An Attachment-Based Model of Parental Alienation: Foundations
is now available on Amazon.com
Craig Childress, Psy.D.
Clinical Psychologist, PSY 18857
Category: Therapy
Psychologist Consultant Model
The solution to “parental alienation” requires a paradigm shift away from the failed Gardnerian paradigm of Parental Alienation Syndrome (PAS), over to an attachment-based model of “parental alienation” that describes the nature of the pathology from entirely within standard and established psychological constructs and principles.
Until we are able to achieve this paradigm shift, however, we are stuck working with the systems that we have, and these systems are broken. The mental health response is inept and too often colludes with the pathology, and the response of the legal system is glacial at best, prohibitively expensive, and entirely inadequate. So how are we to cope with these failed systems when we need the support of the mental health and legal systems to achieve a solution to “parental alienation?”
Until we are able to achieve a paradigm shift that will allow us to solve all cases of attachment-based “parental alienation” quickly and effectively as they arise, we must find ways of resolving the ignorance and incompetence in mental health and the inadequacy of the legal response.
The Single-Subject Design remedy that I wrote about in my recent blog post and on my website (Single Subject Design Remedy) may (or may not) offer a remedy acceptable to the Court.
My professional recommendation, however, is that the appropriate treatment response to the presence of the three diagnostic indicators of attachment-based “parental alienation” in the child’s symptom display (see Diagnostic Indicators post) would be an immediate 9-month protective separation of the child from the pathogenic psychopathology of the narcissistic/(borderline) parent; followed by an initial intervention with the intensive “High Road” protocol of Pruter to quickly restore the child’s normal-range authenticity; followed by ongoing recovery stabilization therapy with a capable and competent therapist.
In developing and offering the Single-Subject Design remedy I am trying to find a compromise solution that may be acceptable to the Court and functional in the current context of dysfunctional systems. If you are familiar with the rationale of the SBS Intervention available on my website, you may also recognize the strategic family systems component of the Single-Subject Design remedy that seeks to alter the power dynamics conferred by the child’s symptoms.
The SBS Intervention and the Signal-Subject Design remedy are efforts to address the inadequate response of the legal system which is reluctant to take the necessary treatment related step of ordering the child’s protective separation from the pathogenic parenting of the narcissistic/(borderline) parent during the active phase of the child’s treatment and recovery stabilization.
In my view, we desperately need to end the unproductive and unnecessary debate in mental health surrounding whether or not “parental alienation” exists. The pathology of narcissistic and borderline personalities definitely exists, as does the attachment system, attachment trauma, and the trans-generational transmission of attachment trauma. All of these things definitely exist. And all of these things comprise the core foundation for an attachment-based model of “parental alienation.”
Instead of being frozen in endless unproductive and unnecessary debate, we should be moving forward in actively conducting systematic research on different models for resolving the pathology of attachment-based “parental alienation.” The SBS Intervention and the Single-Subject Design remedy are two offers for compromise solutions that may be acceptable to the Court and that could serve as beginning options for additional treatment research (once we end the unproductive and unnecessary debate in mental health as to whether “parental alienation” exists).
Broken Mental Health Response
But until we can achieve the needed paradigm shift, we must work within the broken systems that we have. In this blog post I will be turning my attention to the broken mental health response. We need to address the ignorance and incompetence which is prevalent in the mental health response to attachment-based “parental alienation.” In this blog post I describe a possible “psychologist consultant” model for the role of an expert professional in assisting the targeted parent in obtaining an appropriate mental health response to the pathology of attachment-based “parental alienation.”
The concept of a psychologist consultant model is not new. Michael Bone and Richard Sauber (2013) have proposed a similar professional consultation role for an expert mental health professional. But in this blog I will be extending the specificity of describing the role of the “psychologist consultant” in helping the targeted parent obtain an appropriate and competent mental health response to the pathology of attachment-based “parental alienation.”
This increased specificity in describing the role of the psychologist as a consultant to the targeted parent is made possible by the shift from the Gardnerian PAS model employed by Drs. Bone and Sauber to an attachment-based model of “parental alienation” that’s based entirely within standard and established psychological constructs and principles. One of the primary advantages offered by a paradigm shift is that an attachment-based model establishes clearly defined boundaries of professional competence within standard and established constructs of professional psychology.
Once we establish domains and boundaries of professional knowledge and competence necessary to diagnose and treat this special population of children and families, we can then begin to hold ALL mental health professionals accountable to a defined standard of practice in diagnosis and treatment.
The attachment-based model for the construct of “parental alienation” defines the pathology being evidenced in the family, and in the child’s symptom display, within the established professional constructs of parental narcissistic and borderline personality pathology, the role-reversal relationship, the triangulation of the child into the spousal conflict through the formation of a cross-generational coalition with the allied and supposedly favored narcissistic/(borderline) parent against the targeted parent, and the severe distortion to the child’s expression of attachment bonding motivations toward a normal-range and affectionally available parent.
The nature of the pathology requires that diagnosing and treating mental health professionals possess an advanced level of professional expertise in the following domains of professional knowledge:
1. The Attachment System
The child’s rejection of a normal-range and affectionally available parent represents a severely pathological distortion to the formation and expression of the child’s attachment system.
As a consequence of the attachment system foundations to the child’s expressed pathology, mental health professionals who are diagnosing and treating the severely pathological distortions to the child’s attachment system must possess an advanced level of professional knowledge and expertise regarding the developmental formation and expression of the attachment system during childhood, including the trans-generational transmission of attachment trauma, in order to competently diagnose and treat this type of child and family pathology.
An advanced professional understanding for the reenactment of attachment trauma patterns that are contained within the “internal working models” of the attachment system is crucial to professional expertise and competence in working with this special population of children and families.
2. Personality Disorder Pathology
The pathology of attachment-based “parental alienation” represents the expression of pathogenic parenting practices by a narcissistic and/or borderline personality parent who is inducing severe psychopathology in the child. The term “pathogenic parenting” is a construct in clinical psychology and child development referring to the creation of severe psychopathology in the child as a result of highly distorted and aberrant parenting practices (patho=pathology; genic=genesis, creation).
The narcissistic/(borderline) parent is engaging the child in a pathogenic role-reversal relationship in which the parent is using the child as a “regulatory object” to regulate the emotional and psychological state of the narcissistic/(borderline) parent. While a role-reversal relationship will superficially appear to be a hyper-bonded parent-child relationship, it is actually an expression of extreme psychopathology which is highly destructive for the child’s healthy development.
Because narcissistic and borderline personality psychopathology plays such a central role in the formation and expression of the child’s symptoms, mental health professionals involved in diagnosing and treating this type of child and family pathology must possess an advanced level of professional knowledge and expertise in narcissistic and borderline personality processes. This includes an advanced professional expertise in recognizing the presentation of narcissistic and borderline psychopathology in clinical interviews, and in recognizing the expression of narcissistic and borderline psychopathology through a role-reversal relationship with the child, in which the child is used as an external “regulatory object” for the parent’s own pathology.
3. Delusional Processes
The narcissistic/(borderline) personality structure is extremely fragile and will readily collapse into distorted, and often delusional, perceptions of others.
Since the fragile narcissistic/(borderline) personality structure is prone to collapse into delusional thinking, mental health professionals working with this type of psychopathology within the family must possess a professional expertise in recognizing the characteristic delusional processes surrounding the collapse of the narcissistic and borderline personality structure. This professional expertise also includes the means by which parental delusional beliefs can be transferred to the child through the child’s role-reversal relationship with the parent.
In a role-reversal relationship, the child is used by the narcissistic/(borderline) parent as a “regulatory object” for the parent’s emotional and psychological state. This requires that the child surrenders self-authenticity in order to adopt the regulating role for the parent as a continual narcissistic reflection for the parent’s emotional and psychological needs. The child’s role as a “regulatory object” for the narcissistic/(borderline) parent is to prevent the collapse of the parent into chaotic displays of emotional and psychological disorganization by stabilizing the fragile self-structure of the parent.
Through the child’s role as the “regulatory object” for the narcissistic/(borderline) parent, the child acquires the delusional perceptions of the narcissistic/(borderline). The child’s role as the “regulatory object” for the parent’s psychopathology requires that the child surrenders self-authenticity to the parent in order to become a regulating narcissistic reflection for the emotional and psychological needs of the parent.
Defining the processes of attachment-based “parental alienation” from entirely within standard and established psychological principles and constructs establishes a set of clearly defined professional domains of knowledge required for professional competence in the diagnosis and treatment of this special population of children and families.
Evaluation of the Child
The evaluation of the child’s pathology occurs in two professional contexts:
1. Treatment: When the child enters either individual or family therapy, the treating mental health professional must evaluate the nature, extent, and the cause of the child’s symptom display in order to develop a treatment plan.
This initial treatment evaluation can be either skillful or inadequate based on the professional expertise and competence of the treating therapist.
If the treating therapist lacks professional expertise in the necessary domains of professional knowledge needed to competently diagnose and treat the pathology of attachment-based “parental alienation,” then the evaluation of the child will be inadequate, incomplete, and faulty.
Physicians who do not understand cancer should not be diagnosing and treating cancer.
Mental health professionals who do not understand the attachment system and personality disorder pathology should not be treating distortions to the attachment system of the child that are caused by the personality disorder pathology of a parent.
Most therapists treating attachment-based “parental alienation” lack the professional knowledge and expertise necessary to appropriately diagnose and treat the pathology involved. As a result, most therapy provided for the pathology of attachment-based “parental alienation” is inadequate, misguided, and entirely ineffective.
2. Custody Evaluation: The Court sometimes seeks the input of professional psychology regarding matters of family conflict and child custody. The input of professional psychology is typically structured into a child custody evaluation regarding family processes and parental capacity.
The quality and conclusions of the child custody evaluation can be either sound or faulty based on the professional expertise and competence of the mental health professional conducting the evaluation.
Typical child custody evaluations involving attachment-based “parental alienation” do a fairly thorough job of gathering and reporting on the clinical data, but the clinical interpretations and conclusions based on the clinical data are frequently faulty and incorrect, and the recommendations offered by the child custody evaluation are often inadequate and fundamentally wrong from a treatment perspective.
The reason that so many child custody evaluations get it wrong regarding the pathology of attachment-based “parental alienation” is that the mental health professionals conducting these evaluations often lack the advanced level of professional expertise regarding the attachment system and personality disorder processes that is needed to recognize and understand the nature of the pathology being expressed in attachment-based “parental alienation.”
The absence of professional expertise in mental health professionals conducting child custody evaluations is in three primary areas:
Role-Reversal Relationship. Many child custody evaluators lack the advanced level of professional expertise needed to recognize and understand the severe pathology of the role-reversal relationship, in which the child is used as an external “regulatory object” to regulate the emotional and psychological state of the narcissistic/(borderline) parent.
Narcissistic & Borderline Pathology: Many child custody evaluators avoid assessing for diagnostic labels in the belief that diagnosis is beyond their role as a custody evaluator. They often see their role as assessing “parental capacity,” not parental pathology. However, diagnostic labels provide an extremely useful function in organizing and interpreting the meaning of clinical data. Diagnostic categories can bring together disparate clinical information into organized constellations of integrated meaning, which then contain important implications for the treatment and resolution of the pathology.
While some diagnostic categories may not affect parenting capacity, prominent indicators of parental narcissistic and borderline personality traits have extremely important implications regarding the potential for creating child psychopathology. As a consequence of the central and primary role of parental narcissistic and borderline personality processes in the subsequent creation of child psychopathology, a focused evaluation for the presence of parental narcissistic and borderline personality traits should be one of the central and primary functions of a child custody evaluation.
So centrally important is the role of parental narcissistic and borderline personality pathology to the creation of subsequent child psychopathology, that an entire section of EVERY child custody report should be dedicated to specifically addressing an analysis of the clinical data surrounding the potential for parental narcissistic and borderline personality pathology.
The Attachment System: The evaluation of a primary disruption to the child’s attachment bonding motivations toward a parent requires that the evaluator possess an advanced level of professional expertise and understanding for the role and functioning of the child’s attachment system, which includes the trans-generational transmission of attachment trauma through the reenactment of parental attachment patterns (especially attachment trauma patterns) from the childhood of the parent into the current family relationships.
This includes processes of parental projective identification with the child and the role-reversal use of the child as a “regulatory object” for the parent.
Projective identification involves the parent’s loss of psychological boundaries with the child. In projective identification, the child becomes a psychological extension of the parent, and the parent will subtly induce emotions in the child that actually belong to the parent. For example, an over-anxious parent may induce the child into becoming overly anxious in order to allow the parent to then nurture the child’s anxiety. In nurturing the child’s (subtly induced) anxiety, the parent is actually nurturing his or her own anxiety that is being “held” or contained by the child.
In projective identification, the parent is projecting the parent’s own experience into the child, and in responding to the child’s symptoms the parent is identifying with the child; i.e., projective identification.
Role-reversal relationships are characteristic of a particular pattern of attachment called “disorganized attachment,” and role-reversal relationship are transmitted across generations. Children who experienced a role-reversal relationship with their parents will subsequently grow up to use their own children in role-reversal relationships when they become parents.
Currently, most therapists and child custody evaluators lack the specialized professional knowledge and expertise necessary to adequately and accurately evaluate the pathology surrounding attachment-based “parental alienation.” As a result, the response of mental health professionals to the pathology of attachment-based “parental alienation” is often flawed.
Professional ignorance leads to professional incompetence. The psychopathology of the narcissistic/(borderline) personality is highly manipulative and exploitative. Naive mental heath professionals can easily be drawn in by the highly manipulative and exploitative pathology of the narcissistic/(borderline) parent. The subtly manipulative and exploitative pathology characteristic of narcissistic and borderline personality dynamics seduces naive and ignorant mental health professionals into becoming allies of the psychopathology.
From professional ignorance and practice beyond the boundaries of their professional competence, many mental health professionals begin to collude with the psychopathology, to the extreme detriment of the child’s healthy emotional and psychological development.
So what do we do…
The solution is to mandate that ONLY those professionals who have the advanced level of professional knowledge and expertise necessary for professionally competent practice with this special population of children and families be allowed to diagnose and treat this special population of children and families.
Professionals who lack the advanced knowledge and expertise in the attachment system, personality pathology (including delusional processes of narcissistic and borderline personality pathology), and the nature of role-reversal relationships, would be prevented by established standards of professional practice from practicing beyond the boundaries of their professional competence.
Actually, this is currently the case. Professionals who lack the specialized professional knowledge and expertise to competently diagnose and treat the pathology of attachment-based “parental alienation” already ARE prevented by professional practice standards from diagnosing and treating the attachment system and personality disorder processes associated with attachment-based “parental alienation.” They just don’t know it yet because the field of professional mental health is still using the old Gardnerian PAS model to define the construct of “parental alienation.”
However, until we are able to achieve a paradigm shift, what do we do in the meantime… before we achieve the solution?
The Consultant Model
Because of my expertise in attachment-based “parental alienation” I am increasingly being asked by targeted parents to provide consultation regarding what they can do. Until we achieve a paradigm shift, there is very little we can do in any specific situation to solve the situation.
We cannot ask the child to expose his or her authenticity until and unless we can first protect the child from the pathology of the narcissistic/(borderline) parent. The pathology of attachment-based “parental alienation” is not a child custody issue, it is a child protection issue.
As a result of my consultations with targeted parents I am sometimes asked to serve as an expert witness to the Court regarding the “pathogenic parenting” evidenced in their particular case. In this capacity I usually work for the attorney in reviewing documents, particularly reports from therapists and child custody evaluations. Based on the information provided to me by the attorney, I will write a report and provide testimony regarding my professional opinions regarding the material I reviewed.
Sometimes the Court appears to be influenced by my report and testimony, other times not.
This model of professional consultation is directed toward the legal system. In order to effectively treat and resolve the child’s symptoms we must first obtain the child’s protective separation from the pathogenic parenting of the narcissistic/(borderline) parent. Obtaining the child’s protective separation from the pathology of the narcissistic/(borderline) parent requires the cooperation of the Court.
More recently, however, I have also been exploring an alternative consultant model that is focused on the currently dysfunctional mental health response to the pathology of attachment-based “parental alienation.” In this “psychologist consultant” model (as opposed to the expert witness model), I serve as a consultant for the targeted parent in trying to achieve an appropriate and professionally competent response from the therapist who is involved in treating the family’s pathology, either individually with the child or in “reunification therapy” (there’s no such thing) with the parent and the child.
An analogy to my role would be to purchasing a home where both the home seller AND the home buyer are represented by their own real estate agents. I’m like the psychology “agent” for the targeted parent in negotiating psychotherapy with the treating therapist.
Targeted parents don’t understand psychopathology, or psychological theories and terminology, or the variety of approaches to psychotherapy that are available. I do. I’m a clinical psychologist; psychopathology and psychotherapy are the areas of my professional expertise.
My role as a psychologist consultant to the targeted parent is to interface with the treatment provider to provide information about “areas of clinical concern” that the targeted parent and I are asking the therapist to consider and further evaluate for us.
This consultation role, however, can become sensitive. Many therapists may be put off by the implication that they don’t know what they’re doing. These therapists may become even more closed and unwilling to listen. Other therapists may feel intimidated by having their work monitored. These therapists may withdraw from the case.
There is also a phenomenon called “resistance.” When we push one way the other person pushes back in the opposite direction. If we say “parental alienation” then we will automatically produce a counter-response of “no its not.” That’s just the nature of resistance.
There’s an interesting explanation of this “backfire effect” on Youtube at
An additional video of interest is on negotiation and anchoring. This video is at
In negotiation, we anchor our frame of reference to the first information we receive. In attachment based “parental alienation” the first information therapists often receive is from the child, so the therapist’s later interpretation of information is anchored to the child’s characterization of the targeted parent as “abusive.”
What I’m currently exploring as a psychologist consultant for the targeted parent is whether we can anchor the treating therapist to an attachment-based definition of the family processes before the therapist becomes anchored to the trauma reenactment narrative of “abusive parent”/”victimized child”/”protective parent” that is being presented to the therapist by the child and narcissistic/(borderline) parent.
But we need to accomplish this without producing the “backfire effect” explained in the first Youtube video. Maybe it will work, maybe it won’t. I’ll keep you posted.
If nothing else, it will place the therapist on notice that the actions of the therapist are being monitored by a clinical psychologist. It’s possible that when the therapist learns that I’m monitoring them they may seek out information from my blog and website to lower their anxiety caused by the unknown of me. This would be a good thing. As they become more educated, they become more competent.
The Treatment Plan
Key to achieving competent treatment in the current no-solution environment is to obtain a written treatment plan from the therapist. Most therapists do not develop a treatment plan, written or otherwise. But they should. One of the courses I teach at the graduate level is how to develop a treatment plan. When I was the Clinical Director for a children’s assessment and treatment center working with foster care children, I always asked the therapists working for me to develop a treatment plan following their initial assessment.
The treatment plan should define:
- The Case Conceptualization: What does the therapist view as being the cause of the issues?
- The Treatment Plan: How does the therapist intend to solve the problems identified as the cause of the issues in the case conceptualization?
- Prognosis & Timeline: How optimistic is the therapist that the issues can be resolved, and how long will it take? Expectation benchmarks for symptom change should be identified at 3-months, 6-months, and 9-months intervals (if therapy is expected to take that long).
As a side-note; therapy for parent-child conflict should achieve a significant resolution of the issues within 6-9 months (without complications from things like autism-spectrum issues that make the problems more treatment resistant and intractable).
A year for severe problems might be necessary. But if therapy is taking longer than a year then the case conceptualization needs to be closely examined and serious consideration needs to be given to possibly redefining the case conceptualization and treatment plan.
Naturally, the prognosis and timeline are subject to revision as things proceed, but the treatment plan sets forth a set of expectations and guidelines to which everyone can agree. If things change and the treatment plan needs to be adjusted, then the new factors and the needed alterations to the treatment plan can be discussed.
This is actually an important part of the process for “Informed Consent” to treatment. How can clients give informed consent to treatment if they don’t know what treatment entails?
When someone has a medical disease, the physician describes for the patient what the disease is and what the various treatment implications are.
The physician would also provide a clear description of what treatment would entail. For example, would the cancer require six cycles of chemotherapy over two years? Or surgery? Or radiation? If there are alternative forms of treatment, these would also be explained to the patient, along with the physician’s estimates for prognosis and recovery.
This is called the “Informed Consent” process, and is a requirement of professional practice. According to Standard 10.01 of the Ethics Code for the American Psychological Association:
Informed Consent to Therapy
“(a) When obtaining informed consent to therapy as required in Standard 3.10, Informed Consent, psychologists inform clients/patients as early as is feasible in the therapeutic relationship about the nature and anticipated course of therapy”
The general informal guidelines within professional standards of practice are that people have a right to all the relevant information that they need in order to make an informed decision regarding their participation in therapy.
Medical physicians describe the disease and its treatment to their patients as part of the informed consent process, why shouldn’t psychotherapists do the same? Actually, they should. But most don’t.
Why don’t they? The primary reason is that many therapists have no idea what they’re doing. How can they explain to you what they’re going to be doing if they don’t know what they’re doing themselves?
This is where the advice in the first Youtube video on avoiding resistance can be helpful. Draw out the therapist to increasingly explain what his or her therapy is going to entail. Cultivate the appearance of oh-so-pleasant ignorance. Don’t assert what truth is, that will just provoke resistance. Instead ask the therapist what their truth is… and keep asking from your oh-so-pleasant ignorance until things make sense to you.
Ask the therapist for the treatment plan.
- What does the therapist see as being the cause of the problem?
- What’s going to happen in therapy to fix the problem? How is talking in therapy sessions going to fix the problem? Find out specifically what the linkage is between what is going to happen in therapy and fixing the problem.
- Do you, as the parent, need to do something specific to fix the problem? And if you do this, whatever the therapist says you need to do to fix the problem, then the problem will be fixed?
- What will the treatment entail? What’s going to happen in the treatment sessions? So if treatment sessions do this, whatever the therapist says will happen, then the problem will fixed?
- How long will it take before the child’s symptoms go away?
We’re not asking for certainty. Of course things will depend on circumstances. But what circumstances? And what is the general expectation?
The incompetent therapist may start to give you voodoo gobblygook about the “need to develop a therapeutic relationship,” and because they’re the professional and you’re not you may accept this gobblygook as if it somehow makes sense.
However, the clinical psychologist who is working as a psychologist consultant for the targeted parent would seek a more complete and coherent description.
Why is a therapeutic relationship important to addressing the cause of the child’s symptoms? How is that exactly going to work, in terms of a “therapeutic relationship” somehow fixing the problem? So the child is going to come to trust the therapist more… and then what? Explain it to me.
Is the therapist talking about a Kohutian therapeutic relationship of mirroring, idealizing, and twinship self-object functions? Or perhaps the therapist is talking about a Rogerian therapeutic relationship of self-actualization of the child’s authenticity? Or perhaps the therapist is talking about a psychoanalytic therapeutic relationship called the transference relationship? What does the therapist mean by building the “therapeutic relationship” and how specifically is this going to fix the problem?
Of note is that the therapeutic relationship is also sometimes called the “therapeutic alliance.” If the child is in a cross-generational coalition with the narcissistic/(borderline) parent against the targeted parent, then in proposing to build a “therapeutic alliance” (i.e., the “therapeutic relationship”) with the child, the therapist is essentially proposing to join the alliance of the child and narcissistic/borderline parent against you.
That doesn’t sound like a good treatment plan.
Or perhaps the therapist doesn’t ’t have a clue as to what they’re doing and they’re simply throwing up a smokescreen of gobblygook “therapy-speak” to hide that they have no idea what they’re doing.
The Danger
The danger, however, is that my working as a psychologist consultant for the targeted parent may simply annoy the therapist into further entrenching into his or her ignorance (the “backfire effect”), or the therapist may become so annoyed with me that they’ll simply quit as the therapist (possibly when they are asked to provide a written treatment plan).
I’m not quite sure yet whether either of those responses are actually bad things though. If the therapist is going to entrench further into his or her ignorance, it’s likely best to know that early rather than after six months or a year of ineffective and pointless therapy. And if the therapist quits when asked to provide a written treatment plan, that too is probably something good to know and deal with early. If the therapist doesn’t want to be held accountable to a treatment plan then it is highly likely the therapist has no clue as to what they’re doing – and that’s why they don’t want to develop a treatment plan.
Your physician will tell you what the disease is and what the treatment entails because your physician knows what they’re doing. Your therapist should do the same… if they know what they’re doing.
If the therapist cannot explain what the treatment plan is in a way that is understandable and makes sense to you, it’s most likely because the therapist has no idea what they’re doing.
When the Therapist Finally “Gets It”
Still, even if the therapist understands the pathology the question still remains, so what do we do about it?
As long as the child remains under the severely distorting pathogenic influence of the narcissistic/(borderline) parent there is little we can do in terms of treatment.
If we try to treat the child while the child is still under the continuing pathogenic influence of the narcissistic/(borderline) parent, then we will simply rip the child apart psychologically from the conflict created between the goal of effective therapy to restore the child’s healthy authenticity and the continuing obsessive and relentless efforts of the narcissistic/(borderline) parent to keep the child pathological.
Turning the child into a psychological battleground because of the narcissistic/(borderline) parent’s relentless efforts to maintain the child’s psychopathology while therapy seeks to restore the child’s healthy functioning will psychologically destroy the child.
The narcissistic/(borderline) parent is essentially playing “chicken” with us. The pathology of the narcissistic/(borderline) parent is completely willing to destroy the child. Are we? I’m not. So then the narcissistic/(borderline) parent wins and can continue to create the child’s psychopathology.
The narcissistic/(borderline) parent will do everything in his or her power to maintain the child’s pathology. For the narcissistic/(borderline) parent it is a psychological imperative that the child reject the other parent. The narcissistic/(borderline) parent actually believes that the parenting practices of the targeted parent are “abusive” and place the child in danger. The narcissistic/(borderline) parent is delusional (i.e., an intransigently held, fixed and false belief that is non-responsive to contrary evidence) and will stop at nothing to keep the child pathological.
On a scale of 1-10, the psychopathology of attachment-based “parental alienation” is 15. It’s off the charts. Attachment-based “parental alienation” is not a child custody issue, it is a child protection issue. We must first protect the child. Only then can we treat the pathology.
So even if I am able to alert the therapist to the nature and severity of the pathology, so what. There’s still nothing we can do.
Except perhaps we can avoid six months, a year, or even two years of unproductive and pointless therapy. And perhaps the therapist will write a treatment letter to the judge saying that for the child’s protection the therapist is declining to do therapy until the child is protectively separated from the pathogenic parenting of the allied and supposedly favored narcissistic/(borderline) parent during the active phase of the child’s treatment and recovery stabilization.
Maybe that would help obtain the necessary period of protective separation… or maybe not. I don’t know, I just don’t know.
Maybe having a psychologist consultant will just result in treating therapists withdrawing from the case. If no therapy is taking place then nothing changes. But nothing changes with ineffective therapy either, so what’s the difference?
The solution is a shift in paradigms. All of these interim half-measures are not likely to produce a solution.
Still, we do what we can until we achieve a paradigm shift in which ALL therapists who work with this special population of children and families are exceptionally skilled and knowledgeable. At that point; no therapist – anywhere – will treat the child unless the child is first protectively separated from the pathology of the narcissistic/(borderline) parent. When mental health speaks with a single voice, the Court will be able to act with the decisive clarity needed to solve “parental alienation.”
It’s Not Me
I’m just one person. I cannot solve everything. I’m in California. I’m busy with my client caseload. I’m expensive.
I am not sharing this information to seek business. For a variety of reasons I am limiting my professional treatment-related consultation to families in the Los Angeles area. I’m sharing this model simply to frame what a psychologist treatment-related consultation model might look like.
I’m 60 years old. I’m coming to the end of my professional career. I’ll be wrapping things up soon. It will be up to the next generation of psychologists and therapists to put into place the procedures needed to solve attachment-based “parental alienation.” I’m providing this possible consultant model to them.
Targeted parents need you, as competent mental health therapists, to educate our professional brethren in mental health, therapist-to-therapist… and we need to hold our brethren therapists accountable. Their ignorance should not be allowed to destroy the lives and development of children. That’s not allowed.
Until we achieve a paradigm shift away from a Gardnerian PAS model over to an attachment-based model for “parental alienation” that will solve “parental alienation” for all targeted parents and all children everywhere, we must find a way to make do with the broken mental health and legal systems as they exist.
From where I sit, the current state of the broken mental health and legal systems won’t allow a solution. But I’m trying to find something anyway.
Craig Childress, Psy.D.
Clinical Psychologist, PSY 18857
References
Bone, M.J. and Sauber, R. (2013). The essential role of the mental health consultant in parental alienation cases. In A.J.L. Baker & S.R. Sauber (Eds.) Working with Alienated Children and Families: A Clinical Guidebook (71-89). New York: Routledge
SBS Intervention
“Remedy: The manner in which a right is enforced or satisfied by a court when some harm or injury, recognized by society as a wrongful act, is inflicted upon an individual.”
http://legal-dictionary.thefreedictionary.com/remedy
Just a reminder, I am not an attorney. I am a psychologist. For legal advice consult an attorney and follow the advice of the attorney. In this post I will be discussing a possible compromise intervention that may, in some cases, be presented to the Court as a proposed remedy based on the legal strategy of the attorney in a given situation.
I am increasingly being asked by attorneys to serve as an expert consultant or witness regarding cases of “parental alienation.”
Just for the record, I am not an expert in “parental alienation.” From a clinical psychology perspective, the term “parental alienation” is not a defined clinical term.
The proper clinical term for the interpersonal and family processes typically called “parental alienation” is “pathogenic parenting” (patho=pathology; genic=genesis, creation). Pathogenic parenting is the creation of significant child pathology as a result of highly distorted parenting practices.
My professional expertise is in child and family therapy, diagnosis and psychopathology, parent-child conflict, and child development.
I recently met with a targeted parent and discussed her situation. I then spoke with her attorney regarding the case. The attorney believes the evidence of “parental alienation” is substantial. There is a history of unsuccessful “reunification” therapy and a child custody evaluation is pending.
From a psychological perspective, I recommended that the approach remain focused on the child’s evident pathology (i.e., on pathogenic parenting) and the child’s treatment needs rather than on trying to prove that “parental alienation” has interfered in the relationship of the targeted parent and child.
Attachment-based “parental alienation” is not just a matter of disrupting the targeted parent’s relationship with the child, it is a matter of inducing serious and severe psychopathology in the child through the distorted pathogenic parenting practices of the allied and supposedly favored narcissistic/(borderline) parent. I believe it is best to remain grounded in the child’s pathology and in the treatment needs of the child.
My concern is that if the focus shifts to proving “parental alienation,” then this invites an identification of harm or injury as being to the parental rights and parental relationship of the targeted parent, leading to a remedy directed toward satisfying the harm and injury done to the targeted parent.
If, on the other hand, the focus remains on the extent and severity of the child’s pathology that is being created by the distorted pathogenic parenting of the allied and supposedly favored parent, then the remedy involves the treatment needs of the child that are necessary to restore the normal-range and healthy development of the child.
It’s not about injury to the parent, its about injury to the child. The remedy isn’t focused toward the parent, the remedy is focused toward the child.
Attachment-based “parental alienation” isn’t a child custody issue, it’s a child protection issue.
Again, I am a psychologist not an attorney, but I would tend to recommend avoiding the construct of “parental alienation” as I view this as chasing a rabbit down the rabbit hole. The narcissistic/(borderline) parent responds, “prove it,” and then we’re into chasing a nearly impossible task of proving distorted parenting and we have lost the grounding afforded by a relentless focus on the nature and severity of the child’s pathology and treatment needs, and on what is necessary to restore the normal-range and healthy development of the child.
When we remain focused on the nature and severity of the child’s symptoms, we open the door to the treatment needs of the child. The treatment needs of the child depend on the clinical diagnosis regarding the origin of the child’s pathology. I am a clinical psychologist. That’s what I do. I identify the origins of child pathology and I develop and implement treatment plans that will restore the child’s healthy development based on what the origins of the child’s pathology are.
Q: Could the nature and extent of the child’s pathology be originating spontaneously from the child? A: No.
Q: Could the nature and extent of the child’s pathology be the product of the pathogenic parenting of the targeted-rejected parent? A: No.
Q: If the child’s severe pathology is not originating spontaneously from the child, and is not a product of the pathogenic parenting of the targeted-rejected parent, then what could be the origins of the child’s pathology?
A: The child’s pathology is being induced by the distorted pathogenic parenting practices of the allied and supposedly favored parent.
Remedy: What are the treatment needs of the child to restore normal-range and healthy development?
Again, this is not legal advice. I am a psychologist. This is just my opinion from my perspective as a clinical psychologist. This is what I do for a living. I first identify the nature and severity of the child’s pathology. I then use features of the child’s pathology to identify the origins of the child’s pathology. I then develop and implement a treatment plan to resolve the child’s pathology based on my assessment regarding the origins of the child’s pathology.
I am a clinical child and family psychologist. That’s what I do. I do this for autism-spectrum disorders, for ADHD-spectrum disorders, for child depressive and anxiety disorders, for oppositional and defiant child behavior, for school failure, for attachment disorders, for parent-child and family conflicts.
I do this across the developmental spectrum; for young children and their families, for school-age children and their families, for adolescents and their families.
1.) Identify the nature and severity of the child’s pathology.
2.) Use features of the child’s symptom display to identify the origins of the child’s pathology.
3.) Develop and implement a treatment plan that will restore the child’s normal-range and healthy development based on the identified origin of the child’s pathology
Treatment Needs
The attorney and I then discussed what the treatment needs of the child are in this case based on the information I had from the targeted-rejected parent.
We discussed the child’s potential triangulation into the spousal conflict through the formation of a cross-generational coalition with the allied and supposedly favored parent against the other parent.
We discussed the child’s apparent narcissistic and borderline symptoms as described by the targeted parent, and the possible origin of these reported child symptoms in the pathogenic parenting practices of the allied and supposedly favored parent.
I described the hypothesis that the child was experiencing a misunderstood and misinterpreted grief response relative to the lost relationship with the beloved-but-now-rejected targeted parent, and we then discussed the treatment for that.
We discussed the means by which the child’s symptomatic rejection of a normal-range and affectionally available parent could be induced through a role-reversal relationship with a narcissistic-borderline parent who is using the child as a “regulatory object” to meet the emotional and psychological needs of the parent.
I discussed the importance relative to an attachment-based model of “parental alienation” of a protective separation of the child from the pathology of the allied and supposedly favored narcissistic/(borderline) parent during the active phase of the child’s treatment and recovery as representing a necessary condition for protecting the child if we are to ask the child to expose his or her authenticity.
Treatment Plan
As we discussed the remedy the attorney could seek from the Court for the severely pathogenic parenting associated with an attachment-based model of “parental alienation,” my recommendation was Dorcy Pruter’s “High Road to Family Reunification” protocol. I have reviewed her protocol and I completely understand how she achieves the recovery of the children’s relationship with the targeted parent. The “High Road” protocol would be my first-line recommendation for restoring the parent-child relationship, over and above any other approach to family reunification.
Her protocol requires that the Court order a 9-month period of protective separation of the children from the pathology of the narcissistic/(borderline) parent. I understand why this is necessary and I entirely agree with the requirement.
With this protective separation in place, she asserts that her protocol is capable of restoring normal-range parent-child relationships in a matter of days, and based on my review of her protocol, I would agree with this assessment of the protocol’s effectiveness..
In my view, this is the best approach for restoring children’s affectionally bonded relationship with the targeted parent because of its effectiveness, its intensity, and its speed. The child’s initial recovery will be fragile at first, so a continued protective separation of the child from the pathogenic pathology of the narcissistic/(borderline) parent is needed to stabilize the child’s recovery.
The attorney and I then discussed the likelihood in this case that the Court would order a protective separation of the child from the allied and supposedly favored pathogenic parent. This will likely be dependent on the strength of the evidence that can be presented to the Court regarding the severity of the pathogenic parenting as evidenced in the child’s symptoms, and the associated treatment needs of the child necessary to restore the child’s healthy and normal-range development.
The SBS Intervention
As we discussed remedies relative to the child’s pathology and treatment, and the possible reluctance of the Court to order the necessary protective separation of the child which would be required for the child’s treatment and recovery, I remembered an old “compromise solution” for the Court that I developed back in 2011, the Strategic-Behavioral-Systems Intervention (SBS Intervention).
The SBS Intervention is a Strategic family systems intervention that targets the power dynamic in the family.
Strategic Family Systems Therapy
From a Strategic family systems framework, the child’s symptom confers power. Strategic family systems therapy analyzes the power dynamics within the family and develops a prescriptive intervention which, if followed, will alter the power dynamics so that the symptom just drops away because it no longer serves its function of conferring power within the family relationships.
Strategic family systems therapy is a less common form of family systems therapy because it requires a fair degree of sophisticated skill in family systems therapy to first analyze the power dynamics within the family and then to also develop a prescriptive solution which, when implemented, will automatically alter the power dynamics within the family in a way to release the symptom.
While difficult to develop, and as a consequence rare in clinical practice, a good Strategic family systems intervention, however, can be quite elegant and powerful in its operation. The major limitation to Strategic family systems therapy is the level of clinical skill required to develop a prescriptive intervention that alters the specific power dynamics within the family in a way that will release the symptom.
The SBS Intervention
The Strategic-Behavioral-Systems Intervention for attachment-based “parental alienation” represents my effort to develop a Strategic family systems intervention for attachment-based “parental alienation.” My goal in this is to provide the Court with a possible compromise solution to removing the child entirely from the care of the allied narcissistic/(borderline) parent.
I sent the SBS Intervention protocol to the attorney with whom I was consulting for her consideration as a possible proposed remedy.
I have also posted the Strategic-Behavioral-Systems Intervention protocol to my website, and a direct link to it is at:
Strategic-Behavioral-Systems Intervention
Note: My recommendation as a clinical psychologist would be for a period of protective separation of the child from the pathogenic pathology of the allied narcissistic/(borderline) parent during the active phase of the child’s treatment and recovery stabilization.
If the SBS Intervention is tried as a compromise solution to a complete protective separation, then I would recommend a six-month trial of the SBS Intervention. If the SBS Intervention has not restored the child’s normal-range development after a six-month “Response-to-Intervention” trial, then I would recommend a complete protective separation of the child from the pathogenic parenting of the allied narcissistic/(borderline) parent and intervention with the High Road protocol.
If the High Road protocol of Pruter’s is not possible, then I would recommend a treatment model along the lines described in my essay on Reunification Therapy available on my website.
Craig Childress, Psy.D.
Clinical Psychologist, PSY 18857
Testimony by a Treating Therapist
I am sometimes asked by a treating therapist for a consultation regarding attachment-based “parental alienation.” I have just added a handout to my website, near the top, regarding my thoughts on how a treating therapist might describe in Court testimony the issues surrounding attachment-based “parental alienation.”
A direct link to this handout is:
Testimony by a Treating Therapist
Craig Childress, Psy.D.
Clinical Psychologist, PSY 18857
Is Reunification Therapy a Defined Construct
I received a Comment response from Dr. Reay to my blog post “There is No Such Thing as Reunification Therapy,” and rather than my responding as a Comment I would like to respond as a separate blog post, since I believe the discussion surrounding a professional definition for the construct of “reunification therapy” is important.
Comment from Dr. Reay:
Hi Dr. Childress
With all due respect, I am going to challenge your argument that there is no such thing as Reunification Therapy as well as some other arguments in your blog. Although I can’t speak for them, I will take the chance and assume that Dr. Randy Rand, Dr. Dierdre Rand, Dr. Richard Warshak, Dr. Douglas Darnall and Linda Gottlieb may not necessarily buy your argument either. It would be most interesting to find out their thoughts. I will send you a copy via private email on the Family Reflections Reunification model and program. This article has been peer-reviewed and accepted for publication in the American Journal of Family Therapy, Volume 43(2) this spring.
Regards,
Dr. Kathleen M. Reay,
Founder & Clinical Director of the
Family Reflections Reunification Program Inc.
http://www.familyreflectionsprogram.com
First, let me thank you Dr. Reay, for challenging my assertion. If professional psychology is to conduct “reunification therapy” then a defined model is needed for what “reunification therapy” entails, so I welcome the opportunity to learn.
You cite a set of professionals I would refer to as the Gardnerian PAS contingent (in contrast to the “DSMite” critics of the construct of “parental alienation”). First, in my view the Gardnerian PAS model is woefully inadequate as a theoretical model for the development of a treatment approach. But let’s put that aside and look at the people you cite.
Dr. Warshak maintains that the “Family Bridges” program is psycho-educational, not psychotherapy, and while he touts the benefits of his intervention model, he has not presented the specifics of what the Family Bridges model is sufficiently for it to be reviewed as a model for psychotherapy. He says its good. I’ll trust him that its good. I just don’t know what it is at a level of specificity necessary for me to either evaluate it or replicate it as a model of psychotherapy. And he says its psycho-educational not psychotherapy.
Linda Gottlieb’s approach is wonderful. She does family systems therapy. Family systems therapy is spot on the appropriate therapy model for addressing “parental alienation,” which essentially involves the child’s triangulation into the spousal conflict through the formation of a cross-generational coalition with a narcissistic/(borderline) parent. The addition of parental narcissistic/(borderline) psychopathology transmutes the family relationship processes into a particularly malignant and virulent form of cross-generational parent-child coalition that seeks to entirely terminate the other parent’s relationship with the child. Linda Gottlieb does family systems therapy. In common parlance she may describe what she does as “reunification therapy” but she then defines what “reunification therapy” is from within family systems constructs. The “reunification therapy” of Linda Gottlieb is family systems therapy. Its wonderful. Everyone should listen to Linda Gottlieb.
But let’s look at this a bit deeper. If, for example, we set a standard of practice for treating this “special population” of children and families that all therapists working with this “special population” need to be professionally familiar with the constructs of Structural Family Systems therapy, there is then a set of literature that sufficiently defines the constructs of Structural Family Systems therapy to allow us to hold these therapists accountable for knowing a certain domain of content.
If we make the same statement about “reunification therapy,” that all therapists treating this “special population” of children and families must be professionally familiar with the constructs of “reunification therapy,” where are these constructs of “reunification therapy” sufficiently defined so that we can hold therapists accountable for this content domain of knowledge? That’s my point.
If therapists say they’re doing client-centered therapy, then there are constructs of self-actualization, empathy, genuiness, unconditional positive regard, false-self, conditions of worth, etc. that all become relevant to treatment.
If therapists say they’re doing object relations therapy then there are issues of self-object functions, mirroring, idealization, twinship, empathic failures, transmuting internalizations, etc.. that all become relevant to treatment.
If therapists say they’re doing Adlerian psychotherapy, then there are issues of inferiority and mastery, self-esteem threats, safeguarding strategies, lifestyles, etc. that all become relevant to treatment.
If therapists say they’re doing Gestalt therapy, then there are issues of contact, boundaries, awareness, the present moment, responsibility, empty chair techniques, etc. that all become relevant to treatment.
If therapists say they’re doing cognitive-behavioral therapy then there are constructs of schemas, irrational beliefs, cueing antecedants, contingency management, etc. that all become relevant to treatment.
Where are the principles relevant to “reunification therapy” described and defined? This isn’t a rhetorical question. I’ve looked and looked and I can’t find any.
Randy Rand, Dierdre Rand, and Douglas Darnall are also wonderful. They present strong arguments in support for the Gardnerian model of PAS. Unfortunately, while Gardner accurately identified the presence of an authentic clinical phenomenon, in my view he too quickly abandoned the professional rigor necessary for defining the clinical phenomenon he identified from within standard and established psychological principles and constructs. Instead, he proposed a “new syndrome” based on the child’s display of a set of anecdotal clinical indicators.
From my perspective as a clinical psychologist, “parental alienation” isn’t a “new syndrome,” it is simply a highly malignant form of the established family systems construct of the child’s triangulation into the spousal conflict through the formation of a cross-generational parent-child coalition against the other parent, referred to as a “rigid triangle” by Minuchin (1974, p. 102) and as a “perverse triangle” by Haley (1977, p. 37).
If anyone wants to argue that “parental alienation” represents a “new syndrome” I would argue that it is first incumbent upon them to describe why the defined and established family systems constructs of the child’s triangulation into the spousal conflict through the formation of a cross-generational coalition with one parent against the other parent do not adequately and better account for the child’s symptom display and family processes (that would include the family systems constructs of the emergence of pathological symptoms in response to inadequate accommodation of the family to a developmental transition, of homeostatic balance being maintained in a pathological family system by the function of the symptom, and of psychological boundary diffusion through an enmeshed parent-child relationship).
I would even argue that some Strategic Family Systems constructs regarding power dynamics within the family relative to the function served by the symptom are highly relevant considerations.
In my view, family systems theory adequately accounts for the clinical symptom display traditionally referred to as “parental alienation.” Add narcissistic/(borderline) personality pathology to the cross-generational parent-child coalition and we have the display of “severe parental alienation.” Without the addition of narcissistic/(borderline) personality pathology we have the display of mild and moderate “parental alienation.” Family systems theory adequately addresses the clinical phenomenon.
We don’t need a “new syndrome” to describe what “parental alienation” is. Nor do we even need the term “parental alienation.” The proper clinical term is “pathogenic parenting” (patho=pathological; genic=genesis, creation). Pathogenic parenting is the creation of significant psychopathology in the child through aberrant and distorted parenting practices. It is a construct most often used in reference to distortions to the child’s attachment system. The attachment system does not spontaneously dysfunction, it distorts only in response to pathogenic parenting practices.
Furthermore, I would argue that the central symptom associated with “parental alienation,” the child’s rejection of a relationship with a normal-range and affectionally available parent, represents a severe distortion to the normal-range functioning of the child’s attachment system. Why then are we looking to create a “new syndrome” rather than applying sufficient professional rigor to identifying what’s going on with the child’s attachment system?
So while Randy Rand, Dierdre Rand, and Douglas Darnall are all wonderful and powerful advocates for a PAS model of “parental alienation,” I think the PAS model represents a failed paradigm across a number of levels. It has been available for 30 years and has given us our current situation of no actualizable solution for the family tragedy of “parental alienation.” A fundamental paradigm shift is needed to a theoretically defined model of “parental alienation” that is based entirely within established psychological constructs and principles so that we can achieve an actualizable solution for targeted parents, and more importantly for the children. That’s what I’ve tried to accomplish with an attachment-based model for the construct of “parental alienation.”
And while Randy Rand, Dierdre Rand, and Douglas Darnall are all wonderful advocates for the PAS model, I have not found where they describe a model for what “reunification therapy” is.
I look forward with eager anticipation to learning of your definition for “reunification therapy” in your article due for publication this spring. Yay! It is about time that someone defined the construct of “reunification therapy” with enough specificity to allow for professional critique and replication. I am optimistic that once we have your definition for the construct of “reunification therapy” then other therapists across the country who are interested in doing “reunification therapy” will be able to replicate your approach to conducting “reunification therapy.”
I realize there might be space limitations to a published article that may limit your ability to describe your model for “reunification therapy” in sufficient detail to fully allow for professional review, critique, and replication. If this is the case, then I await with eager anticipation the publication on your website of the specific protocol used in your model of “reunification therapy” that will allow for its professional review and replication by other therapists.
Until such time as somebody offers a specific description for what “reunification therapy” entails, however, I’m going to stand by my criticism of the construct as being absent any defined meaning.
If there is no definition for the meaning of a construct, then the construct is without meaning.
I know that my criticism as “snake oil” is harsh, but keep in mind the source for the metaphor. In the late 1800’s “doctors” would travel around to local communities selling “medicine” for “what ails ya.” When asked about the specific ingredients of their “patent medicine,” however, the salesmen would claim that the ingredients were a “trade secret” and couldn’t be disclosed, hence the term “snake oil” since the ingredients could be anything.
If we don’t have a specific definition for what the construct of “reunification therapy” entails, then a therapist in North Carolina can make something up and call it “reunification therapy,” and a therapist in Arizona can make up something entirely different and call it “reunification therapy,” and a therapist in Oregon can make up a third different thing and call it “reunification therapy.” The term “reunification therapy” then becomes a cover, a smokescreen, that allows therapists to make stuff up and do whatever they want, under the appearance to the general public of professional practice because they’re doing something called “reunification therapy.”
And as long as no one in mental health challenges this highly questionable professional practice of using the term “reunification therapy” which lacks defined meaning as a means of giving appearance to the general public of professional psychotherapy that lacks professional foundation in established psychological models of psychotherapy, then the term “reunification therapy” will continue to be presented to the general public as if it has meaning when, in truth, it is absent any defined meaning as a psychotherapeutic approach.
Kohut offers a coherent description for what object-relations therapy is. Rogers describes what client-centered therapy entails. Beck describes the components of cognitive-behavioral therapy.
Let’s say I’m going to teach my graduate students how to do “reunification therapy.” What specifically do I teach them in order for them to know how to do “reunification therapy?” Or say I have to supervise an intern in conducting “reunification therapy,” what principles and constructs are relevant to their work? I know the answers to these questions for all the other models of psychotherapy. But I can’t find any information defining the construct of “reunification therapy.”
I have searched and searched for the defined meaning of “reunification therapy” and found nothing but vague descriptions about “de-programming” the child based on assertions that the child is “brainwashed,” both of which are extraordinarily questionable and discomforting constructs in clinical psychology. None of the major theorists in psychology, Freud, Adler, Jung, Kohut, Winnicott, Bowlby, Fairburn, Rogers, Yalom, Perls, Frankl, May, Maslow, Skinner, Beck, Ellis, Minuchin, Haley, Bowen, Satir, Madanes, Berg, Parham, none of them discuss “brainwashing” and “deprogramming” as tenets of psychotherapy.
What school of psychotherapy does “reunification therapy” fit into? Is it a psychoanalytic model? Is it a cognitive-behavioral model? Is it an entirely new school of psychotherapy? Does it rely on family systems constructs for understanding the problem? Does it rely on social constructionist principles? How do the principles of “reunification therapy” fit with the principles of object relations therapy, or humanistic client centered therapy? What are the overlaps? What are the differences?
Suppose I had a graduate student or intern ask me these questions, what’s my answer? Before I can answer these questions I need someone who says they’re doing “reunification therapy” to describe for me what “reunification therapy” is.
I don’t think that’s too much to ask. If you’re going to use a term for a new category of psychotherapy, define the principles that are used in that new category of psychotherapy. So it is with great anticipation and relief that I will finally learn from your upcoming article what the principles of “reunification therapy” are, so that these principles can then be used to define a standard of professional practice when therapists say they do “reunification therapy” similar to the standards we can apply when therapists say they do client-centered therapy, or object relations therapy, or cognitive behavioral therapy, or Gestalt therapy, or structural family systems therapy, or solution focused therapy. I am glad we will finally have a defined model for what “reunification therapy” is.
I think the work of Richard Warshak, Randy Rand, Dierdre Rand, and Douglas Darnell is great, and everyone should listen to Linda Gottlieb. I also think that the PAS model, while a laudable effort by Richard Gardner, is insufficiently grounded in established psychological constructs and principles to serve as a foundation for creating an actualizable solution for targeted parents and their children. In my view, a paradigm shift is needed to a new model for defining the construct of “parental alienation” that is based entirely within standard and established psychological principles and constructs, and I’d recommend we base that new model in the attachment system since a child’s rejection of a relationship with a normal-range and affectionally available parent represents a profound distortion to the normal-range functioning of the child’s attachment system. There is substantial evidence that the development of narcissistic and borderline personality processes are also related to distortions in the development of the attachment system, so that the potential transmission of attachment trauma from the childhood of the “alienating” parent to the current family relationships would seemingly provide a fruitful line of exploration.
Craig Childress, Psy.D.
Clinical Psychologist, PSY 18857
References
Haley, J. (1977). Toward a theory of pathological systems. In P. Watzlawick & J. Weakland (Eds.), The interactional view (pp. 31-48). New York: Norton.
Minuchin, S. (1974). Families and Family Therapy. Harvard University Press.
There is No Such Thing as Reunification Therapy
Call me silly, but I tend to be a stickler for truth and accuracy. I just feel that the world is a better place when we base our discussions on things that are real rather than on fantasies that sound nice, but that don’t actually exist.
I’d love to own a unicorn, but they don’t actually exist. So having a discussion about whether I should buy a unicorn is pointless.
So let me be entirely clear on this, there is no such thing as “reunification therapy.”
There are psychoanalytic psychotherapies, such as Adlerian psychotherapy (Alfred Adler), object-relations psychotherapy (Kohut), and self-psychology (Stolorow & Atwood).
There are humanistic/existential therapies, such as Client-Centered therapy (Rogers) and Gestalt therapy (Perls).
There are cognitive-behavioral therapies, such as those described by Beck and Ellis.
There are family systems therapies, such as Structural family systems therapy (Minuchin) and Strategic family systems therapy (Haley and Madanes).
There are post-modern “social constructionist” therapies, such as Solution-Focused therapy (Berg) and Narrative therapy (Epson & White).
As a clinical psychologist, I am familiar with all these different types of actual psychotherapy. I can describe how they define problems and treatment, and how they go about solving the problems faced by clients. Not only is clinical psychotherapy my profession, I also teach models of psychotherapy to students at the graduate level, and I have provided clinical supervision and training to interns and post-doctoral fellows in the application of differing models of psychotherapy. I know the various models of psychotherapy.
But nowhere, not in any book or article, is there any description or definition of this mythical construct of “reunification therapy.”
There is no such thing as “reunification therapy.”
If anyone ever says that they do “reunification therapy,” please ask them for a book or article that describes what “reunification therapy” is. They will not be able to provide you with any reference because none exists.
Doing something called “reunification therapy” sounds great. And I’d like to own a unicorn. But, unfortunately, neither unicorns nor “reunification therapy” exist.
Seeing as how I’m kind of attached to the concepts of truth and accuracy, I find it annoying that people toss around this phrase “reunification therapy” as though it had meaning. I most often hear this term in reference to Court-involved cases where the Court has perhaps ordered “reunification therapy.”
I am more tolerant of the Court’s use of this term, although I’d like mental health professionals to correct the Court at every opportunity that there is no such thing as “reunification therapy.” I don’t expect legal professionals to understand the various types of psychotherapy, but when the Court uses this term it might as well simply order “therapy” since the term “reunification therapy” adds nothing additional to the basic concept of therapy. Or perhaps if the Court wants to be more precise in its desires it could say “therapy that has as its goal the restoration of the positive parent-child bond.” But I’m willing to show tolerance for the legal system in the inaccurate use of therapeutic terminology.
It’s the mental health professionals who use this term that most irritate me. They should know better. They’re using the term “reunification therapy” as a junk phrase in which they can pretty much make things up as they go, and they offer a circular definition for what “reunification therapy” is:
Q: What is “reunification therapy?”
A: It’s what I do.
Q: And what is it that you do?
A: I do “reunification therapy?”
Q: Okay. So then what is “reunification therapy?”
A: It’s what I do.
Q: So what is it that you do when you do “reunification therapy?”
A: When I’m doing “reunification therapy” then I’m reunifying people in therapy.
Q: And how do you go about reunifying people in therapy?
A: By doing “reunification therapy.”
When a mental health professional uses the term “reunification therapy” it essentially amounts to selling the public a snake oil remedy.
I am aware that this is an exceedingly harsh accusation, yet I challenge anyone in mental health to refute this accusation by providing any description of a model for what “reunification therapy” is.
If there is no description for what a term means, then the term has no meaning.
It is pointless to talk about unicorns if unicorns don’t exist. It is pointless to talk about “reunification therapy” if “reunification therapy” doesn’t exist. Therapists should say they are doing object-relations therapy, or cognitive-behavioral therapy, or family systems therapy, or any model of psychotherapy that actually exists. At least then we will understand what they’re doing. But they should STOP saying they’re doing “reunification therapy” as this is simply selling snake oil to the public.
Correction
Being the stickler for truth and accuracy that I am, I need to correct something I said earlier When I said that there are no articles describing what “reunification therapy” is, that wasn’t exactly accurate.
There is one article that describes a model for “reunification therapy.” I wrote it. It’s up on my website (Childress Description of an Attachment-Based Model for Reunification Therapy).
This is the only article that currently exists that describes a model for what “reunification therapy” is. This definition for “reunification therapy” is based in an attachment-based model of “parental alienation,” so if any therapist claims to be doing “reunification therapy” then he or she should be using my model for “reunification therapy” which is based in an attachment-based model of “parental alienation.”
As the first person to define a model for what “reunification therapy” is, I call dibs on the label.
If you’re going to do “reunification therapy” then you have to use the Childress attachment-based model of “reunification therapy,” or else you have to define your own model for what “reunification therapy” is. But you are not allowed to sell people “unicorns” that are simply dogs, or cats, or gerbils, with pointy sticks taped to their heads.
Craig Childress, Psy.D.
Clinical Psychologist, PSY 18857
Online Seminar: The Diagnosis & Treatment of Attachment-Based Parental Alienation
My 11/21/14 online seminar regarding the Diagnosis and Treatment of Attachment-Based “Parental Alienation” through the Master Lecture Series of California Southern University is now available online for the general public at:
https://vimeo.com/calsouthern/review/113572265/8d0b48de77
A handout of the Powerpoint slides for this seminar is available on my website: www.drcachildress.org
I believe this seminar is significant in several primary areas:
Standards of Practice: This seminar describes clearly defined standards for professional competence in the diagnosis and treatment of this “special population” of children and families experiencing attachment-based “parental alienation.”
Psychological Child Abuse: It establishes the theoretical foundations and support for identifying attachment-based “parental alienation” as psychological child abuse that warrants the DSM-5 diagnosis of V995.51 Child Psychological Abuse, Confirmed.
Diagnostic Criteria: It defines a set of clear diagnostic criteria based in established and accepted psychological principles and constructs that can reliably identify attachment-based “parental alienation” in every case, and that can reliably differentiate attachment-based “parental alienation” from other forms of parent-child conflict, including false allegations of “parental alienation.”
Protective Separation: It defines the structure necessary for treatment that begins with a protective separation of the child from the pathogenic parenting practices of the narcissistic/(borderline) parent during the active phase of the child’s treatment and recovery.
This online seminar is now available for review by therapists, child custody evaluators, attorneys, judges, and the general media, and so can serve as a referral resource for targeted parents trying to increase general public awareness and the understanding of legal and mental health professionals regarding the issues surrounding an attachment-based model of “parental alienation” and the mental health needs of children and families experiencing this type of tragic family process.
With the proper professional understanding that leads to an appropriate legal and mental health response, the solution to attachment-based “parental alienation” in any individual family circumstance is likely to be achievable within a relatively short period of active treatment intervention.
The family tragedy of “parental alienation” needs to end. Today.
Every day that passes that we do not enact the required solution is another day that we tolerate the profoundly destructive psychological abuse of the child.
Craig Childress, Psy.D.
Clinical Psychologist, PSY 18857
High Road to Family Reunification
My blog posts have been somewhat quiet recently because I’ve been focused on writing a book regarding the Theory and Diagnosis of an Attachment-Based Model of “Parental Alienation,” and I had to prepare for my recent Master Series seminar through California Southern University regarding the Diagnosis and Treatment of Attachment-Based Parental Alienation.” I was also focused on a Court case in Hawaii that was operating under time pressures. This case was referred to me through Ms. Dorcy Pruter, a co-parenting and reunification coach at the Conscious Co-Parenting Institute (www.consciouscoparentinginstitute.com)
The Court case had a successful outcome for the targeted-rejected parent, and Ms. Pruter is now handling the mother-daughter reunification process.
I have been aware of Ms. Pruter’s work in this area for a while, but through our work together on this case I have had the opportunity to review Ms. Pruter’s reunification protocol and have also been able to engage her in extensive dialogue regarding her approach and an attachment-based model for the construct of “parental alienation.”
I would like to take this opportunity to provide Ms. Pruter with my unequivocal, full and complete support for her model of family reunification (“High Road to Family Reunification”). Based on my review of her reunification protocol, it is theoretically sound for addressing the issues surrounding an attachment-based model of “parental alienation.” I would anticipate that her reunification protocol will be highly effective in resolving the family issues surrounding an attachment-based model of “parental alienation.”
One of the primary issues regarding enacting Ms. Pruter’s reunification protocol is that it FIRST requires the child’s protective separation from the distorted parenting practices of the narcissistic/(borderline) allied (and supposedly “favored”) parent. This is, however, not a limitation of her protocol but instead represents an authentic treatment-related need of addressing the pathogenic parenting of the narcissistic/(borderline) parent that is inducing the very serious child psychopathology evidenced in attachment-based “parental alienation.”
In my private practice I will no longer treat cases of attachment-based “parental alienation” without first obtaining the child’s protective separation from the pathogenic parenting of the narcissistic/(borderline) parent because I have become convinced that to do so places the child at risk of psychological harm as a result of being turned into a “psychological battleground” between the efforts of therapy to restore the child’s normal-range, balanced and healthy psychological functioning and the unrelenting efforts of the narcissistic/(borderline) parent to maintain the child’s symptomatic rejection of a relationship with the normal-range and healthy targeted parent.
Turning the child into a psychological battleground between the goals of therapy to restore healthy child development and the pathogenic goals of the narcissistic/(borderline) parent to maintain the child’s symptomatic state runs the considerable risk of harming the child-client’s emotional and psychological development. So unless the necessary treatment-related conditions exist to allow effective therapy to restore the child’s healthy functioning without risking psychological harm to the child in the process, then I will decline treatment.
In my professional view, based on my professional experience and expertise in this area, professionally responsible and competent treatment of an attachment-based model of “parental alienation” (i.e., the presence in the child’s symptom display of the three Diagnostic Indicators of attachment-based “parental alienation”) REQUIRES that the child FIRST be protectively separated from the pathogenic parenting of the narcissistic/(borderline) parent during the active phase of the child’s treatment and recovery.
Once the child’s healthy and normal-range functioning has been restored and the child’s healthy and normal-range relationship with the formerly targeted-rejected parent has been recovered, then the pathogenic parenting of the narcissistic/(borderline) parent can be reintroduced under appropriate therapeutic monitoring of the child’s symptoms that ensures that the child’s symptoms do not return upon the reintroduction of the pathogenic parenting of the narcissistic/(borderline) parent (there are treatment-related steps that can be taken to reduce this risk).
In first requiring the child’s protective separation from the pathogenic parenting of the narcissistic/(borderline) parent, Ms. Pruter’s protocol (the “High Road to Family Reunification”) demonstrates its accurate understanding for the family dynamics involved.
Furthermore, Ms. Pruter’s reunification protocol is solution-focused and avoids criticism of the narcissistic/(borderline) parent, thereby respecting the child’s love for BOTH parents, even for the narcissistic/(borderline) parent. The fundamental issue for the child is his or her TRIANGULATION into the spousal conflict through the efforts of the narcissistic/(borderline) parent that enlist the child in a cross-generational coalition against the other parent.
In avoiding criticism of the narcissistic/(borderline) parent, Ms. Pruter’s reunification protocol represents an appropriate response to the child’s triangulation into the spousal conflict by allowing the child to be de-triangulated from the spousal conflict. The child does not need to take sides. I’m sure this is a great relief to the child.
In addition, her protocol is psycho-educational in focus, so that it effectively brings cognitive mediation to emotional processes, thereby lessening the child’s hyper-inflamed emotional distortions toward the targeted parent. The educational material also provides the child with a healthy and balanced narrative for understanding the family experience without blame for anyone, including without guilt for the child stemming from the child’s prior distorted-hostile-rejecting behavior toward the targeted parent.
Ms. Pruter’s reunification protocol elegantly provides the child with a narrative road out of the hostile-rejecting behavior toward the targeted-rejected parent while simultaneously de-triangulating the child from the spousal conflict.
Ms. Pruter claims she has experienced substantial (universal) success with her protocol in reunifying parent-child relationships, and after my review of her protocol I would similarly expect it to be fully successful based upon its structure and approach.
Ms. Pruter’s protocol also has a component for the participation of the narcissistic/(borderline) parent in learning the skills needed to avoid triangulating the child into the spousal conflict, which also recommends this protocol as a complete family intervention. Although Ms. Pruter notes from her experience that participation by the narcissistic/(borderline) parent is irregular at best.
One of the limitations of Ms. Pruter’s reunification protocol is that it is offered in an intensive four-day initial intervention with subsequent follow-up to stabilize the reunited parent-child relationship, which places this protocol beyond the reach of many families that live in other parts of the country or who may have limited financial resources. I am currently in discussion with Ms. Pruter on ways to possibly make training in this reunification protocol available to mental health therapists via online training seminars so as to make this approach more broadly available to targeted-rejected parents and their children.
Another limitation is that the protocol (appropriately) requires that the child be protectively separated from the pathogenic parenting of the narcissistic/(borderline) parent during the active phase of the child’s treatment and recovery. While this is both a necessary and professionally responsible requirement, it will require the cooperation of the Court, which is a hurdle that targeted-rejected parents will need to address and overcome before this protocol becomes available for restoring their relationships with their children that have been so severely damaged by the pathogenic parenting of the narcissistic/(borderline) parent.
Yet even with these barriers to enacting the protocol, I am heartened and optimistic in reviewing a reunification protocol that is both thoughtfully integrated and elegant in its formulation, and that is theoretically sound for addressing and resolving the family dynamics associated with an attachment-based model of “parental alienation.”
Craig Childress, Psy.D.
Clinical Psychologist, PSY 18857
Powerpoint Slides from Master Lecture Series Presentation
This morning I provided an online seminar through the Master Lecture Series of California Southern University regarding the Diagnosis and Treatment of an attachment-based model of “parental alienation.” The seminar seems to have been well-received.
This online seminar was recorded and will become available online in about one week through the Master Lecture Series of California Southern University. Both this seminar on Diagnosis and Treatment, and the earlier companion seminar I delivered in July of 2014 through the Master Lecture Series regarding the Theoretical Foundations of an attachment-based model of “parental alienation” will then be available online to mental health professionals, and as importantly, as a resource for targeted parents to refer treating mental health professionals for further information about an attachment-based model of “parental alienation.”
I have posted a handout of my Powerpoint slides for today’s seminar to my website. Of particular note is my discussion beginning on page 15 of the handout regarding children and families evidencing the diagnostic indicators of attachment-based “parental alienation” as representing a “special population” requiring specialized professional knowledge, training, and expertise to appropriately and competently diagnose and treat.
Failure to possess the specialized professional knowledge, training, and expertise necessary for professional competence in diagnosing and treating this “special population” of children and family issues likely represents practice beyond the boundaries of professional competence in violation of professional practice standards (Standard 2.02 of the Ethical Principles of Psychologists and Code of Conduct of the American Psychological Association (2002).
It is long past overdue to expect and demand professional competence from mental health professionals with regard to diagnosing and treating the severe psychopathology associated with an attachment-based model of “parental alienation.”
Also of note from this seminar is my discussion of the pathogenic parenting associated with an attachment-based model of “parental alienation” as representing a DSM-5 diagnosis of V995.51 Child Psychological Abuse, Confirmed. The presence in the child’s symptom display of the three definitive Diagnostic Indicators of an attachment-based model of “parental alienation” shifts the issue from one of child custody and visitation to one of child protection.
Attachment-based “parental alienation” is not a child custody issue; it is a child protection issue.
Craig Childress, Psy.D.
Clinical Psychologist, PSY 18857
Online Seminar on Diagnosis and Treatment
On November 21, 2014 from 10:00-12:00 Pacific Standard Time I will be presenting an online seminar through the Masters Lecture Series of California Southern University regarding the Diagnosis and Treatment of an attachment-based model for “parental alienation.”
This seminar is offered free to the general public and the seminar will be recorded and made available online through California Southern University’s Master Lecture Series for later viewing.
Registration for this online seminar regarding the Diagnosis and Treatment of attachment-based “parental alienation” is at:
http://www.calsouthern.edu/content/events/treatment-of-attachment-based-parental-alienation/
This Diagnosis and Treatment seminar is a follow-up to my earlier online seminar regarding the Theoretical Foundations for an attachment-based model of “parental alienation” that I delivered on July 18 through the Masters Lecture Series of California Southern University, and which is currently available at:
http://www.calsouthern.edu/content/events/parental-alienation-an-attachment-based-model/
My hope is that these two companion seminars will provide foundational information for mental health professionals in understanding, diagnosing, and treating the family dynamics associated with “parental alienation,” so that these seminars can serve as a resource to which targeted parents can refer diagnosing and treating mental health professionals to improve their understanding for the issues involved.
An attachment-based model for the construct of “parental alienation” is based entirely within standard and established psychological principles and constructs. Within the field of mental health, all of these constructs are fully recognized and fully accepted psychological principles and constructs.
The family systems constructs of the child’s triangulation into the spousal conflict through the formation of a cross-generational coalition of the child with one parent against the other parent is an established psychological principle within family systems therapy (Haley, 1977; Munichin, 1974). Minuchin refers to this cross-generational coalition as a “rigid triangle,” Haley refers to it as a “perverse triangle.”
“The rigid triangle can also take the form of a stable coalition. One of the parents joins the child in a rigidly bounded cross-generational coalition against the other parent.” (Minuchin, 1974, p. 102)
“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)
Narcissistic and borderline personality disorder processes are recognized forms of pathology within the DSM diagnostic system (American Psychiatric Association, 2013) and are fully elaborated and described by preeminent theorists in professional psychology (e.g., Beck, et. al. 2004; Kernberg, 1977; Linehan, 1993; Millon, 2011).
The attachment system is a well-established and accepted psychological construct within professional psychology, with substantial theoretical foundation and research support (Ainsworth, 1989; Bowlby, 1969; 1973; 1980; Bretherton, 1992).
There is nothing new or controversial in any of these psychological principles or constructs. They are all established and accepted psychological principles and constructs with which all mental health professionals should be familiar as a matter of professional competence, particularly if they are diagnosing and treating issues involving a child’s triangulation into the spousal conflict through a cross-generational coalition of the child with a narcissistic/(borderline) parent that results in the induced suppression of the normal-range functioning of the child’s attachment system.
While targeted parents do not possess the professional background, training, and expertise in professional psychology to explain to the mental health professionals involved with their families the application of these established psychological principles and constructs , I do.
In these two online seminars I explain to other mental health professionals the application of these accepted psychological principles and constructs to the family processes traditionally described as “parental alienation.” Hopefully this professional-level dialogue can begin to shift the mental health community into greater professional expertise and responsiveness to the needs of targeted parents and their children that will be necessary if we are to resolve the family tragedy of “parental alienation” for all families in all cases.
Craig Childress, Psy.D.
Clinical Psychologist, PSY 18857
References
Family Systems:
Haley, J. (1977). Toward a theory of pathological systems. In P. Watzlawick & J. Weakland (Eds.), The interactional view (pp. 31-48). New York: Norton.
Minuchin, S. (1974). Families and Family Therapy. Harvard University Press.
Personality Disorders:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Beck, A.T., Freeman, A., Davis, D.D., & Associates (2004). Cognitive therapy of personality disorders. (2nd edition). New York: Guilford.
Kernberg, O.F. (1975). Borderline conditions and pathological narcissism.. New York: Aronson.
Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York, NY: Guilford
Millon. T. (2011). Disorders of personality: introducing a DSM/ICD spectrum from normal to abnormal. Hoboken: Wiley.
Attachment System:
Ainsworth, M.D.S. (1989). Attachments beyond infancy. American Psychologist, 44, 709-716.
Bowlby, J. (1969). Attachment and loss. Attachment, Vol. 1. NY: Basic Books.
Bowlby, J. (1973). Attachment and loss: Vol. 2. Separation: Anxiety and anger. NY: Basic Books.
Bowlby, J. (1980). Attachment and loss: Vol. 3. Loss: Sadness and depression. NY: Basic Books.
Bretherton, I. (1992). The origins of attachment theory: John Bowlby and Mary Ainsworth. Developmental Psychology, 1992, 28, 759-775.
Dr. Craig Childress: Attachment Based "Parental Alienation" (AB-PA) 