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

I received the following Comment from Dr. Mercer.  Since it requires a more elaborated response than I can provide in the Comment section of this blog, I decided to respond as a post.

Here is the Comment from Dr. Mercer:

Can you tell me what was the age of the youngest child you have ever treated? Can you tell me how you ascertain whether or not there is a “good reason” for the child’s rejection? Can you tell me how often you find that you must tell a rejected parent that there seems to have been a reason for the child’s rejection, so you cannot use your treatment to address the problem?

I don’t have a treatment to suggest, and if I did that fact would be irrelevant to the empirical questions I’m asking. As I said to one of your advocates, the burden of proof is on you, not on me. But right now I’m not asking for proof, I’m just asking for a couple of details that I would think would be easy for you to supply. If you prefer not to answer, please just say so and save time for both of us.

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My goodness, Dr. Mercer. I apologize. I thought you were interested in having a professional dialogue about a very serious form of psychopathology involving the child’s triangulation into the spousal conflict through a cross-generational coalition with a narcissistic/borderline parent that is inducing severe developmental, personality, and psychiatric psychopathology in the child. I’m sorry, I didn’t realize you just wanted a “couple of details” that you believe would be easy for me to supply.

Oh, by the way, have you read my book,

An Attachment-Based Model of Parental Alienation: Foundations

I devote all of Chapter 9 to Diagnosis.

You know, Dr. Mercer, I’m beginning to suspect that you don’t want to actually address the pathologies that affect children and families, but that you may have some sort of personal agenda you want to advance.

I’ve tried to address your questions at a well-balanced professional level of discussion, citing references for my statements and my concerns. You have not responded to any of this content material, but have become fixated on how early a narcissistic/borderline parent can distort a child’s functioning. Not only that, you have personalized it as to what is the youngest child I’ve ever treated. What’s it matter to the issues we’re discussing?

And you haven’t even read Foundations.  I’m not sure at this point that you actually want a professional level discussion.

So I apologize, I didn’t realize that you just wanted answers to a few specific “details” rather than a discussion of the broader constructs relevant to the pathology.

So here are my answers:

Detail 1:  “What was the age of the youngest child you have ever treated?”

Actually, I was the Clinical Director for an early childhood assessment and treatment center (ages 0-5) working primarily with children in the foster care system. So the youngest child I’ve personally treated was about 2 ½ years old, although I’ve supervised the treatment of a wide variety of ages, from infancy to five years old at the clinic.

In the area of early childhood, my specialty area is the preschool age range, from three to five years old.

I’m trained to clinical competence in the relationship-based interventions of Watch, Wait, and Wonder (used to improve the infant-mother bond) and Circle of Security (used to improve attachment bonding in preschool-age children).

I’m also trained to clinical competence in the DC-03 diagnostic system (an early childhood alternative to the DSM diagnositic system) and the ICDL-DMIC diagnostic system dealing with the assessment, diagnosis, and intervention for developmental and emotional disorders, autistic spectrum disorders, multisystem developmental disorders, regulatory disorders involving attention, learning and behavioral problems, cognitive, language, motor, and sensory disturbances.

Before developing my sub-specialty expertise in early childhood mental health, my primary focus was ADHD in school-age children and adolescents. One of the reasons I went into early childhood was to increase my professional understanding for the early childhood development of emotional-behavioral regulatory disorders (ADHD). My work with ADHD-spectrum issues spans the school-age and adolescent periods of child development.

My work with school-age kids and adolescents has involved extensive work with Oppositional Defiant Disorder (a co-morbid disorder with ADHD) and severe parent-child conflict. So I am well-familiar with “normal-range,” and by that I mean clinically “normal-range,” parent-child conflict (i.e., severe expressions of parent-child conflict associated with Oppositional Defiant Disorder).

My work in high-conflict divorce began in 2008 with a 10 year old child who had been rejecting a relationship with his mother for two years. The reason he offered for his rejection of his mother was that two years prior she was playing with him on the bed and she playfully held his feet over his head which compressed his diaphragm. He told his mom of his discomfort and she dropped his feet.  That’s why he doesn’t want to have anything to do with his mother for the rest of his life.  And nothing she can do will alter that. —— Yeah. Doesn’t make any sense does it? Didn’t make any sense to me either.

As I worked it out, it became evident the child was being triangulated into the spousal conflict by the father through the formation of a cross-generational coalition with the child against the mother. Standard family systems stuff.

Through a series of meetings with the father, it became evident that the father had prominent narcissistic personality traits with histrionic overtones. The father was angry at the mother for having rejected his self-perceived magnificence and he was using the child’s rejection of the mother as his weapon of revenge. The family process had domestic violence overtones, except instead of using his fists to beat the mother for leaving him, he was using the child.

The child was compliant, because the father would psychologically torment the child with irrational rages if the child deviated from the parentally desired behavior. If the child showed any signs of bonding to the mother, in fact, if the child did not make sufficient displays of rejecting his mother, then the father would subject the child to withering psychological torment.  By rejecting his mother, the child kept the father in a regulated emotional state and avoided the father’s rageful retaliation.

At the time I had never heard of “parental alienation.” But I immediately recognized the nature and severity of the pathology from within standard and established types of pathology; i.e., the child’s triangulation into the spousal conflict by the father through the formation of a cross-generational coalition with the father against the mother in which the child was being used as a regulatory object to stabilize the father’s pathology. When I started to treat the cross-generational coalition rather than validating the child’s rejection of his mother, the father terminated therapy. I decided to look into this more and discovered the construct of Parental Alienation Syndrome and the controversy surrounding it. This pathology is not a new “syndrome.” It is a manifestation of standard and established forms of pathology.

So I set about working out the pathology at a high-level of analysis. I anticipated that the narcissistic and borderline personality pathology with which we are dealing would attack any effort to disrupt the pathology with great vitriol and irrationally based accusations characteristic of the narcissistic/borderline process of splitting. So I needed to make sure that the theoretical foundations for the explanation of this pathology were rock solid. For seven years I’ve been uncovering the linkages within this pathology.

All the while I’ve been posting to my website and blog to make information available as quickly as possible to the parents and children suffering from this form of pathology. In my book, An Attachment-Based Model of Parental Alienation: Foundations, I describe the complexity of this pathology within three separate and distinct levels of analysis, the family systems level, the personality disorder level, and the attachment-trauma level, AND I integrate the analysis across all three levels, explaining how the childhood attachment trauma creates the narcissistic/borderline personality structure, and how the narcissistic/borderline personality structure creates the family systems pathology. No model of a pathology could explain the pathology both within and across three distinct levels of analysis unless it was accurate. The description of the pathology in Foundations is accurate.

You feel I have a “burden of proof,” Dr. Mercer? Foundations is my answer. I suggest you read it before developing opinions about my work.

Detail 2: “Can you tell me how you ascertain whether or not there is a “good reason” for the child’s rejection?”

This is a complex question. As the Clinical Director for an early childhood assessment and treatment center working with children in the foster care system I saw trauma and child abuse up close and personal. I know what authentic child abuse and trauma look like. Because of this, I also know what authentic child abuse trauma doesn’t look like.

This up close and personal experience with treating the sequelae of authentic child abuse trauma helps with the differential diagnosis of the child’s role-reversal relationship with a narcissistic/borderline parent who is using the child as a “regulatory object” to stabilize the parent’s pathology. There is a distinctive difference from the symptom presentation with authentic child abuse trauma.

Among a wide variety of indicators (differential diagnosis is not about any single puzzle piece, it is about the entire picture created by ALL the puzzle pieces) children exposed to authentic child abuse do not display five specific narcissistic/borderline personality symptoms in their symptom display, 1) grandiosity, 2) entitlement, 3) absence of empathy, 4) a haughty and arrogant attitude, and 5) splitting.

On the other hand, children who are in an enmeshed cross-generational coaltion with a narcissistic/borderline parent against the other parent do display all five of these specific narcissistic personalty traits. The only way a child acquires five specific a-priori predicted narcissistic/borderline personality symptoms is through an enmeshed psychological relationship with a narcissistic/borderline parent.  Do you disagree?  Do authentically abused children display a haughty and arrogant attitude of grandiose entitlement toward their abuser? Of course not.  They’re afraid of their abuser.

But differential diagnosis is not about any single indicator, it’s about the entire picture created by the symptoms and family processes. Another important indicator of authentic versus inauthentic parent-child conflict is the locus of “stimulus control” over the child’s behavior. The construct of “stimulus control” is a behavioral (learning theory) construct regarding the cueing of behavior. It is best understood by way of analogy:

Our driving behavior is under the “stimulus control” of traffic lights. When the light is green, we go. When the light is red, we stop. Yellow is a transitional warning. Our driving behavior is under the “control” of the “stimulus” of the traffic light.

In authentic parent-child conflict, the child’s behavior is under the stimulus control of the parent’s behavior.

In inauthentic parent-child conflict the child’s behavior is NOT under the stimulus control of the parent’s behavior.

Since our driving behavior is under the stimulus control of the traffic light, when we change the color of the traffic light we see a corresponding change in the driving behavior. If the child’s behavior is under the stimulus control of the parent’s behavior, then when we change the parent’s behavior we should see a corresponding change in the child’s behavior.

In inauthentic parent-child conflict, however, if we change the parent’s behavior we see no change in the child’s behavior. That’s because the stimulus control for the child’s behavior is in the behavior of the allied narcissistic/borderline parent and the role-reversal, “regulatory object” role of the child in stabilizing the parent’s pathology.

But this is still only another single puzzle piece of the entire puzzle picture. The puzzle “cats in the garden” isn’t this puzzle because of just a few specific pieces. The puzzle is “cats in the garden” because when we put ALL of the puzzle pieces together they display a picture of three cats, one orange cat, one grey cat, and one black and white cat, frolicking among flowers. There is a watering can over here and a fence post in this location. There is a butterfly above these yellow flowers. That’s what makes the puzzle “cats in the garden.”

Authentic trauma, which I diagnosed and treated while serving as the Clinical Director for an early childhood assessment and treatment center treating children in the foster care system, creates a puzzle picture of “boats on a lake.” Both puzzles contain blue pieces and red pieces and yellow pieces. But when we put ALL the puzzle pieces together, one creates a picture of cats frolicking in the garden, and the other creates a picture of boats on a lake.

I would also refer you to my blog post on parent-child conflict, Parenting and Protest Behavior.

Detail 3:  “Can you tell me how often you find that you must tell a rejected parent that there seems to have been a reason for the child’s rejection, so you cannot use your treatment to address the problem?”

First let me correct something, it’s not “my treatment,” it’s family systems therapy. 

Because of my expertise in the pathology of attachment-based “parental alienation” I am sometimes sought out by the targeted-rejected parent for help in resolving this pathology. In about 20% to 30% of these cases I have declined treatment or altered the treatment goal to address the pathology of the supposedly targeted parent because the narcissistic parent actually turned out to be the supposedly targeted-rejected parent. However, my personal experience should not be considered representative of the frequency of this in the general population because I am getting a self-selected sample of clientele in my private practice because of my expertise with this form of pathology.

Once we move beyond the current professional impasse of recognizing that both cats (personality disorder pathology) and dogs (authentic child abuse) exist, we can then begin to conduct research on this exact question. But before we reach that point we first have to recognize that both cats and dogs exist. The existence of cats does not nullify the existence of dogs; and not all animals are dogs. Cats exist.

So hopefully, I’ve addressed your “couple of details” that you think would be easy for me to supply an answer for.

And to you, Dr. Mercer, thank you for answering my previous question. It’s unfortunate that you don’t have any idea how to treat the pathology of a child’s cross-generational coalition with a narcissistic/borderline personality parent in which the child is used as a regulatory object to stabilize the parent’s pathology.

Are you aware that the premier family systems therapist Jay Haley refers to this type of pathology as a “perverse triangle”?  Do you know why he calls it “perverse”?

So I guess if you have no idea how to treat the pathology, then you don’t really have much of relevance to add to the discussion of the treatment for this type of pathology. That’s unfortunate. I guess you’ll just have to defer opinions regarding the treatment of this type of pathology to those of us who know what we’re doing.

Since I’ve addressed your “couple of details,” perhaps you could answer just one question for me. You suggest that I have some sort of “burden of proof.” What I’m wondering is how did you become the arbiter for truth in this? Was it posted on Craigslist, “Wanted: Arbiter of Truth” – or is it just a role you’ve assigned yourself?

Best wishes,

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

This is my response to Dr. Mercer regarding her desire to discuss treatment.

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Hello Dr. Mercer,

First, let me say it’s a pleasure to meet you and to engage you in this professional dialogue. Thank you for your response to my previous post.

Second, let me say, I am not a fan of the Gardnerian PAS model. I will in no way defend the Gardnerian PAS model. Needless to say, I suspect my criticisms of the PAS model have left me few friends among the current PAS advocates. Don’t care. The PAS model isn’t very good.

I’m a conservative clinical psychologist, and I believe we should remain within scientifically established psychological principles and constructs and work at the highest level of professional knowledge, based in the scientifically established literature.

Also, I’ve worked in the foster care system as the Clinical Director for a children’s assessment and treatment center, and I am experienced with authentic child abuse up close and personal. Whatever solutions we develop must protect 100% of children 100% of the time.

Based on your blog and Comment, I recognize your interest in moving into a discussion of treatment, but I would respectfully suggest that a discussion of treatment would be premature before we have an agreed understanding regarding the pathology we are trying to treat.

While I must plead ignorance regarding your work, I suspect you have a strong concern for protecting children from authentic child abuse and a strong reluctance to discount the reports from the children. If I’m correct in my assumptions, your position would be understandable and I would agree with it.

What I’m worried about is a very small population of children who are being parented by a narcissistic and/or borderline personality parent.

A 2008 study regarding the prevalence of Narcissistic Personality Disorder (Stinson, et al., 2008) estimates the prevalence of Narcissistic Personality Disorder at 6%.

A 2008 study regarding the prevalence of Borderline Personality Disorder (Grant, et al., 2008) estimates the prevalence of Borderline Personality Disorder at 6%.

I’m not going to quibble on numbers, but my point is it’s a small, but not insubstantial, group of families. This pathology, the narcissistic and borderline personality pathology, is also likely to be highly represented in high-conflict divorce. The association of this type of personality pathology with disorganized attachment would mean that these spouses/parents have no organized strategy for repairing relationship breaches, such as encountered in the divorce. In addition, the divorce hits dead center on the narcissistic vulnerability of primal self-inadequacy (rejection of the narcissistic personality spouse by the attachment figure of the other spouse), and dead center on the core borderline vulnerability of abandonment fears (by the attachment figure of the other spouse).

So a more florid display of narcissistic and borderline personality pathology surrounding divorce should be expected. So the clinical question becomes, what would that display look like?

In discussing the narcissistic and borderline personality structure, Otto Kernberg notes that,

“They 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, 1977, p. 229)

The divorce experience is a loss, so it will produce a grief response. But if the narcissistic/borderline personality structure is characterologically unable to process sadness and grief, but instead translates it into “anger and resentment, loaded with revengeful wishes” then what we may be looking at is what Bowlby called disordered or pathological mourning.

“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)

I don’t want to go too technical in our discussion at this point, but I don’t feel I’m cherry-picking Bowlby. It think that attachment theory and personality disorder pathology can add considerably to the quality of the discussion that has thus far been dominated by a woefully inadequate proposal of PAS. Personally, I’m going to be leaving the construct of PAS behind as an interesting historical curiosity, and I intend to engage in a more scientifically and clinically anchored discussion of the pathology.

As I said in my post Cats Are Not Dogs, there is a genuine pathology, and it is linked to the pathology of a narcissistic and borderline personality parent. That’s the group of parents and their children that I am concerned about. Not all animals are cats. Not all animals are dogs. And the existence of cats does not discount the existence of dogs. Both cats and dogs have four legs, fur, and a tail. So we don’t want to get them confused. But there are also differences; cats have retractable claws, dogs don’t; dogs bark, cats meow. So once we know what we’re looking for, then we can begin to identify the specific features that clinically differentiate cats and dogs.

Recognizing that you may reasonably disagree with the order of my listing of extremely bad parenting, I would rank order my list of worst possible parents as:

1. Sexual abuse – incest
2. Narcissistic and borderline personality parent
3. Physical abuse
4. Neglect and depression
5. Actively bipolar and schizophrenic

Reasonable people can disagree on the specific order of this list, and even trying to develop a list at this extreme level of pathology may be a fool’s errand. But my point is that narcissistic and borderline personality parents are extremely bad parents.

In this regard, you may also be interested in a wonderful study by Moor and Silvern (2006) regarding the mediating role of parental empathic failure in the subsequent outcome from various forms of childhood trauma exposure. They describe in their study that,

“Only insofar as parents fail in their capacity for empathic attunement and responsiveness can they objectify their children, consider them narcissistic extensions of themselves, and abuse them. It is the parents’ view of their children as vehicles for satisfaction of their own needs, accompanied by the simultaneous disregard for those of the child, that make the victimization possible.” (p. 104)

“An empathically responsive environment precludes abuse and objectification of children. Correspondingly, the act of child abuse by parents is viewed in itself as an outgrowth of parental failure of empathy and a narcissistic stance towards one’s own children. Deficiency of empathic responsiveness prevents such self-centered parents from comprehending the impact of their acts, and in combination with their fragility and need for self-stabilization, predisposes them to exploit children in this way.” (p. 94-95)

“The indication that posttraumatic symptoms were no longer associated with child abuse, across all categories, after statistically controlling for the effect of perceived parental empathy might appear surprising at first, as trauma symptoms are commonly conceived of as connected to specifically terrorizing aspects of maltreatment (e.g., Wind & Silvern, 1994). However, this finding is, in fact, entirely consistent with both Kohut’s (1977) and Winnicott’s (1988) conception of the traumatic nature of parental empathic failure. In this view, parental failure of empathy is predicted to amount to a traumatic experience in itself over time, and subsequently to result in trauma-related stress. Interestingly, even though this theoretical conceptualization of trauma differs in substantial ways from the modern use of the term, it was still nonetheless captured by the present measures.” (p. 197)

The characterological incapacity for empathy and the role-reversal violation of psychological boundaries associated with the narcissistic/borderline personality pathology is what has me so deeply concerned for the children of these parents (Fonagy, Luyten, & Strathearn, 2011).

Splitting and Triangulation Through the Cross-Generational Coalition

Returning to the narcissistic/borderline parent’s response to divorce, what happens when the splitting pathology of the narcissistic/borderline parent is added to a role-reversal cross-generational coalition as defined by Minuchin (1974) and Haley (1977)? The pathology of splitting cannot accommodate to ambiguity (Juni, 1995). It polarizes perceptions into extremes of all-good or all-bad. This polarization does not involve an actual physical separation of brain networks, but rather a neurological cross-inhibition of these networks.

The borderline personality structure has its origins in disorganized attachment involving incompatible motivational directives for attachment bonding and avoidance. According to Aaron Beck and his colleagues (2004),

“Various studies have found that patients with BPD are characterized by disorganized attachment representations (Fonagy et al., 1996; Patrick et al, 1994). Such attachment representations appear to be typical for persons with unresolved childhood traumas, especially when parental figures were involved, with direct, frightening behavior by the parent. Disorganized attachment is considered to result from an unresolvable situation for the child when “the parent is at the same time the source of fright as well as the potential haven of safety” (van IJzendoorn, Schuengel, & Bakermans-Kranburg, 1999, p. 226).” (p. 191)

The pathology of splitting arises to resolve the simultaneous activation of attachment bonding motivations (“haven of safety”) and avoidance motivation (“source of fright”) created by a parent who is “at the same time the source of fright and the potential haven of safety” (creating the disorganized attachment).

Splitting involves the intense neurological cross-inhibition of attachment bonding and avoidance motivations, so that a single coherent motivational directive can be achieved. When one motivating system is on, the other motivating system is entirely turned off (cross-inhibited), so that only one or the other of these motivational systems can be active at any given time, which produces the characteristic polarization of perception into extremes of idealization or devaluation, and the complete absence of ambiguity (i.e., of both networks being on simultaneously which would modulate the perception of the other person).

With the divorce, the spouse becomes an ex-spouse, i.e., the representational networks for the spouse switch from the attachment bonding motivational system to the avoidance motivating system. Since the pathology of splitting cannot accommodate to ambiguity, only one of these motivational networks can be active at any given time, and with the divorce that network for the other spouse/(parent) is the avoidance motivating system. The attachment-bonding networks are entirely turned off (neurologically inhibited). Which means that the narcissistic/borderline parent cannot perceptually register the continuing attachment bond between the child and the other parent because the attachment bonding system in the brain of the narcissistic/borderline parent is being entirely shut down (cross-inhibited by the avoidance system).

This leads to a characteristic feature of this pathology, that the narcissistic/borderline parent cannot recognize, cannot perceptually register, that a normal child’s attachment system would want a relationship with the other parent (the parent who the narcissistic/borderline parent now perceives as being the embodiment of evil because of the splitting pathology).

With the divorce, the spouse has become an ex-spouse, so they must also become an ex-parent. There is no other possibility allowed by the neural networks of the splitting pathology. The ex-husband MUST become an ex-father; the ex-wife an ex-mother. This is a neurologically imposed imperative created by the splitting pathology.

The narcissistic/borderline personality parent accomplishes this goal by engaging the child into a cross-generational coalition (i.e., a role-reversal relationship as a “regulatory object” for the parent) in which the child is induced into rejecting the other parent (actually, the child is induced into adopting a trauma reenactment role of “victimized child” but I don’t want to get too far afield; I describe the symptom induction process in Foundations).

What we’re essentially looking at in the pathology traditionally called “parental alienation” is the manifestation of narcissistic and borderline personality pathology into the family relationships as a consequence of the divorce.

This whole dynamic is much more involved and complex, and I would refer you to Foundations for a complete description of the pathology. My point is that the pathology exists. The pathology of narcissistic and borderline personality disorder exists. And it is this pathology that is creating the child’s symptom display which is traditionally called “parental alienation.” The legions of parents who are claiming that they have been completely cut off from relationships with their children because of the pathological parenting of their ex-spouse are not delusional. The pathology exists as a manifestation into the family processes of narcissistic and borderline personality disorder pathology of the allied and supposedly “favored” parent.

That’s not to say that children do not also reject relationships with parents because of authentic child abuse and domestic violence. Just because cats exist doesn’t nullify the existence of dogs. Both cats and dogs exist.

But right now, I’m discussing cats, not dogs. We can discuss dogs once we recognize the existence of cats. The existence of dogs, while actual, does not nullify the existence of cats. Cats exist. Narcissistic and borderline personality pathology exists.

Treatment

So, returning to your initial desire to discuss treatment, the question becomes what is the treatment for a child’s role-reversal pathology as a regulatory object for a narcissistic/borderline parent? In this regard, my primary concerns would include both the “invalidating environment” described by Linehan (1993) and the role-reversal pathology (Kerig, 2005) in which the child is used as a regulatory object to stabilize the parent’s pathology, both of which are associated with narcissistic and borderline psychopathology.

Linehan and Koerner (1993) describe the invalidating environment,

“A defining characteristic of the invalidating environment is the tendency of the family to respond erratically or inappropriately to private experience and, in particular, to be insensitive (i.e., nonresponsive) to private experience… Invalidating environments contribute to emotional dysregulation by: 1) failing to teach the child to label and modulate arousal, 2) failing to teach the child to tolerate stress, 3) failing to teach the child to trust his or her own emotional responses as valid interpretations of events, and 4) actively teaching the child to invalidate his or her own experiences by making it necessary for the child to scan the environment for cues about how to act and feel.” (p. 111-112)

In their description of the invalidating environment, Fruzzetti, Shenk, and Hoffman, (2005) note the nullification of the child’s self-authenticity,

“In extremely invalidating environments, parents or caregivers do not teach children to discriminate effectively between what they feel and what the caregivers feel, what the child wants and what the caregiver wants (or wants the child to want), what the child thinks and what the caregiver thinks.” (p. 1021)

In the Journal of Emotional Abuse, Kerig (2005) describes the pathology of the role-reversal relationship and notes the nullification of the child’s self-authenticity,

“Rather than telling the child directly what to do or think, as does the behaviorally controlling parent, the psychologically controlling parent uses indirect hints and responds with guilt induction or withdrawal of love if the child refuses to comply. In short, an intrusive parent strives to manipulate the child’s thoughts and feelings in such a way that the child’s psyche will conform to the parent’s wishes.” (p. 12)

“In order to carve out an island of safety and responsivity in an unpredictable, harsh, and depriving parent-child relationship, children of highly maladaptive parents may become precocious caretakers who are adept at reading the cues and meeting the needs of those around them. The ensuing preoccupied attachment with the parent interferes with the child’s development of important ego functions, such as self organization, affect regulation, and emotional object constancy.” (p. 14)

Rappoport (2005) describes the parenting of a narcissistic personality,

“To the extent that parents are narcissistic, they are controlling, blaming, self-absorbed, intolerant of others’ views, unaware of their children’s needs and of the effects of their behavior on their children, and require that the children see them as the parents wish to be seen. They may also demand certain behavior from their children because they see the children as extensions of themselves, and need the children to represent them in the world in ways that meet the parents’ emotional needs.” (p. 2)

In describing the co-narcissist’s relationship with a narcissistic personality, Rappoport (2005) describes the nullification of the other person’s self-experience,

“In a narcissistic encounter, there is, psychologically, only one person present. The co-narcissist disappears for both people, and only the narcissistic person’s experience is important.” (p. 3)

In the family systems literature, the construct would be psychological enmeshment. In the child development literature it would involve the construct of shared “intersubjectivity.”

Ultimately, the role of intersubjectivity is going to become central to understanding the pathology, and the works of Stern, Tronick, Trevarthan, Fonagy, and others is going to become prominent to understanding the pathology and important for understanding treatment.

Stern (2004), for example, describes the neurological underpinnings of shared psychological experience,

“Our nervous systems are constructed to be captured by the nervous systems of others. Our intentions are modified or born in a shifting dialogue with the felt intentions of others. Our feelings are shaped by the intentions, thoughts, and feelings of others. And our thoughts are cocreated in dialogue, even when it is only with ourselves. In short, our mental life is cocreated. This continuous cocreative dialogue with other minds is what I am calling the intersubjective matrix… The idea of a one-person psychology or of purely intrapsychic phenomena are no longer tenable in this light.” (p. 76)

Tronick (2003) refers to this shared psychological state as a “dyadic state of consciousness,”

“When mutual regulation is particularly successful, that is when the age-appropriate forms of meaning (e.g., affects, relational intentions, representations; see Tronick 2002c, d) from one individual’s state of consciousness are coordinated with the meanings of another’s state of consciousness — I have hypothesized that a dyadic state of consciousness emerges.” (p. 475)

The mirror neuron network represents the neurological substrate for this shared psychological state (Iacoboni, et al, 2005; Kaplan & Iacoboni, 2006).

The concern surrounding the pathological parenting of a narcissistic/borderline parent is that the child is being used in a role-reversal relationship as a regulatory object to stabilize the pathology of the narcissistic/borderline parent, and that this role-reversal pathology has nullified the child’s self-authenticity in order to meet the needs of the narcissistic/borderline parent.

So if you wish to begin a discussion of treatment, then I would pose the question to you as to what you propose the treatment to be for the role-reversal pathology of a child’s cross-generational coalition with a narcissistic/borderline parent in which the child is being used as a regulatory object to stabilize the pathology of the narcissistic/borderline parent?

In order to engage the discussion of treatment, we need to first understand what the pathology is that we are treating.

In my view, a discussion of treatment is a bit premature, but if you want a beginning orientation to my basic views, I would refer you to my blog post, On Unicorns, the Tooth Fairy, and Reunification Therapy in which I discuss a general orientation to therapy for this type of narcissistic/borderline personality pathology within the family from multiple perspectives.

In your blog you drew from one possible idea I’ve put foward, a strategic family systems intervention, for treating the pathology of a role-reversal relationship with a narcissistic/borderline parent in which the child is being used as a regulatory object to stabilize… you know that’s an awfully long sentence to write each time I have to refer to this pathology… isn’t there some shorter label we can give to this type of pathology?

Hmmm… people in the general population appear to be calling it “parental alienation.” The problem is, if I call it “parental alienation” then everyone is going to think I’m talking about a Gardnerian model of PAS, and I’m not. But if I label this pathology something different, then people won’t realize that I’m talking about the same type of pathology they are, of a child’s induced rejection of a parent which they’re calling “parental alienation.”

Okay, how about this. I’ll use the term “parental alienation” but I’ll put it in quotes to indicate that it’s not an actually defined pathology, and then I’ll add the words attachment-based to differentiate this description of the pathology from the Gardnerian PAS model.

So that’s what I’ve done. Going forward, Dr. Mercer, if you’d like to refer to the pathology of a narcissistic/borderline parent inducing a role-reversal relationship… on and on long sentence… by some other label, I’m open to that. My preference, based on my analysis of the pathology in Foundations, would be “attachment-trauma reenactment pathology.” But if you want to call it “Bob” – that’s fine by me.

I don’t care what we call it, we just need to recognize that narcissistic and borderline personality disorders exist and that this form of pathology becomes highly activated surrounding divorce (i.e., the loss of the attachment figure and direct hits on the core vulnerabilities of the narcissistic/borderline parent), and that a narcissistic/borderline parent has an extremely devastating impact on child development. Cats exist. Dogs exist. They both exist.

Parallel Process

One of the dangerous features of working with borderline personality pathology is the parallel process of splitting that can occur among the mental health professionals working with the borderline pathology. Marsha Linehan (1993) refers to this parallel process as “staff splitting.”

“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… 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.” (p. 432)

I am concerned that the parallel process of splitting has infected previous discussions of this pathology surrounding the Gardnerian PAS model, in which hyperbolic exaggerations have been used to characterize reasonable and responsible mental health professionals as somehow being unethical and as seeking the abuse of children.

In moving forward with professionally responsible dialogue, I would desperately want to avoid the parallel process of “staff splitting” described by Linehan. “Sides” are a manifestation of the splitting pathology. There are no sides. We all want to protect children from child abuse. 100% of children 100% of the time. The critics of Gardnerian PAS want to protect children from an authentically abusive parent (dogs exist). The supporters of the “parental alienation” construct want to protect children from the pathology of a narcissistic/borderline parent – although they have not been describing it in this way – (cats exist).

In her wisdom, Marsha Linehan has pointed to the door out from the parallel process of splitting. Each side in the dialogue represents “equally valid poles in a dialectic” and “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.”

Working toward a reasonable, professionally sound, and scientifically supported synthesis for addressing all forms of emotional, psychological, physical, and sexual abuse of children is what I seek in proposing an attachment-based reformulation for the pathology traditionally called “parental alienation.”

Best wishes,

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

References

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

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

Fonagy, P., Luyten, P., and Strathearn, L. (2011). Borderline personality disorder, mentalization, and the neurobiology of attachment. Infant Mental Health Journal, 32, 47-69.

Fruzzetti, A.E., Shenk, C. and Hoffman, P. (2005). Family interaction and the development of borderline personality disorder: A transactional model. Development and Psychopathology, 17, 1007-1030.

Grant, B.F., Chou, S.P., Goldstein, R.B., Huang, B., Stinson, F.S., Saha, T.D., Smith, S.M., Dawson, D.A., Pulay, A.J., Pickering, R.P., and Ruan, W.J. (2008). Prevalence, correlates, disability, and comorbidity of DSM-IV Borderline Personality Disorder: Results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry, 69, 533-545.

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

Iacoboni, M., Molnar-Szakacs, I., Gallese, V., Buccino, G., Mazziotta, J., & Rizzolatti, G. (2005). Grasping the intentions of others with one’s own mirror neuron system. Plos Biology, 3(3), e79.

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

Kaplan, J. T., & Iacoboni, M. (2006). Getting a grip on other minds: Mirror neurons, intention understanding, and cognitive empathy. Social Neuroscience, 1(3/4), 175-183.

Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York, NY: Guilford

Linehan, M. M. & Koerner, K. (1993). Behavioral theory of borderline personality disorder. In J. Paris (Ed.), Borderline Personality Disorder: Etiology and Treatment. Washington, D.C.: American Psychiatric Press, 103-21.

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

Moor, A. and Silvern, L. (2006). Identifying pathways linking child abuse to psychological outcome: The mediating role of perceived parental failure of empathy. Journal of Emotional Abuse, 6, 91-112.

Rappoport, A. (2005). Co-narcissism: How we accommodate to narcissistic parents. The Therapist.

Stern, D. (2004). The Present Moment in Psychotherapy and Everyday Life. New York: W.W. Norton & Co.

Stinson, F.S., Dawson, D.A., Goldstein, R.B., Chou, S.P., Huang, B., Smith, S.M., Ruan, W.J., Pulay, A.J., Saha, T.D., Pickering, R.P., and Grant, B.F. (2008). Prevalence, correlates, disability, and comorbidity of DSM-IV Narcissistic Personality Disorder: Results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry, 69, 1033-1045.

Tronick, E.Z. (2003). Of course all relationships are unique: How co-creative processes generate unique mother-infant and patient-therapist relationships and change other relationships. Psychoanalytic Inquiry, 23, 473-491.

This post is a response to Jean Mercer’s analysis of an attachment-based model of “parental alienation” on her blog:

Craig Childress Tries to Drag Attachment Theory Into the Parental Alienation Swamp

I had originally intended to post this response to Dr. Mercer in the Comment section of her blog, but unfortunately the Comment section too severely restricts the number of characters so that my response becomes impractical in that format.

So I instead decided to turn to my blog to respond, and then simply note on Dr. Mercer’s blog that I had responded over here.  Dueling blogs, if you will.  I have posted to the Comment section of Dr. Mercer’s blog the following:

Dr. Mercer, thank you for taking the time to review my work and offer your opinions. I was going to post my response in the Comment section of your blog, but the character limitations of that format are simply too restrictive to allow me a proper response to the issues you raise. So instead, I decided to respond on my blog at drcraigchildressblog.org. Hopefully this will lead to a productive professional dialogue that does justice to the complex issues and family struggles of the children and families we treat. Best wishes, Craig Childress, Psy.D.

So the following is my initial response to Dr. Mercer’s blog which she entitled “Craig Childress Tries to Drag Attachment Theory Into the Parental Alienation Swamp.”

---

First, Dr. Mercer, thank you for your time in reviewing my work, although, based on your analysis of my work, I’m not certain that you’ve read my book, Foundations, yet, which offers a more complete elaboration of the attachment-based foundations to the pathology of “parental alienation” than is provided in my various online writings (although I prefer the more accurate clinical term for the pathology of attachment-trauma reenactment pathology).

Thank you also for crediting me with these ideas. Unfortunately, I cannot take credit for the ideas contained in an attachment-based model as they all represent ideas and constructs derived from the foremost figures in professional psychology, including Theodore Millon, Aaron Beck, John Bowlby, Murray Bowen, Otto Kernberg, Bessel van der Kolk, Salvador Minuchin, Marsha Linehan, Alan Sroufe, Mary Mains, Jay Haley, and Peter Fonagy, among others, and from the established research literature.

In your analysis of my work, you requested a list of references for an attachment-based reformulation for the pathology of “parental alienation,” which leads me to believe that you have not yet read Foundations since I include this list of references in Chapter 11 of Foundations when I discuss the domains of required knowledge necessary for professional competence in the assessment, diagnosis, and treatment of this pathology. So in response to your request, I am including a list of references that I cite in Chapter 11.

I would imagine that since you have decided to critique my work, you have read Foundations in order to offer an informed opinion, and so you have likewise read the material I cited in Chapter 11 and are knowledgeable in the relevant areas of developmental pathology involved in an attachment-based formulation for the pathology traditionally called “parental alienation.” If you have not yet had the opportunity to read the relevant material I cite below, then when you do I would welcome the opportunity to engage in a well-informed discussion of the pathology.

But before turning to the references you requested, let me correct two misrepresentations of me in your analysis, first I am not on faculty at California Southern University. My online lectures for them were part of an invited Master’s Lecture Series that they invited me to present because of my professional knowledge in this area of pathology. Second, your characterization of my treatment recommendations were somewhat distorted, not so much as to be outright misrepresentations, just enough however to be mischaracterizations. I don’t want to distract from the present issue of providing you with the references you requested, so we can address the treatment related issues in future professional dialogue.

In our future discussions of treatment, my hope is that we can engage in a serious professional dialogue rather than relying on rhetorical devices such as setting up a straw-man line of argument.  The nature of the pathology and the family tragedy that is created by a narcissistic and borderline personality parent is too serious for anything but the most sober and reasoned of professional dialogues.

Essentially, the pathology we are treating is a reenactment of childhood attachment-trauma from the childhood of the allied and supposedly favored narcissistic/borderline parent into the current family relationships.  This reenactment of childhood attachment trauma is mediated by the narcissistic and borderline personality pathology of the allied parent, which is itself a product of the childhood trauma.

I am confident that you are not going to deny the existence of narcissistic and borderline personality pathology, as these are both well-established pathologies in both the DSM-5 diagnostic system and the professional literature.

The pathology of both the narcissistic and borderline personality involves a characteristic psychological process called “splitting.” Hopefully, you are not going to deny the pathology of spitting since this pathology was explicitly defined by the American Psychiatric Association in the DSM-IV TR.

The pathology traditionally called “parental alienation” simply represents the addition of the splitting pathology of a narcissistic/borderline personality parent to a cross-generational coalition (as independently defined by the preeminent family systems theorists Salvador Minuchin and Jay Haley) of the child with the narcissistic/borderline parent against the other parent. Hopefully, you are not going to deny a central and well-established tenet of family systems therapy of the child’s triangulation into the spousal conflict.

(I discuss all of this in detail in Foundations.)

So while you graciously attributed the ideas of an attachment-based model to me, I must decline the attribution since the constructs of an attachment-based model of the pathology traditionally called “parental alienation” are actually derived from the most preeminent figures in professional psychology. So here is the reference list you requested, please refer to the following list of references for the original source material for an attachment-based formulation of the pathology

Following this reference list, I provide direct quotes regarding the reenactment of trauma, direct quotes regarding the psychological decompensation of the narcissisistic personality structure into delusional beliefs, direct quotes regarding the triangulation of the child into the spousal conflict through a cross-generational coalition with one parent against the other parent, the definition of the splitting pathology from the American Psychiatric Association, and direct quotes regarding the “invalidating environment.”

I look forward to a sober and professional dialogue that will best serve the children and families we treat.

Best wishes,

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

References for an Attachment-Based Model of “Parental Alienation”

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.

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

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

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

Minuchin, S. (1974). Families and family therapy. Harvard University Press.

Fonagy, P., Target, M., Gergely, G., Allen, J.G., and Bateman, A. W. (2003). The developmental roots of Borderline Personality Disorder in early attachment relationships: A theory and some evidence. Psychoanalytic Inquiry, 23, 412-459.

Fonagy P. and Target M. (2005). Bridging the transmission gap: An end to an important mystery in attachment research? Attachment and Human Development, 7, 333-343.

Fonagy, P., Luyten, P., and Strathearn, L. (2011). Borderline personality disorder, mentalization, and the neurobiology of attachment. Infant Mental Health Journal, 32, 47-69.

Lyons-Ruth, K., Bronfman, E. and Parsons, E. (1999). Maternal frightened, frightening, or atypical behavior and disorganized infant attachment patterns. In J. Vondra & D. Barnett (Eds.) Atypical patterns of infant attachment: Theory, research, and current directions. Monographs of the Society for Research in Child Development, 64, (3, Serial No. 258).

Main, M. and Hesse, E. (1990). Parents’ unresolved traumatic experiences are related to infant disorganized attachment status: Is frightened and/or frightening parental behavior the linking mechanism? In M.T. Greenberg, D. Cicchetti, & E.M. Cummings (Eds.), Attachment in the preschool years: Theory, research, and intervention (pp. 161–182). Chicago: University of Chicago Press.

van IJzendoorn, M.H., Schuengel, C., and Bakermans-Kranenburg, M.J. (1999). Disorganized attachment in early childhood: Meta-analysis of precursors, concomitants, and sequelae. Development and Psychopathology, 11, 225–249.

Kerig, P.K. (2005). Revisiting the construct of boundary dissolution: A multidimensional perspective. Journal of Emotional Abuse, 5, 5-42.

Macfie, J. Fitzpatrick, K.L., Rivas, E.M. and Cox, M.J. (2008). Independent influences upon mother-toddler role-reversal: Infant-mother attachment disorganization and role reversal in mother’s childhood. Attachment and Human Development, 10, 29-39.

Macfie, J., McElwain, N.L., Houts, R.M., and Cox, M.J. (2005) Intergenerational transmission of role reversal between parent and child: Dyadic and family systems internal working models. Attachment & Human Development, 7, 51-65.

Pearlman, C.A. and 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.

Shaffer, A., and Sroufe, L. A. (2005). The developmental and adaptational implications of generational boundary dissolution: Findings from a prospective, longitudinal study. Journal of Emotional Abuse. 5(2/3), 67-84.

Sroufe, L. A. (2005). Attachment and development:  A prospective, longitudinal study from birth to adulthood, Attachment and Human Development, 7, 349-367.

Bacciagaluppi, M. (1985). Inversion of parent-child relationships: A contribution to attachment theory. British Journal of Medical Psychology, 58, 369-373.

Benoit, D. and Parker, K.C.H. (1994). Stability and transmission of attachment across three generations. Child Development, 65, 1444-1456.

Brennan, K.A. and Shaver, P.R. (1998). Attachment styles and personality disorders: Their connections to each other and to parental divorce, parental death, and perceptions of parental caregiving. Journal of Personality 66, 835-878.

Bretherton, I. (1990). Communication patterns, internal working models, and the intergenerational transmission of attachment relationships. Infant Mental Health Journal, 11, 237-252.

Sable, P. (1997). Attachment, detachment and borderline personality disorder. Psychotherapy: Theory, Research, Practice, Training, 34(2), 171-181.

Cassidy, J., and Berlin, L. J. (1994). The insecure/ambivalent pattern of attachment: Theory and research. Child Development, 65, 971−991.

Mikulincer, M., Gillath, O., and Shaver, P.R. (2002). Activation of the attachment system in adulthood: Threat-related primes increase the accessibility of mental representations of attachment figures. Journal of Personality and Social Psychology, 83, 881-895.

Tronick, E.Z. (2003). Of course all relationships are unique: How co-creative processes generate unique mother-infant and patient-therapist relationships and change other relationships. Psychoanalytic Inquiry, 23, 473-491.

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.

van der Kolk, B.A. (1989). The compulsion to repeat the trauma: Re-enactment, revictimization, and masochism. Psychiatric Clinics of North America, 12, 389-411

van Ijzendoorn, M.H. (1992) Intergenerational transmission of parenting: A review of studies in nonclinical populations. Developmental Review, 12, 76-99.

Holmes, J. (2004). Disorganized attachment and borderline personality disorder: a clinical perspective. Attachment & Human Development, 6(2), 181-190.

Lopez, F. G., Fuendeling, J., Thomas, K., and Sagula, D. (1997). An attachment-theoretical perspective on the use of splitting defenses. Counseling Psychology Quarterly, 10, 461-472.

Raineki, C., Moriceau, S., and Sullivan, R.M. (2010). Developing a neurobehavioral animal model of infant attachment to an abusive caregiver. Biological Psychiatry, 67, 1137-1145.

Cozolino, L. (2006): The neuroscience of human relationships: Attachment and the developing social brain. WW Norton & Company, New York.

Siegel, D. (1999). The developing mind: Toward a neurobiology of interpersonal experience (New York: Guilford Press, 1999).

Iacoboni, M., Molnar-Szakacs, I., Gallese, V., Buccino, G., Mazziotta, J., and Rizzolatti, G. (2005). Grasping the intentions of others with one’s own mirror neuron system. Plos Biology, 3(3), e79.

Kaplan, J. T., and Iacoboni, M. (2006). Getting a grip on other minds: Mirror neurons, intention understanding, and cognitive empathy. Social Neuroscience, 1(3/4), 175-183.

Fraiberg, S., Adelson, E., and Shapiro, V. (1975). Ghosts in the nursery. Journal of the American Academy of Child and Adolescent Psychiatry, 14, 387–421.

Moor, A. and Silvern, L. (2006). Identifying pathways linking child abuse to psychological outcome: The mediating role of perceived parental failure of empathy. Journal of Emotional Abuse, 6, 91-112.

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.

Rappoport, A. (2005). Co-narcissism: How we accommodate to narcissistic parents. The Therapist.

Carlson, E.A., Edgeland, B., and Sroufe, L.A. (2009). A prospective investigation of the development of borderline personality symptoms. Development and Psychopathology, 21, 1311-1334.

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

Barnow, S. Aldinger, M., Arens, E.A., Ulrich, I., Spitzer, C., Grabe, H., Stopsack, M. (2013). Maternal transmission of borderline personality disorder symptoms in the community-based Griefswald Family Study. Journal of Personality Disorders, 27, 806-819.

Dutton, D. G., Denny-Keys, M. K., and Sells, J. R. (2011). Parental personality disorder and its effects on children: A review of current literature. Journal of Child Custody, 8, 268-283.

Fruzzetti, A.E., Shenk, C. and Hoffman, P. (2005). Family interaction and the development of borderline personality disorder: A transactional model. Development and Psychopathology, 17, 1007-1030.

Garety, P. A. and Freeman D. (1999) Cognitive approaches to delusions: A critical review of theories and evidence. The British Journal of Clinical Psychology; 38, 113-154.

Hodges, S. (2003). Borderline personality disorder and posttraumatic stress disorder: Time for integration? Journal of Counseling and Development, 81, 409-417.

Levy, K.N. (2005). The implications of attachment theory and research for understanding borderline personality disorder. Development and Psychopathology, 17, p. 959-986.

Stepp, S. D., Whalen, D. J., Pilkonis, P. A., Hipwell, A. E., and Levine, M. D. (2011). Children of mothers with Borderline Personality Disorder: Identifying parenting behaviors as potential targets for intervention. Personality Disorders: Theory, Research, and Treatment. 1-16.

Svrakic, D.M. (1990). Functional dynamics of the narcissistic personality. American Journal of Psychiatry. 44, 189-203.

Widiger, T.A. and Trull, T.J. (2007). Plate tectonics in the classification of personality disorder: Shifting to a dimensional model. American Psychologist, 62, 71-83.

Direct Quotes Regarding Trauma Renactment:

“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)

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.

“Victims of trauma respond to contemporary stimuli as if the trauma had returned, without conscious awareness that past injury rather than current stress is the basis of their physiologic emergency responses. The hyperarousal interferes with their ability to make calm and rational assessments and prevents resolution and integration of the trauma.” (van der Kolk, 1989, p. 226)

“People who have been exposed to highly stressful stimuli develop long-term potentiation of memory tracts that are reactivated at times of subsequent arousal. This activation explains how current stress is experienced as a return of the trauma; it causes a return to earlier behavior patterns.” (van der Kolk, 1989, p.226)

Van der Kolk, B.A. (1989). The compulsion to repeat the trauma: Re-enactment, revictimization, and masochism. Psychiatric Clinics of North America, 12, 389-411.

“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, 1973, p. 369)

Bowlby, J. (1973). Attachment and loss: Vol. 2. Separation: Anxiety and anger. NY: Basic.

“Evaluation of the particular demands of a situation precedes and triggers an adaptive (or maladaptive) strategy. 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)

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

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

“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)

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.

“The conceptualization of the core pathology of BPD [borderline personality disorder] as stemming from a highly frightened, abused child who is left alone in a malevolent world, longing for safety and help but distrustful because of fear of further abuse and abandonment, is highly related to the model developed by Young (McGinn & Young, 1996)… Young elaborated on an idea, in the 1980s introduced by Aaron Beck in clinical workshops (D.M. Clark, personal communication), 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…” (Beck et al., 2004, p. 199)

“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… The abused and abandoned child mode denotes the desperate state the patient may be in related to (threatened) abandonment and abuse the patient has experienced as a child. Typical core beliefs are that other people are malevolent, cannot be trusted, and will abandon or punish you, especially when you become intimate with them.” (Beck et al., 2004, p. 199)

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

“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)

“Trauma, as a wound that never heals, succeeds in transforming the subsequent world into its own image, secure in its capacity to re-create the experience for time immemorial. It succeeds in passing the experience from one generation to the next. The present is lived as if it were the past. The result is that the next generation is deprived of its sense of social location and its capacity to creatively define itself autonomously from the former… when time becomes distorted as a result of overwhelming events, the natural distance between generations, demarcated by the passing of time and changing experience, becomes obscured. (Prager, 2003, p. 176)

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

Direct Quotes Regarding the Decompensation of the Narcissistic Personality into Delusional Beliefs

“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. Rarely physically abusive, anger among narcissists usually takes the form of oral vituperation and argumentativeness. This may be seen in a flow of irrational and caustic comments in which others are upbraided and denounced as stupid and beneath contempt. These onslaughts usually have little objective justification, are often colored by delusions, and may be directed in a wild, hit-or-miss fashion in which the narcissist lashes out at those who have failed to acknowledge the exalted status in which he or she demands to be seen.” (Millon, 2011, p. 407-408; emphasis added)

“Deficient in social controls and self-discipline, the tendency of CEN narcissists to fantasize and distort may speed up. The air of grandiosity may become more flagrant. They may find hidden and deprecatory meanings in the incidental behavior of others, becoming convinced of others malicious motives, claims upon them, and attempts to undo them. As their behaviors and thoughts transgress the line of reality, their alienation will mount, and they may seek to protect their phantom image of superiority more vigorously and vigilantly than ever. Trapped by the consequences of their own actions, they may become bewildered and frightened as the downward spiral progresses through its inexorable course. No longer in touch with reality, they begin to accuse others and hold them responsible for their own shame and failures. They may build a “logic” based on the irrelevant and entirely circumstantial evidence and ultimately construct a delusion system to protect themselves from unbearable reality.” (Millon, 2011, p. 415; emphasis added)

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

Direct Quotes on the 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)

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

“The rigid triangle can also take the form of a stable coalition. One of the parents joins the child in a rigidly bounded cross-generational coalition against the other parent.” (Minuchin, 1974, p. 102)

“An inappropriately rigid cross-generational subsystem of mother and son versus father appears, and the boundary around this coalition of mother and son excludes the father. A cross-generational dysfunctional transactional pattern has developed.” (Minuchin, 1974, p. 61-62)

“The parents were divorced six months earlier and the father is now living alone… Two of the children who were very attached to their father, now refuse any contact with him. The younger children visit their father but express great unhappiness with the situation.” (Minuchin, 1974, p. 101)

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

Definition of Splitting Pathology

“Splitting. The individual deals with emotional conflict or internal or external stressors by compartmentalizing opposite affect states and failing to integrate the positive and negative qualities of the self or others into cohesive images. Because ambivalent affects cannot be experienced simultaneously, more balanced views and expectations of self or others are excluded from emotional awareness. Self and object images tend to alternate between polar opposites: exclusively loving, powerful, worthy, nuturant, and kind — or exclusively bad, hateful, angry, destructive, rejecting, or worthless.” (American Psychiatric Association, 2000, p. 813)

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

“They tend to see reality in polarized categories of “either-or,” rather than “all,” and within a very fixed frame of reference. For example, it is not uncommon for such individuals to believe that the smallest fault makes it impossible the person to be “good” inside. Their rigid cognitive style further limits their abilities to entertain ideas of future change and transition, resulting in feelings of being in an interminable painful situation. Things once defined do not change. Once a person is “flawed,” for instance, that person will remain flawed forever.” (p. 35)

Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York, NY: Guilford

Direct Quotes Regarding the Invalidating Environment

“A defining characteristic of the invalidating environment is the tendency of the family to respond erratically or inappropriately to private experience and, in particular, to be insensitive (i.e., nonresponsive) to private experience… Invalidating environments contribute to emotional dysregulation by: 1) failing to teach the child to label and modulate arousal, 2) failing to teach the child to tolerate stress, 3) failing to teach the child to trust his or her own emotional responses as valid interpretations of events, and 4) actively teaching the child to invalidate his or her own experiences by making it necessary for the child to scan the environment for cues about how to act and feel.” (Linehan & Koerner, 1993, p. 111-112)

Linehan, M. M. & Koerner, K. (1993). Behavioral theory of borderline personality disorder. In J. Paris (Ed.), Borderline Personality Disorder: Etiology and Treatment. Washington, D.C.: American Psychiatric Press, 103-121.

“In extremely invalidating environments, parents or caregivers do not teach children to discriminate effectively between what they feel and what the caregivers feel, what the child wants and what the caregiver wants (or wants the child to want), what the child thinks and what the caregiver thinks.” (Fruzzetti, Shenk, & Hoffman, 2005, p. 1021)

Fruzzetti, A.E., Shenk, C. and Hoffman, P. (2005). Family interaction and the development of borderline personality disorder: A transactional model. Development and Psychopathology, 17, 1007-1030.

Dr. Childress Comment: Far more important than these direct quotes from the works of preeminent mental health professionals, is the surrounding context of information in which these quotes are embedded.  If we are to properly assess, diagnose, and treat the pathologies that affect children and families, it is vital to have a substantial base of information regarding the nature of these pathologies.

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

Cats and dogs are similar.  Both have fur, four legs, and a tail, and both live with us.

But cats are not dogs.  They are different species of animal.

Furthermore not all animals are a dog. Neither are all animals cats. There are both cats and dogs. They both exist as separate species of animals. While they are similar to each other, they are distinctly different species of animals.

And we can tell the difference between cats and dogs. Even though both have fur, four legs, and a tail, it’s actually pretty easy to tell if the animal we’re looking at is a cat or a dog.  Try it if you don’t believe me… See, it’s pretty easy.  Cats and dogs look fundamentally different.

I recently received the following critical Comment to my blog post regarding my Online Seminar on Attachment-Based “Parental Alienation” (it seems the pathogen has located me, which is a good thing).

“You think you’re pretty smart eh?  Have you been physically and psychologically beaten on before?  Interrogated?  Your parenthood been fabricated?  Shame on you for dismissing women abuse!”

This is a common type of argument levied against the existence of the “parental alienation” pathology.  The argument is that to identify the pathology of “parental alienation” is to somehow deny the legitimacy of authentic domestic violence and child abuse. We can even see the remnants of this argument in the Position Statement on Parental Alienation of the American Psychological Association, which begins with a cautionary statement that all allegations of domestic violence need to be taken seriously.

But this is a spurious argument offered up by the allies of the pathogen. Cats are not dogs.  They are different animals.

Just because cats exist (i.e., the delusional reenactment of childhood attachment trauma into current family relationships) does not in any way discount or nullify the existence of dogs (authentic domestic violence and child abuse).  Dogs exist… and cats exist.  Dogs are not cats, and cats are not dogs.

And we can actually tell the difference between cats and dogs.

Authentic violence against women and children exists. The trans-generational transmission of childhood trauma into current family relationships through the personality disorder pathology of the parent, that is itself a product of the childhood trauma, also exists.  Dogs exist and cats exist.

They are two different species of similar types of animal (trauma). Actual violence against women and children is the enactment of trauma in this generation of children and families. The pathology of attachment-based “parental alienation” is the enactment of similar pathology, just one generation removed. The trauma was enacted in the childhood of the current narcissistic/borderline parent and is now being reenacted in the current family relationships in the delusional attachment-trauma pattern of “abusive parent”/”victimized child”/”protective parent.”

But just because cats exist (trauma reenactment) doesn’t mean that dogs don’t also exist (authentic domestic violence and child abuse).  Both types of animal exist.  Both dogs AND cats exist.

And it’s actually pretty easy to tell the difference between dogs and cats once you know what to look for.

The folks who are concerned about domestic violence and child abuse are worried that if we identify the pathology of “parental alienation” as existing (cats) then all animals will become cats and we will no longer identify authentic cases of domestic violence and child abuse (dogs). That’s a valid concern, but it’s also ridiculous.

It’s incredibly easy to tell what’s a cat and what’s a dog. First off, cats have retractable claws and climb trees, dogs don’t. Dogs bark, cats don’t (cats purr). And cats look fundamentally different than dogs. I doubt if anyone over the age of three actually gets confused if the animal in question is a dog or a cat.

Similarly, the pathology of a delusional reenactment of childhood trauma has distinctly different characteristic indicators from authentic violence against women and children. Authentic violence against women and children presents with one set of characteristic indicators while the delusional reenactment of childhood attachment trauma presents with an entirely different set of characteristic indicators. It’s actually pretty easy to tell the difference between cats and dogs once you know what to look for.

The three diagnostic indicators of attachment-based “parental alienation” (Foundations) can reliably and consistently differentiate the delusional trauma reenactment pathology of “parental alienation” from authentic incidents of domestic violence and child abuse (cats have retractable claws – dogs don’t, etc.). Plus, with all of the associated clinical signs, the two forms of pathology look fundamentally different (cats don’t look like dogs).

Not everything is a cat.  Authentic domestic violence and child abuse exists.

Not everything is a dog.  The reenactment of childhood attachment trauma into current family relationships also exists.

The renowned expert in trauma, Bessel van der Kolk, describes the reenactment of childhood trauma into current relationships:

“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)

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.

“Victims of trauma respond to contemporary stimuli as if the trauma had returned, without conscious awareness that past injury rather than current stress is the basis of their physiologic emergency responses. The hyperarousal interferes with their ability to make calm and rational assessments and prevents resolution and integration of the trauma.” (van der Kolk, 1989, p. 226)

“People who have been exposed to highly stressful stimuli develop long-term potentiation of memory tracts that are reactivated at times of subsequent arousal. This activation explains how current stress is experienced as a return of the trauma; it causes a return to earlier behavior patterns.” (van der Kolk, 1989, p.226)

Van der Kolk, B.A. (1989). The compulsion to repeat the trauma: Re-enactment, revictimization, and masochism. Psychiatric Clinics of North America, 12, 389-411.

Sigmund Freud called this reenactment of childhood trauma “transference” (the patient would “transfer” childhood patterns of relationship onto the analyst).

John Bowlby calls these internalized patterns of relationship expectations “internal working models,” and he describes how we reenact these childhood patterns throughout our lifespan,

“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, 1973, p. 369).

Bowlby, J. (1973). Attachment and loss: Vol. 2. Separation: Anxiety and anger. NY: Basic.

The renowned psychiatrist, Aaron Beck, refers to these patterns as “schemas.”  Beck and his colleagues describe how these schemas influence our interpretation of events and relationships,

Evaluation of the particular demands of a situation precedes and triggers an adaptive (or maladaptive) strategy. 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)

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

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

Pearlman and Courtois (2005) describe the pattern of the trauma reenactment narrative.

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. (p. 455)

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 (2003) also describes the pathology of trauma reenactment,

“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. (p. 176)

Trauma, as a wound that never heals, succeeds in transforming the subsequent world into its own image, secure in its capacity to re-create the experience for time immemorial. It succeeds in passing the experience from one generation to the next. The present is lived as if it were the past. The result is that the next generation is deprived of its sense of social location and its capacity to creatively define itself autonomously from the former… when time becomes distorted as a result of overwhelming events, the natural distance between generations, demarcated by the passing of time and changing experience, becomes obscured. (p. 176)

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

The trauma-reenactment pathology of attachment-based “parental alienation” exists.  Cats exist.

This is not to deny that dogs ALSO exist.  Both cats and dogs exist.

To equate the existence of cats (trauma reenactment pathology) with the denial of dogs (authentic domestic violence and child abuse) is stupid.  We are NOT saying that dogs don’t exist.  We are simply saying that cats are NOT dogs.  These are two different animals.

It is the critics of the construct of “parental alienation” who are saying that EVERYTHING is a dog, and that cats don’t exist (“parental alienation” doesn’t exist).

All we are trying to do is get establishment mental health to acknowledge what Freud, van der Kolk, Bowlby, Beck, and others ALREADY acknowledge, that BOTH cats AND dogs exist. They are different animals. Not everything is a dog.

And once we recognize that BOTH cats and dogs exist, it actually becomes pretty easy to tell them apart. But we first need to recognize that there are two different types of animal. Each has fur, four legs, and a tail. But they are different.  Cats are not dogs.

So as we run into this type of distorted argument, in which the person we’re talking to refuses to acknowledge that cats exist because they’re afraid that this denies the existence of dogs, just reassure them that’s not the case, that there are two different types of animal, both with fur, both with four legs, and both with a tail, but that they are entirely different species of animals, and that it’s actually really easy to tell them apart (i.e., the three diagnostic indicators and associated clinical signs of attachment-based “parental alienation”).

Both cats and dogs exist. Both the pathology of trauma reenactment and the pathology of family violence exist. One does not exclude the existence of the other.

All that we are asking for is a change to the APA Position Statement on “parental alienation” to

1.)  Acknowledge that the pathology exists (cats exist)

2.)  Recognize the children and families evidencing the signs of this pathology as representing a “special population” of children and families who require specialized professional knowledge and expertise to competently assess, diagnose, and treat.

(Since both cats and dogs have fur, four legs, and a tail, we want to make sure we don’t misidentify a cat as being a dog, or a dog as being a cat. So we want to require that only experts in cats and dogs identify the animal in question using advanced DNA tests that will determine whether the animal is a cat or a dog).

Once you know what to look for, the difference between cats and dogs is pretty distinctive.

So if anyone runs into this argument that “parental alienation” misidentifies authentic child abuse and domestic violence, just politely reassure the other person that we are talking about different animals. Cats are not dogs.

We’d be happy to talk about the many species of dogs, but that is not addressing the point we are raising that not all animals are dogs. Some animals are cats. We would like to discuss cats, and we need to talk about cats (i.e., the reenactment of childhood attachment trauma into the current family relationships, mediated by the narcissistic and borderline personality pathology of the allied parent that is itself a result of the childhood attachment trauma).

We can discuss dogs at some other time.  Right now we’re discussing cats.

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

I received a Comment from Michelle Jones, LCSW to my blog post Bringing the Era of Gardnerian PAS to a Close.

I found her Comment so articulate and spot-on accurate that I decided to repost it here as a blog.  In my view, her description of the situation is exactly correct.

As preface let me say that the only thing I care about is bringing an end to the family tragedy of “parental alienation.”  And we can accomplish that.  We can bring this family nightmare to an end.  Today.  This instant.  The pathology of “parental alienation” is not some type of new and unique pathology. It is a manifestation of established, well-defined, and well-understood forms of psychopathology that ALL mental health professionals should ALREADY be knowledgeable in, especially if they are working with this type of pathology.

An attachment-based model of “parental alienation” is NOT me… it’s Kernberg, it’s Millon, it’s Beck, it’s Bowlby, it’s Ainsworth, it’s Haley, it’s Minuchin,… it is the work of the preeminent figures in all of psychology. 

All I did was bring this work together and apply it to the pathology commonly referred to as “parental alienation.”  It’s not “my theory.”  It is the fundamental principles within established forms of psychopathology.  Read Kernberg, read Millon, read Beck, read, Bowlby, read… it’s all there.

There is NOTHING new in Foundations.  It is all established and well-defined forms of pathology.

Here is the comment of Michelle Jones, LCSW.  I am in 100% agreement with her.  Solving the pathology of “parental alienation” is the central issue, and it is the ONLY issue.

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From Michelle Jones, LCSW:

As a mental health therapist, I am making this reply directed to mental health therapists. It is difficult for most people to rise above their current situation and see the bigger view of themselves within the context of their own era of history.  Looking back, it’s much easier to see.  As they say, “Hindsight is 20/20.”

When Joseph Lister proved that using antiseptics in surgery could reduce the number of post op infections, you would think the people at that time of history would have shouted for joy that such progress could be made.  Instead it challenged their paradigms and actually caused insult to many of the professionals at the time.  Looking back, we see the ignorance and the extreme shortsightedness of the accepted thinking of that day.  And of course today we all believe in the reality of microbiology and the need for sterile technique, but historically, the idea took some getting used to.  It actually took about a decade for people to start taking Lister seriously.  Further, without Lister’s clear and accurate assessment that “germs” caused infections (and not bad air), there was no way to justify or standardize the use of antiseptics.

We are now in a critical time of change in the history of parental alienation treatment.  I believe it is mandatory to accurately define the pathology of parental alienation in an indisputable, scientifically-based manner, as you have done Dr. Childress–so that we can justify and prescribe the necessary treatments.  We, as mental health therapists should know that our interventions are only as good as our assessments. If we do not accurately identify the pathology, then we cannot justify the necessary and appropriate interventions.

This should not be a debate about whose opinion or construct is better than whose, this should be an objective, scientific and moral endeavor to raise the professional standard of practice across the field of mental health.  If we as professionals truly believe in “doing no harm,” and our focus is truly on helping children and families, who are the foundation of our society, then we need to lay down our egos, and our outdated paradigms, and with integrity and humility, seek truth, even if it challenges us personally.

I am not criticizing Gardner, nor those who have supported the PAS model.  You have all done so much good in the world, and I sincerely appreciate your efforts.  I own and have read most of your books.  What I am asking is, “Is the PAS paradigm really working to the extent that it justifies and allows the needed solutions?”  Gardner did a lot of good to raise awareness, and at great personal expense.  His behavioral observations were accurate, but his theoretical constructs were not complete.  That’s okay.  If he were alive today, I believe he would shout, “That’s okay, just do something that works and stops the abuse!”  After reading many of his articles and books, I truly believe his motives were pure.  But his character and his contributions are not under question and we shouldn’t allow ourselves to be distracted by whether or not we should be loyal to Richard Gardner.  Adopting the constructs of an attachment-based model of parental alienation has nothing to do with being loyal or disloyal to Gardner or the groundwork he laid, it’s about the next step in history and addressing the urgency of bringing about solutions to the devastating problem of parental alienation.

As you have stated, Dr. Childress, staff splitting is a symptom of what happens to the treatment team when working with patients with personality disorders.  Divide and conquer is their MO.  I have spent years working with patients in residential treatment centers (many with personality disorders) and the clinicians would meet once or twice a week in treatment team to collaborate so that we could unite and do effective therapy.  The patients could not be helped without unified treatment interventions.

If we are going to effectively treat parental alienation or pathogenic parenting, it will require the same thing, uniting as a treatment team and implementing appropriate interventions with strict boundaries so that change can actually happen.  How do we determine the needed boundaries and interventions?  Only by first properly and accurately identifying the pathology.  Dr. Childress has painstakingly done this for us in Foundations.  I urge all mental health professionals to read Foundations and see if it fits with the established and accepted therapeutic theories we were trained in. Let’s unite in the spirit of peace and cooperation and reach consensus on the best treatment standards for parental alienation.  And then, let’s unitedly take action.

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I agree 100% with everything Ms. Jones said.

This is only about a scientifically-based description of the pathology so we can move forward in its diagnosis and treatment.  The pathology is NOT a new and unique syndrome, it is a manifestation of entirely understandable and defined forms of psychopathology. 

It is time to end the unnecessary and paralyzing debate in professional psychology and come together in the service of children and families caught in this particular form of pathology.

The focal goal of our efforts needs to be a change in the APA Position Statement on Parental Alienation so that it,

1.)  Acknowledges that the pathology exists, using whatever name establishment mental health wishes to use (“parental alienation,” “pathogenic parenting,” “attachment-trauma reenactment pathology” – or some other label for the pathology).

The pathology of “parental alienation” exists.

2.)  Formally recognize the children and families evidencing this type of pathology as representing a “special population” who require specialized professional knowledge and expertise (in attachment theory, personality disorder pathology, and family systems theory) in order to competently assess, diagnose and treat.

The complex nature of the pathology defines these children and families as a special population who require specialized professional knowledge and expertise to competently assess, diagnose, and treat.

I believe this to be a reasonable and temperate demand on our part.  All we are asking for is professional competence in established domains of professional psychology.

In order to achieve professional competence in established domains of professional psychology, we must first be able to define the pathology within established and existing forms of psychopathology.

That’s what Foundations does.  It establishes the foundations for professional competence. 

It is time to end the divisive and damaging debate within professional psychology and come together, all of us, to meet the very real needs of the children and families experiencing this type of tragic psychopathology.

Thank you for your support Michelle.  Your banner is on the battlefield in support of the children and families who need us.

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

Foundations is not “my theory.”  Here is the source material:

Central References:  Books

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.

Millon. T. (2011). Disorders of Personality: Introducing a DSM/ICD Spectrum from Normal to Abnormal. Hoboken: Wiley.

Beck, A.T., Freeman, A., Davis, D.D., and Associates (2004). Cognitive Therapy of Personality Disorders. (2nd edition). New York: Guilford.

Kernberg, O.F. (1975). Borderline Conditions and Pathological Narcissism. New York: Aronson.

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

• If a mental heath professional is assessing, diagnosing, or treating this population of children and families and has not read these texts by the most preeminent figures in attachment theory, personality disorder pathology, and family systems theory, then the mental health professional is very likely to be practicing beyond the boundaries of his or her professional competence in violation of Standard 2.01 of the Ethical Principles of Psychologists and Code of Conduct of the American Psychological Association.

Additional Central References: Research

Fonagy, P., Luyten, P., and Strathearn, L. (2011). Borderline personality disorder, mentalization, and the neurobiology of attachment. Infant Mental Health Journal, 32, 47-69.

Moor, A. and Silvern, L. (2006). Identifying pathways linking child abuse to psychological outcome: The mediating role of perceived parental failure of empathy. Journal of Emotional Abuse, 6, 91-112.

Fonagy, P., Target, M., Gergely, G., Allen, J.G., and Bateman, A. W. (2003). The developmental roots of Borderline Personality Disorder in early attachment relationships: A theory and some evidence. Psychoanalytic Inquiry, 23, 412-459.

van Ijzendoorn, M.H. (1992) Intergenerational transmission of parenting: A review of studies in nonclinical populations. Developmental Review, 12, 76-99

Kerig, P.K. (2005). Revisiting the construct of boundary dissolution: A multidimensional perspective. Journal of Emotional Abuse, 5, 5-42.

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.

Macfie, J., McElwain, N.L., Houts, R.M., and Cox, M.J. (2005) Intergenerational transmission of role reversal between parent and child: Dyadic and family systems internal working models. Attachment & Human Development, 7, 51-65.

Lyons-Ruth, K., Bronfman, E. and Parsons, E. (1999). Maternal frightened, frightening, or atypical behavior and disorganized infant attachment patterns. In J. Vondra & D. Barnett (Eds.) Atypical patterns of infant attachment: Theory, research, and current directions. Monographs of the Society for Research in Child Development, 64, (3, Serial No. 258).

Main, M. and Hesse, E. (1990). Parents’ unresolved traumatic experiences are related to infant disorganized attachment status: Is frightened and/or frightening parental behavior the linking mechanism? In M.T. Greenberg, D. Cicchetti, & E.M. Cummings (Eds.), Attachment in the preschool years: Theory, research, and intervention (pp. 161–182). Chicago: University of Chicago Press.

van der Kolk, B.A. (1989). The compulsion to repeat the trauma: Re-enactment, revictimization, and masochism. Psychiatric Clinics of North America, 12, 389-411

Pearlman, C.A. and 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.

Shaffer, A., and Sroufe, L. A. (2005). The developmental and adaptational implications of generational boundary dissolution: Findings from a prospective, longitudinal study. Journal of Emotional Abuse. 5(2/3), 67-84.

van Ijzendoorn, M.H. (1992) Intergenerational transmission of parenting: A review of studies in nonclinical populations. Developmental Review, 12, 76-99

Brennan, K.A. and Shaver, P.R. (1998). Attachment styles and personality disorders: Their connections to each other and to parental divorce, parental death, and perceptions of parental caregiving. Journal of Personality 66, 835-878.

Dutton, D. G., Denny-Keys, M. K., and Sells, J. R. (2011). Parental personality disorder and its effects on children: A review of current literature. Journal of Child Custody, 8, 268-283.

Sable, P. (1997). Attachment, detachment and borderline personality disorder. Psychotherapy: Theory, Research, Practice, Training, 34(2), 171-181.

Holmes, J. (2004). Disorganized attachment and borderline personality disorder: a clinical perspective. Attachment & Human Development, 6(2), 181-190.

Lopez, F. G., Fuendeling, J., Thomas, K., and Sagula, D. (1997). An attachment-theoretical perspective on the use of splitting defenses. Counseling Psychology Quarterly, 10, 461-472.

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

Mikulincer, M., Gillath, O., and Shaver, P.R. (2002). Activation of the attachment system in adulthood: Threat-related primes increase the accessibility of mental representations of attachment figures. Journal of Personality and Social Psychology, 83, 881-895.

Garety, P. A. and Freeman D. (1999) Cognitive approaches to delusions: A critical review of theories and evidence. The British Journal of Clinical Psychology; 38, 113-154.

Rappoport, A. (2005). Co-narcissism: How we accommodate to narcissistic parents. The Therapist.

Hodges, S. (2003). Borderline personality disorder and posttraumatic stress disorder: Time for integration? Journal of Counseling and Development, 81, 409-417.

Levy, K.N. (2005). The implications of attachment theory and research for understanding borderline personality disorder. Development and Psychopathology, 17, p. 959-986.

Additional Supporting Research

Fonagy P. and Target M. (2005). Bridging the transmission gap: An end to an important mystery in attachment research? Attachment and Human Development, 7, 333-343.

van IJzendoorn, M.H., Schuengel, C., and Bakermans-Kranenburg, M.J. (1999). Disorganized attachment in early childhood: Meta-analysis of precursors, concomitants, and sequelae. Development and Psychopathology, 11, 225–249.

Macfie, J. Fitzpatrick, K.L., Rivas, E.M. and Cox, M.J. (2008). Independent influences upon mother-toddler role-reversal: Infant-mother attachment disorganization and role reversal in mother’s childhood. Attachment and Human Development, 10, 29-39

Sroufe, L. A. (2005). Attachment and development:  A prospective, longitudinal study from birth to adulthood, Attachment and Human Development, 7, 349-367.

Bacciagaluppi, M. (1985). Inversion of parent-child relationships: A contribution to attachment theory. British Journal of Medical Psychology, 58, 369-373.

Benoit, D. and Parker, K.C.H. (1994). Stability and transmission of attachment across three generations. Child Development, 65, 1444-1456

Bretherton, I. (1990). Communication patterns, internal working models, and the intergenerational transmission of attachment relationships. Infant Mental Health Journal, 11, 237-252.

Cassidy, J., and Berlin, L. J. (1994). The insecure/ambivalent pattern of attachment: Theory and research. Child Development, 65, 971−991.

Tronick, E.Z. (2003). Of course all relationships are unique: How co-creative processes generate unique mother-infant and patient-therapist relationships and change other relationships. Psychoanalytic Inquiry, 23, 473-491.

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.

Raineki, C., Moriceau, S., and Sullivan, R.M. (2010). Developing a neurobehavioral animal model of infant attachment to an abusive caregiver. Biological Psychiatry, 67, 1137-1145.

Kaplan, J. T., and Iacoboni, M. (2006). Getting a grip on other minds: Mirror neurons, intention understanding, and cognitive empathy. Social Neuroscience, 1(3/4), 175-183.

Iacoboni, M., Molnar-Szakacs, I., Gallese, V., Buccino, G., Mazziotta, J., and Rizzolatti, G. (2005). Grasping the intentions of others with one’s own mirror neuron system. Plos Biology, 3(3), e79.

Fraiberg, S., Adelson, E., and Shapiro, V. (1975). Ghosts in the nursery. Journal of the American Academy of Child and Adolescent Psychiatry, 14, 387–421.

Barnow, S. Aldinger, M., Arens, E.A., Ulrich, I., Spitzer, C., Grabe, H., Stopsack, M. (2013). Maternal transmission of borderline personality disorder symptoms in the community-based Griefswald Family Study. Journal of Personality Disorders, 27, 806-819,

Carlson, E.A., Edgeland, B., and Sroufe, L.A. (2009). A prospective investigation of the development of borderline personality symptoms. Development and Psychopathology, 21, 1311-1334.

Fruzzetti, A.E., Shenk, C. and Hoffman, P. (2005). Family interaction and the development of borderline personality disorder: A transactional model. Development and Psychopathology, 17, 1007-1030.

Stepp, S. D., Whalen, D. J., Pilkonis, P. A., Hipwell, A. E., and Levine, M. D. (2011). Children of mothers with Borderline Personality Disorder: Identifying parenting behaviors as potential targets for intervention. Personality Disorders: Theory, Research, and Treatment. 1-16.

Svrakic, D.M. (1990). Functional dynamics of the narcissistic personality. American Journal of Psychiatry. 44, 189-203.

Widiger, T.A. and Trull, T.J. (2007). Plate tectonics in the classification of personality disorder: Shifting to a dimensional model. American Psychologist, 62, 71-83.

Additional Supporting Books

Cozolino, L. (2006): The neuroscience of human relationships: Attachment and the developing social brain. WW Norton & Company, New York.

Siegel, D. (1999). The developing mind: Toward a neurobiology of interpersonal experience (New York: Guilford Press, 1999)

The pathology of “parental alienation” cannot simultaneously be a new syndrome that is unique within all of mental health and, at the same time, also be a manifestation of established and existing forms of pathology.  It is either one or the other.  But both cannot be true.

My position, detailed in Foundations, is that the pathology of “parental alienation” is the product of fully established, well-defined, and well-understood forms of existing pathology.

The challenge currently posed to the Gardnerian PAS experts is whether they accept this model of “parental alienation” as being a manifestation of existing forms of psychopathology, or whether they assert that an attachment-based model is wrong and that the pathology of “parental alienation” represents a new and unique form of pathology in all of mental health.

Both premises cannot simultaneously be true. The pathology cannot simultaneously be a new and unique form of psychopathology AND, at the same time, be a form of established and existing psychopathology. Both positions cannot simultaneously be true. These two positions are logically incompatible. Only one of these foundational premises is true. Whichever one is true, the other one is false.

My position is clear. The pathology of “parental alienation” is a manifestation of well-defined and existing forms of psychopathology involving family systems pathology, personality disorder pathology, and attachment trauma pathology, as described in Foundations.

Established Pathology: Diagnosis

An attachment-based model for the pathology of “parental alienation” produces a set of three definitive diagnostic indicators of the pathology that are derived from standard and established types of symptom features in professional psychology; attachment system suppression, personality disorder traits and/or phobic anxiety, and delusional beliefs. All of these diagnostic indicators are standard and well-defined forms of symptom features within professional psychology. Personality disorder traits, phobic anxiety symptoms, and delusional beliefs are all defined symptom constructs within the DSM diagnostic system, with substantial conceptual and research support in the surrounding literature of professional psychology. Attachment disorders are also a recognized DSM construct and there is substantial theoretical and research support surrounding the functioning and dysfunctioning of the attachment system.

The three definitive diagnostic indicators of attachment-based “parental alienation” are all well-defined and existing psychological constructs within professional psychology. The use of these three definitive diagnostic indicators produces a categorical identification of the pathology as being EITHER present or absent in any individual case. In subthreshold cases where the full diagnostic presentation is not met, Response-to-Intervention trials (such as an ABAB Single Case design) can be employed to further clarify the diagnostic presentation, along with the presence of associated clinical signs that can be used to provide additional confirmation of the diagnosis when the three diagnostic indicators are present.

A focused Diagnostic Checklist for Pathogenic Parenting derived from an attachment-based model of “parental alienation” is available from my website.

An Extended Diagnostic Checklist of attachment-based “parental alienation” pathology that includes the associated clinical signs is also available from my website.

The pathology described by an attachment-based model of “parental alienation” represents existing and well-accepted forms of established psychopathology within professional mental health to which all mental health professionals can be held accountable under Standards 2.01 and 9.01 of the Ethical Principles of Psychologists and Code of Conduct of the American Psychological Association.

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.

9.01 Bases for Assessments
(a) Psychologists base the opinions contained in their recommendations, reports and diagnostic or evaluative statements, including forensic testimony, on information and techniques sufficient to substantiate their findings.

Failure to possess the necessary professional competence (Standard 2.01) to appropriately assess (Standard 9.01) for established forms of personality and attachment trauma pathology “sufficient to substantiate” the mental health professional’s “recommendations, reports, and diagnostic or evaluative statements,” which then causes harm to the client child and parent might then also represent a violation of Standard 3.04 regarding Avoiding Harm to the client;

3.04 Avoiding Harm
Psychologists take reasonable steps to avoid harming their clients/patients, students, supervisees, research participants, organizational clients and others with whom they work, and to minimize harm where it is foreseeable and unavoidable.

Failure to consider the reasonable requests of the client for additional professional consultation regarding the pathology surrounding this particular “special population” of children and families who are evidencing a complex interrelationship of family systems, personality disorder, and attachment trauma pathology may represent a violation of Standards 3.09 regarding professional consultation and 2.03 regarding the professional obligation to maintain professional competence;

3.09 Cooperation with Other Professionals
When indicated and professionally appropriate, psychologists cooperate with other professionals in order to serve their clients/patients effectively and appropriately.

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

Mental health professionals are not allowed to be ignorant and incompetent, and they are not allowed to harm their clients as a result of ignorance and incompetence.

Unique New Syndrome: Diagnosis

The Gardnerian model of PAS proposes that the pathology of “parental alienation” represents a unique “new syndrome” within mental health which is identifiable by a set of eight uniquely developed diagnostic indicators that have no association with any other type of existing mental health pathology or symptom display. These eight clinical indicators of the new and unique pathology of “parental alienation” may or may not be present in any individual case and yield a dimensional diagnosis of mild, moderate, and severe forms, although no guidelines are provided for differentiating the differing levels of severity.

Because neither the American Psychological Association nor the American Psychiatric Association endorse the existence of this proposed “new syndrome” there are no established domains of knowledge required to establish professional competence relative to this model of the “parental alienation” pathology, so that Standards 2.01 and 9.01 of the Ethical Principles of Psychologists and Code of Conduct of the American Psychological Association do not apply and are not relevant to this model of the “parental alienation” pathology.

Choosing a Paradigm

The “new and unique syndrome” and “established and existing pathology” models provide starkly differing diagnostic indicators for identifying the pathology. The model chosen to conceptualize the pathology can be determined by which set of diagnostic indicators the mental health professional uses to diagnose the pathology.

So… the challenge currently presented to Amy Baker, Bill Bernet, Linda Gottlieb, Richard Sauber, Richard Warshak, and the other PAS experts, is which paradigm do you support? The two paradigms are mutually exclusive and result in vastly differing diagnostic indicators for the pathology. Both paradigms cannot simultaneously be true since the pathology of “parental alienation” cannot simultaneously be a new and unique syndrome AND a manifestation of established and existing forms of psychopathology. The foundational assertion of one paradigm is accurate, and the foundational assertion of the other paradigm is wrong.

So which paradigm do you choose? We will know which paradigm you choose by which set of diagnostic indicators for the pathology you choose. Do you use and advocate for the diagnostic indicators from an attachment-based model of the pathology, or do you use and advocate for the diagnostic indicators from a “new syndrome” model of the pathology?

If you believe that the pathology as described by an attachment-based model of “parental alienation” is wrong, then I invite you to describe in what way you believe the description of the pathology in Foundations is in error. There is a Checklist of Component Pathology available on my website that lists the set of component pathologies that make up an attachment-based model to help identity what areas you disagree with. Or you may disagree with how the model integrates these interrelated forms of pathology. Or you may have some other criticism regarding the content of an attachment formulation of the pathology. If you disagree with an attachment-based formulation for the pathology, I would invite your critique.

The time has come for the Gardnerian PAS experts to choose a paradigm. I have been alerting them that this day was coming.  Targeted parents and I are going into battle with the citadel of establishment mental health to create a paradigm shift that will produce an immediate solution to the pathology of “parental alienation.”  The time has come to choose and declare for a paradigm.  Both paradigms cannot simultaneously be true.

Unifying Mental Health

To achieve a solution to the pathology of “parental alienation” we must first protect the child.

In order to protect the child we must be able to efficiently obtain a court-ordered protective separation period in all cases to allow for the child’s treatment and recovery.

In order to obtain a court-ordered protective separation period we must have mental health as an ally; mental health must speak to the court with a single unified voice regarding the need for a protective separation.

In order for mental health to speak with a single unified voice to the court, we must end the division within mental health regarding the pathology of “parental alienation”

In order to end the division within mental health we must bring the two sides in the debate together into a single voice. The citadel of establishment mental has consistently rejected the “new syndrome” Gardnerian PAS model for 30 years, most recently in the DSM-5 revision in which they had full and ample opportunity to review the construct of Gardnerian PAS… and they rejected it.

To end the division and bring mental health together into a single voice we must accept the constructive criticisms offered by establishment mental health that the Gardnerian PAS model is conceptually flawed and offer them an alternative description of the pathology from entirely within standard and established psychological principles and constructs. No “new syndrome” proposal. That’s what an attachment-based model and Foundations does.

I did not develop an attachment-based model and write Foundations as an ego endeavor – I developed the model and wrote the book with the specific purpose of addressing the criticism levied by establishment mental health toward the “new syndrome” model of Gardnerian PAS in order to bring BOTH SIDES together into a compromise solution regarding the pathology of “parental alienation.”

The Compromise

Establishment Mental Health Compromise:

By presenting establishment mental health with an attachment-based model of “parental alienation” that addresses their criticisms of a “new syndrome” model, we are asking the citadel of establishment mental health to compromise and come together with our position by,

1)  Acknowledging that the pathology of “parental alienation” exists (using whatever terminology they wish – which I is why I’ve given them the alternative terminology of “pathogenic parenting” and “attachment-trauma reenactment pathology” – I don’t care what they call it, just acknowledge that the pathology exists), and

2)  Establish that this group of children and families represents a “special population” requiring specialized professional knowledge and expertise to competently assess, diagnose, and treat.

I believe this is a reasonable and temperate position for us to adopt.

Evidence of their compromise is a change in the Position Statement of the American Psychological Association on parental alienation to acknowledge that the pathology exists and that identifies these children and families as a “special population” requiring specialized professional knowledge and expertise to competently assess, diagnose, and treat.

Our Compromise:

In return, we give up the Gardnerian PAS model for the pathology that proposes that they accept a “new syndrome” in professional psychology.

But we cannot give up the Gardnerian PAS model as long as that is the ONLY model of the pathology. In order to give up the Gardnerian PAS model we must have an equivalent model with which to replace it. That’s the second reason I developed the attachment-based model;

The first reason was to provide establishment mental health with an acceptable alternative to the “new syndrome” proposal that they have repeatedly and consistently rejected,

The second reason was to provide advocates for the construct of “parental alienation” with an alternative and equivalent model of the pathology when they are asked to give up the Gardnerian PAS model as part of the compromise solution.

The purpose of the attachment-based model is to bring ALL of mental health together into a single united voice. 

The compromise that we must make to achieve a solution to the pathology of “parental alienation” is to sacrifice the “new syndrome” model of Gardnerian PAS in order to achieve this compromise with establishment mental health.  We cannot continue to demand that the solution to the pathology of “parental alienation” requires that establishment mental health accept a “new syndrome” model for the pathology.

In return:

We receive established standards for assessment and diagnosis to which ALL mental health professionals can be held accountable.

We receive a DSM-5 diagnosis of V995.51 Child Psychological Abuse, Confirmed when the three diagnostic indicators are present in the child’s symptom display, and

We receive the consistent and unanimous professional recommendation for a period of protective separation during the active phase of the child’s treatment and recovery.

I’ve embedded all three of these into the fabric of an attachment-based model.

All we need to do in return is give up the Gardnerian PAS model and stop demanding that establishment mental accept a “new syndrome” in professional psychology.

But I know that is going to be hard for the Gardnerian PAS experts to do, to give up their beloved model of PAS. They have fought so long and hard, with such valor and determination, to have the Gardnerian PAS model accepted, and now they are being asked to give it up. Gardnerian PAS will never be accepted. Not because it is wrong, but because it is unnecessary. The pathology of “parental alienation” will be solved, but just not with the Gardnerian PAS model.

Emotionally and psychologically, I imagine that will be hard for the Gardnerian PAS experts to do.  To the extent that they have grown “attached” to the PAS model, they will grieve its loss. That’s totally understandable. But we must give up the Gardnerian PAS model as part of the compromise with establishment mental health in order to bring all of mental health together into a single voice.

Establishment mental health has consistently and steadfastly maintained that they will NOT accept the “new syndrome” model of Gardnerian PAS.  We need to stop being so rigid in our demand that they accept a “new syndrome” model as a condition to solving the pathology “parental alienation.”

I set about developing an attachment-based model specifically to serve as the compromise solution that can bring BOTH sides together and end the decades-long division in mental health regarding the pathology of “parental alienation.”

Advantages to an Attachment-Based Model

If you look at the attachment-based model, it has a whole lot of perks and advantages

Research:  An attachment-based model provides much improved operationally defined diagnostic indicators for research because they are dichotomous; they establish the pathology as being present or absent

Instead of research continually trying to support the Gardnerian eight symptoms, research can start to examine the different “types” of “parental alienation” – e.g., characteristic features of the borderline type vs. the narcissistic type; the characteristic features correlated with the narcissistic/antisocial type, what types of attachment-based “parental alienation” show false allegations of abuse and what types don’t.  And just look at all those associated clinical signs. What types of “parental alienation” show what types of associated clinical signs?

A whole wealth of research opportunities open up besides endlessly trying to support the Gardnerian symptom indicators once we move beyond the endless and unproductive debate of trying to force establishment mental health to accept a “new syndrome” model of the pathology.

And because an attachment-based model is founded in attachment system pathology, trauma pathology, and personality disorder pathology, a whole new set of researchers become available for the study of the pathology. Right now the pathology of “parental alienation” lives in the back-waters of professional mental health research; ADHD, autism, and substance abuse are at the forefront. But by linking the pathology of “parental alienation” to the trans-generational transmission of attachment trauma, the pathology of “parental alienation” is catapulted into the forefront of modern psychology. Attachment researchers, trauma researchers, personality disorder researchers all become available to study this pathology. Instead of a “new syndrome” that is “not accepted” within professional psychology, the pathology of “parental alienation” becomes front and center of professional study and discussion – the trans-generational transmission of attachment trauma.

DSM Diagnosis:  Heroic efforts have been made in the past to have the DSM committees accept a Gardnerian PAS model. But (I’m sorry to say it, but it’s true) the Gardnerian PAS model was weak. The conceptual weakness of the model did not do justice to the heroic efforts of the advocates trying to establish the pathology as a DSM disorder.

First, there is no natural constituency within the DSM committees for a “new syndrome” of “parental alienation,” and the eight symptom indicators by which the “new syndrome” is identified have no association with any established form of pathology or symptoms. They are unique to the “new syndrome” of “parental alienation.”

An attachment-based model, however, has an established constituency within the DSM committees, in fact several. The primary constituency is the Trauma- and Stress-Related Disorders committee which already houses the other two attachment-related diagnoses. We’d be asking them for a third attachment-related disorder – the trans-generational transmission of attachment trauma (disorganized attachment) mediated by the personality disorder dynamics of the parent which are also the product of the attachment trauma (disorganized attachment). This is a very strong argument and we can immediately pull on all of the existing research on the trans-generational transmission of attachment trauma AND the research linking childhood attachment trauma to the development of personality disorders.

And the construct of attachment trauma reenactment is as old and fundamental as Freud’s construct of the “transference.”

Second, we won’t be asking for something “new” – what we will be asking for in the DSM-5.1 revision is the RETURN to the DSM diagnostic system of a previous DSM diagnosis of Shared Psychotic Disorder (a shared delusional belief), only this time the diagnosis is not in the psychotic section, it’s in the Trauma- and Stress-Related Disorders section of the DSM-5.1 (the trauma and stress-related people get a new disorder – yay for them, congratulations) under the name “Shared Delusional Disorder,” or better still “Attachment-Trauma Reenactment Disorder.” The diagnostic criteria can pretty much remain exactly as they were for the DSM-IV TR diagnosis of Shared Psychotic Disorder, and since this is a previously accepted DSM-IV TR diagnosis we’re in a pretty strong position.

We’d like the addition of two phrases “pathogenic parenting” and “role-reversal relationship” to the general description of the pathology, but we can live without those phrases if need be. The diagnostic criteria could remain identical to the DSM-IV TR diagnostic criteria for a Shared Psychotic Disorder, although if they changed to the three diagnostic indicators of attachment-based “parental alienation” that would be a home run. But the diagnostic criteria for the DSM-IV TR Shared Psychotic Disorder are fine.

And in support of this DSM-5.1 proposal we can pull on the wealth of existing attachment trauma research and personality disorder research as support. 

Overall, this is a much, much stronger DSM case to present for the future DSM-5.1 revision than a continual return, once again, to the “new syndrome” Gardnerian PAS model that has already been turned down for the DSM-5.

Treatment:  I’m already on record as a critic of the ineffective practice of “reunification therapy” as currently practiced by most mental health professionals, and as being a full supporter of the brief intensive interventions currently being developed for the resolution of the “parental alienation” pathology. Once we reach this treatment phase of the solution we can work out the development of a consistent and effective brief and intensive intervention to restore the child’s normal-range functioning within the first few days of the protective separation period, and we can work out a defined model for the subsequent recovery stabilization therapy during the remainder of the protective separation period. We know what the solution needs to be, we just need a consistent diagnosis of the pathology and a protective separation of the child from the pathogenic parenting of the narcissistic/(borderline) parent.

Compromise

All this compromise solution requires from us is that we give up the “new syndrome” proposal of the Gardnerian PAS model.  Establishment mental health has made it abundantly clear, they will not accept the “new syndrome” model of Gardnerian PAS.  It’s time to let that model go.

Recognizing this, I set about developing an alternate model that defines the pathology solely through established and accepted psychological principles and constructs, which could serve as an acceptable alternative to establishment mental health and also serve as a replacement paradigm for the Gardnerian model.

In return for our giving up the Gardnerian PAS model, we achieve the power to enforce the diagnosis of the “parental alienation” pathology under Standards 2.01 and 9.01 of the APA ethics code, a consistent DSM-5 diagnosis of V995.51 Child Psychological Abuse, Confirmed applied to the pathology of “parental alienation,” and a consistent recommendation to the court for a period of protective separation from the pathology of the narcissistic/(borderline) parent (and ultimately a protective separation enacted by child protective services).

This is a good compromise that works to the benefit of the children and families we serve. It is time to bring the divisive conflict in mental health to a close in order to resolve the pathology of “parental alienation” for the children and targeted parents who need the solution today, not in ten years. If this requires that we give up the Gardnerian PAS model as part of a compromise solution within establishment mental health, then this is what we need to do.

Moving Forward

I know I’m an “outsider” who comes to “parental alienation” from the fields of ADHD and early childhood mental health, I know I’m not part of the “inner club” of established Gardnerian PAS experts, and I know I have likely ruffled some professional feathers by my direct challenges of the Gardnerian PAS paradigm.  But I’m also aware of how attached some of you may have become to the Gardnerian PAS model, and I’m aware of how hard it must be for you to let it go, so my challenges have been to alert you that the solution will require that we let go of the Gardnerian PAS model.

We must let it go to achieve the compromise solution that is so desperately needed by the children and their targeted parents.  They cannot wait 5 or 10 years of our trying to force establishment mental health to accept a “new syndrome” model; which they will likely never accept.  These children and families need the solution today. 

We must bring an end to the division within mental health, and the citadel of establishment mental health will NOT accept a “new syndrome” model. To end the division, we must let go of the Gardnerian PAS model. Once we switch to an “existing pathology” attachment-based model for “parental alienation,” the solution becomes available immediately.  Today.  This instant.  Because under the “existing pathology” model of “parental alienation” (the attachment-based model as described in Foundations) we are not asking establishment psychology to accept anything, we are requiring professional competence under Standards 2.01 and 9.01 of the APA ethics code.

So to the Gardnerian PAS experts… I am not your enemy.  But, at the same time, the solution to the pathology of “parental alienation” will require that we let go of the Gardnerian PAS model and switch to an attachment-based model of the pathology that will be acceptable to the citadel of establishment mental health.

But also understand this, because an attachment-based model is not proposing something “new,” there is nothing for establishment mental health to accept or reject. They are not being given the option to accept or reject an attachment-based model of “parental alienation” because the pathology is fully described, in detail, by already established and already accepted psychological principles and constructs.

By proposing a “new syndrome” the Gardnerian model allowed establishment mental health to “reject” the existence of the pathology.  In developing an alternate model I have learned that lesson, and an attachment-based model is not asking them to accept or reject anything. The pathology of “parental alienation” is entirely described through established and accepted forms of existing pathology. There is nothing to accept or reject. The pathology exists, and Foundations describes what it is.

The Coming Battle

In the months ahead, targeted parents and I will be going to battle with establishment mental health to have standards of practice and professional competence in the assessment and diagnosis of the pathology enforced in all cases of the pathology, as reflected in a consistent DSM-5 diagnosis of V995.51 Child Psychological Abuse, Confirmed when the three diagnostic indicators of the pathology are present in the child’s symptom display.  And we will begin to demand a change to the APA Position Statement on the pathology of “parental alienation” to 1) acknowledge that the pathology exists (using whatever name for the pathology they wish), and 2) that establishes this group of children and families as a “special population” requiring specialized professional knowledge and expertise to appropriately assess, diagnose, and treat.

I’m asking you, the Gardnerian PAS experts, to join us in this coming battle. But there will be no Gardnerian battle flag on the battlefield. This battle will be fought under the battle flag of Foundations. Our goal is to bring all of mental health together into a single effective voice that can solve the pathology of “parental alienation.”

Establishment mental health will NOT accept a “new syndrome” Gardnerian PAS model. In order to bring all of mental health together into a single voice to solve the pathology of “parental alienation,” our part of the compromise is to give up the Gardnerian PAS model and stop demanding that establishment mental health accept a unique “new syndrome” in professional psychology.

I ask you to look at the attachment-based replacement. It has everything we need

It has a requirement for professional expertise and competence from the diagnosing and treating mental health professionals.

If provides clear and effective dichotomous diagnostic indicators to which all mental health professional can be held accountable.

It requires that all mental health professionals consistently give a DSM-5 diagnosis of V995.51 Child Psychological Abuse, Confirmed in every case where the three diagnostic indicators are present.

It requires a period of the child’s protective separation from the pathology of the narcissistic/(borderline) parent during the active phase of the child’s treatment and recovery.

And it supports brief intensive interventions at the start of the protective separation period followed by ongoing recovery stabilization therapy (the model for which we can develop through our collaborative voice of professional expertise).

I am not your enemy.  But we must give up the Gardnerian model to achieve the solution. I’m asking you to join us.  My goal is to achieve the solution to the pathology of “parental alienation” by Christmas of 2016 because I am a single psychologist, without power and without influence, working alone to create massive systems changes in the broken mental health and legal systems. With your help, I am confident that we can accelerate this time frame for achieving a solution to the pathology of “parental alienation.”

The paradigm shift is coming.  The time to declare for a paradigm has arrived.  We will know the paradigm you choose by the diagnostic indicators you select.

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

“It is better to be on hand with ten men than absent with ten thousand” – Tamerlane

Gardner proposed that the the pathology of “parental alienation” is a new and unique form of pathology within all of mental health.  According to Gardner and his supporters, the pathology of “parental alienation” is so entirely different from any other form of pathology within all of mental health that it represents something entirely new, a new syndrome, defined by a set of eight symptom indicators that are also unique to the pathology of “parental alienation” and are entirely unrelated to any other type of symptoms for any other mental health pathology (no other pathology in all of mental health has a symptom of a “borrowed scenario,” or a “campaign of denigration,” or an “independent thinker” phenomenon, or any of the other unique symptoms of this new syndrome).

According to Gardner and his supporters, in all of mental health there is no other pathology like the pathology of “parental alienation.”  It is unique in all of psychology.  It is a new form of pathology; it is a new and unique syndrome.

I disagree.

The pathology of “parental alienation” is not a new and unique syndrome.  Instead, the pathology of “parental alienation” is a manifestation of well-established and well-understood forms of existing and accepted types of psychopathology involving established and accepted constructs of family systems pathology, personality pathology, and attachment trauma pathology.

The pathology of “parental alienation” can be fully understood at three separate and also interrelated levels of description.

1)  Family Systems Pathology

Splitting and the Cross-Generational Coalition

At the family systems level of analysis, the pathology of “parental alienation” represents the triangulation of the child into the spousal conflict through the formation of a cross-generational coalition (Haley, 1977; Minuchin, 1974) with a narcissistic/(borderline) parent against the other parent, the targeted-rejected parent.  The addition of the splitting pathology (American Psychiatric Association, 2000) of the narcissistic/(borderline) parent transforms the already pathological cross-generational coalition into a particularly malignant and virulent form that seeks to entirely terminate the other parent’s relationship with the child.

The pathology of “splitting” is defined by the American Psychiatric Association (2000) and the pathology of the cross-generational coalition is defined by the preeminent family systems theorists Jay Haley (1977) and Salvador Minuchin (1974).  These are defined and established forms of pathology within mental health.

Splitting pathology, which is associated with both narcissistic and borderline personalities (Kernberg, 1975), is a psychological process of polarization that cannot accommodate to ambiguity.  As a result, when the spouse becomes an ex-spouse as a consequence of the divorce, this ex-spouse must also become an ex-parent as well.  I describe this process more fully in Foundations.  It has to do with the complete neural cross-inhibition of the attachment bonding and avoidance motivating systems that creates the splitting pathology.

With the addition of the splitting pathology of the allied narcissistic/(borderline) parent to the cross-generational coalition with the child against the other parent, the ex-husband must also become an ex-father; the ex-wife an ex-mother.  The child’s rejection of the targeted parent accomplishes this goal of the spitting pathology of the allied narcissistic/(borderline) parent.

The pathology of “parental alienation” is not some form of new and unique pathology within all of mental health.  It is a manifestation of clearly defined and established forms of family systems pathology when combined with the personality pathology of the parent.

1+1=2

Cross-generational coalition + splitting (narcissistic/borderline parent) = “parental alienation”

2)  Personality Disorder Pathology

Projective Displacement of Parental Inadequacy and Abandonment Fears

The divorce triggered the core vulnerabilities of the narcissistic/(borderline) parent of primal self-inadequacy (narcissistic vulnerability) and fears of abandonment (borderline vulnerability).

In order to restore the narcissistic defense and stabilize the underlying borderline personalty pathology, the narcissistic/(borderline) parent induces the child’s rejection of the other parent through a variety of manipulative communication processes in order to projectively displace (psychologically expel) onto the other parent the experience of primal self-inadequacy and abandonment fears.

N/(B) Parent:  “I’m not the inadequate parent/(person) – you are.  It’s you who are being rejected and abandoned – not me.  I’m the ideal, all-wonderful, and perfect parent/(person).  The child has chosen me and rejected you because of YOUR inadequacy as a parent/(person).”

Scratch the surface of this projective process and the narcissistic/borderline parent will display excessive criticisms of the targeted parent as an “inadequate spouse” and as the “inadequate person.”

The pathology of “parental alienation” is not some new form of unique pathology within all of mental health.  The pathology of “parental alienation” is a manifestation of clearly defined and established personality disorder pathology of the parent.

3)  Attachment System Pathology

Trans-Generational Transmission of Attachment Trauma

The attachment system is the brain system that manages and regulates all aspects of love and bonding.  It mediates the formation of emotionally close and bonded relationships, as well as our approach to repairing ruptured relationship bonds, and the process of grieving for lost relationships.  The internalized patterns of the attachment system guide our individual personal responses to all aspects of love and bonding.

The divorce activates the attachment system of the narcissistic/(borderline) parent to mediate the ruptured marital relationship and the loss of the spousal relationship bond (I refer to this as the attachment system “glowing warm”).  The response of the narcissistic/(borderline) parent in responding to the ruptured spousal relationship bond is guided by the relationship patterns contained in the attachment system, called “internal working models” of attachment by the preeminent attachment theorist John Bowlby and as “schemas” by the renowned psychiatrist Aaron Beck.

The divorce therefore activates two complementary sets of representational networks in the attachment system of the narcissistic/(borderline) parent, one set for the current family members of the targeted parent, the child, and the self-representation of the narcissistic/(borderline) parent, and one set from the past relationship patterns embedded in the “internal working models” of the attachment system.

The formative processes of the narcissistic/(borderline) personality are the result of childhood attachment trauma involving a parent who is simultaneously a source of threat and a source of protection (Beck, 2004), which creates a disorganized attachment network that later constellates into the narcissistic and/or borderline personality traits that are then evidenced in relationships with others.  The childhood trauma networks of the narcissistic/(borderline) parent’s attachment system are embedded in the pattern of “abusive parent”/”victimized child”/”protective parent.”  The dual parental representation is created by the splitting pathology; i.e., the complete neurological cross-inhibition of attachment bonding and avoidance motivating systems necessary to bring coherence to the disorganized attachment motivation of the child in trying to bond to a parent who is simultaneously a source of threat and of nurture.

The divorce therefore activates two sets of corresponding representational networks, one set for the current family members of the ex-spouse, the child, and the self-representation of the narcissistic/(borderline) parent, and one set for the past childhood trauma patterns of “abusive parent”/”victimized child”/”protective parent” that are embedded in the internal working models of the narcissistic/(borderline) parent’s attachment system.  This concurrent co-activation of two sets of representational networks, one from current relationships and one from past attachment trauma, creates a psychological fusion, a psychological equivalency, of these representational networks.  In the mind of the narcissistic/borderline parent, the ex-spouse becomes psychologically equivalent to the “abusive parent” (i.e., the abusive attachment figure), the current child becomes psychologically equivalent to the “victimized child” of the attachment trauma networks (the narcissistic/(borderline) parent as a psychologically vulnerable child in need of protection), and the narcissistic/(borderline) parent adopts the coveted role as the all-wonderful “protective parent” of the attachment trauma.

The roles are then in place for the psychological reenactment of childhood attachment trauma through the current family relationships, mediated by the personality disorder pathology of splitting and the projection of core self-inadequacy and abandonment fears.

The attachment trauma patterns of the narcissistic/(borderline) parent’s attachment system are reenacted into current family relationships by first inducing the child into adopting the “victimized child” role in the trauma reenactment narrative, which then immediately defines the targeted parent into the role as the “abusive parent, irrespective of the actual parenting practices of the targeted parent.  The child’s supposed “victimization” by the allegedly “abusive” parental inadequacy of the targeted parent allows the narcissistic/(borderline) parent to then adopt and conspicuously display to others the coveted role as the all-wonderful, perfect and ideal “protective parent,” thereby completing the trauma reenactment narrative and restoring the narcissistic defense as the ideal and wonderful parent (person), which was threatened with collapse by the divorce.

At its core, the pathology of “parental alienation” represents the trans-generational transmission of attachment trauma, manifested through a trauma reenactment narrative of “abusive parent”/”victimized child”/”protective parent.”  But this narrative storyline is not true.  The child is not a victim, the targeted-rejected parent is not abusive, and the narcissistic/borderline parent is not a protective parent.  It is a false drama (a delusion) created by the pathology of a psychologically decompensating narcissistic/(borderline) parent as a means of stabilizing the fragile psychological state of the parent.

The pathology of “parental alienation” is not some form of new pathology that is unique within all of mental health.  It is a manifestation of clearly defined and established forms of family systems pathology, attachment trauma pathology, and personality disorder pathology.

The Gardnerian PAS Model

The Gardnerian PAS model asserts that the pathology of “parental alienation” is a new and unique form of pathology that represents a new mental health syndrome within professional psychology.  According to the Gardnerian model, the pathology of parental alienation is NOT a manifestation of any type of existing form of pathology.  It is an entirely new and unique syndrome within all of mental health.

This is not true.

The pathology of “parental alienation” is not a new and unique form of pathology; it is a manifestation of established and existing forms of well-defined and well-understood personality disorder pathology, family systems pathology, and attachment trauma pathology.  It is not a unique “new syndrome.”

Any mental health professional who is asserting the validity of the Gardernian PAS model is asserting that the pathology of “parental alienation” is a new and unique pathology in all of mental health, such that it represents a new and unique syndrome in mental health pathology, because that’s what the Gardnerian PAS model asserts.

They are, therefore, disagreeing with the attachment-based reformulation of the pathology as being a manifestation of established and existing forms of personality disorder pathology, family systems pathology, and attachment trauma pathology. 

Both premises cannot simultaneously be true.  The pathology cannot be BOTH a new syndrome which is unique in all of professional psychology, AND at the same time be an expression of established and existing forms of psychopathology.  Both cannot simultaneously be true.

EITHER the pathology is a new and unique syndrome, in which case the Gardnerian PAS model is true and the attachment-based model is false…

OR the pathology of “parental alienation” is a manifestation of established forms of personality disorder pathology, family systems pathology, and attachment trauma pathology, in which case it is NOT a new and unique syndrome so that the Gardnerian PAS proposal of a “new syndrome” that is unique in all of mental health pathology is incorrect.

Both proposals cannot simultaneously be true.

I am 100% convinced that the pathology traditionally called “parental alienation” represents a manifestation of established and existing family systems pathology, personality pathology, and attachment trauma pathology, as described in Foundations, and that an attachment-based model is a correct and accurate description of the pathology.

I am therefore 100% convinced that the Gardnerian PAS proposal that the pathology represents an entirely new and unique syndrome within mental health is conceptually flawed and incorrect.  The Gardnerian PAS model is wrong.  The pathology of parental alienation” is NOT a new and unique syndrome.  The pathology is a manifestation of well-defined and established forms of accepted psychopathology within standard and existing mental health constructs and principles.

Choosing a Paradigm

So far, all the the Gardnerian PAS experts, Amy Baker, Bill Bernet, Linda Gottlieb, Richard Sauber, Richard Warshak, Michael Bone all continue to hold and support the Gardnerian PAS model.  None have announced their shift to an attachment-based reformulation for the pathology of “parental alienation.”

This means that all of the Gardnerian PAS experts, Amy Baker, Bill Bernet, Linda Gottlieb, Richard Sauber, Richard Warshak, Michael Bone all reject that the pathology of “parental alienation” represents a manifestation of existing forms of family systems, personality disorder, and attachment trauma pathology, and they all continue to assert that the pathology of “parental alienation” represents a new and unique form of pathology within all of mental health, entirely unrelated to any other form of established and existing psychopathology, because that’s what the Gardnerian PAS model asserts.

Since BOTH the Gardnerian PAS model AND the attachment-based model cannot simultaneously be true (the pathology of “parental alienation” cannot simultaneously be a new and unique syndrome within all of mental health AND at the same time be a manifestation of existing and well-established forms of psychopathology) then all of these experts in Gardnerian PAS are all asserting their belief that an attachment-based model of “parental alienation” is incorrect, that an attachment-based model of the pathology is wrong.  Because if an attachment-based model is NOT incorrect, then it is the Gardnerian PAS model which is incorrect, because both cannot simultaneously be true (it is a logical impossibility for the pathology to be BOTH a new and unique pathology AND an expression of an existing and well-established form of pathology – it is either one or the other).

However, none of these experts in Gardnerian PAS have offered their justification and critique of an attachment-based model as to why they believe it is wrong.  As far as I can tell, they have simply ignored an attachment-based reformulation of the pathology. 

If they believe that the pathology of “parental alienation” is a new syndrome that is unique in all of mental health and that an attachment-based model that defines the pathology within standard and established forms of accepted psychopathology within mental health is incorrect, tell us why?  What aspect of an attachment-based model of the pathology is incorrect?  Where is an attachment-based model in error?

Because if its not in error, then it is true.   And if it is true, then the Gardnerian PAS model is not true – it is wrong.  It is a logical impossibility for both models to simultaneously be true.  Either the pathology is a new and unique form of pathology within all of mental health OR it is an expression of established and existing forms of pathology.  Both cannot simultaneously be true.

So if they are maintaining that the Gardnerian PAS model is true, then they must also be asserting that the attachment-based model of the pathology is false, that it is wrong.

Why is that?  Why is an attachment-based model wrong?  What part of an attachment-based model do you disagree with?  Because if you don’t disagree with an attachment-based model, then an attachment-based model is correct.  And if an attachment-based model is correct then the Gardnerian PAS model of a new and unique pathology is wrong.  So why would you continue to support and advocate for a model of pathology that you know is wrong and incorrect?  So you must believe that an attachment-based model is wrong.  So tell us why you believe that. 

I’ve done my job in Foundations.  I’ve laid out the theoretical foundations for an attachment-based model in great detail.  If you disagree with this model, tell us why.  What part do you disagree with?  Do you not accept a cross-generational coalition?  Or the splitting pathology?  Or the projective displacement of narcissistic and borderline vulnerabilities onto the targeted parent?  Or the disorganized attachment that leads to narcissistic and borderline personality processes?  Or the creation of a trauma reenactment narrative?  What do you disagree with?

Because if you don’t disagree with the model, then this means that the Gardnerian PAS proposal that the pathology represents a new and unique syndrome is incorrect.  So why would you continue to hold onto and advocate for an incorrect description of the pathology?  So you must believe that the attachment-based model is incorrect.  So tell us why you believe this.  What part of the attachment-based model do you disagree with?

In my view, it is now incumbent upon the experts in “parental alienation” who continue to hold to a Gardnerian PAS model to identify why they believe an attachment-based reformulation of the pathology, as described in Foundations, is wrong.

Otherwise, an attachment-based model of “parental alienation” is accurate, the pathology of “parental alienation” represents a manifestation of established and existing forms of family systems, personality, and attachment trauma pathology, and the Gardnerian PAS proposal of a new and unique form of pathology is wrong (the pathology of “parental alienation” is not a new an unique form of psychopathology).

Both paradigms cannot simultaneously be true.  Only one or the other model is correct.  The other model is incorrect.  The other model is wrong.  EITHER the pathology of “parental alienation” is a new syndrome unique within all of mental health, OR the pathology of “parental alienation” is a manifestation of well-defined, established and accepted forms of psychopathology.  Both propositions cannot logically be true at the same time.

The time for sitting on the fence is over.  Within the next year we will be using the attachment-based model to solve the pathology of “parental alienation” for all families and all children.

If an attachment-based model is correct (which it is), then it is the professional obligation of ALL mental health professionals to adopt an accurate framework for understanding the pathology of “parental alienation.” 

For the critics of “parental alienation” and the binding sites of ignorance for the pathogen, this means acknowledging the existence and the nature of the pathology of “parental alienation” (attachment trauma reenactment pathology), which will require them to become competent in its assessment, diagnosis, and treatment (i.e., a DSM-5 diagnosis of V995.51 Child Psychological Abuse, Confirmed when the three diagnostic indicators of the pathology are present in the child’s symptom display).

For the Gardnerian PAS experts this means relinquishing an inaccurate model of the pathology that proposes a new and unique syndrome within mental health – which is not true – and adopting a more accurate model for the pathology.  It is professionally inappropriate to knowingly propose and support an inaccurate and incorrect model for pathology.

Ending the Division Within Mental Health

The attachment-based model for the pathology of “parental alienation” is going to bring ALL of mental health together into a single united voice.  It is going to heal the decades-long rift within mental health so that mental health can speak to the legal system with a single unified voice regarding the nature, assessment, diagnosis, and treatment of what is a standard and recognized form of family systems, personality disorder, and attachment trauma pathology.

If any mental health professional, either “parental alienation” critic or Gardnerian advocate, believes that the attachment-based model for the pathology is incorrect and that the pathology of “parental alienation” is NOT a manifestation of personality disorder, family systems, and attachment trauma pathology as described in Foundations, let’s hear it.  Tell us why you think an attachment-based model is incorrect.

If not, then it is your professional obligation, whether you were a former critic of Gardnerian PAS or a former advocate for Gardnerian PAS, to switch to and adopt an accurate recognition and description of the family systems, personality disorder, and attachment-trauma pathology.

I’ve presented my position in detail in Foundations.  Your turn.  If you believe the description of the pathology provided in Foundations is wrong, tell us why it is wrong.  If you don’t, then we will assume that you have no argument against the attachment-based model of the pathology described in Foundations… meaning that an attachment-based description of the pathology as described in Foundations is correct… meaning that a Gardernian PAS proposal that the pathology of “parental alienation” represents a new and unique syndrome is wrong.

Either an attachment-based model is correct and the pathology of “parental alienation” is a manifestation of established and defined forms of existing pathology within mental health (personality disorder pathology; family systems pathology; attachment trauma pathology), or a Gardnerian PAS model is correct and the pathology of “parental alienation” is a new and unique form of pathology in all of mental health.  Both cannot simultaneously be true.  Only one of these paradigms is true, the other model is not true.

It’s time to declare your position with regard to the paradigm change.  Either you support the change in paradigms to an attachment-based model for the pathology of “parental alienation” or you seek to maintain a Gardnerian PAS paradigm and prevent the change to an attachment-based model.

If you want to maintain a Gardnerian PAS model, tell us why.  Tell us what solution a Gardnerian PAS model offers.  I’ve told you what solution an attachment-based model offers.  Tell us why a Gardnerian PAS model is a superior model of the pathology. 

Christmas 2016

My goal is to bring mental health together into a single voice to achieve a complete resolution to the pathology of “parental alienation” by Christmas of 2016.  I want to have all alienated children back in the arms of their loving and authentically protective targeted parents by Christmas-time of 2016.

This nightmare must end.  Today.  Now.  Even Christmas 2016 is too long to wait.  But I am only a single psychologist, without connections, without power, working alone.  There is only so much I can do on my own.  I could use help.

If the Gardnerian experts, Amy Baker, Bill Bernet, Richard Sauber, Linda Gottlieb, Richard Warshak, Michael Bone give their fully voiced and active support to a paradigm shift, I wonder if the addition of their power and professional standing could accelerate the paradigm shift, so that we could achieve the paradigm shift to an attachment-based model, and the seven-step solution offered by an attachment-based model, by Christmas of 2015, by this Christmas.

I know that’s only three months away.  But the solution is already here – because the pathology as defined by an attachment-based model is standard and established forms of pathology, already accepted within the citadel of establishment mental health.  The only thing that is preventing the solution is the ignorance of establishment mental health that an attachment-based model exists.  Once this ignorance is overcome, the solution becomes available immediately (i.e., a DSM-5 diagnosis of V995.51 Child Psychological Abuse, Confirmed).

Once the pathology of “parental alienation” is recognized as a manifestation of existing and well-established forms of family systems, personalty disorder, and attachment trauma pathology, then the DSM-5 diagnosis of the pathology becomes V995.51 Child Psychological Abuse, Confirmed, and the seven-step solution becomes immediately available because we can hold ALL mental health professionals accountable under Standard 2.01 and 9.01 of the Ethical Principles of Psychologists and Code of Conduct of the American Psychological Association.

To achieve a solution to the pathology of “parental alienation” we must end the division within mental health that has surrounded the pathology of “parental alienation.”  The Gardnerian model of PAS continues this division.  An attachment-based model brings the division within mental health to a close.  An attachment-based reformulation of the pathology within established and accepted forms of existing pathology can unite all of mental health into a single unified voice.

My goal is to achieve a resolution to the pathology of “parental alienation” by Christmas of 2016, because I am working alone and without support.  I am inviting the current experts in Gardnerian PAS to bring their support to a paradigm shift and see if we can achieve a resolution to the pathology of “parental alienation” a full year earlier than I can accomplish it on my own, by Christmas of 2015 (or the spring of 2016).  Each day that passes without a solution is one day too many.

Or, if you feel that the pathology of “parental alienation” is not a manifestation of existing types of family systems pathology, personality pathology, and attachment trauma pathology (as described in Foundations), and you believe that the pathology represents an entirely new and unique form of pathology in all of mental health, evidenced in a unique set of symptom identifiers, then I ask you to explain your position.  Why do you believe that?  What is incorrect about an attachment-based model of the pathology?  I have explained how a paradigm shift to an attachment-based model will achieve an immediate solution to the pathology of “parental alienation.”  If you disagree, tell us why.  Tell us the steps by which a Gardernian PAS model will provide a solution to the pathology of “parental alienation.”

Paradigm Shift

The Gardnerian PAS model is going away.  It is going to be replaced as a paradigm by an attachment-based model for the pathology.  My goal is to achieve this replacement, this change in paradigms, by Christmas of 2016, to have all of these lost children back in their parent’s arms by Christmas of 2016.  The sooner the Gardnerian PAS model goes away and is replaced in the consciousness of establishment mental health by an attachment-based model, the sooner we achieve the solution and the sooner we can return these lost children to their loving parents whom they currently reject.

Help me bring an end to the Gardnerian PAS paradigm so we can achieve this solution.  Now.  Today.  For all of these children and families who cannot wait another day.

But whether you help us or not, understand this, the Gardnerian PAS model is going away.  My goal is to bring it to an end by Christmas of 2016 so that we can return these lost children back to their loving parents by that date.  The pathology of “parental alienation” is not a new and unique form of pathology within all of mental health.  That proposal is incorrect.  In proposing that the pathology of “parental alienation” is a new and unique form of pathology within all of mental health, the Gardnerian model is wrong.  The pathology of “parental alienation” is a manifestation of established and existing forms of pathology.  Because of this, the moment the paradigm shifts to an attachment-based model we will have the solution immediately: the DSM-5 diagnosis of V995.51 Child Psychological Abuse, Confirmed.

Because the Gardnerian PAS model proposes a new and unique syndrome, it cannot give us this DSM-5 diagnosis today.

Because an attachment-based model describes the pathology from entirely within standard and established forms of pathology, it can give us this DSM-5 diagnosis today.  Immediately.  Once the paradigm shifts.

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

References

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

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

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

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

Minuchin, S. (1974). Families and family therapy. Harvard University Press.

We are all in this together. 

Our goal is to solve parental alienation for everyone, for all children and all families everywhere.

I am often contacted by parents in other nations who are suffering this nightmare in countries with varying degrees of understanding and responsiveness.  I am aware of your struggles and I am working for you and your children as well.

The key to the solution is to switch the paradigm to an attachment-based model that defines the pathology from entirely within standard and accepted psychological principles and constructs.  Gardnerian PAS proposes a “new syndrome.” This allows the citadel of establishment mental health to reject the construct of a “new syndrome.”

Once we switch to an attachment-based reformulation and redefinition of the pathology, there is nothing to accept or reject.  Personality disorder pathology is an established psychological pathology.  Family systems therapy is an established model of family psychotherapy.  The attachment system and attachment trauma are well-defined and accepted constructs within establishment psychology.  These are all accepted psychological principles and constructs.

In bringing archaic mental health systems up to speed, I would focus on describing the pathology as the addition of the “splitting pathology” of narcissistic and borderline personality pathology to the “cross-generational coalition” of family systems theory.

The “foot-in-the-door” is that this pathology (attachment trauma reenactment pathology) is a manifestation of narcissistic/borderline personality disorder pathology following divorce.

That is the first principle to get across. 

What’s happening in my family is a manifestation of narcissistic and borderline personality disorder pathology following divorce.

What’s happening in my family is a manifestation of narcissistic and borderline personality disorder pathology following divorce.

What’s happening in my family is a manifestation of narcissistic and borderline personality disorder pathology following divorce.

Narcissistic and borderline personalty disorders are  defined pathologies within both the DSM diagnostic system of the American Psychiatric Association and the ICD-10 international diagnostic system.  These are professionally established and defined psychopathologies. 

Gardner got us off-track when he proposed that this pathology represented a “new and unique syndrome.”  It’s not.  The pathology expressed as “parental alienation” is not a new and unique syndrome, it is a manifestation of well-established and well-understood forms of acknowledged and existing psychopathologies.  We need to return to the solid foundation offered by established psychological principles and constructs.

Hence the title of my book as, Foundations.

We need to plant our feet on the solid bedrock of established and existing psychological principles and constructs, and wage our battle from this solid foundation.

The diagnosis and treatment of schizophrenia, of bipolar disorder, of ADHD, of autism, are not controversial  Neither should be the diagnosis and treatment of this pathology. It is a manifestation of narcissistic and borderline personality pathology following divorce. 

While a full description of this pathology may initially appear complicated, an introductory description of the pathology can actually be made pretty straightforward.  It is the addition of the “splitting” pathology associated with both narcissistic and borderline personality pathology to a “cross-generational coalition” as defined by the preeminent family systems theorists Jay Haley and Salvador Minuchin.

The pathology of splitting is defined and established by the American Psychiatric Association (2000) as:

“Splitting. The individual deals with emotional conflict or internal or external stressors by compartmentalizing opposite affect states and failing to integrate the positive and negative qualities of the self or others into cohesive images. Because ambivalent affects cannot be experienced simultaneously, more balanced views and expectations of self or others are excluded from emotional awareness. Self and object images tend to alternate between polar opposites: exclusively loving, powerful, worthy, nuturant, and kind — or exclusively bad, hateful, angry, destructive, rejecting, or worthless.” (p. 813)

The family systems pathology of the cross-generational coalition is defined by Haley (1977) as:

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. (p. 37; emphasis added)

Salvador Minuchin, regarded by many as the world’s foremost family systems theorist, also identifies the cross-generational coaltion in his foundational book on family systems therapy, Families and Family Therapy (1974):

“The rigid triangle can also take the form of a stable coalition.  One of the parents joins the child in a rigidly bounded cross-generational coalition against the other parent.” (p. 102; emphasis added)

Minuchin even provides a case example regarding the impact on family relationships of a cross-generational coalition:

“An inappropriately rigid cross-generational subsystem of mother and son versus father appears, and the boundary around this coalition of mother and son excludes the father.  A cross-generational dysfunctional transactional pattern has developed” (p. 61-62)

“The parents were divorced six months earlier and the father is now living alone… Two of the children who were very attached to their father, now refuse any contact with him.  The younger children visit their father but express great unhappiness with the situation.” (p. 101)

This pathology is NOT a “new syndrome.”  It is manifestation of standard and well established pathology.

When the “splitting” pathology of the narcissistic/borderline personality is added to the “cross-generational” coalition, it transforms the already pathological cross-generational coalition into a particularly malignant form that seeks to entirely terminate the other parent’s relationship with the child.

The splitting pathology cannot accommodate to ambiguity and ambivalence.  The other person is perceived to be EITHER entirely good or entirely bad; “ambivalent affects cannot be experienced simultaneously” and “more balanced views and expectations of self or others are excluded from emotional awareness” (American Psychiatric Association, 2000).

Following the divorce the husband becomes an ex-husband, the wife an ex-wife.  The splitting pathology of the narcissistic/borderline parent cannot accommodate to ambiguity and ambivalence. Perceptions of the other person are split “between polar opposites: exclusively loving, powerful, worthy, nuturant, and kind — or exclusively bad, hateful, angry, destructive, rejecting, or worthless.”

As a result of the splitting pathology, the ex-husband MUST become an ex-father, the ex-wife an ex-mother.  No other alternative is allowed within the splitting pathology of the narcissistic/borderline personality.

Through the cross-generational coalition, the child is induced to entirely reject the other parent, thereby turning the ex-husband into an ex-father; the ex-wife into an ex-mother.

Splitting + Cross-Generational Coalition = “Parental Alienation”

1 + 1 = 2

It’s not complicated pathology.

In order to establish firm foundations, I drilled to the absolute bedrock of the attachment trauma at the core of this pathology.  But for an initial explanation you can remain on the surface; splitting + cross-generational coalition = rejection of the normal-range and affectionally available parent.

So start at the level of the personality disorder pathology of splitting. 

What’s happening in my family is a manifestation of narcissistic and borderline personality disorder pathology following divorce.

Then, once you’re able to obtain a second round of interest, introduce the cross-generational coalition:

My ex-wife/ex-husband has formed a cross-generational coalition with my child against me in order to stabilize the psychological pathology of my ex-wife/ex-husband.

The cross-generational coalition may be a barrier to the therapist’s comprehension, but keep at it.  It is not an insurmountable barrier.  The quotes you have available to you are from the preeminent family systems therapists Salvador Minuchin and Jay Haley.

Once you have an awareness opening from the therapist that allows you to move to the next statement, introduce the splitting pathology:

The splitting pathology of the narcissistic/borderline personality structure is creating polarized sides, in which I’m being falsely characterized as the all-bad spouse and parent.  Because of the splitting pathology of my ex-, I must not only become an ex-husband (ex-wife), I must now also become an ex-father (ex-mother).  This is a product of the splitting pathology of my ex-

Notice I’ve never used the term “parental alienation.”  I’m walking the therapist through the pathology using defined and established clinical terms.

Unfortunately, you will encounter ignorant and arrogant mental health professionals who will say, “You don’t tell me what the pathology is, I’ll tell you what the pathology is.”  We have barriers to overcome.  But we will be relentless.

Our biggest barrier is that the citadel of establishment mental health does not currently realize that an alternative paradigm to Gardner’s PAS model even exists. 

Stupidity tends to follow.  Right now that’s a barrier.  However, once the paradigm shift to an attachment-based reformulation of the pathology occurs, stupid will simply follow this new path.  So once we can shift the paradigm within the citadel of establishment mental health, the ignorance of therapists will follow this new paradigm of attachment-based “parental alienation.”

Three diagnostic indicators. 

Checklist format. 

Pretty simple.

There is nothing in an attachment-based model for establishment mental health to accept or reject.  It’s all established and existing pathology.  It just needs to be diagnosed.

This is really important for everyone to understand, because Gardner’s model of PAS got everyone thinking down a problematic path of a “new syndrome” that needs to be accepted by establishment mental health – no, no, no.  The pathology is NOT a “new syndrome.” It is all explained entirely from within standard and established psychological principles and constructs.

That is actually the constructive criticism that establishment mental health has been trying to give to the Gardnerian PAS advocates all along:

Establishment Mental Health:  “Don’t bring us a ‘new syndrome’ proposal.  Instead invest the time and effort necessary to define this pathology using standard and established psychological principles and constructs.”

That is seemingly a reasonable request.

When we meet this standard, which Foundations does, then we will be able to end the division within mental health that currently paralyzes the mental health response to the pathology, and we will be able to bring mental health together into a single voice that effectively ends the pathology through a seven-step solution.

Our goal is to achieve a synthesis of Gardner’s identification of the pathology with the requirement of establishment mental health that the pathology not be defined as a “new syndrome.”  An attachment-based model for the pathology of “parental alienation” accomplishes this integration of positions.

We need to end the rift created in mental health by the proposal of a “new and unique” pathology.  It’s not a “new and unique” pathology, it is a well-understood and well-established pathology.

We now just need to let establishment mental health know that their definitional requirement has been met.  The pathology of “parental alienation” has been defined entirely within standard and established psychological principles and constructs.  Since the pathology is defined through existing and established constructs, there is nothing to accept or reject.  The definition of the pathology will be incorporated into practice, and we will achieve a seven-step solution to the pathology of “parental alienation.”

Once this lack of institutional awareness is overcome in any one country, it will cascade through the establishment mental health systems of all countries. The pathology of “parental alienation” is a manifestation of narcissistic and borderline personality pathology (splitting) following divorce. Once they have an initial grasp of the pathology, we can then unwrap for them the next level of pathology involving “projection,” and then the next level involving “attachment trauma.”

We are all in this together.  Once the light dawns in Australia’s mental health system, it will ripple back to the U.S., and then across the Atlantic. If the light dawns first in the U.S., then it will ripple up to Canada, to Australia, and over to Europe and South Africa (interestingly I haven’t heard much from Asia regarding their struggles with the pathology).

We are all in this together.  We cannot solve the pathology of “parental alienation” for any one family unless we solve it for all families.  And once the paradigm shift occurs in one country, it will ripple across all countries. We are all in this together.

The solution requires a paradigm shift in how we define the construct of “parental alienation.”  Creating this paradigm shift is our challenge.

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

References

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

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

Minuchin, S. (1974). Families and family therapy. Harvard University Press.

Occasionally I have been admonished for being too critical of Gardnerian PAS. The argument is that my criticisms of Gardnerian PAS give fuel to the critics of PAS.

Science advances through professional dialogue and discussion. To suggest that I should withhold criticism of a theoretical model in order to advance a particular agenda is both professionally and scientifically inappropriate. Open discussion, critique, and criticism are good things. They strengthen theoretical formulations and advance scientific understanding. Our goal is not a particular agenda, our goal is the truth and the protection of children, all children, 100% of the time.

A concern I have about suggestions that I should withhold criticisms of Gardnerian PAS is that the construct of “sides” may have crept into the discussion. Polarized “sides” are a manifestation of the splitting pathology. When the splitting pathology surrounding borderline personality processes infects the mental health professionals treating the pathology, it is called “parallel process.”   A leading figure in the treatment of borderline personality processes, Marsha Linehan (1993), refers to it as “staff splitting.”

“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… 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.” (p. 432; emphasis added)

Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York, NY: Guilford

There are no sides. We are all on the same side. Our goal should be to recognize that both “sides” in a professionally responsible discussion represent “equally valid poles” in the dialogue, and we should work toward a synthesis that recognizes the legitimacy of reasonable arguments and counter-arguments.

My position is that the Gardnerian model of PAS fails to provide a solution to the pathology of “parental alienation,” and that we need a paradigm shift to a more substantial and scientifically anchored description of the pathology in order for us to achieve a solution to the pathology traditionally described as “parental alienation.”  Once such a paradigm shift takes place, the solution to “parental alienation” will become available immediately.

In order to achieve this paradigm shift that will provide an immediate solution to the pathology, we need to recognize and acknowledge the limitations of the Gardnerian PAS model in providing a solution.  We must be willing to let go of the Gardnerian PAS model in order to allow the paradigm to shift to a more theoretically substantial and powerful model for that pathology that will provide an immediately actualizable solution.

In 2013 I posted an essay to my website (that’s still up there) entitled

The Failure of Gardner’s Model of “Parental Alienation.”

This essay will appear in a book that’s coming out shortly entitled Essays in Attachment-Based Parental Alienation: The Internet Writings of Dr. Childress. This book is a selection of my online essays from my blog and website, and the essay The Failure of Gardner’s Model of “Parental Alienation” is Chapter 1.

I am posting this essay to my blog so that we are all clear on what my criticism of Gardnerian PAS entails. Read this essay.  I believe that all of the arguments I make are reasonable and balanced. If someone wants to challenge these arguments, I can accept the criticism, but to simply say that I shouldn’t even raise these criticisms is, in my view, both scientifically and professionally inappropriate.

Both science and the practice of professional psychology benefit from open and direct discussion. Read my criticisms so that we can have a balanced discussion regarding the need for a paradigm shift.

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 The Failure of Gardner’s Model of “Parental Alienation”

C.A. Childress, Psy.D. (2013)
Retrieved from http://www.drcachildress.org 8/14/15

The Gardner model of “parental alienation” is a failed paradigm. Gardner was correct in identifying a clinical phenomena in which a child is induced by one parent to reject a relationship with the other parent, and his model for describing “parental alienation” succeeded in directing professional and legal attention to the issue. However, his forays into the veracity of sexual abuse allegations were problematic, and his troubling personal views distracted from a more central focus on the clinically relevant issue of induced child rejection of a parent. In addition, his initial gender focus on alienating mothers distracted from a more balanced perspective of recognizing the clinical phenomena of induced child rejection of a parent as equally prevalent across both genders of parents. The model initially proposed by Gardner created an unfortunate schism within professional psychology.

In the decades since its introduction into professional dialogue, Gardner’s (1987) model of “parental alienation” has been rejected as a legitimate psychological construct. The most recent rejection of Gardner’s model of “parental alienation” is evidenced by its failure to be included, even by mention, in the DSM-5 (American Psychiatric Association, 2013) despite concerted efforts by the supporters of the construct who actively lobbied for its inclusion in the DSM-5.

Gardner’s model of “parental alienation” represents a failed paradigm in four major domains; legal, theoretical, diagnostic, and treatment.

The Legal Domain:

Gardner’s model for describing “parental alienation” has achieved some success in the legal arena, due in large measure to the laudable efforts of researchers such as Amy Baker (Baker, 2006; Baker & Darnall, 2007), and it has been admitted into legal evidence in some cases. However, while the legal system may be well suited to structure schedules for child custody visitations, the legal arena is an ill-suited venue for resolving interpersonal family conflicts. The process of proving “parental alienation” in court is typically long, arduous, and extremely expensive for targeted parents, often placing this avenue for resolution of “parental alienation” beyond the financial scope of many targeted parents. Furthermore, proving “parental alienation” in court requires experienced legal representation. For many targeted-rejected parents the financial expense of continual legal battle becomes too great, so they must turn to self-representation. Yet without the benefit of expert legal counsel the practicality of proving “parental alienation” in the legal arena can prove extremely difficult, if not impossible.

In addition, even if “parental alienation” is eventually proven in court, the years of protracted legal battles that have been necessary to prove “parental alienation” in any particular case may only have allowed the alienation to become so firmly entrenched by the passage of time and the continuing negative influence of the alienating parent that it has essentially become treatment resistant. With “parental alienation,” time and delay are on the side of the alienator. The longer that effective intervention can be delayed, the more intractable to treatment the alienation becomes.

Furthermore, even if parental alienation is proven in court, the failure of Gardner’s model of “parental alienation” to effectively identify a professionally accepted treatment framework undermines the potential responsiveness of the court to the proven alienation. Oftentimes, the court will be reluctant to remove custody from the “favored” parent out of concern for the potentially “traumatic” impact of such a decision on the child, an (erroneous) opinion that will be voiced by some mental health professionals in support of the child’s continued custody with the alienating parent. Reluctant to remove custody from the “favored parent,” court orders will often split custody between the parents and require something called “reunification therapy” for the child and targeted-rejected parent, which far too often proves to be entirely ineffectual because the therapy lacks a coherent model for understanding the nature of “parental alienation” that would allow for a coherent treatment framework.

So while some gains have been made in the legal arena regarding Gardner’s model of “parental alienation,” these gains have been wholly inadequate to resolving the issue for the vast majority of targeted-rejected parents. The process of proving Gardner’s model of “parental alienation” in court remains prohibitively expensive, inexact, excessively long, and of uncertain ultimate outcome, even if “parental alienation” is proven.

Theoretical Domain:

Gardner was correct in identifying a set of interrelated clinical phenomena reflected in a child’s induced rejection of a relationship with a parent. However, he too quickly abandoned the structure of traditional psychology in proposing a new “syndrome” characterized by a set of disparate symptom indicators that held no association to any established psychological or psychiatric process or diagnosis, and his problematic foray into the veracity of sexual abuse allegations was conceptually flawed and generated excessive controversy. In abandoning the structure of established psychological constructs, Gardner abandoned the necessary professional rigor that would allow for a more complete understanding for the clinical phenomena he observed. Yet it must also be kept in mind that Gardner was one of the first theorists in this clinical domain of investigation, and some leeway in judging from hindsight an investigator’s initial exploratory models should be allowed to the initial investigators of any clinical phenomena. At the same time, the more conservative elements of professional psychology were correct, and remain correct, in rejecting his initial conceptualizations as scientifically inadequate.

Gardner’s model of “parental alienation” lacks sufficient conceptual rigor. He too quickly moved outside of established and accepted psychological constructs, and he failed to adequately respond to criticisms regarding the absence of conceptual rigor. Rather than offering increasingly elaborated frameworks for “parental alienation” using established psychological principles and constructs, Gardner and his supporters steadfastly pressed for the accuracy of his initial conceptualizations and diagnostic indicators. This led to controversy and the splitting of the professional community into supporters and detractors of the construct of “parental alienation.”

This splitting of the professional community has been extremely unfortunate, as it distracts from a professionally unified effort to develop an accurate model of the clinical phenomena first noted by Gardner, that employs established psychological constructs which can illuminate the exact nature and features of the clinical phenomena of “parental alienation,” and which would allow, in turn, for the development of reliable diagnostic indicators and effective treatment frameworks. Once a theoretical model for “parental alienation” is established within standard and professionally accepted psychological and psychiatric constructs, then professional standards of practice can be established to guide both the diagnosis and treatment of “parental alienation,” and to which mental health professionals can be held accountable.

A unifying theoretical framework allows for the return of the family conflict associated with “parental alienation” to the proper venue of mental health instead of the ill-suited domain of the legal system. Once mental health speaks with a single voice, the legal system can act with the decisiveness and clarity necessary to resolve the psychological issues associated with what has traditionally been referred to as “parental alienation.” Targeted and rejected parents are not concerned about professional squabbles within mental health; they just want their relationship with their child restored. Targeted-rejected parents are fully aware that “parental alienation,” in whatever form mental health professionals may wish to describe it, exists and is an all too real and tragic nightmare. They simply want it identified, treated, and resolved.

For the benefit of our clients, the children and targeted-rejected parents who are so tragically hurt by this clinical phenomenon, it is time to resolve the split within mental health and work together in developing a more complete and accurate description for the construct of “parental alienation” that employs established and professionally accepted constructs that can be used to guide diagnosis and treatment, and that can establish a professionally accepted standard of practice. To the extent that Gardner’s model continues the professional rift, even after decades of professional discourse, and continues to divide and distract from professional efforts to resolve the clinical phenomena of “parental alienation,” Gardner’s model represents a failed paradigm, and an alternative paradigm is called for that can bring mental health together in a common effort.

Diagnostic Domain:

Gardner’s model of parental alienation also fails diagnostically. While commendable efforts have been engaged to support the diagnostic criteria identified by Gardner, none of Gardner’s diagnostic criteria are associated with any established psychological or psychiatric disorder or process. The vague and imprecise specification of the psychological processes by which “parental alienation” occurs has undermined professional confidence in the both the construct and the symptom identifiers proposed by Gardner. A more coherent explanation of the underlying dynamics of “parental alienation” that employs established psychological constructs would be able to more adequately support the conceptual reasoning for identifying a specific set of symptom indicators.

In the absence of an underlying conceptual framework that relies on established and accepted psychological constructs, the diagnostic indicators identified by Gardner represent an incoherent array of disparate qualities and features, some of which may be present, some of which may be absent, and many of which may overlap with non-alienation parent-child conflict, so that the differential diagnosis of “parental alienation” from non-alienation parent-child conflict becomes inexact. Furthermore, since the diagnostic indicators of Gardner are outside of established psychological constructs, they cannot provide an accepted standard of practice to which mental health professionals can be held accountable. Gardner’s model also fails to provide clinically definitive criteria for determining the presence or absence of proposed symptom identifiers, or established guidelines for the required number of symptoms necessary to assign a diagnosis of “parental alienation.” This leaves much of the diagnosis of “parental alienation” to the discretionary judgment of the diagnostician, which undermines diagnostic reliability.

Gardner’s diagnostic indicators do not provide sufficiently clear and professionally accepted standards of practice to which mental health professionals can be held accountable. In order to provide appropriate clinical utility, the diagnostic indicators of “parental alienation” must reliably identify every case of “parental alienation” and they must reliably differentiate every case of non-alienation parent-child conflict. Gardner’s model of “parental alienation” cannot accomplish this goal, and so represents a failed diagnostic paradigm.

Treatment Domain:

Even if a custody evaluator or therapist identifies “alienation” as a factor in the child’s rejection of visitations with a parent, there exists no standard of practice for resolving the problem since Gardner’s model is outside of accepted and established psychological constructs. What is the treatment for “parental alienation”? While Gardner offers his opinions, these opinions are countered by alternative opinions from other mental health professionals. Gardner, for example, recommends separating the child from the alienating parent whereas other mental health professionals respond that abruptly separating the child from the “favored” parent would be too “traumatic” for the child. How is this disagreement to be resolved? We are potentially looking at another 20 years of treatment research, even if and once Gardner’s model of “parental alienation” is accepted as a legitimate construct, in order to identify what the treatment response should be.

So even though a custody report may identify “parental alienation,” the proposed recommendations of the evaluation may nevertheless be inadequate to resolve the child’s rejection of a parent. Often, the recommendation of the custody evaluation is for joint custody and “reunification therapy,” yet there is no clear model within professional psychology for what “reunification therapy” entails. Within professional psychology, there are models for family therapy (Haley & Hoffman, 1967; Minuchin, 1974), cognitive behavioral therapy (Beck, 1976; Beck, Freeman, Davis, & Associates, 2004; Ellis, 1962), psychodynamic therapy (Kohut, 1984; Stolorow, Brandchaft, & Atwood, 1987), and humanistic-existential therapy (Frankl, 1997; Rogers, 1961, Yalom, 1980), but there exists no proposed and accepted model within professional psychology for what constitutes “reunification therapy.” The construct of “reunification therapy” is a myth. There is no such thing.

Mental health therapists who supposedly engage in this mythical “reunification therapy” are therefore free to engage in any form of dialogue, discussion, or approach in their “therapy” without reference to any established model. In some cases, this reunification therapy is simply listening to the child’s litany of complaints against the targeted parent, having the targeted parent apologize to the child for supposed parental failures (often exaggerated, distorted, or even fabricated by the child), and encouraging the further disempowerment of the targeted parent who must seek to appease the child, continually, and without success in altering the child’s rejection.

In other cases where the “reunification therapy” employs approaches that may be effective, tactics of the alienating parent and child, who postpone, reschedule, and fail to attend appointments, will delay the “reunification therapy”. The targeted parent must then return to court to seek legal enforcement of court orders for “reunification therapy,” thereby incurring additional delays in acquiring the necessary therapy across months, and sometimes even years, as legal schedules respond to the petitions of the targeted parent and legal maneuverings of the alienating parent. In other cases, the child and alienating parent engage in tactics to remove therapists who challenge the child to behave more appropriately, in favor of therapists who enable the child’s over-empowerment and collude with the family psychopathology that is manifesting in the child’s rejection of the targeted parent. A common tactic to remove non-desired therapists is for the child to become “symptomatic” (typically “anxiety” and “stress”) related to the therapy, which the alienating parent then exploits to obtain a change in therapists so as avoid “stressing” the child by therapy. The exploitation of the child’s (elicited) symptomatology by the narcissistic/borderline parent is the established pattern for control.

In order for the construct of “parental alienation” to be useful, it must be defined sufficiently within established mental health constructs so that it provides a clear treatment framework for its resolution, and which can define clear standards of practice regarding the nature of “reunification therapy” to which mental health professionals can be held accountable. Gardner’s model does not provide sufficient professional acceptance of the underlying theoretical constructs, which lay outside of existing and professionally accepted psychological frameworks, so as to provide accepted treatment standards. Gardner’s model of “parental alienation” therefore represents a failed treatment paradigm.

Conclusion:

Gardner was the first pioneer in a new domain. Consideration should be given to both his clinical acumen and his professional courage. His pioneering efforts drew professional and legal attention to an important clinical phenomenon, and have served as comfort to many targeted-rejected parents that the upside-down world they were experiencing was the product of the other parent’s psychopathology. But after 30 years of professional review, Gardner’s model of “parental alienation” has failed to provide the vast majority of targeted-rejected parents with actualized solutions, and it has not provided a standard of practice to guide diagnosis and treatment, and to which mental health professionals can be held accountable.

The division within mental health regarding the construct of “parental alienation” only harms the client. In line with Linehan’s (1993) observation on the splitting of mental health professionals as the consequence of working with borderline personality processes,

“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.” (p. 432)

It is time to resolve the split within mental health regarding the construct of “parental alienation” so that we can work toward a synthesis within professional psychology that recognizes the “equally valid poles” of the dialectic. The advocates for the construct of “parental alienation” are correct; there exists a valid clinical phenomenon that they identify. In addition, the opponents of the construct of “parental alienation” are correct, Gardner’s model lacks sufficient scientific foundation and conceptual rigor. A polarity arose with two “equally valid poles.” The synthesis requires a reconceptualization of “parental alienation” from within established psychological principles and constructs that offers theoretical coherence, explanatory power, testable hypotheses, diagnostic reliability, and clarity regarding the necessary treatment framework.

In my view, an attachment-based reconceptualization of the construct of “parental alienation offers this synthesis.

• The central symptom of “parental alienation” is the child’s rejection of a parent. This central symptom represents a massive distortion to the normal-range functioning of the child’s attachment bonding motivations toward a parent that requires clinical explanation.

• The child’s symptom display also evidences narcissistic (grandiosity, entitlement, lack of empathy, haughty/arrogant attitude) and borderline (splitting) personality disorder features that strongly suggest potential narcissistic and borderline personality disorder dynamics within the family.

• Narcissistic and borderline personality disorder processes are increasingly being linked to insecure disorganized and anxious-preoccupied attachment (i.e., internal working models of attachment related to themes of personal inadequacy that coalesce into narcissistic defenses, and internal working models of attachment involving an intense fear of abandonment that coalesce into borderline personality disorder traits), suggesting that an attachment-based exploration of personality disorder processes within the family would be productive.

• Research has indicated that attachment patterns are transmitted across generations. An insecure anxious-disorganized attachment is associated with role-reversal parent-child relationships, and “parental alienation” represents a role-reversal parent-child relationship in which the child’s induced symptoms are being used (exploited) by the alienating parent.

• The term “borderline” personality was initially given to this type of personality structure because this type of personality was thought to reside on the “borderline” between neurotic and psychotic processes. Kernberg (1975) conceptualized narcissistic personality structure as a type of borderline personality organization. Millon (2011) describes the ready decompensation of narcissistic personality processes into persecutory delusions under stress. The inherent interpersonal rejection (abandonment) of divorce and the family’s dissolution would represent just the sort of “narcissistic insult” (Beck, Freeman, & Associates, 2004) that could create a decompensation into persecutory delusional beliefs (Millon, 2011). The formation of a shared delusional belief regarding the supposedly “abusive” parental inadequacy of the targeted-rejected parent is reasonable within the context of the potential reenactment of attachment-related trauma and the decompensation of a narcissistic/borderline parent into persecutory delusional beliefs in response to the narcissistic injury and perceived abandonment associated with the divorce.

• Within an attachment-based framework, the disordered internal working models of a parent’s traumatized attachment networks (that resulted in the formation of prominent narcissistic and borderline personality disorder traits) would be activated by the rejection (abandonment) and narcissistic insult associated with divorce, potentially resulting in the reenactment and trans-generational transmission of the attachment trauma patterns (that are embedded in the internal working models of the alienating parent’s attachment networks) from the childhood of the alienating parent to the current family relationships, mediated by the narcissistic and borderline personality disorder traits of the alienating parent (that, in themselves, represent the coalesced product of the alienating parent’s disordered attachment system).

In my professional view, there are sufficient clinical indicators to suggest that an attachment-based reconceptualization of the construct of “parental alienation” can afford a synthesis of the “equally valid poles” of the dialectic, which can repair the split in professional psychology to the benefit of the clients we serve. In my work (Childress, 2013a; Childress, 2013b), I have proposed an attachment-based model to describe the clinical features of “parental alienation” from entirely within established psychological constructs. My hope is that this initial model, subject to revision and elaboration, can formulate professional dialogue that leads to a broader synthesis that brings mental health together into a single voice to address the needs of our clients.

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Returning to 2015…

I believe my critique of the Gardnerian PAS model is reasonable and balanced.  I do not see a problem in open and honest discussion. Professional dialogue and critical analysis are acceptable.  This essay was written and posted to my website two years ago.  If someone wants to respond to the issues I raise I would welcome the healthy professional discussion engendered by dialogue and debate.

In the coming posts I will continue the line of argument that a change in paradigms is needed to enact a solution to the pathology of “parental alienation.”  This change in paradigms will, of necessity, require the end of the Gardnerian PAS model as an active paradigm; not because the Gardnerian paradigm is necessarily wrong, but because it is unnecessary. 

We are going to solve the pathology of “parental alienation” by a switch to an alternate model, so that the pathology of “parental alienation” will be solved without the need for a Gardnerian PAS model.

Once the pathology of “parental alienation” is solved using an attachment-based reformulation for defining the pathology, the Gardnerian PAS paradigm essentially becomes irrelevant.  The pathology of “parental alienation” is solved without it. The Gardnerian PAS model is going to disappear as a relevant paradigm.  Soon.

The sooner it is replaced by an attachment-based model, the sooner we have the solution.  The longer we hold on to a Gardnerian PAS model, the longer it takes to enact the solution.  From this point on, holding onto the Gardnerian PAS model slows down our ability to achieve a solution.

The change to an attachment-based model for the pathology provides an immediate solution:

The Seven-Step Solution

1.)  The practice of assessing, diagnosing, and treating this type of pathology (this “special population” of children and families) will be restricted to only mental health professionals with the established professional competence in personality disorders, family systems principles, and attachment system trauma pathology (enforced by Standards 2.01, 9.01, and 3.04 of the Ethical Principles of Psychologists and Code of Conduct of the American Psychological Association based on established and recognized domains of professional competence in personality disorder pathology, family systems pathology, and attachment trauma pathology).

2.)  All mental health professionals assessing, diagnosing and treating this form of pathology (attachment trauma reenactment pathology) will assess for the three definitive diagnostic indicators of an attachment-based model of the pathology, as well as the associated clinical signs indicative of the pathology, as defined and predicted a priori from the description of the pathology in Foundations.

3.)  When the three diagnostic indicators of attachment-based “parental alienation” are present in the child’s symptom display, all mental health professionals will make a DSM-5 diagnosis of V995.51 Child Psychological Abuse, Confirmed, they will document this diagnosis in the child’s treatment record, and they will file a suspected child abuse report with the appropriate child protection services agency in order to appropriately discharge their “duty to protect.”

4.)  The social worker at the child protection services agency who receives this child abuse report from the mental health professional will then apply the same model for the pathology (attachment trauma reenactment pathology) and will assess for the three diagnostic indicators of the pathology of attachment-based “parental alienation”.

5.)  When the three diagnostic indicators of attachment-based “parental alienation” (attachment trauma reenactment pathology) are present in the child’s symptom display, the social worker will confirm the DSM-5 diagnosis made by the mental health professional of V995.51 Child Psychological Abuse, Confirmed and will initiate a protective separation of the child from the pathology and pathogenic parenting of the narcissistic/borderline parent.

6.)  The social worker with the child protection agency will place the child in the care of the normal-range and affectionally available targeted parent, and treatment will be initiated under the expert guidance of a knowledgeable and competent mental health professional.

7.)  Once the child’s symptoms of pathology are resolved and the child’s normal-range development has been restored and stabilized, the pathogenic parenting of the narcissistic/borderline parent will be reintroduced under careful therapeutic monitoring to ensure that the child’s symptoms do not return with the reintroduction of the parent’s pathology.

This seven-step solution is what we are seeking to enact in a paradigm shift to an attachment-based model.  My goal is to have this seven-step solution in place throughout mental health by Christmas of 2016.

Just this past week I consulted with a therapist in Chicago who will be enacting exactly this approach. So already this solution is underway. Let that sink in for a moment. This seven-step solution is already being enacted over the next few weeks in Chicago. The solution is already here.

I will be discussing more about this consult in an upcoming post.

The only thing that prevents this seven-step solution from being enacted with all families and all children is that the citadel of establishment mental health is not aware that an alternative paradigm to Gardnerian PAS even exists. 

The moment they become aware of an attachment-based reformulation for the pathology, professional psychology will integrate this model into established standards of practice because the pathology of an attachment-based model is nothing new. An attachment-based model of “parental alienation” is conceptually sound and it is based entirely on established and accepted forms of existing pathology. 

An attachment-based model is nothing new.  It’s not a “new syndrome.”  It is based on pathology that is already established and acknowledged within professional mental health.  Because of this, an attachment-based reformulation for the pathology from entirely within standard and established psychological constructs and principles provides an immediate solution.  Today.  Now.

All that stands in the way of this solution is the paradigm shift.

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

References

Baker, A.J.L. (2006). Patterns of parental alienation: A qualitative research study. American Journal of Family Therapy, 34, 63-78.

Baker, A.J.L. & Darnall, D. (2007). A construct study of the eight symptoms of severe parental alienation syndrome: A survey of parental experiences. Journal of Divorce and Remarriage, 47, 55-75.

Beck A.T. (1976) Cognitive Therapy and the Emotional Disorders. New York: International Universities Press.

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

Childress, C.A. (2013). Reconceptualizing Parental Alienation: Parental Personality Disorder and the Trans-generational Transmission of Attachment Trauma. Retrieved 11/18/13 from http://www.drcachildress.org/asp/Site/ParentalAlienation/index.asp

Childress, C.A. (2013). DSM-5 Diagnosis of “Parental Alienation” Processes. Retrieved 11/18/13 from http://www.drcachildress.org/asp/Site/ParentalAlienation/index.asp

Ellis A. (1962). Reason and emotion in psychotherapy. New York: Stuart.

Frankl, Viktor (1997). Man’s Search for Meaning. Pocket.

Gardner, R.A. (1987). The Parental Alienation Syndrome and the differentiation between fabricated and genuine child sex abuse . Cresskill, NJ: Creative Therapeutics.

Haley, J., & Hoffman, L. (1967). Techniques of family therapy. New York: Basic Books.

Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York, NY: Guilford

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

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

Rogers, Carl. (1961). On Becoming a Person: A Therapist’s View of Psychotherapy. London: Constable.

Stolorow, R., Brandchaft, B. & Atwood, G. (1987), Psychoanalytic treatment: An intersubjective approach;

Kohut, H. (1984) How does analysis cure Chicago: Univ. Chicago Press.

Yalom, I. (1980). Existential Psychotherapy. Basic Books.

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Battles are chaotic.  That’s to be expected.  In July, I raised the battle flags of our assault on the citadel of establishment mental health.  In August we are mustering our forces on the battlefield.  In September and October we begin our focused assaults.  Leadership is beginning to emerge from within your ranks and I’ll be working with that leadership in the days and months ahead.  They will help and support you.  Follow their guidance.

Our goal is to achieve a paradigm shift.

Gardner’s model of PAS took us down a wrong road in proposing a “new syndrome.”  In order to achieve a solution, the pathology of “parental alienation” must be defined within standard and established psychological principles and constructs to which all mental health professionals can be held accountable.

An attachment-based reformulation for the pathology as described in Foundations accomplishes this.

Foundations defines specific professional domains of knowledge necessary for professional competence and activates Standards 2.01, 9.01, and 3.04 of the Ethical Principles of Psychologists and Code of Conduct of the American Psychological Association.

The attachment-based model of the pathology as described in Foundations establishes the DSM-5 diagnosis of V995.51 Child Psychological Abuse, Confirmed for the pathogenic parenting practices of the narcissistic/borderline parent who is inducing severe developmental, personality, and psychiatric symptoms in the child in order to use the child in a role-reversal relationship to regulate the pathology of the parent.

Once we achieve the paradigm shift from the old Gardnerian model to the new attachment-based model, the solution to the pathology of “parental alienation” becomes available immediately:

1.)  The practice of assessing, diagnosing, and treating this type of pathology will be restricted to only mental health professionals with the established professional competence in personality disorders, family systems principles, and attachment system trauma pathology.

2.)  All mental health professionals assessing, diagnosing and treating this form of pathology (attachment trauma reenactment pathology) will assess for the three definitive diagnostic indicators of an attachment-based model of the pathology, as well as the associated clinical signs indicative of the pathology, as defined and predicted a priori from the description of the pathology in Foundations.

3.)  When the three diagnostic indicators of attachment-based “parental alienation” are present in the child’s symptom display, all mental health professionals will make a DSM-5 diagnosis of V995.51 Child Psychological Abuse, Confirmed, they will document this diagnosis in the child’s treatment record, and they will file a suspected child abuse report with the appropriate child protection services agency in order to appropriately discharge their “duty to protect.”

4.)  The social worker at the child protection services agency who receives this child abuse report from the mental health professional will then apply the same model for the pathology (attachment trauma reenactment pathology) and will assess for the three diagnostic indicators of the pathology of attachment-based “parental alienation”.

5.)  When the three diagnostic indicators of attachment-based “parental alienation” (attachment trauma reenactment pathology) are present in the child’s symptom display, the social worker will confirm the DSM-5 diagnosis made by the mental health professional of V995.51 Child Psychological Abuse, Confirmed and will initiate a protective separation of the child from the pathology and pathogenic parenting of the narcissistic/borderline parent.

6.)  The social worker with the child protection agency will place the child in the care of the normal-range and affectionally available targeted parent, and treatment will be initiated under the expert guidance of a knowledgeable and competent mental health professional.

7.)  Once the child’s symptoms of pathology are resolved and the child’s normal-range development has been restored and stabilized, the pathogenic parenting of the narcissistic/borderline parent will be reintroduced under careful therapeutic monitoring to ensure that the child’s symptoms do not return with the reintroduction of the parent’s pathology.

This is the seven-step solution made available today by a paradigm shift to an attachment-based definition for the construct of “parental alienation.”

That’s the solution we seek.  That’s the solution that is available right now, this instant, once the paradigm shifts from a Gardnerian PAS model to an attachment-based model for the pathology.  The only thing that stands in the way of this solution is achieving the paradigm shift from a Gardnerian PAS model to an attachment-based redefinition of the pathology.

At this point, the only thing that stands between us and this solution is ignorance.  Once the paradigm shifts to an attachment-based model for describing the pathology of “parental alienation,” this solution becomes available immediately.

Our goal is to achieve this paradigm shift within mental health to an attachment-based description of the pathology.

The Battle for Mental Health

We are not proposing a “new syndrome.”  We are not proposing anything “new.”  All of the component pathology of an attachment-based model of “parental alienation” is existing and well-defined pathology within establishment mental health.

We are simply asking for professional competence in the assessment, diagnosis, and treatment of this already recognized and established form of psychopathology.

The attachment-based paradigm defines specific domains of professional knowledge necessary for professional competence in the assessment, diagnosis, and treatment of the pathology traditionally called “parental alienation” (i.e., attachment trauma reenactment pathology; narcissistic/borderline personality pathology in a cross-generational coalition with the child against the targeted parent).

By defining specific domains of professional knowledge necessary for professional competence, the attachment-based model activates existing standards of practice established by the American Psychological Association governing the practice of professional psychology:

Standard 2.01 requiring that mental health professionals ONLY practice within the boundaries of their professional competence. If you don’t possess professional expertise in personality disorder pathology, family systems principles, and attachment trauma pathology then you should stay away from assessing, diagnosing, and treating this type of pathology.

Standard 9.01 requiring that mental health professionals conduct an appropriate and adequate assessment to support their diagnosis. If you are assessing, diagnosing, and treating personality disorder pathology, family systems pathology, and attachment trauma pathology, you must conduct an appropriate assessment of these domains of pathology and document the results of that assessment in the patient record.

Standard 3.04 requiring that mental health professionals not harm their clients. If, in practicing beyond the boundaries of your competence, you harm your clients, then you are in violation of this Standard.

The professional “duty to protect” requires that mental health professionals take active steps to protect their clients and the general public from harm, including protecting children from all forms of child abuse.

NONE of these Standards are activated by the Gardnerian PAS paradigm, because the Gardnerian PAS paradigm is proposing a “new syndrome.”

ALL of these Standards are activated by an attachment-based paradigm, because the attachment-based model describes the pathology from entirely within standard and established psychological principles and constructs.

The moment the paradigm shifts, all of these Standards become active. In fact, they are already active but are simply not recognized because of professional ignorance regarding the established forms of pathology that comprise the pathology traditionally called “parental alienation.”

So our first step is to eliminate professional ignorance. That’s the booklet Professional Consultation. That booklet is designed to eliminate professional ignorance locally, in your specific case.  Case-by-case we are eliminating ignorance, we are creating the paradigm shift for your specific case, and we are activating Standards 2.01, 9.01, 3.04 and the duty to protect for your specific case.

If, after being alerted to the paradigm shift, the mental health professional…

• Continues to practice beyond the boundaries of his or her competence regarding the assessment, diagnosis, and treatment of personality disorder pathology, family systems pathology, psychiatric (delusional) pathology, and attachment trauma pathology;

• Continues to not assess for and accurately diagnose the personality disorder pathology, the family systems pathology, the psychiatric (delusional) pathology, and the attachment trauma pathology;

• Inflicts harm on you and your child by their failure to adequately assess and accurately diagnose the pathology and by their failure to protect the child from the evident psychological abuse being inflicted on the child by the pathogenic parenting of the narcissistic/borderline parent;

Then that mental health professional is likely in violation of these activated Standards of professional practice and may be vulnerable to a licensing board complaint relative to Standards 2.01, 9.01, 3.04, and failure in their “duty to protect.”

Warriors in the Paradigm Shift

Our first set of warriors in creating the paradigm shift are those parents who are currently actively involved with the mental health system. You can create a small paradigm shift related to your specific case by providing the mental health professional with the booklet Professional Consultation and requesting the assessment for the type of pathology it describes.

A week after providing the therapist with the booklet Professional Consultation you can offer to provide the therapist with the Diagnostic Checklist from my website. You have now created a mini paradigm shift surrounding your specific case. The book Foundations is referenced in the booklet Professional Consultation, so the description of the pathology contained in Foundations has now become active in your case.

When you provide the therapist with Professional Consultation, boundaries of competence regarding established and fully accepted forms of psychopathology have been established relative to your specific case to which the mental health professional can now be held accountable. One of three things will then occur:

1.)  The mental health professional will assess for the pathology.

Great. This is exactly what we want.

If the three diagnostic indicators are not present in the child’s symptom display then you will want to ask that the mental health professional document in the patient’s record (and describe for you) which specific diagnostic indicators are not present.

If the three diagnostic indicators are present, then you’ll want the mental health professional to provide the appropriate DSM-5 diagnosis of V995.51 Child Psychological Abuse, Confirmed.

2.)  The mental health professional will withdraw from the case.

Great. This is exactly what we want.

If the mental health professional is “in over their head” in diagnosing and treating this type of pathology, and doesn’t want to learn about the pathology and acquire the professional competence necessary to accurately assess, diagnose, and treat this domain of pathology, then it is best for them to withdraw from the case now rather than messing everything up with their ignorance and incompetence.

3.) The mental health professional will reject your input and yet will continue to treat the case despite your efforts to alert them to the nature of the pathology.

This is a problem. This will probably result in your filing a licensing board complaint relative to boundaries of competence, inadequate assessment of the pathology, creating harm to the client, and failure in their “duty to protect.”

Note too, that Standard 3.09 requires professional consultation “when indicated and professionally appropriate… in order to serve their clients/patients effectively and appropriately” (APA, 2002, p. 6), and Standard 2.03 regarding Maintaining Competence states, “Psychologists undertake ongoing efforts to develop and maintain their competence” (APA, 2002, p. 5).

So most likely your licensing board complaint is going to reference five Standards of practice, 2.01, 9.01, 3.04, 2.03, and 3.09 along with the failure in their “duty to protect.”

Now I understand that many of you are eager to start filing licensing board complaints, particularly against perceived wrongs done by past therapists who failed to make an accurate diagnosis of the pathology.  Let me caution you to take a deep breath and wait just a bit.

Our battle flags were raised in July. The booklet Professional Consultation only came out a few weeks ago.  We are still mustering our forces on the battlefield.  Imagine an army where some eager and undisciplined troops rush headlong into battle. They are defeated piecemeal and we lose valuable troops from the battle.

Leadership is emerging from within your ranks.  By mid-September we will have “sample wordings” for your complaints.  I’ll be working with your community leadership on understanding the process and how to frame your complaints for maximum effect.  There’s no hurry.  If we have a disciplined assault we will have more impact.

One of the things you will want to do prior to filing a complaint is to request the treatment records of the therapist. You have a right to review the treatment records for you children. You will want to identify the laws for your state regarding review of records. HIPAA also covers review of records. Work with your community leaders to identify these laws in each state so that you can support each other with this information.  For example, I’ve posted the California laws governing review of records to my website.

The first step to filing a licensing board complaint will be to request the treatment records of the therapist. This will make you even more dangerous to incompetence. Patience and discipline. Work with the community leadership that is emerging.

Also, our strategy for enacting the solution is to work with CURRENTLY diagnosing and treating mental health professionals to create localized pockets of paradigm shifts to which these currently treating mental health professionals can be held accountable.

Previous treatment was still under the Gardnerian paradigm of PAS, so that the standards of practice activated by a paradigm shift to an attachment-based model were not active for your case at that time. So it will be harder to hold these previous mental health professional accountable. The words “parental alienation” have no power. We first have to enact the paradigm shift to define boundaries of competence, then we can hold mental health professionals accountable to these domains of professional knowledge needed for professional competence.

Because there is nothing new about an attachment-based model, there is still the potential of a malpractice lawsuit, but that’s a different category of accountability. Licensing boards don’t care about the specifics of your case. They don’t care if the right diagnosis was made or the correct treatment was provided. They just care about procedural issues. Was informed consent obtained? Was confidentiality maintained? Did the mental health professional have the necessary background and training to treat this type of issue (such as family problems and parent-child conflict)?

Malpractice lawsuits, on the other hand, do care about whether a correct diagnosis was made and whether the correct treatment was initiated.   But malpractice lawsuits are more difficult, complicated, and expensive to pursue.

Our focus in creating a paradigm shift is not on retaliating for prior wrongs, it is to focus on creating paradigm shifts regarding current practice. We are creating pockets of localized paradigm shifts regarding current treatment to which the current mental health professionals can then be held accountable.

If you want to try to use your empowerment under an attachment-based model of “parental alienation” to seek some form of justice for past wrongs that you believe were done to you, simply recognize that this involves a personal motivation for retaliation and revenge and is not part of the overall strategy to achieve a paradigm shift that solves “parental alienation.” Also recognize that this may be more difficult since the paradigm governing “parental alienation” at the time was the Gardnerian PAS paradigm that does not activate standards for professional competence.

Our front-line direct assault is being led by targeted parents who currently have active involvement with the mental health system that allows them to create localized paradigm shifts regarding their specific cases. In these cases, we are done asking for professional competence. We are expecting professional competence.

In interacting with your current treatment provider, be kind. Be relentless, but be kind.

A haughty and arrogant attitude is a narcissistic trait. A sense of entitlement is a narcissistic trait. Motivations for retaliation and revenge are narcissistic traits. Externalization of blame and lack of self-insight are narcissistic traits.

Kindness, compassion, empathy, and personal self-reflection are healthy qualities. I ask that you demonstrate how healthy you are, not how narcissistic you are. Your actions reflect on all of us.

Good cop; bad cop. Let me carry the demands, the arrogant challenges, the fight, so that you can be kind, relentless but kind. We absolutely will not tolerate mental health complicity with the continuing psychological abuse of children and the destruction of families, and at the same time, “you catch more flies with honey than with vinegar.”

While you are part of a larger movement to create a paradigm shift and solution to “parental alienation” for all children and all families, this is also your specific child, your specific family, not a “movement.”  In kindness and (reasonable) cooperation you have the best chance of recovering your specific child right now.  You don’t want to fight with the current mental health professional, you want to cooperate with their cooperation.

If, however, they are stubbornly entrenched in their ignorance, even in the face of your honest and sincere efforts at cooperation, then we have no choice. We will not tolerate mental health collusion with the continuing psychological abuse of children by the pathogenic parenting of a narcissistic/borderline parent. That is going to end. There are existing standards of practice expected of ALL mental health professionals (2.01, 9.01, 3.04, 2.03, 3.09, and the “duty to protect”).

Think Gandhi.  Relentless but kind.  Think Martin Luther King, Jr.  Relentless yet reasonable.

Splitting into polarized positions is a manifestation of the pathogen. There are no sides. We are all on the same side. We want to prevent 100% of child abuse 100% of the time. That includes the psychological abuse of children by the pathology and pathogenic parenting of a narcissistic/borderline parent.

The Second Assault Wave

Our second set of warriors are assaulting the citadel of establishment mental health directly.  Our goal is to achieve a paradigm shift within establishment mental health away from a Gardnerian PAS paradigm that provides no solution whatsoever, to an attachment-based model that provides an immediate solution today (as described in the seven-step solution outlined above).

The focal point of this paradigm shift is a change in the official position statement of the American Psychological Association on “parental alienation.”

The current APA position statement has been co-opted by the pathogen through its allies, who have distracted the discussion away from the pathology of “parental alienation” (attachment trauma reenactment pathology; narcissistic/borderline personality pathology in a cross-generational coalition with the child against the targeted parent) onto the issue of domestic violence.

What we are seeking from the citadel of establishment mental health is:

1.)  Formal Acknowledgement of the Pathology:  We want the position statement of the APA to formally acknowledge that this type of pathology exists (using whatever label for the pathology they want), thereby definitively penetrating the pathogen’s “veil of concealment” under which it hides and enacts the pathology. The pathology exists. Call it what you want, the pathology exists.

2.)  Special Population Status:  Recognition that these children and families represent a “special population” who require specialized professional knowledge and expertise to competently assess, diagnose, and treat, thereby eliminating the “binding sites of ignorance” for the pathogen who are recruited by the pathology to be used as allies to disable an effective mental health response to the pathology.

We want to penetrate the pathogen’s “veil of concealment” and nullify its allies, the “binding sites of ignorance,” who are used by the pathology to disable the mental health response to the pathology.

This assault on the citadel of establishment mental health will be through letter-writing campaigns to the leadership of professional psychology, and through generating lots and lots of media exposure regarding the paradigm shift.  The community leadership that emerges from within your ranks can help organize these efforts and provide guidance.

You may want to generate models for press releases and press packets.  As articles are generated regarding an attachment-based model of parental alienation (not the Gardnerian model; they are not the same thing. We are seeking a paradigm shift not simply awareness), collect these articles and include them in your press packet.  Sell the media on the story hooks offered by a “new paradigm,” such as a grassroots “revolt of parents” led by a psychologist in California, of an “unrecognized form of child abuse” and the collusion of the mental health and legal systems in continuing this psychological abuse of children.

Create the story, write the story, for your press packets.  Take different perspectives, such as the failure of mental health, the failure of the legal system, the unrecognized abuse of children, a grassroots revolt of parents against establishment mental health, the “trauma” of divorcing a narcissistic/borderline spouse, etc.

The goal is not simply to raise “awareness” of “parental alienation,” it’s to create a paradigm shift to a new definition of “parental alienation.”  As long as the Gardnerian PAS paradigm is the dominant paradigm defining the construct of “parental alienation” then there is NO solution to “parental alienation.”  The seven-step solution I described earlier is ONLY available once a paradigm shift occurs to an attachment-based reformulation and redefinition of the construct of “parental alienation.”

This is important to understand. Gardnerian PAS offers no solution to the pathology of “parental alienation.”

The moment Gardnerian PAS is replaced by an attachment-based paradigm for the pathology, the solution becomes available immediately.

The continuance of the Gardnerian PAS model is actually a hindrance to enacting the solution.  The sooner it’s replaced by an attachment-based model for defining the pathology, the sooner we have a solution.

Our goal is to create this paradigm shift that solves parental alienation today.  Now.

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