The Return of Clinical Psychology to Court-Involved Practice

Professional psychology is divided into three primary domains,

Research Psychology:  Conducted through universities, research psychologists primarily work through grant-funded projects and are typically not licensed to assess, diagnose, or treat pathology.  To the extent that the research works with the assessment, diagnosis, or treatment of pathology, research psychologists typically hire a clinical psychology team through the grant as a component part of the research.

Clinical Psychology:  The role of clinical psychology is to assess, diagnose, and treat pathology; all types of pathology, from autism to ADHD, to trauma, to depression, to anxiety disorders.  The domain of assessment, diagnosis, and treatment of pathology is the domain of clinical psychology.

Forensic Psychology:  The domain of forensic psychology is defined as any professional activity by a psychologist that involves the court.  Forensic psychology as a field does not encompass a domain of knowledge.  Rather, it highlights the procedures used by professional psychology in a court-involved, legal jurisdiction context.  The requirements of the legal system are different than the requirements of professional psychology.  Forensic psychology requires that court-involved psychologists understand their role in a court-involved legal context.

Family Courts & Clinical Psychology: Shared Goals

In the family courts, however, the goals and mission of clinical psychology are highly attuned to the goals and mission of the court; the healthy emotional and psychological development of the child, often referred to as the “best interests of the child.”

In clinical psychology, it is always in the best interests of the child for the family to make a successful transition from the prior intact family structure united by the marriage, to a new separated family structure, that is now united by the child through the child’s shared bonds of affection with both parents.

The goal and mission of clinical psychology is consistent with the goal and mission of the family courts; ensuring the healthy emotional and psychological development of the child.  In cases of child abuse, this means protecting the child from an abusive parent.

The Role of Clinical Psychology

It is the responsibility of clinical psychology to solve pathology.  The solution to high-conflict family pathology surrounding divorce requires the clinical application of four domains of professional knowledge:

The attachment system,
Personality disorder pathology,
Family systems therapy,
Complex trauma.

The attachment-related family pathology of a child rejecting a parent following divorce can be understood through the application of each of these domains of knowledge individually, and professional-level understanding improves substantially when all four domains of professional knowledge are combined and integrated in their application to the pathology.

Attachment System:  A child rejecting a parent is fundamentally an attachment-related pathology, The attachment system is the brain system that governs all aspects of love and bonding throughout the lifespan, including grief and loss.  A problem in love and bonding between a parent and child is a problem in the attachment system of the brain; the love-and-bonding system of the brain.

The high-conflict family processes evidenced in the family can be described as the manifestation of one parent’s foundationally disorganized attachment system (a defined category of attachment).  The specific problem is the pathological processing of sadness and grief by one spouse surrounding the failed marriage, called “pathological mourning” (Bowlby, 1980).  This pathological parent is then triangulating the child into the spousal conflict surrounding the divorce (through creating custody visitation conflict) as a means for this parent to stabilize his or her own psychological response to the failed marriage and divorce (the pathological processing of sadness, grief, and loss).

Abundant research indicates that the processing of sadness occurs within and through the attachment networks of the brain.  The patterns for love and bonding created in the attachment networks of the brain serve to regulate emotions, particularly the emotion of sadness through parental comforting.  In response to the child’s sadness, a responsive parent comforts the child into a re-regulated state, which then builds through use-dependent neural processes the child’s capacity for self-comforting (self-regulation) of sadness and loss. 

Failures in healthy parent-child comforting are created through problems in the parent-child attachment bonding relationship, that then become instantiated in the neurological networks of the attachment system (called “internal working models” by Bowlby and “schemas” by Beck).  Bowlby notes that the pathology of “disordered mourning” is associated with personality disorder pathology, and the pathological processing of sadness is a feature of both narcissistic and borderline personality pathology (Kernberg, 1975; Briand-Malenfant, Lecours, & Deschenaux, 2012). 

The application of professional research and knowledge from the attachment system literature expands to fully capture and describe high-conflict attachment-related family pathology surrounding divorce as the sequelae of disorganized attachment networks (a defined category of attachment, well researched in the attachment literature) creating personality pathology in one of the parents who is pathologically unable to process the sadness and grief surrounding the failed marriage and divorce. 

A child rejecting a parent is fundamentally an attachment-related family pathology; a problem in the love and bonding system of the brain.  The knowledge base of professional psychology related to the attachment system is foundational knowledge required for the assessment, diagnosis, and treatment of attachment-related family pathology surrounding divorce.

Personality Disorder Pathology: Narcissistic and borderline personality processes are recognized DSM diagnoses with a substantial research evidentiary base in professional psychology.  Estimates from the research for the prevalence of narcissistic personality disorder in the general population is approximately 6%, and for borderline personality pathology is also about 6%.  This means that 10% to 15% of all divorces will involve one parent with prominent narcissistic or borderline personality pathology, and probably an even high proportion for the sub-sample of high-conflict court-involved divorce will involve at least one narcissistic or borderline personality parent. 

Narcissistic and borderline personality pathology will create high family conflict surrounding divorce, and can often create significant psychopathology in children.  The narcissistic personality is vulnerable to rejection, the borderline personality is vulnerable to abandonment fears.  Divorce involves both rejection and perceived abandonment, and both rejection and abandonment fears will become highly activated by divorce.  A full display of narcissistic and borderline personality pathology should therefore be expected surrounding divorce involving a narcissistic or borderline personality parent (estimated prevalence of 10%-15% of all divorces, and a much higher percentage of high-conflict divorces). 

Both the narcissistic and borderline personalities are entirely self-absorbed, and as parents they are incapable of empathy for the child’s experience, causing these parents to actively manipulate and exploit their children to be used as weapons against the other parent in the spousal conflict.  Exploitation and manipulation are prominent characteristics for both the narcissistic and borderline personality.  The pathology of the narcissistic and borderline parent will absolutely manipulate, use, and exploit the child in whatever way the parent needs surrounding the divorce and inter-spousal conflict.

The development of both narcissistic and borderline pathology can be more fully understood through the application of research knowledge regarding the attachment system. The narcissistic personality represents disorganized attachment with anxious-avoidant overtones (both defined categories of attachment), and the borderline personality pathology represents disorganized attachment with anxious-ambivalent overtones (also a defined category of attachment).  Uniting the research and professional literature for personality disorder pathology with the research and professional literature for the attachment system exponentially increases a clinical psychology understanding for attachment-related family pathology surrounding divorce.

Family Systems Therapy:  The child expressing attachment-related family pathology surrounding divorce is being triangulated into the spousal conflict through the formation of a cross-generational coalition with the allied parent against the targeted parent, resulting in an emotional cutoff of the child’s relationship with the targeted parent (Bowen; Haley; Minuchin).  Family systems therapy fully describes and captures the pathology of a child rejecting a parent surrounding divorce.

The renowned family therapist, Salvador Minuchin, provides a structural family diagram minuchin cross-gen diagramfor the pathology of a cross-generational coalition and emotional cutoff in his 1993 book, Family Healing, with Michael Nichols, and both Minuchin and Jay Haley, another preeminent figure in family systems therapy, describe the process of a cross-generational coalition

From Haley:  “The people responding to each other in the triangle are not peers, but one of them is of a different generation from the other two… In the process of their interaction together, the person of one generation forms a coalition with the person of the other generation against his peer.  By ‘coalition’ is meant a process of joint action which is against the third person… The coalition between the two persons is denied.  That is, there is certain behavior which indicates a coalition which, when it is queried, will be denied as a coalition… In essence, the perverse triangle is one in which the separation of generations is breached in a covert way.  When this occurs as a repetitive pattern, the system will be pathological.” (Haley, 1977, p. 37)

From Minuchin:  “An inappropriately rigid cross-generational subsystem of mother and son versus father appears, and the boundary around this coalition of mother and son excludes the father… The parents were divorced six months earlier and the father is now living alone… Two of the children who were very attached to their father, now refuse any contact with him. The younger children visit their father but express great unhappiness with the situation” (Minuchin, p. 61-62; p. 101)

A child rejecting a parent represents an “emotional cutoff” in the parent-child relationship (Bowen).  The preeminent family systems therapist, Murray Bowen, links the family pathology of an emotional cutoff to unresolved trauma in the family.  The unresolved trauma leads to poor differentiation of psychological boundaries, and ultimately to an emotional cutoff in a family relationship to balance the psychological over-involvement (enmeshment; the absence of psychological differentiation) in another relationship within the family.

The high-conflict divorcing family is having difficulty transitioning from the prior intact family structure that was united by the marriage, to the new separated family structure united by the children because of the pathological processing of sadness by the narcissistic-borderline parent.  The narcissistic-borderline personality pathology of the allied parent is instead processing sadness surrounding the failed marriage and divorce as excessive anger, hostility, and blame directed toward the other spouse.  The pathological processing of sadness as anger and blame is being transferred to the child through the pathogenic parenting of the narcissistic-borderline parent.  

Family systems therapy fully understands, describes, and captures the family pathology surrounding a child’s rejection of a parent following divorce, and the addition of professional information sets regarding the attachment system and personality disorder pathology substantially enhances the fullness of the clinical psychology description of the pathology.

Complex Trauma:  The child’s rejection of a parent following divorce represents the trans-generational transmission of attachment trauma from the childhood of an allied narcissistic-borderline parent to the current family relationships, mediated by the personality disorder pathology of the allied narcissistic-borderline parent, which is itself a product of this parent’s childhood attachment trauma.

The divorce triggered the concurrent activation of two sets of representational networks in the attachment networks of the brain, one created in the childhood attachment trauma of the narcissistic-borderline parent, instantiated in the schema expectation pattern (internal working model) of “abusive parent”/”victimized child”/”protective parent,” and a second set of representational networks in the attachment system for the current family relationships. 

The simultaneous activation of two representational networks results in a psychological fusion of these networks.  In the mind of the narcissistic-borderline parent, the other parent becomes – psychologically to the narcissistic-borderline parent – the supposedly “abusive parent” from the childhood attachment trauma of the narcissistic-borderline parent, while the current child becomes, in the mind of the narcissistic-borderline parent, psychologically equivalent to the “victimized child” of this parent’s childhood attachment trauma (the trauma reenactment narrative), which allows the narcissistic-borderline parent to then self-adopt and conspicuously display the coveted role as the supposedly all-wonderful “protective parent” in the trauma reenactment narrative.

It is all, however, a false trauma reenactment narrative born in the childhood attachment trauma of the narcissistic-borderline parent. The targeted parent is not “abusive,” the child is not being “victimized,” and the allied narcissistic-borderline parent is not a “protective” parent.

The creation of the false trauma reenactment narrative into the current family relationships is achieved by psychologically coercing and manipulating the child into adopting the supposedly “victimized child” role relative to the targeted parent.  Once the child adopts the false role of the supposedly “victimized child,” this role immediately identifies the targeted parent into the supposedly “abusive parent” role, and allows the narcissistic-borderline parent to self-adopt and conspicuously display the coveted role as the all-wonderful “protective parent.”

The combination and integration of four domains of professional psychology fully captures and explains the attachment-related family pathology involved in a child rejecting a normal-range parent following divorce.

Curriculum

The foundational curriculum for professional competence in the assessment, diagnosis, and treatment of attachment-related family pathology surrounding divorce includes:

John Bowlby: attachment system
Salvador Minuchin: family systems therapy
Aaron Beck: personality disorder pathology
Mary Ainsworth: attachment system

Theodore Millon: personality disorder pathology
Otto Kernberg: personality disorder pathology
Murray Bowen: family systems therapy
Jay Haley: family systems therapy
Bessel van der Kolk: complex trauma
Marsha Linehan: personality disorder pathology
Alan Sroufe: attachment system
Daniel Stern: neuro-relationship development
Peter Fonagy: Intersubjectivity
Edward Tronick: Intersubjective relationship development
Bruce Perry: developmental trauma

These are among the most preeminent figures in professional psychology.  The knowledge they represent is the foundational knowledge of professional psychology.  This curriculum is required for professional competence in the assessment, diagnosis, and treatment of attachment-related family pathology surrounding divorce.

This knowledge is not optional.  This knowledge is a requirement of professional competence in the assessment, diagnosis, and treatment of attachment-related family pathology surrounding divorce.  This knowledge represents professional standard of practice in clinical psychology.

The Return of Clinical Psychology

The standards of practice for forensic psychology are substantially below those for clinical psychology.  In forensic psychology, there is no pathology-related foundational knowledge required for professional competence.  Forensic psychologists are allowed to apply, misapply, or not apply – any, some, or none of the established foundational knowledge of professional psychology in their assessment, diagnosis, and treatment of pathology… including the established DSM diagnostic system of professional psychology.

The standards of practice for forensic psychology are substantially below those for clinical psychology.

AB-PA, an attachment-based description of attachment related pathology, grounded in personality disorder pathology, family systems therapy, complex trauma, and the professional research literature, is the application of the standard and established knowledge of professional psychology to assessment, diagnosis, and treatment of family pathology.  AB-PA represents standard of practice in clinical psychology for the assessment, diagnosis, and treatment of attachment-related family pathology.

The AB-PA pilot program for the family courts represents the return of clinical psychology to court-involved consultation, court-involved assessment of pathology, and court-involved treatment of pathology.  The goal and mission of the AB-PA pilot program for the family courts is to provide the court with the highest caliber of professional knowledge and standards of practice in professional psychology. 

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

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