Parenting and Protest Behavior

Preface

Let me begin this post by acknowledging that it is technical.  I need the material described in this post as a foundation for later discussion of parenting.


The child’s symptomatic rejection of a relationship with a parent inherently accuses the targeted-rejected parent of poor parenting practices, which then requires that we assess the parenting practices of the targeted parent to determine if they represent normal-range parenting practices or whether the parenting of the targeted-rejected parent is sufficiently problematic as to account for the child’s rejection of a relationship with this parent.

Yet by what criteria do we assess parenting?  In my next series of blog posts I plan to address this issue.

My professional background is in ADHD and parent-child conflicts generally, not in “parental alienation.” In addition, I am a bit of an odd-bird professionally because I have a secondary expertise in early childhood mental health (ages 0-5).  Acquiring this expertise in early childhood mental health required that I develop a professional-level understanding for the various brain systems and how they develop, since brain systems are coming online all over the place in early childhood.

To work professionally in early childhood requires a fairly sophisticated understanding for how the brain works, and this foundational understanding for how the brain works has profound implications regarding our approach to parenting and parent-child conflict generally.

In order for me to address the issue of parenting, I need to first lay some foundational groundwork in the current scientific evidence regarding parenting and brain development during childhood that I can then refer to in my future discussions regarding the criteria by which we can assess parenting.

This blog post lays one of those foundational bricks regarding the scientific evidence concerning parenting and the neuro-development of the brain during childhood that I will need in future discussions of assessing parenting.

Parent-Child Conflict is Developmentally Normal, Healthy, and Necessary

Context: Understanding Child Development

Parent-child conflict is both normal and developmentally healthy. It is only when there are distortions in how parent-child conflict is addressed that the developmental consequences of parent-child conflict elevates to problematic levels.

The issue is NOT that parent-child conflict occurs, parent-child conflict is SUPPOSED to occur, the issue is how we respond to it.

To understand the developmental origins of normal range parent child-conflict requires an understanding for the context for how the brain develops during childhood.

We Build What We Use

The brain develops based on the principle of “we build what we use.” Whenever we use a brain system or pathway, that system or pathway becomes stronger, more sensitive, and more efficient.

The technical term for this process is called “canalization,” like building canals or channels in the brain, only these are not actually physical channels in the brain, but instead are chemical “channels,” chemical “grooves” in the brain that are created by structural changes in the molecules along the used pathway that make it more likely for that set of neurons, for that set of brain cells, to fire in that pattern again in the future. The technical term for these use-dependent chemical changes is “long-term potentiation.”

Brain cells that are used together also grow additional interconnections, called synapses, along the pathway that has been used in a process called “synaptogenesis.” This increase in the number of brain connections along used pathways makes it more likely that the used pathway will fire in that same pattern in the future.

Key Construct: We build what we use

The renowned neuroscientist, Donald Hebb (1949), referred to this as “neurons that fire together, wire together.”

The Brain is the Cause

Behavior is a symptom. The brain is the cause.

The organized and integrated functioning of the various brain systems produces organized and integrated behavior. Organized and integrated behavior is socially pleasant and cooperative.

When the integrated functioning of brain systems becomes disorganized and dysregulated for whatever reason, such as when emotions become too intense or too painful, or when there is a conflict between differing motivational goals, then this produces disorganized and dysregulated behavior.

Disorganized and dysregulated behavior is referred to as “protest behavior” and can be reflected in children becoming defiant and uncooperative, evidencing behavior that is too rigid and inflexible or that is too fluid and disorganized, and in emotional expressions that are too extreme such as angry tantrums in response to frustration.  All of these “protest behaviors” reflect disorganized and dysregulated behavior that is the product of disorganization and dysregulation in the functioning of the underlying brain systems.

Key Construct: A disorganized and dysregulated brain produces disorganized and dsyregulated behavior.

Key Construct: Disorganized and dsyregulated behavior is called “protest behavior”

Protest behavior is annoying to the parent, who then wants to make the child’s protest behavior stop.

In this way, the child’s protest behavior elicits the involvement of the parent who is motivated (i.e., annoyed by the protest behavior) to help the child regain an organized and well-regulated state (i.e., to make the protest behavior stop).

For mental health professionals:

Protest behavior is “designed” by nature to elicit the involvement of a more mature nervous system (i.e., the parent) who then mediates the transition of the child from a disorganized-dysregulated state back into an organized and well regulated state.

There are a variety of ways of transitioning the child back into an organized and well-regulated state. Essentially these approaches involve the use of either discipline or guidance strategies.

Discipline uses coercive strategies involving punishment to activate the child’s fear system and so induce submissive behavior in the child. The submissive override available through the activation of the fear system organizes the child’s brain networks into a submissive state and so eliminates the protest behavior that was emerging from a disorganized and dysregulated brain state.

Guidance strategies use social negotiation strategies to reorganize and re-regulate brain systems. Authority based guidance strategies are social communications of parental authority that trigger child cooperation with the socially expressed authority of the parent. This social communication of parental authority is predicated on prior (and possibly current) parental use of discipline strategies. The difference is that the communication of authority within a guidance-based approach is sufficient to engage the child’s cooperation without the need for a threatened application of punishment (i.e., the activation of the fear system override); the social communication of authority is sufficient to enlist social cooperation.

Guidance-based strategies also include social negotiation in which reasonable parent-child dialogue is engaged to encourage the child’s socially responsible communication of distress and the child’s consideration of the social and environmental context, in which a mutual goal can be achieved of meeting the child’s needs within the context of social and environmental restrictions.

A disorganized-dysregulated brain produces disorganized-dysregulated behavior (i.e., protest behavior) that elicits the involvement of the parent (because protest behavior is annoying and the parent wants to make it stop). The involved parent then uses discipline and guidance-based strategies to transition the child back into an organized and regulated brain state (i.e., protest behavior stops).

Now this is important to understand…

Through this process of the parent’s mediation of the child’s state transition from a disorganized-dysregulated state to an organized and regulated state, ALL OF THE BRAIN NETWORKS that were used as part of this state transition from a disorganized-dysregulated state to an organized and regulated state become stronger, more sensitive, and more efficient as a result of USE-DEPENDENT processes (i.e.. long-term potentiation and synaptogenesis).

In the scientific literature, the parent’s mediation of the child’s state transition from a disorganized-dysregulated state to an organized and regulated state is called “scaffolding.”

The parent “scaffolds” the child’s transition from a disorganized-dysregulated state to an organized and regulated state, and in doing so BUILDS the neural pathways in the child’s brain for making this transition. We build what we use.

Do this once, do this twice, do this five thousand times, and eventually the pathway is grooved in the child’s brain (i.e., “canalized”) for making this transition, so that the next time the child’s brain begins to enter this type of disorganized and dsyregulated brain state, the child can slip back into an organized and regulated brain state on his or her own without the parent’s active involvement, because the parent has BUILT the transition networks for this phase-state transition.

The capacity for the child to make this phase-state transition from a disorganized-dysregulated brain state (emitting disorganized-dysregulated behavior; i.e., protest behavior) back into an organized and regulated state (emitting organized and regulated behavior; i.e., socially calm and cooperative behavior) as a result of prior scaffolding of the neuro-development of this transition network is called the development of the child’s capacity for “self-regulation.”

The capacity for child “self-regulation” is initially mediated by the “scaffolding” support of the parent, whose involvement is elicited by the child’s “protest behavior” (i.e., disorganized-dysregulated behavior that is the product of a disorganized and dsyregulated brain state in response to a developmental challenge that the child cannot independently master).

Important Points:

1.)  Children are supposed to be annoying.

When a child is faced with a developmental challenge that he or she cannot independently master, the effective integration of the underlying brain systems begins to become disorganized and dsysregulated (such as from too intense or too painful an emotional state, or from conflicts in motivational goals). As the effective integration of the brain begins to break down into a disorganized and dsyregulated state, the child begins to display disorganized and dsyregulated behavior (i.e., “protest behavior”) as a consequence of the underlying disorganized and dsyregulated brain state.

The protest behavior is “designed” to elicit the involvement of the parent who then scaffolds the child’s transition back into an organized and regulated brain state (and organized and regulated behavior) through the well-modulated use of discipline and guidance strategies. In doing this, the parent builds the networks in the child’s brain (through use-dependent neural processes) for managing the developmental challenge that the child initially faced and that was threatening the collapse of the organized and integrated functioning of the child’s brain systems.

That’s EXACTLY how things are SUPPOSED to work.

The child’s protest behavior is not a “problem” – we only perceive it to be a “problem” because we find protest behavior annoying. But protest behavior is supposed to be annoying in order to elicit our involvement.

The child, or more accurately, the child’s brain, is doing EXACTLY what it is supposed to be doing. A disorganized and dsyregulated brain produces disorganized and dsyregulated behavior to elicit the involvement of a more mature nervous system to help re-regulate the brain and in the process of re-regulation to BUILD through use-dependent processes of “canalization” the neural capacity to manage the developmental challenge.

These developmentally vital relationship exchanges are called “breech-and-repair” sequences.

2.)  The issue is not that children are annoying, of course they’re annoying, they’re supposed to annoy us whenever they are having trouble and need our help.  The issue is not that children’s protest behavior is annoying, the issue is how do we respond to their protest behavior?

That becomes the central question of parenting.

Parent-child conflict is normal and natural.  Minor parent-child “breech-and-repair” sequences are developmentally essential for the healthy maturation of the child’s brain systems. It is what is SUPPOSED to occur.

Parenting involves an ongoing dance of consolidating the relationship through affectionate bonding, followed by minor “breech-and-repair” sequences of helping the child navigate developmentally challenging situations.

Vygotsky called these developmental challenges the “zone of proximal development”

Kohut called the normal-range breech-and-repair sequences providing the child with “optimal frustration” that builds the child’s “self-structure.”

3.)  Protest behavior is neuro-biologically “designed” to elicit the parent’s involvement.

Protest behavior (i.e., angry-oppositional behavior, inflexible-defiant behavior, angry tantrums, fearful-timid behavior, etc.) is an “attachment behavior” designed to elicit GREATER parental involvement. That’s how the brain works.

Protest behavior is NEVER a “detachment behavior” designed to DECREASE parental involvement. That is NOT how the brain works.

A disorganized brain creates disorganized behavior (i.e., protest behavior) that elicits greater parental involvement in order to mediate (“scaffold”) the brain’s transition back into an organized and regulated state, and thereby build all of the brain networks associated with this phase-state transition from a disorganized-dysregulated state to an organized and regulated state.

A Complex Self-Organizing System

I’m going to close this post with a somewhat technical construct that I need to establish relative to criteria for evaluating parenting.  Placing restrictions on children that force the child to accommodate to the restriction is developmentally vital for the healthy maturation of brain systems.  In addition, these imposed restrictions must be well-modulated to the child’s own rhythms and “periodicities.”

The brain is a complex self-organizing system.  As such, its maturation benefits from some external restrictions (challenges) being placed upon its “degrees of freedom” so that in accommodating to these restrictions the integrated functioning of the various brain systems will be forced to organize their integration at a higher maturational level. 

If no restrictions are placed on the degrees of freedom afforded to the developing brain then there is little impetus for it to develop into a higher organizational level, and the elaboration and integration of its brain systems remains flaccid and immature,

See Vygotsky’s construct of “zone of proximal development”

At the same time, if these imposed restrictions on the degrees of freedom afforded to the brain’s functioning are too rigid and inflexibly applied, then the organized functioning of the brain will collapse into chaos.

The restrictions placed on the integrated functioning of the developing brain of the child must be well-modulated and responsive to the child’s own rhythms and “periodicities.”

“A controlling parameter effectively limits the degrees of freedom within the system and thus constrains the system to assemble itself in more stable and productive ways. Mothers/instructors can act as communication partners/control parameters who constrain their children’s behavior in a way that promotes transitions to more highly organized, complex phases of organization.” (Cherkes-Julkowski & Mitlina, 1999, p. 7)

“Constraints must be well modulated. Strong constraints could infuse excessive amounts of energy, causing extreme perturbation, wildly chaotic activity, and a resultant rapid fall to a less organized, more entropic state. On the other hand, constraints that are too weak may provide little impetus for higher order development (Nicolis & Prigogine, 1989; Schmidt et al., 1990).” (Cherkes-Julkowski & Mitlina, 1999, p. 7)

“Well developing dyads move together as intentions move in a more gradual progression back and forth between the instructional intention and the child’s intention.” (Cherkes-Julkowski & Mitlina, 1999, p. 13-14)

“Effective instruction would begin with a goal not too disparate from the child’s and pursue it flexibly, with ample acknowledgment of the child’s intention. This is tantamount to providing weak constraint, one that provides some reduction of response parameters while at the same time allowing enough degrees of freedom for the child to self-organize according to her or his own periodicities.” (Cherkes-Julkowski & Mitlina, 1999, p. 14)

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

References

Cherkes-Julkowski, M. and Mitlina, N. (1999). Self-Organization of mother-child instructional dyads and latter attention. Journal of Learning Disability, 32(1), 6-21.

Brain Development References

Hebb, D.O. (1949). The organization of behavior. New York: Wiley & Sons

LeDoux, J. (2002). Synaptic Self: How Our Brains Become Who We Are. London: Penguin Books.

Perry, B. D., Pollard, R. A., Blakley, T. L., Baker, W. L., & Vigilante, D. (1995). Childhood Trauma, the Neurobiology of Adaptation, and “Use-dependent” Development of the Brain: How “States” Become “Traits”. Infant Mental Health Journal, 16(4), 271-291.

Shore, A. N. (1994). Affect regulation and the origin of the self: The neurobiology of emotional development. Hillsdale, NJ: Earlbaum.

Shore, A.N. (1996). The experience-dependent maturation of a regulatory system in the orbital prefrontal cortex and the origin of developmental psychopathology. Development and Psychopathology, 8, 59-87.

Trevarthen, C. (2001). The neurobiology of early communication: Intersubjective regulations in human brain development. In Kalverboer, A.F. and Gramsbergen, A. (Eds) Handbook of Brain and Behaviour in Human Development. London: Kluwer Academic Publishers

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.

Restoring Authenticity: Compassion, Empathy, and Gentle Kindness

Gandhi said, “the antidote is the opposite.”

The child is expressing anger, hatred, and rejection.  The antidote is compassion, empathy, and gentle kindness.

The authentic child is lost.  The antidote is a calm and gentle assertion of a truth that guides the child’s return to authenticity, that the child is loved, and that the child wants to love in return.

Understanding

Empathy is the single most important parenting quality.  Children flourish with parental empathy, and they starve in its absence.

Children absorb their parents.  Children experience what their parents experience.  This is because of a primary relationship system in the brain called “intersubjectivity” (Fonagy, Luyten, & Strathearn, 2011; Stern, 2004); Trevarthan, 2001; Tronick, et al., 1998), and it is so central to a deep understanding of the “parental alienation” process that ALL mental health professionals involved in the assessment of parental capacity and the diagnosis and treatment of “parental alienation” need to be professionally well-versed in the nature and functioning of the intersubjective system.

The intersubjectivity system (which I refer to as “psychological connection” in my practice) is one of two primary relationship systems in the brain, the other relationship system is the attachment system.

One of the premiere researchers and theorists in child development and the intersubjective system, Daniel Stern (2004), said of this fundamental psychological connection system,

“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.” (p. 76).

At the cellular level, this intersubjective system of shared psychological states (the “interpenetration of minds”) is mediated by a set of brain cells called “mirror neurons.” There is a wonderful PBS Nova program online about mirror neurons and I highly recommend watching it:

http://www.pbs.org/wgbh/nova/body/mirror-neurons.html

Stern (2004) also discusses the linkage of intersubjectivity (empathy) and the mirror neuron system:

“The discovery of mirror neurons has been crucial. Mirror neurons provide possible neurobiological mechanisms for understanding the following phenomena: reading other people’s states of mind, especially intentions; resonating with another’s emotion; experiencing what someone else is experiencing; and capturing an observed action so that one can imitate it — in short, empathizing with another and establishing intersubjective contact.” (p. 78)

“Mirror neurons sit adjacent to motor neurons. They fire in an observer who is doing nothing but watching another person behave (e.g., reaching for a glass). And the pattern of firing in the observer mimics the exact pattern that the observer would use if he were reaching for the glass himself… We experience the other as if we were executing the same action, feeling the same emotion, making the same vocalization, or being touched as they are being touched.”(p. 79).

At a fundamental neurobiological and relationship level, children psychologically absorb the experience of their parents.  This means that your child is absorbing the psychopathology of the narcissistic/(borderline) parent, and what the child is expressing through anger and hatred, through the rejection of love, is the pathology of the narcissistic/(borderline) parent that is being absorbed psychologically into and through the child.

Understanding the Pathology

The origin of the narcissistic and borderline personality is found in an immense pain and suffering.  This type of personalty has its source in an intense experience of deep personal inadequacy, an abyss of inner emptiness. From within this core experience of fundamental emptiness the narcissistic/borderline personality expects and anticipates that no one will love them because of their deep, primal, fundamental inadequacy as a person.  They are empty inside, unloved and unlovable.

The narcissistic personality defends against this primal inadequacy of being unloved and unlovable by adopting a superficial veneer of grandiose self-inflation. But this defensive veneer requires continual input of “narcissistic supply” from others because it is not sustained by any authentic internal source of true self-value.  Inside, at their core of self-experience, is a dark void of fundamental inadequacy and an abiding belief that they are fundamentally unloved and unlovable. 

If their superficial defensive veneer of narcissistic self-inflation is challenged then their fragile self-structure is threatened with collapse into the void of their self-inadequacy, the dark abyss of being fundamentally unloved and unlovable.  They then protect their fragile self-structure by exploding into narcissistic rage at the source of threat, attacking with irrational accusations and haughty arrogance, striving to maintain their fragile narcissistic defense against a collapse into the void of primal emptiness of self.  Holding their fragile self-structure together by the sheer cohesive force of their rage and anger.

At its core, the narcissistic personality has a borderline organization of primal self-inadequacy and an intense fear of abandonment because they experience themselves as fundamentally unloved and unlovable.  The difference is that the borderline personality experiences this abyss directly and continually, which creates a chaotic self-experience of intense emotions, desperately seeking to be loved, needing to have their inner emptiness filled by the love of others (which could be called “borderline supply”), only to then collapse into their primal experience of fundamental inadequacy, unloved and unlovable, at any sign of a real or imagined rejection, producing the “borderline rage” of accusations and denigration of the formerly beloved object

“you’re not loving me well enough to hold me outside the abyss of my inner emptiness”

When eventually the borderline personality’s self-structure is able to restabilize itself after its collapse into the abyss of the borderline’s inner emptiness, they desperately reach out once again, seeking the love of the other to fill the fundamental void of their self-structure and to hold at bay the experience of their being fundamentally unloved and unlovable. 

And this pattern is endlessly repeated, seducing love from the other which supports the borderline’s self-experience as “I am loved and lovable,” followed by a collapse into the abyss of core-self inadequacy and a profound experience of inner emptiness at any sign of real or imagined rejection, leading to a hostile-aggressive attack on the other person for failing to provide the needed self-supply of fundamental adequacy that the borderline person is fundamentally loved and lovable as a person (i.e., the message communicated by the real or imagined rejection is that “you are unloved and unlovable” which provokes the self-structure collapse into the dark abyss of personal inadequacy), and then a return once more to desperately seeking (seducing) once again the love of the other when the borderline self-structure eventually recovers from its collapse into the void.

The source of the narcissistic/borderline personality is in pain and suffering.  They protect themselves from their immense pain and suffering by projecting into the world their core inadequacy and their fundamental unloveableness.  It is the world that is inadequate, it is the world that doesn’t “deserve” to be loved by the narcissistic/borderline personality.

The dark abyss of emptiness at the inner core of the narcissistic/borderline personality is psychologically expelled from the self-structure of the narcissistic/borderline personality by projecting it, externalizing it, into the world, into us. We are unloved and unlovable.  We are inadequate. 

The narcissistic personality style adopts a detached haughty and arrogant contempt and disdain for the inadequacy of others, which they use to inflate their own narcissistic specialness, while the borderline personality style alternately seeks continual displays of love from others for their specialness, and then savages the formerly beloved with hostility and contempt for their inadequacy in failing to provide the borderline with the continual perfect love that their specialness deserves.

For the narcissistic/(borderline) parent, it is essential that the targeted parent is inadequate, unloved, and unlovable, because the targeted parent is the external container that holds for the narcissistic/(borderline) parent their own inner emptiness and suffering.  They can avoid the abyss by projecting it, externalizing it, into us. 

And they accomplish this through the child, through the beloved of the targeted parent. 

You are inadequate as a parent and you are rejected because of your fundamental inadequacy.  You are unloved and unlovable because of your inadequacy. 

Through the child’s rejection of a loving relationship, you are made to hold the inner suffering of the narcissistic/(borderline) parent.  The pain you feel is measure for measure the pain of the narcissistic/borderline experience being transferred into you as the “holding container” for their inner emptiness and suffering. 

As a parent rejected by your beloved child, you experience a profound inner emptiness at the core of your being.  This is the dark abyss of emptiness at the core of the narcissistic/borderline personality.  Your suffering is their primal suffering being transferred into you.

Your immense pain at being rejected by your child, unloved and unlovable, is measure for measure the inner suffering-of-being experienced by the narcissistic/borderline parent of being fundamentally unloved and unlovable because of their primal self-inadequacy.

What the narcissistic/borderline parent is doing in distorting the child’s love and self-experience is an abomination, yet we can nevertheless have compassion and empathy for the immense inner suffering of the narcissistic/borderline personality that is driving the abomination of twisting and distorting the child’s authentic love for a normal-range and loving parent into hatred, loss, and rejection.

The antidote is the opposite.

The Conduit

The child is the medium, the conduit, for this transfer of suffering from the narcissistic/(borderline) parent to you.

And in this transfer process, the child absorbs the suffering of the narcissistic/(borderline) parent and gives it to you.  The anger, hateful rage, absence of empathy and cruelty displayed by the child represents the distortions caused to the authentic child by the immensity of the psychological suffering passing through them in the transfer.

As the suffering moves from the core-self of the narcissistic/(borderline) parent into you, the child absorbs the psychological pain of their narcissistic/(borderline) parent, and the child’s cruelty, anger, and hatred are expressions of the pain and suffering of this parent, that the other parent doesn’t experience directly but projects onto the world.

The child loves this other parent, the narcissistic/(borderline) parent.  The child feels the deep emotional pain and suffering of this parent, not at a conscious level, but at a deeper level of the mirror neurons, of the shared psychological state, the intersubjective state.  The child hurts for this parent and wants to heal this parent’s pain. And the child knows that this parent, the narcissistic/(borderline) parent, needs the child more than you do.

By surrendering to the role-reversal relationship with the narcissistic/(borderline) parent the child understands at a non-conscious but fundamental level that the child is helping to heal this parent’s immense pain and suffering.  The act of the child in rejecting you is the child’s act of compassion for the suffering of the narcissistic/(borderline) parent.

It is imperative that any therapist treating attachment-based “parental alienation” understand that at the core of the child’s experience are two deep feelings, one toward the targeted-rejected parent of misunderstood and unprocessed grief at the loss of the beloved targeted parent, and one toward the narcissistic/(borderline) parent of compassion for the deep primal suffering of the narcissistic/borderline parent. 

Restoring the child’s authenticity requires that we understand the complexity of the child’s authenticity.

If the therapist is able to work with the narcissistic/(borderline) parent to lessen the psychological pain and fear of this parent, then this will potentially free the child from the role of taking care of this parent.  However, the strongly entrenched defensive structure of the narcissistic/(borderline) personality that externalizes their pain through its projection into the world restricts our ability to help with this pain because they never acknowledge it as their own, but instead attribute it to the failures and inadequacy of others.

The child’s rejection of the targeted parent emerges from an act of the child’s compassion for the immense psychological suffering of the narcissistic/(borderline) parent.  But the “splitting” dynamic within the family created by the presence of narcissistic and borderline personality processes (see Key Concept: Splitting post) splits the child’s empathy and compassion into polarized extremes of complete compassion and empathy for the psychological suffering of the narcissistic/(borderline) parent (i.e., the 100% attachment bonding motivation) and a complete absence of empathy and compassion for the suffering of the targeted parent (i.e., the 100%  avoidance motivation), rather than a more balanced and integrated blend of healthy compassion and empathy.

Restoring Authenticity

The antidote is the opposite.

In responding to the child’s distorted anger, cruelty, and lack of empathy it is helpful to remain grounded in our own empathy and compassion for the child’s experience as a conduit for an immense suffering born in the core personality suffering of the narcissistic/(borderline) parent whom the child loves.  While we cannot condone the child’s hostility and irrational cruelty, we can nevertheless respond from our own place of compassion and empathy for the amount of pain the child is channeling.

In the response of therapists and targeted parents, it will be helpful to remain in a gentle place of calm and simple assertion; that the child’s hostility toward the targeted parent comes from a misunderstood and misattributed experience of sadness and grief at the loss of an affectionally bonded relationship with the targeted parent.  Children absorb their parents. If we are calmly confident in our assertion that the child actually loves us and is sad at the loss of an affectionally bonded relationship with us, then the child absorbs this belief through the resonance of their mirror neurons and intersubjectivity.

When we pluck the middle “C” string on a harp, the other two “C” strings an octave above and below begin to vibrate in harmonic resonance. If we respond from a calm confidence that our child loves us, the child’s inner experience will begin to vibrate in neural resonance to our psychological state.  Gentle smiles help. Kindness helps.

Recognize that as we show greater love and kindness we will activate the child’s attachment bonding motivations which will produce a larger sadness and grief at the loss of an affectionally bonded relationship with us.  So as we become kinder and more loving, the child might become angrier and more hostile.

Overtly, the child will actively deny that the targeted parent is loved. But the therapist and targeted parent can simply remain calm in their certainty of this attribution. The child loves the targeted parent, and the actual source of the child’s pain associated with the targeted parent is not what this parent does or doesn’t do, it’s that the child is not expressing and receiving the love and affection available from this beloved parent.

The child’s pain originating from the targeted parent is real and authentic.  The child thinks the pain is caused by some fundamental inadequacy in the parenting of the targeted parent.  The true cause of the child’s pain is the grief and sadness at the loss of an affectionally bonded relationship with the targeted parent.  Once affectional bonds with the targeted parent are restored the child’s pain will vanish.

The child will deny any grief and sadness, which has been distorted under the pathogenic influence of the narcissistic/(borderline) parent into “anger and resentment loaded with revengeful wishes” (Kernberg, 1975, p. 229), but the therapist and targeted parent can gently encourage the child to test whether it’s true,

“Try it out, see if what I’m saying is true.  See if giving hugs, and smiles, and sharing laughter together, see if that doesn’t make your inner pain go away.”

The pain being channeled by the child is that we are unloved and unlovable. The narcissistic/(borderline) parent as the source, the other parent as the target, and the child as the conduit are all, in their own way, unloved and unlovable.  But this is not true.  The child and the targeted parent are both loved and lovable.  And the narcissistic/(borderline) parent is loved by the child.  Once the affectional bond is restored with the targeted parent, then this love can be taken back through the channel by the child to the source of the pain to heal the narcissistic/(borderline) parent to the extent possible, because this parent too is loved and is lovable for the child.

I might also suggest that targeted parents consider whether they too can bring compassion, empathy… and love… to the suffering of the narcissistic/(borderline) parent, even within the context of the family tragedy of “parental alienation.”  The core dynamic within the family is one of being unloved and unlovable.  That is an extremely painful experience for anyone, to feel unloved and unlovable, and it is a self-experience that lies at the very core of the narcissistic/(borderline) personality.

The antidote is the opposite.  Empathy, compassion, affection, and shared love will heal the pain that is too widely distributed within the family.

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

References

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

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

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

Trevarthen, C. (2001). The neurobiology of early communication: Intersubjective regulations in human brain development. In Kalverboer, A.F. and Gramsbergen, A. (Eds) Handbook of Brain and Behaviour in Human Development. London: Kluwer Academic Publishers

Tronick E.Z., Brushweller-Stern N., Harrison A.M., Lyons-Ruth K., Morgan A.C., Nahum J.P., Sander L., Stern D.N. (1998). Dyadically expanded states of consciousness and the process of therapeutic change. Infant Mental Health Journal, 19, 290-299.

False Allegations of Abuse: Technical Issues

False Allegations of Incest

Let me approach this discussion with the basic premise that all mental health professionals have the child’s best interests as their primary consideration. All mental health professionals wish to protect children from sexual abuse. No mental health professional seeks to expose a child to sexual abuse victimization.

If there are differing viewpoints on how to accomplish this goal, they are good-faith expressions of “equally valid poles of a dialectic” (Linehan, 1993), and the goal should be to move toward synthesis of differing perspectives rather than adopting adversarial positions.

Authentic sexual abuse occurs far too frequently. We must act to protect children from sexual abuse victimization.

And… on occasion,

A narcissistic/(borderline) parent will induce or elicit false allegations from the child of sexual abuse victimization by the other parent as a means to exploit these child allegations to achieve power over the situation and the other parent. When this occurs, not only does the child lose a loving and affectionally bonded relationship with a normal-range targeted parent, the child also loses the potential protective influence that the normal-range psychological organization of the targeted-rejected parent can have in lessening the distorting pathogenic influence of the narcissistic/(borderline) parent on the child’s development.

Furthermore, for a narcissistic/(borderline) parent to induce or elicit from a child false allegations of sexual abuse against the other parent represents extremely distorted parenting that rises to the level of severe psychological abuse of the child. Failure to respond to this type of psychological child abuse when it is present is to abandon the child to the severely distorting effects of the psychological child abuse of the narcissistic/(borderline) parent that will have a long-term destructive impact on the child’s psychological development, likely influencing future generations of the family as well through the transmission of the effects of the child abuse to the next generation through the future pathogenic parenting of the current child with his or her own children.

Our goal should be to protect the child from ALL forms of child abuse, particularly the severe forms being considered in this discussion. It is NEVER acceptable to abandon a child to any form of child abuse.

Assertion 1: Child Sexual Abuse Allegations are Not Developmentally Normal

Under no circumstances does a child ever spontaneously develop a false belief that a parent sexually abused the child. It doesn’t happen. Ever.

Children may develop on their own symptoms of hyperactivity or inattention, or anger control problems, or cognitive delays, or social problems, or phobic anxieties. All of these types of symptoms can sometimes arise endogenously to the child’s own developmental course.

Children NEVER spontaneously develop, on their own, a false belief that a parent sexually abused the child.

When a child asserts that a parent sexually abused the child, there are only three differential diagnostic possibilities:

1)   Authentic child abuse incest by the parent

2)   Extremely distorted pathogenic parenting by a narcissistic/borderline parent in which this parent induces or elicits the child’s false belief of sexual abuse,

A)  In order to exploit the child’s symptoms to achieve power over the situation or other parent, or

B)  As a result of semi-psychotic decompensation of the narcissistic/borderline parent into a delusional belief in the (false) threat represented by the other parent, with the parental delusional belief then being transferred to the child through severely distorted parenting practices of the narcissistic/borderline parent.

“When particular schemas are hypervalent, the threshold for activation of the constituent schemas is low: they are readily triggered by a remote or trivial stimulus. They are also “prepotent”; that is, they readily supersede more appropriate schemas or configurations in processing information. (Beck et al., 2004, p. 28)

“The conceptualization of the core pathology of BPD 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… 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)

3)    The child, typically an adolescent, lacks a moral conscience, typically as a result of extraordinarily poor parenting, and is consciously, intentionally, and independently using a false allegation of sexual abuse against a parent as an intentional manipulation to achieve a desired goal or outcome.

This is not a spontaneous development of a false belief, this is simply a conscious lie perpetrated by the adolescent for manipulative gain.

Exclusionary caveat: The adolescent’s actions are not the product of influence from an allied and supposedly “favored” parent to allow the parent (or parent-child alliance) to then exploit the child’s allegations for manipulative gain (i.e., Causal Origin 2).

In my clinical practice I have known adolescents who admitted to me that they colluded with peers on how to create marks on their body to substantiate false allegations they made about physical abuse from a parent. In one of these cases the motivation of the adolescent was to obtain a custody change from the current parent to the desired parent. However, it wasn’t so much that the desired parent was in a cross-generational coalition with the child as much as the desired parent was exceedingly lax and permissive as a parent, which was a parenting style preferred by this adolescent over the current parent’s more structured expectations.  Other adolescents in my clinical practice have threatened their parents with filing false child abuse allegations against the parent if the parent did not capitulate to the child’s demands in some area. These families had a history of highly dysfunctional relationships.

In all three causal origins for sexual abuse allegations made by a child against a parent, there is extremely bad parenting somewhere within the family. Sexual abuse allegations made by a child against a parent are ALWAYS evidence of extremely bad parenting occurring somewhere within the family. The only question is where.

Personal Estimates of Prevalence

Note: There is no existing reliable data to support these estimates. These are personal estimates based solely on my clinical judgment.

From the domain consisting of all sexual abuse allegations made by a child of incest by a parent, my estimates of the prevalence for the three different origins for the child’s sexual abuse allegations against a parent are:

1. Authentic child abuse

Estimate of the likely prevalence of this causal origin for the child’s allegations: I would estimate that authentic sexual abuse of the child is the causal origin of the child’s allegations in approximately 95% of the cases of children’s alleged sexual abuse by a parent.

2.  Extremely distorted pathogenic parenting by a narcissistic/borderline parent that induces or elicits from the child a false allegation of sexual abuse against the other parent

Estimate of the likely prevalence of this causal origin for the child’s allegations:  I would estimate that pathogenic parenting by a narcissistic/borderline parent that induces or elicits from the child a false allegation of sexual abuse against the other parent is the causal origin of the child’s allegations in approximately 1% – 2% of the cases of children’s alleged sexual abuse by a parent.

3. An intentional adolescent lie as a manipulative or retaliatory action against the parent

Estimate of the likely prevalence of this causal origin for the child’s allegations:  I would estimate that an independent intentional lie created by an adolescent as a manipulative or retaliatory action against the parent is the causal origin of the child’s allegations in approximately 3% to 5% of the cases of children’s alleged sexual abuse by a parent

Individual Assessments

In any individual case, the estimated population prevalence is not a relevant consideration.

For example, in the 1% or 2% of the cases in which the child’s allegation of sexual abuse incest against a parent is induced and elicited by the pathogenic parenting practices of a narcissistic/borderline parent, in those 1% – 2% of cases the likelihood that the child’s symptoms were induced or elicited by the pathogenic parenting practices of a narcissistic/borderline parent is 100% – in those cases.

Is the specific case under consideration one of these rare cases? Perhaps. And if this specific individual case is one of those rare cases, then the probability that the child’s allegations are the induced or elicited product of pathogenic parenting practices by a narcissistic/borderline parent is 100% (i.e., if this specific case is one of those 1% – 2% of cases).

So population prevalence is not a consideration in evaluating any specific case. Each case is individual.

This is a foundational construct in psychological testing.  Just because the population prevalence of any specific issue, such as learning disabilities, ADHD, or mental retardation, is an infrequent occurrence in the general population doesn’t mean that this specific child doesn’t have the issue in question.

General population prevalence is not relevant to the assessment of any individual case. The assessment of each specific case is individualized to the specific data of that individual case.

Decisional Errors

There are technical considerations in establishing the criteria by which we make decisions.  In some cases the data allows us to make decisions based on 100% certainty, but this is extremely rare in decisions about psychological issues. When 100% certainty is not available, there are two possible types of errors we can make in our decisions based on the data

When a child makes sexual abuse allegations against a parent, there are two possible hypotheses that can be supported or disconfirmed by the data,

“Null Hypothesis” – no sexual abuse occurred

“Clinical Hypothesis” – sexual abuse did occur

Type I Error: A Type I error is when we erroneously accept the Clinical Hypothesis that sexual abuse occurred when, in truth, there was NO sexual abuse of the child. This is called a “false positive” decisional error, when we erroneously say something took place when it actually didn’t occur.

Type II Error: A Type II error is when we erroneously accept the Null Hypothesis that NO sexual abuse occurred, when in actuality the child was sexually abused by the parent. This is called a “false negative” decisional error, when we say nothing took place when it actually did occur.

These two types of decisional errors are interrelated. The lower the probability of making one type of decisional error, the higher the probability of making the other type of decisional error.

In establishing the criteria for making a decision from data that does not allow 100% certainty, the question is which type of error is worse in the context of the issue under consideration. So if we are making a decision about whether a child has been sexually abused by a parent, is it worse to,

A)  Erroneously conclude that the child was sexually abused when in actuality no sexual abuse took place (a Type 1 Error).

The consequences of this decisional error would be that we would needlessly and erroneously terminate the child’s relationship with a normal-range and affectionally available parent, and we would abandon the child to the custody of a narcissistic/borderline parent who is engaging in extremely distorted parenting practices that will severely distort the child’s emotional and psychological development (Causal Origin 2), or

We will terminate the child’s relationship with a parent in collusion with the child’s manipulative intent of attaining a desired goal or outcome (Causal Origin 3)

B) Erroneously conclude that the child was NOT sexually abused when in actuality the child was sexually abused by the parent (a Type II Error)

The consequence of this decisional error would be that we DO NOT terminate the child’s relationship with a sexually abusive incestuous parent, thereby abandoning the child to continued sexual abuse victimization.

One of the particularly devastating consequences of this decisional error with regard to child sexual abuse allegations against a parent is that we communicate to the child that we do not believe the child’s report is accurate when the child is, in actuality, telling us the truth. This is psychologically devastating to the sexually abused child. For the child to overcome the personal shame and family secrecy surrounding sexual abuse victimization and to come forward in disclosing the abuse, and then not to be believed and to be abandoned to their continued victimization, is psychologically devastating to the child, compounding the severity of the trauma for the child.

The decision as to which is worse, the impact of Type I errors or the impact of Type II errors, with regard to any particular issue is a value judgment regarding the comparative impacts. Based on this value judgment we then set decisional criteria that minimize either the likelihood of making a Type I decisional error (thereby increasing the likelihood of making a Type II decisional error), or we establish decisional criteria that minimize the likelihood of making a Type II error (thereby increasing the likelihood of making a Type I decisional error), or we seek decisional criteria that provide some sort of balance between the risks of making Type I and Type II errors in our decision making about the data.

But the criteria we establish for making our decisions is based on value judgements regarding the relative dangers of making a Type I decisional error (called a “false positive”) compared to the dangers associated with making a Type II decisional error (called a “false negative”).

Prosecution and Child Protection

The legal system in the United States has traditionally made a value judgment to minimize the potential for Type I errors (“false positive” decisions of convicting an innocent person). The decisional criteria in the legal system would prefer to set free numerous criminals (i.e., Type II errors of “false negatives”; saying the person is innocent when the person is actually guilty) in order to avoid (to the extent possible) convicting an innocent person (i.e., to minimize the risk of making a Type I error of a “false positive”).

This approach to establishing decisional criteria is based on our value judgments concerning our desired system of justice.

The impact of this approach within mental health and social service systems dealing with child allegations of parental sexual abuse, however, is troubling to many. The value judgment of the legal system to minimize Type I errors (“false positives” of saying there was child abuse when in actuality there was no child abuse) will correspondingly increase the probability of making Type II decisional errors (“false negatives” of saying there was no child sexual abuse when in truth there actually was child sexual abuse), meaning that many instances of actual child sexual abuse by a parent will not result in a proper child protection response as a result of our Type II decisional error.

Advocates for child protection rightly become extremely concerned about the rate and frequency of Type II decisional errors that leave children unprotected, even when, and especially when, the child discloses the sexual abuse. Parental sexual abuse of the child is surrounded by tremendous personal shame for the child, and is masked beneath the cover of family secrecy. For the child to break free from this family secrecy and personal shame associated with parental incest is a significant achievement for the child. But then for the child not to be believed and to be cast back into the abusive relationship with an incestuous parent compounds trauma upon trauma.

The psychological injury caused to the child by a Type II decisional error of saying there was no sexual abuse of the child when in truth there was, and when the child actually takes the momentous step of disclosing the sexual abuse to others, is extremely severe and devastating to the child. That child advocates within the mental health and family service fields are highly concerned about the frequency of Type II decisional errors is understandable and justified.

And…

There are a certain percentage of cases of false child allegations of parental sexual abuse (i.e., Causal Origins 2 and 3).

Within the legal system, the wrongful conviction of a parent as a pedophile (i.e., a Type I decisional error of a “false positive” attribution), so that this parent is wrongly identified with the lifelong stigma as being a “sex offender” can have an extremely devastating impact on this parent. Given the heavy consequences for an innocent person of a wrongful conviction as being an incestous sexual pedophile, the legal system is justifiably reluctant to make Type I errors, and would prefer to allow some guilty people to go free rather than convict an innocent person. So the decisional criteria within the legal system are adjusted toward limiting the probability of making Type I decisional errors (i.e., a “false positive” attribution that convicts an innocent person).

Most people support this general legal philosophy of limiting to the extent feasible the probability of convicting innocent people for crimes they did not commit (i.e., of making Type I decisional errors of saying something happened when in truth it didn’t), and we are willing to adjust to the negative consequences associated with sometimes allowing the guilty to go free in order to minimize to the extent feasible the risk of convicting an innocent person.

Despite our best efforts, we nevertheless sometimes convict innocent people (i.e., make a Type I decisional error), and this is extremely distressing for both the legal system and the general public, and yet it is also unavoidable. The only way we can ensure with 100% certainty that we will NOT make a Type I decisional error of convicting an innocent person is to set our decisional criteria so far in favor of not making a Type I error that we make far too many Type II errors of allowing all, or nearly all, criminals go free rather than run even the barest of infinitesimal risks of possibly convicting an innocent person.

In our decisions we must balance the risks of making a Type I error (a “false positive”) against the risks of making a Type II error (a “false negative”). As we lessen the risk of one type of decisional error we increase the risk of making the other type of decisional error. That’s just the way it works.

While in general, we can appreciate the reluctance of the legal system to convict an innocent person, so that we accept and tolerate the release of burglars and thieves, and even murderers, when it comes to the sexual abuse of children we become disturbed by the possibility of exposing children to continued sexual abuse victimization in order to limit the risk of making a Type I decisional error of a “false positive” attribution that the parent is an incestuous pedophile when in truth no sexual abuse of the child occurred, especially when the likely population prevalence of “false positives” is so incredibly low (for example, my estimate of between 4% to 7% of all sexual abuse allegations made by children against a parent; Causal Origins 2 and 3).

While we are willing to tolerate the consequences of a “false negative” decision that results in the release of a thief or even a murderer, we are much more reluctant to tolerate the consequences of a “false negative” decision that results in the release of a parental pedophile, in which we will be re-exposing the child to continued sexual abuse predation by the parent.

Given the very low estimated population prevalence of “false positives” (i.e., parents who are accused of sexual child abuse when NO abuse occurred), if we wanted to eliminate the risks of making a Type II error (a “false negative” of saying there was no sexual abuse of the child when in fact the child had been sexually abused by the parent) because of the devastating effect of a Type II decisional error on the emotional and psychological well-being of the child, we could simply accept all child allegations of sexual abuse as valid. This would mean that we would likely make between 4% and 7% Type I errors of making a “false positive” attribution (i.e., saying there was sexual abuse of the child by the parent when, in truth, the parent did not actually sexually abuse the child). In accepting the consequences of making an estimated 5% to 10% (rounding off) wrongful convictions of innocent parents as being incestuous sexual predators when they are not, we can ensure that we do not re-expose ANY child to authentic sexual abuse victimization.

This would represent a value decision regarding the comparative negative consequences associated with making a Type I decisional error as compared to making a Type II decisional error.  The decisional criteria we decide on regarding the acceptable probability of making Type I versus Type II decisional errors is based on our value judgments regarding the comparative damage of making each type of decisional error. The more we reduce the chances of making one type of decisional error, the more we increase the chances of making the other type of decisional error.  

Since the estimated population prevalence of “”false positives” (i.e., false child allegations of parental sexual abuse) is so small relative to all child allegations of parental sexual abuse, it is conceivable that a reasonable discussion would consider the relative benefit of accepting all child allegations of parental sexual abuse as valid in order to eliminate the possibility of making Type II decisional errors of “false negative” decisions that continue a child’s exposure to an incestuous pedophiliac parent even after the child has disclosed the predatory sexual abuse victimization.

However, if this decision is made we should also recognize that we are accepting that there will be a certain, not insubstantial number of “false positive” Type I decisional errors in which we wrongly say that an actually innocent parent sexually abused his or her own child. Recognizing that we will be making such errors in a relatively substantial number of cases (my personal estimates are between 5% to 10% of all cases of child sexual abuse allegations), we would likely want to limit the damage to these wrongly convicted parents.

One approach to limiting the damage to innocent parents who are wrongly accused of sexual abuse that they did not actually commit is to separate the legal from the social service responses, so that the social service response to child allegations of parental sexual abuse would be to accept ALL child allegations of parental sexual abuse as valid, recognizing that approximately 5% to 10% of these allegations are not true, in order to eliminate the damage to children re-exposed to authentic sexual abuse incest because of an erroneous Type II “false negative” decision and response from us. Whereas the legal response of convicting the parent as a “sex offender” would be disconnected from the social service response, so that the legal criteria for conviction would maintain higher standards against making a Type I “false positive” decisional error of convicting an innocent person.

This approach would result in ALL child accusations of parental sexual abuse being accepted as valid by social service agencies, so that ALL child accusations of parental sexual abuse result in termination of parental contact with the child, but only a limited number of these cases would actually result in a legal conviction of the parent as a “sexual offender.”

While separating our social service response to child allegations of parental sexual abuse (limiting our risk of making Type II decisional errors) from our legal response to child allegations of parental sexual abuse (limiting our risk of making Type I decisional errors) would provide for interesting and lively discussion, such an approach to separating decisional criteria would be unlikely to withstand legal challenge in the Courts. But I believe this possibility at least merits considered discussion as we strive for synthesis of equally valid poles of the dialectic.

Low Base-Rate Phenomenon

When a condition is rare in the general population this can substantially affect the rate of “false positive” decisions (Type I errors) we make from our assessments. For example,

Say we are assessing for TRAIT X in the population.

The population prevalence of TRAIT X is 5% (i.e., a “low base-rate”) and our instrument for identifying TRAIT X is 95% accurate. No approach to identifying a psychological trait in a population will be 100% accurate and in most cases a sensitivity of 80% is generally considered excellent. But for the purposes of our example, let’s say we have an amazingly good assessment instrument that can accurately identify 95% of the cases of TRAIT X.

So out of 1000 people assessed for TRAIT X, the prevalence of TRAIT X will be 50 people (i.e., 5%). Our 95% accurate instrument will then correctly identify roughly 48 people with TRAIT X, and will miss only 2 people who actually have TRAIT X but who we said didn’t have the trait (i.e., “false negatives,” a Type II error). Correctly identifying 48 of the 50 people with TRAIT X (i.e., “true positives”) while only missing 2 people with TRAIT X (i.e., “false negatives”) is pretty good.

Great. So far, so good.

However, there are 950 people in our population of 1000 without TRAIT X, and our instrument has a 5% error rate, so our 95% accurate instrument will identify 5% of the 950 people without TRAIT X as incorrectly having the trait (i.e. “false positives”), so that our instrument will incorrectly say that 48 people have TRAIT X when they don’t (5% of 950).

This means that out of 1000 people, our 95% accurate instrument will correctly identify 48 people as having the trait (“true positives”) and will miss only 2 who have the trait (“false negatives”), and will also incorrectly identify 48 people as having the trait when they don’t (“false positives”). So essentially, our identification of TRAIT X is only 50% accurate, we correctly identify as many people as having the trait (“true positives”) as we incorrectly identify people as having the trait when in actuality they don’t (“false positives”).

This is the result of what’s called “the low base-rate phenomenon” – no matter how accurate our assessment instrument (even an insanely accurate 95%) we will nevertheless produce and inordinately high number of “false positives” because of the low-base rate of the characteristic in the population.

Out of all the cases of child allegations of parental sexual abuse, the base rate of false child allegations is going to be low (my estimate is around 1% to 2%, others may assert other prevalence estimates).

If our value system says that we should avoid “false positive” identifications (i.e., avoid Type I decisional errors), then any approach that identifies as many “false positives” as “true positives” is going to present a problem. If we are trying to identify cases of “false child allegations of sexual abuse” and out of 1000 cases of alleged sexual abuse we identify 50 cases of false allegations, but in order to do this we also incorrectly identify 50 children who were ACTUALLY sexually abused by the parent as NOT being sexually abused by the parent, that’s a lot of kids who were authentically abused who we are not protecting simply because of the low base-rate phenomenon.  We protect as many children from child abuse as we expose to child abuse.

AND… if our assessment method is less that 95% accurate, then the number of decisional errors increases substantially. So in actual practice, in order to identify the 50 cases of false allegations of sexual abuse we may wind up erroneously identifying 200 or 300 children who were actually sexual abused as NOT being sexually abused by the parent.  This may mean that for every one parent-and-child we protect from the pathology of a false allegation of sexual abuse, we expose as many as four or five other, authentically abused children to continued sexual abuse victimization.

At what point does the damage caused to the 200 or 300 children who were authentically abused outweigh the damage to the 50 children who were not abused and whose false allegations were the product of severely distorted parenting by a narcissistic/borderline parent?

And yet do we simply abandon these “false allegation” children to the severe psychological abuse inflicted on them by the psychopathology of the narcissistic/borderline parent in order for us to reduce the harm to other children who were authentically sexually abused?  Is it moral to knowingly sacrifice one to save many?

Or do we still try to identify these “false allegation” children anyway, even though we know that this will lead to more Type II errors in identifying children who were authentically abused, so that we will be abandoning some authentically abused children to the psychopathology of their pedophile parent?

It would be wonderful if we could achieve 100% accuracy in our diagnosis of both “true positives” (children we identify as being sexually abused who were actually sexually abused by the parent) and “true negatives” (children who make false allegations of sexual abuse and who we identify as false allegations), but be we can’t. There will always be some error in our decisional criteria. Do we wish to limit Type I errors and increase Type II errors, or do we wish to limit Type II errors and increase Type I errors. This is a value judgment based on the relative damage we judge to result from each type of decisional error.

Another consideration in this discussion is that the legal system itself will bias decisional criteria to limit Type I errors (i.e., to limit the probability of incorrectly identifying children as being sexually abused by a parent when there was no sexual abuse), so that the rates of not identifying authentic sexual abuse will already be inordinately high.  Since this is already the case, should we then try to identify actual cases of false allegations of child sexual abuse in order to rescue and protect as many of these children as we can, since trying to identify actual cases of false allegations of child abuse is not likely to affect rates of identifying authentic child sexual abuse cases since the Court is already not identifying these cases anyway by its decisional criteria to limit Type I errors.

Conclusion to Part I

The issues are complex. My assumption is that ALL mental health professionals want what is best for children, and that ALL mental health professionals want to protect all children from all forms of child abuse.

Differing views on how to achieve this represent “equally valid poles of a dialectic” (Linehan, 1993). We should work for synthesis of these poles in which we achieve consensus on a reasonable approach to very difficult and challenging issues, rather than engaging in continual unproductive adversarial conflict in which each side falsely “demonizes” the other as being callously unconcerned about protecting children from child abuse.

We all want to protect children from child abuse. The issues are difficult and challenging.

Moving forward, I hope to engage in productive dialogue regarding these complex and challenging issues in which reasonable people can disagree about approaches while still maintaining a fundamental agreement about the underlying desire to protect ALL children from ALL forms of child abuse.

In a future blog post (Part II) I will discuss my personal views regarding potential resolutions of the complex and difficult issues surrounding child allegations of parental sexual abuse. In this next blog post on the subject of false child allegations of parental sexual abuse, I will offer my thoughts on whether there are specific distinctive identifying features in the 1% to 2% of cases reflecting false child allegations of sexual abuse as a result of the pathogenic influence on the child of a cross-generational coalition with a narcissistic/(borderline) parent (Causal Origin 2).   If there are distinctive and reliable identifying features for false child allegations of parental sexual abuse originating from the pathogenic influence on the child of a narcissistic/(borderline) parent, then we may be able to protect some of these children without inordinately affecting our ability to ALSO protect children whose allegations of parental sexual abuse are true.

I recognize ahead of time that no matter what position I take in this second blog post there will be those who disagree, and that the views of these people are reasonable and well founded. Down the road, they may convince me of the greater correctness of their views, or I may convince them of my views. At this point I believe the primary issue is engaging in reasoned and productive dialogue that recognizes that both poles in the dialectic represent reasonable and understandable positions that merit careful consideration and dialogue.

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

 References

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

“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)

Key Concept: Splitting

Understanding Splitting

This post builds some bricks in the structure for understanding the construct of “parental alienation” which I will then be able to reference in future discussions. 

In this post I’m going to discuss a key construct, the nature of the splitting dynamic that is characteristic of both narcissistic and borderline personality organizations.  As part of this discussion, I will also elaborate on the equivalence of narcissistic and borderline personality organizations at the attachment level, and the key role of splitting in the symptom manifestation of “parental alienation” within an attachment-based framework of the construct (i.e., as the child’s cross-generational coalition with a narcissistic/(borderline) parent).

Splitting

Central to the psychological processes of narcissistic and borderline personalities is the characteristic of “splitting,” which is a polarized perception of events and people into extremes of all-good, ideal, and wonderful or all-bad, entirely devalued, and demonized.  In splitting, thinking and perception are black-or-white. Modulated shades of grey, of mixed positive and negative qualities, are not possible. People are EITHER idealized as the all-wonderful source of nurture and narcissistic supply, OR they are entirely demonized as being “abusive” and as “deserving” to be punished for their inadequacy.  Splitting involves black-or-white extremes of polarized thinking and perception.

The American Psychiatric Association (2000) defines splitting 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, nurturant, and kind — or exclusively bad, hateful, angry, destructive, rejecting, or worthless.” (p. 813)

One of the leading figures in personality disorder dynamics, Otto Kernberg (1977), links the characteristic of splitting to the capacity for denial as a defense mechanism,

“Denial here is typically exemplified by “mutual denial” of two independent areas of consciousness (in this case, we might say, denial simply reinforces splitting). The patient is aware of the fact that at this time his perceptions, thoughts, and feelings about himself or other people are completely opposite to those he has had at other times; but this memory has no emotional relevance, it cannot influence the way he feels now. At a later time, he may revert to his previous ego state and then deny the present one, again with persisting memory, but with a complete incapacity for emotional linkage of these two ego states.” (p. 31-32)

One of the leading authorities on borderline personality disorder processes, Masha Linehan, captures the characteristic inflexibility of the splitting mindset,

“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 for 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)

Both the narcissistic and borderline personality display spitting as a characteristic feature of their personalities. This is because both the narcissist and borderline personality share an underlying personality organization with differing surface manifestations.

Both the narcissistic and borderline personalities have an experience of tremendous core-self inadequacy and both believe that this core-self inadequacy will result in their being rejected and abandoned by others, principally by attachment figures. These personality disorder dynamics are the product of underlying patterns in their attachment system that serve as the formative core for the development of the personality structure. Bowlby (1969; 1973; 1980), who initially described the formation and nature of the attachment system, called these underlying patterns “internal working models” of attachment. Beck et al., (2004) refer to them as organizing “schemas” that guide our perceptions of events and relationships.

The underlying internal working models of attachment, or organizing schemas, for both the borderline personality and the narcissist are the same, a fundamental experience of core-self inadequacy (belief about self-in-relationship) and a belief that he or she will be rejected and abandoned by the attachment figure because of this fundamental core-self inadequacy (belief about other-in-relationship). The difference between the borderline and narcissistic personality is the differing manner in which each personality style copes with and defends against this identical underlying core belief system.

Equivalence of Narcissistic and Borderline Organizational Structure

Kernberg (1975), one of the leading figures in understanding narcissistic and borderline personality dynamics, equates the two types of personalities as essentially representing differing external manifestations of an underlying borderline personality organization,

“One subgroup of borderline patients, namely, the narcissistic personalities… seem to have a defensive organization similar to borderline conditions, and yet many of them function on a much better psychosocial level.” (Kernberg, p. xiii)

“Most of these patients [i.e., narcissists] present an underlying borderline personality organization.” (p. 16)

For mental health professionals reading this post, let me extend Kernberg’s discussion a little deeper,

“Underneath the feelings of insecurity, self-criticism, and inferiority that patients with borderline personality organization present, one can frequently find grandiose and omnipotent trends. These very often take the form of a strong unconscious conviction that they have the right to expect gratification and homage from others, to be treated as privileged, special persons. If an external object can provide no further gratification or protection, it is dropped and dismissed because there was no real capacity for love of this object in the first place.” (p. 33)

Childress Comment: it is interesting to note that when the targeted parent supposedly “provides no further gratification” for the child (according to the child’s report), the relationship with this parent is “dropped and dismissed” as if “there was no real capacity for love” in the child in the first place.  This child presentation is classically characteristic of narcissistic/borderline personality processes, and it is entirely inconsistent with the authentic functioning of the attachment system.

“In attachments, as in other affectional bonds, there is a need to maintain proximity, distress upon inexplicable separation, pleasure and joy upon reunion, and grief at loss.” (Ainsworth, 1989, p. 711)

“The difference between narcissistic personality structure and borderline personality organization is that in the narcissistic personality there is an integrated, although highly pathological grandiose self… The integration of this pathological, grandiose self compensates for the lack of integration of the normal self-concept which is part of the underlying borderline personality organization: it explains the paradox of relatively good ego functioning and surface adaptation in the presence of a predominance of splitting mechanisms, a related constellation of primitive defenses, and the lack of integration of object representations in these patients.” (p. 265-266)

“The pathological grandiose self compensates for the general “ego-weakening” effects of the primitive defensive organization, a common characteristic of narcissistic personalities and patients with borderline personality organization, and explains the fact that narcissistic personalities may present an overt functioning that ranges from the borderline level to that of better integrated types of character pathology.” (p. 269)

Both the narcissistic and borderline personalities experience a primal core-self inadequacy that, at the attachment system level, represents the internal working models in the attachment system for self-in-relationship.

Both the narcissistic and borderline personalities also have a corresponding belief that they will be rejected and abandoned by the primary attachment figure, which represents at the attachment system level their internal working model for other-in-relationship.

Bowlby refers to these basic internalized belief systems that comprise the attachment system as “internal working models,” while Beck et al., (2004) refer to them as “schemas,”

Bowlby: Internal Working Models

“No variables, it is held, have more far-reaching effects on personality development than have a child’s experiences within his family: for, starting during the first months of his relations with his mother figure, and extending through the years of childhood and adolescence in his relations with both parents, he builds up working models of how attachment figures are likely to behave towards him in any of a variety of situations; and on those models are based all his expectations, and therefore all his plans for the rest of his life.” (Bowlby, 1973, p. 369).

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

Beck: Schemas

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

“The content of the schemas may deal with personal relationships, such as attitudes toward the self or others, or impersonal categories… When schemas are latent, they are not participating in information processing; when activated they channel cognitive processing from the earliest to the final stages.” (Beck et al., 2004, p. 27)

“In personality disorders, the schemas are part of normal, everyday processing of information… When hypervalent, these idiosyncratic schemas displace and probably inhibit other schemas that may be more adaptive or more appropriate for a given situation. They consequently introduce a systematic bias into information processing.” (Beck et al., 2004, p. 27)

”Some subsystems composed of cognitive schemas are concerned with self-evaluation, others are concerned with evaluation of other people.” (Beck et al., 2004, p. 28)

These distorted internal working models of attachment (or organizing schemas) guide and direct the interpretation of relationships and the responses made to these distorted interpretations of reality by the narcissistic/(borderline) parent. Some “alienating” parents will present with stronger narcissistic personality styles while other “alienating” parents will present with stronger borderline personality styles. Note in this regard, Kernberg’s analysis of the narcissistic personality that,

“…narcissistic personalities may present an overt functioning that ranges from the borderline level to that of better integrated types of character pathology.” (Kernberg, 1977, p. 269)

It is this wide variability in the overt presentation of the narcissistic/(borderline) parent in “parental alienation,” combined with the absence of personality disorder expertise in the mental health professionals who are diagnosing and treating general child and family problems, that may have contributed to the seeming non-recognition of the narcissistic/(borderline) pathology associated with “parental alienation.”

It is IMPERATIVE that ALL mental health professionals, all child custody evaluators and all therapists, who are involved in diagnosing and treating this “special population” of children and families have a professional level of expertise regarding the nature, dynamics, and presentation of personality disorder processes, particularly narcissistic and borderline personality development and characteristics.

I would strongly urge and strongly recommend that ALL mental health professionals involved in diagnosing and treating this special population of children and families, which means all child custody evaluators and treating therapists, read the following set of literature to establish professional competence in the requisite domain of personality disorder components for this special population:

Core Texts:

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.

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

Readings of Special Note:

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.

Childress Comment: Highly recommended regarding parental empathic failure as a form of psychological child abuse and developmental trauma. Failure of parental empathy is a characterological feature of both narcissistic and borderline personalities.

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

Childress Comment: Highly recommended regarding the nature of role-reversal parent-child relationships.  Role-reversal relationships are an extremely common feature of narcissistic and borderline parenting.

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

Childress Comment: Recommended review of the impact of narcissistic parenting

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

Childress Comment: Recommended discussion of children’s presentation when living with a narcissistic parent.

There is no excuse or justification for professional ignorance.  If a mental health professional is going to be involved in the diagnosis and/or treatment of families that involve narcissistic and/or borderline personality dynamics, then the mental health professional MUST be professionally knowledgeable and competent in personality disorder dynamics.

There is NO EXCUSE for professional ignorance.

The Neurological Origins of Splitting

Spitting is not an actual physical splitting of areas in the brain. It involves the excessive “cross-inhibition” of two brain areas, so if one area is active (the area containing positive representations, for example) then this active area of the brain triggers inhibitory connections that entirely suppress the activity of another area of the brain (the area containing negative representations), so that only one or the other area of the brain can be active at any one time.

So, as noted earlier by Kernberg regarding denial and splitting, the person will continue to have a memory that he or she previously didn’t feel this way, “but this memory has no emotional relevance” for the person because that area of the brain that was previously active is now entirely turned off (entirely inhibited by the activity of the other brain area).

For the rest of us, living in a normal-range brain, we can have both brain areas on simultaneously. Our brain area containing positive representations can be on AT THE SAME TIME as our brain area containing negative representations, so that we can have a complex blend of both positive and negative features about an event or person. Yet even in our normal-range brains we still have a little bit of cross-inhibition occurring. If we like someone, we tend to see more positive things about that person, and we’ll tend to overlook their negative qualities (this is called a “positive halo” effect), whereas if we don’t like someone we will tend to interpret what they do in a more negative and critical way (this is called a “negative halo” effect).

But our cross-inhibition is relatively mild (hopefully), which allows us a more balanced perception of events and people. For the narcissistic and borderline personalities, however, the cross-inhibition of the two brain areas is complete and totalEITHER the positive representation area is active, in which case the negative representation area is entirely turned off (i.e., creating the all-good, perfectly nurturing, and idealized extreme), OR the negative representation area is active, in which case the positive representation area is entirely turned off (i.e., creating the all-bad, entirely devalued, and demonized extreme).

No balanced blend of perception is possible in the brain circuitry of the narcissistic borderline parent. Black-or-white extremes. This is called “splitting.”

How does a situation like this develop?

Spitting occurs in the attachment system, and it is a response to a parent who is simultaneously a source of fear and a source of nurture.

“Various studies have found that patients with BPD are characterized by disorganized attachment representations… 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).” (Beck et al., 2004, p. 191)

The positive representation area of the brain is the area containing attachment bonding motivations, and the negative representation area of the brain is the area containing avoidance motivations. The parent, as a source of nurture for the child, naturally triggers the child’s attachment bonding motivations. However, when this parent is simultaneously a source of threat who provokes an intense fear in the child, the child’s avoidance motivations also become active, and the child becomes strongly motivated to flee from the source of threat and danger (the hostile-abusive parent) and seek nurture and protection from… the parent… who is… the source of threat and danger and who is triggering the child’s avoidance motivation.

This creates a state of intolerable inner conflict, where both the attachment bonding and avoidance motivation systems are simultaneously active at high intensities. If this becomes a chronic experience, the brain begins to resolve this conflict by excessively cross-inhibiting these networks, so that if one network is active, say the attachment bonding network, then the other network, the avoidance network, is entirely inhibited and becomes completely inactive. Or, if the avoidance motivation system is active, then this entirely inhibits the attachment bonding motivation system. So that ONLY one or the other motivating system is on at any given time.

So unlike our normal-range brains that can simultaneously experience both attachment bonding and avoidance motivations, with only minimal cross-inhibition (i.e., the halo effect), the brain of the narcissistic/borderline personality experiences EITHER one OR the other motivation (an intense bonding motivation or an intense avoidance motivation), but never both simultaneously (i.e., never a complex blend of good and bad).

This is what “splitting” is. It is a distinctive and characteristic feature of both narcissistic and borderline psychopathology. It is easily recognized by a competent mental health professional.

Splitting and “Parental Alienation”

The narcissistic/(borderline) parent is neurologically unable to simultaneously experience both positive and negative perceptions of a person. Either the other person is seen as an idealized source of nurture and narcissistic supply, or the other person becomes a devalued object of complete contempt and scorn. No middle ground is possible. Ambiguity is neurologically impossible for the narcissistic/(borderline) personality.

When the divorce occurs, the targeted parent becomes an ex-husband or an ex-wife.

In the black-and-white polarized brain pathways of the narcissistic/(borderline) parent, the “bad husband” MUST also become the “bad father” and the “bad wife” MUST also become the “bad mother.”  There is no other possibility.  This is an imperative imposed by the neurological networks of the narcissistic/(borderline) brain, i.e., by the splitting dynamic characteristic of both narcissistic and borderline personalities.

What’s more, since the narcissistic/(borderline) brain cannot experience (fundamentally cannot experience) ambiguity, the ex-husband must also become an ex-father; the ex-wife must become an ex-mother. To the mind of the narcissistic/(borderline) parent this seems self-evident and obvious. Remember Kernberg’s discussion of denial,

“The patient is aware of the fact that at this time his perceptions, thoughts, and feelings about himself or other people are completely opposite to those he has had at other times; but this memory has no emotional relevance, it cannot influence the way he feels now… [There is] a complete incapacity for emotional linkage of these two ego states.” (p. 31-32)

All memories held by the narcissistic/(borderline) parent of the positive relationship the targeted parent may have had with the children are lost to relevance. The bad spouse has now become a bad parent, and the ex-husband must become an ex-father, the ex-wife must become the ex-mother, and there is a “complete incapacity for emotional linkage” to any prior experiences of the targeted parent as a good spouse or good parent. These memories have “no emotional relevance.”

And, since the child is in a shared psychological state with the narcissistic/(borderline) parent (variously called an “intersubjective” state (Stern, 2004; Trevarthan, 2001), a “dyadic state of consciousness” (Tronick, 2003), or “enmeshment” (Minuchin, 1974), the child is acquiring the orientation and belief systems of the narcissistic/(borderline) parent, hence the presence of narcissistic and borderline traits in the child’s symptom display (i.e., diagnostic indicator 2).

So the child will exhibit the SAME splitting process (diagnostic indicator 2.5). The child’s memories of formerly positive experiences with the targeted parent will also lose relevance for the child. The child may remain “aware of the fact that at this time his perceptions, thoughts, and feelings about [the targeted parent] are completely opposite to those he has had at other times; but this memory has no emotional relevance, it cannot influence the way he feels now… [There is] a complete incapacity for emotional linkage of these two ego states.”

This explains what otherwise is a very puzzling feature of “parental alienation.”

Why doesn’t the child remember all the good times with the targeted parent? Their love and affection, their laughter and warmth? What happened to all those positive memories?

“In this case, we might say, denial simply reinforces splitting” (Kernberg, 1977, p. 31)

Now Kernberg wasn’t talking about “parental alienation.” Kernberg was describing the narcissistic/borderline personality. Which highlights an important point, the moment we ground our definition of “parental alienation” in established psychological constructs and principles, a wealth of relevant information immediately becomes available to us, and explanations are revealed.

Understanding the role of splitting in “parental alienation” is just one more brick in a comprehensive and accurate explanation of what “parental alienation” is from within standard and established psychological principles and constructs.

Parallel Process

Whenever multiple mental health professionals work with borderline personality processes (and narcissistic processes have an underlying borderline organization), there always exists the potential that the splitting dynamic of the borderline process will be transferred and expressed among the involved mental health professionals, variously called “parallel process” and “staff splitting.”

Linehan, one of the premiere experts in borderline personality processes, describes this potential for the transfer of splitting into the professional team working with borderline personality dynamics in patients,

“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)

This very much sounds to me like the professional discussion surrounding “parental alienation” that has occurred over the past 30 years, in which each side (pole in the dialectic) is advocating for their position without finding synthesis with the other side (the other pole in the dialectic).  Establishment mental health (symbolized by the DSM committees) have discounted Gardnerian PAS as “junk science” and have withheld granting legitimacy to the construct of PAS, and a separate partisan divide has swirled around the construct of false allegations of child abuse, with each side taking staunchly polarized positions. 

For their part, the Gardnerian PAS advocates have failed to grasp and appreciate the legitimate criticism of PAS as being founded on a set of loose anecdotal indicators that have no connection to established psychological constructs or principles. Rather than take this criticism to heart and employ the professional rigor necessary to define “parental alienation” within standard and established psychological constructs and principles, the Gardnerian PAS supporters have simply tried to storm the gates of the DSM with the same continual argument of “it exists.”

From the perspective of “staff splitting,” Marsha Linehan provides us the way out of this unproductive professional squabbling.  First, we must recognize that a polarity has arisen, and that both sides represent equally valid poles of a dialectic.  Second, we must come together to work toward synthesis.

The criticism of Gardner’s model of PAS as not being sufficiently grounded in scientifically established psychological principles and constructs is a valid criticism.  An attachment-based reconceptualization of the construct of “parental alienation” addresses this criticism levied by establishment mental health against Gardner’s model of PAS.  And, in applying the professional rigor necessary to describe the construct of “parental alienation” entirely from within standard and established psychological constructs and principles, a wealth of explanatory information is made available to guide both diagnosis and treatment.

Equally, establishment mental health needs to similarly work toward synthesis by recognizing the legitimacy of a clinical phenomenon associated with what has traditionally been called “parental alienation.”  It doesn’t matter what it’s called, but it represents severe distortions to family processes as a result of a cross-generational coalition of the child with a narcissistic/(borderline) parent that is creating serious developmental (diagnostic indicator 1), personality (diagnostic indicator 2), and psychiatric (diagnostic indicator 3) pathology in the child, which defines it as “pathogenic parenting.”

Because the construct has a history of being labeled as “parental alienation,” I would recommend we keep this descriptive label, but I have added the prefix “attachment-based” to the label to differentiate this scientifically grounded model for the clinical phenomenon from the earlier Gardnerian PAS model.

Fundamentally, however, within mental health we must show enlightened professionalism and bring this parallel process of “staff splitting” to an end for the benefit of our client children and families.  Both sides are right, both sides represent equally valid poles in a dialectic.  It is time we engage in professional dialogue that recognizes this truth so that we can maintain our professional focus on serving the needs of our client families by coming together to work toward synthesis

This is ALSO true surrounding the divisive issue of false allegations of abuse.  We need to protect children from child abuse and a healthy trust for children’s reporting of abuse is warranted.  One of the absolutely worst things we can do in a case of authentic child abuse is allow the child to report the abuse, and then not believe the child and not do anything to stop the abuse.  That is psychologically devastating to the child.  The skeptics of false allegations of child abuse, who are advocating for providing greater credibility to child reporting of abuse have an extremely legitimate and important point.  They are right.

And…

In some cases, particularly when there is parental narcissistic and borderline processes and a cross-generational role-reversal relationship in which the child has been induced/seduced into meeting the emotional and psychological needs of the narcissistic/borderline parent, there are occurrences of the narcissistic/borderline parent inducing/seducing false and distorted allegations of abuse from the allied child directed toward the other parent in order that the narcissistic/borderline parent can exploit the allegations to achieve power over the situation and the targeted parent.  Furthermore, borderline personality parents may have been abused themselves and so have a pre-potentiated schema of fearfulness in which they see abuse where none exists (the term “borderline” refers to being on the “border” of neurosis and psychosis).

“Young’s schema model… patients with BPD were characterized by higher self-reports of beliefs, emotions, and behaviors related to the four pathogenic BPD modes (detached protector, abandoned/abused child, angry child, and punitive parent model.” (Beck et al., 2004, p. 193)

“Patients with BPD are characterized by hypervigilance (being vulnerable in a dangerous world where nobody can be trusted) and dichotomous thinking.” (Beck et al., 2004, p. 193)

“The conceptualization of the core pathology of BPD 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…” (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. (p. 199)

Narcissistic personalities can also decompensate into paranoid and persecutory delusional beliefs (Millon, 2011). 

“Owing to their excessive use of fantasy mechanisms, they [narcissists] are disposed to misinterpret events and to construct delusional beliefs… Among narcissists, delusions often take form after a serious challenge or setback has upset their image of superiority and omnipotence… Delusional systems may also develop as a result of having felt betrayed and humiliated. Here we may see the rapid unfolding of persecutory delusions…” (Millon, 2011, p. 407)

The presence of parental narcissistic and borderline personality dynamics realistically elevates the risk of false allegations of abuse directed toward a normal-range targeted parent as a consequence of the psychopathology of the narcissistic/(borderline) parent, especially when the child has been induced/seduced into a cross-generational coalition with the narcissistic/(borderline) parent against the other parent that involves a role-reversal relationship in which the child is being used to meet the emotional and psychological needs of the narcissistic/(borderline) parent.

We need to protect children from ALL forms of child abuse.

Both sides represent “equally valid poles in a dialectic.”  For the well-being of our clients, professional psychology must demonstrate sufficient self-reflective insight to avoid the parallel process dynamic of staff splitting associated with treating borderline personality processes (i.e., “parental alienation”) and must work together, NOT as adversaries, toward a synthesis of understanding that recognizes the legitimacy of both poles in the dialectic.

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.

Attachment

Ainsworth, M.D.S. (1989). Attachments beyond infancy. American Psychologist, 44, 709-716.

Bowlby, J. (1969). Attachment and loss. Attachment, Vol. 1. NY: Basic Books.

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

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

Personality Disorders

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

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

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

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.

“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.” (Moor & Silvern, 2006, p. 197)

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

“The breakdown of appropriate generational boundaries between parents and children significantly increases the risk for emotional abuse. (Kerig, 2005, p. 6)

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)

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

“One of the most impactful consequences brought about as a result of growing up with parental PD is the way in which a child is raised with emotionally unavailable, unpredictable, or hostileabusive parenting and the consequences of this upbringing on attachment issues.” (p. 271)

“The results [of Horne’s study] indicated mothers’ narcissism rates correlated significantly and positively with their sons’ narcissism and negatively with their sons’ expressions of empathy.”

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

“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. (Rappoport, 2005, p. 2)

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. Children raised by narcissistic parents come to believe that all other people are narcissistic to some extent. As a result, they orient themselves around the other person in their relationships, lose a clear sense of themselves, and cannot express themselves easily nor participate fully in their lives. (Rappoport, 2005, p. 3)

“Often, the same person displays both narcissistic and co-narcissistic behaviors, depending on circumstances. A person who was raised by a narcissistic or a co-narcissistic parent tends to assume that, in any interpersonal interaction, one person is narcissistic and the other co-narcissistic, and often can play either part. Commonly, one parent was primarily narcissistic and the other parent primarily co-narcissistic, and so both orientations have been modeled for the child. (Rappoport, 2005, p. 2)

 Intersubjectivity & Enmeshment

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

Trevarthen, C. (2001). The neurobiology of early communication: Intersubjective regulations in human brain development. In Kalverboer, A.F. and Gramsbergen, A. (Eds) Handbook of Brain and Behaviour in Human Development. London: Kluwer Academic Publishers

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.

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

What Can I Tell the Court?

I received the following question from a targeted parent:

“I am in a custody/divorce battle that has gone on for over two years. I have spent every penny that I could raise on this, over $150k and I am now little more than a broken parent living on very little. I can no longer afford anything for my case so I am now representing myself in Court. I would love to get some ideas on how to present PA in Court.  Thanks much.”

I receive variations of this request a lot. I wish there was some positive answer I could offer.

This is exactly why the Gardnerian model of PAS is a failed paradigm. The Gardnerian PAS paradigm requires that the targeted parent prove “parental alienation” in Court, and this becomes a long and expensive process. Too expensive for all but a few parents, and it takes years of legal struggles.  And all the while, through the years of protracted legal battles trying to prove “parental alienation” in Court, the child’s symptoms become ever more severely entrenched, so that recovering the authentic child becomes increasingly difficult even if there is a positive outcome in Court.

But, except in the most severe cases of “parental alienation,” there is seldom a positive outcome in Court.

The Court will issues orders for custody and visitation that the narcissistic/(borderline) parent will ignore. The targeted parent will return to Court seeking contempt charges, and the Court will not levy sanctions but will instead modify its orders and stress to the narcissistic/(borderline) parent the importance of following Court orders, and these new orders will simply be ignored by the narcissistic/(borderline) parent. The targeted parent will AGAIN need to return to Court to obtain the compliance of the narcissistic/(borderline) parent with the PREVIOUS Court orders and the judge will reprimand BOTH parents for not adequately co-parenting.

Meanwhile, time passes and the child’s symptoms become ever more severely entrenched, the child grows farther away from the love of the targeted parent, and the child increasingly surrenders with each passing day to the distorted influence of the narcissistic/(borderline) parent.

The Court will order “reunification therapy,” even though no such thing as “reunification therapy” exists in any established models of psychotherapy (see On Unicorns, the Tooth Fairy, and Reunification Therapy post). The construct of “reunification therapy” is a fraud perpetrated by mental health professionals on the Court and public. No such thing exists.

I’m aware that “fraud” is a strong accusation, but this blog has a Comments section and I challenge any mental health professional to provide me with a professional reference for what “reunification therapy” entails.  None exists.   No model of “reunification therapy” has ever been proposed or defined within the professional literature. There is no such thing as “reunification therapy” and professional psychology should be ashamed of itself for fostering this “junk therapy” upon the Court and public.

Since “reunification therapy” has no established model, it is essentially whatever the “reunification” therapist makes it up to be. The construct of “reunification therapy” is a made up and fraudulent therapy construct. If any therapist disagrees, there is a Comment section available to you on this post…

There are psychoanalytic models of therapy, humanistic-existential models of therapy, cognitive-behavioral models of therapy, family systems models of therapy, and post-modern models of therapy, but there are no models that define what “reunification therapy” entails.

Nevertheless, the Court will order “reunification therapy” as if it exists, and even this therapy will be delayed by the non-cooperation of the narcissistic/(borderline) parent. When it does eventually take place, the reunification therapist is revealed to be clueless regarding how to treat and resolve “parental alienation” and the ineffective and pointless “reunification therapy” will continue for months, or even years, without producing any change whatsoever.

And all the while, the child’s symptoms become ever more established and entrenched, the loving relationship with the targeted parent becomes ever more hostile and rejecting, and the child falls ever more fully under the distorting pathogenic influence of the narcissistic/(borderline) parent. No one apparently sees or recognizes the degree of the pathology.

This is the only “solution” offered by Gardner’s model of PAS, and it is no solution at all. Gardner’s model requires the litigation and proof of “parental alienation” in Court. As long as the construct of “parental alienation” is defined through Gardner’s model of PAS then there will be no solution available to the nightmare of “parental alienation.”

An attachment-based model for the construct of “parental alienation” redefines the construct of “parental alienation” entirely from within standard and established psychological constructs and principles, and seeks the solution FIRST in the mental health system, which can then be leveraged to achieve an efficient and effective solution in the legal system.

When mental health speaks with a single voice, then the legal system will be able to act with the decisive clarity necessary to solve “parental alienation.” The solution to “parental alienation” is in the mental health system, not the legal system. Mental health remains divided by the Gardnerian model of PAS (i.e., it is not accepted by establishment mental health as represented by the DSM diagnostic system), so it requires that targeted parents prove “parental alienation” in Court.

An attachment-based model for the construct of “parental alienation” is based entirely in established psychological constructs and principles that are accepted by establishment mental health (i.e., the attachment system, personality disorder dynamics, delusional processes), which can then be used to establish professional standards of practice, and the single voice from mental health can then be used to efficiently and effectively guide decisions before the Court.

Until a paradigm shift occurs, no solution is available.

I fully understand the desperate struggle of targeted parents seeking a solution, as you feel your relationship with your child slipping away into a nightmare of distortions, hostility, and rejection. I understand that you’re hoping that because I understand what “parental alienation” is that I will have some magic words to give you that will help the Court and therapists understand. Unfortunately, I don’t have magic words to enlightened the unenlightened.

The solution is to be found in a paradigm shift to an attachment-based model of parental alienation (see Finding Empowerment post), and until this paradigm shift occurs within establishment mental health, no solution will be available.  I’m sorry.  I wish it were different. But its not.

If you’re struggling with the Court, your attorney may find my expert testimony helpful (my professional expertise is in child and family therapy, child development, and parent-child conflict; not in “parental alienation”). I can review reports by other mental health professionals and provide a second opinion on the clinical data contained in these reports, and I can provide testimony in response to hypothetical questions that are posed to me by your attorney that mirror the features of your case. This may or may not be helpful to your case.  I am not an attorney.  For legal advice consult an attorney and follow the advice of your attorney.

In general, my opinion as a psychologist is that reframing the issue away from “parental alienation” and over to “pathogenic parenting” that focuses on the child’s symptoms may possibly be helpful, but that is a decision for you to make in consultation with your attorney.

For parents who lack the financial resources to hire an attorney… I fully understand, and I am sorry, because it is unlikely that you will be able to have my testimony or materials admitted into your case because you probably don’t know how to navigate the requirements of the legal system. That’s the expertise that attorneys provide. But legal representation is expensive. I understand that, which is why I am convinced that any solution to “parental alienation” that requires extensive litigation will be unproductive. We need a solution that is practical, that can be accomplished within 6 months, and that does not require excessive financial expenditures. In my view, an attachment-based model of “parental alienation” provides this solution once it is accepted into establishment mental health.

However, I am not an attorney. For legal advice, consult an attorney.

To achieve any hope of a solution, the Gardnerian paradigm of PAS requires that you have a good attorney who can effectively navigate the legal system. Trying to be successful in the legal system on your own will very likely prove unproductive with regard to “parental alienation.” To make use of my testimony or my materials in Court will likely require the expertise of an attorney to actualize. I’m sorry. I wish it was different. I’m working to make it different. But that is seemingly the current state of affairs.

The current Gardnerian model of PAS is a failed paradigm. There is no pragmatic and practical solution available under the current paradigm. Under the Gardnerian paradigm you must prove “parental alienation” in Court.  In the vast majority of cases, this is not a practical solution that can be actualized.

However, the moment an attachment-based model of “parental alienation” is accepted by establishment mental health (and there are no barriers to this acceptance, see Nothing New – No Excuses post) then the solution becomes available immediately.

The solution to parental alienation” is to be found in the mental health system, not the legal system. Any effort at a solution that requires the litigation of “parental alienation” in the legal system will be unsuccessful. Litigation in the legal system is far too expensive, takes far too long, and almost invariably produces inadequate results.

I wish I had a different answer. I don’t know what you can provide to the Court to persuade them. If you have an attorney and your attorney thinks my expert testimony may be helpful, then I am available to provide my insight to the Court .

Note: Not every post-divorce parent-child conflict is the result of “parental alienation.” In any analysis of clinical data, I will follow wherever the clinical data leads.  If other potential factors besides “parental alienation” are evident in the clinical data, I will say so.  I have no personal investment in finding “parental alienation,” and I am clear in my writings that I define what has traditionally been called “parental alienation” as “pathogenic parenting” evident in a specific set of child symptoms.  I am a clinical psychologist, and my expertise is in child and family therapy, child development, and parent-child conflict, not in “parental alienation.”

The ultimate solution to parental alienation, however, is to be found in the mental health system, not the legal system, and the solution is not to be found on a case-by-case basis.  The fate of targeted parents will rise or fall together.  It will be solved for everyone, or will be solved for no one.

Once mental health speaks with a single voice, then the legal system will be able to act with the decisive clarity necessary to solve the family tragedy of “parental alienation.”

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

Diagnostic Checklist for Pathogenic Parenting

I have just posted to my website a Diagnostic Checklist for the three Primary Diagnostic Indicators and Secondary Clinical Features for the pathogenic parenting associated with an attachment-based model of “parental alienation.”

This diagnostic checklist is available at the link below:

Diagnostic Checklist for Pathogenic Parenting, and directly through my website

I am not sure if this checklist will be helpful to targeted parents, but I am trying to provide you with something simple that you can give to therapists and child custody evaluators.

Unfortunately, as the saying goes, we can lead a horse to water but we can’t make him drink.

We can’t force mental health professionals to be knowledgeable.  If you have cancer and you’re in the position of educating your physician regarding the diagnosis and treatment of cancer… you’re in trouble.  The treating physician should know more than you about the disorder.  Would that this were the case with mental health professionals and “parental alienation.”

This Diagnostic Checklist for Pathogenic Parenting may, or may not, be helpful in educating therapists and child custody evaluators.

If the three Primary Diagnostic Indicators are present then a diagnosis of pathogenic parenting associated with an attachment-based model of “parental alienation” is warranted, because no other possible explanation can account for this specific set of child’s symptoms.  It is simple.  It is clear.  It is definitive.

In addition, there are a set of secondary clinical features that can be used as confirmatory support for the diagnosis, or as initial signs triggering additional focused assessment for the three Primary Diagnostic Indicators.

The diagnosis of pathogenic parenting associated with an attachment-based model of “parental alienation” is made solely on the presence or absence of the three Primary Diagnostic Indicators.

If one or more of the three Primary Diagnostic Indicators is sub-threshold, then a 6-month Response to Intervention (RTI) trial of therapy would be warranted to assist in clarifying the diagnosis. If the parent-child conflict with the targeted parent is NOT due to the pathogenic influence of the child’s cross-generational coalition with a narcissistic/(borderline) parent (i.e., “parental alienation”), then 6 months of appropriate therapy should produce a significant resolution to the parent-child conflict.  Perhaps not a complete resolution in 6 months, but significant gains should be achieved from 6 months of therapy.

If, however, the parent-child conflict IS the result of the pathogenic influence of the child’s cross-generational coalition with a narcissistic/(borderline) parent (i.e., “parental alienation”), then 6 months of therapy will have had no effect, the Primary Diagnostic Indicators would have become more clearly evident, and the presence of secondary clinical features could confirm the diagnosis.

If you want to remain focused in educating a therapist or child custody evaluator, I structured the checklist so you can simply present the first two pages.  At the end of the first page are resources of my website, blog, and online seminar if the mental health professional wants more information.  At the end of the second page is the appropriate DSM-5 diagnosis (including V995.51 Child Psychological Abuse, Confirmed) with a reference in the footnote to the article on my website where I provide an analysis of the DSM-5 diagnosis for an attachment-based model of “parental alienation.”

The third page is a single-page checklist for all of the associated secondary clinical features, followed by bullet-point descriptions of each secondary clinical feature.  I’m planning to address each one in turn in future blog posts, describing each feature and explaining why it occurs.

Again, this may, or may not, be helpful.  We can lead a horse…

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

 

Finding Empowerment

I recently received the following offer from a targeted parent, and I wish to respond on my blog because I believe my response may be of interest to other targeted parents,

“I would like to volunteer myself and my son to assist you in any way we can.”  Shawn

That’s very kind, thank you. I appreciate your offer.  Here’s what I would suggest…

This is important to understand:  There needs to be a paradigm shift within mental health The moment an attachment-based model of “parental alienation” becomes accepted within establishment mental health, the solution to the nightmare of “parental alienation” becomes available immediately.

The attachment-based model of “parental alienation” offers,

  • Clear diagnostic criteria (the three diagnostic indicators) immediately become available to allow the consistent diagnosis of attachment-based “parental alienation” in EVERY case, for ALL therapists and ALL child custody evaluators. The nature and degree of the psychopathology becomes immediately identified the moment it enters any aspect of the mental health system.
  • The pathology of “parental alienation” immediately becomes defined as “pathogenic parenting” (i.e., severely distorted parenting practices that are inducing significant developmental, personality, and psychiatric psychopathology in the child) that requires a child protection response.  

The child’s protective separation from the pathogenic parenting of the narcissistic/(borderline) parent during the active phase of the child’s treatment and recovery immediately becomes the professionally responsible and required treatment response to the pathogenic parenting of the narcissistic/(borderline) parent.

  • Children and families evidencing the three diagnostic indicators for an attachment-based model of “parental alienation” become defined as a “special population” requiring specialized professional knowledge, training, and expertise to competently diagnose and treat.  Immediately, all child custody evaluators and all therapists working with this group of children and families must possess an advanced level of knowledge related to,

1.  Narcissistic and borderline personality dynamics, their characteristic presentation and their impact on family relationships,

2.  Family systems dynamics involving children’s triangulation into spousal conflicts through cross-generational parent-child coalitions,

3.  The characteristic functioning and dysfunctioning of the attachment systems during childhood,

4.  The nature and features of parent-child role-reversal relationships, and

5.  The formation of delusional belief systems as a product of decompensating narcissistic and borderline personality processes.

This immediately prohibits diagnosis and treatment by unqualified mental health professionals under standard of practice guidelines laid out in the Ethical Principles of Psychologists and Code of Conduct, Standard 2.01a. 

“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.”

Since ONLY knowledgeable and competent mental health professionals will be able to diagnose and treat this “special population” of children and families, and, since professionally responsible treatment REQUIRES the child’s protective separation from the pathogenic parenting of the narcissistic/(borderline) parent during the active phase of treatment, no therapist, anywhere, will treat without first acquiring a protective separation of the child from the pathogenic parenting of the narcissistic/(borderline) parent.

This will provide a clear and consistent directive from professional mental health to the Court that the issue is NOT one of child custody and visitation but is one of child protection, and that the child’s protective separation from the allied and supposedly “favored” parent is required during the active phase of treatment.

  • Since the appropriate DSM-5 diagnosis for an attachment-based model of “parental alienation” includes the DSM-5 diagnosis of V995.51 Child Psychological Abuse, Confirmed (see Diagnostic Indicators and Associated Clinical Signs), and since ONLY trained and competent mental health professionals will be diagnosing and treating this “special population” of children and families, then all mental health professionals involved in the diagnosis and treatment of an attachment-based model of “parental alienation” will be aware of this DSM-5 diagnosis and will have the decision as legally mandated child abuse reporters to file a child abuse report with the appropriate child protection service agency (note: reporting psychological and emotional abuse is an optional not a mandated report). 

If (when) child protective service agencies begin to receive an influx of these child psychological abuse reports related to the diagnostic indicators for an attachment-based model of “parental alienation” these agencies won’t know how to investigate and resolve these reports. They will seemingly have two options,

1.  To accept the DSM-5 diagnosis of V995.51 Child Psychological Abuse, Confirmed from the licensed and specially trained and competent mental health professional, which will then necessitate removing the child from the custody of the psychologically abusive narcissistic/(borderline) parent, thereby enacting the child’s protective separation from the pathogenic parenting of the narcissistic/borderline parent, or

2. To train their investigators in the three diagnostic indicators and associated clinical signs of attachment-based “parental alienation,” so that ALL investigators at ALL child protection service agencies are trained to professional competence in the recognition of pathogenic parenting by a narcissistic/borderline parent that is inducing significant developmental, personality, and psychiatric psychopathology in a child.  I suspect this will be the option chosen by child protective service agencies once an attachment-based model of “parental alienation” becomes accepted within establishment mental health and these agencies begin to receive child abuse reports resulting from clinical diagnoses of V995.51 Child Psychological Abuse, Confirmed

If (when) ALL investigators at ALL child protection service agencies are trained to professional competence in the recognition of the pathogenic parenting associated with attachment-based “parental alienation,” then this will help to resolve issues surrounding the reporting of false allegations of child abuse by the narcissistic/(borderline) parent, because a child abuse report now becomes a double-edged sword.  Not only will the investigator be investigating the reported abuse, but also the potential for child psychological abuse from the pathogenic parenting of a narcissistic/(borderline) parent associated with an attachment-based model of “parental alienation.”  If evidence for the reported abuse is insubstantial but the child’s symptoms display the definitive three diagnostic indicators of pathogenic parenting associated with an attachment-based model of “parental alienation,” then the child protection services may initiate a child protection response of removing the child from the custody of the narcissistic/(borderline) parent due to a confirmed DSM-5 diagnosis of V995.51 Child Psychological Abuse made by the investigator.

The potential of having the child removed from the custody of the narcissistic/(borderline) parent when false allegations of child abuse are made may cause the narcissistic/(borderline) parent to reconsider before making false allegations of child abuse, and so may have a deterrent effect on the filing of false allegations of child abuse by narcissistic/(borderline) parents.  Of note is that in cases of good faith but erroneous child abuse reports by parents, the child’s symptoms will not display the three diagnostic indicators associated with attachment-based “parental alienation.”

The cooperation of the Court will be necessary to obtain the required protective separation of the child from the pathogenic parenting of the narcissistic/(borderline) parent during the active phase of treatment. To gain the cooperation of the Court, the targeted parent will need the strong support of mental health, and mental health must speak with a single voice to the Court, so that all mental health professionals will make exactly the same diagnosis when the child’s symptoms display the three characteristic diagnostic indicators of an attachment-based model of “parental alienation” – and all therapists who treat this “special population” are trained and expert in the attachment-based model of “parental alienation” so that no therapist, anywhere, will treat “parental alienation” without first obtaining the child’s protective separation from the pathogenic parenting of the narcissistic/(borderline) parent.

When professional mental health speaks to the Court with a single voice, the Court can act with the decisive clarity necessary to solve “parental alienation.”

Note: We do not need to litigate the parental psychopathology of the narcissistic/(borderline) parent.  The issue is pathogenic parenting and the diagnosis can be made solely based on the child’s symptom display of the three definitive diagnostic indicators of attachment-based “parental alienation.”

The solution to “parental alienation” is not through the legal system. Any solution that relies on extended litigation to prove “parental alienation” in the legal system will fail. The legal system is far to expensive, takes far too long, and is far too easily manipulated by the narcissistic/(borderline) parent.

Family relationship problems, particularly parent-child relationship problems, need to be resolved within the mental health system.  The legal system needs to be able to rely on a single clear voice from ALL of mental health as to what is needed to resolve the family problems. The attachment-based model of “parental alienation” provides the solid bedrock of accepted and established psychological constructs and principles that can unite mental health into that single voice.

Paradigm Shift

A paradigm shift is needed in mental health, away from the failed paradigm of Gardnerian PAS to an attachment-based model of “parental alienation” that is based entirely within accepted and established psychological principles and constructs.

Note: I’m not saying Gardner’s model is wrong, it’s just inadequate to the task of solving “parental alienation.” In proposing the existence of a new “syndrome” defined by a set of anecdotal clinical indicators, Gardner too quickly abandoned the professional rigor imposed by standard and established clinical constructs and principles.  The attachment-based model of “parental alienation” returns to the basic clinical construct first identified by Gardner and applies the theoretical rigor necessary to define the construct entirely within standard and established psychological constructs and principles, thereby correcting the flaw in his approach that led to his construct of PAS being labeled as “junk science.”

There can be no such criticism of an attachment-based model since it meets the standards set by the critics of Gardner’s PAS model.  The attachment-based model of “parental alienation” is defined entirely within standard and established psychological constructs and principles.

A foundational paradigm shift is needed to a theoretical framework that is grounded on the solid bedrock of established psychological constructs and principles.  An attachment-based model of “parental alienation” accomplishes this.

The necessary paradigm shift in mental health is not an evolutionary progression from Gardnerian PAS into a new model, it is a revolutionary change in the foundational framework for conceptualizing “parental alienation.”  The Gardnerian model of PAS becomes irrelevant.

We used to think that the earth was the center of the universe and that the sun and all the planets circled the earth.  As we gathered knowledge, our scientific evidence then clearly indicated that the sun was the actual center of our solar system, and that the earth and the other planets circled the sun. Our paradigm for understanding the solar system shifted.  

Yet it took many years for the Catholic church to accept the change in paradigms. Once it emerges, a paradigm shift can nevertheless take a long time to actualize.  Thomas Kuhn, who described the model of paradigm shifts within science, said that the completion of the paradigm shift is accomplished when all the adherents to the old paradigm die. 

The next generation of young psychology and law students will likely be the ones who will carry the paradigm shift in “parental alienation” into professional psychology and the legal system.  The current experts in Gardnerian PAS will likely hold to their favored and familiar model, and the inertia within establishment mental health will simply ignore the attachment-based model for decades, until the current graduate students enter establishment psychology and law.

The solution to “parental alienation” is not to be found in the Gardnerian PAS paradigm. The Gardnerian model of PAS represents a failed paradigm.  In the thirty years since Gardner first proposed PAS we have achieved the current abysmal situation of failed solution.  For a variety of reasons, the solution to “parental alienation” cannot be found in the Gardnerian model of PAS.  It is a failed paradigm. I’m not saying it’s wrong, I’m saying it is inadequate to the task of actualizing a solution.

The solution to “parental alienation is located in a paradigm shift within professional psychology to an attachment-based model of “parental alienation.”  My estimate is that this paradigm shift will take about 10 to 15 years to enact.  The empowered activism of targeted parents may be able to reduce this time frame to a year or two, depending on how actively targeted parents advocate for the paradigm shift.

All of the constructs within an attachment-based model of “parental alienation” are established and accepted psychological constructs and principles, so the only barrier to the acceptance of this paradigm by establishment mental health is awareness.  The traditional approach to bringing this information into establishment mental health is through publication of professional papers in peer-reviewed journals.  If I were younger in my career, just starting out and wanting to build my professional reputation, and if the need for a solution weren’t so pressing, I might take this more gradual approach to building the information regarding an attachment-based model of “parental alienation” into the professional literature of establishment mental health.

But I’m not a young psychologist trying to establish my professional career, and the need for a solution is dire.  As for me, I’m 60 years old and I have already had one stroke.  I’m not sure how much longer I’ll be around.  Probably at most another 10 or 12 years before I leave or simply start winding down.  So if I were you, the community of targeted parents, I’d try to get this information into establishment mental health as quickly as possible in order to make as much use of me as you can while I’m still here. 

What I understand is that with every passing day the tragic nightmare of “parental alienation” continues.  A solution is already too long overdue.  Targeted parents and their children don’t have time to wait 10 or 15 years for establishment psychology to gradually accommodate to and adopt a new paradigm.  You need a solution today.

So when I began my journey to define the clinical phenomena of “parental alienation” entirely from within standard and established psychological constructs and principles, I decided to post material to my website as soon as it became available in my work, rather than delay it by writing for publication, and I’ve decided to write for this blog to make the information as broadly available as I possibly can as quickly as I possibly can, because I fully appreciate that the solution is needed yesterday.  With each day that passes the nightmare tragedy continues for targeted parents and their children.

Once I get this information up and out in the public domain, then I’ll return to write for publication.  But not now.  The solution is needed as soon as possible.

But ultimately, this is not my fight.  It’s your fight.  I can give you the tools and weapons, but you must enact the solution.  It is time to act into your power.  The foundational paradigm in mental health needs to change to allow the solution, which means we need to bring the awareness of establishment mental health to the attachment-based model for “parental alienation.” 

I have done my part.  The theoretical foundations are solid and accurate.  I have provided you with articles and essays, with a publicly available online seminar through the Masters Lecture Series of California Southern University, and with all of these blog posts.  There are no conceptual barriers to professional acceptance of an attachment-based model of “parental alienation,”  the theoretical foundations are strong. It is just a matter of awareness within the broader mental health and legal fields.

But an attachment-based model of “parental alienation” has no allies within establishment mental health.  I am a solitary voice.  Current Gardnerian experts in parental alienation will ignore an attachment-based model of “parental alienation” because it’s foreign to them and, ultimately, it will replace the Gardnerian model with which they have grown comfortable.  They’ve spent decades arguing in favor of the Gardnerian model of PAS.  They are experts in the Gardnerian model of PAS.  It is known, familiar, and comfortable.

And in a blink of an eye, the Gardnerian model of PAS will be replaced and will become irrelevant, and it will be replaced by something foreign and unknown to them.  It’s not an evolution of their favored Gardnerian model, it is a revolution that overthrows their favored, known, and familiar Gardnerian model of PAS. Where a moment before they were experts in “parental alienation,” now they become like everyone else, needing to learn a new model, a new paradigm.

But there are no arguments against the attachment-based model, because it’s accurate; it’s what “parental alienation” is.  So Gardnerians will simply ignore the attachment-based model of “parental alienation” and continue talking about how the sun circles the stationary earth, until they are eventually replaced by the next generation in professional psychology.

Nor does an attachment-based model of parental alienation have allies within establishment mental health. For the most part, establishment mental health simply doesn’t care about “parental alienation.”  In establishment mental health, “parental alienation” is simply a small pocket of limited professional interest surrounding child custody evaluations and high-conflict divorce.  The only people interested in “parental alienation” are those who advocate for Gardner’s PAS model, and they’re going to hold onto their PAS model and ignore the attachment-based model of “parental alienation,” and a pocket of opponents to PAS who question the scientific validity of Gardner’s paradigm.  If you’re not in one of these two pockets of professional interest, then the construct of “parental alienation” isn’t really much of a consideration.

Establishment mental health will simply lump an attachment-based model of “parental alienation” in with the Gardnerian PAS group without taking the time to understand the paradigm shift.  So an attachment-based model of “parental alienation” will generally be ignored by establishment mental health simply because they don’t care all that much.  That’s why the paradigm shift that will bring a solution to “parental alienation” will take between 10 to 15 years to achieve, because the attachment-based model of “parental alienation” that contains the solution will simply languish in obscurity because it has no allies to advocate for its acceptance.

So, you ask what you can do to be helpful?  I am a lone voice.  It would be helpful to have allies within the targeted parent community who will bring the awareness of establishment mental health to the existence of this new paradigm for understanding the construct of “parental alienation.”  The sooner it becomes accepted within establishment mental health, the sooner the solution to “parental alienation” becomes available.

Possible Suggestions

I might suggest the following:

1. Organize advocacy groups of targeted parents who are willing to contact leadership in professional mental health to increase awareness of an attachment-based model of “parental alienation.”  Send emails to the identified leadership in establishment mental health suggesting that they, 1) watch the online seminar available through the Masters Lecture Series of California Southern University, 2) read my blog posts, and 3) read the articles and essays on my website.  You might want to also attach an article or essay from my website, such as the Professional-to-Professional letter, or The Hostage Metaphor article, or the Reunification Therapy article.  Be gentle, be kind, but be relentless.  You’re fighting for your child and you’ve tolerated the professional incompetence of mental health far too long.  It is time that you demand professional competence from professional psychology.  Be kind, but be relentless.  Things must change within professional psychology.

2. Identify and create a list of leadership in professional mental health.

If I were to approach this task, I might look around the homepages of the American Psychological Association, along with various relevant divisions, such as Division 41: American Psychology-Law Society, Division 43: Society for Family Psychology, Division 53: Society of Clinical Child and Adolescent Psychology, Division 12: Society of Clinical Psychology, looking to identify the leadership of these groups and organizations.

I’d then google the names of the leadership to find email addresses, and I’d send them a brief and polite email suggesting that they watch the online seminar of Dr. Childress regarding a new attachment-based model for describing “parental alienation.”  It’s not Gardner.  It’s new.  It describes a model for understanding “parental alienation” from the perspective of the attachment system.  And attached is an article by Dr. Childress from his website, and you might want to follow up by checking out his blog, he has some very interesting pieces on “parental alienation” from an attachment system perspective on his blog.

I might also google State Psychological Associations, such as the Texas Psychological Association, the New York Psychological Association, the Ohio Psychological Association, the California Psychological Association, etc. and do the same thing, identify and google the leadership of these organizations to find email addresses, and then send them brief and polite emails promoting their awareness for the attachment-based model of “parental alienation.”

I might explore other professional associations, such as the Association of Family and Conciliation Courts and the American Academy of Psychiatry and the Law.  Psi Chi is an International Honor Society in Psychology for undergraduate and graduate students in psychology. They might be interested in a new attachment-based model of “parental alienation.  Identify and google the leadership to find email addresses, and send them a brief and polite email.

Google APA journals, such as Law and Human Behavior;  Couple and Family Psychology: Research and Practice;  Personality Disorders: Theory, Research, and Treatment;  Professional Psychology: Research and Practice;  Journal of Personality Disorders;  Child Maltreatment;  Journal of Family Studies;  Family Relations: Interdisciplinary Journal of Applied Family Studies;  Journal of Child and Family Studies;  Journal of Child Psychology and Psychiatry.  Identify and google the editors to find email addresses and send them a brief and polite email suggesting they watch the online seminar of Dr. Childress regarding an attachment-based model for “parental alienation.”

3. Begin a campaign of emailing the identified leadership in establishment psychology.  Not all at once, but pinging them regularly from time to time. Different people, pinging them now and then.  You have tolerated professional incompetence within mental health for far to long.  Things need to change.  But be kind and gentle, but also be relentless.

4. Email editors for various law reviews at university law schools, suggesting that they watch the online seminar on an attachment-based model of “parental alienation.” The hook for an article in a law school review is how changing the paradigm affects the presentation of “parental alienation” in court.  Instead of “parental alienation” the issue becomes “pathogenic parenting” and instead of a child custody issue the issue becomes one of child protection.  Students will be the ones who will most likely actualize the paradigm shift.

I think it would be interesting for a student bar association at a university law school to join with the Psi Chi honor society at the same university, or at another university, to host an online seminar or panel discussion on “The Changing Paradigm in Defining Parental Alienation in Family Law” or some such topic.  I suspect you might be able to find interest and energy in graduate student organizations.

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