Orienting to Parallel Process

It’s called parallel process, when the same thing occurs at two different levels.  It’s most notable in treating borderline personality pathology when the treatment team develops and expresses the splitting pathology of the borderline patient.

The treatment team splits into the “good therapist” who is “understanding” of the patient’s fragility and seeks to make allowances and offers support, and the “bad therapist” who wants to set firm boundaries and is accused of being too “hard” and harsh on the patient.

Splitting.  The “good therapist” and the “bad therapist.”  This is axiomatic in treating borderline personality pathology on a treatment team – parallel process, splitting.  Marsha Linehan, the developer of Dialectic Behavior Therapy calls it “staff splitting.”

I remember encountering it vividly when I was a clinical supervisor in Choc’s APA internship program.  Choc had about five licensed pediatric psychologists on staff covering different rotations in the hospital, and about five interns and post-docs in the training program.

We met weekly, all of the clinical supervisors, to discuss the trainees because we shared supervision responsibilities across rotations.  Each trainee had a primary supervisor, but then additional supervisors for each specific rotation.

We had this one trainee, a post-doc. I wasn’t her primary but I was a secondary supervisor.  She was having difficulty on some of the other rotations.  One week there was an escalating disagreement in the supervision group as to how to respond to the trainee’s evident deficiencies.

One supervisor was supporting the post-doc and minimizing the difficulties, the other was being harsh and critical and asking for immediate remediation of the alleged problems. The intensity of disagreement began to become elevated into sides.

Then one of the supervisors in the group said, “splitting” and everyone immediately stopped all discussion of the post-doc.  We turned to the splitting pathology in the supervision group, the “good supervisor” in the “supportive” role and the “bad supervisor” in the “harsh and critical” role.

We found middle, we then recognized that there was borderline spectrum pathology with the post-doc, that means unresolved trauma, which will affect her counter-transference issues with clients, we need to get that cleared up.  So a remediation plan was developed that was trauma-informed relative to the professional needs of the post-doc.

With the recognition of parallel process, the professional discussion shifted from the prior superficial conflict of division, to the remediation of unresolved trauma with the post-doc regarding their professional development as a psychologist.

That’s what you do in a treatment team when the parallel process of splitting emerges, first person to see it says, “splitting” and everyone stops.  The entire conversation about whatever, stops.  The discussion becomes about staff-splitting, the “good therapist” (typically the individual therapist) and the “bad therapist” (typically the family therapist).

Find middle.  Then reevaluate the situation from a borderline (unresolved trauma) perspective. There will be distorted perceptions of “victimization,” emotional regulation problems under stress, and use of external regulatory objects (i.e., manipulation and exploitation of others).  Borderline (unresolved trauma) pathology will also allege “abuse,” using that specific word, that will elevate intensity immediately and claim a position of “victimization” in response to any structure or limitations imposed on them.

Document everything carefully and fully with borderline and narcissistic pathology, they will attack. Make sure your documentation is clean.

Borderline personality pathology (unresolved trauma, unresolved sexual abuse trauma, emotional regulation problems and problems in self-identity stability) is challenging to deal with as a professional.  Typically, the advice within the profession, passed mentor to trainee, is to only have one borderline (max) on your caseload at any one time.

Many (most) psychologists will not carry any borderline pathology on their caseload.  They are the most challenging of diagnostic populations to deal with.

Except with DBT, Dialectic Behavior Therapy, developed by Marsha Linehan at the University of Washington.  She combined the structure of Cognitive-Behavior Therapy (CBT) with Eastern principles of Mindfulness, a grounding in our now, a release from the chattering of monkey-mind, and radical self-acceptance.

The construct of radical self-acceptance is an amazing trauma recovery orientation.  In the application of this construct, Dr. Linehan developed a key to unlocking pathological shame.  That is centrally important in treating sexual abuse pathology, what is typically called “borderline” personality pathology is actually unresolved sexual abuse trauma – we are pathologizing that little girl twice, first with the abuse, and then we call her “borderline” when she’s an adult because of the damage to love-and-bonding done to her as a child.  That is wrong, we need to stop doing that.

DBT is a treatment team, that’s another thing Dr. Linehan understood about treating “borderline” personality pathology, it’s exhausting as a professional, and there are a lot of facets of both education and therapy.  DBT is a treatment team model, as is all trauma recovery therapy.

Trauma is always a treatment team, it’s too tough on a single therapist.  When there is a treatment team and borderline pathology involved, there will be parallel process, the primary one will be splitting.

From Linehan:  “Staff splitting,” as mentioned earlier, is a much-discussed phenomenon in which professionals treating borderline patients begin arguing and fighting about a patient, the treatment plan, or the behavior of the other professionals with the patient.” (Linehan, 1993, p. 432)

From Linehan:  “Arguments among staff members and differences in points of view, traditionally associated with staff splitting, are seen as failures in synthesis and interpersonal process among the staff rather than as a patient’s problem… Therapist disagreements over a patient are treated as potentially equally valid poles of a dialectic.  Thus, the starting point for dialogue is the recognition that a polarity has arisen, together with an implicit (if not explicit) assumption that resolution will require working toward synthesis.” (Linehan, 1993, p. 432)

I discussed the construct of parallel process and staff splitting in a recent blog:

Parallel Process

I will be expanding on that discussion of parallel process to the current societal surround.  Our society is reflecting a parallel process, or we are reflecting that process here in this court-involved pathology, the reflection is actually an illusion, the parallel process of each has the same origins in both.

Rippling Trauma

Complex trauma (relationship-based trauma) is like a rock thrown into a lake; there is the rock of the abuse, the splash of the trauma, and the ripple across generations through the distorted parenting that unresolved childhood trauma creates.

We all ripple our parent’s and grandparent’s child abuse and complex trauma, and our children ripple ours, and we don’t even see it, because it surrounds us, to us, it’s natural and ordinary, it’s unconscious.

We ripple trauma in the distorted parenting practices that complex trauma, relationship-based childhood trauma, creates. Yet with each passing generation, we process a little more out, we become slightly healthier from generation to generation.

Our children are healthier than we are, and we are healthier than our parents.

To orient to reality of who we are I offer four names, Caligula, Genghis Kahn, Robespierre, and Adolf Hitler.  A substantial span of time, yet the level of savagery remains consistent, our insanity, our trauma, our pathological violence, our personality pathology born of trauma is who we are.

The Burning Times the Holocaust, centuries apart, the same savagery of inhumanity, of pathology, a narcissistic pathology born of trauma, creating trauma, endlessly.

Yet with each generation, we parent slightly better, our complex trauma gets worked through a bit in a process of projective identification with the child. The child becomes us psychologically and we re-parent ourselves through our parenting of the child.

With each generation, humanity improves, our children are healthier than we are because our parenting improves somewhat from what we received.  Look to 1940 Imperial Japan and their Bushido culture and to how far away that is from now to understand the progress in mere generations.

Once shared trauma united our shared psychology, trauma pathology was the norm, trauma was the constant of experience.  In that world the narcissistic absence of empathy and capacity for savage cruelty is not pathological, that’s survival in reality of the context.

We’re getting better, but we’re still rippling trauma of child abuse and complex trauma – in our society.  Our society is constructed by us, it is a reflection of us, it is a reflection of our traumas, and of our efforts at synthesis and resolution of the splitting, the sides, the divisions, and the restoration of normal-range human empathy.

Our society is a reflection of our psychology, and our psychology is a creation of our societal surround – a mirror of each, a reflection of both.  That is the source of parallel process.  It’s because both our society and our psychology reflect us, our structures, our inherent beliefs that we don’t even question.

We repeat patterns without thinking, without awareness, the patterns born in our complex trauma.

Narcissistic Pathology

Childhood complex trauma creates a constellation of symptoms from damaged information structures in the attachment networks of the brain, the love-and-bonding system.  Complex trauma, relationship-based trauma, primarily damages two sets of information structures in the attachment networks, empathy and the stability of self-identify.

The consequences of these damaged love-and-bonding networks is a constellation of symptoms termed “narcissistic personality” pathology; grandiosity, absence of empathy, haughty and arrogant attitude, need to be seen as special and the center of attention, a sense of entitlement, manipulation and exploitation of others, and splitting into polarized sides.

In the age of Caligula these traits were adaptive, same with the Crusades, Henry VIII, Napoleon as well.  Less so with each generation.

Now these traits of trauma, i.e., a narcissistic capacity for human cruelty and a fear-organized brain, are no longer adaptive, in fact, quite the opposite.  We now need our frontal lobe executive function systems fully operational in this up-and-coming tech-world of information.

We are releasing our trauma through our children, we are gradually freeing them from us, from our rippling of trauma.  We succeeded, not with ourselves, but through our children.  They are healthier than us, because of us.  We rippled just a little less of our trauma, as our parents rippled a little less of their’s to us.

Understand the trenches of World War I, the horrors of World War II, Stalin’s genocide, the Belgian Congo, the slave trade, and the devastating brutality of colonialism.  Our parents rippled their parents who rippled their’s, all of it unseen at the time, because it was “normal.”

We don’t see ours, except in the mirror, if we have the courage and clarity for self-reflection.  Portland, 2020 is no accident, it is a ripple, Black Lives Matter & Say Her Name are ripples, Make American Great Again, division, discord, and conflict are a ripple of trauma, complex trauma, relationship-based trauma in the love and bonding system.

The pathology here in high-conflict court-involved family conflict is narcissistic and borderline personality pathology activated by the rejection and abandonment inherent to the failed marriage and divorce.

Narcissistic personality pathology is the abuse pathology, child abuse and spousal abuse, those are the narcissistic personality pathologies, they are trauma pathologies just like the narcissistic personality disorder; relationship-based trauma.

Adolph Hitler and the Nazis offer a full display of the narcissistic pathology in all its myriad features.  I know it’s common to hyperbolically describe someone as being like Hitler, but with narcissistic pathology of abuse the parallels are valid.

The example of Hitler and that cadre of coldly malevolent cruelty in the surrounding humans, and with Imperial Japan, and in colonialism, are all applicable to gain increased understanding for the pathology.

The psychology of the narcissistic pathology achieves reflection in the societal surround. We don’t see the ripple because we are the ripple, we are unconscious of our patterns because they surround us, they are “normal,” they disappear from view because we are everywhere we look.

It used to be common, entirely common, spousal abuse and child abuse.  Child abuse laws were only enacted this past century, women have only received the vote this past century, our founding father’s were slave owners, and we’re just now ending the Civil War, the racist traitors lost, the union won and prevailed, all people are created equal and are endowed with certain inalienable rights.

I am introducing a line of discussion, using symptoms of trauma expressed in the societal surround for education and illumination of the symptom features of narcissistic pathology.

In narcissism, there is a continuum of self-esteem, from damaged self-worth to high levels of self-confidence, then it stops, the continuum stops at high self-confidence and strong self-esteem.  Then there is a gap, and then it resumes with pathological narcissism, the narcissistic personality disorder, it is not on the continuum of normal-range self-esteem.  It is a pathology, a deviant development from childhood complex trauma.

Narcissist pathology is low self-worth masquerading as high.

From Beck: “The core belief of narcissistic personality disorder is one of inferiority or unimportance.  This belief is only activated under certain circumstances and thus may be observed mainly in response to conditions of self-esteem threat.  Otherwise, the manifest belief is a compensatory attitude of superiority.” (Beck, et. al, 2004, p. 249)

Narcissistic pathology is born in childhood complex trauma (relationship-based trauma) and it creates trauma, it is abusive, it is cruel; the absence of empathy is the capacity for human cruelty.

The narcissistic personality collapses into delusions, persecutory delusions. Stalin is the most florid example.

There is a social distribution feature in narcissistic pathology, that’s Himmler, Goring, Heydrich, and all the loyal party members at the Nazi rallies, Mussolini’s Black Shirts, Hitler’s SA Brown Shirts, the thugs, the ruffians.  A group-mind develops, a shared delusional disorder, a persecutory delusion, they need to defend their race (self-identity), their beliefs (self-identity) against the threat from the “other,” the outsider, the not-me.

It represents a hyper-activation of their need to impose boundaries against psychological intrusion, against the violation by the other, that was born in a history of relationship-based trauma of psychological boundary violations.

From Beck: “Narcissistic individuals also use power and entitlement as evidence of superiority… As a means of demonstrating their power, narcissists may alter boundaries, make unilateral decisions, control others, and determine exceptions to rules that apply to other, ordinary people. (251)

From Beck: “Out of their vehement certainty of judgment, boundary violations of all sorts may occur, as narcissists are quite comfortable taking control and dictating orders (“I know what’s right for them”) but quite uncomfortable accepting influence from others” (p. 251)

In his book, Prisoners of Hate, Aaron Beck noted an important point, evil never sees itself as evil, it sees itself as the victim.  The Nazi’s saw themselves as victims of the Jews, the racists see themselves as victims, as being threatened, they see the other person as the danger, as the threat.  Evil never sees itself as evil, it projects itself onto the “other,” the split.

From Cohen: “The narcissist exaggerates his own importance, achievements, abilities, talents, and efforts, while splitting off, disassociating, or repressing negative elements of his self and projecting them onto others.” (Cohen, 1998, p. 198)

From Cohen: “The propensity to blame is an outstanding feature of narcissistic behavior in general.  It is a way for the narcissist to see himself in a good light and a manifestation of the splitting off of the negative aspects of the self and projecting them onto others that is a major narcissistic defense.” (Cohen, 1998, p. 206)Slide2

We are the all-wonderful, the pinnacle of ideal virtue.  They are the evil, malevolent, and all-bad.  Spitting, polarities, narcissistic and borderline personality disorder pathology.

Kill the infidels, kill the non-believers, the Protestants, the Catholics, the darker ones, them, the ones with the wrong beliefs, kill them, they’re evil, they deserve to die.

Our projected shadow.

From Kernberg: “The normal tension between actual self on the one hand, and ideal self and ideal object on the other, is eliminated by the building up of an inflated self concept within which the actual self and the ideal self and ideal object are confused.  At the same time, the remnants of the unacceptable self images are repressed and projected onto external objects which are devalued.” (Kernberg, 1975, p. 217)

From Svrakic: “Narcissist persons eliminate bad aspects of themselves using massive projections.  Naturally, such projections contaminate external objects that are then experienced as “dangerous, threatening, and worthless.” (Svrakic, 1990,  p. 193)

Humans are not “enemies,” we are family, we have merely forgotten, we are remembering, our children are learning again that we are family.  Family has no enemies, family is family, if family struggles, we support the more fragile and vulnerable family member and figure it out through empathy, care, and dialogue.

We’re family, brothers and sisters, mothers and fathers, sons and daughters, granted, a thousand times removed, we wandered all over the place, and in wandering, we forgot.

Then things happened, “civilization” came, and brutality, savagery, trauma, and suffering increased exponentially for centuries.  I offer Caligula and Rome as my citation, the Crusades or Mongol hordes work equally as well.  Shall we talk about Vlad the Impaler?  How about the Spanish Inquisition?  The Burning Times?

Pathological violence created by the absence of normal-range human empathy.  Henry VIII wasn’t a king, he was a psychopath, so was Julius Caesar, so were all of them, it was adaptive, the sensitive and compassionate ones didn’t last long.

We are changing, our psychology is changing.  Our pathology is being exposed in order to be worked through, processed, and resolved.  It is a narcissistic pathology of cruelty, hatred, fear, and brutality, of shared persecutory delusions, of violence, conflict, oppression, power, control, and intimidation.

Portland 2020.  BLM.  MAGA.  The Covid response of delusional denial.  There is a parallel process in our societal surround.  Shared persecutory delusions in conspiracy theories captivate many, Bill Gates is going to implant tracking microchips into the vaccines for Covid-19 to follow us, to control us, to violate our freedoms, Hillary was operating a pedophile sex ring out of a pizza place in New York, someone went with a gun to stop the delusional ring of non-existent pedophiles.

Conspiracy theories, shared persecutory delusions, parallel process from the same pathology, the same narcissistic personality pathology, a trauma pathology, complex trauma, relationship-based trauma that damages empathy and self-identity networks.

I will be expanding the discussion of parallel process into the societal surround for education and illumination regarding pathological narcissism, a trauma pathology with social distribution features, not to create political division into sides, not even to engage in political discussion, George Will, Bill Crystal, Steve Schmidt, ideology aside – to expose a pathology – a shared persecutory delusion from pathological narcissism, a trauma pathology.

We must find middle and avoid the parallel process of splitting – we must seek synthesis, not division and conflict.

In political debate, reasonable minds can disagree.  That’s not what I will be discussing, I will be discussing the symptoms of pathological narcissism for public education, consideration, and illumination.

The courts, the judges, need to see clearly and understand the nature of the pathology.  It is a pathology of lies, is a pathology of fear, it is a pathology of endless interminable conflict, of brutality, cruelty, and revenge.

It is not on the continuum of normal, it is pathological.

Our psychology is our society, we create one from the other, and each to both, we are a product of our childhood, a product of our surround.

Self-reflective insight is an executive function system of the frontal lobe, so is linear and logical reasoning, foresight and planning ahead.  So is the prefrontal cortex regulation of the limbic emotional system of fear-based responding from activated arousal (vagal nervous system) and a fear-organized brain (amygdala dominant).

I will be discussing the parallel process in our societal surround.  We are working through our trauma, led by our children, our healthier selves.

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

 

 

 

 

 

 

 

 

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