The universe has this. We are part of an integrated weave. This is a narcissistic pathology – the solution must be non-narcissistic. The Age of Experts is over. Apply knowledge to solve pathology. Knowledge belongs to everyone.
We each have our role in the solution. I’m a clinical psychologist, assessment, diagnosis, and treatment. That’s my role. I don’t create knowledge, I apply it.
I cannot solve this for everyone one at a time. We must come together in our collective approach seeking a solution. My role is to provide consultation from clinical psychology to the families and the court regarding assessment, diagnosis, and treatment of pathology.
In this case, high-intensity family conflict and severe attachment pathology surrounding divorce.
There are no clinical psychologists working with court-involved family conflict. They have abandoned parents and children to a “specialty” field called “forensic” psychology. Forensic psychologists are the worst imaginable.
Forensic psychologists are ignorant, incompetent, and unethical. Rehabilitating unethical and lazy psychologists is not a goal. We will need clinical psychologists to return to court-involved family conflict.
I’m the only clinical psychologist over here. It’s my call right now what therapy we do for this court-involved family conflict. The clinical psychologists will refuse to come because it is too professionally dangerous. My role is to make it safe for them.
I have. If they walk where I walk, and step where I step, clinical psychologists will be safe in resolving court-involved family conflict.
Requirement 1. We need to establish basic-fundamental standards of practice.
There is no such thing as “parental alienation”, that’s a made-up diagnosis. We need to establish our diagnosis based on real pathology – diagnosis guides treatment.
There is no such thing as “reunification therapy”, that’s a made-up therapy. We need to use real therapy for real pathology. The diagnosis is a shared (induced) delusional disorder; a DSM-5 diagnosis of V995.51 Child Psychological Abuse.
What is the therapy?
The treatment will need to meet several requirements.
It can’t be anything Dr. Childress. Nothing about the solution can be Dr. Childress, not the diagnosis of the pathology, not the treatment of the pathology. I’m solving this pathology with both hands tied behind my back.
The Age of Experts is over, this must be a distributed solution. Apply knowledge to solve pathology. Knowledge belongs to everyone.
This pathology is court-involved, the courts are an adversarial system that, by its fundamental nature, encourages conflict. Added to that is the splitting pathology of personality disorder pathology, this means we will fight about everything, even the solution.
We must bring the fighting to an end.
The pathogen wants to make the fight-and-fight about Dr. Childress. I’m not a real thing, I’m a catalyst not a thing of substance. Nothing about the solution is Dr. Childress.
This is personality disorder pathology (narcissistic-borderline), a high-conflict personality. Narcissistic-borderline personality pathology is highly disorganized. We will need an appropriately structured therapy to contain the disorganization of the personality pathology (trauma).
This is a trauma pathology, the trans-generational transmission of trauma. Our treatment needs to be a trauma relevant treatment appropriate to personality disorder pathology.
That’s Dialectic Behavior Therapy (DBT – Linehan).
DBT will bring a basic-fundamental standard of practice to court-involved family conflict. I am not anticipating forensic psychologists becoming DBT therapists, I anticipate DBT therapists will return to work with this court-involved family conflict.
We need to turn to clinical psychology for solutions – treatment not custody.
Who? Who do parents turn to in clinical psychology to come treat their families? DBT trained psychologists and therapists. Applied Behavioral Analysis, behavior-chain interviewing, skills instruction and coaching.
Currently, DBT therapists are not familiar with court-involved practice. No one is. Court involved families have been abandoned to a “specialty” field of “forensic” psychology, they are the worst imaginable. We need to orient the returning clinical psychologists to routine court-involved clinical psychology with high-intensity family conflict.
That’s my role. I am a court-involved clinical psychologist. Walk were I walk, step where I step, and clinical psychology can resolve the family conflict pathology in the courts. Come back. We need clinical psychology in the family courts.
There’s more. This is an attachment pathology, the trans-generational transmission of attachment trauma. We need an attachment therapy.
That’s Emotionally Focused Therapy (EFT – Johnson).
We will be integrating DBT and EFT. Doing that is my role, I am a clinical psychologist. I know DBT. I know EFT.
The core structure will be DBT. The therapy I recommend will be court-involved DBT family therapy. DBT is based on a Behavioral model with mindfulness added. Fundamentally, DBT is in the Behavioral school of psychotherapy (B.F. Skinner).
DBT is sufficiently structured to bring basic standards of practice back to court-involved family conflict. DBT is sufficiently structured to bring organization to the disorganized personality pathology processes of this pathology. DBT is substantially empirically validated as a treatment for personality pathology.
My recommended therapy for this court-involved family conflict will be DBT family therapy. The principles of DBT and the skill sets taught and applied will need to be adapted to the specifics of this court-involved family conflict.
There is more. The pathology is an attachment pathology displayed in a parent-child relationship, the pathology is not a behavior, the pathology is a fundamental attachment bond. The therapist will need to know about the attachment system and how to treat attachment pathology.
That’s Emotionally Focused Therapy (EFT -Johnson). I am not recommending EFT as the front-line treatment for this court-involved family conflict. The front-line treatment is Dialectic Behavior Therapy (DBT-Linehan).
Emotionally Focused Therapy (EFT – Johnson) will be an integrated treatment that provides the core understanding for the treatment of attachment pathology. EFT is from the Humanistic school of psychotherapy (Rogers – empathy) and relies on the research surrounding the attachment system (Bowlby), incorporating the most advanced current scientific research on attachment and brain development (Tronick).
EFT’s Rogerian acceptance will be integrated with DBT along the mindfulness line. The expansion into family systems is through Satir and into Minuchin. I love Satir, she is found throughout EFT. Virginia Satir is Humanistic family systems therapy, she’s wonderful.
Court-involved DBT family therapy will be an integrative therapy, integrating three schools of psychotherapy within the DBT structure, Behavioral (DBT; Skinner/Mindfulness), Humanistic (EFT; Rogers; attachment), Family Systems (EFT; Satir, Minuchin – systems).
A competent therapist for this court-involved family conflict will work from a DBT family therapy model, and will have background competence in complex trauma (van der Kolk) and in the treatment of attachment pathology (EFT – Johnson).
I have placed three PESI trainings on my vitae as demonstrations of my competence in these three domains of knowledge necessary for professional work with this pathology (Standard 2.01 Boundaries of Competence).
I recommend that all mental health professionals working with court-involved family conflict obtain these three trainings from PESI or equivalent. I recommend that parents look for these three domains of knowledge in their mental health professional.
- Complex Trauma: Bessel van der Kolk. How the Body Keeps Score: Intensive Trauma Treatment Course – 12-hour PESI seminar, online.
- Dialectic Behavior Therapy (DBT): Dialectic Behavior Therapy Intensive Training; 12-hour PESI seminar, online.
- Emotion Focused Therapy (EFT): Sue Johnson. Intensive Course in Emotionally Focused Therapy: Attachment-Based Interventions for Couples in Crisis; 12-hour PESI seminar, online.
Complex Trauma – knowledge of child abuse
Dialectic Behavior Therapy (DBT) – behavioral analysis; treatment of invalidating environment; skills-based coaching
Emotionally Focused Therapy (EFT) – attachment bonding; process analysis; Rogerian empathy
Sue Johnson: Emotion Focused Therapy
None of this information is new to me. I am a trained behavioral psychologist. I cite my work with Jim Swanson, Ph.D. and the UCI Child Development Center. I trained in DBT during my foster care days.
I know Emotionally Focused Therapy and more – I know the basics from which EFT derives. My specialty practice is the attachment system and attachment pathology – i.e., Early Childhood Mental Health. I know everything about the attachment system – everything – I know everything about the development of the brain in childhood – everything. I know everything about its treatment – everything.
That’s what an Early Childhood Mental Health specialization means.
I know two treatments for attachment pathology in early childhood – I treat the attachment system, I treat attachment pathology – THAT is my specialty practice in Early Childhood Mental Health – I even have Infant Mental Health certification from Fielding Graduate Institute. I was the Clinical Director overseeing a three-university assessment and treatment center for children ages zero-to-five in the foster care system.
I know the attachment system. I know behavioral psychology. This is not new information for me. I am selecting from among the various treatment options available.
The disorganization, personality pathology, and child abuse component all require a structured approach. A structured data-driven therapy also integrates well with the court’s reliance on evidence. The behavioral-mindfulness treatment of DBT provides the necessary structure, and the mindfulness component of acceptance blends seamlessly into the Rogerian approach of EFT.
The skill sets of DBT will need to be attachment informed and guided since this is an attachment bonding pathology. The focus is not a behavior, it’s a relationship. The model offered by EFT provides the roadmap into the relevant information for resolving attachment pathology.
The process analysis of EFT is exactly the Applied Behavioral Analysis of DBT, just less formally applied and with a different focus (on relationship sequences in the session, not behavioral sequences outside the session).
The enactments of emotional experiences in EFT is the role-playing of skills in individual DBT therapy. EFT is more emotionally focused, DBT is more cognitively focused. This is an attachment pathology. The attachment knowledge of Bowlby and Tronick is superior in application to the behavioral strategies of B.F. Skinner. The schemas described by Beck (and Piaget) have application.
In treatment we have two questions, the what and the how. What are we treating, and how? The what is attachment pathology (EFT), the how is through structure (DBT). Diagnosis guides treatment. The diagnosis involved is DSM-5 V995.51 Child Psychological Abuse.
The structure of a behavioral approach can help bring organization to disorder, and when child abuse is a consideration, structure and organization in symptom monitoring are necessary for treatment efficacy.
There is a coaching and skills component to DBT. There is no coaching of skills in EFT which relies entirely on Rogerian principles – for a reason. The EFT Rogerian approach is what behaviorism finds in mindfulness – except Rogerian therapy is distilled mindfulness to a purpose. Rogerian therapy is an artful movement in mindfulness. Rogerian therapy is the core of empathy.
The structured skills coaching and data documentation focus of DBT will violate the Rogerian principles necessary for EFT. The treatment will be fundamentally a DBT model. The adaptation of the DBT model to court-involved attachment pathology and family conflict will be to bring in EFT as the guiding principles for treatment. The structure is DBT, the content is EFT along the mindfulness line.
In DBT, the therapy is through an Applied Behavioral Analysis, with the addition of psycho-educational skills training. EFT is entirely Rogerian therapy, remaining in the here-and-now of empathic tracking, which represent a moment-to-moment relationship-behavior analysis, a process analysis of the relational moves.
The DBT therapist does a behavioral analysis, the EFT therapist does a process analysis. The information is the same. A process analysis is simply conduced in the here-and-now of relationship with a focus on experiential change.
The mindfulness and radical acceptance of DBT is the Rogerian acceptance of EFT, which is the key bridge of their integration.
The integration of DBT structure with EFT content should be an interesting alchemical transformation. EFT combines Humanistic-Existential therapy (Rogers) with Psychoanalytic object relations (Bowlby), with a Family Systems orientation of Satir and Minuchin.
The one school that’s missing is CBT. Court-involved DBT therapy with an EFT content core integrates all four schools of psychotherapy, and is on the leading edge of scientific research (Tronick) on child development.
Apply knowledge to solve pathology. Ignorance solves nothing.
Craig Childress, Psy.D.
Clinical Psychologist, CA PSY 18857