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

This is my fourth post of my line-by-line notes for the AFCC & NCJFCJ Joint Statement on Parent-Child Contact Problems.

Notes 4 is in response to the third sentence of the Problem Statement

Line-by-Line Notes 4

From the AFCC & NCJFCJ:

“This problem may be exacerbated by (1) gendered and politicized assumptions that either parental alienation or intimate partner violence is the determinative issue; (2) contradictory rhetoric about the application of research findings and the efficacy of interventions; (3) indiscriminate use of services; and (4) a lack of understanding of different perspectives, education among family law practitioners, and resources.”

Dr Childress Notes 4:

From the AFCC & NCJFCJ: “(1) gendered and politicized assumptions that either parental alienation or intimate partner violence is the determinative issue.”

There is no such pathology as “parental alienation” and the use of that construct in a professional capacity is substantially beneath professional standards of practice in clinical psychology, and is in violation of Standard 2.04 Bases for Scientific and Professional Judgements of the APA ethics code.

2.04 Bases for Scientific and Professional Judgments
Psychologists’ work is based upon established scientific and professional knowledge of the discipline

Professional organizations should abide by ethical Standards of practice. The AFCC and NCJFCJ have failed in this obligation. There is no such pathology as “parental alienation.”

Note: the AFCC and NCJFCJ identify a non-existent pathology and IPV (intimate partner violence) but they fail to note possible child abuse, including possible psychological child abuse by a pathological narcissistic-borderline-dark personality parent, as a possible “determinative issue” of the pathology in the family courts. Why did they omit possible child abuse as a possible “determinative issue” (particularly possible Child Psychological Abuse – DSM-5 V995.51) for possible pathology concerns?

The family conflict in the courts potentially also represents a DSM-5 diagnosis of spousal emotional and psychological abuse of the targeted parent by the allied parent using the child as the weapon, a DSM-5 diagnosis of V995.82 Spouse or Partner Abuse Psychological – which would represent IPV of the targeted parent by the allied parent using the child as the weapon.

IPV is a possible “determinative issue” in creating the pathology. In fact, it may be a driving issue.

Attachment pathology is always caused by pathogenic parenting, the diagnostic question is which parent? When possible child abuse is a considered diagnosis, a proper risk assessment needs to be conducted.

In all cases of severe attachment  pathology displayed by a child, a proper risk assessment for possible child abuse needs to be conducted to the differential diagnosis of:

• • • Possible child abuse by the targeted parent creating the child’s attachment pathology toward that parent (identify it, treat it, resolve it and restore the child’s attachment bond to the parent),

• • • Possible Child Psychological Abuse (DSM-5 V995.51) by the allied narcissistic-borderline-dark personality parent who is creating a shared persecutory delusion in the child that then destroys the child’s attachment bond to the other parent for the secondary gain of manipulating the court’s decision surrounding child custody – a false attachment pathology imposed on the child – a Factitious Disorder Imposed on Another (DSM-5 300.19)

The Problem Statement of the AFCC and NCJFCJ has lost its focus on the issue of importance, i.e., is there child abuse by a parent? Is the child at risk? Is a child protection response needed?

From the AFCC & NCJFCJ: “(2) contradictory rhetoric about the application of research findings and the efficacy of interventions;”

All psychologists should be applying the same information, i.e.., the “established scientific and professional knowledge of the discipline,” as the bases for thiir professiona judgments.

2.04 Bases for Scientific and Professional Judgments
Psychologists’ work is based upon established scientific and professional knowledge of the discipline

Standard 2.04 Bases of Scientific and Professional Judgments requires – mandatory – that the “established scientific and professional knowledge of the discipline” be applied as the bases for professional judgements.

Google mandatory: required by law or rules; compulsory.

Google required: officially compulsory, or otherwise considered essential; indispensable.

Google indispensable: absolutely necessary.

All psychologists should be applying exactly the same information (the best), to reach exactly the same conclusions (accurate), and make exactly the same recommendations (effective) based on the application of the “established scientific and professional knowledge of the discipline.” If two doctors disagree on a diagnosis, that is a serious problem for one of the doctors because it means they are wrong. That’s called a misdiagnosis, and that’s bad for a doctor.

The established scientific and professional knowledge of the discipline that is required to be applied as the bases for professional judgmens is:

• • • Attachment – Bowlby and others
    • Family systems therapy – Minuchin and others
    • Personality disorders – Linehan and others
    • Complex trauma – van der Kolk and others
    • Child development – Tronick and others
    • Self psychology – Kohut and others
    • DSM-5 diagnostic system & delusional thought disorders

If there is concern about the research or professional constructs being used in any of the above domains of knowledge, then specify what concerns exist in the attachment research, in the family systems principles and constructs used, in the personality disorder research applied, in the research on child abuse and complex trauma, in the child development research, in Kohut’s psychoanalytic model of child psychological development, or in the diagnostic criteria surrounding delusional thought disorders and Factitious Disorder Imposed on Another.

Be specific. What professional knowledge is not being applied appropriately, or being misapplied, from the “established scientific and professional knowledge of the discipline.”

This is the professional action required:

1, Document the child’s symptoms and surrounding family context.

2. Apply the diagnostic criteria for possible child abuse by the targeted parent – i.e., for Child Physical Abuse (V995.54), Child Sexual Abuse (V995.53), Child Neglect (V995.52), Child Psychological Abuse (V995.51).

3. Apply the diagnostic criteria for possible Child Psychological Abuse by the allied parent, i.e., creating a false attachment pathology and shared persecutory delusion in the child.

From the APA: “Persecutory Type: delusions that the person (or someone to whom the person is close) is being malevolently treated in some way.”

If the child is not being “malevolently treated in some way” by the normal-range parenting of the targeted parent, then rate the child’s false belief using the Brief Psychiatric Rating Scale (BPRS), “one of the oldest, most widely used scales to measure psychotic symptoms” (Wikipedia: BPRS: https://en.wikipedia.org); Item 11 Unusual Thought Content.

BPRS (Ventura, Lukoff, Nuechterlein, Liberman) https://www.researchgate.net/publication/284654397_Brief_Psychiatric_Rating_Scale_Expanded_version_40_Scales_anchor_points_and_administration_manual

In my clinical opinion, a BPRS rating should be obtained for child symptom severity for ALL court-involved evaluations of parent-child relationship conflict on the following items: Item 2 Anxiety, Item 3 Depression, Item 4 Suicidality (if warranted), Item 5 Guilt, Item 6 Hostility, Item 9 Susiciousness, Item 11 Unusual Thought Content.

If there is concern about the information being relied upon, then rely upon the “established scientific and professional knowledge of the discipline.” Document the child’s symptoms. Apply the diagnostic criteria for the respective differential diagnoses under consideration that could be causing the child’s symptoms. Diagnose the pathology in the family – identify the problem in the family – and place the problem (pathology) on a written treatment plan to fix it.

Google WikiHow Mental Health Treatment Plans

For personality disorder pathology, I recommend Dialectic Behavior Therapy (DBT; Linehan) as the organizing treatment structure for the family therapy, informed by attachment-related principles and treatment approaches (e.g., Tronick breach-and-repair sequence, Emotionally Focused Therapy; Johnson).

Treatment is based on diagnosis. The treatment for cancer is different than the treatment for diabetes. What diagnosis is being treated in the family courts? Is it an accurate diagnosis or a misdiagnosis? If we treat cancer with insulin then the patient dies from the misdiagnosed cancer. The appellate system for a disputed diagnosis is second opinion.

From Improving Diagnosis: “Clinicians may refer to or consult with other clinicians (formally or informally) to seek additional expertise about a patient’s health problem. The consult may help to confirm or reject the working diagnosis or may provide information on potential treatment options. If a patient’s health problem is outside a clinician’s area of expertise, he or she can refer the patient to a clinician who holds more suitable expertise. Clinicians can also recommend that the patient seek a second opinion from another clinician to verify their impressions of an uncertain diagnosis or if they believe that this would be helpful to the patient.”

Improving Diagnosis in Healthcare, a report from the National Academies of Science, Engineering, and Medicine: https://pubmed.ncbi.nlm.nih.gov/26803862/

There is substantial research and professional knowledge that can be universally agreed on and applied to understanding and treating the attachment pathology in the family courts. This represents the “established scientific and professional knowledge of the discipline.”

If it is not known or is not being applied by the forensic psychologists in court-involved practice, then that speaks to the deficient standards of practice in forensic psychology and raises prominent concerns for compliance with Standard 2.01 Boundaries of Competence related to the following domains:

• • • Attachment pathology
      • When assessing, diagnosing (identifying), and treating (fixing) severe attachment pathology displayed by the child.

• • • Delusional thought disorders
      • When assessing, diagnosing (identifying), and treating (fixing) possible delusional thought disorder pathology in the parent being imposed on the child.

• • • Narcissistic, borderline, and dark personalities
      • When assessing, diagnosing (identifying), and treating (fixing) the potential impact on family relationships of parental personality pathology.

• • • Family systems therapy and constructs
      • When assessing, diagnosing (Identifying), and treating (fixing) family conflict.

Does the Joint Statement by the AFCC & NCJFCJ meet professional Standards for Competence in the relevant domains of pathology, i.e., Standards 2.01 Boundaries of Competence, for the involved psychologists, and with regard to Standard 2.04 Bases for Scientific and Professional Judgments regareding the established scientific and professional knowledge they applied or failed to apply as the bases for their professional judgments?

From the AFCC & NCJFCJ: “(3) indiscriminate use of services;”

Mental health services should accurately diagnose the pathology and effectively treat it and resolve it. Over-use of mental health services should not be an issue because the pathology should be accurately diagnosed, treated, and resolved when it encounters the mental health system.

If pathology is not being effectively resolved when it enters the mental health system, that’s a problem in the mental health system not in the use of services by the clients.

“Indiscriminate use” is not the client’s concern, the existence of this feature suggests a breakdown in the ability of the “services” to effectively resolve the pathology (problem) on the initial encounter.

Diagnosis guides treatment. The treatment for cancer is different than the treatment for diabetes. What diagnosis for the family conflict pathology is guiding the “use of services” in the family courts?

From the AFCC & NCJFCJ: “(4) a lack of understanding of different perspectives, education among family law practitioners, and resources.”

These sound like personal opinions. Citations please to the research support for all four assertions:

• • That the problem in the family courts is being exacerbated by assumptions that either parental alienation [note there is no such diagnostic entity] or Intimate Partner Violence is the determinative issue;

• • • Why was possible child abuse omitted from consideration as a “determinative issue”?

• • • Where is the research support for this statement?

• That the problem in the family courts is exacerbated by rhetoric about the application of research findings and the efficacy of interventions;

• • • Where is the research support for this statement?

• That the problem in the family courts is exacerbated by indiscriminate use of services;

• • • Where is the research support for this statement?

• That the problem in the famiy courts is exacerbated by a lack of understanding of different perspectives, education among family law practitioners, and resources.

• • • Where is the research support for this statement?

This Problem Statement appears to be unsupported personal opinions of whoever is on the committee drafting the Joint Statement from the AFCC and NCJFCJ.

In professional psychology, a “lack of understanding…” is called incompetence. In professional psychology, a “lack of understanding” represents deficient professional practice. In professional psychology, a “lack of understanding” is called misdiagnosis.

All psychologists are expected to understand the pathology they work with (Standard 2.01 Boundaries of Competence) or else they shouldn’t be working with it.

All doctors should be applying exactly the same knowledge (the best) to reach exactly the same conclusions (accurate), and apply exactly the same treatments (effective). Psychologists are required to be competent by their education, training, and experience in the pathology they are working with (Standard 2.01 Boundaries of Competence) and to undertake ongoing efforts to maintain their competence, Standard 2.03 Maintaining Competence.

2.01 Boundaries of Competence
(a) Psychologists provide services, teach, and conduct research with populations and in areas only within the boundaries of their competence, based on their education, training, supervised experience, consultation, study, or professional experience.

2.03 Maintaining Competence
Psychologists undertake ongoing efforts to develop and maintain their competence.

The professional standard for competence with a pathology in clinical psychology is to know everything there is to know about the pathology, and then read journals to remain current.

It sounds like the AFCC & NCJFCJ are identifying professional incompetence, i.e., a “lack of understanding” due to inadequate “education” among the various professionals. Psychological pathology is the domain of psychologists. The psychologists should know what they are doing. There should be no “lack of understanding” displayed by the psychologists, and their education and training level should be appropriate to the pathology they are working with.

It sounds like the AFCC & NCJFCJ are offering the unsupported personal opinions of the committee members. A review of the psychologists’ vitaes on the committee is warranted to examine for their competence relative to Standard 2.01 in the following domains:

• • • Attachment pathology
      • When assessing, diagnosing (identifying), and treating (fixing) severe attachment pathology displayed by the child.

• • • Delusional thought disorders
      • When assessing, diagnosing (identifying), and treating (fixing) possible delusional thought disorder pathology in the parent being imposed on the child.

• • • Narcissistic, borderline, and dark personalities
      • When assessing, diagnosing (identifying), and treating (fixing) the potential impact on family relationships of parental personality pathology.

• • Family systems therapy and constructs
    • • When assessing, diagnosing (Identifying), and treating (fixing) family conflict.

Does the AFCC & NCJFCJ Joint Statement meet Standards for professional practice, or does it instead represent personal opinions offering “contradictory rhetoric about the application of research findings and the efficacy of interventions”?

Dr. Childress Notes 4.

Craig Childress, Psy.D.
Clinical Psychologist, CA PSY 18856

This is my third post of my line-by-line notes for the AFCC & NCJFCJ Joint Statement on Parent-Child Contact Problems.

Notes 3 is in response to the second sentence of the Problem Statement

Line-by-Line Notes 3

From the AFCC & NCJFCJ:

“Children are at greater risk when parent-child contact problems are not effectively addressed and when family law professionals and others echo and intensify the polarization within the family.”

Dr Childress Notes 3:

There is no such pathology as “parent-child contact problems” – a professional Joint Statement should use professional-level knowledge and constructs to describe pathology. What is the professional-level description of the pathology they are describing?

• • • The correct professional construct is attachment pathology.

• • • The correct professional construct is child abuse.

If there are risks to the child as they clearly assert, then the professional concern is one of possible child abuse and a proper risk assessment needs to be conducted.

Why are professional organizations hiding the pathology of possible child abuse from professional-discussion by using euphemisms? When possible child abuse is a considered diagnosis, this should be clearly stated, discussed, and professionally addressed.

When there is a risk, that means there is a potential dangerous pathology involved (suicide, homicide, or abuse). In all cases where there is a potential risk, a proper risk assessment needs to be conducted.

Risk Assessment

A risk assessment is conducted when any of three types of dangerous pathology are presented by a client, suicide, homicide, or abuse (child, spousal, elder). The type of risk assessment depends on the type of danger involved, such as a suicide risk assessment when the client expresses suicidal thoughts (i.e., an assessment of prior history, current plan, recent loss, means, etc.).

There are four diagnoses of child abuse in the Child Maltreatment section of the DSM-5, each of these warrants a proper risk assessment; Child Physical Abuse (V995.54), Child Sexual Abuse (V995.53), Child Neglect (V995.52), Child Psychological Abuse (V995.51). All of these child abuse diagnoses are equivalent in the severity of the damage they cause to the child, they differ only in the type of damage done, not in the severity of damage done to the child. Psychological child abuse is devastating, it destroys the child from the inside out.

A suspicion of child physical, sexual, or neglect abuse is a mandated report to Child Protective Services (CPS) to allow their trained assessment professionals to conduct a proper risk assessment for these types of child abuse, and then to take the proper child protection steps when warranted. Mental health professionals in the community are prohibited from conducting the risk assessment themselves for these forms of child abuse, and they are mandated to refer to Child Protective Services (CPS) to ensure a proper assessment and the proper protection of the forensic evidence if needed.

Psychological child abuse, however, is not a mandated report, it is a “permitted” report to CPS, but not required. Psychological child abuse (i.e., creating severe pathology in the child through aberrant and distorted parenting) is more difficult to assess and diagnose, and typically requires a higher level of training than is available to the CPS professionals who are more focused on child physical, sexual, and neglect abuse.

The assessment for possible child psychological abuse requires a higher level of professional knowledge in attachment pathology, complex trauma, personality pathology, and thought disorders. Since psychological child abuse is not a mandated CPS report, this allows the involved mental health professionals to conduct the risk assessment for psychological child abuse, thereby allowing CPS to remain focused on identifying the other more overt forms of child abuse.

The professional concern with child psychological abuse is the creation of a thought disorder in the child, an induced persecutory delusion, by the aberrant and distorted parenting practices of the allied parent. A delusion is a fixed and false belief that is maintained despite contrary evidence. The type of delusion of concern is a potential persecutory delusion, i.e., a fixed and false belief in supposed “victimization.”  The American Psychiatric Association provides the definition of a persecutory delusion:

From the APA: “Persecutory Type: delusions that the person (or someone to whom the person is close) is being malevolently treated in some way.” (American Psychiatric Association, 2000)

Creating a shared persecutory delusion with a child that then destroys the child’s attachment bond to the other parent represents a DSM-5 diagnosis of V995.51 Child Psychological Abuse. The assessment for thought disorder pathology (delusions) is a Mental Status Exam of thought and perception conducted with the child and allied parent. Obtaining direct observation of the symptoms displayed in the parent-child relationship would confirm the diagnosis from the Mental Status Exam of thought and perception.

The clinical pathology of concern in the family is for possible unresolved trauma with a parent that then distorts their thinking and perception of situations, and that the parent’s persecutory delusion is then imposed on the child through aberrant and distorted parenting practices, creating a shared persecutory delusion (ICD-10 F24) relative to the other parent.

An additional clinical concern is that the allied parent is inducing this thought disorder in the child in order to (intentionally?) destroy the child’s attachment bond to the other parent in vengeful retaliation against the targeted parent for the failed marriage and divorce. Using the child as a weapon of spousal emotional and psychological abuse would represent Intimate Partner Violence (IPV; “domestic violence”), and would warrant a DSM-5 diagnosis of V995.82 Spouse or Partner Abuse, Psychological.

Creating a false attachment pathology (a factitious attachment disorder) and imposing that pathology on the child (on another) for the secondary gain of manipulating the court’s decisions surrounding child custody would represent a DSM-5 diagnosis of 300.19 Factitious Disorder Imposed on Another.

Google factitious: artificially created or developed.

By weaponizing the child into the spousal conflict, the allied parent creates such significant pathology in the child that it rises to the level of Child Psychological Abuse (DSM-5 V995.51). Spousal emotional and psychological abuse of the targeted parent by the allied parent using the child as the weapon is a second dangerous pathology of concern in the family that warrants a proper risk assessment.

Attachment pathology is only created by problematic parenting (pathogenic parenting), either from the targeted-rejected parent or from the allied parent. Whenever there is significant attachment pathology displayed by a child surrounding divorce, a proper diagnostic risk assessment needs to be conducted.

From AFCC & NCJFCJ: “Children are at greater risk..”

When children are at risk, a proper risk assessment needs to be conducted and psychologists’ duty to protect obligations are active.

In all cases of a dangerous pathology, including possible psychological child abuse (DSM-5 V995.51 Child Psychological Abuse) and possible spousal emotional and psychological abuse using the child as the weapon (DSM-5 V995.82 Spouse or Partner Abuse, Psychological), a proper risk assessment is required. Mental health professionals have duty to protect obligations.

The Joint Statement notes the “risk” associated with “parent=child contact problems.” This then clearly requires that a proper risk assessment for possible child abuse be conducted to the differential diagnosis of:

1. 1. • Possible child abuse by the targeted parent creating the child’s attachment pathology toward that parent (identify it, treat it, resolve it and restore the child’s attachment bond to the parent),

1. 1. • Possible Child Psychological Abuse (DSM-5 V995.51) by the allied narcissistic-borderline-dark personality parent who is creating a shared persecutory delusion in the child that then destroys the child’s attachment bond to the other parent for the secondary gain of manipulating the court’s decision surrounding child custody – a false attachment pathology imposed on the child – a Factitious Disorder Imposed on Another (DSM-5 300.19)

Note: “polarization” of perceptions is a psychiatric symptom called “splitting” and it is associated with both borderline and narcissistic personality pathology. When this polarization symptom of splitting spreads to the surrounding professionals, Marsha Linehan calls it “staff splitting.”

Parallel Process Staff Splitting (Childress, 2019)

https://drcraigchildressblog.com/2019/10/01/parallel-process-staff-splitting/

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

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

Linehan, M. M. (1993). Cognitive-Behavioral Treatment of Borderline Personality Disorder. New York, NY: Guilford

Why are professional organizations masking and covering-up the serious nature of the pathology in the family by using non-professional terms that hide what the pathology is, and by insead using euphemisms for child abuse (i.e., parent-child contact problems”)?

Is it because the forensic psychologists do not know the “established scientific and professional knowledge of the discipline” necessary for professional competence with this court-involved family conflict pathology?

The established scientific and professional knowledge of the discipline is:

• • • Attachment – Bowlby and others
    • Family systems therapy – Minuchin and others
    • Personality disorders – Linehan and others
    • Complex trauma – van der Kolk and others
    • Child development – Tronick and others
    • Self psychology – Kohut and others
    • DSM-5 diagnostic system & delusional thought disorders

Are the forensic psychologists working on this Joint Statement competent based on their education, training, and experience in the “established scientific and professional knowledge of the discipline” required for professional competence?

2.01 Boundaries of Competence
(a) Psychologists provide services, teach, and conduct research with populations and in areas only within the boundaries of their competence, based on their education, training, supervised experience, consultation, study, or professional experience.

A review of the vitaes of the forensic psychologists participating in this Joint Statement from the AFCC and NCJFCJ is warranted regarding Standard 2.01 Boundaries of Competence in the following domains of scientifically established professional knowledge:

• • Attachment pathology

When assessing, diagnosing (identifying), and treating (fixing) severe attachment pathology displayed by the child.

• • Delusional thought disorders

When assessing, diagnosing (identifying), and treating (fixing) possible delusional thought disorder pathology in the parent being imposed on the child.

• • Narcissistic, borderline, and dark personalities

When assessing, diagnosing (identifying), and treating (fixing) the potential impact on family relationships of parental personality pathology.

• Family systems therapy and constructs

When assessing, diagnosing (identifying), and treating (fixing) family conflict pathology.

When a child is at “risk,” all mental health professionals have duty to protect obligations and a proper risk assessment for possible child abuse needs to be conducted. Psychologists have duty to protect obligations.

Dr. Childress Notes 3.

Craig Childress, Psy.D.
Clinical Psychologist, CA PSY 18856

This is my second post of my line-by-line notes for the AFCC & NCJFCJ Joint Statement on Parent-Child Contact Problems.

Notes 2 is in response to the first sentence of the Problem Statement

Line-by-Line Notes 2

From the AFCC & NCJFCJ:

“Problem Statement: The vast majority of separating and divorcing parents maintain safe, healthy, and positive relationships with their children; however, a small percentage of parent-child relationships remain strained and/or problematic.”

Dr Childress Notes 2:

An estimated 90% of post-divorce parents successfully resolve custody schedules without court involvement. Approximately 10% of families become “high-conflict” custody conflicts litigated in the court.

From Saini & Birnbaum (2007): “The term ‘high conflict’ has been used as an umbrella term to describe parents who experience high rates of litigation and relitigation, high degrees of anger and distrust, verbal, physical and emotional abuse, and ongoing difficulty in communicating and cooperating about the needs of their children (Johnston 1994). In fact, most estimates of high conflict families are based on ongoing litigation rates post separation/divorce. Mnookin and Kornhauser (1979) note that less than 10 per cent of parents remain in high conflict as evidenced by on-going litigation. Maccoby and Mnookin (1992) and Hetherington, Stanley-Hagan, and Anderson (1989) also used ongoing litigation rates as a measure when they described that 10 per cent of families remain in high conflict situations.”

Saini, M., & Birnbaum, R. (2007) Unraveling the label of “high conflict”: What factors really count in divorce and separated families. Journal of the Ontario Association of Children’s Aid Societies. 51(1), 14-20.

Research estimates a prevalence of narcissistic personality disorder in the general population at approximately 6%:

From Grant et al: “Prevalence of lifetime BPD was 5.9%”

Grant, et al., (2008). Prevalence, correlates, disability and comorbidity of DSM-IV borderline personality disorder. Journal of Clinical Psychiatry. 533—545

Research estimates a prevalence of borderline personality disorder in the general population at approximately 6%:

From Stinson et al: “Prevalence of lifetime NPD was 6.2%”

Stinson, et al., (2008). Prevalence, correlates, disability, and comorbidity of DSM-IV narcissistic personality disorder. Journal of Clinical Psychiatry. 1033-1045.

Both narcissistic and borderline personalities are known to be high-conflict personality styles.

Approximately 12% of the population have prominent narcissistic and borderline personality traits, and approximately 10% of divorces devolve into high-conflict custody litigation following divorce. It is reasonable to anticipate that a large percentage of the highly litigated custody conflict surrounding divorce involves either narcissistic or borderline personality pathology in a parent.

The potential presence of narcissistic or borderline personality pathology in a parent prominently raises the possibility of a dark personality parent, i.e., Dart Triad, Vulnerable Dark Triad, Dark Tetrad.

Dark Personalities and Induced Delusional Disorder (Greenham & Childress):

https://www.researchgate.net/publication/363197057_Dark_Personalities_and_Induced_Delusional_Disorder_The_Research_Gap_Underlying_a_Crisis_in_the_Family_and_Domestic_Violence_Courts

The collapse of narcissistic and borderline personality pathology into persecutory delusions is established knowledge.

From 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).

Millon. T. (2011). Disorders of personality: introducing a DSM/ICD spectrum from normal to abnormal. Hoboken: Wiley.

From Barnow et al: “This review reveals that psychotic symptoms in BPD patients may not predict the development of a psychotic disorder but are often permanent and severe and need careful consideration by clinicians. Therefore, adequate diagnosis and treatment of psychotic symptoms in BPD patients is emphasized… In conclusion, we therefore suggest that it is not a cognitive developmental deficit but rather a tendency to construe interpersonal relations as malevolent that characterizes BPD, and this may be shared with certain psychotic disorders. p. 187

Barnow, S., Arens, E. A., Sieswerda, S., Dinu-Biringer, R., Spitzer, C., Lang, S., et al  (2010). Borderline personality disorder and psychosis: a review. Current Psychiatry Reports, 12,186-195

From the APA: “Persecutory Type: delusions that he person (or someone to whom the person is close” is being malevolently treated in some way.” (American Psychiatric Association, 2000)

From Walters & Friedlander: “In some RRD families [resist-refuse dynamic], a parent’s underlying encapsulated delusion about the other parent is at the root of the intractability (cf. Johnston & Campbell, 1988, p. 53ff; Childress, 2013). An encapsulated delusion is a fixed, circumscribed belief that persists over time and is not altered by evidence of the inaccuracy of the belief.”

From Walters & Friedlander: “When alienation is the predominant factor in the RRD [resist-refuse dynamic}, the theme of the favored parent’s fixed delusion often is that the rejected parent is sexually, physically, and/or emotionally abusing the child. The child may come to share the parent’s encapsulated delusion and to regard the beliefs as his/her own (cf. Childress, 2013).” (Walters & Friedlander, 2016, p. 426)

Walters, M. G., & Friedlander, S. (2016). When a child rejects a parent: Working with the intractable resist/refuse dynamic. Family Court Review, 54(3), 424–445.

The potential Machiavellian manipulation associated with dark personalities and their collapse into persecutory delusions under stress raises prominent concerns for the creation of a false attachment pathology in the child by the pathogenic parenting of the dark personality parent for the secondary gain of manipulating the court’s decisions on child custody as a result of the induced pathology in the child – which would represent DSM-5 diagnoses of 300.19 Factitious Disorder Imposed on Another (a false attachment pathology and persecutory delusion imposed on the child) and V995.51 Child Psychological Abuse (i.e., creating a delusional thought disorder in the child that then destroys the child’s attachment bond to the other parent).

The differential diagnosis for severe attachment pathology in the child is possible child abuse, either 1) child abuse by the targeted parent creating the child’s attachment pathology toward this parent (a two-person attribution of causality), or 2) child psychological abuse (DSM-5 V995.51) by the allied parent who is creating a shared persecutory delusion and false attachment pathology in the child (a three-person triangular attribution of causality).

From Bowen Center: “A triangle is a three-person relationship system. It is considered the building block or “molecule” of larger emotional systems because a triangle is the smallest stable relationship system. A two-person system is unstable because it tolerates little tension before involving a third person. A triangle can contain much more tension without involving another person because the tension can shift around three relationships. If the tension is too high for one triangle to contain, it spreads to a series of “interlocking” triangles. Spreading the tension can stabilize a system, but nothing is resolved.”

From Bowen Center Triangles: https://www.thebowencenter.org/triangles

From Stone, Buehler, & Barber: “The concept of triangles “describes the way any three people relate to each other and involve others in emotional issues between them” (Bowen, 1989, p. 306). In the anxiety-filled environment of conflict, a third person is triangulated, either temporarily or permanently, to ease the anxious feelings of the conflicting partners. By default, that third person is exposed to an anxiety-provoking and disturbing atmosphere. For example, a child might become the scapegoat or focus of attention, thereby transferring the tension from the marital dyad to the parent-child dyad. Unresolved tension in the marital relationship might spill over to the parent-child relationship through parents’ use of psychological control as a way of securing and maintaining a strong emotional alliance and level of support from the child.  As a consequence, the triangulated youth might feel pressured or obliged to listen to or agree with one parents’ complaints against the other. The resulting enmeshment and cross-generational coalition would exemplify parents’ use of psychological control to coerce and maintain a parent-youth emotional alliance against the other parent (Haley, 1976; Minuchin, 1974).” (Stone, Buehler, & Barber, 2002, p. 86-87)

Minuchin structural diagram:

Standard 2.04 of the APA ethics code requires – mandatory – the application of the “established scientific and professional knowledge of the discipline” as the bases for professional judgements:

2.04 Bases for Scientific and Professional Judgments
Psychologists’ work is based upon established scientific and professional knowledge of the discipline

The established scientific and professional knowledge of the discipline is:

• • • Attachment – Bowlby and others
    • Family systems therapy – Minuchin and others
    • Personality disorders – Millon and others
    • Complex trauma – van der Kolk and others
    • Child development – Tronick and others
    • Self psychology – Kohut and others
    • DSM-5 diagnostic system & delusional thought disorders

In all cases of severe attachment pathology surrounding divorce, a proper risk assessment for possible child abuse needs to be conducted to the differential diagnosis of:

1) Possible child abuse by the targeted-rejected parent creating the child’s attachment pathology toward this parent (a two-person attribution of causality),

2) Possible child psychological abuse (DSM-5 V995.51) by the allied parent who is creating a shared persecutory delusion and false attachment pathology in the child (a three-person triangular attribution of causality) for the secondary gain of manipulating the court’s decisions for child custody.

Note that the opening sentence of the Problem Statement places the adjective “safe” as a primary parental obligation, with the clear implication that court-involved families may not be “safe” for the child. A proper risk assessment for possible child abuse to the differential diagnosis of “which parent” needs to be conducted with all cases of court-involved child custody conflict when there is severe attachment pathology displayed by the child.

Dr. Childress Notes 2.

Craig Childress, Psy.D.
Clinical Psychologist, CA PSY 18856

The Association of Family and Conciliation Courts (AFCC) and the National Council of Juvenile and Family Court Judges (NCJFCJ) have produced a joint statement on the attachment pathology in the family courts.

https://www.ncjfcj.org/publications/afcc-and-ncjfcj-approve-statement-on-parent-child-contact-problems/

I  am going to provide a response from clinical psychology to this statement from the AFCC & NCJFCJ.

Whenever I review the professional work of forensic psychologists, I always approach my analysis in a structured way. I begin by taking line-by-line notes on my first reading – I don’t want to have to read it twice. I then rely on my notes for the opinions contained in my Summary Report.

I will be producing a Summary Report & Analysis of the AFCC and NCJFCJ Joint Statement on Parent-Child Contact Problems. In order to generate my Summary Report & Analysis from clinical psychology regarding this Joint Statement from the AFCC forensic psychologists and the juvenile and family court judges, I will be creating line-by-line notes from my first reading of their Joint Statement that will then serve as the basis for my opinions.

Rather than wait for the completion of my notes and writing of my Summary Report & Analysis, I will be posting my notes as they are generated. This will provide transparency to my analysis and support for my later Summary Report & Analysis, I will be posting to my blog my line-by-line review and commentary in a serial format as it is generated.

This post, Notes 1, represents the first notes generated. This is my response as a clinical psychologist to the title of their Joint Statement:

AFCC & NCJFCJ Joint Statement on Parent-Child Contact Problems

Judges are not professionally trained to diagnose or treat pathology. In this joint collaboration between judges and the forensic psychologists in the AFCC, the forensic psychologists are providing guidance to the judges regarding the assessment, diagnosis, and treatment of the attachment pathology (“parent-child contact problems”) in the family courts.

We must first diagnose what the pathology is before we know how to treat it. We must first diagnose what the problem is before we know how to fix it. It is the professional obligation of the forensic psychologists of the AFCC who are contributing to this joint statement with judges to provide appropriate professional guidance to the judges regarding the identification and treatment of pathology in the family.

Diagnose = identify
Pathology = problem
Treatment = fix it.

I will not be commenting on the legal aspects of this joint statement as I am trained as a doctor, I went to psychology graduate school, not law school. I’m a doctor, a licensed clinical psychologist, my domain is the diagnosis and treatment of pathology.

The judges and legal professionals on this Joint Statement were guided in their understanding of pathology by the forensic psychologists on the committee. I will be providing a second-opinion review and analysis of the work-product from the forensic psychologists, and their professional guidance provided to the judges and other legal professionals.

These are my line-by-line Notes 1 regarding the title of the Joint Statement on Parent-Child Contact Problems from the AFCC & NCJFCJ.

Line-by-Line Notes 1

From the AFCC & NCJFCJ: “AFCC and NCJFC Joint Statement on Parent-Child Contact Problems”

Dr Childress Notes 1:

There is no such pathology as “parent-child contact problems” – there is no professional definition for that pathology.

• • • The correct professional-level construct is parent-child attachment pathology – attachment problems.

• • • The correct professional-level construct is child abuse.

There are two differential diagnoses for a severe attachment pathology displayed by the child:

1.) Child abuse by the targeted parent creating the child’s attachment pathology toward that parent.

If this is the case, identify what the child abuse is, treat it, resolve it, and restore the child’s attachment bond to the parent,

2.) Child Psychological Abuse (DSM-5 V995.51) by an allied narcissistic-borderline-dark personality parent who is creating a shared persecutory delusion in the child that then destroys the child’s attachment bond to the other parent for the secondary gain of manipulating the court’s decision surrounding child custody – a false attachment pathology imposed on the child – a Factitious Disorder Imposed on Another (DSM-5 300.19).

If this is the case, identify the child abuse and protect the child. Then restore the child’s healthy and normal-range development. Then, once the child’s healthy development has been recovered and stabilized, restore contact with the abusive parent with enough safeguards in place to protect the child from a return of the child abuse when contact with the abusive parent is reintroduced.

The differential diagnosis for severe attachment pathology surrounding divorce (“parent-child contact problems”) is child abuse by one parent or the other. Why are the professional organizations of the AFCC and NCJFCJ using euphemisms for child abuse?

By using non-professional constructs and euphemisms for child abuse, the AFCC and NCJFCJ are not identifying the child abuse – they are colluding in the cover-up of the child abuse occurring in the family courts by not clearly identifying the issue of child abuse.

When severe attachment pathology is displayed by a child, the differential diagnosis is child abuse one way or the other. Professionals and professional organizations should use real professional constructs and established diagnoses and should NOT make up euphemisms for child abuse to hide the child abuse from clear identification and disclosure.

The use of the construct of “parent-child contact problems” in a professional capacity is substantially beneath professional standards of practice in clinical psychology and is in violation of Standard 2.04 of the ethics code of the American Psychological Association that requires the application of the established scientific and professional knowledge of the discipline.

2.04 Bases for Scientific and Professional Judgments
Psychologists’ work is based upon established scientific and professional knowledge of the discipline

The established scientific and professional knowledge of the discipline is:

• • • Attachment – Bowlby and others
    • Family systems therapy – Bowen and others
    • Personality disorders – Millon and others
    • Complex trauma – van der Kolk and others
    • Child development- Tronick and others
    • Self psychology – Kohut and others
    • DSM-5 diagnostic system & delusional thought disorders

There is no such pathology as “parent-child contact problems” – it is severe attachment pathology and child abuse. The only diagnostic question is, which parent? The psychologists participating in this Joint Statement are in violation of ethical Standard 2.04 Bases for Scientific and Professional Judgments of the American Psychological Association.

There is no such pathology (problem) as “parent-child contact problems” defined in the professional literature with research support. It is a made-up diagnostic construct created by forensic psychologists from their imaginings and ignorance without professional research support.

Google ignorance: lack of knowledge or information

There is no such pathology as “parent-child contact problems” and the use of that diagnostic construct in a professional capacity is substantially beneath professional standards of practice in clinical psychology, and is in violation of Standard 2.04 Bases for Scientific and Professional Judgments of the APA ethics code.

Dr. Childress Notes 1.

Craig Childress, Psy.D.
Clinical Psychologist, CA PSY 18856

Amy Baker and Jennifer Harman are both research professors. They are not licensed clinical psychologists.

They have never been educated (doctoral courses) in clinical psychology, i.e., in the assessment, diagnosis, treatment of pathology. They have never been trained (two full years of supervised practice) in the assessment, diagnosis, or treatment of any pathology – ever in their lives.

They are not competent by their background education, training, and experience in the assessment, diagnosis, or treatment of any pathology.

Their competence is restricted to their research – only. They may discuss their research – but – they should NOT opine on the nature of pathology, it’s assessment, diagnosis, or treatment. The domain of clinical psychology, the assessment, diagnosis, and treatment of pathology, is beyond their boundaries of competence based on their education, training, and professional experience.

2.01 Boundaries of Competence
(a) Psychologists provide services, teach, and conduct research with populations and in areas only within the boundaries of their competence, based on their education, training, supervised experience, consultation, study, or professional experience.

Offering professional opinions on issues of pathology, its assessment, diagnosis, or treatment, is substantially beyond the boundaries of competence of Amy Baker and Jennifer Harman, and is in violation of Standard 2.01 Boundaries of Competence of the Ethical Principles of Psychologists and Code of Conduct of the American Psychological Association.

Clinical Psychology

I am a clinical psychologist with a doctoral degree in the coursework of  Clinical Psychology from Pepperdine University. I have the required one year of supervised pre-doctoral training from the APA accredited internship at Children’s Hospital of Los Angeles (CHLA), and I have two years of supervised post-doctoral training at CHLA.

This educational and training background then qualified me to sit for and pass the licensing examination for the state of California. That is the required education, training, and professional experience required to be a licensed clinical psychologist.

Amy Baker and Jennifer Harman completed none of that. They have none of the coursework in the assessment, diagnosis, and treatment of pathology. They have none of the required years of supervised training, pre-doctoral and post-doctoral. They have never taken the licensing exam because they have never been qualified to even apply to take it.

I am working currently working as a licensed clinical psychologist in the field of court-involved family conflict. This professional field involves personality disorder pathology, attachment pathology, complex trauma, and delusional thought disorders, These are the required domains of knowledge needed for clinical competence.

Amy Baker and Jennifer Harman are not competent by their background education, training, or experience in the clinical assessment, diagnosis, and treatment of any pathology.

Not attachment pathology in childhood.

Not personality disorder pathology.

Not family therapy.

Not child development.

Not delusional thought disorders.

Not child abuse and complex trauma.

As a licensed clinical psychologist, I AM competent by my education, training, and experience in all of those domains. I cite to my vitae for support:

Dr. Childress Vitae

I come to the family courts from my position as Clinical Director for a three-university assessment and treatment center for children ages zero-to-five in foster care, CPS was our primary referral source. I have background professional experience in attachment pathology, complex trauma, and child abuse. I also have background professional experience in the assessment and diagnosis of delusional thought disorders. I cite to my specialized expertise:

Dr. Childress Specialized Expertise

I also have specialized professional experience and training in the assessment and diagnosis of Factitious Disorder Imposed on Another (DSM-5 300.91; Munchausen by proxy) from my tenure at both Children’s Hospital of Los Angeles (CHLA) for three years of training, one pre-doctoral and two post-doctoral, and from my position on the medical staff at Children’s Hospital Orange County (Choc) as a pediatric psychologist.

As a licensed clinical psychologist, I also have professional background and experience in the assessment, diagnosis, and treatment of the attachment and family conflict pathology surrounding child custody conflict in the family courts, with presentations to the national conventions of the APA and AFCC (among others) regarding the pathology in the family courts, its assessment, diagnosis, and treatment.

From my role, position, and professional standing as a licensed clinical psychologist working directly with the pathology in the family courts, I am formally instructing Amy Baker and Jennifer Harman to stop using the construct of “parental alienation” in a professional capacity as this is a rejected diagnostic construct by the American Psychiatric Association for being substantially beneath professional standards of clinical practice.

The diagnostic model of “parental alienation” is the worst diagnostic model for a pathology ever proposed with substantial-substantial flaws as a diagnostic construct, which is why it was rejected as a diagnostic construct by the American Psychiatric Association in 2013 after a full and complete review.

The American Psychiatric Association said no.

The use of the rejected clinical diagnostic construct of “parental alienation” in a professional capacity is in violation of Standard 2.04 of the APA ethics code that requires – mandatory – that the “established scientific and professional knowledge” of professional psychology be applied as the bases for scientific and professional judgments.

2.04 Bases for Scientific and Professional Judgments
Psychologists’ work is based upon established scientific and professional knowledge of the discipline.

If, after having applied the “established scientific and professional knowledge of the discipline,” there remains some gap in understanding the pathology in the family courts using the scientifically established constructs and principles from – personality disorder pathology – attachment – complex trauma – family systems – child development – and delusional thought disorders – then, and ONLY then, are they allowed to propose a unique “new pathology” in mental health – so unique that it needs its own unique symptom identifiers.

Apply the “established scientific and professional knowledge of the discipline” first. Then, after applying the established knowledge first, if  a unique new pathology is needed to describe the pathology, then, and ONLY then, can they offer their proposal for a unique new pathology in mental health (that has been already been rejected by the American Psychiatric Association).

As a clinical psychologist treating the pathology in the family courts, the use of the construct of “parental alienation” substantially degrades the quality of clinical practice and clinical services that are received by parents and children in the family courts by encouraging professional ignorance and a professional disregard for ethical standards of practice.

The use of the construct of “parental alienation” degrades the quality of clinical services and clinical care received by parents, children, and the courts. It is essential and required that ALL psychologists rely ONLY on the “established scientific and professional knowledge of the discipline” as the bases for their professional judgments.

The relevant “established scientific and professional knowledge” of psychology is:

Attachment – Bowlby and others

Family systems therapy – Minuchin and others

Personality disorders (Dark) – Beck and others

Complex trauma – van der Kolk and others

Child development – Tronick and others

Self psychology – Kohut and others

Thought disorders – DSM-5 diagnostic system

This represents the “established scientific and professional knowledge of the discipline” that is required to be applied as the bases for scientific and professional judgments – first – not after – not instead of – FIRST.

By using the rejected diagnostic construct of “parental alienation” and promoting this made-up pathology to the general public, mental health professionals, and the court, Amy Baker and Jennifer Harman are degrading the quality of professional clinical services and clinical care received by children and parents in the family courts, and they are providing the courts with substantially inferior and professionally rejected professional information on which to base its decisions (rejected by the American Psychiatric Association as a legitimate clinical diagnostic pathology).

The use of the construct of “parental alienation” in a professional capacity degrades the quality of clinical services received by parents and children in the family courts – and is in violation of Standard 2.04 Bases for Scientific and Professional Judgments.

Neither Amy Baker nor Jennifer Harman are licensed – they have never been educated nor received the training necessary to be qualified for licensure. Neither is competent by their background education, training, or experience to opine on the assessment, diagnosis, or treatment of pathology – any pathology.

As a licensed clinical psychologist, I believe that there “may have been an ethical violation” of Standards 2.01 and 2.04 by another psychologist, Amy Baker and Jennifer Harman, when they opine on the assessment, diagnosis, and treatment of the pathology in the family courts, and when they rely on the rejected diagnostic construct of “parental alienation” as the bases for their scientific and professional judgments.

As are result of their being unlicensed, however, no recourse to their licensing boards is available for correction of their apparent violations to Standards 2.01 Boundaries of Competence when they opine on the assessment, diagnosis, or treatment of pathology, or for apparent violations to Standard 2.04 that degrades the quality of clinical services and clinical care received by parents and children.

Amy Baker and Jennifer Harman are not licensed clinical psychologists, so no corrective guidance is available from their licensing boards for their degradation of clinical care in the family courts because of apparently unethical practice (violations to Standards 2.01 & 2.04).

As a licensed clinical psychologist active in the family courts, I am therefore instructing Amy Baker and Jennifer Harman to discontinue using the construct of “parental alienation” in a professional capacity as it substantially degrades the quality of clinical services provided to parents and their children in the family courts, and to restrict themselves to the application of the “established scientific and professional knowledge” of professional psychology as the bases for their professional judgments first – not after – not instead of.

First.

The relevant established scientific and professional knowledge of the discipline is:

Attachment – Bowlby and others
Family systems therapy – Minuchin and others
Personality disorders – Beck and others
Complex trauma – van der Kolk and others
Child development – Tronick and others
Thought disorders – DSM-5 diagnostic system

Ethical practice is not optional. It is mandatory for all psychologists, including Amy Baker and Jennifer Harman. Ethical Standards apply to everyone, or they apply to no one. Standard 2.04 says what it says, and the “established scientific and professional knowledge of the discipline” is what it is.

We need to establish baseline standards for professional clinical practice in the family courts. By disregarding the mandatory requirements of the APA ethics code and spreading misinformation to the general public, other mental health professionals, and to the court, Amy Baker and Jennifer Harman are encouraging others to do the same. Either the APA ethics code applies to ALL psychologists, or it applies to NO psychologists.

It applies to all psychologists. Amy Baker and Jennifer Harman are not exempt from their mandatory ethical obligations under Standards 2.01 and 2.04 of the Ethical Standards of Psychologists and Code of Conduct of the American Psychological Association. The APA ethics code is mandatory – ethical practice is NOT optional

Google mandatory: required by law or rules; compulsory.

Google required: officially compulsory, or otherwise considered essential; indispensable.

Google indispensable: absolutely necessary.

Ethical practice by all psychologists is indispensable and absolutely necessary. Compliance with ethical Standards 2.01 and 2.04 is mandatory-required.

Unethical practice and the spread of psychiatric/psychological misinformation degrades the quality of clinical services and clinical care delivered to children and parents in the family courts. The children, their parents, and the Court, deserve the highest quality of professional services, not the lowest.

Compliance with the APA ethics code is mandatory – compulsory – essential and required – for all psychologists. Amy Baker and Jennifer Harman are not exempt from their professional ethical obligations to restrict their views to the boundaries of their competence (2.01), and to rely on the “established scientific and professional knowledge” as the bases for their scientific and professional judgments (2.04) – first – not after –  not instead of.

As a licensed clinical psychologist working directly with these children and parents in the family courts, I am instructing Amy Baker and Jennifer Harman to discontinue the use of “parental alienation” in a professional capacity because the use of that construct substantially degrades the quality of clinical services received by parents and children in the family courts.

Promoting the APA-rejected diagnostic construct of “parental alienation” through the Internet to the general public and to other other mental health professionals, represents a reckless and irresponsible spreading of psychiatric/psychological misinformation to the general public, causing substantial harm to the parents and children in the family courts, and it substantially degrades the quality of clinical services received by children, parents, and the Court.

Standards 1.04 & 1.05

I am required – mandated – by Standard 1.04 of the Ethical Principles of Psychologists and Code of Conduct of the American Psychological Association to bring apparent ethical violations to the “attention of that individual” seeing informal resolution.

I am doing that through this notification in an attempt at an informal resolution, because, as a licensed clinical psychologist working with parents and children in the family courts, I believe there may have been an ethical violation by another psychologist – Amy Baker and Jennifer Harman.

By their continuing irresponsible spreading of medical-psychiatric misinformation to the general public about a non-existent pathology, their disregard of their ethical obligations under Standard 2.01 and 2.04 is causing substantial harm to the parents and children in the family courts by degrading the quality of clinical services they seek and receive.

If the concerns for apparent the ethical violations to Standards 2.01 Boundaries of Competence and 2.04 Bases for Scientific and Professional Judgments are not properly resolved by bringing it to the attention of the individuals involved, then I am required (mandatory) under Standard 1.05 to “take further action appropriate to the situation” – with offered guidance from Standard 1.05 of making a “referral to state or national committees on professional ethics, to state licensing boards, or to the appropriate institutional authorities.”

Since neither Amy Baker nor Jennifer Harman are licensed clinical psychologists, no recourse to their licensing boards is available because they have none, leaving only the other recommended options for “further action appropriate to the situation” – i.e., referral to state or national committees on professional ethics, or to appropriate institutional authorities.

As a licensed clinical psychologists, for the well-being of the parents and children in the family courts who need an accurate diagnosis and effective treatment for the pathology in their families, I urge Amy Baker and Jennifer Harman to restrict themselves to the application of the established scientific and professional knowledge of the discipline FIRST – not after – not instead of – FIRST.

The appropriate clinical descriptions of the pathology to provide to parents, other mental health professionals, and the courts are the following:

Delusional thought disorders – cite to Walters & Friedlander (2016), cite to Childress (2015)..

Cross-generational coalitions and emotional cutoffs – cite to Minuchin and Bowen.

Personalty disorders – cite to Beck, Millon, Kernberg, Linehan, and Dark personality research.

Complex trauma and child abuse – cite to van der Kolk and Cicchetti.

Attachment – cite to Bowlby, Tronick, Lyons-Ruth, Sroufe.

If you are not competent in these domains of established scientific and professional knowledge, then I refer you to Standard 2.03 Maintaining Competence.

2.03 Maintaining Competence
Psychologists undertake ongoing efforts to develop and maintain their competence.

The continued spreading of psychiatric/psychological misinformation on the Internet must stop – it substantially degrades the quality of clinical services received by parents and children in the family courts, causing substantial harm to both the children and their parents.

There is a reason for ethical Standards of practice. There is a reason they are mandatory. Unethical practice hurts people – a lot. Like here.

We must establish a baseline of professional quality in the clinical services provided to these parents and children in the family courts. I urge Amy Baker and Jennifer Harman to more fully embrace their ethical obligations under Standards 2.01 and 2.04.

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

There are three Diagnostic Indicators that will always be present in an attachment-based model of “parental alienation” (AB-PA),

1) Attachment Suppression: the child will show suppression of attachment bonding motivations toward a normal-range parent.

2) High Protest Behavior: the child will evidence either high-anger protest (DI-2a) diagnostically defined as the presence of five specific narcissistic personality traits, and/or high-anxiety protest (DI-2b) as defined by meeting DSM-5 diagnostic criteria for a Specific Phobia with the parent as the target.

3) Persecutory Delusion: the child will evidence a persecutory delusion toward a normal-range parent.

A normal-range parent is diagnostically defined as a rating from the assessing mental health professional as either Level 3 (Normal-Range Problematic) or Level 4 (Normal-Range Healthy) parenting on the Parenting Practices Rating Scale.

Abusive-range parenting is diagnostically defined as a rating from the assessing mental health professional as either Level 2 (Highly Problematic) or Level 1 (Abusive) parenting on the Parenting Practices Rating Scale.

In addition to the three Diagnostic Indicators of AB-PA that are always present, there are also 12 Associated Clinical Signs which, while not always present, are often present surrounding the shared persecutory delusion of AB-PA.

ACS-1: Use of the Word “Forced”

This symptom represents a manipulative communication used to disable efforts to resolve the child’s symptoms by disempowering any attempts to change the child’s views and behavior.

• • The child shouldn’t be “forced” to have a relationship with the other parent.

• • “What can I do? I can’t “force” the child to go on visitations with the other parent.” (“…get in the car”, etc.)

The accurate reframing of the situation actual situation is that the child is being given the “opportunity” to have a bonded relationship with both parents.

ACS 2: Empowering the child:

The child is empowered by the allied parent to reject the other parent.

ACS-1 and ACS-2 are typically used in tandem; we should not influence the child (ACS-1) and the child should be allowed to decide (ACS-2).

• • “The child should decide on visitation”

• • “We need to listen to the child”

• • Seeking the child’s testimony in court, empowering the child to reject the parent directly to the judge

ACS 3: “The Exclusion Demand”

The child seeks to exclude the targeted parent from the child’s activities (sporting events, award ceremonies, music recitals).

• • The child’s role is as a “regulatory object” to stabilize the narcissistic/(borderline) parent.

• • The narcissistic/(borderline) parent becomes dysregulated when the targeted parent attends the child’s activities, and the child feels the stress of keeping the narcissistic/(borderline) parent regulated.

• • It is the allied parent who wants to exclude the other parent, and the child is then manipulated as the “regulatory object” to achieve the parent’s objectives.

This symptom is not present in any other pathology and is not present in normal-range children. When this symptom is present, it is nearly 100% diagnostic of AB-PA.

ACS 4: Parental Replacement

The child rejects ownership of the targeted parent, either by calling the targeted parent by his or her first name or by calling the new step-parent spouse of the allied narcissistic/(borderline) parent by the parental appellations of “mom” or “dad.”

This never happens with an authentic child attachment system.  When the symptom of Parental Replacement is present, it is nearly 100% diagnostic of AB-PA.

ACS 5:  The “Unforgivable Event”

A negative past event is used as justification for all current and future rejection of the targeted parent.

This is a feature of the symptom of splitting:

From Linehan: “It is not uncommon for such individuals to believe that the smallest fault makes it impossible for the person to be “good” inside. Things once defined do not change.  Once a person is “flawed,” for instance, that person will remain flawed forever.” (Linehan, 1993, p. 35)

ACS 6:  Liar– “Fake”

The child claims that the targeted parent is “fake” or that the targeted parent is a liar, often said when responding to the parent’s sadness or love.

This symptom arises from the child’s efforts to cope with the child’s guilt for rejecting a beloved and loving parent. The child seeks to discount the authenticity of the parent’s sadness and loss (and the authenticity of the child’s own sadness and loss).

ACS 7:  Themes for rejection

A characteristic set of reasons are offered for the rejection of the parent:

• • Too controlling
  • Too angry – anger management problems
  • Targeted parent doesn’t take responsibility – doesn’t apologize
  • New romantic relationship neglects the child
  • Prior neglect of the child by the parent
  • Vague personhood
  • Non-forgivable grudge
  • Not adequately feeding the child

ACS 8:   Unwarranted Use of the Word “Abuse”

The allied parent (or child) uses the word “abuse” to describe the normal-range parenting practices of the targeted parent. Borderline personalities frequently characterize other people’s normal-range actions using the term “abusive.”  Normal-range people typically use less inflammatory words to characterize disagreements with others.

• • Using the word “abuse” has two differential diagnostic possibilities: 1) authentic abuse, 2) borderline personality pathology.

The unwarranted use of the word “abuse” originates in the unresolved childhood of the pathological parent that currently distorts perceptions of current interactions.

ACS 9:   Excessive texting

The child and the allied parent maintain almost continual contact while the child is with the targeted parent.

The child acts as a “regulatory object” for the fragile personality structure of the narcissistic/(borderline) parent, who becomes excessively anxious when separated from the child (because the child might bond with the targeted parent). Intrusion into the other parent’s time prevents bonding to this parent and regulates the anxiety of the narcissistic/(borderline) parent.

ACS 10:  Role-reversal use of the child

The allied parent abdicates parental decision making to the child, placing the child out front as supposedly wanting what the allied parent wants.

• • “It’s not me, it’s the child who wants…”

The narcissistic/(borderline) parent first manipulates the child’s desire and then hides their manipulation behind the child’s supposed “independent” decision (“It’s not me, it’s the child who…”).

ACS 11:  The parent “deserves” to be rejected

The child and the allied narcissistic/(borderline) parent both maintain the theme that the targeted parent “deserves” to be rejected.

This represents a classic spousal abuse theme (“of course I hit her, my dinner was cold, she deserved to be hit”). When challenged on the cruelty done to the targeted parent by the child’s angry-hostile rejection, the response of the child and targeted parent is that the targeted parent “deserves” to be rejected (the narcissistic value of justifying abuse and cruelty toward another person).

Note: the healthy value we teach is that we are not nice to other people because of who they are, we are nice because of who we are. This is the healthy counter-value to the narcissistic value that it is okay to be cruel as long as the target of our “deserves” it for some justification.

ACS 12:  Disregard of court orders

The narcissistic personality does not recognize the construct of “authority” – for the narcissistic personality “authority” is synonymous with “power.”

This symptom represents narcissistic entitlement, i.e., that they are exempt from rules that govern other ‘ordinary’ people (i.e., they’re ‘special’).

From Beck et al: “Narcissistic individuals also use power and entitlement as evidence of superiority… As a means of demonstrating their power, narcissists may alter boundaries, make unilateral decisions, control others, and determine exceptions to rules that apply to other, ordinary people.” (Beck, et al., 2004, p. 251)

Interpretation

The 12 ACS offer additional supporting symptoms for the diagnosis when the three Diagnostic Indicators of AB-PA are present. A general interpretation for the degree of support offered by the Associated Clinical Signs identified for the family would be:

2-3 ACS: Mild Support

4-5 ACS: Moderate Degree of Support

6-8 ACS: High Degree of Support

9-12 ACS: Extremely High Degree of Support

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

I should discuss my consultation practice. You are a “vulnerable population” and I need to be careful with you.

You are what’s considered a “vulnerable population” in professional psychology because of your compromised autonomy in decision-making due to the court’s involvement in your lives, and because of the immense emotional distress and need you are experiencing.

That makes you vulnerable to exploitation.

Psychologists are not allowed to directly market to possible mental health clients because of your vulnerability. But we have to earn a living. Often the way we recruit into our practice is by giving lectures and talks to the target population of our referral base, such as to PTAs for a school=based practice, or to autism parent groups if that’s where we are, and we leave our cards in the back of the room for people to take.

We also collect into professional groups and then refer among our colleagues based on our personal connections within these groups, “You should go see so-n-so, they specialize in that.”

You families in the courts are even more vulnerable, and you qualify as a special designation within professional psychology – a “special population” (like prisoners) – because of your compromised autonomy in decision-making surrounding your life resulting from the court’s involvement.

You are vulnerable to exploitation – and – you are being financially exploited by all the professionals around you. They take your money and solve nothing. That’s called financial exploitation of a vulnerable population.

I need to tread carefully with you when I discuss my consulting practice. I make my living from you – and – you are a needy population and an especially vulnerable population.

I’m fine making my living from you – I’m a clinical psychologist, it’s my job. My current practice is fine without you entering my practice, there are enough clients coming to me that I do not necessarily need to recruit more – there is always a risk of exploitation with a vulnerable population.

Spousal Financial Abuse

The primary difficulty surrounding your vulnerability is the potential financial spousal abuse of the targeted parent by the narcissistic-borderline Dark Triad-Tetrad personality, using the court system and the high cost of attorneys to drain the targeted parent of the financial resources they need to protect themselves and their child.

To the extent that forensic custody evaluations charge parents from $20,000 to $40,000 for a custody evaluation that solves nothing, this represents financial exploitation of a vulnerable population by the forensic psychologists and participation in the spousal financial abuse of the targeted parent.

The forensic psychologists are participating in the spousal financial abuse of the targeted parent by exploiting the vulnerability of these parent rather than solving the pathology in the family. They take the parent’s money for an activity – but that activity solves nothing and the family continues to its destruction.

The forensic psychologists are participating in the financial spousal abuse of the targeted parent by the narcissistic-borderline Dark Triad-Tetrad personality parent. I won’t participate.

I make my living from your families – from human suffering – I’m a clinical psychologist, it’s my job to go to the suffering to help lessen it and hopefully end it. I’m a trauma psychologist out of foster care, this is my pathology, child abuse and complex trauma. Specifically, the trans-generational transmission of trauma.

We need outside and independent review of the practices in court-involved professional psychology – of everyone. You are a vulnerable population and you warrant professional designation as such, subject to additional safeguards and protections surrounding your compromised autonomy in decision-making regarding your life because of the court’s involvement.

We need to develop procedural safeguards and steps to protect this vulnerable population from exploitation of their vulnerability by the surrounding mental health professionals.

Until that occurs, how do you protect yourself from exploitation?

Get a second opinion for your decisions. Talk to a family member support person, discuss your options with your attorney. In the legal system, always follow the advice of your attorney. In the healthcare system, follow the advice of your doctor. If there is a question about their advice, get a second opinion.

You have a court-involved problem that needs a healthcare solution.

Dr. Childress Consulting Practice

I have a clinical psychology (treatment) consulting practice in the courts surrounding divorce, parent-child attachment pathology, and child custody conflict. I don’t do direct treatment anymore, I have no real-world office. I am an old clinical psychologist in a consulting practice now.

Once things settle-down in the family courts, I may develop a private online psychotherapy practice with something OTHER than court-involved family conflict.

Currently, I hold general public consultations the first week of every month at my online office (doxy.me/drchildress) with scheduling through my website. For non-California residents, I limit these general public consultations to one session (maybe two depending on circumstances).

Attorneys seeking consultation on any mental health issue (I am a full-service clinical psychologist in the domains of by expertise) can contact me directly through my email at: drcachildress.bainbridge@gmail.com.

I am typically engaged in three possible roles:

1) Content Expert Testimony – I am provided with no material specific to the situation and my testimony is limited to the knowledge domains of professional psychology.

I bill my expert testimony separately from any other scope-of-service agreement, and I bill in 4-hour blocks of time reserved from my schedule for testimony at my standard clinical rate.

2) Document Review & Consultation – I am provided with material from the attorney to review, typically surrounding mental health reports (and perhaps some additional material) to provide an opinion from clinical psychology on the material reviewed. My involvement is developed through a scope-of service-agreement developed with the attorney and their client.

I bill to the scope of service agreement, not to my hours. For my billing purposes, I think in small-package (one or two therapy reports with minimal additional information), or large-package (a forensic custody report or complex cases with extensive information needing to be reviewed). I provide the client with a set-fee for the scope of service sought, this provides the parent-client with a set cost for my involvement for the scope of service.

3) Second-Opinion Consultation on Active Assessment – In this role, I am engaged as a clinical consultant to the involved mental health professionals in conducting a current clinical assessment with the family. The Tele-Health Consulting Handout available on my ‘gold-trees’ Consulting website Attorney Resources section contains more information about options for my clinical second-opinion consultation with the involved mental health professionals.

You are a vulnerable population who warrant additional safeguards and protections from exploitation by the involved mental health professionals – I am an involved mental health professional.

Protections come from established standards of practice, such as those required by the APA ethics code. Additional protections are afforded by second-opinion consultations.

If you are considering involving Dr. Childress into your matter, I recommend you seek a second opinion from someone else that you trust – hopefully you trust your attorney, and that should be the person whose judgment you should rely on when navigating the legal system.

Other trusted family members or close friends can provide valuable counsel in decision-making.

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