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Dr. Childress' Response to Parent On Diagnosis

Re-blogged from:  

This is a weblog of Dr. Craig Childress, a licensed clinical psychologist. regarding the highly problematic family relationship process of parental alienation.

Dr. Childress Response to a Parent

On Diagnosis

I receive many requests for help and guidance.  When I am contacted, professional standards of practice prevent me from commenting on the specifics of an individual case.  However, the relationship dynamics involved with the pathogenic parenting of “parental alienation” processes are exceedingly similar across families, because they originate in the same type of parental psychopathology (a narcissistic personality disorder with borderline features decompensating into persecutory beliefs regarding the targeted/rejected parent’s abuse potential relative to the child).



Recently I received the following question from a parent, and I thought my response to this parent might be helpful to other parents (and to mental health professionals).
“Hello Dr. Childress, What assessment tools do you use to identify the possibility of a likely Parental Alienation Dynamic?  Would you need to interview the children?  Melissa”
Hello Melissa,
The assessment of "parental alienation" (i.e., pathogenic parenting) involves clinical interviews primarily with the child, but also with the targeted parent and child.  Additional interviews with the "alienating" parent can be helpful to confirm the diagnosis but are not necessary to making the diagnosis of "pathogenic parenting" associated with "parental alienation" processes.
Three separate symptom features are evident in the child's symptom display:
1:    Suppression of the normal range functioning of the child's attachment system relative to one parent.
2.   The presence of a specific set of narcissistic and borderline personality disorder features in the child's symptom display, involving:
a.)  "Splitting," in which the child views one parent as overly idealized and the other parent as overly devalued (see attached Appendix A: Splitting)
b.)  A grandiose judgment of a parent in which the child is in an elevated status position in the family hierarchy above that held by the targeted/rejected parent; 
c.)  A sense of entitlement in which the child feels justified in inflicting a retaliatory retribution on the targeted/rejected parent if the child's entitled expectations are not met to the child's satisfaction;
d.)  A haughty and arrogant attitude of contempt regarding the "fundamental human inadequacy" of the targeted/rejected parent; 
 e.) A complete absence of normal-range empathy and compassion for the feelings of the targeted/rejected parent;
3. An intransigently held, fixed and false belief system regarding the fundamental inadequacy of the targeted/rejected parent and/or the abuse potential (typically "emotional abuse") of the targeted/rejected parent.
If this specific set of 3 symptoms is present in the child's symptom display, the only possible origin of this particular symptom set is through induction.  This specific symptom set CANNOT originate authentically to the functioning of the child's nervous system.  This symptom set MUST be induced through pathogenic parenting - either from the distorted and aberrant parenting of the targeted/rejected parent, or from the distorted and aberrant parenting of the allied/idealized parent.  One way or the other, this symptom set only arises from being induced in the child through aberrant and distorted parenting practices.
The next diagnostic step is to rule-out pathogenic parenting emanating from the targeted/rejected parent.  This involves joint parent-child sessions in which the parenting behavior of the targeted/rejected parent, and the child's responses to the parenting behavior of the targeted/rejected parent, are clinically evaluated.
If the parenting behavior of the targeted/rejected parent is broadly normal range[1] (i.e., no evidence of alcoholism, chronic drug use, excessive anger dysregulation, domestic violence, severely distorted communication processes), so that the parenting behavior of the targeted/rejected parent could not reasonably account for the creation of the child's symptom constellation of the three specific features noted above, then the pathogenic parenting MUST be originating in the aberrant and distorted parenting of the other parent. 
There is no other alternative explanation for the presence of that specific set of symptoms displayed by the child.  That symptom set CANNOT arise endogenously to the authentic functioning of a child's nervous system. That specific set of symptoms MUST be induced through interpersonal processes - i.e., through pathogenic parenting emanating either from the targeted/rejected parent or from the allied/idealized parent.  If the targeted/rejected parent is not inducing that specific symptom set, then it MUST be induced by the allied/idealized parent.  There is no other alternative explanation regarding the origins of that specific child symptom set.
Diagnosis is made from clinical interviews with the child and targeted/rejected parent.  If the allied/idealized parent consents to clinical interviews, then these interviews can confirm the diagnosis, but they are not necessary to make the diagnosis.
Associated Clinical Signs:
Additional confirmatory symptoms are also typically present, and while not necessary for the diagnosis, these additional "associated clinical signs" can support the diagnosis:
1)   Listen to the Child:  The allied/pathological parent prominently evidences the phrase "...listen to the child..." - such as "I'm only listening to the child" -  "you [i.e., therapists, attorneys, etc.] should just listen to the child" - "why isn't anyone listening to the child."  This phrase by the allied/pathological parent comes from a need to empower the child, both to exploit the child’s expressed rejection for the other parent and also for a specific need to empower the child, originating from particular psychological dynamics with the allied/pathological parent.  An associated effort for empowering the child is the allied/pathological parent advocating that “the child should be allowed to decide” if he or she goes on visitations with the targeted/rejected parent.  The core issue is a need to empower the child.
2)   Exploiting the Child’s Symptoms:  An exploitation of the child's symptoms by the allied/pathological parent to limit, restrict, disrupt, and nullify the ability of the targeted/rejected parent to form a relationship with the child.
3)    Protecting the Child:  The allied/pathological parent prominently presents in the role as the "protector" of the child from the abuse (typically emotional abuse) of the targeted/rejected parent.  The need to "protect the child" can reach almost obsessional levels.
4)   Selective Parental Incompetence:  The allied/pathological parent presents as selectively incompetent, typically using the phrase "...what can I do, I can't make the child..." - for example; "I encourage the child to go on visitations with the other parent, but what can I do, I can't make the child go if the child doesn't want to go." - "I tell the child to cooperate with the other parent, but what can I do, I can't make the child be nice to the other parent.  I'm not there, how am I supposed to make the child be nice to the other parent?" The presence of this phrase has to do with the narcissistic exploitation of the child's symptoms.
5)  Justifying – “I know just how the child feels…”:  The selective incompetence of the allied/pathological parent is often accompanied by a statement of understanding for the child's hostility and rejection of the other parent - "I tell the child to be cooperative, but what can I do, I can't make the child be cooperative, I'm not there.  And, actually, I know just how the child feels.  The other parent acted just like that with me during our marriage."
6)  Typical Complaints: The typical complaints regarding the targeted/rejected parent are, 
  A)  too insensitive, the targeted/rejected parent doesn't “listen to the child;” 
  B)  too rigid, inflexible and controlling, the targeted/rejected parent always has to have things his (or her) way;
  C)  anger management issues, the targeted/rejected parent has anger management problems;
  D) too selfish and self-centered, combines doesn't listen to the child and always has to have things his or her own way.
7)   Disregard of Court Orders:  The allied/pathological parent displays a cavalier disregard for the authority of Court orders, so that the targeted/rejected parent must continually return to Court seeking enforcement of Court orders.  This represents the expression of narcissistic personality processes of the allied pathological parent.  Narcissists to not recognize (i.e., perceptually register) the construct of "authority" - only the power to compel.  For the narcissist, the construct of "authority" (such as the Court's authority) is synonymous with the "power to compel." If the Court does not compel, then the Court has no authority in the mind of the narcissist.
Appendix A: Splitting
Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder.  New York, NY: Guilford
Linehan on Splitting:
 “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; emphasis added)
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (Revised 4th ed.). Washington, DC: Author.
“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 – orexclusively bad, hateful, angry, destructive, rejecting, or worthless.”  (p. 813; emphasis added)
Borderline Personality Disorder Criterion 2:
“A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation” (p. 710; emphasis added)
Siegel, J.P. (2006). Dyadic splitting in partner relational disorders. Journal of Family Psychology, 20(3), 418–422.

“Splitting is an identified symptom of both borderline and narcissistic personality disorders.” (p. 419)
Watson P. J. and Biderman, M.D. (1993). Narcissistic personality inventory factors, splitting, and self-consciousness. Journal of Personality Assessment, 61 (1), 41-57.
“Splitting is often thought to be central to pathological narcissism” (p. 44)


[1] Consider normal-range parenting – not perfect parenting.  What type of parental behavior occurs in most typical homes?  Does this less than “perfect” parenting (i.e., typical parenting) result in the type of child reactions evidenced in the child’s symptom display?  Parents frequently become angry at children, set rules for children, deny children a favored toy or activity, and none of these parenting practices results in the child displays of total rejection and excessive hostility seen with “parental alienation” processes (e.g., the child’s haughty and arrogant attitude of contempt, verbal abuse, complete lack of empathy, and desire to completely sever the relationship with a parent).


4 comments:

  1. HOW DID CHILDREN OF DIVORCE GET STUCK WITH THE VISITATION PLAN THAT AFFORDS THEM ACCESS TO THEIR NON-RESIDENTIAL PARENT ONLY ONE NIGHT DURING THE WEEK AND EVERY OTHER WEEK-END?

    What is the research that supports such a schedule? Where is the data that confirms that such a plan is in the best interest of the child?

    Well, reader, you can spend your time from now until eternity researching the literature and YOU WILL NOT DISCOVER ANY SUPPORTING DATA for the typical visitation arrangement with the non-residential parent! The reality is that this arrangement is based solely on custom. And just like the short story, "The Lottery," in which the prizewinner is stoned to death, the message is that deeds and judgments are frequently arrived at based on nothing more than habit, fantasy, prejudice, and yes, on "junk science."

    This family therapist upholds the importance of both parents playing an active and substantial role in their children's lives----especially in situations when the parents are apart. In order to support the goal for each parent to provide a meaningfully and considerable involvement in the lives of their children, I affirm that the resolution to custody requires an arrangement for joint legal custody and physical custody that maximizes the time with the non-residential----with the optimal arrangement being 50-50, whenever practical. It is my professional opinion that the customary visitation arrangement for non-residential parents to visit every other weekend and one night during the week is not sufficient to maintain a consequential relationship with their children. Although I have heard matrimonial attorneys, children's attorneys, and judges assert that the child needs the consistency of the same residence, I deem this assumption to be nonsense. I cannot be convinced that the consistency with one's bed trumps consistency with a parent!

    Should the reader question how such an arrangement can be judiciously implemented which maximizes the child's time---even in a 50-50 arrangement----with the non-residential parent, I direct the reader to the book, Mom's House, Dads House, by the Isolina Ricci, PhD.

    Indeed, the research that we do have supports the serious consequences to children when the father, who is generally the non-residential parent, does not play a meaningful role in lives of his children. The book, Fatherneed, (2000) by Dr. Kyle Pruitt, summarizes the research at Yale University about the importance of fathers to their children. And another post on this page summarizes an extensive list of other research.

    Children of divorce or separation of their parents previously had each parent 100% of the time and obviously cannot have the same arrangement subsequent to their parents' separation. But it makes no sense to this family therapist that the result of parental separation is that the child is accorded only 20% time with one parent and 80% with the other. What rational person could possibly justify this?

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  2. FLORIDA TODAY - OPINION
    Written by Gordon E. Finley, Ph.D., Miami

    While I applaud columnist Paul Flemming for a sound review of the issues in Saturday’s “Alimony bill will be great — for lawyers,” his bottom-line conclusion is dead wrong.

    The proposed state alimony reform bill will reduce litigation, not increase litigation. A bit of history: For years, the divorce vultures (a.k.a., the Family Law Section of the Florida Bar) have conned the Florida Legislature into writing divorce legislation that maximizes litigation and thus maximizes their income. In part, they have accomplished this by maximizing judicial discretion, which in practice means endless conflict and, of course, endless paid litigation.

    No matter what they may say, the divorce vultures are interested only in one thing — maximizing their income.

    I can irrefutably demonstrate this point with Flemming’s own words: “Thomas Duggar, an attorney in Tallahassee and a member of the Florida Bar’s Family Law Section, said last week at a Tallahassee Bar Association meeting that the section has a $100,000 war chest to sway public opinion against the legislation.”

    Do your readers honestly believe they are spending all this money so they will lose income? The divorce vultures get the message in terms of what alimony reform will cost them — and save the children, fathers and mothers of divorce. I regret Mr. Flemming did not do the same.

    Full Disclosure: I am an alimony-paying divorced father of two young adult daughters and retired university divorce researcher with multiple research and scholarly publications on this topic.

    ReplyDelete
  3. "CHILDREN OF DIVORCE DESERVE FULL ACCESS TO BOTH PARENTS, WHENEVER POSSIBLE."
    Personally, I can’t find anyone willing to reject that statement publicly. It’s a fundamental truth. We now have a wealth of evidence demonstrating children are better off, in most situations, when they have something near equal time with each parent. So why are shared-parenting bills are being rejected throughout the country?

    Do legislators believe mothers are more important to children than fathers? For the most part, I don’t think so. Politicians are, however, under quite a bit of pressure from some very powerful anti-shared parenting special interests. Recently, we’ve seen these opponents contribute to shared-parenting bills failing to pass in South Dakota and Minnesota.

    Some would argue disappointments like those are clear signs that shared parenting legislation will not happen anytime soon. The opposite is true. The near victories in these states and others is an enormous indication politicians are beginning to understand the vast majority of American citizens believe children of divorce deserve equal access to both parents, whenever possible.

    In fact, South Dakota’s bill lost in a 21-13 Senate vote. That’s a swing of 5 senators. If merely 5 senators felt more pressure from South Dakotans than they did from special interests, South Dakota would have a shared parenting statute. We should commend the remaining politicians in South Dakota’s Senate for doing the right thing.

    In Minnesota … well, Minnesota is a travesty. That bill passed, and on May 24, 2012 Governor Mark Dayton vetoed it. Governor Dayton claimed that both sides made “compelling arguments,” but because the “ramifications” of the legislation were “uncertain,” he decided to single-handedly overrule the will of his constituents and their representatives. Mr. Governor, unless you are ending slavery or beginning women’s suffrage, you will likely never have the benefit of “certainty” in your political career. Again, we should praise the Minnesotan politicians who voted for the bill.

    Six people. Six people stopped two states from enacting shared parenting. Six people do not indicate shared parenting is a distant hope – they indicate profoundly that it is an imminent inevitability.

    Mike Haskell is a divorced dad, shared parenting supporter and practicing family law attorney in Grand Rapids, Michigan.

    ACFC is America's Shared Parenting Organization

    "CHILDREN NEED BOTH PARENTS"

    The members of the American Coalition for Fathers and Children dedicate ourselves to the creation of a family law system and public awareness which promotes equal rights for ALL parties affected by issues of the modern family.

    ACFC is challenging the current system of American family law and policy. Through a national system of local affiliates and in alliance with other pro-family and civil liberties groups, ACFC is shifting the public debate to the real causes of family dissolution.

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  4. PRO SE RIGHTS:
    Sims v. Aherns, 271 SW 720 (1925) ~ "The practice of law is an occupation of common right."

    Brotherhood of Trainmen v. Virginia ex rel. Virginia State Bar, 377 U.S. 1; v. Wainwright, 372 U.S. 335; Argersinger v. Hamlin, Sheriff 407 U.S. 425 ~ Litigants can be assisted by unlicensed laymen during judicial proceedings.

    Conley v. Gibson, 355 U.S. 41 at 48 (1957) ~ "Following the simple guide of rule 8(f) that all pleadings shall be so construed as to do substantial justice"... "The federal rules reject the approach that pleading is a game of skill in which one misstep by counsel may be decisive to the outcome and accept the principle that the purpose of pleading is to facilitate a proper decision on the merits." The court also cited Rule 8(f) FRCP, which holds that all pleadings shall be construed to do substantial justice.

    Davis v. Wechler, 263 U.S. 22, 24; Stromberb v. California, 283 U.S. 359; NAACP v. Alabama, 375 U.S. 449 ~ "The assertion of federal rights, when plainly and reasonably made, are not to be defeated under the name of local practice."

    Elmore v. McCammon (1986) 640 F. Supp. 905 ~ "... the right to file a lawsuit pro se is one of the most important rights under the constitution and laws."

    Federal Rules of Civil Procedures, Rule 17, 28 USCA "Next Friend" ~ A next friend is a person who represents someone who is unable to tend to his or her own interest.

    Haines v. Kerner, 404 U.S. 519 (1972) ~ "Allegations such as those asserted by petitioner, however inartfully pleaded, are sufficient"... "which we hold to less stringent standards than formal pleadings drafted by lawyers."

    Jenkins v. McKeithen, 395 U.S. 411, 421 (1959); Picking v. Pennsylvania R. Co., 151 Fed 2nd 240; Pucket v. Cox, 456 2nd 233 ~ Pro se pleadings are to be considered without regard to technicality; pro se litigants' pleadings are not to be held to the same high standards of perfection as lawyers.

    Maty v. Grasselli Chemical Co., 303 U.S. 197 (1938) ~ "Pleadings are intended to serve as a means of arriving at fair and just settlements of controversies between litigants. They should not raise barriers which prevent the achievement of that end. Proper pleading is important, but its importance consists in its effectiveness as a means to accomplish the end of a just judgment."

    NAACP v. Button, 371 U.S. 415); United Mineworkers of America v. Gibbs, 383 U.S. 715; and Johnson v. Avery, 89 S. Ct. 747 (1969) ~ Members of groups who are competent nonlawyers can assist other members of the group achieve the goals of the group in court without being charged with "unauthorized practice of law."

    Picking v. Pennsylvania Railway, 151 F.2d. 240, Third Circuit Court of Appeals ~ The plaintiff's civil rights pleading was 150 pages and described by a federal judge as "inept". Nevertheless, it was held "Where a plaintiff pleads pro se in a suit for protection of civil rights, the Court should endeavor to construe Plaintiff's Pleadings without regard to technicalities."

    Puckett v. Cox, 456 F. 2d 233 (1972) (6th Cir. USCA) ~ It was held that a pro se complaint requires a less stringent reading than one drafted by a lawyer per Justice Black in Conley v. Gibson (see case listed above, Pro Se Rights Section).

    Roadway Express v. Pipe, 447 U.S. 752 at 757 (1982) ~ "Due to sloth, inattention or desire to seize tactical advantage, lawyers have long engaged in dilatory practices... the glacial pace of much litigation breeds frustration with the Federal Courts and ultimately, disrespect for the law."

    Sherar v. Cullen, 481 F. 2d 946 (1973) ~ "There can be no sanction or penalty imposed upon one because of his exercise of Constitutional Rights."

    Schware v. Board of Examiners, United State Reports 353 U.S. pages 238, 239. ~ "The practice of law cannot be licensed by any state/State."

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