry this theme for a bit.  Like a spiral, we’ll be drilling down in a circle of three sentences to expose the rock-solid core of the issues.

Assessment:  This is what you’re looking for…

Diagnosis:  If you see that, then this is what you’re looking at:

Treatment:  If that is what you’re looking at, then this is what you do:

Assessment leads to diagnosis, and diagnosis guides treatment.

Assessment

Assessment is the set of procedures used to identify the symptom patterns of various pathologies.

In assessment, the clinician is looking for the symptom patterns of known pathologies.  The more patterns one is familiar with as a mental health professional, the more the symptoms tell you about the origins of the pathology.

Assessment begins by knowing what symptoms you’re looking for from various pathologies.  That’s why we earn advanced degrees in psychology, we’re learning the patterns of symptoms for various pathologies from differing organizing systems.  What is the pattern of symptoms for autism?  What is the pattern of symptoms surrounding ADHD?  Is the child displaying the pattern of symptoms associated with an anxiety disorder?

Now here’s a very specific question:

What is the pattern of symptoms displayed in a family containing a spouse/parent who has prominent narcissistic and/or borderline personality pathology, in response to the inherent rejection and perceived abandonment surrounding divorce?

We know that the narcissistic personality is vulnerable to rejection and that the borderline personality is vulnerable to abandonment fears.  Neither of these personalities is going to respond well to the inherent rejection and the triggering of abandonment fears associated with divorce.  So what is the pattern of symptoms we’re going to see in the family as a result of the psychological collapse of a narcissistic/(borderline) parent surrounding divorce?

This is the key to the assessment of “parental alienation”:

Q:  What is the pattern of symptoms associated with the collapse of a narcissistic/(borderline) personality parent in response to the inherent rejection and perceived abandonment surrounding divorce?

A:  AB-PA answers that question by identifying three specific child symptoms that are evidence of the psychological collapse of a narcissistic/(borderline) personality spouse/parent in response to divorce:

Attachment system suppression toward a normal-range parent (diagnostic indicator 1)

Personality disorder traits in the child’s symptom display (diagnostic indicator 2)

Delusional belief in the child’s supposed “victimization” (diagnostic indicator 3)

This is the symptom pattern described by AB-PA (Foundations) to answer the question of what pattern of symptoms is displayed in a family with a narcissistic/(borderline) spouse/parent who is psychologically collapsing in response to the divorce.

Foundations describes exactly and fully where these three symptoms come from in the pathology of the narcissistic/(borderline) personality.

The ONLY pathology in all of mental health that will create this specific pattern of three child symptoms (attachment system suppression, personality disorder traits, an encapsulated persecutory delusion) is the psychological collapse of a narcissistic/(borderline) personality spouse/parent in response to divorce (as described in Foundations).

No other pathology in all of mental health will produce this specific set of three child symptoms other than the collapse of a narcissistic/(borderline) personality spouse/parent in response to divorce.

This is what you’re looking for:

Attachment system suppression (diagnostic indicator 1)

Specific personality disorder pathology in the child’s symptom display (diagnostic indicator 2)

An encapsulated persecutory delusion in the child’s symptom display (diagnostic indicator 3)

This is what you’re looking for (this is what you’re assessing for): those three symptoms of AB-PA, attachment system suppression, personality disorder traits, an encapsulated persecutory delusion.

This is what you’re looking at:

If you see those three symptoms (assessment), then this is what you’re looking at… (diagnosis)

This is what you’re looking for (assessment):  The three diagnostic indicators of AB-PA.

This is what you’re looking at (diagnosis):  The collapse of a narcissistic/(borderline) parent surrounding divorce.

Do we need to prove that the allied parent has narcissistic and/or borderline personalty pathology?  No.  Why?  Because those three child symptoms are the symptom pattern for the collapse of a narcissistic/(borderline) personality parent surrounding divorce.  No other pathology in all of mental health will produce that specific pattern of symptoms in the child other than pathogenic parenting by a narcissistic/(borderline) parent.

This is what you’re looking for:  The three diagnostic symptoms of AB-PA.

If you see that, this is what you’re looking at:  Severe Parental Psychopathology.

Narcissistic and borderline personalty pathology is severely distorting to interpersonal relationships and is unlikely to ever change.  This parent will, with almost 100% certainty, triangulate the child into the spousal conflict.

Because narcissistic and borderline personality pathology is so severely pathological and highly resistant to change, it is highly likely that this family will require at least five years (maybe more) of active mental health stabilization following the divorce.

This is what you’re looking at:  Child Psychological Abuse.

Parental narcissistic/(borderline) personality pathology that is creating:

1.)  Severe developmental psychopathology in the child (diagnostic indicator 1: attachment system suppression),

2.)  Severe personality disorder psychopathology in the child (diagnostic indicator 2: five specific narcissistic personality disorder traits displayed by the child),

3.)  Severe delusional-psychotic psychopathology in the child (diagnostic indicator 3: an encapsulated persecutory delusion),

is a DSM-5 diagnosis of V995.51 Child Psychological Abuse, Confirmed.

This is what you do:

If this is what you’re looking at (diagnosis), then this is what you do (treatment):

Assessment:  This is what you’re looking for:  The three diagnostic indicators of AB-PA.

Diagnosis:  If you see that (the three diagnostic indicators), then this is what you’re looking at:

1.)  The collapse of a narcissistic/(borderline) personality parent surrounding divorce,

2.)  Severe parental psychopathology,

3.)  A DSM-5 diagnosis of V995.51 Child Psychological Abuse (the creation of severe psychopathology in the child by pathogenic parenting practices).

Treatment:  If that is what you’re looking at, then this is what you do:

Protective Separation:  In all cases of child abuse (physical child abuse, sexual child abuse, and psychological child abuse) the professional standard of practice and duty to protect requires the child’s protective separation from the abusive parent.

High Road Protocol:  If needed, Dorcy Pruter’s High Road workshop will gently and effectively restore the normal-range functioning of the child’s attachment bonding motivations within a matter of days.

The Contingent Visitation Schedule:  A Strategic family systems intervention that offers a Response to Intervention (RTI) alternative to a complete protective separation, and that can help stabilize family functioning following a protective separation and the reintroduction of the pathogenic parenting of the psychologically abusive parent.

AB-PA Key Solution:  The teaming of an AB-PA Certified mental health professional with an AB-PA Knowledgeable amicus attorney to provide long-term stabilization of family functioning.

The professional rationale for the protective separation is the confirmed DSM-5 diagnosis of V995.51 Child Psychological Abuse.

The AB-PA Key teaming of an AB-PA Certified mental health professional with an AB-PA Knowledgeable amicus attorney is the treatment-oriented solution response to the severity and chronicity of the parental personality pathology within the family.

The High Road protocol and the Contingent Visitation Schedule are additional options that can be applied as warranted in individual cases.

If the High Road protocol is used to quickly and gently restore the child’s normal-range attachment bonding motivations within a matter of days, then the AB-PA Certified mental health professional serves as the follow-up recovery stabilization and “maintenance care” therapist for the family.

If the Contingent Visitation Schedule is used, then the AB-PA Certified therapist serves as the Organizing Family Therapist to develop and implement the court-ordered Contingent Visitation Schedule.

Assessment leads to diagnosis, and diagnosis guides treatment.

Assessment:  This is what you’re looking for…

The three diagnostic indicators of AB-PA: attachment system suppression toward a normal-range parent (diagnostic indicator 1), five specific narcissistic personality traits in the child’s symptom display (diagnostic indicator 2), an encapsulated persecutory delusion regarding the child’s supposed “victimization” by the normal-range parenting of the targeted parent.

Diagnosis: If you see that, then this is what you’re looking at…

The psychological collapse of a narcissistic/(borderline) parent surrounding the divorce (and/or surrounding the remarriage of the other spouse following divorce).

A DSM-5 diagnosis of V995.51 Child Psychological Abuse, Confirmed based on the severity of the child’s pathology created by the pathogenic parenting of the allied narcissistic/(borderline) personality parent.

Treatment: If that is what you’re looking at, then this is what you do…

Protective Separation

The High Road Protocol

The Contingent Visitation Schedule

AB-PA Key Solution

This linkage series is not a matter of opinion.  This is a rock solid fact.

There is no other pathology in all of mental health that will produce that specific set of three child symptoms other than the collapse of a narcissistic/(borderline) parent surrounding divorce. (Assessment)

The collapse of a narcissistic/(borderline) personality is a severe form of psychopathology within the family, and the creation of severe psychopathology in the child is a DSM-5 diagnosis of V995.51 Child Psychological Abuse, Confirmed. (Diagnosis)

The confirmed DSM-5 diagnosis of V995.51 provides the professional rationale for the protective separation, and the severity of the parental personality pathology warrants the insertion of an AB-PA Key team to stabilize the family’s post-divorce functioning and transition to a healthy separated family structure. (Treatment)

This linked series is not a matter of opinion.  It is a rock-solid locked-in fact.

Assessment leads to diagnosis, and diagnosis guides treatment.

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