Dr. Craig Childress: Attachment Based "Parental Alienation" (AB-PA)

In my previous blog post, A Solution to Assessing Parental Capacity, I describe how the most basic and fundamental principle in developing an assessment procedure for any construct is to first define the construct (which is called its “operational definition” for assessment purposes).

This is absolutely Assessment 101 – basic and foundational. 

First, operationally define the construct.

For the construct of intelligence, Spearman proposed a two-factor definition of intelligence involving an overarching form of intellectual ability – a general intelligence factor which he called g – along with specific individual factors which he callled s, such as Vocabulary, Reading Comprehension, Arithmetic Reasoning, and Computation, .

Thurstone, on the other hand, rejected Spearman’s proposal of a general factor (g) and instead proposed a multi-factor theory.  Thurstone analyzed scores from 56 different tests taken by children of different ages, from which he identified seven “primary mental abilities” that include; 1) Numerical Ability, 2) Verbal Comprehension Ability, 3) Word Fluency Ability, 4) Memory Ability, 5) Reasoning Ability, 6) Spatial Ability, and 7) Perceptual Speed.

Raymond Cattell and John Horn proposed a two-factor model for intelligence comprised of Fluid intelligence (the ability to solve problems and adapt to new situations) and Crystallized intelligence (acquired knowledge through education and personal experience).

Sternberg proposed a Triarchic theory of intelligence comprised of three aspects, Analytic intelligence which is the ability to perform academic problem-solving tasks, Creative intelligence which is the ability to respond effectively to novel situations by finding new solutions to problems, and Practical intelligence which is the ability to solve real-life problems as they arise.

Alternatively, Howard Gardner (different Gardner) proposed a theory of Multiple Intelligence that includes eight different types of intelligence; 1) Linguistic Intelligence, 2) Logical/Mathematical Intelligence, 3) Spatial Intelligence, 4) Bodily/Kinesthetic Intelligence, 5) Musical/Rhythmic Intelligence, 6) Interpersonal Intelligence, 7) Intrapersonal Intelligence, and 8) Naturalistic Intelligence.

Look how much effort has been put into the assessment of children’s intellectual development, their “intelligence,” because the assessment of children’s intellectual development and the recommendations that result from the assessment can have such profound effects on the lives of children.

Child custody decisions can have equally profound effects on the lives of children.  Yet no effort has been employed by professional psychology to define the construct of “best interests of the child” which is central to the child custody evaluation.  This absence of professional rigor is unconscionable.

Each of the differing definitions of intelligence will produce a different method for assessing “intelligence.”

What’s more, the process of first defining the construct of intelligence promotes vigorous professional dialogue which enhances our understanding for the core meaning of the construct.  Vigorous professional debate surrounding the definition of the construct greatly improves our ability to assess the construct.

But all of this valuable professional debate is absent surrounding the construct of “best interests of the child” as applied in child custody evaluations. There is no established operational definition for what the construct of “best interests of the child” means in the context of child custody evaluations.

The absence of an established definition of this fundamental construct in child custody evaluations is described by Stahl and Simons,

“A critical subject facing those working in the field of family law, whether they’re legal professionals or psychological professionals, is the concept of the best interests of the children. Even recognized experts in this concept differ with regard to what it means, how it should be determined, and what factors should be considered in determining what is in the best interest of a child. Thus, this ubiquitous term escapes consensus and remains fundamentally vague.” (Stahl & Simon, 2013, p. 10-11)

“It is defined differently from state to state; and even in Arizona, where there are nine statutory factors associated with the best interest of the child, the meaning behind many of the factors is obscure.  Additionally, when psychologists refer to the best interests of children, they are referring to a hierarchical set of factors that may have different meanings to different children with different families and that may be understood differently by psychologists with different backgrounds and different training.” (Stahl & Simon, 2013, p. 11)

Stahl, P.M. and Simon, R.A. (2013). Forensic Psychology Consultation in Child Custody Litigation: A Handbook for Work Product Review, Case Preparation, and Expert Testimony, Chicago, IL: Section of Family Law of the American Bar Association

And yet, despite this violation of a fundamental and incredibly basic principle of psychological assessment – to first operationally define the construct to be assessed – the scientifically unsupported (but financially lucrative) practice of child custody evaluations continues.

Determining Best Interests

So how should we define the best interests of the child relative to various custody time-share alternatives?

Answer:  There is no information in the research or theoretical literature that would allow professional psychology to develop or render an opinion regarding this question.  None.

I know the child development literature.  I know the clinical psychology literature. I know the research literature surrounding children, families, and divorce.  There is no information in the research or theoretical literature that would allow professional psychology to develop or render an opinion regarding this question.  None.

The best professional psychology can do is to identify child abuse, in which case a child protection response of 100% – 0% custody time-share is warranted for as long as the abuse potential exists.  But short of child abuse, there is no information in the research or theoretical literature of professional psychology that would allow professional psychology to develop or render an opinion regarding various custody time-share options relative to the “best interests” of the child.

There is no information in the research or theoretical literature of professional psychology that would allow professional psychology to provide an opinion that a 60-40% custody time-share will be in the long-term best interests of the child over a 70-30% custody time-share, or a 50-50% custody time-share.  These gradations are far too fine – exceedingly too fine – and far surpass our research and theoretical knowledge.

Define “best interest of the child” for me in a way that this definition can be applied to the variety and complexity of parent-child and family relationships (across cultural contexts).  You will immediately begin to see the immense (and unsolvable) problem posed by even attempting this definition.

Short of determining the presence of child abuse in which a child protection response is warranted, professional psychology should avoid being drawn into a spousal dispute to determine who is the “better parent” and who is to be “awarded the prize” of the child for being the “better parent.”  Becoming the arbiter in a spousal dispute as to who is the “better parent” to be “awarded the prize of the child” following divorce is an inappropriate professional role for professional psychology. 

If there is a problem in family relationships, psychotherapy can fix the problem.  But determining who is the 60% better parent relative to the other parent’s 40% good parenting, or who is the 70% better parent relative to the other parent’s 30% good parenting is not an appropriate role (and is actually an impossible role) for professional psychology to undertake.

If a custody evaluator decides that the child’s “best interests” are better served by an 80% custody time-share with the supposedly “better” parent (based on some yet undefined criteria for determining the “better” parent), how does the custody evaluator know this?  Where is the research literature that supports this decision regarding the long-term best interests of the child (based on some as yet undefined criteria for determining the long-term “best interests” of the child)?  Where is the research literature that indicates that the child’s long-term “best interests” are better served by being placed 80% of the time with the parenting practices of the “better” parent and that limiting the child’s contact and relationship with other parent to only 20% of the time is in the long-term “best interests” of the child?  Where is the scientific evidence to support this?  There is none.

There are simply too many complexities to this question that it far-far surpasses even the hope of an answer from the research base and theoretical literature of professional psychology.

There is absolutely no way – no way – professional psychology can come up with any opinion regarding the long-term benefits or impairments to a child from a 60-40% custody time-share, versus a 70-30% custody time-share, versus a 50-50% custody time-share in a specific individual family context.  Rendering such an opinion far exceeds the extent and capacity of our knowledge.

It’s analogous to asking a Neanderthal to design and build a computer.  The Neanderthal doesn’t even have electricity yet.  The Neanderthal is chipping spear points out of stone and making fire with sticks.  There is absolutely no way the Neanderthal can design and build a computer.

There are simply too many complexities (way-way too many) and too many variable factors (way too many), and our knowledge base is way too limited, to even get close to answering the question of whether a 60-40% custody time-share is in the long-term best interests of a specific child rather than a 70-30% custody time-share, or a 50-50% custody time-share.  It is just complete speculation.  Not even educated speculation.  Just pull it out of the sky pure unadulterated guesswork.

Might as well have a monkey throw darts at a dartboard.  Seriously.

Disagree?  There’s a Comment section on this blog.  Feel free to define for me the construct of “best interest of the child” in a way that can be applied to all the various complexities of parent-child and family relationships, and THEN cite for me any research whatsoever that would allow us to apply this definition of the “best interests of the child” to such a fine-grained discrimination as a 60-40% custody time-share versus a 70-30% custody time-share versus a 50-50% custody time-share, and that describes what parenting factors in all of the complexity of parent-child and family relationships (across cultures) would allow for such fine-grained custody time-share decisions relative to the proposed definition for the “best interests of the child.”

Impossible.  Impossible.  Impossible.

So why isn’t the impossibility of this exposed?  Because everyone in professional psychology is pretending that they see the emperor’s beautiful new clothing.

The emperor has no clothes.  The emperor is naked.

Once professional psychology lives up to its own established standards of practice regarding the development of “assessment techniques” (Standard 9.05 of the APA ethics code), or is forced to live up to these standards by the Court, so that an operational definition for the construct of “best interests of the child” becomes required of the professional assessment practice, then the entire house of cards surrounding the biased and unscientific practice of child custody evaluations will collapse.

Standard 9.05 of the APA ethics code regarding the construction of “assessment techniques” requires:

9.05 Test Construction
Psychologists who develop tests and other assessment techniques use appropriate psychometric procedures and current scientific or professional knowledge for test design, standardization, validation, reduction or elimination of bias and recommendations for use.

“…and other assessment techniques…” – like child custody evaluations. 

And “standardization” refers not just to standardizing the procedures for data collection, standardization also refers to standardizing the interpretation of the collected data. If two different evaluators can interpret the data differently based on the fact that the best interests of the child “may be understood differently by psychologists with different backgrounds and different training” (Stahl & Simon, 2013), then the interpretation of the data is not standardized.

Vigorous Professional Debate

For the life of me, I cannot come up with a cogent definition for the “best interests of the child” based on “current scientific or professional knowledge” – it’s like asking this poor Neanderthal to design and build a computer.  I can’t fathom how to accomplish the impossible task of defining the “best interests of the child” for the astounding complexity of the various parent-child and family relationship factors involved.

But if the practice of child custody evaluations is not to be replaced by a monkey throwing darts at a dartboard, it is incumbent upon the advocates for the practice of child custody evaluations to operationally define the construct of “best interests of the child” (like Spearman, and Thorndike, and Cattell, and so many others did relative to the construct of intelligence) in order to afford professional psychology the opportunity for the vigorous professional dialogue commensurate with the astounding importance of making custody decisions that will have such a profound impact on the child and family.

The methodology for child custody evaluations that is then created as a product of this vigorous and healthy debate within professional psychology should then be subjected to the rigors of inter-rater reliability, validity (construct validity; content validity; predictive validity; convergent validity; divergent validity), and cross-cultural validation that represents the “appropriate psychometric procedures… for test design, standardization, validation, [and] reduction or elimination of bias” referenced by APA Standard 9.05 of the Ethical Principles of Psychologists and Code of Conduct.

Until this is accomplished, there exists NO INFORMATION in the professional literature or research base that would allow professional psychology to answer the question regarding the “best interests of the child” relative to alternative custody time-share options (with the exception of determining child abuse that warrants child protection considerations; leading to a 100% – 0% custody recommendation for the duration of child protection concerns).

The Solution

Children’s emotional and psychological development benefits from a complex relationship with both parents.  The complexity of the parent-child relationship and the complexity of the relationship processes involved in healthy child development preclude the formation of any informed opinion or recommendation regarding the potential “best interests” of the child resulting from various custody time-share alternatives (with the exception of child abuse and child protection considerations; 100% – 0%) for specific individual family circumstances.

As a consequence of professional psychology’s inability to form or render a cogent, reliable, and demonstrably valid opinion regarding the “best interests of the child” that will result from various custody time-share options (with the exception of child abuse and child protection considerations; 100% – 0%), the custody recommendation from professional psychology for all cases that don’t involve child abuse and child protection considerations should be for a 50-50% time-share based on the principle that children benefit from complex relationships with both parents.

In the absence of child protection considerations, there is no scientifically or theoretically supported foundation for any other decision or opinion from professional psychology regarding a fine-grained discrimination in the child’s long-term “best interests” resulting from a 60-40%, 70-30%, 80-20%, or 90-10% custody time-share in specific individual family circumstances following divorce.

Professional psychology should avoid being drawn into spousal conflicts surrounding divorce to render an opinion as to who is the “better parent” to be “awarded the prize” of the child following divorce.

If the parents wish to work out some alternative custody time-share arrangement, that is their right and that is their prerogative. 

But if professional psychology is asked for an opinion, the only rational and supported opinion which can be offered by professional psychology given the immense complexity surrounding parent-child and family relationships (including the cultural context of parenting and family relationship structures) regarding various custody time-share alternatives is for 50-50% custody timeshare equally with both parents (with the exception of child abuse and child protection considerations; 100% – 0%) based on the principle that children benefit from complex relationships with both parents.

If family problems exist with a 50-50% custody time-share, this represents a family therapy issue, not a custody-related issue.  The family problems should be assessed and a treatment plan can be developed to resolve the family problems.  This is not a custody-related issue.  This is a treatment issue.

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

I teach a graduate level course in assessment.  Professional assessment begins with first defining the construct to be assessed. 

For example, if we seek to create an assessment for intelligence, we must first define what we mean by the construct of “intelligence.” 

If we are creating an assessment for self-esteem, we must first define what we mean by the construct of “self-esteem.” 

The professional process of developing an assessment procedure BEGINS with defining the construct to be assessed.

In professional psychology, defining the construct to be assessed is called developing an “operational definition” for the construct.  For example, do we define intelligence as the amount of knowledge a person has, or is intelligence an approach to reasoning and solving problems?  Or both?  Based on our operational definition of the construct, we then develop an approach to assessing for that definition of the construct.

If we define intelligence as being the amount of information the person knows, then we develop questions to sample how much the person knows.  If we define intelligence as the person’s reasoning ability, then we develop questions that challenge the person’s ability to solve abstract problems.  In professional psychology, our assessment procedures are dependent on how we define the construct to be assessed – our “operational definition” for the construct.

However, child custody evaluations have entirely skipped this crucial step in the assessment process.  Child custody evaluations are supposedly assessing two key constructs of family functioning:

• Parental capacity
• The best interest of the child.

Yet neither of these key constructs is operationally defined in the custody evaluation procedures.

The failure to operationally define the key constructs that are being assessed by child custody evaluations leads to a fundamentally and fatally flawed assessment in which the evaluator is allowed to make up his or her own idiosyncratic definition of these constructs, which introduces into the assessment process the inherent biases of the individual evaluator.  Different evaluators will have differing interpretations and definitions for the key constructs of “parental capacity” and “best interests of the child,” leading to differing conclusions and recommendations from different evaluators.

Reliability and Validity

Reliability: The stability of the findings from one assessment to the next (test-retest reliability), or from one evaluator to the next (inter-rater reliability).

Validity:  The truth and accuracy of the assessment’s findings.

If the conclusions and recommendations reached by an assessment practice are not stable across evaluators (if an assessment procedure is not reliable) then the conclusions and recommendations cannot, by definition, be valid.

If an assessment procedure for a person’s intelligence results in a finding of normal-range intelligence when the assessment is administered by Psychologist A, but results in a finding of significant cognitive impairment when the assessment is administered by Psychologist B, then this assessment procedure is not reliable, and if an assessment procedure is not reliable, then the findings, by definition, cannot be valid. 

In this example, is the person being assessed of normal-range intelligence?  Or is the person cognitively impaired?  If the results of an assessment depend on who conducts the assessment, then the findings are not a valid indicator of person’s actual intelligence but are simply a reflection of the personal biases introduced by the individual evaluator.

The first step toward making an assessment reliable (stable across evaluators; called “inter-rater” reliability), is to operationally define the construct to be assessed.  Operationally defining the construct allows all assessors to apply the same definition of the construct to the assessment data, thereby improving the inter-rater reliability of the assessment.

Operationally Defining Parental Capacity

In developing an operational definition for the construct of parental capacity, the central issue is to identify the key factors of parenting that capture the quality of parenting behavior.  Identifying the key qualitative descriptors for parental behavior will allow evaluators to more reliably assess parental behavior on these key qualities.

In an effort to provide a solution – or at the very least to initiate a discussion of the issue – I have developed a checklist of key parenting qualities that can describe parenting practices.  This checklist is on my website:

Parenting Practices Rating Scale

This rating scale identifies four aspects of parenting behavior as central to defining the construct of parental capacity:

1.)  Classification of Parenting Behavior:  A categorical classification of parental behavior within a 4-tiered hierarchy.

Level 1: Child abuse

Level 2: Severely problematic parenting

Level 3: Problematic parenting

Level 4: Healthy parenting

 2.)  Permissive-Authoritarian Parenting: A dimensional rating from 1 to 100 along the parenting spectrum of permissive parenting, through communication-based and discipline-based parenting, to authoritarian parenting practices.

 3.)  Capacity for Authentic Empathy: A rating from 1 to 5 along the parenting dimension of authentic empathy for the child’s experience; from narcissistic self-absorbed parenting at one end of the spectrum, through authentic empathy, to over-intrusive enmeshed parenting at the other end of the spectrum.

 4.)  Issues of Clinical Concern:  A categorical indicator of additional issues of clinical concern relative to the parent.

If court-involved mental health professionals, including child custody evaluators, court-involved therapists, and court-appointed parenting coordinators, were to begin including this brief Parenting Practices Rating Scale in their assessments and reports, the increased clarity afforded by this rating scale would substantially improve the standardization for the definition of parental capacity.

Professional assessment BEGINS by operationally defining the construct to be assessed.  The Parenting Practices Rating Scale is my offer of an operational definition for the construct of parental capacity.

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

Caveat:  Dr. Childress is not an attorney, he is a psychologist.  His commentary on this blog is as a psychologist, not an attorney.  For legal advice consult an attorney and follow the advice of the attorney.

---

In my professional consultation work with attorneys, I am frequently asked to help them prepare their lines of cross-examination for child custody evaluators who have reached problematic conclusions relative to the pathology of attachment-based “parental alienation” (AB-PA).

There are so many problems inherent to the practice of child custody evaluations that it’s hard to know where to begin.

The multitude of problems all stem from how the practice of child custody evaluations began.  The practice of child custody evaluations developed gradually and piecemeal over the course of time in response to the needs of the Court for guidance in family matters.  But this gradual and piecemeal origin means that the practice of child custody evaluation is not well thought out.

With the increase in the divorce rate occurring in the 1970s and 80s, professional psychology was increasingly asked to provide input to the Court regarding child custody arrangements in high-conflict families.  The initial response of professional psychology was to provide haphazard and idiosyncratic assessments and opinions of varying quality based on variable methodology.

In an effort to improve the practice of offering child custody recommendations to the court, various “standards” were developed by professional organizations, such as the American Psychological Association in 1991 (Specialty Guidelines for Forensic Psychology) and the Association of Family and Conciliation Courts in 2006 (AFCC: Model Standards of Practice for Child Custody Evaluations) which sought to provide standardized methodology for the conduct of child custody evaluations.

However, these “standards” exclusively address the role-relationships of the evaluator to the client and court, and the methodology for collecting the data – they do NOT address how the data is to be interpreted, and it’s the interpretation of the data that is central to forming the conclusions and recommendations provided by the evaluation. The interpretation of the data collected in child custody evaluations is left entirely (100%) to the discretion of the particular evaluator, as is the decision regarding what information from professional psychology is to be applied – or not applied – to the interpretation of the data.

I want to be entirely clear on this, child custody evaluations consider themselves exempt from the standards governing clinical psychology, and so they believe themselves exempt from systematically applying all of the established constructs or principles drawn from professional psychology to the interpretation of the data, including the DSM diagnostic system for identifying pathology (see AFCC Standard 4.6c), or they apply these principles and constructs in such haphazard, random, and idiosyncratic ways as to be essentially worthless in providing a standardized professional interpretation of the data based on established psychological principles and constructs.

Let me just add something about Standard 4.6c of the AFCC standards; while “diagnostic labels” may have a “prejudicial” impact against the person who is diagnosed with a pathology, such as a narcissistic or borderline personality parent, intentionally withholding relevant diagnostic information from the Court in order to influence the Court’s decision would seemingly have an equally “prejudicial” impact in the opposite direction (against the normal-range parent seeking custody) and would be equally – if not more – problematic in my opinion.  I believe professional psychology has a fundamental obligation to provide the Court with ALL of the relevant mental health information, including relevant DSM diagnostic information, and allow the Court to determine the relative weight given to this information.  In my opinion, it is not within the purview of professional psychology to preempt the decisional authority of the Court by unilaterally making  a preemptive decision about the potential prejudicial or probative value of mental health information and to then intentionally withhold relevant DSM diagnostic information from the Court in order to influence – in any direction – the decision of the Court. We should simply be reporting on the relevant mental health information, not making preemptive decisions that would bias – in any way – the reporting of the relevant mental health information.

Instead of being circumscribed within the confines of established psychological constructs and principles, child custody evaluators are free to just make up their conclusions and recommendations based on their personal beliefs and personal biases, which are highly vulnerable to “counter-transference” issues (influence from the evaluator’s own childhood and family-of-origin experiences that affect the evaluator’s interpretation of the custody evaluation data). 

When it comes to the interpretation of the data, they just make it up based on their own idiosyncratic beliefs and biases.

At times, child custody evaluators use “psychology-sounding” words to make it seem like they are applying established constructs and principles, and these “psychology-sounding” words fool legal professionals and the public who don’t know the literature and research in professional psychology. But I’m a psychologist – I know the literature and research in psychology – and these child custody evaluators are talking complete nonsense when they use these “psychology-sounding” words… 100% nonsense.  They are making it up, completely and totally making this stuff up.

Child custody evaluators are not applying any existing models or principles of professional psychology to the interpretation of the data, or they are doing so in odd and idiosyncratic ways that essentially fit with their preconceived biases.  The “Standards” for Forensic Psychology produced by the APA and AFCC are essentially putting lipstick on a pig – it’s still a pig.  And not a very pretty pig at that. 

Read them. The standards are entirely about how to collect data and about how the professional relationship is to be established with the client and court.  There is nothing about how the data should be interpreted – specifically interpreted.  There are statements about “best interests of the child” and applying the knowledge from child development, and divorce, and other related areas of professional psychology, but in any specific case, the application – or non-application – of this professional knowledge base is left entirely – 100% – to the idiosyncratic and highly variable discretion of the individual evaluator.

The very foundation for the practice of child custody evaluation is inherently flawed.  So let me begin with this foundational line of questioning which is available to attorneys:

Line 1:  There is no established scientific foundation for the practice of child custody assessments.

The core premise – the foundational premise – upon which child custody evaluations are based is deeply and inherently flawed, resulting in a deeply and inherently flawed application of this premise.  The scientific foundation for the practice of child custody evaluations is non-existent, and as a result, the practice of child custody evaluation is built on a fragile house-of-cards.

While it looks like an elegant construction, if we breathe on this house-of-cards it will collapse.

The Emperor Has No Clothes

Hans Christian Anderson wrote a short story about an emperor who wanted a wonderful new set of clothing.  The emperor hired two (charlatan) tailors who said that they could create a “magical” suit of clothing that would be invisible to anyone who was incompetent and unfit for their position.  Anyone who was incompetent and stupid would be unable to see the “magical” clothing.

As these charlatan tailors began their work on sewing their supposedly “magical” clothing, the emperor and all of his courtiers were afraid to say that they couldn’t see the clothing because that would mean that they were unfit for their positions, that they were stupid and incompetent, so everyone pretended to see the clothes.  They all praised the magnificent beauty and quality of the “magical” clothing, and since everyone else seemed to see the clothing each person thought that they alone could not see the “magical” clothing.

When the clothes were finally finished, the tailors were paid and they quickly left the kingdom (making a lot of money for their supposedly “magical” clothing).  The emperor decided to proudly display his magnificent new clothing in a parade before his people.  Again, all of the people along the parade route also pretended to see the clothing because no one wanted to admit that they couldn’t see the emperor’s new clothes, because that would mean that they were incompetent and stupid since everyone else obviously saw the clothing.  But as the emperor paraded past his people, a young child turned to his mother and said, “Look mommy, the emperor has no clothes.”  With that, the collusion of silence was broken and everyone began to admit that they too saw no clothing, and they began to laugh at the emperor who stood naked before his people, duped by the charlatan tailors.

With regard to child custody evaluations, I am that little kid on the parade route; “Look mommy, the emperor has no clothes.”

The practice of child custody evaluations violates every standard of professional practice regarding assessment.  But no one in professional psychology is saying anything.  It’s a collusion of silence.

So I’ll say it, “the emperor has no clothes” – and family law attorneys need to begin saying it too.

There is no scientifically established validity to the conclusions or recommendations of child custody evaluations.  None.  Zero.

Don’t believe me, or don’t agree?  There is a Comment section to the blog. I invite anyone to provide a single citation in the research literature that establishes the inter-rater reliability or validity (construct validity; content validity; predictive validity; convergent validity, discriminant validity) for the conclusions and recommendations of child custody evaluations.  Not for the data collection procedures, but for the conclusions and recommendations of child custody evaluations, which are made based on the interpretation of the data.

<crickets>

Child custody evaluations do not apply in any systematic or rational way the established constructs and principles of professional psychology, and the conclusions and recommendations offered by child custody evaluators are simply made up based on the individual idiosyncratic biases of the individual custody evaluator.

They simply make it up.

Child custody evaluations are little more than voodoo assessment.  Rattle some beads, recite some magical incantations, and read the entrails of a goat. Seriously.

• Rattle some beads: The procedures used for data collection
• Recite some magical incantations: Write a report with psychology-sounding words
• Read the entrails of a goat: Make recommendations about the “best interests of the child”

Here’s what two leading figures in Forensic psychology, Stahl and Simon, say about the definition of “best interests of the child” (and notice who published this work, The Family Law Section of the American Bar Association):

“A critical subject facing those working in the field of family law, whether they’re legal professionals or psychological professionals, is the concept of the best interests of the children. Even recognized experts in this concept differ with regard to what it means, how it should be determined, and what factors should be considered in determining what is in the best interest of a child. Thus, this ubiquitous term escapes consensus and remains fundamentally vague.” (Stahl & Simon, 2013, p. 10-11)

“It is defined differently from state to state; and even in Arizona, where there are nine statutory factors associated with the best interest of the child, the meaning behind many of the factors is obscure.  Additionally, when psychologists refer to the best interests of children, they are referring to a hierarchical set of factors that may have different meanings to different children with different families and that may be understood differently by psychologists with different backgrounds and different training.” (Stahl & Simon, 2013, p. 11)

Stahl, P.M. and Simon, R.A. (2013). Forensic Psychology Consultation in Child Custody Litigation: A Handbook for Work Product Review, Case Preparation, and Expert Testimony, Chicago, IL: Section of Family Law of the American Bar Association

“may have different meanings to different children with different families and that may be understood differently by psychologists with different backgrounds and different training.”

This is related to a property of the assessment called “inter-rater reliability” – the stability of the conclusions and recommendations derived from the data across different evaluators.

They just make it up.  Seriously.  They – just – make – it – up.

Voodoo assessment.  Rattle some beads (data collection procedures), recite some magical incantations (write a report with psychology-sounding words), and read the entrails of a goat (make recommendations from the “spirit world” of professional psychology regarding the supposed “best interests” of the child).

I am making a strong allegation.  This blog has a Comment section.  I invite any advocate for the practice of child custody evaluations to provide a citation for a single study – just one – that has demonstrated the inter-rater reliability and validity (construct validity, content validity, predictive validity, convergent validity, divergent validity) for the conclusions and recommendations produced by child custody evaluations.

<crickets>

There is NO scientific foundation for the practice of child custody evaluations.

Inter-Rater Reliablity

The construct of “reliability” is the professional term for the stability of an assessment’s results.  If I give you an IQ test this week and your score is 100 (normal-range), then your IQ score should be roughly the same when I retest you one week later. 

If, one week later, your IQ score drops to 70 (cognitively deficient), then my assessment procedure for establishing your IQ is NOT reliable.  My assessment procedure does not yield stable results from one assessment administration to another.

In the IQ example given above, the type of reliability is called “test-retest reliability,”  There are four methods in the professional practice of assessment that are used to establish an assessment procedure’s reliability:

• Test-retest reliability
• Inter-rater reliability
• Split-half (internal consistency) reliability
• Alternate forms reliability

This is all standard – and basic – professional psychology assessment stuff.  I teach it every semester to graduate students in my Psychometrics of Assessment class.  Basic stuff.

By definition, an assessment procedure cannot be valid if it is not reliable. If your IQ changes from normal-range to developmentally delayed because of the inherent instability of my assessment procedure, my assessment procedure is NOT a valid assessment of your intelligence.

Validity is the professional psychology term that refers to the actual truth or accuracy of the findings from an assessment procedure.

A fundamental axiom within the field of professional assessment is that:  An assessment procedure CANNOT BE VALID if it is not reliable.  In the example above, my assessment procedure for your IQ cannot be valid (true and accurate) if the findings from the assessment procedure fluctuate radically from one test administration to the next (in one assessment you’re deemed to be of normal-range intelligence but in the next assessment a week later you’re deemed to be cognitively delayed).

In the case of child custody evaluations the appropriate form of reliability would be inter-rater reliability, which means that two raters (two evaluators) would reach the same conclusions and recommendations based on the same data set.  Inter-rater reliability.

No research has ever been conducted to establish the inter-rater reliability for the conclusions and recommendations reached by child custody evaluations.  None.

And note, this is in the context of Stahl and Simon’s (2013) analysis regarding the fundamental construct being assessed in child custody evaluations, the “best interests” of the child:

“Even recognized experts in this concept differ with regard to what it means, how it should be determined, and what factors should be considered in determining what is in the best interest of a child.” (Stahl & Simon, 2013, p. 10)

The inter-rater reliability for the conclusions and recommendations of child custody evaluations has NEVER been scientifically established.

So if two different custody evaluators can reach two radically different sets of conclusions and recommendations from the same data – based on their differing interpretations regarding the meaning of the data – then the conclusions and recommendations from child custody evaluations are not reliable.

And if the conclusions and recommendations from child custody evaluations are not reliable (are not stable from one custody evaluator to the next; inter-rater reliability), then the conclusions and recommendations from child custody evaluations CANNOT, by definition, be valid.

Let that sink in for a moment.  If the conclusions and recommendations are not reliable (stable) from one evaluator to the next (inter-rater reliability), then the conclusions and recommendations cannot, by definition, be valid.

There is no scientific evidence establishing the inter-rater reliability for the conclusions and recommendations from child custody evaluations.

Foundational Line of Questioning

This is the basis for the first line of questions; to question the custody evaluation in such a way so as to:

1.)  Expose the absence of any data in the scientific literature that establishes the “inter-rater” reliability for the conclusions and recommendations of child custody evaluations.

1A.) Walk the evaluator through definitions for the constructs of “reliability” and “validity” – defining the four types of reliability, with a focus on inter-rater reliability.

• Reliability: The stability of the assessment findings across situations (raters)
• Validity: The truth or accuracy of the findings

1B) Ask for citations from the scientific literature that establish the “inter-rater reliability” and “validity” (to be discussed later) for the conclusions and recommendations of child custody evaluations – there are none.

1C.) Lead the evaluator into a key question, “Can the findings from an assessment procedure be valid if they are not reliable? – A: No.

2.)  Expose the meaning of this: “Can two different child custody evaluators reach markedly different conclusions and recommendations based on the same data set?” A: Yes.

2A.) If the child custody evaluator tries to assert that other psychologists would agree with his or her interpretation of the data, ask how the evaluator knows this if there has never been any research done on the inter-rater reliability for the conclusions and recommendations of child custody evaluations (that they all collect data in the same way does not establish that they would all interpret the data in the same way).

2B)  Use the phrase “conclusions and recommendations” when referring to reliability and validity because you’ll want to avoid issues surrounding data collection procedures. The data collection procedures are highly standardized – they are likely to be reliable-stable in the data they produce – it’s the interpretation of the data to reach conclusions and recommendations that is at issue.  What is being set up by this line of questions is a second line of question regarding what constructs and principles from professional psychology did the child custody evaluator apply to the interpretation of the data – this second line will be a key line of questioning.

3.)  Expose that the conclusions and recommendations of the child custody evaluator are simply the opinions of one psychologist and may not represent the opinions of other psychologists who would review the data;

3A.) Q: “So there’s no way of knowing whether your opinions represent the opinions of other psychologists, or whether a vast majority of other psychologists would disagree with your conclusions and recommendations, there’s simply no way of knowing that is there?”

4.)  Expose that the conclusions and recommendations of the child custody evaluator are simply the opinions of one psychologist and may be biased by the personal attitudes and beliefs of the evaluator.

4A.) This sets up a second line of questions regarding what established constructs from professional psychology were applied in interpreting the data (not collecting the data; interpreting the data) as a means to limit the potential introduction of bias.

4B.) The custody evaluator may try to answer the bias question by pointing out the standardized collection of data.  That’s irrelevant.  The issue is NOT the collection of data, it’s the interpretation of data.  The cross-examination seeks to expose that NO established principles of professional psychology (specifically, principles from family systems theory; triangulation, cross-generational coalition, inverted hierarchy, emotional cutoff – and attachment theory) were applied to interpreting the data.  This will be addressed in the second line of questioning.

The second part of this scientific foundation line of questioning is about the construct of “validity.”  It’s a short line of questions, but on the same topic area of undercutting the scientific foundation for the practice of child custody evaluation.  The emperor has no clothes.

I’ll cover issues of “validity” (construct validity; content validity; predictive validity; concurrent validity; discriminant validity) in a future blog post, but essentially the issue is that no studies have ever been conducted to establish the “validity” for the conclusions and recommendations of child custody evaluations.

There is no established scientific validity to the conclusions and recommendations of child custody evaluations.  None.  Zero.  Nothing.  The emperor has no clothes.

A Monkey Throwing Darts

Child custody evaluations are voodoo assessment. Rattle some beads (data collection procedures), recite some “magical” incantations (write a report with “psychology-sounding” words), and read the entrails of a goat (offer conclusions and recommendations from the “spirit world” of professional psychology).

But as for the scientifically established validity (truth and accuracy) for the conclusions and recommendations of child custody evaluations… we might as well have a monkey throwing darts at a dartboard.

Seriously, neither the monkey throwing darts nor child custody evaluations have any data whatsoever regarding the reliability and validity of these respective “assessment” procedures.  And at least the monkey throwing darts approach would be much cheaper, and probably more entertaining.

Q: “Dr. So-n-So, if we had a monkey throwing darts at a dartboard regarding various custody time-share options, where in the scientific literature is there evidence that the conclusions and recommendations reached by child custody evaluations are more reliable and any more valid than the outcome of a monkey throwing darts at a dartboard?”

A: There is no evidence from the scientific literature that the conclusions and recommendations from child custody evaluations are any more reliable or valid than the conclusions and recommendations reached by a monkey throwing darts at a dartboard.

Again, for all the advocates who are in favor of the “assessment” practice of child custody evaluations, there is a Comment section on this blog.  Feel free to prove me wrong.  Cite for me a single research study demonstrating the inter-rater reliability and construct validity, or content validity, or predictive validity, or convergent validity, or discriminant validity for the conclusions and recommendation provided by child custody evaluations.

<crickets>

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

I want to make a quick announcement. 

I learned that my blog has been nominated for inclusion in The Expert Institute’s Best Legal Blog Contest.

The voting site for the contest is at:

Best Legal Blog Contest Voting

What’s The Expert Institute, you might ask?  I don’t know.

And honestly, I don’t care all that much either.  Any solution that involves having targeted parents prove “parental alienation” in court is no solution at all.  Proving “parental alienation” in the legal system is far too expensive for most targeted parents to afford and it takes far to long.  Time is on the side of the pathogenic parent.  The pathogenic parent can delay and delay legal proceedings for years.

The solution to “parental alienation” is through the mental health system:

The Solution

I’m working on the solution for all children and all families, not just one family at a time. This solution will ultimately be through fixing the broken mental health system, not the legal system. But until we fix the mental health system response, there’s little alternative for targeted parents other than proving “parental alienation” in court.

I’m sorry that professional psychology has so completely failed you.  The first step is to get all mental health professionals to properly assess for the pathology using the Diagnostic Checklist for Pathogenic Parenting.

Yet even as I work on the solution for all children and all families, I know that for each targeted parent this is a directly personal experience with your specific child. I realize that each targeted parent is trying to solve their problem today, now, before the mental health system has been fixed first. 

Based on this understandable motivation of individual targeted parents, I am sometimes asked to serve as an expert witness in court proceedings in hopes that my testimony about “triangulation” and “cross-generational coalitions” might be able to persuade the court.  I’m not optimistic about that.  The legal system response remains broken. But if your attorney thinks my expert testimony might be helpful and that’s a route you want to go, then your attorney can contact me by email and I will provide the attorney with additional information about my potential role as an expert consultant and witness.

(Just as an FYI regarding my expert testimony, I have found my testimony to be the most helpful when the mental health professional who is involved with your family has used the Diagnostic Checklist for Pathogenic Parenting and my testimony then addresses the meaning and implications of the symptom ratings made on the Diagnostic Checklist by the involved mental health professional.)

Again, however, my focus is not (yet) on fixing the broken legal system response.  My focus is on fixing the broken mental health system response for all children and all families in order to ensure that all children and all families receive appropriate assessment of the pathology, accurate diagnosis of the pathology, and effective treatment for the pathology of attachment-based “parental alienation” (AB-PA).

I suppose it’s nice that my blog has been nominated in a contest for the “Best Legal Blog.”  Getting the attention of the legal system regarding this form of attachment-related pathology is a good thing.

Craig Childress, Psy.D.
Psychologist, PSY 18857

Of all the symptoms displayed by the child, the absence of empathy is the most disturbing. The absence of empathy is associated with the capacity for human cruelty

I am a psychologist, not an attorney.  My opinions represent those of an old-school clinical psychologist, not an attorney.  But given the profoundly incompetent and professionally negligent practices surrounding mental health’s involvement with the family law system (sometimes called “court-involved therapy” or “court-involved mental health” services), I’d be open to collaborating with a legal team of substance in exploring the possibility of a class action lawsuit.

---

Negligent Professional Practice

In my non-legal view… the professional negligence involves the consistent and system-wide failure to apply standard and established constructs and principles of professional psychology to the professional work of court-involved mental health professionals working in the family law system, resulting in the system-wide failure by mental health professionals to appropriately and accurately diagnose child psychological abuse and respond with an appropriate child protection response consistent with their “duty to protect.”

As a result of a consistent and negligent disregard for the application of standard and established psychological constructs and principles to their work surrounding the family law system, mental health professionals are failing in their professional “duty to protect” children from psychological child abuse, resulting in significant and potentially irrevocable developmental harm to children, and in significant emotional and psychological trauma to parents.

Is a Test Case Needed?

The Tarasoff case in professional psychology explicated a mental health professional’s “duty to warn” the potential intended victims of violence.  A similar legal landmark case may be needed regarding the mental health professional’s “duty to protect” obligations surrounding the role of professional psychology in family law and child custody decisions made by the court which have profound and lasting impact on the family, centering on the application of standard and established constructs and principles in the diagnosis of child psychological abuse.

The pathology we are discussing (traditionally called “parental alienation” in the common culture but more accurately conceptualized as the trans-generational transmission of attachment trauma, mediated by the personalty disorder pathology of the allied parent), conceptually represents psychologically “killing” the targeted parent’s child.  Prior to the enactment of this severe form of delusional-psychiatric pathology by the allied parent, the other parent, the targeted parent, has a child.  After the enactment of this emotionally and psychologically brutal pathology, the targeted parent no longer has a child. This parent’s relationship with the child has been killed.  For all intents and purposes, this parent’s child has been psychologically murdered.

The consistent and negligent disregard by court-involved mental health professionals for the application of standard and established psychological constructs and principles to their work within the family law system is directly responsible for their failure to protect the child and targeted parent victims of this brutal emotional and psychological pathology. 

The psychological murder of one’s child – to lose completely one’s relationship with a beloved child – is a severe emotional and psychological trauma of profound proportions for the targeted parent; and for the child, the loss of a parent (the “psychological death” of this child’s parent for the child) can have profoundly negative developmental repercussions throughout the child’s life, including carrying this emotional and psychological trauma into the child’s own marriage and family. 

Standard and Established Constructs

The rejection of a parent is an attachment-related pathology. 

This form of brutal family pathology is driven by the narcissistic/borderline personalty disorder pathology of the allied parent, triggered by their perceived rejection and abandonment surrounding the divorce.

This form of brutal family pathology represents the child’s triangulation into the family conflict through the formation of a cross-generational coalition with one parent against the other parent.

These are standard and established forms of mental health pathology.

Because court-involved mental health professionals are involved in family matters of such profound consequence to the child and targeted parent, a high degree of professional expertise is expected in the relevant domains of pathology which they are tasked with assessing, diagnosing, and treating; i.e., attachment trauma and the trans-generational transmission of attachment trauma; the assessment and diagnosis of personality disorder pathology and its impact on family relationships, including the assessment and diagnosis of encapsulated delusional pathology emerging from the personality disorder pathology of the parent; and family systems constructs regarding the causal interrelationships of family behavior.

Child Psychological Abuse

The clinical psychology term for this form of family attachment-related pathology is pathogenic parenting by the allied narcissistic/(borderline) parent (patho=pathology; genic=genesis, creation).  Pathogenic parenting is the creation of significant psychopathology in the child through aberrant and distorted parenting practices.

Pathogenic parenting that is creating significant developmental pathology in the child (diagnostic indicator 1), personality disorder pathology in the child (diagnostic indicator 2), and delusional-psychiatric pathology in the child (diagnostic indicator 3) in order to meet the emotional and psychological needs of the parent, and that results in the loss for the child of a healthy attachment bond to a normal-range and affectionally available parent, represents a DSM-5 diagnosis of Child Psychological Abuse, Confirmed.

A mental health professional’s “duty to protect,” especially under circumstances of such profound developmental consequence to the child and emotional trauma for the parent who is targeted by this brutal family pathology, would seemingly engage the professional’s obligation to apply standard and established psychological principles and constructs in the assessment, diagnosis, and treatment of this pathology in order to fulfill the professional’s “duty to protect” relative to the psychological abuse of the child and the infliction of potentially lifelong emotional trauma on the targeted parent.

The failure to reasonably employ standard and established psychological principles and constructs (from attachment theory relative to an attachment-related pathology, from the field of personality disorder pathology relative to the impact of parental personality disorder pathology on the family, and from family systems theory relative to the interrelationship of causality for family behavior) would seemingly represent negligent professional practice. 

But that’s just my non-legal, psychologist opinion.  Maybe I’m wrong.  Maybe court-involved mental health professionals don’t need to know about the functioning and dysfunctioning of the attachment system when they treat attachment-related disorders.  Maybe court-involved mental health professionals don’t need to know about personality disorder pathology when they treat families whose relationships are being heavily influenced by parental personality disorder pathology.  Maybe court-involved mental health professionals don’t need to know about standard constructs from family systems theory when they are assessing, diagnosing, and treating families.

Maybe I’m wrong.  Maybe court-involved mental health professionals don’t need to properly diagnose child psychological abuse, even through V995.51 Child Psychological Abuse is a DSM-5 diagnosis and all mental health professionals are responsible for knowing and properly diagnosing all disorders in the DSM diagnostic system as a standard of professional practice.

Maybe I”m wrong… but personally, I don’t think so.  Personally, I think it’s negligent professional practice to so cavalierly disregard standard and established psychological constructs and principles in the assessment, diagnosis, and treatment of mental health pathology.  Personally, I think it’s negligent professional practice to not know what you’re doing.

Extended Responsiblity

Again, I’m not a legal professional.  But from where I sit as a simple clinical psychologist, it would seem that by providing professional “guidelines” for the practice of court-involved mental health, both the American Psychological Association (APA) and the Association of Family and Conciliation Courts (AFCC) have seemingly taken professional responsibility and provided their professional imprimature for the professional practices of court-involved mental health.  But, then again, maybe I’m wrong.

I can’t help but wonder though… in providing guidelines for the practice of court-involved mental health, would their imprimature for the practices surrounding court-involved mental health make the APA and AFCC legally liable for those practices?  I don’t know.  I’m just a psychologist.

However, if a legal team ever wanted to consider a class action lawsuit, I can certainly point out the relevant professional literature regarding attachment theory, personality disorder pathology, and family systems theory which, in my opinion, should reasonably be guiding professional practice in assessing, diagnosing, and treating an attachment-related pathology involving a potentially allied narcissistic/(borderline) parent in a cross-generational coalition with the child against the other parent following divorce.

(Attachment: Bowlby, Ainsworth, Mains, Sroufe, Fonagy, Ruth-Lyons; Bretherton; )

(Personality Disorder: Kernberg, Millon, Beck, Linehan; Dark Triad Personality)

(Family Systems: Bowen, Minuchin, Haley)

According to the ethical code of the American Psychological Association, mental health professionals are not allowed to be incompetent.  I would think this would extend to negligently incompetent.  Profoundly incompetent… resulting in the destruction of children’s lives and the destruction of parent-child relationships.  But what do I know.  Maybe I’m wrong.

---

Child Custody Evaluations

The professional practices surrounding court-involved mental health lack scientific and professional foundation in the established psychological principles and constructs of professional psychology.  For example, there is not a single research study establishing the validity of the conclusions and recommendations derived from child custody evaluations.  Not one.  Nothing.

No study demonstrating the face validity of the conclusions and recommendations of child custody evaluations.

No study demonstrating the content validity of the conclusions and recommendations of child custody evaluations.

No study demonstrating the construct validity of the conclusions and recommendations of child custody evaluations.

No study demonstrating the predictive validity of the conclusions and recommendations of child custody evaluations.

No study demonstrating the discriminant validity of the conclusions and recommendations of child custody evaluations.

Nothing.  Zero.  There is no scientifically established foundation for the validity of the conclusions and recomendations of child custody evaluations.

Nor is there any research study demonstrating the inter-rater reliability of the conclusions and recommendations of child custody evaluations.

If the results of an assessment are not reliable, they cannot, by definition, be valid.  So what is the data regarding the inter-rater reliability of the conclusions and recommendations from child custody evaluations?  There is none.  Nothing.  No data whatsoever.

There is no scientifically established foundation for the validity of the conclusions and recommendations of child custody evaluations.

But it’s even worse…

There are no operational definitions for the key constructs that are supposedly being assessed by child custody evaluations; the “best interests of the child” and “parental capacity.”  The absence of operational definitions for the key constructs of the assessment violates a basic tenet of professional assessment.

I want to be very clear on this, because I teach assessment, and I do assessment as a clinical psychologist.  I know assessment.  The absence of operational definitions for the key constructs of the assessment violates a basic tenet of professional assessment.

Prior to assessing for “intelligence” we must first define what we mean by the construct of “intelligence.”

Prior to assessing for “self-esteem,” we must first define what we mean by the construct of “self-esteem.”  This is a foundational tenet of professional assessment.

We are not allowed to assess first and then define the construct afterwards based on the results of our assessment because then the assessment would be subject to… wait for it… inherent bias.  If I define the construct after the assessment, then I can make the construct be whatever I want the results to be.  That’s not allowed.  We define the construct first, and then we assess.

Child custody evaluations violate this basic tenet of professional assessment practice by not first defining the meaning of the key constructs of the assessment; what represents the “best interests of the child” and what represents “parental capacity.”

Instead, these key constructs are defined idiosyncratically after-the-fact by the child custody evaluator.

In their analysis of child custody evaluations, Stahl and Simon (2013) describe the absence of any coherent operational definition for the key construct of the best interest of the child:

“A critical subject facing those working in the field of family law, whether they are legal professionals or psychological professionals, is the concept of the best interests of the children.  Even recognized experts in this concept differ with regard to what it means, how it should be determined, and what factors should be considered in determining what is in the best interest of a child.  Thus, this ubiquitous term escapes consensus and remains fundamentally vague.” (Stahl & Simon, 2013, p. 10-11)

If you have not defined the central construct of the assessment PRIOR to the assessment, then the assessment lacks scientific credibility.  You can’t just do an “assessment” and then make up what it means after-the-fact based on personal whims and biases (this form of bias is called “counter-transference” in the clinical psychology literature).

Bias:  Counter-Transference

Q:  If a child custody evaluator has “mother-issues” or “father-issues” from his or her own childhood and family of origin, what protection is there that these buried psychological issues from the evaluator’s own childhood won’t influence his or her interpretation of the data? 

A:  None.  There are no protections whatsoever against this subtle but pervasive – and indeed expectable – form of bias from entering into the current practice of child custody evaluations.

Q:  Is it possible that these “mother-issues” or “father-issues” from the evaluator’s own childhood might color the evaluator’s interpretations of the data from the child custody evaluation? 

A:  Yes.  Absolutely. In fact, from all the scientific research on schemas and internal working models within the attachment system, it is extremely likely that these subtle forms of personal bias will influence the evaluator’s interpretation of the data.  This form of inherent bias should be expected.

Q:  Child custody evaluators are typically confronted with differing and conflicting narratives about what is occurring within the family.  What protections are there that the potential “mother-issues” or “father-issues” of the evaluator won’t influence the evaluator toward accepting and co-constructing a narrative of the family conflict influenced by the evaluator’s own family-of-origin issues? 

A:  There are no protections against this form of bias whatsoever.  And this bias can be 100% unconscious for the evaluator.  The evaluator may 100% believe that he or she is being “objective” because the source of the bias in the family-of-origin issues of the child custody evaluator can be unconscious.   This is called “counter-transference” in the psychological literature.

The protection against this form of inherent, 100% expectable, and likely pervasive “counter-transference” bias in ALL child custody evaluations is to follow the standard and established professional practices for creating assessment protocols:

1.)  Operational Definition:  Operationally DEFINE the construct being assessed in terms of how the construct is to be measured – whether it’s “intelligence,” or “self-esteem,” or the “best interests of the child” in the case of child custody evaluations.

2.)  Construct the Protocol to the Operational Definition:  Construct the collection of data to address the operational definition of the construct by defining how the data leads to a conclusion about the construct (e.g., high scores compared to the general population on a visual puzzle task are evidence of the construct of “intelligence” – endorsing a pre-specified level of positive or negative self-statements from a list of positive, negative, and neutral self-statements is evidence for the construct of positive or negative “self-esteem.”).

3.)  Establish the Reliability and Validity of the Protocol:  Collect reliability and validity data on the assessment protocol.  In the case of child custody evaluations, it would likely be inter-rater reliability data and at least face validity data (the assessment protocol superficially “looks like” it measures what it purports to measure). 

Construct and content validity data would be recommended.  This might involve subjecting the assessment protocol to a panel of experts to critique the operational definition of the construct (construct validity) and whether the assessment protocol actually measures the definition of the construct (content validity).

Given the importance of the decisions involved for the family, predictive validity data for the assessment would be recommended.  This might involve follow-up assessments of family functioning regarding whether the assessment was successful in predicting outcome based on some pre-defined outcome criteria.

That’s how professional assessment practices protect against the introduction of inherent bias into the assessment practice.  Professional psychology knows how to construct assessments.  Child custody evaluations have followed none of these procedures.

---

Reunification Therapy

From what I can see, many, most, nearly all, court-involved therapists are simply making things up without reliance on any standard or established constructs of child development and family pathology, and then they are using vague psychological words to cover their nearly complete absence of the application of standard and established psychological principles and constructs from unknowing legal professionals and the general public, who unfortunately simply trust that the mental health professional knows what he or she is doing.

From what I can see, this public trust is unwarranted.

Take, for just one example, the ubiquitous use of the term “reunification therapy.”  There is no such thing as “reunification therapy.”  No such thing exists.  There is no model anywhere that has ever been defined or described about what “reunification therapy” is, what it entails, or or how it accomplishes “reunification.”   Nothing.  Zero.

The term “reunification therapy” is snake oil, pure and simple.  It’s a term that sounds like it has meaning when used by a mental health professional to a parent or attorney, but which, in truth, is an unknown concoction of unknowable ingredients that’s guaranteed to “cure what ails ya” but which actually winds up killing the patient.  Snake oil pure and simple.  It allows mental health professionals to do whatever they want, without any reference to established psychological or psychotherapeutic models, under the guise of so-called “reunification therapy.”

“Reunification therapy” doesn’t exist.  There is not one professional description of what “reunification therapy” entails.  Zero.  Nothing.  If any mental health professional uses the term “reunification therapy,” ask for a citation reference to the theorist who describes what “reunification therapy” is.

Parent or Attorney:  I’d like to know more about reunification therapy.  Can you please direct me to a book or author who describes the process of reunification therapy.

MH Professional:  Well, that’s just a term we use to describe this, and there isn’t really one place that… obfuscate, double-talk.  Bottom-line… no reference.

The correct psychological term for the therapy is family systems therapy.  Family systems therapy is fully defined and described by such preeminent figures in professional psychology as Murray Bowen, Salvador Minuchin, Jay Haley, Chloe Madanes, Virginia Satir, and others.  Family systems therapy describes both the origin of the family relationship problem and its solution.

Family systems therapy is one of the four primary schools of psychotherapy (the others being psychoanalytic, cognitive-behavioral, and humanistic-existential), and family systems therapy is the only school of psychotherapy that deals with resolving current interpersonal relationships within the family – the others are all forms of individual therapy.  Family system therapy is the correct and applicable model to use in conceptualizing and resolving family-related problems.

I’m a clinical psychologist.  I teach models of psychotherapy.  I know what I’m talking about.

Central to family systems therapy is the construct of the triangle; the child is being triangulated into the spousal conflict.  This is the technical clinical psychology term for the child being “put in the middle.”

There are two forms of triangulation.  In one, the parents unite to form a coalition against the child.  This occurs when the level of inter-spousal conflict threatens to tear the marriage apart in divorce, so the child develops symptoms that divert and distract the parents’ attention away from the spousal conflict over onto the child’s behavior problems.  The child (who is called the “identified patient” in this form of triangulation) develops a symptom in order to bring the parents together in their shared concern over the child’s symptom, thereby saving the marriage by diverting the attention and conflict away from the marital conflict and onto the child.

The second type of triangulation is a cross-generational coalition in which one parent forms a coalition with the child against the other parent.  This is the type of triangulation involved in the pathology traditionally called “parental alienation” in the general-culture.  It is a cross-generational coalition of one parent (the allied and supposedly “favored” parent) against the other parent (the targeted and rejected parent).

From a professional diagnostic standpoint, this is no big deal.  This is all standard and fully established principles of family therapy that are amply described and explained in the family systems literature.

But from what I see, many, most, nearly all court-involved mental health professionals do not rely on family systems constructs in their case conceptualization, diagnosis, and treatment.  Instead, they just make stuff up based on their whims and fancies.  But then they use the term “reunification therapy” to hide from parents and legal professionals that they’re actually just making stuff up.  By using vaguely defined terms that sound as if they had meaning, these court-involved therapists can essentially make up whatever they want and do whatever they want, in complete ignorance and without any reference to any standard principles or constructs of professional psychology.

Oh, and by the way, did I mention that court-involved mental health professionals can make a lot of money off of this, because families are so desperate for solutions and the court often mandates the family’s participation in court-involved mental health services.  Hmmm, who reviews the practices of court-involved mental health professionals?  Oh, other court-involved mental health professionals.  Sweet deal.

But I have a question, by providing guidelines and, through these guidelines, their official imprimature for the practice of court-involved mental health services, do the APA and AFCC incur any liability for the system-wide negligent conduct of court-involved mental health services?  Maybe not.  What do I know.  I’m just a psychologist.

---

Standard and Established Constructs

A child’s rejection of a parent is an attachment-related pathology.  The attachment system is the brain system for managing all aspects of love and bonding throughout the lifespan, including grief and loss.

Court-involved mental health professionals should therefore be relying on constructs from attachment theory – a fully established and well-researched domain of professional psychology – for the application of standard and established psychological principles and constructs.

In the pathology traditionally called “parental alienation” in the common-culture, the child is being triangulated into the spousal conflict through the formation of a cross-generational coalition with one parent against the other parent.

Court-involved mental health professionals should therefore be relying on constructs from family systems therapy – a fully established and well-documented domain of professional psychology – for the application of standard and established psychological principles and constructs.

The pathology traditionally called “parental alienation” in the common-culture represents the trans-generational transmission of attachment trauma from the childhood of a narcissistic/(borderline) parent to the current family relationships, mediated by the personality disorder pathology of the narcissistic/(borderline) parent which is itself a product of the childhood attachment trauma of this parent.

Court-involved mental health professionals should therefore be relying on constructs from personalty disorder pathology – a fully established and well-documented domain of professional psychology – for the application of standard and established psychological principles and constructs.

Pathogenic parenting that is creating significant developmental pathology in the child (diagnostic indicator 1), personality disorder pathology in the child (diagnostic indicator 2), and delusional-psychiatric pathology in the child (diagnostic indicator 3) in order to meet the emotional and psychological needs of the parent represents a DSM-5 diagnosis of V995.51 Child Psychological Abuse, Confirmed.

Court-involved mental health professionals should therefore be relying on constructs from the DSM-5 diagnostic system – a fully established professional diagnostic system – for the application of standard and established psychological principles and constructs.

But that’s just the non-legal opinion of a clinical psychologist.

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

References

Stahl, P.M. and Simon, R.A. (2013). Forensic Psychology Consultation in Child Custody Litigation: A Handbook for Work Product Review,Case Preparation, and Expert Testimony, Chicago, IL: Section of Family Law of the American Bar Association.

 

The pathology typically called “parental alienation” in the popular culture is NOT some “new form” of pathology.  It is all standard and established stuff.

Rejection of a parent is an attachment-related pathology.

The attachment system is the brain system that manages all aspects of love and bonding throughout the lifespan, including grief and loss.

Within attachment theory (Bowlby, 1969, 1973, 1980), this family attachment-related pathology would be considered a form of “pathological mourning” surrounding the divorce.

“The deactivation of attachment behavior is a key feature of certain common variants of pathological mourning.” (Bowlby, 1980, p. 70)

The pathology is fundamentally the inability of the family (of the narcissistic/(borderline) parent within the family) to process the grief and loss surrounding the divorce.  Instead, the narcissistic/(borderline) personality transforms the sadness and grief into anger and resentment, loaded with revengeful wishes:

“They [narcissists] are especially deficient in genuine feelings of sadness and mournful longing; their incapacity for experiencing depressive reactions is a basic feature of their personalities.  When abandoned or disappointed by other people they may show what on the surface looks like depression, but which on further examination emerges as anger and resentment, loaded with revengeful wishes, rather than real sadness for the loss of a person whom they appreciated.” (Kernberg, 1975, p. 229)

The characterological inability of the narcissistic/(borderline) personality to process sadness and grief creates the “pathological mourning” and “deactivation of attachment behavior” in the family – in the child – through the child’s cross-generational coalition with this parent.

Cross-Generational Coalition: “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; emphasis added)

This is not some “new form” of pathology.  We already know exactly what it is.  It’s just that many, most, almost all, current mental health professionals are simply incompetent.  They are misdiagnosing the pathology.

(Gardnerian PAS experts… are you correctly diagnosing the pathology?)

The personality pathology of the allied parent is the product of childhood attachment trauma (a disorganized attachment) that coalesced in late adolescence and early adulthood into their narcissistic and borderline personality traits.

“Disturbances of personality, which include a bias to respond to loss with disordered mourning, are seen as the outcome of one or more deviations in development that can originate or grow worse during any of the years of infancy, childhood and adolescence.” (Bowlby, 1980, p. 217)

The rejection and abandonment by the attachment figure of the spouse surrounding the divorce reactivates the “internal working models” (the schemas) of the childhood attachment trauma for the narcissistic/(borderline) personality parent.

Internal Working Models

“No variables, it is held, have more far-reaching effects on personality development than have a child’s experiences within his family: for, starting during the first months of his relations with his mother figure, and extending through the years of childhood and adolescence in his relations with both parents, he builds up working models of how attachment figures are likely to behave towards him in any of a variety of situations; and on those models are based all his expectations, and therefore all his plans for the rest of his life.” (Bowlby, 1980, p. 369; emphasis added).

“Every situation we meet within life is construed in terms of the representational models we have of the world about us and of ourselves.  Information reaching our sense organs is selected and interpreted in terms of those models, its significance for us and for those we care for is evaluated in terms of them, and plans of action conceived and executed with those models in mind.” (Bowlby, 1980, p. 229; emphasis added)

Schemas

“How a situation is evaluated depends in part, at least, on the relevant underlying beliefs.  These beliefs are embedded in more or less stable structures, labeled “schemas,” that select and synthesize incoming data.” (Beck, et al., 2004, p. 17)

“The content of the schemas may deal with personal relationships, such as attitudes toward the self or others, or impersonal categories… When schemas are latent, they are not participating in information processing; when activated they channel cognitive processing from the earliest to the final stages… When hypervalent, these idiosyncratic schemas displace and probably inhibit other schemas that may be more adaptive or more appropriate for a given situation.  They consequently introduce a systematic bias into information processing.” (Beck, et al., 2004, p. 27)

“In personality disorders, the schemas are part of normal, everyday processing of information.” (Beck, et al., 2004, p. 27)

“Arntz (1994) hypothesized that childhood traumas underlie the formation of core schemas, which in their turn, lead to the development of BPD [borderline personality disorder].” (Beck, et al., 2004, p 192)

“BPD patients process information through a specific set of three core beliefs or schemas of themselves and others, i.e., ‘I am powerless and vulnerable’, ‘I am inherently unacceptable’, and ‘Others are dangerous and malevolent’.  Needing support in a dangerous world but not trusting others brings BPD patients into a state of hypervigilance.  Schema-specific information is highly prioritized or difficult to inhibit in this state, resulting in biases in early information processing phases.” (Sieswerda, Arntz, Mertens, & Vertommen, 2006, p. 1011)

“Patients with BPD were characterized by higher self-reports of beliefs, emotions, and behaviors related to the four pathogenic BPD modes (detached protector, abandoned/abused child, angry child, and punitive parent mode).” (Beck, et al., 2004, p 192)

The “internal working models” for the childhood attachment trauma of the narcissistic/(borderline) parent are in the pattern, “abusive parent“/”victimized child“/”protective parent“

“Young elaborated on an idea, in the 1980s introduced by Aaron Beck in clinical workshops, that some pathological states of patients with BPD are a sort of regression into intense emotional states experienced as a child.  Young conceptualized such states as schema modes… Young hypothesized that four schema modes are central to BPD: the abandoned child mode (the present author suggests to label it the abused and abandoned child); the angry/impulsive child mode; the punitive parent mode, and the detached protector mode.” (Beck, et all, 2004, p. 199)

“One primary transference-countertransference dynamic involves reenactment of familiar roles of victim–perpetrator–rescuer-bystander in the therapy relationship.  Therapist and client play out these roles, often in complementary fashion with one another, as they relive various aspects of the client’s early attachment relationships.” (Pearlman & Courtois, 2005, p. 455)

These patterns of “internal working models” become overlaid onto the current family members.  The current child is assigned the role as the supposedly “victimized child,” the targeted parent is assigned the trauma reenactment role as the “abusive parent,” and the allied narcissistic/(borderline) parent adopts and conspicuously displays to others the coveted role as the all-wonderful “protective parent.”

The “bystander role” is assigned to the various mental health professionals, attorneys, parenting coordinators, judges, and school personnel whose role becomes to validate and legitimize the false trauma reenactment narrative created by the narcissistic/(borderline) parent.

The trauma-roles (the “internal working models” of attachment trauma) are all in place to reenact the childhood trauma of the narcissistic/(borderline) parent into the current family relationships. All that’s required to initiate the trauma reenactment narrative is to convince the child through manipulative communication techniques to adopt the role of “victimized child” relative to the parenting practices of the targeted parent.

This is important to understand… the rejection of the targeted parent is not created by the allied parent “bad-mouthing” and saying negative things about the other parent.  The child’s rejection of the targeted parent is created by convincing the child through manipulative techniques of subtle psychological influence and control to accept the role as the “victimized child.”  The allied narcissistic/(borderline) parent gets the child to believe that the child is being victimized by the supposedly inadequate, insensitive, and “abusive” parenting practices of the other parent.

This is accomplished by first eliciting from the child a complaint about the other parent through motivated and subtly directive questioning by the narcissistic/(borderline) parent.  Once the child offers a criticism, no matter how small, the narcissistic/(borderline) parent then responds with distorted and exaggerated displays of concern regarding the supposedly inadequate and insensitive parenting practices of the other parent, thereby distorting the normal-range parenting practices of the targeted parent into supposed evidence of “abusive” parental inadequacy – “Oh you poor thing.  I can’t believe the other parent treats you so horribly.”  The key is to convince the child that the child is a “victim” of the other parent’s inadequate and insensitive parenting. 

To all external appearances, however, the allied narcissistic/(borderline) parent is not “badmouthing” the other parent; it’s the child who is criticizing the other parent.  The allied narcissistic/(borderline) parent presents as simply being a nurturing and protective parent (or so it appears) – “I’m just listening to the child.”  Manipulative, manipulative, manipulative.  The narcissistic/(borderline) parent is first eliciting a criticism from the child thorough motivated and directive questioning, and then is hiding their manipulation behind this elicited criticism – “I’m just listening to the child.  It’s not me, it’s the child who is saying these bad things about the other parent. I’m just listening to the child.”

The moment the child surrenders to the manipulation of the narcissistic/(borderline) parent and adopts the (false) “victimized child” role relative to the other parent, this immediately imposes the “abusive parent” role in the trauma reenactment narrative onto the targeted parent, irrespective of the targeted parent’s actual parenting behavior, and the child’s presentation as the “victimized child” allows the narcissistic/(borderline) parent to adopt and conspicuously display to the “bystanders” the coveted role as the all-wonderful “protective parent.”

But none of this created storyline is true. It is all a kabuki theater display of a false drama created in the childhood trauma of the narcissistic/(borderline) parent, embedded in the internal working models – the schemas – of this parent’s attachment networks.  It is a reenactment of childhood attachment trauma into the current family relationships.

“Reenactments of the traumatic past are common in the treatment of this population and frequently represent either explicit or coded repetitions of the unprocessed trauma in an attempt at mastery.  Reenactments can be expressed psychologically, relationally, and somatically and may occur with conscious intent or with little awareness.” (Pearlman & Courtois, 2005, p. 455; emphasis added)

“Freud suggests that overwhelming experience is taken up into what passes as normal ego and as permanent trends within it’ and, in this manner, passes trauma from one generation to the next.  In this way, trauma expresses itself as time standing still…  Traumatic guilt — for a time buried except through the character formation of one generation after the next — finds expression in an unconscious reenactment of the past in the present.” (Prager, 2003, p. 176; emphasis added)

“Victims of past trauma may respond to contemporary events as though the trauma has returned and re-experience the hyperarousal that accompanied the initial trauma.” (Trippany, Helm, & Simpson, 2006, p. 100)

“When the trauma fails to be integrated into the totality of a person’s life experiences, the victim remains fixated on the trauma.  Despite avoidance of emotional involvement, traumatic memories cannot be avoided: even when pushed out of waking consciousness, they come back in the form of reenactments, nightmares, or feelings related to the trauma… Recurrences may continue throughout life during periods of stress.” (van der Kolk, 1987, p. 5; emphasis added)

None of this trauma reenactment narrative is true.  The child is not a victim.  The targeted parent is not abusive.  And the narcissistic/(borderline) parent is not a protective parent.  None of it is true.

It is a fixed and false belief that is maintained despite contrary evidence.  It is a delusion.  An encapsulated delusion.  An encapsulated persecutory delusion.

Encapsulated Delusion:  “A delusion that usually relates to one specific topic or belief but does not pervade a person’s life or level of functioning.” (www.medilexicon.com)

Persecutory Delusion: “Delusions that the person (or someone to whom the person is close) is being malevolently treated in some way” (American Psychiatric Association; DSM-IV TR)

It is an encapsulated persecutory delusion.  This is called diagnosis.  This is not a theory.  The application of standard and established psychological constructs and principles – and, by the way, these are all scientifically validated and fully peer reviewed psychological constructs and principles – to a set of symptoms is called diagnosis.  Diagnosis.

This is not Dr. Childress saying this stuff, it’s some of the most respected figures in the field of professional psychology: Aaron Beck, John Bowlby, Otto Kernberg, Bessel van der Kolk, the American Psychiatric Association, and in a moment one of the top experts in personality disorder pathology, Theodore Millon.  This is all standard and fully established stuff.

This pathology represents an encapsulated persecutory delusion of a narcissistic/(borderline) parent that is being transferred to the child through the distorted parenting practices of the narcissistic/(borderline parent):

ICD-10 Diagnostic System of the World Health Organization. Diagnostic Description of a Shared Psychotic Disorder Diagnosis (F24): “A condition in which closely related persons, usually in the same family, share the same delusions.  A disorder in which a delusion develops in an individual in the context of close relationship with another person who already has that established delusion.”

This pathology is a delusional disorder – a shared delusional disorder.  It is a psychotic disorder created by the psychological collapse of a narcissistic/(borderline) personality surrounding the divorce.

From Theodore Millon:

“Under conditions of unrelieved adversity and failure, narcissists may decompensate into paranoid disorders.  Owing to their excessive use of fantasy mechanisms, they are disposed to misinterpret events and to construct delusional beliefs.  Unwilling to accept constraints on their independence and unable to accept the viewpoints of others, narcissists may isolate themselves from the corrective effects of shared thinking.  Alone, they may ruminate and weave their beliefs into a network of fanciful and totally invalid suspicions.  Among narcissists, delusions often take form after a serious challenge or setback has upset their image of superiority and omnipotence.  They tend to exhibit compensatory grandiosity and jealousy delusions in which they reconstruct reality to match the image they are unable or unwilling to give up.  Delusional systems may also develop as a result of having felt betrayed and humiliated.  Here we may see the rapid unfolding of persecutory delusions and an arrogant grandiosity characterized by verbal attacks and bombast.” (Millon, 2011, pp. 407-408; emphasis added).

This is NOT some “new form” of pathology.  We absolutely understand exactly what it is.

From the American Psychiatric Association; DSM-IV TR Shared Delusional Disorder:

“The essential features of Shared Psychotic Disorder (Folie a Deux) is a delusion that develops in an individual who is involved in a close relationship with another person (sometimes termed the “inducer” or “the primary case”) who already has a Psychotic Disorder with prominent delusions (Criteria A).” (American Psychiatric Association, 2000, p. 332)

“Usually the primary case in Shared Psychotic Disorder is dominant in the relationship and gradually imposes the delusional system on the more passive and initially healthy second person.  Individuals who come to share delusional beliefs are often related by blood or marriage and have lived together for a long time, sometimes in relative isolation.  If the relationship with the primary case is interrupted, the delusional beliefs of the other individual usually diminish or disappear.  Although most commonly seen in relationships of only two people, Shared Psychotic Disorder can occur in larger number of individuals, especially in family situations in which the parent is the primary case and the children, sometimes to varying degrees, adopt the parent’s delusional beliefs.” (American Psychiatric Association, 2000,p. 333; emphasis added)

“especially in family situations in which the parent is the primary case and the children, sometimes to varying degrees, adopt the parent’s delusional beliefs.”

This is NOT some “new form” of pathology.  We absolutely 100% understand what this pathology is.  It’s simply that some – many – most – nearly all – mental health professionals are misdiagnosing the pathology because of their profound professional ignorance and incompetence.

A psychotic disorder is sitting right in front of them in their offices, right there, in the chair right across from them, and they are entirely missing the diagnosis of a psychotic disorder sitting right in front of them.  Incompetence, incompetence, incompetence.  Profound professional incompetence.  A psychotic disorder.  Inexcusable.

This is NOT some “new form of pathology.”  We absolutely know what it is.  It’s just that profound professional incompetence is entirely missing the diagnosis of a psychotic pathology that is sitting right in front of them.

The pathology commonly referred to as “parental alienation” in the common culture represents an encapsulated persecutory delusion of a narcissistic/(borderline) parent that is being transferred to the child by the manipulative psychological influence and distorted pathogenic parenting practices of the allied narcissistic/(borderline) parent in a cross-generational coalition with the child.

The pathology commonly referred to as “parental alienation” in the common culture represents the trans-generational transmission of attachment trauma from the childhood of the allied narcissistic/(borderline) parent to the current family relationships (through the creation of a false trauma reenactment narrative), mediated by the personality disorder pathology of the narcissistic/(borderline) parent which is itself a product of this parent’s childhood attachment trauma.

It is an attachment-related pathology.  It is a trauma-related pathology.  It is a delusional-psychotic pathology.

The complexity of this attachment-related, trauma-related, and personality disorder pathology warrants the designation of children and families evidencing this form of pathology as a “special population” requiring specialized professional knowledge and expertise to competently assess, diagnose and treat.

Failure to possess the necessary professional competence in attachment-related pathology, trauma-related pathology, and personality disorder pathology required to properly assess, accurately diagnose, and effectively treat this form of attachment-related, trauma-related, and personality disorder pathology would very likely represent practice beyond the boundaries of professional competence in violation of Standard 2.01a of the APA ethics code.

Failure to properly assess for this form of attachment-related pathology, trauma-related pathology, and personality disorder pathology would likely represent a violation of Standard 9.01a of the APA ethics code which requires that “Psychologists base the opinions contained in their… diagnostic or evaluative statements, including forensic testimony, on information and techniques sufficient to substantiate their findings.”  If the psychologist has not even assessed for the attachment trauma pathology of a shared encapsulated delusion (the false trauma reenactment narrative), then the diagnostic statements (or forensic testimony) of the psychologist cannot possibly be based on “information and techniques sufficient to substantiate their findings.”

Diagnostic Checklist for Pathogenic Parenting

Pathogenic parenting that is creating significant developmental pathology in the child (diagnostic indicator 1), personality disorder pathology in the child (diagnostic indicator 2), and delusional-psychiatric pathology in the child (diagnostic indicator 3) in order to meet the emotional and psychological needs of the parent represents a DSM-5 diagnosis of V995.51 Child Psychological Abuse, Confirmed.

Pathogenic parenting is not a child custody issue; it is a child protection issue.

Because of their profound professional incompetence, many, far too many, mental health professionals are colluding with the psychological abuse of children.

Holding Mental Health Accountable

Targeted parents must begin holding ALL mental health professionals accountable to standards of professional competence (Standards 9.01a and 2.01a of the APA ethics code).  Mental health professionals are NOT ALLOWED to be incompetent.  It’s not me saying this, it’s the American Psychological Association saying it.  Mental health professionals are not allowed to be incompetent.

All actively incompetent mental health professionals must be made to understand that they will – with 100% certainty – face a licensing board complaint for their professional incompetence when they fail to properly assess and accurately diagnose this form of attachment-related, trauma-related, and personality disorder pathology.

I don’t care what the licensing board chooses to do.  If they choose to collude with the psychological abuse of children by allowing professional incompetence, there is nothing we can do about that.  But we need to make it clear to every single mental health professional that they are playing Russian roulette with their license. 

“Did the licensing board do anything this time?  No?  Lucky you.  How about this time, did the licensing board do anything this time?  No?  Lucky you.  How about this time, did the licensing board do anything this time?…”

We need to make all actively incompetent mental health professionals play Russian roulette with their professional career.  There may not be a bullet in the chamber this time, but what about the next board complaint, and the next one, and the next one…

We will not abandon the children to professional incompetence.  We will fight.  We will fight with Standards 2.01a requiring professional competence, and we will fight with Standard 9.01a requiring appropriate assessment.  These are the professional practice Standards of the American Psychological Association.  These Standards belong to you.  They are to protect you.  Use them.

Eventually, the licensing boards will begin to grow weary of colluding with professional incompetence, eventually the licensing boards will grow uncomfortable allowing the psychological abuse of children. 

We will not abandon your children. 

We will not stop and we will not relent until we have achieved professional competence in the professional assessment and diagnosis of this attachment-related, trauma-related, and personality disorder pathology. 

This is not a “new form” of pathology.  We know exactly what it is.  We just need an accurate diagnosis.

Pathogenic parenting that is creating significant developmental pathology in the child (diagnostic indicator 1), personality disorder pathology in the child (diagnostic indicator 2), and delusional-psychiatric pathology in the child (diagnostic indicator 3) in order to meet the emotional and psychological needs of the parent represents a DSM-5 diagnosis of V995.51 Child Psychological Abuse, Confirmed.

This is not a child custody issue; it is a child protection issue.

Craig Childress, Psy.D.
Psychologist, PSY 18857

References

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (Revised 4th ed.). Washington, DC: Author.

Beck, A.T., Freeman, A., Davis, D.D., and Associates (2004). Cognitive therapy of personality disorders. (2nd edition). New York: Guilford.

Bowlby, J. (1969). Attachment and Loss: Vol. 1. Attachment. 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.

Haley, J. (1977). Toward a theory of pathological systems. In P. Watzlawick & J. Weakland (Eds.), The interactional view (pp. 31-48). New York: Norton.

Kernberg, O.F. (1975). Borderline conditions and pathological narcissism. New York: Aronson.

Pearlman, C.A., Courtois, C.A. (2005). Clinical applications of the attachment framework: Relational treatment of complex trauma. Journal of Traumatic Stress, 18, 449-459.

Prager, J. (2003). Lost childhood, lost generations: the intergenerational transmission of trauma.  Journal of Human Rights, 2, 173-181.

Sieswerda, S., Arntz, A., Mertens, I., and Vertommen, S. (2006). Hypervigilance in patients with borderline personality disorder: Specificity, automaticity, and predictors. Behavior Research and Therapy, 45, 1011-1024.

Trippany, R.L., Helm, H.M. and Simpson, L. (2006). Trauma reenactment: Rethinking borderline personality disorder when diagnosing sexual abuse survivors. Journal of Mental Health Counseling, 28, 95-110.

van der Kolk, B.A. (1987). The separation cry and the trauma response: Developmental issues in the psychobiology of attachment and separation. In B.A. van der Kolk (Ed.) Psychological Trauma (31-62). Washington, D.C.: American Psychiatric Press, Inc.

The term “parental alienation” is not a defined construct in clinical psychology.  It is a term used in the popular culture to refer to a child’s rejection of a normal-range and affectionally available parent surrounding high-conflict divorce.

Attachment-Related Pathology

The rejection of a parent is an attachment-related pathology.  The attachment system is the brain system for managing all aspects of love and bonding throughout the lifespan – including grief and loss experiences such as occurs through divorce.

The pathology called “parental alienation” in the common culture is an attachment-related pathology. 

Therefore, all mental health professionals involved in the assessment, diagnosis, and treatment of this form of family pathology must have a strong clinical expertise in the attachment system; its characteristic functioning and its characteristic dysfunctioning.

The pathology called “parental alienation” represents a form of “disordered mourning” (Bowlby, 1980) within the family in which the emotions of sadness and grief surrounding the divorce are being translated into “anger and resentment, loaded with revengeful wishes” (Kernberg, 1975, p. 229).

“Disturbances of personality, which include a bias to respond to loss with disordered mourning, are seen as the outcome of one or more deviations in development that can originate or grow worse during any of the years of infancy, childhood and adolescence.” (Bowlby, 1980, p. 217)

“The deactivation of attachment behavior is a key feature of certain common variants of pathological mourning.” (Bowlby, 1980, p. 70)

Family Systems Pathology

The pathology called “parental alienation” in the common culture involves family relationships.  The child is being triangulated into the spousal conflict through the formation of a cross-generational coalition with one parent against the other parent (Haley, 1977; Minuchin, 1974). 

The pathology called “parental alienation in the common culture is a family systems pathology.  All mental health professionals involved in the assessment, diagnosis, and treatment of this form of family systems pathology must have a strong clinical expertise in family systems therapy, particularly the recognition, diagnosis, and treatment surrounding a cross-generational coalition in the family.

Parental Personality Pathology

The pathology called “parental alienation” in the common culture is created by the narcissistic and borderline personality traits of the allied parent (particularly projection and splitting) that become activated by the inherent rejection (and abandonment) surrounding the divorce.

The addition of the splitting pathology from the allied narcissistic/(borderline) parent to a cross-generational coalition with the child transmutes an already pathological cross-generational coalition into a particularly malignant form in which the child seeks to entirely terminate the child’s relationship with the targeted parent.

Splitting pathology cannot accommodate to ambivalence (Juni, 1995).  As a result of the splitting pathology of the narcissistic/(borderline) parent who is allied with the child, when the spouse becomes an ex-spouse (an ex-husband or ex-wife), this now ex-spouse must also become an ex-parent as well (an ex-father or ex-mother) in order to maintain the consistency imposed by the splitting pathology of the narcissistic/(borderline) parent who is allied with the child in a cross-generational coalition. 

The pathology called “parental alienation” in the common culture is a consequence of parental personality pathology (narcissistic and borderline personality traits) that is severely distorting family relationships following the rejection and abandonment of this parent surrounding the divorce.  All mental health professionals involved in the assessment, diagnosis, and treatment of this form of family pathology must have a strong clinical expertise in the recognition of narcissistic and borderline personality pathology, including role-reversal relationships, manipulation and exploitation of others, and delusional distortions to their perception of relationships, that are characteristics of the narcissistic and borderline personality organizations.

Attachment Trauma Pathology

The personality disorder pathology of the allied parent represents the coalesced product of childhood attachment trauma (disorganized attachment).  This childhood attachment trauma of the narcissistic/(borderline) parent is embedded in the “internal working models” (schemas) of this parent’s attachment system in the pattern of:

“abusive parent”/”victimized child”/”protective parent”

This attachment pattern from childhood has become reactivated in the attachment system of the narcissistic/(borderline) parent due to the loss surrounding the divorce, and this attachment pattern from childhood is being imposed on the current family members by the pathology of the narcissistic/(borderline) parent in a reenactment of the childhood trauma narrative:

Abusive parent = targeted parent

Victimized child = the current child

Protective parent = the role adopted by the allied narcissistic/(borderline) parent

But this is a false narrative born in the childhood attachment trauma of the narcissistic/(borderline) parent.  It’s not true.  The targeted parent is not abusive.  The child is not a victim.  And the narcissistic/(borderline) parent is not a protective parent.  None of this is true.  It’s a delusion.  A false narrative created in the childhood attachment trauma of the narcissistic borderline parent.

“Reenactments of the traumatic past are common in the treatment of this population and frequently represent either explicit or coded repetitions of the unprocessed trauma in an attempt at mastery.  Reenactments can be expressed psychologically, relationally, and somatically and may occur with conscious intent or with little awareness. One primary transference-countertransference dynamic involves reenactment of familiar roles of victim-perpetrator-rescuer-bystander in the therapy relationship.  Therapist and client play out these roles, often in complementary fashion with one another, as they relive various aspects of the client’s early attachment relationships.” (Pearlman & Courtois, 2005, p. 455)

It is a false trauma reenactment narrative, transferred from the childhood of the narcissistic/(borderline) parent into the current family relationships.  This false trauma reenactment narrative represents an encapsulated delusion (google the term encapsulated delusion).

One of the leading experts on personality pathology, Theodore Millon, describes how the narcissistic personality collapses into delusional beliefs under stress:

“Under conditions of unrelieved adversity and failure, narcissists may decompensate into paranoid disorders.  Owing to their excessive use of fantasy mechanisms, they are disposed to misinterpret events and to construct delusional beliefs.  Unwilling to accept constraints on their independence and unable to accept the viewpoints of others, narcissists may isolate themselves from the corrective effects of shared thinking.  Alone, they may ruminate and weave their beliefs into a network of fanciful and totally invalid suspicions.  Among narcissists,delusions often take form after a serious challenge or setback has upset their image of superiority and omnipotence.  They tend to exhibit compensatory grandiosity and jealousy delusions in which they reconstruct reality to match the image they are unable or unwilling to give up.  Delusional systems may also develop as a result of having felt betrayed and humiliated.  Here we may see the rapid unfolding of persecutory delusions and an arrogant grandiosity characterized by verbal attacks and bombast.” (Millon, 2011, pp. 407-408).

This pathology is a delusion, a false narrative, created in the unresolved childhood trauma of the parent and displayed for the benefit of “bystander” therapists and legal professionals.  All mental health professionals who are involved in assessing, diagnosing, and treating this form of delusional trauma reenactment pathology must possess an expertise in the recognition of encapsulated persecutory delusions associated with narcissistic and borderline personality pathology.

To create the false trauma reenactment narrative in the current family, all the narcissistic/(borderline) parent must do is manipulate the child into adopting the role as the “victimized child” in the false trauma reenactment narrative. 

Once the child adopts the role as the “victimized child,” this immediately imposes the “abusive parent” role onto the normal-range targeted parent, irrespective of the actual parenting practices of this parent.  The child’s role as the “victimized child” automatically places the targeted parent into the trauma reenactment role as the “abusive parent.”

And when the child adopts the role as the “victimized child,” this also allows the allied narcissistic/(borderline) parent to then adopt and conspicuously display to others the coveted role as the all-wonderful “protective parent.”  The moment the child is manipulated into adopting the false “victimized child” role in the trauma reenactment narrative, then both of the other trauma reenactment roles are immediately assigned to the respective parents and the stage is set for the reenactment of the childhood attachment trauma of the narcissistic/(borderline) parent.

The pathology called “parental alienation” in the common culture is a trauma-related pathology.  All mental health professionals involved in the assessment, diagnosis, and treatment of this form of trauma-related pathology must have a strong clinical expertise in complex developmental trauma, including the symptom features of authentic trauma and trauma reenactment.

“When the trauma fails to be integrated into the totality of a person’s life experiences, the victim remains fixated on the trauma.  Despite avoidance of emotional involvement, traumatic memories cannot be avoided: even when pushed out of waking consciousness, they come back in the form of reenactments, nightmares, or feelings related to the trauma… Recurrences may continue throughout life during periods of stress.” (van der Kolk, 1987, p. 5)

Professional Competence

The pathology called “parental alienation” in the common culture is a complex attachment-related; trauma-related; personality disorder-related; family systems pathology requiring a sophisticated level of professional expertise to competently assess, diagnose, and treat. 

Due to the complexity of this form of family attachment-related pathology, the children and families evidencing this form of family pathology (i.e., the child’s rejection of a parent surrounding divorce that includes high inter-spousal conflict) warrant the designation as a “special population” requiring specialized professional knowledge and expertise to competently assess, diagnose, and treat.

This type of family pathology requires specialized professional knowledge and expertise in the following domains of professional psychology in order to competently assess, diagnose, and treat:

The Attachment System: Particularly the characteristic functioning and characteristic dysfunctioning of the attachment system, including the grief response and “disordered mourning.”

Attachment Trauma: Particularly the indicators reflecting the trans-generational transmission of attachment trauma through the creation of a false trauma-reenactment narrative.

Personality Disorder Pathology: Particularly the origins, assessment, and diagnosis of narcissistic and borderline personality pathology; with a particular focus on the associations of narcissistic and borderline personality pathology to childhood attachment trauma;

Family Systems Therapy: Particularly the diagnostic features of the child’s triangulation into the spousal conflict through the formation of a cross-generational coalition with one parent against the other parent.

Key professional literature to establish professional competence with this special population of children and families is:

Bowlby: regarding the attachment system

Ainsworth: regarding the attachment system

Mains & Lyons-Ruth: regarding disorganized attachment

Millon: regarding personality pathology

Beck: regarding personality pathology

Kernberg: regarding personality pathology

Linehan: regarding personality pathology

Minuchin: regarding Structural family systems therapy

Haley: regarding Strategic family systems therapy

van der Kolk: regarding childhood trauma

Failure to possess the necessary professional knowledge and expertise to competently assess, diagnose, and treat this complex form of attachment-related family pathology may represent practice beyond the boundaries of professional competence in violation of Standard 2.01a of the ethics code of the American Psychological Association.

DSM-5 Diagnosis

There is no defined pathology of “parental alienation” within clinical psychology.  The correct and accurate clinical psychology term for the attachment-related pathology called “parental alienation” in the common culture is pathogenic parenting (patho=pathology; genic=genesis, creation).  Pathogenic parenting is the creation of significant psychopathology in the child through aberrant and distorted parenting practices.

The construct of pathogenic parenting is a defined construct in clinical and developmental psychology and is typically referenced with regard to attachment-related pathology, since the attachment system never spontaneously dysfunctions but only dysfunctions in response to pathogenic parenting.

The attachment-related pathology involving the trans-generational transmission of attachment-trauma from the childhood of a narcissistic/(borderline) parent to the current family relationships, mediated by personality disorder pathology of the parent that is itself a product of the childhood attachment trauma (a pathology called “parental alienation” in the common culture) can be reliably and definitively identified by a set of three diagnostic indicators in the child’s symptom display:

1.) Attachment System Suppression: The suppression of the child’s normal-range attachment bonding motivations toward a parent represents diagnostic evidence for an attachment-related pathology involving pathogenic parenting.

2.) Narcissistic Personality Symptoms: The presence in the child’s symptom display of five specific a-priori predicted narcissistic personality traits represents the diagnostic evidence for the influence on the child’s attitudes, beliefs, and behavior from a narcissistic/(borderline) parent (i.e., the “psychological fingerprints” of control and influence on the child by a narcissistic/(borderline) parent).

3.) Delusional Belief in the Child’s Victimization: The child’s symptom display of an intransigently held fixed and false belief (a delusion) regarding the child’s supposed “victimization” by the normal-range parenting practices of the targeted parent represents diagnostic evidence of the child’s incorporation into the false trauma reenactment narrative of the allied narcissistic/(borderline) parent who is influencing the child’s attitudes, beliefs, and behavior.

The presence of all three diagnostic indicators in the child’s symptom display represents definitive diagnostic evidence of the pathology.  No other pathology in all of mental health will produce this specific set of three diagnostic indicators in the child’s symptom display other than pathogenic parenting by an allied narcissistic/(borderline) parent as a manifestation of the trans-generational transmission of attachment-trauma from the childhood of the narcissistic/(borderline) parent to the current family relationships, mediated by the personality disorder pathology of the parent that is itself a product of the childhood attachment trauma (an attachment-related pathology traditionally called “parental alienation” in the common culture).

Pathogenic parenting that is creating significant developmental pathology in the child (diagnostic indicator 1), personality pathology in the child (diagnostic indicator 2), and delusional-psychiatric pathology in the child (diagnostic indicator 3) in order to meet the emotional and psychological needs of the parent represents a DSM-5 diagnosis of V995.51 Child Psychological Abuse, Confirmed.

The complete DSM-5 diagnosis for this form of attachment-related pathology is:

DSM-5 Diagnosis

309.4  Adjustment Disorder with mixed disturbance of emotions and conduct

V61.20 Parent-Child Relational Problem

V61.29 Child Affected by Parental Relationship Distress

V995.51 Child Psychological Abuse, Confirmed (pathogenic parenting)

Failure to properly assess for this form of attachment-related pathology when a child is displaying a rejection of a parent surrounding divorce would likely represent a violation of Standard 9.01a of the APA’s ethics code which requires that diagnostic statements, including forensic testimony, be based on information “sufficient to substantiate” the findings.  If an appropriate assessment of the pathology has not been conducted, then the diagnostic statements are NOT based on information “sufficient to substantiate” the findings.

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

References

Bowlby, J. (1980). Attachment and Loss: Vol. 3. Loss: Sadness and Depression. NY: Basic Books.

Haley, J. (1977). Toward a theory of pathological systems. In P. Watzlawick & J. Weakland (Eds.), The interactional view (pp. 31-48). New York: Norton.

Juni, S. (1995).  Triangulation as splitting in the service of ambivalence. Current Psychology: Research and Reviews, 14, 91-111.

Kernberg, O.F. (1975). Borderline conditions and pathological narcissism. New York: Aronson.

Minuchin, S. (1974). Families and Family Therapy. Harvard University Press.

Pearlman, C.A., Courtois, C.A. (2005). Clinical Applications of the Attachment Framework: Relational Treatment of Complex Trauma. Journal of Traumatic Stress, 18, 449-459.

van der Kolk, B.A. (1987). The psychological consequences of overwhelming life experiences. In B.A. van der Kolk (Ed.) Psychological Trauma (1-30). Washington, D.C.: American Psychiatric Press, Inc.

From Wikipedia:

The germ theory of disease states that some diseases are caused by microorganisms.  These small organisms, too small to see without magnification, invade humans, animals, and other living hosts.  Their growth and reproduction within their hosts can cause a disease.  “Germ” may refer to not just a bacterium but to any type of microorganisms, especially one which causes disease, such as protist, fungus, virus, prion, or viroid.   Microorganisms that cause disease are called pathogens, and the diseases they cause are called infectious diseases.  Even when a pathogen is the principal cause of a disease, environmental and hereditary factors often influence the severity of the disease, and whether a particular host individual becomes infected when exposed to the pathogen.

The germ theory was proposed by Girolamo Fracastoro in 1546, but scientific evidence in support of this accumulated slowly and Galen’s miasma theory remained dominant among scientists and doctors.  A transitional period began in the late 1850s as the work of Louis Pasteur and Robert Koch provided convincing evidence; by 1880, miasma theory was still competing with the germ theory of disease.  Eventually, a “golden era” of bacteriology ensued, in which the theory quickly led to the identification of the actual organisms that cause many diseases

https://en.wikipedia.org/wiki/Germ_theory_of_disease

---

The continued use of the Gardnerian PAS construct (Parental Alienation Syndrome) is a major hindrance to enacting the solution for the family pathology traditionally called “parental alienation” in the common culture (i.e., the trans-generational transmission of attachment trauma from the childhood of the allied narcissistic/(borderline) parent to the current family relationships, mediated by the personality disorder pathology of the parent that is itself a product of the childhood attachment trauma of the parent).

1.)  The diagnostic indicators of Gardnerian PAS are too vague to be useful in clinical psychology.  The vague and ill-defined diagnostic indicators of Gardnerian PAS allow for the rampant professional incompetence currently displayed by far too many mental health professionals.

2.)  The Gardnerian PAS model is so poorly defined that it is “controversial” and is not accepted by establishment professional psychology.  This allows mental health professionals to discount the solution afforded by AB-PA (attachment-based “parental alienation”) under the false assertion that it is the same as Gardnerian PAS.  The continued existence of Gardnerian PAS prevents mental health professionals from examining the pathology using standard and fully established psychological principles and constructs.

The model of the pathology offered by Gardnerian PAS must die.  It is a bad model and leads to enormous problems. 

I am willing to debate this with any Gardnerian PAS “expert” anytime.  I propose we get a joint WordPress blog and present our arguments.  They can present why they think Gardnerian PAS offers a solution to “parental alienation” and I can offer my arguments as to why Gardnerian PAS needs to die.  I am willing to debate this with any Gardnerian PAS “expert” anytime. 

Or we can debate this in any other forum they’d like.  Anytime.  Gardnerian PAS must die.

The family pathology of “parental alienation” will be unsolvable as long as Gardnerian PAS remains an active paradigm for defining the pathology. 

Thirty years… no solution.  Scoreboard.

The definition of the family pathology of “parental alienation” must switch to an AB-PA model (attachment-based “parental alienation”).  This will provide an immediate solution to the family pathology.

Achieving Professional Competence

The attachment system represents the set of brain networks governing all aspects of love and bonding throughout the lifespan.  The attachment system functions in characteristic ways, and it dysfunctions in characteristic ways.

The pathology called “parental alienation” in the common culture is an attachment-related pathology.  A child’s rejection of a parent is a disorder to the attachment system. 

The pathology called “parental alienation” in the common culture represents the trans-generational transmission of attachment trauma mediated through a false trauma reenactment narrative in the pattern of “abusive parent”/”victimized child”/”protective parent” that is the product of the “internal working models” (schemas) of the narcissistic/(borderline) parent’s attachment-trauma networks.

All mental health professionals must begin assessing for the attachment-related pathology of AB-PA whenever there is evidence of a suppression to the child’s normal-range attachment bonding motivations toward a parent, particularly surrounding divorce and high inter-spousal conflict.

Diagnostic Checklist for Pathogenic Parenting

All mental health professionals must begin providing an accurate DSM-5 diagnosis when the three diagnostic indicators of AB-PA are present in the child’s symptom display:

Pathogenic parenting that is creating significant developmental pathology in the child (diagnostic indicator 1), personality pathology in the child (diagnostic indicator 2), and delusional-psychiatric pathology in the child (diagnostic indicator 3) in order to meet the emotional and  psychological needs of the parent represents a DSM-5 diagnosis of V995.51 Child Psychological Abuse, Confirmed.

Pathogenic parenting (patho=pathology; genic=genesis; creation) is the accurate clinical psychology term for this form of family pathology – not “parental alienation.” 

Pathogenic parenting is the creation of significant psychopathology in the child through aberrant and distorted parenting practices. 

All mental health professionals should begin using the accurate clinical psychology terminology to refer to this form of family pathology.  Targeted parents and the general population can still refer to this pathology with the common-culture term of “parental alienation,” but all mental health professionals should use the correct and accurate clinical psychology term for this form of pathology; pathogenic parenting (the creation of psychopathology in the child through aberrant and distorted parenting practices).

All targeted parents must begin holding mental health professionals accountable for properly assessing and diagnosing this form of family pathology (i.e., the trans-generational transmission of attachment trauma from the childhood of the narcissistic/(borderline) parent to the current family relationships, mediated by the personality disorder pathology of the parent which is itself a product of the childhood attachment trauma of this parent).

All targeted parents must request a proper assessment of the pathology and should lay the proper “paper trail” to hold the mental health professional accountable under Standard 9.01a and Standard 2.01a of the Ethical Principles of Psychologists and Code of Conduct of the American Psychological Association.

These are established standards of professionally competent practice in professional psychology.  Mental health professionals are not allowed to be incompetent.

AB-PA activates for targeted parents Standard 9.01a and Standard 2.01a of the APA’s ethics code. 

Gardnerian PAS does not activate these Standards of professional practice.  Gardnerian PAS proposes an entirely new and unique form of pathology that is unlike any other pathology is all of mental health and which is identified by an equally unique set of poorly defined symptom identifiers.

By analogy, Gardnerian PAS represents “Galen’s miasma theory” of disease which proposed that disease is caused by “bad air.”  Just as Galen’s miasma theory was replaced by a more scientifically accurate germ theory (an accurate identification of the pathogen causing the pathology), Gardnerian PAS needs to be replaced by a more scientifically accurate attachment-based description of the pathology (AB-PA) in order to create the solution to the pathology of “parental alienation” (pathogenic parenting in high-conflict divorce).

Targeted parents need to begin fighting for each other; to eliminate active professional incompetence for the next family and the next child.  To do this, targeted parents need to:

• Provide mental health professionals who are involved with your family with the Diagnostic Checklist for Pathogenic Parenting. 

• Provide involved mental health professionals with the booklet Professional Consultation. 

• Provide involved mental health professionals with my email address (drcraigchildress@gmail.com) and ask that the mental health professional involved with your family seek professional-to-professional consultation with me.

---

I will provide one hour of professional-to-professional consultation without charge to any mental health professional who contacts me by email requesting this professional-to-professional consultation.

Please Note: I cannot provide consultation to targeted parents directly unless you come and see me in my office in Southern California.  I can only provide professional consultation to other mental health professionals who are diagnosing and treating cases of AB-PA or to attorneys who are litigating cases of AB-PA.  This limitation is based on the guidelines governing professional standards of practice.

---

Targeted parents should lay the “paper trail” regarding your request to the mental health professional that he or she assess the pathology of… pathogenic parenting (AB-PA).  Be kind, not demanding.  Be respectful, not arrogant.  But be clear in what you want.

And document your request of the mental health professional in a letter to the mental health professional.  This lays the “paper trail” to hold the mental health professional accountable.

Document in this letter that you have provided the mental health professional with the Diagnostic Checklist for Pathogenic Parenting.

Document in this letter that you have requested that the mental health professional assess for the specific symptoms identified in the Diagnostic Checklist for Pathogenic Parenting.  

Document in this letter that you have provided the mental health professional with the booklet Professional Consultation and with my email address.

Document in this letter that you are requesting that the mental health professional seek a professional-to-professional consultation with Dr. Childress.

Lay the paper trail.  Remember, your letter is ultimately going to be included with your licensing board complaint.  Don’t be angry.  Be measured, reasonable, and appropriate.

I recommend you read:  Letter to a Stranger

The “Letter to a Stranger” is a strategy for advocacy in a school setting.  I recommend that you apply this strategy in advocating in a mental health setting.  In this specific case the “stranger” is the licensing board who will ultimately review the actions of the mental health professional.  You want to seem reasonable.  Not angry.  Not arrogant.  Not demanding. 

You want to be kind, reasonable, and oh-so-concerned for the emotional and psychological well-being of your child.  And clear in your request.

Dear Dr. So-n-So,

As we discussed in our recent meeting, I am deeply concerned regarding the potential pathogenic parenting of my ex-spouse that is creating significant behavioral and emotional pathology in my child.  I love my child dearly and I am deeply distressed by the changes to my child’s behavior surrounding the divorce that I believe are the product of my ex-spouse triangulating our child into the family conflict surrounding the divorce, in which a cross-generational coalition of my ex-spouse with the child has been formed that is severely distorting my child’s relationship with me.

This letter is to confirm that I have provided you with a copy of the Diagnostic Checklist for Pathogenic Parenting developed by Dr. Childress which is designed to specifically assess for the pathology of pathogenic parenting in the family that is of concern to me, and this letter also confirms that I have asked that you specifically assess for the symptom features identified on this symptom checklist.  I love my child dearly and I deeply appreciate your cooperation in assessing specifically for the pathology identified on this symptom checklist, and I look forward to discussing with you the outcome of your assessment.

Dr. Childress is an expert in the attachment-related pathology of pathogenic parenting surrounding high-conflict divorce and he has indicated that he is available for professional-to-professional consultation if this professional consultation is sought by mental health professionals.  His email address is drcraigchildress@gmail.com, and I am also asking that you seek his professional-to-professional consultation that he may more fully describe the nature of the family dynamics that are of concern to me.

Thank you so much for your cooperation with this.  My child means the world to me, and all I want is to restore the loving bonds of affection we shared prior to the divorce.  All children deserve to love both parents and to receive the love of both parents in return, and I truly appreciate your help in restoring the bonds of deep love and affection between my child and me that have been so severely disrupted by the divorce process.

Sincerely,
Loving Parent

Become Dangerous to Incompetence

In defining AB-PA from entirely within standard and established psychological principles and constructs, I have made targeted parents dangerous to incompetent mental health professionals.  Become dangerous.  We need to ensure that all actively incompetent mental health professions will – with 100% certainty – face licensing board complaints for their professional incompetence. 

It may not change your specific situation with your specific child, but you must fight for each other.  You must ensure that ALL actively incompetent mental health professionals will – with 100% certainty – face a licensing board complaint for their professional incompetence so that the next family they treat will receive professionally competent assessment, diagnosis, and treatment.  You must fight for each other and for each others’ children.  You must fight for the next family.

I guarantee that your allies in mental health, the mental health professionals who properly assess and accurately diagnose the pathology of AB-PA will – with 100% certainty – face a licensing board complaint from your narcissistic/(borderline) ex-spouse.

Narcissistic/(Borderline) Parent: “How dare you say I am psychologically abusive of the child.  The child and I have a wonderful bond of shared affection.  You’re incompetent to say our wonderful bond of shared affection is psychologically abusive of the child.  It’s the other parent who is the abusive parent.  You’re incompetent.” – a licensing board complaint will be filed by the narcissistic/(borderline) parent.

I guarantee that your allies in mental health, the mental health professionals who properly assess and accurately diagnose the pathology of AB-PA, will – with 100% certainty – face a licensing board complaint from your narcissistic/(borderline) ex-spouse.

Targeted parents must stand up for us, for your allies in mental health who properly assess for the family pathology of AB-PA and who have the courage to face the licensing board complaint from your narcissistic/(borderline) ex-spouse that is certain to follow from our accurate diagnosis of the family pathology as V995.51 Child Psychological Abuse, Confirmed .

The way you can protect your allies in mental health is to become as dangerous to the ignorant and incompetent mental health allies of the pathogen as the pathogen is to your mental health allies.

We must ensure that every single mental health professional who is assessing, diagnosing, and treating this form of family pathology (i.e., attachment system suppression surrounding high-conflict divorce) will – with 100% certainty – face a licensing board complaint:

Either from the narcissistic/(borderline) parent if the mental health professional makes the accurate DSM-5 diagnosis of the pathology as V995.51 Child Psychological Abuse, Confirmed…

Or from the targeted parent if the mental health professional does not assess for the pathology and does not make an accurate DSM-5 diagnosis of the pathology when the three diagnostic indicators of pathogenic parenting are present in the child’s symptom display.

You, the child’s authentic protective parent, must ensure that one way or the other ALL mental health professionals who are assessing, diagnosing, and treating the pathology of attachment system suppression in high-conflict divorce will – with 100% certainty – face a licensing board complaint, either from your narcissistic/(borderline) ex- or from you.

When the field becomes incredibly dangerous for ALL mental health professionals, many mental health professionals may withdraw from practice in this area of specialty.  Good.

If 98 out of 100 mental health professionals stop practicing in this domain of psychology it means that 98 ignorant and incompetent mental health professionals are no longer assessing, diagnosing, and treating your families.  The two remaining mental health professionals will know what they’re doing and they will accurately assess and diagnose the pathology. 

They will use the Diagnostic Checklist for Pathogenic Parenting and will document the findings of their assessment in the patient record. 

And they will make an accurate DSM-5 diagnosis of V995.51 Child Psychological Abuse, Confirmed when the three diagnostic indicators of pathogenic parenting are present in the child’s symptom display.

We will have established a domain of specialized professional expertise and a defensible standard of practice for the assessment and diagnosis of the pathology as child psychological abuse.

Will the licensing board do anything about your complaint?  No, probably not.  But it doesn’t matter what the licensing board does.  We cannot control what they do.  If they choose to allow professional incompetence, so be it. 

But you are not fighting for your child alone; you are fighting for each others’ children.  You are fighting for the next targeted parent and the next child who comes to this mental health professional.  You are demanding professional competence in the assessment, diagnosis, and treatment of this pathology.

Gardnerian PAS Must Die

There is no such pathology in clinical psychology as Gardnerian PAS.  It doesn’t exist. 

No one is talking about Gardnerian PAS.  The pathology is AB-PA (i.e., an attachment-based model of “parental alienation” that is fully defined within established and accepted psychological principles and constructs).  Gardnerian PAS must die in order for us to achieve the solution.

We must begin to hold mental health professionals accountable for standards of professional competence defined through fully established, fully accepted, and scientifically validated forms of mental health pathology – an AB-PA definition of the pathology.

An attachment-based model of “parental alienation is not a theory.  The application of standard and established psychological principles and constructs to a symptom set is called diagnosis.

Assessment leads to diagnosis. Diagnosis guides treatment.

Assessment:  Diagnostic Checklist for Pathogenic Parenting

Diagnosis:  Pathogenic parenting that is creating significant developmental pathology in the child (diagnostic indicator 1), personality pathology in the child (diagnostic indicator 2), and delusional-psychiatric pathology in the child (diagnostic indicator 3) in order to meet the emotional and psychological needs of the parent represents a DSM-5 diagnosis of V995.51 Child Psychological Abuse, Confirmed.

Professional psychology must return to the solid bedrock of established and scientifically validated constructs and principles in the assessment and diagnosis of the family pathology called “parental alienation” in the common culture (i.e., pathogenic parenting by an allied narcissistic/(borderline) parent)

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

From Wikipedia:

Medieval medicine in Western Europe was composed of a mixture of existing ideas from antiquity, spiritual influences and what Claude Lévi-Strauss identifies as the “shamanistic complex” and “social consensus.”

In the Early Middle Ages, following the fall of the Western Roman Empire, standard medical knowledge was based chiefly upon surviving Greek and Roman texts, preserved in monasteries and elsewhere.  Many simply placed their hopes in the church and God to heal all their sicknesses.  Ideas about the origin and cure of disease were not purely secular, but were also based on a world view in which factors such as destiny, sin, and astral influences played as great a part as any physical cause.  The efficacy of cures was similarly bound in the beliefs of patient and doctor rather than empirical evidence, so that remedia physicalia (physical remedies) were often subordinate to spiritual intervention.

The underlying principle of medieval medicine was the theory of humours.  This was derived from the ancient medical works, and dominated all western medicine until the 19th century.  The theory stated that within every individual there were four humours, or principal fluids – black bile, yellow bile, phlegm, and blood, these were produced by various organs in the body, and they had to be in balance for a person to remain healthy.  Too much phlegm in the body, for example, caused lung problems; and the body tried to cough up the phlegm to restore a balance.  The balance of humours in humans could be achieved by diet, medicines, and by blood-letting, using leeches.

https://en.wikipedia.org/wiki/Medieval_medicine_of_Western_Europe

---

Our current mental health approach to the family pathology traditionally called “parental alienation” in the popular culture is absolutely medieval. 

“Bring me the leeches.”

The degree of professional ignorance and incompetence is incredibly profound.  Professional psychology should be ashamed of itself.

“The patient’s humours are clearly out of balance. There is too much phlegm.  We must balance the patient’s humours to restore good health.  Bring me the leeches, we must bleed the patient.”

There is no such thing as “reunification therapy.”  Nowhere in any of the professional literature is there a defined model for what “reunification therapy” entails.  No theorist.  No description.  Nothing.  Nowhere.  They are just making stuff up – completely making stuff up.  Any mental health professional who says they do “reunification therapy” is selling snake oil.  Who knows what’s in the bottle of elixir they’re selling.

There is no such thing as “reunification therapy.”  It doesn’t exist. 

“Bring me the leeches.”

There are NO studies – not one – demonstrating the validity of the conclusions and recommendations of child custody evaluations.  Child custody evaluations spend extensive amounts of time collecting data and writing reports, but when it comes to interpreting what the data means – they just make it up.  Really.  They just make it up.  Whatever they feel like.

“The patient has too much black bile which is causing the patient to be overly melancholic.  Bring me the leeches.”

Seriously, it’s that bad.

I continually receive requests from targeted parents for help. 

“What can I do?  Do you know any therapists in wherever?”

I’m sorry, but as long as our mental health professionals are “diagnosing” an imbalance in humours, there is no hope whatsover.

It’s like going to a physician and being diagnosed with diabetes and being treated with insulin.  The problem is… what the patient actually has is cancer.  So the patient is treated with insulin and dies from the undiagnosed and untreated cancer.

That’s the state of our current mental health response to the family pathology traditionally called “parental alienation.”

But it’s even worse than that, because instead of receiving an even remotely accurate diagnosis and possibly effective treatment, the patient is actually diagnosed with an imbalance in their humours and is treated with leeches.  Oh my God.  I am astounded by the degree of professional ignorance and incompetence.

Because of the profound degree of professional ignorance – “bring me the leeches” – the patient is left to educate the professional.  Targeted parents must EDUCATE the mental health professional regarding the nature of the pathology.  Oh my God.  What sort of upside-down world is that?

Imagine going to a physician with symptoms of a disease and having to EDUCATE the physician regarding the nature of the disease you have.  That’s absurd.  Yet that’s exactly the situation targeted parents face.  Because the degree of professional ignorance is so incredibly profound, the patient has no choice but to try to educate the professional.  Bizarre.  Truly bizarre.

Imagine going to an architect and having to instruct the architect on the intricacies of load-bearing structures and blueprint design.

Imagine going to an attorney and having to instruct the attorney in the nature, precedent, and interpretations of the law.

Imagine going to a cardiac surgeon and having to instruct the surgeon on the nature of the circulatory system and then educate the surgeon on surgical procedures.

Imagine having to instruct the mental health professional regarding the nature of the mental health pathology and its treatment.

Bizarre.  Truly bizarre.  Professional psychology should be ashamed of itself.

The current state of professional psychology with regard to the assessment, diagnosis, and treatment of the family pathology traditionally called “parental alienation” is absolutely medieval.  Bring me the leeches.

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