Court Consideration of Adolescent Wishes

I was recently asked a question by a targeted parent about the practice in some Courts of considering the wishes of an adolescent in custody placement decisions, and I’d like to share my response.

While I will explain my response in a lengthy post, it’s actually quite simple: 

At no time should the Court ever consider the wishes expressed by the child whenever there is spousal-parental conflict.

Pretty simple.  Now let me explain why.  There are two primary reasons.

First, the authenticity of the child’s expressed wishes may likely have been compromised by a “role-reversal” relationship with the allied and supposedly favored parent (who is likely seeking the admission of the child’s wishes for Court consideration).

Second, whenever there is spousal conflict, seeking the child’s input essentially triangulates the child into the spousal-parental conflict.  This is EXACTLY the WRONG thing to do.  Bad.  Bad.  Bad.  Extremely destructive.  It not only supports the pathology in the family, it actually fosters and creates pathology in the family and it will have extremely harmful effects on the child’s underneath psychology.  We DO NOT ever want to triangulate the child into the spousal conflict.  No. No. No.  Never.  I don’t care what the age of the child is.  Never.  No.

1. The Role-Reversal Relationship

One of the central concepts in understanding “parental alienation” is the role-reversal relationship.

In healthy child development, the child uses the parent as a “regulatory other” for the child’s emotional and psychological state.  When the child faces a developmental challenge that the child cannot independently master, the child emits “protest behaviors” that elicit the involvement of the parent who helps the child regain an emotionally and psychologically organized and regulated state.

The parent acts as an external “regulatory other” (also called a “regulatory object”) for the child.  In doing so, the parent “scaffolds” the building of the child’s own internal networks for self-regulation.  With the brain, we build what we use.  Every time we use a brain system it gets a little stronger, more sensitive, and more efficient through use-dependent changes.

In healthy child development, every time the parent acts as a “regulatory other” for the child by scaffolding the child’s state transition from a disorganized and dysregulated brain state (as manifested in disorganized and dysregulated behavior) back into an organized and well-regulated brain state (as manifested by calm and cooperative behavior) all of the brain networks and brain systems that were used in this transition process become stronger, more sensitive, and more efficient.  We build what we use.

Over multiple repetitions of these state transitions, the child’s own brain networks for making these transitions become stronger, more sensitive, and more efficient so that the child develops the internalized capacity for “self-regulation” without the need for the scaffolding support of the “regulatory other” of the parent.  Overall, this development of internalized self-regulatory capacity is called the child’s development of “self-structure.”

This is a very important construct… the development of the child’s own self-structure through the repeated scaffolding support provided to the child by the “regulatory other” role of the parent.

The parent’s role as a “regulatory other” for the child is extremely important for the healthy development of the child.  In fact, it is THE central role of parenting beyond providing basic food and safety.  By acting as a “regulatory other” for the child, the parent “scaffolds” the child’s internal development of healthy “self-structures” for the child’s independent self-organization and self-regulation.

One of the leading figures in attachment research, Alan Sroufe, describes this process.

“At first, they [caregivers] are almost solely responsible for maintaining smooth regulation.  They attend to the infant’s changes in alertness or discomfort and signs of need, imbuing primitive infant behaviors with meaning  In the typical course of events, caregivers quickly learn to “read” the infant and to provide care that keeps distress and arousal within reasonable limits.  And they do more.  By effectively engaging the infant and leading him or her to ever longer bouts of emotionally charged, but organized behavior, they provide the infant with critical training in regulation.”

“The movement toward self-regulation continues throughout the childhood years, as does a vital, though changing, role for caregivers.  During the toddler period, the child acquires beginning capacities for self-control, tolerance of moderate frustration, and a widening range of emotional reactions, including shame and, ultimately, pride and guilt.  Practicing self-regulation in a supportive context is crucial.  Emerging capacities are easily overwhelmed.  The caregiver must both allow the child to master those circumstances within their capacity and yet anticipate circumstances beyond the child’s ability, and help to restore equilibrium when the child is over-taxed.  Such “guided self-regulation” is the foundation for the genuine regulation that will follow.” (Sroufe, 2000, p. 71)

However, in a role-reversal relationship the normal roles for the parent and child are reversed, so that it is the parent who uses the child as a “regulatory object” for the parent’s emotional and psychological state.  This is extremely destructive to the child’s emotional and psychological development.  The parent is essentially robbing the child’s self-structure development to support the parent’s own inadequate self-structure.

In healthy child development, the parent empathizes with the child and responds in ways that keep the child in a regulated state, i.e., acts as a “regulatory other” for the child.  This scaffolds the healthy development of the underlying neurological networks in the child’s brain that are central to healthy self-structure development.

In a role-reversal relationship, this is reversed so that it is the child who empathizes with the parent and responds in ways that keep the parent in a regulated state.  The roles are reversed.  The parent becomes the child and the child fulfills the psychological parent-role for the psychologically infantile parent.  This is extremely destructive to the child’s healthy development of self-structure.

And this unhealthy role-reversal relationship will be passed on to future generations.  The child in a role-reversal relationship will have his or her self-structure development robbed by the parent to feed the parent’s own inadequate self-structure.  When this child grow up, this child-now-adult will have inadequate self-structure organization because it was robbed in it’s healthy development in order to feed the parent’s inadequate self-structure. 

So this child, now an adult, will repeat the role-reversal use of the child with his or her own children.  The child-now-adult will use his or her own children in a role-reversal relationship to feed the inadequate self-structure of the parent which had been robbed from the parent’s development during the parent’s childhood. 

The role-reversal relationship is a pathology that is passed on trans-generationally from one generation to the next.

And so it goes, from generation to generation.  Parents using their children to meet the emotional and psychological needs of the parent, rather than healthy child development in which the parent meets the emotional and psychological needs of the child.  Instead, in the pathology of the role-reversal relationship each generation of parents rob their children of their healthy childhood development to meet the inadequate childhood development of the parent who had been robbed of self-structure development in his or her own childhood with his or her own parent.

Key Construct:

In a healthy parent-child relationship, the child uses the parent as a “regulatory other” for the child’s emotional and psychological state. 

In a pathological role-reversal relationship, the parent uses the child as a “regulatory other” for the parent’s emotional and psychological state.

So, to turn now to the question of adolescents’ “independent” judgment;

For any child no matter the age who is engaged in a role-reversal relationship with a parent, the child’s capacity for “independent” judgment has been significantly compromised by both the severity and the specific nature of the pathology of the role-reversal relationship. 

Instead of a normal and healthy childhood development that would result in normal-range and healthy self-structure, the child’s psychological development has been severely compromised by the use of the child in the parent’s psychopathology to serve as a “regulatory object” for the parent’s own emotional and psychological needs.

If a child has experienced normal-range development then we may be willing to provide some consideration to the expressed wishes of an adolescent.  However, the development of a child in a role-reversal relationship with a parent has been severely distorted by the role-reversal relationship so that their judgment is significantly compromised.  The child’s expressed wishes no longer reflect the authenticity of the child, but are instead being used in the service of meeting the needs of the pathological parent. 

When the child is in a role-reversal relationship with the pathology of the parent in which the child is meeting the needs of the psychologically infantile parent, the child’s expressed wishes are no longer authentic to the child.

The analogy would be to a hostage situation.  In the case of a role-reversal relationship the child is a “psychological hostage” as a “regulatory object” to the needs of the pathological, inadequate, and psychologically infantile parent.

Would we consider the statements made by a hostage as being authentic while the hostage is still in the custody of the hostage taker?  Absolutely not.

The child is acting under psychological duress (whether the child realizes it or not). 

Would it be sufficient to ask the hostage, “Are you being influenced by anyone in making these statements?” while the hostage was still in the custody of the hostage taker?  Absolutely not.  Of course the hostage will say, “No, I’m not being influenced” to our question.

Imagine an American hostage held by Islamic terrorists.  The American makes a televised statement critical of American policies.  Would we believe that these statements made by the hostage while the hostage was still being held by the terrorists represented the authentic beliefs of the hostage, and weren’t being coerced and influenced by his captors?  Of course not. 

What if the Islamic terrorists allowed a newspaper reporter to ask the hostage, “Are you making these statements of your own free will, or are you being told what to say by your captors?”  and the hostage said, “I am making these statements of my own free will.  No one is telling me what to say.”  Would we then say, “Well, I guess that settles it, these are the hostage’s authentic beliefs.”  That would be just plain stupid beyond imagination.

The statements made by the hostage are under duress as long as the hostage is in the custody of the captors, even if it is under psychological duress.

In a role-reversal relationship, the child is a “psychological hostage” to the pathology of the parent.  The child is being “psychologically held” in a role-reversal relationship by the pathology of the parent to act as a “regulatory object” for the parent so that the pathology of the parent can feed off of the child’s self-structure development, robbing the child of self-structure to support the inadequate self-structure formation of the parent.

But to all external appearances, the child will appear to be in a hyper-bonded relationship with the allied and supposedly favored – but actually severely pathological – parent. 

Role-reversal relationships are extremely pathological. The inadequate self-structure of the parent is feeding off of the healthy self-structure of the child to the extreme detriment of the child’s healthy development. 

The child is being robbed of a normal and healthy childhood in the service of meeting the emotional and psychological needs of a pathological parent, who was robbed in his or her own childhood of healthy development. 

Parents feeding off of their children’s self-structure to support the parent’s own inadequate self-structure development is extremely pathological.

So when evaluating the statements made by a child of any age, a prominent “moderator variable” in our consideration needs to be the possible presence of a role-reversal relationship in which the child is being used by a pathological parent as a “regulatory other” to meet the emotional and psychological needs of the parent. 

Before considering the statements of any child, the question is whether the child is being held as a psychological hostage through the child’s use as a “regulatory other” to the pathology of the parent.

To all external appearances, the child will look like he or she is in a bonded relationship with the pathological parent.  But to a trained and expert eye, the role-reversal relationship is clearly evident in a variety of features.  Only an incompetent and ignorant psychologist will miss a role-reversal relationship and believe the superficial presentation of a bonded relationship. 

Unfortunately, many mental health professionals who work with children are incompetent and ignorant.

If a role-reversal relationship exists, this is extremely destructive to the child’s healthy emotional and psychological development, and if left untreated and unresolved the role-reversal relationship represents a continuing risk not only to the current child but to the development of future generations of his or her children as well, so that treatment and resolution of the pathology becomes imperative and child protection considerations become prominent concerns.

2. Triangulation of the Child

Whenever there is spousal conflict there arises a significant risk that the child will be “triangulated” into the spousal conflict.

Triangulating the child into the spousal conflict is extremely destructive for the child’s healthy emotional and psychological development.  We NEVER want to triangulate the child into the spousal conflict.  Never, never, never.  Under any circumstances.  Never.

The spousal conflict is a two-person event.  When the child is brought into the middle of it, either the child will be torn apart by allegiances to both parents, or the child will need to take sides in the spousal conflict.  Either way, it is extremely destructive to the child to be triangulated into the spousal conflict.  We want to keep children out of the middle of their parents’ conflict.

When the child does become triangulated into the spousal conflict, the direct goal of therapy is to untriangulate the child from the spousal conflict.

Whenever there is spousal conflict, the risk of pathologically triangulating the child into the spousal conflict is extreme.

If we ask the child or adolescent what they want, WE ARE TRIANGULATING THE CHILD INTO THE SPOUSAL CONFLICT!!!!!!

No. No. No. This is exactly what we DON’T want to do.

Furthermore, any hopes for therapy will be smashed.  Abandon all hope of successful therapy for the child’s well-being.  The Court has essentially inflicted the pathology onto the child. 

Under NO circumstances do we ever want to ask the child what the child wants when there is spousal conflict.  We are essentially asking the child to choose sides in the spousal conflict, and we are opening the door directly to the role-reversal use of the child by the parent to meet the parent’s emotional and psychological needs. Pathology, pathology, pathology.

If the Court is concerned about the child’s well-being, then the Court should appoint a psychologist to serve as the voice of the child’s healthy development.  But under no circumstances should we ask the child to choose sides in the spousal conflict.

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


Sroufe, L.A. (2000). Early relationships and the development of children. Infant Mental Health Journal, 21(1-2), 67-74.

Testimony by a Treating Therapist

I am sometimes asked by a treating therapist for a consultation regarding attachment-based “parental alienation.”  I have just added a handout to my website, near the top, regarding my thoughts on how a treating therapist might describe in Court testimony the issues surrounding attachment-based “parental alienation.”

A direct link to this handout is:

Testimony by a Treating Therapist

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

The Exclusion Demand as Independence

I received a Comment from a targeted parent to my Exclusion Demand post in which the targeted parent indicated that a prior therapist had justified the child’s “exclusion demand” rejection of the targeted parent as representing the child’s desire for independence. 

I want to address this (and any other therapist-offered justifications for the “exclusion demand”) as a separate blog post because I believe professional competence to be so incredibly important as a required expectation for all therapists working with children.

The suggestion by ANY therapist that the child’s “exclusion demand” represents even a remotely normal-range expression of emerging child independence is incredibly ignorant, and just plain stupid. Let me describe why:

Preparatory Foundation

First, there are a number of cultural factors that are involved in a consideration of this therapist suggestion that the “exclusion demand” represents the child’s seeking independence. The construct of independence is culturally defined and tends to be a more prominent construct in Northern European cultural values than in more collectivist cultures, such as Hispanics and Asian cultures. Furthermore, the construct of “independence” reflects a male-dominated value system rather than a more female-oriented value system that emphasizes mutual interdependence.

But let’s put all this entirely relevant information aside so we can get right the heart of the immense stupidity of suggesting that the “exclusion demand” represents the child’s normal-range (or even abnormal-range) seeking of independence.

1. Frequency

All children – 100% – must deal with issues of separation and independence (interdependence) from parents and the family of origin. If the “exclusion demand” was a normal-range expression of the child’s seeking independence, then we would expect to see this symptom in a vast number of normal-range children, since ALL children must deal with this issue. So we would expect to see millions of children expressing the “exclusion demand.”

Go to any park on a Saturday afternoon. How many children are demanding that their parents not attend their soccer or baseball games?  None.  Not a single child. Go to any school music performance by children, how many children are demanding that their parents not attend their school concert performance.  None.  Not a single child. Go to any high school football or basketball game, how many of the adolescent players are demanding that their parents not attend their game.  None.  Not a single adolescent.

And many of these families have significant pathology. Yet we NEVER see the “exclusion demand.”  Never.  Yet if the “exclusion demand” was an expression of the child’s independence and 100% of children need to address this issue, then we would expect to see millions of children expressing the “exclusion demand” but instead the rate of the “exclusion demand” in the normal (and abnormal) range population is 0%.

Furthermore, the developmental challenge of independence occurs in adolescence (Erikson), so we should NEVER see the “exclusion demand” prior to the age of 12.  And developmentally, adolescents do not express their emerging independence by excluding parents from public events. The most common way of establishing adolescent independence is through the increased frequency and intensity of angry exchanges between the adolescent and parent that psychologically highlights boundaries of self-autonomy. Go to any high school football or basketball game. How many players have demanded that their parents NOT attend the game.   None.  Not a single one. Yet all of the players are adolescents, and many of the families have significant pathology.

To suggest that the “exclusion demand” is an expression of the child’s seeking “independence” is just plain stupid.

2.  Healthy Child Development

Healthy children love their parents.  “Independence” – whatever that concept may mean – with regard to children and families is weird.  Children and families are inter-dependent.  Children are separate and independent, and they are involved and integrated into the family.  Healthy child development NEVER means the child’s rejecting a parent.

Normal adolescents express independence by causing conflicts that highlight psychological boundaries.  Normal adolescents express independence by withholding information about friends and activities from parents.  Normal adolescents express independence by socially different clothing or grooming choices, or by holding and expressing different values from their parents.

Children, even adolescent children, do not express independence by not loving a parent.  Not loving a parent is a symptom of extreme clinical concern

3.  Separation-Individuation

Furthermore, the primary model of “individuation” is Margaret Mahler’s from her direct research with children.  Mahler describes three component phases of separation-individuation, 1) the separation phase, 2) the depressive phase, and 3) the rapprochement phase.  In the separation phase the child seeks greater psychological independence by increasing angry exchanges with the parent.  This is followed by the depressive phase in which the child’s emotional expansiveness created by separation collapses in the child’s psychological isolation, which is then followed by the child’s return to the parent to repair the relationship with the parent (the rapprochement phase).

So if the “exclusion demand” represents the child’s seeking of independence, we would also expect to see the rapprochement phase in which the child seeks to repair the bond to the rejected parent.  But we NEVER see the child seeking to restore the parent-child bond following the “exclusion demand” symptom. Never.

4.  Independence from Whom?

If the “exclusion demand” is an expression of the child’s desire for independence, then the child should be expressing the symptom toward BOTH parents, since the child needs to separate and become independent from both parents (assuming the irrational belief in independence rather than the actual construct of healthy inter-dependence).

But wait. The child is already rejecting the targeted parent. So the child has a whole bunch of independence from the targeted parent.  If the child is seeking independence then the child should be displaying the “exclusion demand” symptom toward the bonded-parent not toward the parent the child is ALREADY separated from.

Why would the child need to separate from the parent the child is already separate from, but NOT from the parent the child isn’t separated from?

Why would telling a parent not to come to a music recital attended by every other child’s parent, represent “independence?”  Why would a parent sitting in the bleachers with all the other parents watching the child play sports at a public event reflect the child’s “independence?”

Stupid, stupid, stupid.

Stupid Reasons

Just because a therapist offers a “reason” doesn’t make the reason rational.

“Your child is excluding you from attending his baseball games because his horoscope has Jupiter in the house of Sagittarius.”

Is that a reason?  Yep.  Is it a stupid reason?  Yep.

“Your child is excluding you from attending her school Christmas play because she’s seeking independence.

Is that a reason?  No doubt.  Is it a stupid reason.  Absolutely.

The “exclusion demand” is nowhere near normal.  It’s not even close to abnormal.  The “exclusion demand” is a symptom of extreme pathology. When I hear this symptom my clinical concern immediately becomes a 10 on a 10-point scale.

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


The Exclusion Demand Symptom

It is beyond my comprehension how so many mental health professionals can entirely miss the extreme psychopathology involved in attachment-based “parental alienation.”  I am truly stunned.

Let me describe just one example, the “exclusion demand” symptom made by children, in which the child demands that the targeted parent no long attends the child’s events.

The Exclusion Demand:

Child: “I don’t want you to come to my baseball games (school open house, dance recital, school awards ceremony, etc.). I get too anxious.”

This “exclusion demand” by the child is often followed with a statement that the child wants the targeted parent to show “respect” for the child’s feelings and “boundaries.”

The “exclusion demand” is among the more common symptoms of pathology displayed by the child in attachment-based “parental alienation.”

Extremely Severe Psychopathology

The “exclusion demand” is a symptom of extreme psychopathology. It floors me how mental health professionals can act like this child symptom is anywhere near normal-range. So let me explain the psychopathology inherent to this symptom.

Normal-Range Children

A parent attending a child’s activity is entirely normal range and healthy. I recommend all parents everywhere attend their children’s school activities, sporting events, musical recitals, awards ceremonies, etc.

There is nothing, absolutely nothing, wrong or problematic about a parent attending a child’s event. Normal-range children are happy and excited when their parent attends an event of the child’s.

A child who becomes hyper-anxious and seeks to exclude a parent’s attendance at an event is demonstrating extremely pathological behavior of GREAT CLINICAL CONCERN.

There is no – NO – normal-range reason for this symptom display by a child. No normal-range child EVER displays this symptom. Never happens. Never.

The only thing that can produce this symptom is extreme psychopathology, either from the targeted-rejected parent or from the allied and supposedly favored parent. But under NO circumstances is this symptom EVER displayed by anything near normal-range children.

In evaluating this symptom, every mental health professional should consider a normal-range child’s response to a parent attending an event; excitement, joy, a feeling of being loved by the parent, a feeling of being special to the parent. This is normal.

So if this is normal, then when the child exhibits the “exclusion demand” symptom, this means that the child’s normal-range capacity for excitement and joy have been twisted into something unrecognizable as even remotely resembling excitement and joy. What type of pathology needs to be involved to twist a child’s normal-range capacity for excitement and joy into such a perversely distorted form?

So, if a child’s normal-range response to a parent attending the child’s event is to feel loved and wonderfully special by the parent, this means that the child’s normal-range capacity for feeling loved and special has also been twisted into a distorted and unrecognizable shape that rejects love that rejects feeling special. Let that sink in.

All children want their parents love. That’s normal. That’s healthy.

Unhealthy child development occurs when children DON’T feel that they are special and loved by their parents.

Unhealthy child development NEVER occurs because a child feels special and loved. Never.

So then how completely unhealthy is it for a child to display a symptom of REJECTING feeling special and loved? The child is displaying a symptom that, in itself, is the actual SOURCE-ORIGIN of childhood pathology. That is really twisted.

The source-origin of childhood pathology causes childhood psychopathology. But here, the child’s symptom is not an outcome of the source-origin of childhood pathology, the symptom itself IS the source-origin of childhood pathology. It’s as if the symptom is its own cause.  The symptom is caused by the absence of parental love, that is the symptom itself, the child’s rejection of parental love.  That is so weird and twisted.

The “exclusion demand” symptom is 180 degrees opposite of normal. It is so far away from normal-range that it is stunning to me that ANY mental health therapist can act like this symptom is even remotely understandable and acceptable.

It would be like a physician doing a medical exam and finding the child had no internal organs and responding, “Oh. Okay. So I guess this kid just doesn’t’ need internal organs.”

What?  Are you kidding me?   What human body doesn’t need internal organs?  That is so totally weird that the child doesn’t have internal organs. How is that even possible?  How is it possible to be alive and not have any internal organs?  That’s just extremely weird.

ALL normal-range children want their parents’ love.  All normal-range children want to feel special to their parents. All of them. Every single normal-range child on the planet.  All.

Pathological child development occurs because of the ABSENCE of parental love.

So how is it that the child is presenting as if this one child, among all the children on the planet, this one child does not want a parent’s love?  How is it that this one child doesn’t want to feel special to a parent?  Explain it to me.

The very fundamental core of children thrives on parental love. Children’s psychological development starves in the absence of parental love. Parental love is the very essence of healthy child development. And here we have a child REJECTING parental love. That is extraordinarily pathological and simply weird.

Yet many, many mental health professionals simply accept this extremely pathological symptom display by children as if it’s somehow understandable. It is bizarre.

No even remotely normal-range child rejects parental love. Ever. The child’s rejection of parental love is extremely weird and requires explanation. A therapist response of, “Okay, well I guess that’s just the way it is for this child” is not an explanation.  A therapist response of “What? Are you kidding me? You don’t want your mom to watch you play baseball. Wow, that’s really weird.” is a healthy therapist response reflecting an accurate understanding for child psychology and child development.

If child and family therapists are not completely stunned by this symptom then they need to re-set their understanding for what represents normal and what is abnormal child behavior.

Grumpy-angry kids, relatively normal.

Very active and annoying kids, relatively normal.

Shy and quiet kids, relatively normal.

Irresponsible kids who resist doing homework, relatively normal.

Kids who reject parental love, extremely weird.

Kids who are made hyper-anxious by their parents, extremely weird.

How can child and family therapists be so ignorant regarding normal and abnormal child development to accept as reasonable child symptoms of such extreme pathology? I am aghast at the level of professional ignorance.

Let me be clear on this to all mental health professionals, it is NOWHERE NEAR normal-range child behavior to reject a parent’s love. Not even close. It is extremely abnormal and pathological and requires an explanation.

Targeted Parent Pathology

A child symptom of such extreme pathology requires an explanation.

Maybe it’s a history of profound domestic violence by the targeted-rejected parent. Maybe the targeted-rejected parent sexually abused the child. Maybe the targeted rejected parent physically beats the child, screaming curses and insults at the child.

Okay, this is an explanation. This level of parental psychopathology by the targeted-rejected parent could account for the degree of pathology displayed by a child who makes an “exclusion demand” of a parent, “I don’t want you to attend my games (my awards ceremony, my play, my music recital, etc.).

So immediately these possibilities all become relevant domains for diagnostic consideration.

So the moment the therapist hears an “exclusion demand” the immediate thought of the therapist should be, “Uh-oh, this is very serious. We may be looking at severe child abuse here” not, “Hmm, okay, I guess that’s just the way this child is.”

If I hear this symptom from a child my seriousness alert response immediately maxes out at a 10 on a 10-point scale. There is no symptom I could hear that would give me more concern. An “exclusion demand” symptom is consistent with severe domestic violence exposure, incestuous sexual abuse of the child, or severe physical and emotional abuse of the child.

But wait… if the child is actually afraid of the parent’s violence then the child would likely be very reluctant to displease the parent because then the child would face retaliation from the hostile-aggressive parent. But with the “exclusion demand” the child is assertively demanding that the hostile-aggressive parent not attend events, thereby overtly displeasing the extremely hostile-aggressive parent. Yet if the targeted-rejected parent is actually extremely hostile and aggressive (the domestic violence and physical violence categories) then the child’s behavior would INCREASE the child’s exposure to possible hostile-aggressive retaliation by the targeted-rejected parent.

Making an “exclusion demand” toward a parent instead suggests that the child feels safe enough to be willing to displease the rejected parent without fearing retaliation. So an “exclusion demand” suggests that the targeted-rejected parent does not make the child anxious. But wait, the child is saying the reason for the “exclusion demand” is that the parent makes the child feel anxious. This is a very odd symptom that doesn’t make any sense whatsoever. This symptom keeps getting curiouser and curiouser the more I look at it.

What if the child actually feels excited by the presence of the targeted parent at the child’s events, consistent with the normal response of every normal-range child on the planet, but the child is then misinterpreting the feeling of “excitement” as “anxiety.”  That would make sense.

The child actually isn’t afraid of the targeted parent, so the child feels safe enough to displease the targeted parent without fear of retaliation. But the child is misinterpreting excitement as anxiety.  This explanation makes sense of what otherwise is a very odd constellation of features.

In any event, the child’s “exclusion demand” symptom is NOT fully consistent with exposure to severe domestic violence or physical abuse. It’s possible, but not likely. I would need to look for corroborating signs of exposure to domestic violence or physical child abuse. These could be a wide array of signs, among which might be:

  • A documented history of domestic violence or child abuse (not merely allegations by the allied and supposedly favored parent, although I wouldn’t dismiss these allegations outright, I’d just need ADDITIONAL evidence besides the allegations of the allied and supposedly favored parent)
  • A child display of over-anxiousness generally, such as toward me in our discussions, or with teachers, or in public generally.
  • Or perhaps the child may be evidencing an increased anger response to the child’s exposure to parental violence. Is the child getting in trouble at school for aggressive acts? Does the child assault siblings?
  • The age of the child. Younger children are more vulnerable, so child anxiety in response to the child’s exposure to domestic violence and physical child abuse would be more consistent with a 6-10 year old child than with a 12-16 year old adolescent. Not impossible, but less likely.
  • Especially for older children, I’d want to explore what the child fears the parent would do at the event.  Assault the child?  Really?  The child fears that the targeted parent is going to assault the child at the child’s music recital or school awards ceremony? Normal-range children NEVER fear parental violence at a school awards ceremony or dance recital. That would be a really odd belief system. How did the child acquire such a peculiar belief system? Has the targeted parent ever become violent at a child’s activity before? Perhaps assaulting opposing coaches at the child’s soccer game? Perhaps the targeted parent is a chronic alcoholic, and the child is afraid the parent will be overtly drunk at the event (but then the child’s reason will be expressed as “embarrassment” not “anxiety”).  Anything like that? Or is the child asserting that the child’s anxiety is a PTSD response to the child’s prior exposure to violence. Okay, what violence? Tell me what you’ve seen from this parent in the past? Beating and kicking the mother in drunken rages? Hitting and kicking the child? What’s the trauma the child has been exposed to that is producing a very serious PTSD response? It must be pretty severe if it has produced a PTSD response, so my seriousness alert response remains maxed out at a 10.

I’ll keep an ear open for other indicators of severe domestic violence and physical child abuse, but these two possibilities of domestic violence exposure and physical child abuse will fall slightly lower in my differential diagnosis considerations.

On the other hand, an “exclusion demand” would be consistent with incestuous sexual abuse of the child by the targeted-rejected parent. That’s a possibility. I am extremely concerned by this child symptom.

The incestuous sexual abuse of the child would account for the extreme level of distortion and pathology displayed by this extremely weird child symptom. Sexual abuse would also account for the absence of the child’s fear of retaliation because the parent is disgusting, NOT hostile-aggressive, and sexual abuse of the child would account for the strange combination of the child being anxious about being in the presence of the parent and yet also not fearful of retaliation from the parent for the child’s making an “exclusion demand.”

Sexual abuse of the child by the targeted rejected parent would account for the level and pattern of the extreme pathology.


The parental pathology that is creating the child’s extremely strange and highly concerning symptom is to be found in the parenting practices of the allied and supposedly favored parent.

In this case, the parental psychopathology would be a role-reversal relationship with the child in which the child is being used as a “regulatory other” by the pathology of the parent to regulate the parent’s own emotional and psychological state.

Uh-oh. This too is an extremely damaging psychopathology to the child’s healthy development. My seriousness alert response to a role-reversal relationship is in the 8-10 range.

In normal and healthy child development, the child uses the parent as a “regulatory other” to regulate the child’s emotional and psychological state.  This is healthy and this is entirely normal. At a neuro-biological level, this is what’s suppose to happen to wire up the child’s brain systems.

In a role-reversal relationship the parent uses the child as a “regulatory other” for the parent’s emotional and psychological state. This type of role-reversal is extremely pathological and will have a variety of extremely destructive impacts on the emotional and psychological development of the child.

If the “exclusion demand” symptom is the product of a role-reversal relationship with the allied and supposedly favored parent, then I am very concerned.

In the case of a role-reversal relationship, the child is emitting the “exclusion demand” in the child’s role as a “regulatory other” for the allied and supposedly favored parent, so that the origin of the child’s “exclusion demand” is the desire of the allied and supposedly favored parent for the child to reject the other parent, and the child is simply emitting the parentally desired child behavior as a means to keep the pathology of the parent in an organized and regulated state.

And if the child is emitting this highly pathological symptom involving a highly twisted distortion to the child’s expression of joy, and excitement, and feelings of being loved and special, then the child is likely emitting other rejection-type symptoms toward the targeted parent as a product of the child’s role of being used by the allied and supposedly favored parent as a “regulatory other” for the parent’s own emotional and psychological state.

Role-reversal relationships and parental use of the child as an external “regulatory object” for the emotional and psychological state of the parent are associated with a disorganized attachment classification.  Yikes.  This is getting very serious. Is there other evidence for the presence of a disorganized attachment within the family, such as a high degree of chaos and disorganization in family relationships following a divorce?

Disorganized attachment is associated with the development of narcissistic and borderline personality traits, so if the allied and supposedly favored parent has a disorganized attachment pattern, then they might also have borderline and narcissistic personality traits. Are there any signs of borderline or narcissistic traits with the allied and supposedly favored parent?

How is the targeted parent describing the marital history with the other parent, the parent who is supposedly favored by the child. Are these descriptions consistent with possible narcissistic or borderline traits with the allied and supposedly favored parent? The descriptions by the targeted parent are not definitive, but they might help to disconfirm the hypothesis if there is no reported description consistent with narcissistic or borderline traits in the allied and supposedly favored parent, and yet if there are descriptions by the targeted parent regarding the marital history with the other parent that are consistent with the other parent possibly having narcissistic or borderline personality traits then these parental descriptions by the targeted parent might contribute to an overall preponderance of clinical evidence supporting the role-reversal hypothesis.

Splitting. Splitting is a highly characteristic symptom of disorganized attachment and for narcissistic or borderline personality. Is there evidence of splitting? Does the child evidence polarized thinking of all-good and all-bad? Does the child believe that once a person is defined as being all-bad, as being fundamentally flawed, then that person will stay that way forever?

According to Marsha Linehan in describing the splitting dynamic evidenced by borderline personalities:

“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.” (Linehan, 1993, p. 35)

Does the child or allied and supposedly favored parent see the targeted parent as “abusive” without substantiating evidence for the allegation? The use of the term “abusive” is characteristic of a borderline personality organization.  The term “abusive” is rarely used by normal-range people (sometimes it is, typically in cases of authentic abuse).  Normal range people use words like mean, or insensitive, or rude.  Rarely “abusive.”  But borderline personalities often use the term “abusive” to describe other people.  It’s not definitive, but it’s suggestive.

How does the allied and supposedly favored parent describe the targeted parent? Are there indications of splitting into the all-bad characterization of the targeted parent in the descriptions of the targeted parent by the allied and supposedly favored parent?

If there is a narcissistic or borderline parent, then my seriousness alert response maxes out at a 10. Only sexual abuse of the child would cause me more clinical concern for the child’s emotional and psychological development than would parental narcissistic or borderline pathology.

Very Serious Pathology

One way or the other, the child’s symptom display of an “exclusion demand” is of extraordinarily serious clinical concern.

It may be evidence of the child’s sexual abuse victimization, of the child’s traumatic exposure to severe parental domestic violence, to prior severely traumatic physical and emotional abuse of the child, or of a highly pathological role-reversal relationship with a narcissistic/borderline parent that is producing severe psychopathology in the child.

My two primary differential diagnoses would be sexual abuse of the child by the targeted parent OR a role-reversal relationship with the allied and supposedly favored parent in which the child is being used by a narcissistic/borderline parent as an external “regulatory other” for the emotional and psychological state of the parent.

An “exclusion demand” symptom is NOWHERE NEAR normal range. It is highly pathological and REQUIRES an explanation.

That child and family therapists would act like this child symptom is anywhere near to being an understandable or reasonable child symptom is stunning to me.

When I hear the “exclusion demand” symptom, my level of clinical concern is immediately at a 10. An “exclusion demand” is among the most concerning symptoms I could possibly hear. If you are a child and family therapist and you are not equally as concerned by a child’s presentation of an “exclusion demand” symptom as I am, then I would question your competence to be working with children.

Craig Childress, Psy.D.
Psychologist, PSY 18857


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

Is Reunification Therapy a Defined Construct

I received a Comment response from Dr. Reay to my blog post “There is No Such Thing as Reunification Therapy,” and rather than my responding as a Comment I would like to respond as a separate blog post, since I believe the discussion surrounding a professional definition for the construct of “reunification therapy”  is important.

Comment from Dr. Reay:

Hi Dr. Childress

With all due respect, I am going to challenge your argument that there is no such thing as Reunification Therapy as well as some other arguments in your blog. Although I can’t speak for them, I will take the chance and assume that Dr. Randy Rand, Dr. Dierdre Rand, Dr. Richard Warshak, Dr. Douglas Darnall and Linda Gottlieb may not necessarily buy your argument either. It would be most interesting to find out their thoughts. I will send you a copy via private email on the Family Reflections Reunification model and program. This article has been peer-reviewed and accepted for publication in the American Journal of Family Therapy, Volume 43(2) this spring.

Dr. Kathleen M. Reay,
Founder & Clinical Director of the
Family Reflections Reunification Program Inc.

First, let me thank you Dr. Reay, for challenging my assertion.  If professional psychology is to conduct “reunification therapy” then a defined model is needed for what “reunification therapy” entails, so I welcome the opportunity to learn.  

You cite a set of professionals I would refer to as the Gardnerian PAS contingent (in contrast to the “DSMite” critics of the construct of “parental alienation”).  First, in my view the Gardnerian PAS model is woefully inadequate as a theoretical model for the development of a treatment approach. But let’s put that aside and look at the people you cite.

Dr. Warshak maintains that the “Family Bridges” program is psycho-educational, not psychotherapy, and while he touts the benefits of his intervention model, he has not presented the specifics of what the Family Bridges model is sufficiently for it to be reviewed as a model for psychotherapy. He says its good. I’ll trust him that its good. I just don’t know what it is at a level of specificity necessary for me to either evaluate it or replicate it as a model of psychotherapy.  And he says its psycho-educational not psychotherapy.

Linda Gottlieb’s approach is wonderful. She does family systems therapy. Family systems therapy is spot on the appropriate therapy model for addressing “parental alienation,” which essentially involves the child’s triangulation into the spousal conflict through the formation of a cross-generational coalition with a narcissistic/(borderline) parent. The addition of parental narcissistic/(borderline) psychopathology transmutes the family relationship processes into a particularly malignant and virulent form of cross-generational parent-child coalition that seeks to entirely terminate the other parent’s relationship with the child. Linda Gottlieb does family systems therapy. In common parlance she may describe what she does as “reunification therapy” but she then defines what “reunification therapy” is from within family systems constructs. The “reunification therapy” of Linda Gottlieb is family systems therapy. Its wonderful. Everyone should listen to Linda Gottlieb.

But let’s look at this a bit deeper. If, for example, we set a standard of practice for treating this “special population” of children and families that all therapists working with this “special population” need to be professionally familiar with the constructs of Structural Family Systems therapy, there is then a set of literature that sufficiently defines the constructs of Structural Family Systems therapy to allow us to hold these therapists accountable for knowing a certain domain of content.

If we make the same statement about “reunification therapy,” that all therapists treating this “special population” of children and families must be professionally familiar with the constructs of “reunification therapy,” where are these constructs of “reunification therapy” sufficiently defined so that we can hold therapists accountable for this content domain of knowledge?  That’s my point.

If therapists say they’re doing client-centered therapy, then there are constructs of self-actualization, empathy, genuiness, unconditional positive regard, false-self, conditions of worth, etc. that all become relevant to treatment.

If therapists say they’re doing object relations therapy then there are issues of self-object functions, mirroring, idealization, twinship, empathic failures, transmuting internalizations, etc.. that all become relevant to treatment.

If therapists say they’re doing Adlerian psychotherapy, then there are issues of inferiority and mastery, self-esteem threats, safeguarding strategies, lifestyles, etc. that all become relevant to treatment.

If therapists say they’re doing Gestalt therapy, then there are issues of contact, boundaries, awareness, the present moment, responsibility, empty chair techniques, etc. that all become relevant to treatment.

If therapists say they’re doing cognitive-behavioral therapy then there are constructs of schemas, irrational beliefs, cueing antecedants, contingency management, etc. that all become relevant to treatment.

Where are the principles relevant to “reunification therapy” described and defined? This isn’t a rhetorical question. I’ve looked and looked and I can’t find any.

Randy Rand, Dierdre Rand, and Douglas Darnall are also wonderful. They present strong arguments in support for the Gardnerian model of PAS. Unfortunately, while Gardner accurately identified the presence of an authentic clinical phenomenon, in my view he too quickly abandoned the professional rigor necessary for defining the clinical phenomenon he identified from within standard and established psychological principles and constructs. Instead, he proposed a “new syndrome” based on the child’s display of a set of anecdotal clinical indicators.

From my perspective as a clinical psychologist, “parental alienation” isn’t a “new syndrome,” it is simply a highly malignant form of the established family systems construct of the child’s triangulation into the spousal conflict through the formation of a cross-generational parent-child coalition against the other parent, referred to as a “rigid triangle” by Minuchin (1974, p. 102) and as a “perverse triangle” by Haley (1977, p. 37).

If anyone wants to argue that “parental alienation” represents a “new syndrome” I would argue that it is first incumbent upon them to describe why the defined and established family systems constructs of the child’s triangulation into the spousal conflict through the formation of a cross-generational coalition with one parent against the other parent do not adequately and better account for the child’s symptom display and family processes (that would include the family systems constructs of the emergence of pathological symptoms in response to inadequate accommodation of the family to a developmental transition, of homeostatic balance being maintained in a pathological family system by the function of the symptom, and of psychological boundary diffusion through an enmeshed parent-child relationship). 

I would even argue that some Strategic Family Systems constructs regarding power dynamics within the family relative to the function served by the symptom are highly relevant considerations.

In my view, family systems theory adequately accounts for the clinical symptom display traditionally referred to as “parental alienation.”  Add narcissistic/(borderline) personality pathology to the cross-generational parent-child coalition and we have the display of “severe parental alienation.”  Without the addition of narcissistic/(borderline) personality pathology we have the display of mild and moderate “parental alienation.”  Family systems theory adequately addresses the clinical phenomenon.

We don’t need a “new syndrome” to describe what “parental alienation” is. Nor do we even need the term “parental alienation.” The proper clinical term is “pathogenic parenting” (patho=pathological; genic=genesis, creation). Pathogenic parenting is the creation of significant psychopathology in the child through aberrant and distorted parenting practices. It is a construct most often used in reference to distortions to the child’s attachment system. The attachment system does not spontaneously dysfunction, it distorts only in response to pathogenic parenting practices.

Furthermore, I would argue that the central symptom associated with “parental alienation,” the child’s rejection of a relationship with a normal-range and affectionally available parent, represents a severe distortion to the normal-range functioning of the child’s attachment system. Why then are we looking to create a “new syndrome” rather than applying sufficient professional rigor to identifying what’s going on with the child’s attachment system?

So while Randy Rand, Dierdre Rand, and Douglas Darnall are all wonderful and powerful advocates for a PAS model of “parental alienation,” I think the PAS model represents a failed paradigm across a number of levels. It has been available for 30 years and has given us our current situation of no actualizable solution for the family tragedy of “parental alienation.” A fundamental paradigm shift is needed to a theoretically defined model of “parental alienation” that is based entirely within established psychological constructs and principles so that we can achieve an actualizable solution for targeted parents, and more importantly for the children. That’s what I’ve tried to accomplish with an attachment-based model for the construct of “parental alienation.”

And while Randy Rand, Dierdre Rand, and Douglas Darnall are all wonderful advocates for the PAS model, I have not found where they describe a model for what “reunification therapy” is.

I look forward with eager anticipation to learning of your definition for “reunification therapy” in your article due for publication this spring. Yay!  It is about time that someone defined the construct of “reunification therapy” with enough specificity to allow for professional critique and replication. I am optimistic that once we have your definition for the construct of “reunification therapy” then other therapists across the country who are interested in doing “reunification therapy” will be able to replicate your approach to conducting “reunification therapy.”

I realize there might be space limitations to a published article that may limit your ability to describe your model for “reunification therapy” in sufficient detail to fully allow for professional review, critique, and replication. If this is the case, then I await with eager anticipation the publication on your website of the specific protocol used in your model of “reunification therapy” that will allow for its professional review and replication by other therapists.

Until such time as somebody offers a specific description for what “reunification therapy” entails, however, I’m going to stand by my criticism of the construct as being absent any defined meaning.

If there is no definition for the meaning of a construct, then the construct is without meaning.

I know that my criticism as “snake oil” is harsh, but keep in mind the source for the metaphor.  In the late 1800’s “doctors” would travel around to local communities selling “medicine” for “what ails ya.”  When asked about the specific ingredients of their “patent medicine,” however, the salesmen would claim that the ingredients were a “trade secret” and couldn’t be disclosed, hence the term “snake oil” since the ingredients could be anything. 

If we don’t have a specific definition for what the construct of “reunification therapy” entails, then a therapist in North Carolina can make something up and call it “reunification therapy,” and a therapist in Arizona can make up something entirely different and call it “reunification therapy,” and a therapist in Oregon can make up a third different thing and call it “reunification therapy.”  The term “reunification therapy” then becomes a cover, a smokescreen, that allows therapists to make stuff up and do whatever they want, under the appearance to the general public of professional practice because they’re doing something called “reunification therapy.”

And as long as no one in mental health challenges this highly questionable professional practice of using the term “reunification therapy” which lacks defined meaning as a means of giving appearance to the general public of professional psychotherapy that lacks professional foundation in established psychological models of psychotherapy, then the term “reunification therapy” will continue to be presented to the general public as if it has meaning when, in truth, it is absent any defined meaning as a psychotherapeutic approach.

Kohut offers a coherent description for what object-relations therapy is. Rogers describes what client-centered therapy entails. Beck describes the components of cognitive-behavioral therapy.

Let’s say I’m going to teach my graduate students how to do “reunification therapy.”  What specifically do I teach them in order for them to know how to do “reunification therapy?”  Or say I have to supervise an intern in conducting “reunification therapy,” what principles and constructs are relevant to their work?  I know the answers to these questions for all the other models of psychotherapy.  But I can’t find any information defining the construct of “reunification therapy.”

I have searched and searched for the defined meaning of “reunification therapy” and found nothing but vague descriptions about “de-programming” the child based on assertions that the child is “brainwashed,” both of which are extraordinarily questionable and discomforting constructs in clinical psychology. None of the major theorists in psychology, Freud, Adler, Jung, Kohut, Winnicott, Bowlby, Fairburn, Rogers, Yalom, Perls, Frankl, May, Maslow, Skinner, Beck, Ellis, Minuchin, Haley, Bowen, Satir, Madanes, Berg, Parham, none of them discuss “brainwashing” and “deprogramming” as tenets of psychotherapy.

What school of psychotherapy does “reunification therapy” fit into?  Is it a psychoanalytic model?  Is it a cognitive-behavioral model?  Is it an entirely new school of psychotherapy?  Does it rely on family systems constructs for understanding the problem?  Does it rely on social constructionist principles?  How do the principles of “reunification therapy” fit with the principles of object relations therapy, or humanistic client centered therapy?  What are the overlaps?  What are the differences?

Suppose I had a graduate student or intern ask me these questions, what’s my answer? Before I can answer these questions I need someone who says they’re doing “reunification therapy” to describe for me what “reunification therapy” is.

I don’t think that’s too much to ask. If you’re going to use a term for a new category of psychotherapy, define the principles that are used in that new category of psychotherapy.  So it is with great anticipation and relief that I will finally learn from your upcoming article what the principles of “reunification therapy” are, so that these principles can then be used to define a standard of professional practice when therapists say they do “reunification therapy” similar to the standards we can apply when therapists say they do client-centered therapy, or object relations therapy, or cognitive behavioral therapy, or Gestalt therapy, or structural family systems therapy, or solution focused therapy.  I am glad we will finally have a defined model for what “reunification therapy” is.

I think the work of Richard Warshak, Randy Rand, Dierdre Rand, and Douglas Darnell is great, and everyone should listen to Linda Gottlieb. I also think that the PAS model, while a laudable effort by Richard Gardner, is insufficiently grounded in established psychological constructs and principles to serve as a foundation for creating an actualizable solution for targeted parents and their children. In my view, a paradigm shift is needed to a new model for defining the construct of “parental alienation” that is based entirely within standard and established psychological principles and constructs, and I’d recommend we base that new model in the attachment system since a child’s rejection of a relationship with a normal-range and affectionally available parent represents a profound distortion to the normal-range functioning of the child’s attachment system.  There is substantial evidence that the development of narcissistic and borderline personality processes are also related to distortions in the development of the attachment system, so that the potential transmission of attachment trauma from the childhood of the “alienating” parent to the current family relationships would seemingly provide a fruitful line of exploration.

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


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

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

There is No Such Thing as Reunification Therapy

Call me silly, but I tend to be a stickler for truth and accuracy. I just feel that the world is a better place when we base our discussions on things that are real rather than on fantasies that sound nice, but that don’t actually exist.

I’d love to own a unicorn, but they don’t actually exist. So having a discussion about whether I should buy a unicorn is pointless.

So let me be entirely clear on this, there is no such thing as “reunification therapy.”

There are psychoanalytic psychotherapies, such as Adlerian psychotherapy (Alfred Adler), object-relations psychotherapy (Kohut), and self-psychology (Stolorow & Atwood).

There are humanistic/existential therapies, such as Client-Centered therapy (Rogers) and Gestalt therapy (Perls).

There are cognitive-behavioral therapies, such as those described by Beck and Ellis.

There are family systems therapies, such as Structural family systems therapy (Minuchin) and Strategic family systems therapy (Haley and Madanes).

There are post-modern “social constructionist” therapies, such as Solution-Focused therapy (Berg) and Narrative therapy (Epson & White).

As a clinical psychologist, I am familiar with all these different types of actual psychotherapy.  I can describe how they define problems and treatment, and how they go about solving the problems faced by clients.  Not only is clinical psychotherapy my profession, I also teach models of psychotherapy to students at the graduate level, and I have provided clinical supervision and training to interns and post-doctoral fellows in the application of differing models of psychotherapy.  I know the various models of psychotherapy.

But nowhere, not in any book or article, is there any description or definition of this mythical construct of “reunification therapy.”

There is no such thing as “reunification therapy.”

If anyone ever says that they do “reunification therapy,” please ask them for a book or article that describes what “reunification therapy” is. They will not be able to provide you with any reference because none exists.

Doing something called “reunification therapy” sounds great. And I’d like to own a unicorn. But, unfortunately, neither unicorns nor “reunification therapy” exist.

Seeing as how I’m kind of attached to the concepts of truth and accuracy, I find it annoying that people toss around this phrase “reunification therapy” as though it had meaning. I most often hear this term in reference to Court-involved cases where the Court has perhaps ordered “reunification therapy.”

I am more tolerant of the Court’s use of this term, although I’d like mental health professionals to correct the Court at every opportunity that there is no such thing as “reunification therapy.”  I don’t expect legal professionals to understand the various types of psychotherapy, but when the Court uses this term it might as well simply order “therapy” since the term “reunification therapy” adds nothing additional to the basic concept of therapy.  Or perhaps if the Court wants to be more precise in its desires it could say “therapy that has as its goal the restoration of the positive parent-child bond.” But I’m willing to show tolerance for the legal system in the inaccurate use of therapeutic terminology.

It’s the mental health professionals who use this term that most irritate me. They should know better. They’re using the term “reunification therapy” as a junk phrase in which they can pretty much make things up as they go, and they offer a circular definition for what “reunification therapy” is:

Q: What is “reunification therapy?” 

A: It’s what I do.

Q: And what is it that you do? 

A: I do “reunification therapy?”

Q: Okay.  So then what is “reunification therapy?” 

A: It’s what I do.

Q: So what is it that you do when you do “reunification therapy?” 

A: When I’m doing “reunification therapy” then I’m reunifying people in therapy.

Q: And how do you go about reunifying people in therapy? 

A: By doing “reunification therapy.”

When a mental health professional uses the term “reunification therapy” it essentially amounts to selling the public a snake oil remedy. 

I am aware that this is an exceedingly harsh accusation, yet I challenge anyone in mental health to refute this accusation by providing any description of a model for what “reunification therapy” is.

If there is no description for what a term means, then the term has no meaning.

It is pointless to talk about unicorns if unicorns don’t exist.  It is pointless to talk about “reunification therapy” if “reunification therapy” doesn’t exist.  Therapists should say they are doing object-relations therapy, or cognitive-behavioral therapy, or family systems therapy, or any model of psychotherapy that actually exists.  At least then we will understand what they’re doing.  But they should STOP saying they’re doing “reunification therapy” as this is simply selling snake oil to the public.


Being the stickler for truth and accuracy that I am, I need to correct something I said earlier  When I said that there are no articles describing what “reunification therapy” is, that wasn’t exactly accurate.

There is one article that describes a model for “reunification therapy.”  I wrote it.  It’s up on my website (Childress Description of an Attachment-Based Model for Reunification Therapy).

This is the only article that currently exists that describes a model for what “reunification therapy” is. This definition for “reunification therapy” is based in an attachment-based model of “parental alienation,” so if any therapist claims to be doing “reunification therapy” then he or she should be using my model for “reunification therapy” which is based in an attachment-based model of “parental alienation.”

As the first person to define a model for what “reunification therapy” is, I call dibs on the label.

If you’re going to do “reunification therapy” then you have to use the Childress attachment-based model of “reunification therapy,” or else you have to define your own model for what “reunification therapy” is. But you are not allowed to sell people “unicorns” that are simply dogs, or cats, or gerbils, with pointy sticks taped to their heads.

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

Subjective Reality of the Narcissistic/(Borderline) Parent


Equivalence of Core Narcissistic and Borderline Personality Dynamics

Narcissistic and borderline personalities are variants of the same underlying core dynamics.  While their superficial presentations differ, both the narcissistic and the borderline personality have the same underlying core structures.

Narcissistic and borderline personality structures represent the coalesced product of the “internal working models,” or “schemas,” of the attachment system. 

The attachment system creates “internal working models” regarding expectations for self-in-relationship and other-in-relationship.  Within the attachment system for both the narcissistic and borderline personality structures, the internal working model for self-in-relationship is “I am fundamentally inadequate as a person” and the other-in-relationship expectation is that “I will be abandoned by the other because of my fundamental inadequacy.”

The difference between the narcissistic and borderline personalities is that the borderline personality experiences these core beliefs directly and continually, resulting in continually disorganized emotions and relationships, whereas the narcissistic personality is able to develop a psychological defense of narcissistic self-inflation that prevents the direct experience of self-inadequacy and fears of abandonment.  Instead, the narcissistic personality projects the self-inadequacy onto others, who the narcissist then devalues and rejects for their inadequacy.  Puncture the narcissistic defense, however, and the underlying borderline emotional disorganization becomes evident in hostile tirades of venom and vitriol.

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

“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.” (p. xiii)

Subjective Reality

For the narcissistic-borderline personality structure, truth and reality are fluid constructs that are subject to the ever changing emotional needs of the moment.

For both the narcissistic and borderline personality structure, regulating their intense emotional distress originating from their core sense of primal self-inadequacy and fear of abandonment takes precedence over external restrictions, even the external restrictions placed on them by truth and reality.  If they need truth or reality to be different in order to regulate their emotions, then they simply assert a different truth, a different reality.

“Narcissists are neither disposed to stick to objective facts or to restrict their actions within the boundaries of social custom or cooperative living… Free to wander in their private world of fiction, narcissists may lose touch with reality, lose their sense of proportion, and begin to think along peculiar and deviant lines.” (Millon, 2011, p. 415)

For the narcissistic/borderline personality, there is no objectivity to reality or truth. Reality and truth are subjective experiences that can change as the subjectivity of the narcissistic or borderline personality requires.  If the narcissistic/borderline personality requires the sky to be red, they simply assert the sky is red, and that becomes reality. If 10 minutes later they need the sky to be green,  they simply assert that the sky is green and that becomes reality.

For the narcissistic and borderline personality structure, “truth and reality are what I assert them to be.”

If we try to hold them accountable to a set and verifiable reality, the narcissistic/borderline personality will unleash a hostile assault of accusations, creating communication chaos with unrelated accusations, fabricated distortions, and flat denial of reality that follow so rapidly upon one another that the factual accuracy of any accusation or denial can’t be addressed.

The ability to assert whatever truth and reality is required in the moment thrives in chaos and dies in clarity. As long as chaos reigns, the narcissistic/borderline personality is free to assert and change reality and truth as needed.

Theodore Millon, one of the premier experts in personality disorders, describes the narcissistic propensity to dissolve into idiosyncratic thinking that is unconnected to reality,

“Were narcissists able to respect others, allow themselves to value others’ opinions, or see the world through others’ eyes, their tendency toward illusion and unreality might be checked or curtailed. Unfortunately, narcissists have learned to devalue others, not to trust their judgments, and to think of them as naïve and simpleminded. Thus, rather than question the correctness of their own beliefs they assume that the views of others are at fault. Hence, the more disagreement they have with others, the more convinced they are of their own superiority and the more isolated and alienated they are likely to become. These ideational difficulties are magnified further by their inability to participate skillfully in the give-and-take of shared social life… They are increasingly unable to assess situations objectively, thereby failing further to grasp why they have been rebuffed and misunderstood. Distressed by these repeated and perplexing social failures, they’re likely, at first, to become depressed and morose. However, true to their fashion, they will begin to elaborate new and fantastic rationales to account for their fate. But the more they conjecture and ruminate, the more they lose touch, distort, and perceive things that are not there. They may begin to be suspicious of others, to question their intentions, and to criticize them for ostensive deceptions…

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

Yet the narcissistic/borderline personality can superficially present well, so that the extent of their psychopathology goes unnoticed, even by mental health professionals.  According to Cohen (1998),

“The perception [of narcissism in a patient] is hampered by the fact that narcissistic individuals may well be intelligent, charming, and sometimes creative people who function effectively in their professional lives and in a range of social situations (Akhtar, 1992; Hendler, 1975)… While narcissism is recognized as a serious mental disorder, its manifestations may not be immediately recognized as pathological, even by persons in the helping professions, and its implications may remain unattended to. (p. 197)

Beck et al., (2004) note that narcissists can display “a deceptively warm demeanor” (p. 241) and Millon (2011) describes that “when not faced with humiliating or stressful situations, CENs [confident-egoistic-narcissists] convey a calm and self-assured quality in their social behavior. Their untroubled and self-satisfied air is viewed by some as a sign of confident equanimity” (p. 388-389).

The borderline personality can also present well superficially. The borderline style will present as a victim of cruelty from others that elicits a nurturing/protective response from unsophisticated mental health professionals.  As long as these mental health professionals do not challenge the constructed “reality” presented by the borderline personality, then these mental health professionals will be co-opted into becoming allies within the splitting dynamic of the borderline personality, and will be rewarded with displays of gratitude as the all-good wonderfully understanding and protective other within the borderline’s splitting dynamic. 

Being the idealized, all-wonderful, perfectly understanding and protective other can be quite seductive for the naive and unsophisticated mental health professional, who is by nature a helpng person.  But it represents a failure of professional knowledge and understanding in favor of the personal ego-gratification of the mental health professional.

The borderline personality is quite adept at presenting in the victim role to elicit protective nuturance from others.  A leading figure in personality disorders, Aaron Beck, notes that is is often difficult even in his own clinic to recognize the borderline personality presentation,

“Underdiagnosis constitutes a big problem that results in insufficient treatment. In many cases we saw, it took years of fruitless attempts to treat these patients before it became clear they were in fact suffering from BPD [borderline personality disorder].” (Beck et al., 2004, p. 196)

Special Population

The children and families evidencing attachment-based “parental alienation” represent a “special population” requiring specialized professional knowledge, training, and expertise to professionally diagnose and treat. 

Among the domains of knowledge necessary is a professional level of expertise regarding the presentation features and underlying dynamics of narcissistic and borderline personality structures.  Expertise in narcissistic and borderline personalities is not typical for most child and family therapists since personality disorders are an extremely rare presentation in children, and a rare presentation in parents. 

Child and family therapists tend to focus on the common disorders of childhood, child oppositional-defiant behavior, attention deficits and hyperactivity, autism-spectrum problems.  A professional level of expertise in narcissistic and borderline personality characteristic presentations and dynamics is typically not something most child and family mental health professionals possess. 

In most, if not nearly all, cases of typical child and family issues the therapist can trust that the reports of parents are within an acceptable range of truth and reality.  This assumption is not necessarily accurate when interacting with narcissistic and borderline personalities.  Mental health professionals working with this “special population” of children and families require specialized professional knowledge, training, and expertise related to narcissistic and borderline personality characteristics and dynamics so that they may be alert for the profound distortions of truth and reality associated with narcissistic/borderline personality processes.

In addition, narcissistic and borderline personality dynamics are not necessarily easily recognizable.  However, narcissistic and borderline personality dynamics are DIRECTLY RELEVANT to the diagnosis and treatment of attachment-based “parental alienation” so that these personality dynamics are directly relevant to professional competence with this “special population” of children and families.

Professionals who are diagnosing and treating attachment-based “parental alienation” require specialized professional knowledge, training, and expertise for professional competence with this “special population” of children and families, and one of the most important domains of specialized expertise is in the recognition of narcissistic and borderline personality dynamics within the family.

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


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

Cohen, O. (1998). Parental narcissism and the disengagement of the non-custodial father after divorce. Clinical Social Work Journal, 26, 195-215

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