“When someone seeks,” said Siddhartha, “then it easily happens that his eyes see only the thing that he seeks, and he is able to find nothing, to take in nothing because he always thinks only about the thing he is seeking, because he has one goal, because he is obsessed with his goal. Seeking means: having a goal. But finding means: being free, being open, having no goal.” — Hermann Hesse, Siddhartha
Diagnosis is not seeking, diagnosis is following, diagnosis is discovering.
The goal of clinical assessment is to follow the symptom pattern to discover the cause. In court-involved mental health, the findings of the assessment should be carefully documented in the patient record.
The goal of clinical assessment is not to “find” something, like ADHD or autism or bipolar disorder. The goal of clinical assessment is to follow the symptoms into the pattern that discloses the cause, discloses the ADHD diagnosis or the bipolar diagnosis. As a clinical psychologist, I don’t care what pathology is identified through the assessment. We will fix whatever it is.
We simply need an accurate diagnosis in order to develop an effective treatment plan. In clinical psychology, we follow the symptoms into the pattern that discloses the diagnosis.
The application of standard and established constructs and principles to a set of symptoms is called diagnosis. A description of pathology using the standard and established constructs and principles of professional psychology is called a diagnostic model; it explains why we see a particular symptom pattern.
The diagnostic model of attachment-based “parental alienation” (AB-PA) makes a prediction about the child’s symptom pattern. AB-PA predicts the presence of three disparate, extremely rare, and seemingly unconnected child symptoms:
1.) Attachment system suppression toward a normal-range parent,
2.) Specific personality pathology in the child’s symptom display,
3.) An encapsulated persecutory delusion.
If these symptoms are not present in the child’s symptoms, then the assessment and diagnosis follows the symptoms wherever they lead to discover the cause.
However, if these three a-priori predicted symptoms of AB-PA are present in the child’s symptom display, they need explanation.
How does a child acquire this specific set of three highly unusual and disparate symptoms?
How does a child develop an attachment bonding rejection pathology toward a normal-range and affectionally available parent?
AND… How does the same child develop five specific narcissistic personality traits expressed specifically toward a parent? AND…
AND… How does the same child develop an encapsulated persecutory delusion about the normal-range parenting of a normal-range parent? This symptom is impossible to explain other than AB-PA.
If these three symptoms are present, they require an explanation. An attachment-based model for the pathology of “parental alienation” surrounding divorce not only explains these symptoms, it predicts these specific symptoms.
The presence of these three symptoms in the child’s symptom display confirms the diagnostic model that makes this prediction.
Each of these symptoms is exceedingly rare generally, and exceptionally rare in children. Attachment bonding rejection from a child toward a normal-range parent is essentially unheard of beyond the age of 18 months, except in severe cases of child abuse such as incest or severe physical abuse. Personality disorder pathology is also extremely unusual in a child. An encapsulated persecutory delusion toward a normal-range parent is not only rare, it is impossible to explain outside of the pathology of AB-PA. There is no method by which a child acquires an encapsulated persecutory delusion regarding a normal-range parent except through the pathology of AB-PA (a cross-generational coalition with an allied parent against the targeted parent).
Not only does a Bowlby-Minuchin-Beck model of attachment-based “parental alienation” explain the presence of these three disparate and unusual symptoms in the child’s symptom display, a Bowlby-Minuchin-Beck diagnostic model predicts these symptoms.
The presence of these three symptoms in the child’s symptom display is confirmatory evidence for the diagnostic model that predicts these symptoms.
Assessment leads to diagnosis, and diagnosis guides treatment.
It begins with assessment. Three symptoms.
Craig Childress, Psy.D.
Clinical Psychologist, PSY 18857
2 thoughts on “Three Symptoms”
The pathogen wants people to believe that if a parent is bad enough to their child the child will reject them. We had a case in Australia recently where it became known that an adult child still had a good relationship with the parent who tried to murder him, other cases where government child welfare workers report that no matter how bad any parent is to a child the child just does not want to leave them. Of course there is the well known Stockholm Syndrome where hostages form an affinity with their captors. Dr Childress’s explanation about children having it in their genes to want to stay close to their parents to be protected from predators makes so much sense.
My understanding is that what keeps a kid close to its parents are bonds of attachment and abuse. What might cause a child to want to reject a parent is some kind of mind control or fault in their DNA.
I can understand that if one parent was really bad and the child told the story to other people that the child would want to reject a parent. I am struggling with the concept that the child could of its own volition without the influence of outside people reject a parent. Maybe I have understood Dr Childress’s blog post wrong but that is what it comes across to me.
I hope that anyone who writes about AB:PA is able to write in such a way that people might not have any scope to think being a bad parent is a reason a child will of their own volition want to reject a parent.
We don’t want wording written to explain a 1 in one million case to be used by 99 % of parents who want to cut the other parent out of the life of a child.
Dr. Childress’ statement that the attachment system does NOT spontaneously malfunction (my wording might be a bit off..), is a tenet that I see as critical in confronting ABPA. The malfunction, so easily seen as the rejection of a parent, is the “black eye” of ABPA, the whip marks, the starvation that triggers mandated reporting. Caused only by pathogenic influences, it must be addressed with the same urgency as any suspected physical and sexual abuse.
Over the years I had many conversations with mandated reporters, pouring out my story of loss. Teachers, guidance counselors, school psychologists, lawyer after lawyer, their pediatrician, even their dentist… All would listen with furrowed brow, perhaps a wringing of the hands. But nothing. Absolutely nothing was done. How perversely I hoped for that black eye, that whip mark, that sign of neglect. Nothing…
Yes, the pathogen is good at covering its tracks, but following Occam the best evidence is the most visible – a child has severed a relationship with a parent. Ding! Ding! – time to asses for the “why”.