Stupid Pathogen: Damaged Executive Function

Stupid Pathogen: Damaged Executive Function

The pathogen can’t reason.

The set of damaged information structures in the attachment system, damaged by childhood trauma, the pathogenic structures that are at the root of this family conflict pathology moving across generations, that pathogen shuts down frontal lobe “executive function” systems for logical reasoning, foresight, and planning.

That’s why I call it the “stupid pathogen” – I’m highlighting this symptom feature of the trauma pathogen, it’s inability to track logical reasoning.

The reason it’s unable to reason, is that unresolved trauma needs to alter reality in stressful situations in order for the person to remain emotionally and psychologically organized and regulated. If the trauma-impacted person doesn’t alter reality perception, then they’re going to collapse into painful psychological and emotional disorganization.

So the trauma-impacted brain alters reality perception as a coping response to stress. And reasoning, logical reasoning, gets in the way of that.

If the person needs to alter what reality is, then they can’t be held within the confines of structures like logical reasoning. So the brain inhibits the operation of these systems for reasoning. Have you ever watched Monty Python’s She’s a Witch? Logical reasoning is lost in trauma pathology.

As we’ve been resolving our trauma across historical generations, our reasoning is getting better (Childress & Pruter, 2019; deMause, 1974; Grille, 2013), look… the industrial revolution, the information revolution.

“I got better.”

But we’re still rippling trauma, and it’s captured by the symptom feature of ignorance. The trauma pathogen shuts down frontal lobe executive function systems for logical reasoning.

Ever say or hear this said to the allied parent:

“What do you mean you can’t “force” the child to xyz?  Can you “force” them to go to the dentist, can you “force” them go to school?”

That’s people responding to the “illogic symptom” of the trauma pathogen. I use it in my clinical interviews, the “illogic symptom,” it’s one of the symptom features of unresolved trauma – the inability to track a logical sequence; damaged frontal lobe, unresolved trauma.

The other thing the frontal areas of the brain do, the executive function systems, is they anticipate into the future – it’s the executive function systems that do all the “what if” scenarios needed to plan ahead.

That’s why 18-20 year old young people are okay with reasoning, their frontal lobes are mostly active, but it’s their anticipation, planning, and foresight that are still fragile until about 22-24. It’s a brain maturation thing… frontal lobes for reasoning and foresight-planning are the last to develop (Sapolsky)

A Web of Lies

The pathogen has three defenses, it hides, it seeks allies, and it attacks threat to put the threat of exposure on the defensive.

The pathogen lies.  All the time.

It fluidly “creates” its reality, remember what I just said about it needing to alter reality to remain regulated?  The pathogen lies – that’s it altering reality.  The point of my repeating “all the time” is to indicate that, yes, indeed, it is ALL the time… because it is a symptom feature of the pathology – the lies (distorting-altering reality).

It’s not actually “lies” so much, it is a symptom feature of delusional pathology, the continual fluidity and distortion to consensual reality… it constantly twists and distorts reality, that’s the impact of unresolved trauma.  It’s analogous to a “black hole” in the psychology of the person, we can’t see it directly but we can see its effects, its influence on surrounding gravitational bodies, it distorts reality.

The pathogen loves ignorance, that’s it’s ally.  It uses ignorance to hide.  Ignorance believes the lies.

The pathogen hates knowledge.  Knowledge knows reality, knowledge sees the lies.  The pathogen can’t understand knowledge, it’s reasoning systems are shut down.  The pathogen fears knowledge, it can’t understand knowledge.

The pathogen hates knowledge.  Ignorance is the ally of the pathogen.

And knowledge, then, becomes the anti-viral agent that cleanses the pathogen’s allies from the system.  When we require knowledge, the allies of the pathogen in professional psychology, the ones with their own unresolved trauma (called “counter-transference”), won’t be able to understand knowledge.  What will they do?

They will resist, and then they will flee.  The pathogen is timid, you see, it’s afraid.  It hides and savages because of its fear, it manipulates and controls, and it hides.  When it is exposed, however, when it is seen… it is afraid.  The allies of the pathogen will not stand their ground on ignorance, there is no ground to stand on.

Their frontal lobe reasoning systems are shut down… stupid pathogen… does she weigh as much as a duck?  When knowledge is required, ignorance will move on, into other cracks in the dark fabric of unresolved trauma.  But it will be gone from here.  We are cleansing the pathogen by cleansing ignorance from professional psychology.

We are standing on true, and just, and proper grounds, anchored in the established foundations of professional knowledge, Bowlby, Minuchin, Beck, van der Kolk, Tronick, anchored on the bedrock foundations of professional practice as codified in the Ethical Principles of Psychologists and Code of Conduct for the American Psychological Association (Standards 2.04, 2.01, 2.03, 9.01a, 3.04a, duty to protect, Principle D).

The allies of the pathogen will resist the application of knowledge… because learning knowledge is beyond their capability.  They only survive in a professional world were everyone makes up whatever they want.

Know and apply actual knowledge?  Uh-oh.  The pathogen-brain, a brain with unresolved trauma, can’t know knowledge…  the frontal lobes are not working.

That’s AB-PA.  It’s an anti-pathogen, anti-viral agent.  It’s entering the meme-scape (Dawkins) of professional psychology, it is designed to cleanse the allies of the pathogen (ignorance) from professional psychology… it’s knowledge… AB-PA… Foundations… is the application of knowledge.

No “made up” stuff – no “new theories” – no, stupid pathogen… it’s the application of knowledge.

Once ignorance is gone, and once knowledge is applied, the lies are exposed, truth and reality are fully evident, we stop the pathogen’s pathological manifestation of its unresolved trauma, and we fix things so the children can have their normal childhoods back.

Children need love from mom, lots and lots of mom-love, 100 mom-love – and children need love from dad, lots and lots of dad-love, 100 dad-love.

This is not complicated.  Diagnosing the pathology is incredibly easy… when we apply knowledge.

Ignorance will solve nothing.  I know.  Ignorance is an ally of the pathogen.  Of course, ignorance will solve nothing.  It wants nothing solved.

Ignorance is the pathogen’s ally.  The pathogen loves ignorance… and hates knowledge.

Changes.  Knowledge.

Well guess what’s on the way, stupid pathogen… knowledge.  Betcha didn’t see that one coming, did ya?  I know, damaged foresight and planning – not a clue as to what’s coming, no anticipation, very now-focused orientation.

A trauma-impacted brain that contains the pathogen-structures is very now-oriented, whatever works now, whatever needs to be said now, truth and reality are irrelevant – now, constantly regulating themselves now.

No frontal lobe for planning.  That’s why none of your families have treatment plans… no foresight or planning.

Written treatment plans require foresight and planning.  The pathogen-brain won’t be able to do that.  Unresolved trauma is inhibiting frontal lobe executive function systems for foresight and planning.

So… let’s start asking for written treatment plans.  That will be spot-on the vulnerability of a trauma-impacted pathogen brain, the ally of the pathogen.

The pathogen thinks this is “new theory” – that’s what it’s been playing for 40 years with the Gardnerian PAS “experts” – “new theory.”

Now it thought it had a “new theory” again – Dr. Childress (Gardner) and AB-PA (PAS).  I know, stupid pathogen.  Because you can’t reason, and you don’t have knowledge… because knowledge doesn’t make sense to you… too complicated, all that knowledge stuff… keep it simple.

That’s the pathogen-brain of unresolved trauma, damaged frontal lobe executive function systems for logical reasoning and foresight-planning.  What AB-PA does is inputs a… meme-structure… an intervention… a catalytic agent… that divides brains in professional psychology.

One set of psychology brains will see the knowledge and apply the knowledge.  AB-PA will be adopted by them, because they understand that there is no such thing as AB-PA, there is only knowledge, the scientifically established knowledge of professional psychology.  They know knowledge, they apply knowledge… that is an attachment-based model of “parental alienation” (pathogenic parenting surrounding divorce).

A second set of brains will be unable to learn and comprehend knowledge, Bowlby, Minuchin, Beck. These are the brains of ignorance, that make up things, that lack knowledge, that are the pathogen’s allies of ignorance in disabling the immune system response of professional psychology to a pathology-toxin of severe family conflict.

When ignorance is the “expert,” we are in the world of unresolved trauma… if she weighs as much as a duck, she’s a witch, the ignorance of trauma, damaged frontal lobe reasoning and executive function systems.  Truth and reality become fluid constructs, supposed knowledge housed in the anointed “experts” of special understanding, the “inquisitors” and “evaluators” judging human frailty.

Science is based on research.  Dr. Childress is not strong enough to leverage change in systems, no “new theory” provides solution.  With AB-PA, however, I stand on the shoulders of Galileo, Newton, Faraday, Darwin, Bohr, Bowlby, Beck, Tronick… science.

In the world of science, questions are answered… “What does the research say?” – then that’s the answer. 

Not what do “experts” say… that’s not science.  Opinions are all very interesting in that they might lead to research, but opinions are not relevant… what does the research say?  Even Einstein got it wrong sometimes (cosmological constant), everyone does, even Aristotle, even Issac Newton, even Freud, everyone.  We don’t do “expert” – we do science.  It’s called science.  We follow where the data and research leads.

What does the research say?  That’s the answer. Whatever the research says… that’s the answer to whatever the question is. That’s called science.  The scientifically established knowledge of professional psychology: Bowlby, Minuchin, Beck, van der Kolk, Tronick.

Returning from Complex Trauma

We’re cleansing professional psychology of the pathogen’s allies.  The pathogen uses their ignorance to hide beneath its lies.  Bye-bye.  Knowledge is required, as is planning and foresight, written treatment plans.

Stupid pathogen. It’s not “new theory” – it’s Dr. Childress.  I’m a clinical psychologist.  That’s all.  That’s enough.

A clinical psychologist knows everything there is to know about the pathology they work with… including you, stupid pathogen.  I see you as clear as day.  I know you’re afraid, nothing bad will happen, everything is going to be okay, for everyone.

Unresolved trauma rippling through generation; AB-PA.

The application of knowledge, Bowlby, Minuchin, Beck.

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

Monty Python: She’s a Witch

 

Read More –>

Narcissistic Parent booket cover

Phases of Immediate Solution

When Dr. Childress provides training to Child Protective Services, at that point we will have reached the end. That is the arc we are on. It will eventually result in ether Dr. Childress providing training to CPS, or if I’m not around, then the rest of clinical psychology will be providing training for Child Protective Services.

There are points along the path. The publication of Foundations was a substantial step forward along that path.  The presentation to the APA of the paper, Empathy, the Family, and the Core of Social Justice (Childress & Pruter, 2019) at the national APA convention represents another milestone point along the path.

Beginning the Journey to (Immediate) Solution

I had the structure of AB-PA by 2013, you can see that from my posts to my website: 

Childress, (2013) Reconceptualizing Parental Alienation: Parental Personality Disorder and the Trans-Generational Transmission of Attachment Trauma

Childress, (2013) Parental Alienation and Boundaries of Professional Competence

I didn’t think this knowledge would be used at the time, it was too early in the process. But one of the primary principles guiding my work throughout has been to make the information available as quickly as I had it.  If it can help one person, one family as we shift into system-wide solutions, then the knowledge and information is available.

Public Education Responsibilities

Part of our role as clinical psychologists is to provide the public with knowledge from professional psychology when that knowledge would be helpful for solving problems.

For example, in school-based clinical psychology (ADHD, learning disabilities, behavior problems) we are often in the role of educating teachers about the knowledge of professional psychology and interventions in the classroom. If we do an assessment and the child has a learning disability, autism-spectrum pathology, or ADHD-spectrum pathology, we explain the child’s difficulties to the parents, teachers, and school in language and ways they can understand, that will help the child receive the proper support and treatment. In our reports we provide specific recommendations for solutions that parents and teachers can use at home and in the classroom to reduce the child’s pathology and maximize the child’s development and education.

Take a look at my vitae (Childress Vitae). Toward the back you’ll see where I have all those preschool training seminars. That corresponds to my work at Children’s Hospital and the University of California Irvine (UCI), Child Development Center. I was out providing education seminars for preschool teachers on ADHD-spectrum issues in children, and solutions for the preschool-age child.

Who was paying me to do that? Not the preschools. Choc and UCI Child Development Center had grants from the state and county, and part of the grant money allowed me to provide training for preschool teachers on issues like school readiness, child development, functional behavioral analysis (FBA), and behavioral and attachment issues. Preschool age is a prominent age for attachment and separation issues.

I’m not the “AMAZING” Dr. Childress, “expert” in child development. I’m just a clinical psychologist doing what we all do, in our areas of knowledge. If a clinical psychologist works with eating disorders, they educate the public with whom they interact about eating disorders, same for a psychologist who works with schizophrenia, or autism, etc. That’s what we do, that’s part of our job.

Sometimes it’s one-on-one with a teacher, sometimes it’s in session with our specific client, sometimes it’s more general seminars for the public on our domain of pathology knowledge.  For me as a school-oriented clinical psychologist, I provided seminars for teachers or the PTA (parents).  I once provided a day-long seminar arranged through the UCI Child Development Center (Dr. Swanson) for all of the county’s Head Start teachers.  Several  years later, while in private practice, I provided a seminar for all the summer camp counselors for Los Angeles county, several hundred summer counselors, on handling and responding to autism-spectrum pathology in children.  

That’s what clinical psychologists do.  Commonly.  We educate, about pathology, about solutions.

We’re not “experts” – we’re clinical psychologists. We have knowledge, we apply knowledge, that’s what we do. Most of the time, no one notices us. We work with the client child and parents, in our office, confidential, no one sees… we change things by applying knowledge.

What knowledge? Anything we need. We know everything about the pathology we’re working with, and if we shift pathologies, we learn everything there is to know about the new pathology. That’s called “boundaries of competence” – the “boundary” is knowing everything about that pathology. Everything.

Knowledge & Boundaries of Competence

On my Vitae, you can see when I expanded into early childhood and attachment I took additional training in diagnosis and treatments related to early childhood mental health, and an additional seminar series from Fielding Graduate University in infant psychology.  I was already a clinical psychologist working with ADHD and autism, and when I expanded to early childhood more generally, I sought out additional training.  You can see it on my vitae.

If a clinical psychologist is working with a pathology, that clinical psychologist knows everything there is to know about that pathology.  That’s called standard of practice for a clinical psychologist.

That’s what I find so amusing and frightening about these people calling themselves “experts” over here in forensic psychology.  If they know everything there is to know about the complex attachment-trauma family systems personality disorder pathology they are involved with, then they have just reached the ground foundational level of a clinical psychologist.

Hi.  Glad to see you.  I’ve been waiting to have a discussion about the epigenetic transfer of a fear-organized brain from trauma instead of a healthy brain organized by healthier attachment bonding motivations.  And I’ve been dying to discuss the hyper-aroused intersubjective field from selective affective attunement and misattunement, the child as a regulatory object, and the child’s disordered emotional regulation during the breach-and-repair sequence.  Clearly this is a cross-generational coalition and emotional cutoff from multigenerational trauma, in which unresolved parental anxiety from childhood trauma is intruding into and overwhelming the child’s psychological boundaries, creating the enmeshed over-involved relationship that is compensated for by the emotional cutoff.

Perry, Sapolsky, Stern, Tronick, Minuchin, Bowen.

That discussion would be basic competence for a clinical psychologist.  Over here in forensic psychology, those sentences are like speaking Martian to another professional.  Parents shouldn’t understand what I just said and engage me in professional dialogue on each of those three points (there are only three points in all of that, one for each sentence).  Nor should legal professionals necessarily know what I just said and be able to engage in professional dialogue about those three issues.

But every single mental health professional working with this pathology should absolutely understand the full meaning and impact of all three issues raised by that paragraph, and should be able to dialogue about each one at a professional level.

Number four is, to what degree is the delusional pathology related to disorganized attachment pathology in the parent?  There’s four issues that should be easily conversant for the clinical psychologist.

If the “expert” knows everything there is to know about attachment, and trauma, and family systems therapy, and personality pathology, and the neuro-development of the brain in the parent-child relationship, then… they have reached the standard level of a clinical psychologist working with that pathology. 

So on a scale of 1-to-100, if a clinical psychologist knows 99-100, everything there is to know about the pathology… what’s the rating for an “expert” over here in forensic psychology?

From what I’ve seen, it’s about 0-to-5.  Seriously, that is what I see.  I see a lot of made up stuff, no actually grounded application of knowledge.

But the “experts” are claiming some sort of superior special “knowledge” beyond everything there is to know in multiple domains of psychology (attachment, family systems therapy, personality disorders, complex trauma, the neuro-development of the brain; Bowlby, Minuchin, Beck, van der Kolk, Tronick).  Yet they don’t even actually apply any of the existing knowledge of professional psychology. 

And they are supposedly the “experts” in the pathology.  A truly remarkable phenomenon of the social distribution of narcissistic pathology when ignorance becomes the “expert.”

In ADHD, Russell Barkley, Keith Conners, and Jim Swanson would all be considered preeminent “experts” – but it is others who look to them in that role, they don’t claim to be “experts” – we, the rest of us, see it in their body of work.  They are the producers of the knowledge through their research, often clinical research, and yet we all know exactly the same knowledge – every one of us knows the same knowledge.  We’re clinical psychologists working with ADHD, we know everything there is to know about the pathology, the recognized preeminent figures are the ones generating knowledge, we all know the same knowledge, we learn, we apply, we all know the same knowledge.

We, clinical psychologists, also rely heavily on the research, that’s why we basically know the same knowledge across all clinical psychologists working with any given pathology. We learn everything there is to know, then we read journals to stay current. That’s true of the clinical psychologists working with eating disorders, or autism, or attachment pathology, or ADHD. That’s considered standard of practice.

It’s been a while since I was directly involved with autism, but back in the day I would have considered Stanley Greenspan (Floor Time) the preeminent “expert” among many. Autism clinical psychology relies heavily, heavily, on research knowledge. I studied directly with Dr. Greenspan.  You see that DMIC diagnostic system on my vitae?  That’s from Dr. Greenspan and the Interdisciplinary Council.  For DMIC diagnostic training, I went back to Virginia for a 4-day series of training seminars in that early childhood diagnostic system.  

The DMIC is way more sensitive to autism-spectrum symptom features than the DSM-IV back then, but the DSM-5 revision caught up to some degree, I like the direction of the DSM-5 revisions to the autism-spectrum diagnosis.  The other early childhood diagnostic system on my vitae, the DC:0-3, is wonderfully sensitive to attachment symptoms and features.  It’s become established as THE early childhood diagnostic system for clinical care.  For billing purposes the DSM-5/ICD-10 system remains required, but the DC:0-3 is the clinical care diagnostic system for early childhood (attachment-spectrum pathology).

When we work with a pathology, a clinical psychologist knows everything there is to know about that pathology.  Everything.  Everything.  That’s called the boundary of our competence… everything there is to know, that is the boundary.  When we reach everything, then we reach the boundary and are now competent with that pathology.

In trauma, the recognized “experts” are Bruce Perry and John Briere for death-trauma and Bessel van der Kolk for complex trauma (relationship-based trauma in childhood). Death-oriented trauma is when the nervous system becomes overwhelmed by fear and arousal.  That’s from community violence or combat exposure, or rape. Perry and Briere are the leading figures there.  Then there’s a second type of trauma where the nervous system never becomes overwhelmed by fear, but is always bathed in constant unrelenting stress and fear.  That’s called “complex trauma” and the leading figure in complex trauma is Bessel van der Kolk.  I am a huge-huge fan of van der Kolk in childhood trauma.

When I was Clinical Director for an early childhood assessment and treatment center, our clinical staff participated in a three-day online seminar with Bruce Perry on trauma.  Remarkable.  His work on full trauma is remarkable, spot-on.  Briere is wonderful, I am fully in line with Bruce Perry for trauma.

Yet we all know the same knowledge, they are leaders in finding that knowledge. They share it.  We learn it. We use it.  We teach it.  The scientifically established knowledge is what it is.

We could consider the leaders in finding the knowledge, Perry, Briere, van der Kolk in trauma; Barkley, Connors, Swanson for ADHD; Bowlby, Ainsworth, Sroufe for attachment; Minuchin, Bowen, Madanes in family systems therapy; Kernberg, Beck, and Millon in personality disorders, they could be considered the “experts” in their respective fields because they generate the scientifically established knowledge… but we all know the same knowledge, and we all apply the same knowledge, the scientifically established knowledge of professional psychology.

Through scientifically grounded research, they find knowledge and share knowledge, we learn knowledge and we apply knowledge.  Everyone knows the same knowledge in whatever field we work, and we always know everything there is to know about the pathology, that is the entry into professional competence in working with that pathology.

So the knowledge of professional psychology moves from its source in the scientific research out into application through the clinical psychologist.  They find it in research, we apply it in practice.

In personality disorders, it is absolutely start with Otto Kernberg (depth), that’s what I Kernberg book coverwas told by Dr. Schfranske when I entered personality disorders, that’s what I would tell a post-doc entering personality disorders – start with Kernberg.  Then expand to Theodore Millon (descriptions), Aaron Beck (models), and Marsha Linehan (treatment). All four are essential, each has a different orientation, they blend into a comprehensive understanding of “personality disorder” pathology.  I put quotes around “personality disorder.”  

With the pathology, you’ll also want to know the Dark Triad personality.

Paulhus, D. L., & Williams, K. M. (2002). The dark Triad of Personality: Narcissism, Machiavellianism, and Psychopathy. Journal of Research in Personality, 36, 556–563.

“First cited by Paulhus and Williams (2002), the Dark Triad refers to a set of three distinct but related antisocial personality traits: Machiavellianism, narcissism, and psychopathy. Each of the Dark Triad traits is associated with feelings of superiority and privilege. This, coupled with a lack of remorse and empathy, often leads individuals high in these socially malevolent traits to exploit others for their own personal gain.” (Giammarco & Vernon, 2014, p. 23)

Personality disorders as a separate pathology are going away.  They almost went away with the DSM-5.  The research is identifying “personality disorders” as trauma-related pathology, particularly complex trauma attachment-related pathology.

For attachment pathology, the grand-god is John Bowlby.  The grand-pantheon of clinical psychology is Freud, Beck, and Bowlby.  My personal pantheon is Stern (neuro-development), Ainsworth (attachment research), and Minuchin (family systems therapy).

Bowlby has three volumes, Attachment, Separation, and Loss.  For me, Mary Ainsworth symbolically represents all of the research handbook of attachmenton the attachment system from the past 50 years.  There is substantial research on the attachment system, it is one of the best research data sets in professional psychology, rivaling autism and surpassing ADHD in my opinion.  The attachment research even extends down to the neuro-biological level (right prefrontal orbital cortex; Shore). 

The central organizing book for the research information is the Handbook of Attachment: Theory, Research, and Clinical Application.  If I was training a post-doc in attachment, this is the book I would assign the post-doc to read.  For a post-doc under my supervision, I would require all of the book (it’s a thick book) and about 20 additional articles I’d select, for a pre-doctoral intern, I’d assign three or four chapters from this book and two articles if the intern was working with attachment pathology under my supervision.

But that is definitely not all that’s needed from attachment.  Fonagy is must, Stern is a must, Tronick is a must, Sroufe’s longitudinal research is a must… all four… must know.  Siegel, The Developing Mind: How Relationships and the Developing MindBrain Interact to Shape Who We Are is an entry book.  Siegel is not the direct line researcher (Stern, Tronick, Shore, Trevarthan, others) but he pulled all of the knowledge into one organized book place.

We all know what each other knows.  Research.  It is all based on the scientific research.  Some, like Ainsworth and Stern and Tronick, generate the research, some like Siegel and Shore organize the research into single location books.  The rest of clinical psychology learns and applies the research when working with the pathology, any pathology, all pathology.

That’s how clinical psychology works throughout all of the rest of professional psychology… except here, in court-involved forensic psychology, a “special” type of psychology.  

When a clinical psychologist is working a pathology, that psychologist knows everything there is to know about that pathology… everything.  That is called the “boundary” of our competence – knowing everything about the pathology.  Once we reach everything we cross the boundary into competence.

Everything.  Then we read journals to stay current. That is the boundary.  If that is true, then you are competent to practice with that pathology.  If that is not yet true, then you are not yet competent to practice with that pathology and you need to learn more until that becomes true – know everything.

APA Ethics Code
Standard 2.01 Boundaries of Competence 
(c) Psychologists planning to provide services, teach, or conduct research involving populations, areas, techniques, or technologies new to them undertake relevant education, training, supervised experience, consultation, or study.

That’s why you will typically not see clinical psychologists with a very wide spread of treatment specialties, because we need to know EVERYTHING about the pathology in order to add it to our competence… everything = basic competence.  If you don’t know everything, then you need to “undertake relevant education, training, supervised experience, consultation, or study” – that’s not optional, that’s required, mandatory.

The APA ethics code is not optional for psychologists.  Mandatory, required.

What’s pretty “special” over here in forensic psychology are the huge number of “experts” of all hues and shades.   Positively awash in “experts” and entirely absent of applied knowledge, a remarkable phenomenon.  Rather than knowing everything about a pathology being standard of practice for professional competence, instead we have “experts” describing ideas without any research foundation to support them. It’s a loose definition of “knowledge” that’s not linked to any actual reality.

From everything I see as a clinical psychologist, the “experts” here in forensic psychology are actually ignorant.  That is not a personal criticism, that’s simply language.

Google search: ignorant ADJECTIVE
1. lacking knowledge or awareness in general; uneducated or unsophisticated.
2. lacking knowledge, information, or awareness about a particular thing.

The glaring absence of knowledge is in family systems therapy.  Attachment is another area of complete ignorance.  Again, that’s language.

Google search: ignorance NOUN
1. lack of knowledge or information.

The neuro-development of the brain in the parent-child relationship is another area of complete ignorance (language: a complete lack of knowledge and information).

Complex trauma is still another area of near-complete ignorance, and even for personality disorders there is only marginal knowledge only occasionally displayed.

In order to be competent with complex family conflict surrounding divorce, the mental health professional must be knowledgeable in five areas of professional psychology (i.e., know everything), 1) attachment, 2) family systems therapy, 3) personality disorders, 4) complex trauma, 5) the neuro-development of the brain in the parent-child relationship.

Bowlby – Minuchin – Beck – van der Kolk – Tronick.

Yet none of the mental health professionals here in forensic psychology possess all five domains of required knowledge, and most of them possess none of the necessary knowledge… zero.  They are, by definition, ignorant… and yet they self-assert that they are “experts.”  I fell down the rabbit hole into Wonderland, a world where ignorance is the “expertise.”

So, the “experts” who are claiming to be an “expert” when I am identifying merely as a clinical psychologist (Bowlby, Minuchin, Beck are “experts” if anyone is), these “experts” here in forensic psychology are claiming that they know more about court-involved complex family conflict pathology than Dr. Childress… who is simply a clinical psychologist, and that they are at some higher top-tier echelon of professional psychology, the level of Bowlby, Minuchin, Beck, Kohut, Rogers, Bowen, and above that even since they are applying none of that knowledge.

Me, Dr. Childress, I am no different than any of my professional colleagues, any other clinical psychologists, except in the pathologies we work.  I am simply a clinical psychologist, it is my professional obligation of competence to know everything there is to know about any pathology I work with.  If I don’t know everything, I refer the patient to someone who does and I set about learning everything there is to know about the pathology.

I have worked with many pathologies over my career, so I know a lot of stuff.  I am competent in many areas of professional practice.

I have worked with the following pathologies, I would consider each one to be within the boundaries of my professional competence, meaning that I know everything about that pathology;

ADHD, oppositional-defiant behavior, learning disabilities, mental retardation and developmental disabilities, conduct disorder, personality disorders, schizophrenia, depression of adults and children, anxiety disorders of adults and children, autism-spectrum pathology, pediatric-medical psychology, substance abuse disorders, attachment pathology, trauma and complex trauma, family and marital therapy, and the  procedures for assessment, diagnosis, and treatment of pathology.

I have worked with each of those listed pathologies, which means that I am competent in each of those domains, which means I know everything there is to know about each one of those listed domains of knowledge.  Everything there is to know. 

Don’t believe me, ask me a question.  Knowing everything means that I am at a fundamental level of competence as a clinical psychologist in that pathology.

Do you want your heart surgeon to know everything there is to know about heart surgery?  Do you want your oncologist to know everything there is to know about cancer?  If your child has autism, do you want your clinical psychologist to know everything there is to know about autism? 

Of course.  Of course.  Of course.

Keith Nuechterlein, a leading figure in schizophrenia, a researcher generating the scientifically established knowledge for understanding and unlocking schizophrenia, and everyone at the UCLA Aftercare Clinic where I worked, knows everything there is to know about schizophrenia.  Every one of them. 

Jim Swanson and everyone at the UCI Child Development Center knows everything there is to know about ADHD. All pediatric psychologists at all Children’s Hospitals know everything there is to know about pediatric-medical psychology.  That’s called standard of practice and boundaries of competence… everything = competence.

The term for knowing everything is “competence” – the “boundary” for competence is everything there is to know.   Once you know everything there is to know, then you are competent.  Is there an acceptable level of ignorance for your heart surgeon?  No.  Is there an acceptable level of ignorance for your child’s clinical psychologist?  No.

Master’s Level Acceptable Ignorance

It could be argued that there is an acceptable level of ignorance for Master’s level mental health professionals because their work is more limited in scope and less sophisticated in application (the construction worker does not need the knowledge of the architect, the front-line soldier does not need the guiding knowledge of the officer). 

I don’t believe that.

I’ve worked with a lot of Master’s level clinicians over the years in many-many settings, and all of them have held themselves to the “knows everything there is to know” standard for professional competence in the domain of pathology they work.  

Psychiatrist Boundary of Professional Competence

For psychiatrists, they are MD doctors with nearly zero education or training in clinical psychology, psychological psychopathology, or psychotherapy.  Psychiatrists go to medical school.  They are MD doctors.  Toward the end of medical school, they specialize, some become heart surgeons, some become pediatricians, some go into psychiatry where they learn everything there is to know (competence) about the many-many types of medications for all the many different types of mental disorders in the DSM-5. That is their specialty, medications.  They are MD doctors.

Clinical psychologists know some information about medication if we are working with a medication-involved pathology, such as ADHD, bipolar disorder, or schizophrenia, but we always defer to the greater knowledge of psychiatrists regarding medication-related decisions.  They are MD doctors, their specialty is medication.

I have worked with some top-tier psychiatrists and developmental pediatricians (my favorite medical professional is a developmental pediatrician, more than psychiatry).  These top-tier psychiatrists and developmental pediatricians have always been excellent in insight and applied knowledge, and have deferred as warranted to the greater knowledge of the clinical psychologist on matters of clinical psychology.  Keith Nuechterlein is a PhD psychologist.  Jim Swanson is a PhD psychologist.  In the domain of psychology, the clinical psychologist is the top professional.  In the realm of medicine, the physician is the top professional.  In law, the attorney is, in construction it’s the architect and engineer.

In trauma, the clinical psychologist is typically in charge of the trauma recovery team. Sometimes a pediatric trauma-recovery nurse will take charge of the trauma recovery team.  In some cases of organized post-trauma community response mental health teams, an experienced Master’s level trauma therapist can take clinical care leadership of the mental health community response team.  Rarely, almost never, is it an MD psychiatrist in charge.  They are physicians, medical doctors.  They are an integral part of the team, not central and direct.  That’s the clinical psychologist in every psychological pathology.

Clinical psychologists are the… psychologists.  For issues related to psychology and psychotherapy… that’s us.  Not Master’s, not psychiatrists.

“Experts”

As a clinical psychologist, I am not an “expert” – I am just a clinical psychologist.  I know everything about the pathology with which I work… everything… that is considered the boundary that defines professional competence – the boundary for competence is knowing everything there is to know about the pathology.

Right now, for me as a clinical psychologist working with this court-involved pathology, I’m working with family systems therapy, attachment pathology, complex trauma in mid-generational transmission, personality disorder pathology, and brain regulatory networks of meaning construction, self-identity formation, affect regulation, attachment bonding, and intersubjectivity.

Which means… if I’m working with all of that, then I know everything there is to know about all those areas. I’m a clinical psychologist. Everything there is to know = competence.

That’s not unusual for clinical psychologists. That’s expected. It defines the “boundary” of competence.  What’s the “boundary” – i.e., when do we cross over and achieve professional competence in a pathology? A: When we know everything about the pathology, then we read journals to stay current.

Do you want your child’s oncologist to know everything about cancer? Do you want your heart surgeon to know everything about heart surgery? Everything? Of course.  That’s not considered being an “expert” – that’s called professional competence in heart surgery and oncology. 

If you don’t know everything about cancer, you’re not an oncologist. If you don’t know everything about heart surgery, you’re not an open-heart surgeon.

So that is the… interesting… thing over here in forensic psychology, where you can’t hardly turn around without bumping into an “expert.” Someone who asserts they know MORE than a clinical psychologist, MORE than everything there is to know about a pathology and all of professional clinical psychology, more than a Licensed Clinical Psychologist who works with the pathology. That’s quite the claim.

I don’t believe you.

Applying Knowledge

In 2013 I had the structure of the pathology understood. I made this knowledge available immediately to the public, educating the public on the established knowledge of professional psychology, and its application. That basic principle of clinical psychology, among many, has guided me throughout. The moment I have knowledge it becomes immediately available.

This is a trauma pathology in open ongoing abuse, emotional brutality, and developmental damage. It is an ongoing IPV spousal-abuse trauma pathology of brutal emotional abuse of the ex-spouse, and for the child it is a deeply damaging pathology of complex trauma and Child Psychological Abuse (DSM-5).

In 2014, I provided two online seminars for the Master’s Lecture Series of California Southern University: Parental Alienation: An Attachment-Based Model (7/18/14) and Treatment of Attachment-Based Parental Alienation (11/21/14).  The information from both remains entirely accurate today, in 2019.

Foundations coverThe following year, in 2015, I published Foundations.  The world shifted at that point, the moment knowledge becomes available and is applied the solution becomes inevitable, it is just a matter of how long it will take.

Back in my college days, I put myself through part of my Master’s program by working as a construction worker for a while, hanging drywall on a subcontracting crew. Construction always begins by laying the foundation, those are the first people on the job site… level the ground, lay the foundations.

That’s the start for building any and all structures, including the structure for a solution to court-involved family conflict. We start by laying the foundation first, before we start any of the other work.  A structure is only as strong as its Foundations.

Based on the solidly grounded foundations of established professional knowledge (Bowlby, Minuchin, Beck), I then constructed the diagnostic assessment instruments for the pathology.

Remember, the PsyD after my name means I know everything there is to know about assessment, everything about diagnosis, everything about attachment, everything about personality disorders, everything about family systems therapy, everything about oppositional-defiant behavior, everything about trauma and complex trauma, everything about all forms of psychotherapy, and everything about the neuro-development of the brain in childhood. That’s called being a clinical psychologist, that’s call boundaries of competence… knowing everything.

Based on these foundations of professional psychology, I constructed the assessment instruments, the Diagnostic Checklist for Pathogenic Parenting and the Parenting Practices Outcome Scale, along with the symptom documentation instrument (monitoring three brain-relationship systems; attachment, emotional regulation, and arousal-mood), the Parent-Child Relationship Rating Scale (PC-RRS). 

That’s what clinical psychologists are trained by education and clinical experience to do… construct assessment instruments and assessment protocols.  We know everything there is to know about constructing assessment instruments and assessment protocols.

I also provided a beautiful Strategic family systems therapy intervention, the Contingent Contingent Visitation booklet pictureVisitation Schedule, although the world will not be prepared to comprehend and apply it for awhile. There’s a lot of catch-up that needs to occur first. I anticipate the Contingent Visitation Schedule may become an important treatment-related factor in about five or ten years, when other things have evolved and are in place, along ABAB booklet coverwith the Single-Case ABAB Assessment and Remedy protocol.

I published booklets of educational material (trying to keep them to about 50 pages), providing the knowledge of professional psychology Narcissistic Parent booket coverwhich parents could pass along to their involved professionals, The Narcissistic Parent for legal Professional Consultation coverprofessionals, and Professional Consultation for mental health professionals.

Do you see the multiple lines of solution forming? Establish the foundations of professional knowledge. On these foundations of established professional knowledge, begin to construct the assessment and diagnostic protocol.

This led to the publication of the assessment protocol in 2016, the Assessment of assessment booklet pictureAttachment-Related Pathology Surrounding Divorce. I am a clinical psychologist. Constructing assessment protocols for pathology is what we do. I know everything there is to know about the construction of an assessment protocol. That’s what it means to be a clinical psychologist.

If I was an architect, I’d know about designing buildings, if I was a lawyer, I’d know about the law.  I’m neither of those things, I’m a clinical psychologist, we know everything there is to know about developing assessment instruments and assessment protocols for psychopathology.

I have done this before for a court-involved pathology (juvenile firesetting) for FEMA and the DOJ. There is work product from that assessment protocol posted to my website for review (Screening Instrument, semi-structured Clinical Interview, and Data Summary form).

Construction of assessment protocols for pathology is what clinical psychologists are specifically trained to do.

The High Road Workshop

In 2013/2014, Ms. Pruter recognized my application of knowledge from professional psychology, even through she is not a psychologist, and she understood the approach toward solution.  She and I had brief encounters across several “parental alienation” events, culminating in an office meeting and my review of her High Road workshop protocol.

I know everything about attachment, trauma, complex trauma, family systems therapy, all forms of psychotherapy, and everything about the neuro-development of the brain in child development. I had never seen the type of intervention change agents used in the High Road workshop. It is gentle and entirely effective.

It’s not what we do in any of our forms of psychotherapy. 

Ms. Pruter also described how the High Road workshop protocol is an off-shoot of another curriculum model she’s developed called Higher Purpose Mastery, applicable to a range of trauma-related pathologies.

It works phenomenally well, remarkably well. I understand how it works, I have personally observed all four days of the workshop.  I have received a client from the High Road workshop into my clinical practice, the client entered my therapy entirely normal-range and with an entirely normal-range and bonded relationship to the formerly targeted-rejected parent.  Two days of the High Road workshop achieved a full and complete recovery from years of documented complex trauma and child abuse.

The moment I became aware of the High Road protocol in 2014, my first referral and top recommendation is to Ms. Pruter and the High Road workshop. I included reference to and a description of the High Road workshop in my book, Foundations, and provided declarations to the court in support of the workshop protocol.

In 2017, I accompanied Ms. Pruter to the AFCC national convention in Boston where we presented on a return to established knowledge (AB-PA) and the High Road workshop, and we explained how the High Road protocol achieves its remarkable success. The Powerpoint slides from our 2017 AFCC presentation are available on my website.

Childress & Pruter: 2017 AFCC Presentation 

In 2018, I developed an AB-PA pilot program for the family courts in support for an independent group in Houston. I also traveled to Washington, DC with parent advocates, Wendy Perry and Rod McCall, to hand-deliver the Petition to the APA to the APA. This petition signed by over 20.000 parents and still available on Change.org, identifies the specific ethical code violations within forensic psychology, and seeks three specific remedies.

In 2019, I began active collaboration with Ms. Pruter as a consulting clinical psychologist writing reports for the Custody Resolution Method (CRM), a data tagging and data compilation method applied to documented data surrounding family conflict (archival data; emails, texts, reports, court records, etc.).

In association with my work for CRM, in 2019 I also created a Psychology Tagging protocol, the Checklist of Applied Knowledge, for tagging and providing professional critique and analysis of mental health reports.

In August of 2019, Dr. Childress and Dorcy Pruter presented a paper to the American Psychological Association,

APA: Empathy, the Family, and the Core of Social Justice
(Childress & Pruter, 2019)

Powerpoint of APA Paper Presentation

This paper expands and anchors the discussion into core human rights issues and the trans-generational transmission of trauma, and documents the recovery from complex trauma achieved by the High Road workshop, an evidenced-based approach for recovering children from complex trauma and child abuse. The data is lock.

The only methodological issue with a single-case research design is replication. Ms. Pruter welcomes outreach, discussion, and proposals from university based researchers for professional collaboration surrounding the High Road workshop and surrounding extensions of the workshop and skill-based approach to recovery from other trauma-related pathologies.  Ms. Pruter is a businesswoman and a child of complex trauma, and recovery.  You are the researchers.  Develop collaboration.

Ms. Pruter also routinely collects the Parent-Child Relationship Rating Scale (PC-RRS) for all High Road workshops. Additional collection of PC-RRS data from the follow-up maintenance care therapist will turn each High Road workshop into another replication of a single case ABA design, and success for each family enrolled in the workshop is documented for each child and parent-child relationship.  The professional term for that is “evidence-based practice” – success in each case is documented by evidence, by data.

In the High Road single-case ABA data presented to the APA Division 24, the child’s ending scores on the PC-RRS are highly positive ratings of 5-6 at the two-day point of the High Road workshop.  This is evidence that the child is immensely relaxed and happy, high affection, high cooperation, high sociability.  He was very happy.  Recovery from complex trauma and child abuse feels good.

Upcoming 2019

The next phase begins in the fall, when Dr. Childress and Dorcy Pruter offer a comprehensive training seminar series for mental health professionals in AB-PA and solutions for complex family conflict surrounding divorce.

I am a clinical psychologist competent across multiple domains of pathology. Ms. Pruter is a top-tier trauma recovery specialist, she is my first referral and my first recommendation as a clinical psychologist.

If the High Road workshop is not available in a specific case, then the next option becomes traditional solution-focused family systems therapy to restore the parent-child attachment bond and stabilize family functioning into a healthy post-divorce separated family structure.

Dorcy Pruter and Dr. Childress will also be providing a separate seminar for legal professionals in the fall, describing an alternative treatment-oriented argument package for the court, centering around a trauma-informed clinical psychology assessment of the family conflict with the referral question of:

Referral Question: Which parent is the source of pathogenic parenting creating the child’s attachment pathology, and what are the treatment implications?

If a trauma-informed assessment of pathogenic parenting returns a DSM-5 diagnosis of V995.5 Child Psychological Abuse, then the targeted parent and legal counsel return to the court seeking a protective separation order based on a DSM-5 diagnosis of Child Psychological Abuse made by a licensed mental health professional.

If there is disagreement surrounding the diagnosis, then get a second opinion. That’s how diagnostic issues are addressed in clinical psychology and in medical care. A physician’s diagnosis of cancer is not litigated by trial. If the diagnosis is in question, get a second opinion.

In the fall of 2019, top-level professional seminars with Dr. Childress and Dorcy Pruter for both mental health professionals and legal professionals will be held.

Writing – Writing – Writing

In September, I will be traveling to Barcelona and the Spanish Pyrenees on a personal scouting trip for my next phase, settling into semi-retirement writing books and journal articles. First up is the book Diagnosis

The paper for the APA represents the opening journal article writing phase for me, it is time for me to start writing professional journal articles and the additional books in the series – Foundations – Diagnosis – Treatment, and then more beyond that.

One of the benefits of being an old clinical psychologist is that we know a lot of stuff about psychology. The more pathology we have worked with, the more we know. I’ve worked with a lot of pathology, I know a lot.

The downside of being an old clinical psychologist… is that we’re old. My career is winding down, I’ll be headed off to book writing and working to solve the terrorist mind of pathological anger and pathological hatred.

All the tools needed for solving complex family conflict surrounding divorce are available. I am your advocate within professional psychology, I am your weapon.  You are the warriors, you are the healthier parent, you are the parent chosen by the child to lead the family out of conflict and into healthy family stability. 

This has always been solvable immediately… from the start, with the application of the established knowledge of professional psychology; Bowlby, Minuchin, Beck, van der Kolk, Tronick (attachment, family systems therapy, personality disorders, complex trauma, neuro-development of the brain during childhood).

Family systems therapy provides a full solution, the addition of attachment knowledge and complex trauma provides even further clarity in diagnosis and treatment, the addition of personality disorder pathology domains of knowledge provide crystal clarity on the diagnosis and treatment, and the addition of neuro-developmental knowledge provides a full and complete diagnostic explanation and clear treatment directions.

This next phase will likely extend for several years, and it will end with Dr. Childress or clinical psychology providing training seminars for Child Protective Services.  That will mark the final step in achieving a solution to complex court-involved family conflict surrounding divorce.

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

Read More –>

Scandinavian Ethics Code for Psychologists

Scandinavian Ethics Code for Psychologists

 

I was emailed a google-translate of the Etiske Principper for Nordiske Psykologer Denmark.Sweden.Norway and I was asked for comment regarding possible ethical violations for Scandinavian psychologists similar to the professional concerns surrounding American psychologists, and others internationally.

I cannot make official comment on the Scandinavian ethics code until I locate an official English translation, then I can provide formal comment and analysis because then I’ll be on solid ground regarding what’s being said by the constructs used, but I can provide some initial thoughts based on this translation.

Professional Competence is discussed in Section II.2

II.2 Competence

The psychologist strives to develop and maintain a high level of professional qualifications in his work.

First, I would note how they incorporated “high level” as the standard for practice.  I am unaware of the translated construct in the original language, but if an appropriate construct was used that would bear the weight of argument, I would emphasize that the ethics code for Scandinavian psychologists specifically designated a “high level” of professional practice.

That would mean application of knowledge – Bowlby, Munuchin, Beck, van der Kolk, Tronick – that is entirely consistent with “high level” – and failure to apply established knowledge would NOT meet this “high level” standard.

From the Translation: The psychologist seeks awareness of his professional and human strengths and weaknesses so that he can realistically assess with which competence he can take on tasks.

This sentence says… “It is your responsibility as a psychologist to know what the limits of your competence are.”  It’s not up to you, the consumer, to identify it… it’s up to them to know their limitations, and to practice only within those limitations, which is the next sentence.

From the Translation:  The psychologist takes on only the tasks, offers only the services and uses only those methods he is qualified by virtue of education, training and experience.

That’s the core sentence.  What Foundations does, and an attachment-based model of pathogenic parenting surrounding divorce does (AB-PA), is establish that a knowledge of five domains of professional psychology are needed for competence,

  • Attachment
  • Family systems therapy
  • Personality disorders
  • Complex trauma
  • Neuro-development of the brain in childhood

I use a main person in each field to represent each domain, Bowlby (attachment), Minuchin (family systems therapy), Beck (personality disorders), van der Kolk (complex trauma), and Tronick (neuro-development of the brain).  This is established knowledge. 

Working with complex family conflict surrounding divorce requires professional competence in all five of these domains of knowledge.  That’s what the work of Dr. Childress asserts.  It is now up to them to either,

A.)  Know and apply the knowledge domains, i.e., be competent, or,

B.)  Defend why they don’t need to know that knowledge domain for the type of work they do.

Notice too, the method of qualification, “education, training, and experience” – that’s their vitae.  Show us, on your vitae, where is your “education, training, and experience” in those five domains of knowledge.

I suspect that no psychologist currently has professional-level “education, training, and experience” in all five of those domains of knowledge.  I do, because I’m competent in what I do.  If I need to know it, I know it.  But for other psychologists, that then becomes the leverage point for them to receive additional training for professional competence. 

Do I care what type of training?  No, I don’t. 

As long as every mental health professional on the planet who is working with court-involved pathology receives additional training in whatever they don’t know from those five domains.  If you know attachment and trauma, but don’t know family systems therapy… hurry-hurry, all five for competence… go get “education, training, and experience” in family systems therapy – hurry-hurry, required for competence.

I might be asked to help in the transition, but I don’t speak Swedish, or Spanish, or Japanese.  Each country will need to develop its own “high level” of professional knowledge applied.  I can help, it’s up to you to do it, because you want to do it. It is the right thing to do… apply knowledge to solve pathology.  It’s what we do as psychologists.

I’m a catalyst for change.  I established the solid foundations of knowledge that change can rest on, the scientifically grounded foundations of professional psychology, where debate is answered by the question and answer, “What does the research say?”  That’s the answer.

I recently provided an invited lecture at the Erasmus Medical Center in Rotterdam.  I was part of a panel, with additional Dutch psychologists from attachment and trauma also presenting.  Yay.  Exactly as it should be.  There was no “parental alienation” on the panel – that is a construct beneath professional standards of practice – trauma… attachment… family systems therapy… personality disorders… the neuro-development of the brain in childhood – Bowlby, Minuchin, Beck, van der Kolk, Tronick.

I am not the source of knowledge, but I can be a helpful orienting conduit TO the knowledge during a transitional up-grade in professional standards of practice.  I don’t speak Danish.  I don’t speak French.  I don’t speak Italian. Each nation will have to find psychologists within your country who step up to deliver the highest level of professional practice for the courts.

The courts deserve the HIGHEST standards of professional practice.  Lives hang in the balance of court decisions.  Professional standards of practice for court-involved psychology need to excel, they need to be at the absolute-top in the application of knowledge and scientific research to the information and to decision-making.  People’s lives hang in the balance of the court’s decision, there is no tolerance for professional ignorance and sloth.

There will be a transition period.  We need indigenous psychologists within each country to understand their professional responsibilities in this regard, and the professional responsibilities of their colleagues.  Continuing education on the matter of foundational knowledge is warranted as the application of scientifically established knowledge is increased.

Reading the Scandinavian ethics code, there are exceedingly positive indicators of sanity.  The next sections reveal these.

Ethical Awareness

From the Translation: A prerequisite for a high professional competence is that the psychologist is aware of the ethical principles and integrates ethical assessments into its professional practices.

This establishes, clearly establishes, that the line of discussion and critique we are taking into professional dialogue is a requirement of consideration for all psychologists in Scandinavia.  Ethical practice is central to the required “high level” of professional practice.

Competence and Skills Development

From the Translation: The psychologist works in accordance with scientific principles and substantiated experience and endeavors for continuous professional development. The psychologist acquires knowledge about scientific and professional development within its scope of work.

This is an interesting statement, “in accordance with scientific principles and substantiated experience”- that seems identical to Standard 2.04 of the APA ethics code requiring the application of scientifically established knowledge.  An English translation, however, may not capture nuanced complexity to the original language terms used, so I will defer to a native interpretation for this requirement. But it seems to me, it’s saying that you must apply Bowlby, Minuchin, Beck, van der Kolk, and Tonick.

Limitations of Competence

From the Translation: The psychologist works within the limits on his own competence that stems from education, training, experience and personal strength and limitation, and seeks professional help and support in difficult situations.

You are not allowed to be incompetent.  You need to know what you’re doing if you are going to do it.  Note again, the qualifications, “education, training, experience.”  Note also, the direction made to psychologists to seek professional consultation support in difficult situations, again deferring to meaning in the original-language as to intent.

Method Limitations

From the Translation: The psychologist is aware of the limitations that lie in the methods and methods of the subject, and the limitations that must be placed on the conclusions that can be drawn.

Know your limitations.

As psychologists, we shouldn’t be in the business of judging human frailty and vulnerabilities to decide who “deserves” to be a parent.  We fix things.   We shouldn’t go beyond the scope of what we know and what we can do.  Parents – normal-range parents – should be afforded wide latitude to parent according to their cultural, personal and spiritual values.  If it’s not child abuse, then we should not be judging human frailty, that’s not the role of psychologists.

Be aware of our limitations, and the limitations of what the scientific evidence will support and will allow us to say.  What are the psychometric properties of your assessment protocol, what is your referral question?  Stay within the limitations of our professionally grounded knowledge.

Limitations of the Framework Conditions

From the Translation: The psychologist is aware of how social and working conditions can promote or inhibit the appropriate use of his competence and methods.

We are working with the court.  The court appreciates evidence.  In clinical psychology, our term is documentation.  In research methods, the term is data.  Professional psychology should ground its interactions with the court in clean documentation and clean data for decision-making. 

Not a problem.  Clearly documented assessment, clearly documented diagnosis, case conceptualization and written treatment plan, and outcome measures documenting treatment response and treatment outcome should be standard of practice.

The lives of multiple people, including children, hang in the balance of the court’s decisions surrounding the family.  It is essential that court-involved professional psychology provides the court with the highest standards in the application of professional knowledge and standards of practice.  It is vital for court-involved professional psychology to be aware of how its input to the court can have dramatic long-term impacts on multiple people, necessitating the highest standards of practice in the application of professional knowledge.

The Liability section contains the provisions regarding Avoiding Harm

II.3 Liability

From the Translation: The psychologist is aware of the professional and scientific responsibilities he has for its clients and that organization and the community in which he lives and works.

We have responsibilities.

From the Translation: The psychologist avoids causing harm and is responsible for his actions.

The psychologist avoids causing harm and is responsible for his actions. That seems simple, direct and clear.  There are no exclusions noted.  There was no, “avoids causing harm, except with parent litigants in divorce – them… it’s okay to harm them, but not other people.”  It doesn’t say that.  No exceptions were indicated.

The statement was clear and direct in its simplicity, and the psychologist is clearly held accountable, no “just following instructions” excuses… “responsible for his actions” – “the psychologist avoids causing harm.”

Did the actions of the psychologist, either directly or through failed application of knowledge (a violation of II.2 Competence)… harm you?

With the mere assertion of this, it then becomes incumbent upon the psychologist to DEMONSTRATE through vitae and in their documentation of their assessment, diagnosis, and treatment… that they applied knowledge; Bowlby, Minuchin, Beck, van der Kolk, and Tronick – attachment, family systems therapy, personality disorders, complex trauma, the neuro-development of the brain in childhood, consistent with their obligations under II.2 Competence.

From the Translation: Secures as far as possible that his benefits are not abused.

It’s not simply that the psychologist avoids harming people – anyone – even you – the psychologist must also “secure” (defer to the original term) that BENEFITS are indeed benefits, and are not misused and abused.

The Scandinavian professional ethics code expects a “high level” of professional responsibility.  Know what you’re doing, make sure it helps and doesn’t hurt, and that is YOUR responsibility to ensure, not someone else’s.

Responsibility

From the Translation: The psychologist takes responsibility for himself the quality and consequences of its work, but at the same time be aware of, that he is experienced by others as a representative of his stand.

Do quality work, and also understand that you represent the entire field of professional psychology.  Represent well, the professional standards of practice for psychologists.

Avoidance of Abuse / Injury

From the Translation: The psychologist strives to avoid that psychology professional knowledge or practice being abused and taking responsibility for, that an injury is inevitable, and which can be foreseen will be as small as possible.

This seems identical to Standard 3.04 of the APA ethics code.  Psychologists are not allowed to hurt people – anyone, there are no exceptions noted in the code – and when harm is “inevitable” (defer to the original term), then psychologists make it as “small as possible” (defer to the original term).

Conclusion

The Scandinavian ethics code for psychologists contains nearly identical standards in II.2 Competence as in the APA ethics code Section 2: Competence.  The Scandinavian ethics code for psychologists mandates knowing the established domains of psychology relevant to the domain for practice:

From the Translation:  The psychologist takes on only the tasks, offers only the services and uses only those methods he is qualified by virtue of education, training and experience (APA: Standard 2.01a)

And the ethics code for Scandinavian psychologists mandates the application of scientifically established knowledge:

From the Translation: The psychologist works in accordance with scientific principles and substantiated experience and endeavors for continuous professional development. The psychologist acquires knowledge about scientific and professional development within its scope of work. (APA: Standard 2.04)

These requirements would seemingly mandate knowing and applying the scientific principles” (defer to original term) for attachment, family systems therapy, personality disorders, complex trauma, and the neuro-development of the brain in childhood – Bowlby, Minuchin, Beck, van der Kolk, Tronick.

Where questions are answered with the question and answer of, “What does the research say, that’s the answer.”

The ethics code for Scandinavian psychologists also has nearly an identical Avoiding Harm standard as APA Standard 3.04 Avoiding Harm.

From the Translation: The psychologist avoids causing harm and is responsible for his actions.

Psychologists are not allowed to be ignorant or incompetent (II.2 Competence), and psychologists are not allowed to hurt people – even you – (II.3 Liability).  You might want to check the exact cultural-legal use of the term, because the term “liability” has legal responsibility meaning in the United States.

Craig  Childress, Psy.D.
Clinical Psychologist, PSY 1885

Read More –>

Attachment and the Psychoanalytic School of Psychology

Difficult Position

Karen Woodall, I have been in a difficult position since reading one of your recent blogs (Karen’s blog).  In your blog you indicated that you are beginning a personal “research” study (without IRB oversight or review) with adult children of child abuse and childhood trauma. 

In your blog, you announced that you had begun recruiting for your personal research study in order for you to learn from these now-adult survivors of childhood trauma, and that you were going to use what you learned from your “research” to develop a new form of therapy for them.  Here is your exact statement:

From Karen Woodall:  “Last week I put a call out to adults alienated as children, inviting them to take part in my research which will form the basis of a new therapy for this group of people.”

That you would need to conduct “research” to develop a “new therapy” means that you don’t already know what the therapy is for adult children of child abuse and that you have to do “research” to learn what you are doing – to create your “new therapy.”

Those are your words, Karen.  That is your sentence statement.  You are conducting your own personal “research” so that you can learn how to do therapy – this “new therapy” you are creating – for adult survivors of childhood trauma. 

Which means that you currently don’t know how to do therapy with adult survivors of trauma, necessitating your need to conduct your “research.” 

The ethical issue of using people as guinea pigs for your “research” and your new experimental forms of therapy, without IRB oversight and review, is concerning.

The fact that you will be conducting therapy with a new population without proper education, training, and background to ALREADY know the treatment for adult survivors of child abuse would likely represent a violation of Standard 2.01a of the APA ethics code regarding boundaries of competence.  Every ethics code for every level of professional in every country, has a Standard regarding boundaries of competence.

If you have to do “research” on the people in order to learn therapy with that population, that means you are currently not competent to treat that population, and that treating them would be beyond the boundaries of your competence.

Standard 2.01c of the APA’s ethics code on competence governs the requirements for a psychologist expanding an area of practice.

Standard 2.01 Boundaries of Competence
(c) Psychologists planning to provide services, teach, or conduct research involving populations, areas, techniques, or technologies new to them undertake relevant education, training, supervised experience, consultation, or study.

If you look on my vitae, Karen (Childress Vitae) you will see after I list my work experience, I list a section of Early Childhood Training.  Do you see that?  That involved my expansion of practice into early childhood mental health from ADHD and school-involved psychology. 

Mind you, while at Children’s Hospital of Los Angeles I had early childhood training with the therapeutic preschool there, and at Choc-UCI I was working with ADHD in preschoolers… still, when I moved to early childhood I went and got training.  See that?  That’s what is required when we shift areas of practice.

Interesting note, look right above my Early Childhood Training, since coming over here I’ve taken training in Divorce Mediation.  With everything I know, Karen.  I went and got training in Divorce Mediation.  That’s what we do, Karen.

So it becomes professionally disturbing to hear you “put out a call” for “research” subjects on whom you can practice with your new new forms of experimental therapy.  If you have to research how to do therapy, you don’t yet know how to do therapy with this population.

I do, Karen.  I already know how to do therapy with adult survivors of child abuse.  That is already within the scope of my practice.  I know what the therapy is, and I have treated a range of adult child abuse survivors, including from this divorce-involved psychological abuse.  I already know what the therapy is, and I’ve already worked directly with the population of adult survivors of child abuse (including psychological abuse surrounding divorce).

If you have to do “research” in order to learn what the therapy is for adult survivors of childhood trauma and abuse, you are not currently competent to practice with this population, and according to APA Standards, you should seek additional training, supervised experience, or consultation. 

I’d be more than happy to provide education, training, or supervision for your expansion of practice into adult survivors of childhood abuse and trauma, but for consultation with this population, I would instead refer you to Dorcy Pruter. 

I suspect you will be unwilling to avail yourself of my offer to train or supervise your practice expansion, and I also know that you’ll not find another person as familiar with adult children from this specific “alienation” form of child abuse trauma as Dorcy, she’s world-class in that regard.  If you want to learn therapy for adult survivors of this form of child abuse, turn to Dorcy Pruter for professional consultation, Karen.

I fully understand that you believe yourself to be in some “battle of experts” with me.  I’m not, Karen.  Every act, every sentence, is as a clinical psychologist.  There are professional standards of practice, Karen.  They exist to protect the patient.  It is unwise to flout and disregard professional standards of practice.

When entering a new area of practice, seek training, consultation, or supervision.

If I were to expand my practice into veteran combat PTSD – even with all my background in trauma, I’d be taking at least three trainings and I would be consulting for the first 18 months.  And I am already well familiar with PTSD in combat veterans.

Look at everything I know, Karen, how fully established my vitae is over here, books and everything.  I took a training course in divorce mediation.  Boundaries of competence, that’s what we’re supposed to do. 

I’m not taking any training in child custody evaluations because I’m never doing one.  If I did, I would.  I would not conduct a child custody evaluation (ever) without first receiving additional training.  My child custody evaluation would be a magnificent professional work, far exceeding any standards of practice in child custody evaluations.  I would still seek additional training before conducting a child custody evaluation (never) because that’s what we do.

So, Karen.  If adult survivors of childhood trauma is a new domain for you… seek consultation.  Who is the top professional in adult children of “alienation” – Dorcy.  Stronger even than me.  I will absolutely consult with her on cases of adult children of “alienation” – any hint of a question for me, that’s who I would turn to for professional consultation.

No ego, Karen.  These kids need the best.  Put your ego aside and work to learn before you enter a new area of practice.  That is the Standard that is expected of us.

You also indicated that your “research” subjects would be receiving your new experimental therapy. 

From Karen Woodall:  “Alongside the research, I will treat those adult children who are coming forward using a combination of therapeutic approaches which I consider fits the needs of this overlooked cohort of traumatised individuals.”

So you are serving as both the treating clinician and the Principle Investigator of your private research, without any IRB oversight or review, that sounds like a dual role called a “multiple relationship.” Are you charging your “research” subjects for their new experimental therapy you are providing to them?  That would likely be viewed as exploiting your multiple relationship with them, one serving the other, and both serving your interests.

Here’s an ethical concern if I’m sitting on your IRB, might your role as a treating clinician influence the perceived freedom and self-autonomous decision-making of the research participant regarding their research participation decisions.  Might they agree to participate in new experimental treatments because they want to please you as the treating therapist and keep you as a therapist, rather than from a truly autonomous informed consent for the nature of the experimental research procedures you’re doing.

And if one of your “research” subjects alleges that your therapy harmed them, then your statement that you are doing research in order to learn how to do therapy with that population, meaning that you do not already know what the therapy is for adult children of child abuse and trauma, they are likely to have a very strong legal case.

Are you using an informed consent for treatment or an informed consent for research, or both?  Have these been reviewed?  By whom?  If not, I would recommend you post your Informed Consent for Research to obtain at least some degree of professional review.  I’m seeing liability issues for you on a fairly substantial scale if you fail in your professional obligations surrounding research.

People are not your guinea pigs for your learning.  There are ethical standards of practice, Karen.  If you are entering a new field, seek additional education, training, supervision, or consultation – I suspect your ego will not permit my involvement in your education – but your ego should NOT interfere with your professional duty of care to the client… seek professional consultation with Dorcy, she will substantially improve the quality of care you provide to adult survivors of childhood trauma and child abuse – specifically this type – this “alienation” type of attachment trauma.

This is not an ego thing, Karen.  I know you think you’re in some sort of battle of “experts” with Dr. Childress – because you’re stuck in a mindset of “experts” – that’s all going away, Karen.  Even me. 

This is not an ego thing, Karen.  If you’re moving into treating adult children of “alienation” you must, absolutely beyond all shadow of doubt, consult with Dorcy Pruter.  If it were me, I’d do two-hours monthly, and I’d seriously consider two-hours weekly, for about six months.

No doubt on that, you heard how I phrased that… If it were me.  No ego on this, Karen.  Dorcy absolutely knows her stuff, and, regarding adult children… she is one.  Dang, she will tell you everything you need to know Karen.  Dorcy would be absolutely the person I would consult with personally, no ego. The only thing I care about is the quality of care to my kid, my client.  If Dorcy’s understanding improves that, I’m there, absolutely.  Patient care… my kid… always comes first.  No ego.

If you start working with adult children of child abuse and trauma and you don’t consult substantially with Dorcy… I don’t know what to say, Karen.  That’s getting your ego wrapped up in the quality of care you provide to your patients.  I just can’t understand that type of thinking, Karen.  Where ego takes precedence over patient care.

There are professional standards of practice, Karen. They’re there for a reason. They’re there to protect our patients… and us.  It’s not a good idea to disregard them, Karen.  When going into a new area, seek additional education, training, supervised practice or consultation.  Karen, we’re working with children and families, leave your ego at the door and worry more about the quality of your work, than who’s the “expert.” 

I understand if you won’t accept my knowledge, but then seek and accept Dorcy’s.  This is not a competition… this is not a game of “experts” – we need to have a solution now.  Today.  Yesterday would be even better. 

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

Read More –>

Attachment and the Psychoanalytic School of Psychology

Diagnosis, Karen. Diagnosis.

Well, I had so much hope that when Karen identified her “new pathology” as a Dissociative Identity Disorder (multiple personality) that she had finally returned to established constructs for describing pathology – you know, the ideas and terms that EVERYBODY else in professional psychology uses.

I was wrong.  She’s wandering back into her grandiosity on her more recent blog, again.  She is using professional terms incorrectly – not in their established definitions.  In doing that, she is creating confusion.  She needs to stick to reality. (Karen’s blog).

A fixed and false belief that is maintained despite contrary evidence.  In the case of elevated self-opinion “without” commensurate background” it would be considered a grandiose delusion.  Did I mention that grandiose delusions are associated with two pathologies, a grandiose delusion is a “mood-congruent” psychotic delusion in mania, so a biplolar disorder with psychotic features is one place they occur, and a grandiose delusion is associated with narcissistic personality pathology.

From Millon:  “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)

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

Karen is not only wandering in the world of making up new forms of pathology, she’s now starting to make up new forms of treatment for the new forms of pathology she’s making up.  She’s entirely making everything up, just her, making stuff up.  Listen to her.  She’s making up a new pathology, entirely on her own, and now she’s making up a new treatment for this new pathology she’s making up, entirely on her own.

That’s not professional practice, Karen.  In professional practice, we apply knowledge, we don’t simply make it up on our own because our ideas make us feel warm and fuzzy.  Karen, however… appears to believe she is exempt from this requirement for applying knowledge, and instead considers herself entitled to make up new pathologies and new treatments entirely on her own, because I guess she believes that truth and reality are whatever she asserts them to be.

No, Karen, there is actual truth and there is actual reality.  We’re leaving Wonderland, Karen.  No more summer croquet parties on the lawn, no more afternoon tea with friends, no more hookah smoking caterpillars pontificating about the world.  Reality Karen.  There is an actual reality.

Karen, have you ever heard of the concept of diagnosis?   Serious question, Karen.  Have you ever heard of diagnosis?  Because you are nowhere close yet to actually diagnosing the pathology you’re treating.

Say you have a bad tummy pain and go to your doctor? Does the doctor diagnose you with this new pathology that the doctor is just discovering, Tummy Pain Disorder, or do they diagnose you with Appendicitis?  Does you doctor then treat you with a new form of therapy they’ve created for Tummy Pain Disorder, or does your doctor treat you for Appendicitis?

Which would you prefer as a patient, Karen?  Would you like your physician to diagnose and treat your Tummy Pain Disorder with a new treatment, both of which your doctor just created, or Appendicitis with established treatment?  I think most humans who live in reality would prefer a real diagnosis and real treatment.

But you like your Tummy Pain Disorder, don’t you, Karen.  What are you calling it? Traumatic Spitting, a dissociative identity disorder of a “split” personality – it’s called an Dissociative Identity Disorder by every other mental health professional on the planet, except you Karen.  Do you think that might be a tad confusing for people, when you don’t use professional language in any agreed-upon definitions within professional psychology, but just kind of go making up your own definitions for the words that already HAVE definitions, just not the ones you’re using, do you think that will add to clarity… or confusion?

You know who Aaron Beck is, right Karen, the guy who’s the the grand-high kahuna of CBT therapy?  He’s also heavily involved in CBT cognitive therapy for personality disorders.  Linehan is over in the CBT model with her Dialectic Behavior Therapy for borderline personality pathology.  Listen to what Beck says about the sense of entitlement surrounding narcissistic pathology

From Beck:  “Another conditional assumption of power is the belief of exemption from normal rules and laws, even the laws of science and nature.” (p. 251-252)

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

“exemption from normal rules” – like diagnosis, Karen?

Are you exempt from diagnosing your patients, Karen?  You’re creating a new pathology, you are not diagnosing your patients.  Upset Tummy Disorder is not a replacement diagnosis for Appendicitis.  And creating new therapies when you haven’t even diagnosed the pathology first is extremely questionable professional practice, Karen.

Have you ever heard of diagnosis?  What is the DSM-5 or ICD-10 diagnosis for this “Traumatic Splitting” pathology you’re creating, Karen, your Tummy Pain Disorder?

But, hey, I’m never adverse to a stroll through Wonderland, we always meet such interesting characters, let’s see who we’ll meet on this stroll.  So let’s just walk along with Karen for awhile, shhh, let’s not disrupt her grandiose delusion, she’s having such fun with it.  Not only does it allow her to make up diagnoses willy nilly, apparently she feels entitled to make up treatments now willy nilly too.  She’s having such good fun.

Now, that’s special, developing new treatments for new pathologies she thinks she’s “discovering.”  Oh my goodness.   In developing a “new treatment” for a “new pathology” that she’s “discovering,” Karen Woodall enters the pantheon of the most elite figures of professional psychology who described new pathology and developed new forms of therapy; Sigmund Freud, Carl Rogers, B.F. Skinner, Aaron Beck. Salvador Minuchin… and Karen Woodall.

Thanks so much, Karen.  We needed a new form of psychotherapy. The psychotherapy we had from all of the previous great minds of professional psychology simply weren’t enough… we needed you.  Thank you for bestowing your magnificence upon us, Karen, and for leading all of professional psychology from the darkness of our ignorance into the magnificence our your brilliance.

Thank you, Karen.

DSM-5 Narcissistic Personality Disorder Criterion 3: “Believes that he or she is “special” and unique.”

That’s quite a special thing you’re doing for all of us, Karen, discovering this pathology that no one has ever seen before, and then developing a new therapy for it.  My, that seems like such hard work.  Thank you Karen.  I don’t think there’s anyone else who could have understood this pathology at such depth, wow, you’re special, and to develop a whole new form of therapy, like Freud and psychoanalysis or Minuchin and family systems therapy, or Aaron Beck and CBT… and now you, Karen Woodall.  Wow.  You’re like… unique, aren’t you.  Well maybe not totally unique, you’re like Freud or Minuchin or Beck unique.  One of the elite of all time.

DSM-5 Narcissistic Personality Disorder Criterion 4: Requires excessive admiration.

Thank you, Karen. Thank from all of professional psychology for coming to our rescue in our darkness and ignorance.  We needed you, and you came.  I can’t tell you how grateful we all are to have your magnificence, Karen.  I don’t think there’s another person on that planet would could have “discovered” this new pathology of… what is it again?  Right, Traumatic Splitting.

DSM-5 Narcissistic Personality Disorder Criterion 5: Has a sense of entitlement.

Question.  Karen.  Have you ever heard of this concept called “diagnosis”?  The application of established knowledge to a set of symptoms.  Diagnosis.

Now, I really appreciate what you’re doing for all of us here in professional clinical psychology and all, developing these wonderful new insights into this new form of pathology, and coming up with these new forms of treatment entirely on your own.  That’s great.  Thanks so much for doing that, and for leading us all out of the darkness of our ignorance and into your light made manifest before us as you spread your magnificence with all the world.  Thanks for that, great job, only you could be so wonderful, thanks for saving us.

But my question… have you ever heard of diagnosis?  You know, applying established constructs to a set of symptoms.  Like say… the DSM-5.

You see, with the DSM-5 we stay anchored in symptoms.  We don’t go wandering into worlds of strange stuff, anybody’s strange stuff, not even Freud’s, or Skinner’s, or Minuchin’s.  No one’s theories.  It’s all anchored on symptoms.  That’s what diagnosis is, ever heard of it?

Like for Major Depression.  The DSM-5 lists 8 symptoms for a depressive episode.  If the patient displays five of the eight, then they have a DSM-5 diagnosis of Major Depressive Disorder.  Six of nine symptoms of hyperactivity, the child has ADHD.  Five personality disorder traits, that’s a personality disorder.  See how that works, that diagnosis thing.

There’s a certain set of symptoms specified, “operationally defined” it’s called, and then there is a specified cutoff identified, a criterion number of symptoms needed for the diagnosis.  Below that number – no diagnosis.  Above that number – diagnosis.

Anywhere close to that with your “Traumatic Splitting” disorder there, Karen?  You know, identifying the symptom set and the cutoff criteria… oh, and the research base.  New pathology proposal require research bases like ADHD and autism.  I’m looking forward to yours to support this new Traumatic Splitting dissociative identity pathology you’re proposing.

It’s all symptom driven, diagnosis is.  That’s what makes it so wonderful in anchoring us.  What are the symptoms?  We always start by identifying, with a fair degree of operationally defined specificity, the symptoms.  If all psychologists and mental health people are going to reliably identify a symptom, it has to be described with enough specificity that we call all do that, all the time.  That’s important with diagnosis.  If our symptom descriptions allow too much latitude for interpretation, then our diagnostic model collapses.

Like for a Narcissistic Personality Disorder, DSM-5 Criterion 1…

DSM-5 Narcissistic Personality Disorder Criterion 1:  Has grandiose sense of self-importance

What’s a “grandiose sense”?  Well, that could be open to interpretation.  Me, for example, I think I am an exceptionally good clinical psychologist.  Is that grandiose, or just self-confidence?  But say I thought I was discovering some new scientific breakthrough that wasn’t really a breakthrough, it was just me making stuff up and thinking I was “discovering” something, would that be a “grandiose sense” of my own self-importance.   If I thought everybody needed to listen to me because of my special “new discovery” I’m making up, now I’m not simply claiming to be just a good psychologist, I’m a wonderfully special psychologist apart from other ordinary everyday kinds of psychologists, I’m superior, like I’m some kind of “expert” or something.  Would I have a “grandiose sense” of my own self-importance then?

So you can see where some degree of interpretation comes into the symptom’s identification, but the DSM-5 provides a clear set of symptoms, as clear as they can possibly be made (that’s why they provide a lot of descriptive comment in the text for each diagnostic pathology and a huge research base that the diagnostician can refer to for understanding the symptom features of the diagnostic label).

So Karen, what we do with diagnosis is we start with some structured diagnostic model, most people use the DSM system of the American Psychiatric Association, or the ICD system of the World Health Organization is also commonly used.   The American Psychiatric Association and WHO have worked together to mostly line up the two diagnostic systems, the DSM and ICD, there’s only a few, but important, discrepancies.  For example, the ICD has a diagnosis for a Shared Delusional Disorder, F24, but the DSM does not, they dropped their diagnosis of a shared delusional disorder from the DSM-5 that they previously had in the DSM-IV.

That’s a subtle, but very important difference in the DSM and ICD systems.  The ICD diagnostic system of the World Health Organization assigns all professionally established medical and psychiatric diagnoses a code number.  So it’s sort of the grand-bible of all recognized medical and psychiatric pathologies, each one has a code number. The ICD-10 has a code for a shared delusional disorder; F24… and, here’s the interesting thing, the ICD-10 diagnostic system is THE required diagnostic system for ALL insurance billing in the United States.

All insurance billing requires an ICD-10, not a DSM-5 diagnosis.  That switched over that way a few years ago.  Before that, before the switch, the U.S. used the DSM system and Europe used the ICD system.  The ICD system though, also covers all medical pathologies like cancer and heart disease diagnoses, everything, all possible medical and psychiatric pathologies… that’s the ICD.   The DSM is just psychiatric.  But because it’s from the American Psychiatric Association, the DSM diagnostic system provides a more fully identified and more fully described set of diagnostic pathologies.  The ICD describes a diagnostic category in one or two paragraphs, the DSM describes the diagnostic pathology in five or ten pages.

Insurance billing for medical diagnoses has always used the ICD system, because that’s a comprehensive system for identifying all types of medical diagnoses.  But in the U.S. the insurance companies went American and used the American Psychiatric Association DSM-5 diagnostic codes for billing the treatment of mental health diagnoses.  Well, somewhere a decade ago or so, the insurance companies finally said enough, we’re switching to the ICD for all coding of diagonses.  They gave everyone plenty of warning, so the ICD and DSM set about lining up their codes.  The rollout of a partial switch happened with the ICD-9, and a full switch to the ICD-10 was mandatory for all insurance billing for mental health pathology.

So in the U.S. and in Europe, all mental health professionals have diagnostic access to the ICD-10 diagnosis of F-24, a shared delusional disorder, and since there is no current corresponding diagnostic category in the DSM-5 for that ICD-10 code, that means we should turn to the DSM-IV when this diagnostic category WAS still in the DSM system.  The DSM diagnostic system of the American Psychiatric Association had a diagnostic category corresponding to an ICD-10 diagnosis of a shared delusional disorder, but they dropped it for the DSM-5, they moved it to a “specifier” rather than a stand-alone diagnostic category, which essentially makes it diagnostically inaccessible in actual practice.

But a shared delusional disorder was in the DSM-IV, it’s called a Shared Psychotic Disorder.  Listen to this description of the diagnostic pathology by the American Psychiatric Association.

From the DSM-IV:  “The essential features of Shared Psychotic Disorder (Folie a Deux) is a delusion that develops in an individual who is involved in a close relationship with another person (sometimes termed the “inducer” or “the primary case”) who already has a Psychotic Disorder with prominent delusions (Criteria A).” (p. 332)

That fits this pathology, doesn’t it?  The allied parent has the persecutory delusion (the primary case; the “inducer”) and the child is the secondary case and acquires the persecutory delusion from the allied parent.  A parent-child relationship qualifies as a “close relationship,” so far so good.

From  the DSM-IV:  “Usually the primary case in Shared Psychotic Disorder is dominant in the relationship and gradually imposes the delusional system on the more passive and initially healthy second person. Individuals who come to share delusional beliefs are often related by blood or marriage and have lived together for a long time, sometimes in relative isolation.” (p. 333)

Still fits.  The allied parent, the “primary case,” is in a dominant parental role with the child, “gradually imposes” yes, that’s exactly what’s happening, “more passive and initially healthy” that’s the child, yes still fits, “often related by blood” yes, “and have lived together for a long time” yes, in “relative isolation” in the family, yes.  So we’re still spot-on in the diagnostic pathology description.

Now here’s an interesting statement from the American Psychiatric Association because it carries treatment implications.  It was a communication from the diagnostic committee of the American Psychiatric Association to the diagnosing professionals… if you’re seeing this pathology, this is what typically helps…

From the DSM-IV:  “If the relationship with the primary case is interrupted, the delusional beliefs of the other individual usually diminish or disappear.” (p. 333)

A protective separation of the child from the “primary case” of the persecutory delusional pathology is the treatment recommendation offered by the American Psychiatric Association for a shared delusional disorder.  Works for me. I’m not going to argue with the American Psychiatric Association when they come up with their diagnoses.  You tell me.  I apply the criteria to make a diagnosis.

From the DSM-IV:  “Although most commonly seen in relationships of only two people, Shared Psychotic Disorder can occur in larger number of individuals, especially in family situations in which the parent is the primary case and the children, sometimes to varying degrees, adopt the parent’s delusional beliefs.” (p. 333)

A shared delusion can occur “especially in family situations” we still have a complete fit of diagnosis pattern, “in which the parent is the primary case” yes, “and the children, to varying degrees, adopt the parent’s delusional beliefs” yes.

We have a full and complete fit for this child-family pathology with the diagnostic description provided by the American Psychiatric Association.  Diagnosis is symptom-driven, not theory driven.  There are no theories in the DSM, there are symptoms and diagnostic categories for defined patterns of symptoms.

But let’s look even further at what the American Psychiatric Association says about exactly this pathology;

From the DSM-IV Associated Features and Disorders:  “Aside from the delusional beliefs, behavior is usually not otherwise odd or unusual in Shared Psychotic Disorder.” (p. 333)

Yes, the child is functioning okay at school, there’s no overt or “otherwise odd or unusual” behavior from the parent or child.  The diagnostic description still fits exactly, without deviation from the description for a shared delusional disorder diagnosis in the DSM-IV.

From the DSM-IV:  “Impairment is often less severe in individuals with Shared Psychotic Disorder than in the primary case.” (p. 333)

The allied parent is more pathological than the child, yes.

From the DSM-IV:  Prevalence:  “Little systematic information about the prevalence of Shared Psychotic Disorder is available. This disorder is rare in clinical settings, although it has been argued that some cases go unrecognized.” (p. 333)

Yes, all of court-involved family conflict has gone “unrecognized” – yes.

From the DSM-IV Course: “Without intervention, the course is usually chronic, because this disorder most commonly occurs in relationships that are long-standing and resistant to change.” (p. 333)

Again, spot on.  The parent-child conflict with the targeted parent is “chronic,” “long-standing,” and “resistant to change,” yes, yes, yes.

According to the American Psychiatric Association, this pathology MUST receive treatment and it will NOT be resolved by waiting for something to change.

So… American Psychiatric Association, any recommendations about treatment?

From the DSM-IV:  “With separation from the primary case, the individual’s delusional beliefs disappear, sometimes quickly and sometimes quite slowly.” (p. 333)

So you, the American Psychiatric Association, are recommending a protective separation of the child from the “primary case” in a shared delusional disorder diagnosis, that’s what you, the American Psychiatric Association are recommending for treatment?  A protective separation.  The American Psychiatric Association.

If this pattern of symptoms lines up with the symptoms being displayed, you’re saying, the American Psychiatric Association is saying, that there MUST be treatment or else the situation will remain “chronic,” “long-standing,” and “resistant to change,” and that the treatment should be the child’s protective “separation from the primary case” – the treatment recommendation of the American Psychiatric Association for a DSM-IV diagnosis of a shared parent-child delusional disorder is the child’s protective separation from the “primary case” of the allied narcissistic-borderline parent.

Karen.

The DSM-IV was superseded by the DSM-5 in 2013.  Remember that?  Sure you do.  Bill Bernet and you, and all the Gardnerian PAS “experts” were putting on a major push to the American Psychiatric Association, trying to get your beloved Gardnerian “parental alienation” pathology mentioned somewhere, anywhere, in the DSM-5.  You just wanted them to use the word somewhere.  So you presented them with all your decades-long “research” and your diagnostic proposals for the pathology.

Remember that?  By the way, what’d they say? Oh, that’s right, “No.”

Do you remember what I was arguing back in that 2012 run-up period to the DSM-5.  I was seriously concerned that they were going to monkey with the Narcissistic personality category, which they ALMOST did, the new proposal for personality disorders went into an Appendix, whew, that was close – and I was also arguing that we needed to keep the Shared Delusional Disorder diagnosis.  That we should be focused on that diagnosis, on keeping that DSM diagnosis.  Remember that?

That was where we should have been putting our focus with the DSM-5, not on some “new pathology” – I mean seriously, holy cow – look at that Shared Delusion diagnosis, spot-on every criteria, leading to a protective separation recommendation made by the American Psychiatric Association.  The moment we – as mental health professionals – give that diagnosis, the moment we do that, the American Psychiatric Association makes a treatment recommendation for the child’s protective “separation from the primary case” BASED on our diagnosis.  Wow.  Simple.  Give that diagnosis.  It absolutely 100%  applies criteria-by-criteria, give that DSM-IV diagnosis and immediately get a recommendation from the American Psychiatric Association for a protective  “separation from the primary case” based – based – on my diagnosis.

That is immense power in diagnosis alone.  Karen, isn’t that amazing?  If you had just been diagnosing the pathology, think of all the wonderful things.

But, instead, your Gardnerian PAS “experts” group led by Bill Bernet went all-in on “parental alienation” and we lost the Shared Delusional pathology from the DSM-5, it got shifted to a “specifier” rather than a diagnosis, and we lost all the descriptive information about the pathology.  Shame.

You know when the American Psychiatric Association told you “No” to your new pathology of “parental alienation” idea, they’re telling you something, Karen.  You’re not listening.  They are telling you that diagnostically, whatever you think you have going on… it’s already in the DSM.  Already there.  You’re just not doing a good diagnostic job.  That’s what they’re telling you, Karen.  You are a bad diagnostician, the pathology you think you’re “discovering” is already in the DSM – you’re just a bad diagnostician.

Go back to the symptoms, and organize them up by DSM category.  You can do that, right Karen?  Not by your willy nilly ideas.  Organize the symptoms into the patterns described in the DSM diagnostic system, and if the symptoms line up with something, give that diagnosis.  And you see, there is it, Karen, it IS in the DSM after all.  You just weren’t doing your job of diagnosis.

You skipped the step of diagnosis.  Instead of diagnosing the pathology, you went running off into your fertile imagination of creating “new” pathologies.

And yet… and here is the truly disturbing part… you treated the pathology, without having first diagnosed the pathology. Oh my goodness, Karen, you DO realize that the treatment for cancer is different than the treatment for diabetes, don’t you? How can you possibly treat a pathology when you haven’t even first diagnosed what it is you’re treating?

That’s insane, Karen.  To treat a pathology you haven’t even diagnosed yet.  You have no idea what it is you’re even treating.

No, that can’t be.  That’s absurd.  You would NEVER treat a pathology for 20 years without EVER having diagnosed what the pathology is that you’re treating.  That’s laughable.  You’d never do that.  The treatment for cancer is different than that treatment for diabetes, you’d never just start treating something without first diagnosing what it is.

You’ve clearly been using the DSM-IV diagnosis of a Shared Psychotic Disorder extensively during your work, first as a DSM-IV diagnosis and now as an ICD-10 diagnosis.

So, let’s see, the DSM-IV came out in 2000, the DSM-5 in 2013, so the active period for the DSM-IV and the Shared Psychotic Disorder diagnosis was from 2000 to 2013 and you’ve been twenty years treating this court-involved family conflict stuff, so pretty much the entire time you’ve been treating this pathology, the DSM-IV was the active diagnostic system.

And oh my goodness, the spot-on accurate diagnosis of a Shared Psychotic Disorder is right there, in the DSM-IV, and it makes a recommendation, from the American Psychiatric Association for a protective “separation from the primary case” – what’s your clinic called, Karen, oh, that’s right, the Separation Clinic – and the APA is saying… authorizing you, Karen Woodall, to recommend a protective separation of the child from the “primary case” of a shared persecutory delusional disorder, because that’s what the American Psychiatric Association recommends based on your diagnosis Karen in applying their diagnostic criteria from the DSM-IV.

So clearly and obviously you’ve been diagnosing this pathology as a Shared Psychotic Disorder pretty much your entire career, haven’t you?  Because you wouldn’t start treating something that you hadn’t even diagnosed yet? That’s absurd. No one would do that.  Would your physician just start treating you for something without having first diagnosed what’s wrong.  That’s an absurd suggestion.  No rational human would do that, just start treating something without having diagnosed it first.  My goodness gracious, the treatment for cancer is different that the treatment for diabetes.  No one would do that.

So… if the diagnostic entity of a Shared Psychotic Disorder has been in existence your entire career working with this pathology, first as a DSM-IV diagnosis and now as an ICD-10 diagnosis, I’m sure you’ve made this diagnosis countless times, and argued on behalf of your clients, the targeted parents, countless times that a protective “separation from the primary case” of the shared persecutory delusional disorder is the treatment recommendation from the American Psychiatric Association for your diagnosis.

Haven’t you.  Sure you have.  You must have.  Because you wouldn’t possibly treat something you haven’t even diagnosed yet. That’s absurd, nobody treats something without first diagnosing what it is they’re treating.  So you must have used this DSM-5 and ICD-10 diagnosis countless times before, right Karen.

What’s been the response when you share the protective separation recommendation of the American Psychiatric Association for your diagnosis?  I’ll bet your targeted parent clients really appreciated getting that diagnosis from you, didn’t they.  Must of helped them a lot when they went to seek a protective separation order from the court, to have your DSM-IV or ICD-10 diagnosis of a Shared Psychotic Disorder and the recommendation of the American Psychiatric Association for a protective separation order based on your DSM-IV or ICD-10 diagnosis.

I’ll bet your targeted parent clients were pretty happy about that, weren’t they Karen.

All you have to do is give the diagnosis, Karen, and immediately the power of the American Psychiatric Association recommending the child’s protective “separation from the primary case” becomes available to you and to the targeted-rejected parent.  So surely you must have given this DSM-IV diagnosis countless times across your 20-year career that spans the exact period of this diagnosis in the DSM-IV, a Shared Psychotic Disorder.

I’m sure you’ll agree, Karen, lucky for us the ICD-10 kept the diagnosis of a Shared Psychotic Disorder, F24.  Whew.  Now we just give that ICD-10 diagnosis, and since there isn’t a corresponding diagnosis in the DSM-5, we turn to the corresponding description from the DSM-IV for this pathology, and we still maintain our access to the DSM-IV descritors for the pathology.  Whew, that was close, wasn’t it Karen.  I’ll bet you’re as relieved about that as I am.

As you remember, Karen, I only became active over here with this court-involved family conflict pathology starting around the 2012 period, at the time I was posting a lot of stuff to my website on the personality disorder linkages, that’s what I was unlocking during that 2012 period.  You can still see all my early stuff up on my website, I posted the DSM-IV Shared Psychotic Criteria to my website.  It’s still up there:

DSM-IV TR Shared Psychotic Disorder Criteria

I leave everything I post up there, so if I’m posting DSM-IV TR diagnostic criteria, you know this is pre-2013 when the DSM-5 came out.

So you can see how I come over here to this pathology and I immediately start hitting the DSM-IV diagnosis of a shared delusional belief, a Shared Psychotic Disorder.  I’m a little worried by the intensity of the diagnostic label as “Psychotic” – it is, but it can be disorienting to someone unfamiliar with psychosis – it’s not running around crazy lunatic psychosis, it’s more contained, it’s a delusion, a false and distorted thinking pattern, persecutory, jealousy delusions, eroto-manic (the movie-star stalker).  An encapsulated pocket of delusional belief that’s shared between two people in a close relationship, the “primary case” creates the shared delusion in the secondary case, the formerly healthy person.

So no sooner than I get over here than I’m starting to highlight the DSM-IV pathology of the shared delusional disorder.   It’s a diagnosis.  I give every patient a diagnosis.  How can I possibly develop a treatment plan if I don’t know what I’m treating.  That is absurd.  So obviously I start with a diagnosis, and I have a DSM-IV diagnosis of Shared Psychotic Disorder spot-on describing this pathology, and with a protective “separation from the primary case” of the allied parent as the treatment-oriented recommendation of the American Psychiatric Association for my diagnosis.

I’m the one making the diagnosis.  There is no “peer review” of my DSM-IV diagnosis – apply the DSM criteria to symptoms, pattern match, make the diagnosis.  Pretty goll darn straightforward.

What’s forensic psychology’s malfunction about diagnosis? Oh, they openly say, “We don’t diagnose anything (identifying what the problem is) because we don’t like placing labels on people.”   Well that’s the nuttiest thing I ever heard.   We’ll have to address their nuttiness around diagnosis at some point.

You do realize mental health people, that we are mental health people, we’re the ones who are supposed to be diagnosing pathology.   Plumbers aren’t.  They’re supposed to fix our plumbing.  Attorneys aren’t.  They argue our cases for us in court.  Hmmm, who is it that’s tasked with the professional obligation of diagnosing pathology, oh, right, the mental health professional.

So if I’m starting with this DSM-IV diagnosis back in 2010-2012, and you’ve already been here and been established with your Separation Clinic, Karen, for what, ten years by that point.  So clearly you’ve been using this DSM-IV diagnosis lots and lots by that point.   Because, holy cow, Karen, the American Psychiatric Association is recommending a protective “separation from the primary case” based solely on your diagnosis.  If someone challenges your diagnosis, they’re welcome to get a second opinion.  Our diagnosis is our diagnosis.  We apply criteria, we match pattern, we make diagnosis.

You know that, Karen.  You know the power we have in diagnosis, right?  You do diagnose pathology, right Karen?

You see how I walked through step-by-step, sentence-by-sentence, the diagnostic descriptions of the DSM-IV.  It all applies spot-on.  So clearly, Karen, as an “expert” in this pathology with 20 years of experience that spans the exact period of the DSM-IV and the Shared Psychotic Disorder, you surely have given this DSM-IV diagnosis countless times, and argued for a protective separation of the child from the “primary case” of the shared perscutory delusional disorder, the allied parent, many-many times, based on the treatment recommendations made by the American Psychological Association based on your diagnosis, right Karen?  .

So tell us, what was it like to apply this DSM-IV diagnosis, what happened?  Because surely you wouldn’t treat a pathology without having first diagnosed what it is, the treatment for cancer is entirely different than the treatment for diabetes, so that’s just absurd that you would skip diagnosing a pathology and would just jump into treating something that you had no idea what it even was.  So you clearly have been applying the diagnosis of a Shared Psychotic Disorder a lot.

It’s still in the ICD-10 too, F24.  Lucky for us and targeted parents, right Karen.  So now we can keep using it as our formal diagnosis by just switching to the ICD-10 system and referencing back to the DSM-IV (because there’s no corresponding DSM-5 diagnosis for ICD-10 F24 Shared Psychotic Disorder).

Whew, I think you’ll agree with me that we’re lucky the ICD-10 kept the Shared Psychotic diagnosis.  I’ll bet targeted parents are thrilled when you tell them, that based on our diagnosis alone, the American Psychiatric Association will recommend the child’s protective separation from the allied narcissistic-borderline parent.  They must be so happy to hear that.

Because, as you and I both know, it’s all based on our diagnosis.  You do know how to diagnose something, don’t you Karen?  I mean, you wouldn’t treat something for twenty years without ever having diagnosed what it is you’re treating.

I see you’ve been traveling a lot, talking to people, educating them about this pathology.  That’s great.  Tell us, what’s been their reaction when you tell them about the ICD-10 diagnosis and protective separation recommendation of the APA based solely on your individual diagnosis.  Pretty excited I bet.  What about when you tell them that if they apply the three diagnostic criteria of AB-PA that are grounded in Bowlby, Minuchin, Beck, then the DSM-5 diagnosis – our current DSM- the DSM-5 diagnosis is V995.51 Child Psychological Abuse, Confirmed.  I’ll bet they go through the roof with excitement when you tell them that.  You do tell them that the pathology is diagnosable using the DSM-5 and AB-PA as Child Psychological Abuse, don’t you?.

They must be so excited to hear that.  What’s been their response when you tell them about the Shared Psychotic Disorder diagnosis and the Child Psychological Abuse diagnosis available through AB-PA?  I can only imagine their excitement at hearing about this.

Imagine… all this time people have been saying this “parental alienation” pathology isn’t in the DSM-IV or DSM-5.  Of course it is, right Karen.  In the DSM-IV it was a Shared Psychotic Disorder, and in the DSM-5 it’s Child Psychological Abuse, page 719.  Boy, I’ll bet they are so happy to hear that when you explain that to them. Of course the pathology is already in the DSM, we just have to diagnose it properly, right Karen.

But… I’m confused, Karen.  If they’ve been saying “parental alienation” is not in the DSM all this time, and you’ve known that it is actually in the DSM this whole time, as a shared delusion of a Shared Psychotic Disorder, why didn’t you clear up their confusion? Of course it’s in the DSM-IV, it’s a Shared Psychotic Disorder. Why didn’t you say something, Karen?

You do know how to diagnose pathology, right Karen? And you certainly wouldn’t start treating something before you diagnosed what it was, right Karen?  So why didn’t you correct them and point out that this pathology is in the DSM-IV, as a shared delusional disorder, with the American Psychiatric Association recommending a protective separation of the child from the allied “primary case” of the persecutory delusion?  What did they say when you pointed that out to them, Karen, that it IS in the DSM-IV?

Or does your role as a grandiose self-appointed “expert” in a supposedly new form of pathology exempt you from the requirements of diagnosis, Karen?  You’re special because of your special knowledge, you’re not bound by the same standards of professional practice for diagnosis as everyone else, us average psychologists, because you’re an “expert” – you get to skip actually diagnosing pathology, you get to just make up stuff… because.  Because you’re just entitled to do that, right Karen.

These people you’re educating on your travels must be so excited when you tell them about diagnosis.  I can imagine their amazement when they learn that this power of our diagnosis, that we’ve had it this whole time.  Wow, that must be something, when they hear that.

You do diagnose before you treat pathology, don’t you Karen? Tell me that you do diagnose a pathology before you begin to treat it – DSM-5; ICD-10.

And seriously, Karen, isn’t that American Psychiatric Association recommendation for a protective separation from the “primary case” wonderful.  You and I both know how useful that can be for targeted parents in presenting their cases to the court, to have a direct quote from the American Psychiatric Association recommending a protective “separation from the primary case” based solely on your DSM-IV/ICD-10 diagnosis of F24 Shared Psychotic Disorder.

Everyone must be so excited when you tell them this about diagnosis.  But you’ve known all this all along, haven’t you Karen.  Because you certainly wouldn’t treat a pathology that you haven’t even diagnosed yet.  That be absurd.  No one does that.  The treatment for cancer is different than the treatment for diabetes, you have to diagnose a pathology first, to know what the treatment plan is.  Right, Karen?

Of course. That would be absurd. Right, Karen.

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

 

 

Read More –>

Attachment and the Psychoanalytic School of Psychology

What makes you think we have time?

I have a client.  A targeted parent father.  He so very much loved his daughter.  She’s nine.  Her mother created all sorts of barriers to the father’s love for his daughter.  Most recently was an effort by the mother to replace the father with her new boyfriend.

The father was set to actively fight for his love in court.  That’s why he contacted me, he wanted my help.  He has a very strong case. 

But then he had a massive stroke that left him paralyzed, conscious but not able to communicate.  It’s severe.  He’ll wind up dying eventually from this stroke and its aftermath, maybe six months, maybe a couple of years, but he’s not going to recover language or the ability to move.

What makes you think we have time?

My heart breaks for his daughter, the love of this dad’s life.  She will never know ever again, the kind words of love from her father, her father’s warm embrace.  Because the mental health people thought there was time, “She’s not ready” to be loved they said.  She needed time, they said.  There is no time.  Don’t they understand how this life thing works, time slips through our fingers, sand flowing away even as we try to hold onto the passing moments.

She had no time, and what little time that little girl had with her father was stolen from her by her mother’s pathology and the therapists’ ignorance.  Now, she will never be able to fix things with her father – ever.  She was robbed of that opportunity by the mental health people and their ignorance.

What makes them think we have time?  We don’t.

What really grieves me is the thought of this little girl at 18 and 25 and 35, for the rest of her life.  Her final memories of her beloved father will be of her cruelty and rejection toward him.  She’ll never have the chance to fix that.  She was robbed of that chance by the ignorance and incompetence of the mental health people who said we had time.  They were wrong. 

We have no time, only now.  We need to fix things now.  The father-daughter bond is too special.  A son’s bond to his mother, or a father and son, or a daughter’s bond to her mother, these are all too important to risk.  We need to fix them, restore love, now.  Not tomorrow, not some imaginary time when things are “ready” – ready to be loved?  How absurd.  Being loved, receiving the love of mom or dad is always a good thing.  Today, yesterday, now, whenever.  A child receiving a father’s love, a mother’s love, is always a good thing.

And we don’t have time.  Don’t you understand how this life thing works?  Children are only children once, and they have only one mother, and only one father.  The love of a father, the love of a mother is too important.  There is no time.  We need to fix things now.

We don’t have time to restore the parent-child bond.  What makes you think that the targeted parent won’t develop cancer, or have a stroke, or die in a car accident… tomorrow.  And then the child never has an opportunity for her father’s love – ever.

And her last memory of her beloved father will be of her cruelty and rejection of him.  A memory for the rest of her life.  Why did they do this to her? The mental health people.  Why did the mental health people do this to her, prevent her from loving her father and receiving her father’s love.  Now, she has lost the chance.  Forever.

It breaks my heart.  And makes me so furious at the ignorance and incompetence in forensic psychology that creates such widespread suffering, grief, and immense tragedy.   The mental health people that prevented this little girl’s bonding with her father are despicable for their ignorance and incompetence, and for what they did to this 9 year-old little girl, robbing her of her father’s love, and burdening her with a tragic final memory of her cruelty and rejection.

Understanding

We die.  We leave, so that our children can have their turn.

I’ll be leaving at some point.  Of course I will, you didn’t realize that?  You did, but you’re in denial just like those mental health people and the little girl.  They thought they had time.  A fixed and false belief that is maintained despite contrary evidence – a delusion.

It’s the way we cope with our fear and anxiety about our fragility, and our tremendous grief if we ever allowed ourselves to recognize how time will take from us all that we love and everything we hold dear.  Of course it will.  Didn’t you realize that?  Nobody is getting out of this alive.  And I wouldn’t want it any other way.  A world without children would be a terrible place to live.  Our children merit their turn on the rides, their turn at courage and struggle, victory and failure, and love.

I’ve had my 20s and my 30s.  It’s our children’s turn.

I’ll be leaving at some point.  I’ve already had two strokey things, I’m 64 and I never have taken very good care of myself – I’ve had my 20s and my 30s and my 40s, I’m okay.  And reality is real, time moves inexorably forward, for us all.

At 64, I figure I only have one more round of active work in me, if that.  By the time I’m 70 I’m going to be pretty toasty and ready to watch sunsets on my front porch with my whiskey and cigar.  You’re on your own.  And seeing the generation that’s arriving, they’re magnificent.  Your turn.

I’ll be headed over to Barcelona and the Pyrenees in September to scout possibly nesting for my final days in the Spanish Pyrenees.  My next phase is to write books.  I have four or five or six books in me.  There’s two more in the AB-PA series, Foundations was the first, but there’s still Diagnosis, and Treatment to come.  For the last two, Diagnosis and Treatment, I’m just waiting to pull the trigger on those because the time wasn’t right.  No point talking to people who aren’t listening.  I’ll wait til people are listening.

Then I’ll have another four or five books after that.  Writing in the Spanish Pyrenees with a home city of Barcelona… things could be worse.

But that means I’ll only be actively around for a bit more here.  If you want to make use of me, I’m here.  Otherwise, I’m headed off to write and watch sunsets. 

What makes you think we have time?  We don’t.

Understanding

That little girl misses her father.  She’s lost him.  Forever.  Because the ignorant mental health people thought they had time.  They didn’t.  They were just ignorant, and because of that, she going to suffer for the rest of her life.  Without escape.  They took that from her.

What makes you think we have time?  We need to fix things now.  Today.  Immediately.  Love is always a good thing for a child to receive.  Especially today.

Craig Childress, Psy.D.
Clinical Psychologist

 

 

Read More –>

Slide5

Someone check on Karen, make sure she’s doing okay.

I’m worried about Karen Woodall’s psychological state, but I’m in Los Angeles.  Can someone over in England please check on her to make sure she’s okay.

Whenever I sign into my blog I get a newsfeed panel, and her blog has been showing up in this panel recently.  I typically don’t read them.  They’re just her own stuff without any scientific support.  She’s just making stuff up.  And as long as she’s basing her work on Gardnerian PAS, she’s pretty much irrelevant to any solution.  Gardnerian PAS prevents the solution.

But recently I’ve been attending to her, because we’re shifting into solutions that are grounded in actual knowledge, and as we do that the Gardnerians, particularly Karen, are seeking to sow confusion, co-opting terms and constructs that don’t apply to the PAS model, but then using them as a way of sowing confusion.  They want to pretend that there’s no such thing as AB-PA and Dr. Childress – a fantasy world where I don’t exist, so they can simply take all “my ideas” as their own.

Stupid pathogen.  They’re not my ideas.  Bowlby, Minuchin, Beck.  But I guess if you don’t know Bowlby, Minuchin, and Beck, it might sound like their my ideas.  None of this is Dr. Childress.

For the narcissistic personality – “Truth and realty are whatever I asset them to be… “I’ve always said…”  No, you haven’t. 

So I’m having to attend to the obstructionism of Karen Woodall, and Bill Benet, and the Parental Alienation Support Group (PASG).  The PASG is essentially inert.  It’s an organization created by Bill Bernet with the goal of studying “parental alienation,” as if after 40 years as a construct it needs more “study.”

Notice the difference between Bill Bernet and Dr. Childress, he forms a group to “study” “parental alienation,” I form a group to solve it.  We don’t need to study it… we need to solve it.  Different foundational attitudes.

Bill and I were in Venice last year presenting at a small conference.  I invited him and his wife to dinner, along with my wife, Peter Knudsen who had arranged my presentation in Venice, and Dorcy, who had joined me over there for the talk and for the meeting with Dr. Bernet.  We all met for dinner at the hotel.

I tried to convince Dr. Bernet to join us and collaborate on developing solutions.  I offered to write two joint articles together, one on the history and future of “parental alienation.”  In the first half of the article, Bill could describe the history of the struggle to solve “parental alienation” over the years.  Then for the second half I could talk about future directions.

We could then write a second joint article on the DSM-5 diagnosis of “parental alienation,” with a proposal for an actual full diagnosis – not simply a mention – a full diagnosis in the DSM-5 for this pathology – in the Trauma Disorders section of the DSM-5 – with – get this – the SAME diagnostic criteria as Shared Psychotic Disorder from the DSM-IV.  We’d bring back an already existing diagnosis in the DSM-IV (Shared Psychotic Disorder) and simply move it over to the Trauma Disorders section – the trans-generational transmission of trauma.  I’ll talk more about this proposal when I get around to writing the second book in the trilogy – Foundations – Diagnosis – Treatment.

But Bill refused to work together.  He insisted that I had to accept that there is a new form of pathology unique in mental health.  It’s not true.  There is no new form of pathology, the pathology is all entirely explainable using standard and established constructs and principles.

I must admit, I became frustrated at that point, and expressed my frustration to Bill, about all the children who would be lost, who would be sacrificed to this pathology because he was refusing to work together toward a solution.  It breaks my heart each family, and each day without a solution is one day too long.   And here Bill is being obstructionist, not because he thinks it will lead to a solution… he knows he has no solution… it’s because he wants to hold on to his beloved Gardner and the PAS model.  And for that, he’s willing to sacrifice tens of thousands of children to the pathology – ONLY Gardnerian PAS is allowed to solve the pathology.

On something this important, that type of obstructionism is frustrating, and heartbreaking.

I suspect the reason these “experts” have become obstructionists instead of allies is that these “experts” are not really experts in anything.  Once they lose this “new pathology” idea that they’re so fond of, they become ordinary.  They don’t like being ordinary.  I wonder why?

They’re special.  They’re “experts” and everyone needs to listen to them, because they’re discovering this whole new form of pathology.  They’re not.  They’re just atrocious diagnosticians.

At one point I tried to get Bill to activate the PASG into an advocacy organization.  Imagine if the PASG were putting pressures on the APA and forensic psychology.  Bill said no.  He said that the PASG is a “Study” group, not an advocacy group.  It’s mission was to study “parental alienation,” not advocate for any changes to anything.  PASG membership… did you know that?  That your mission isn’t really to solve or change anything… it’s just to “study” the pathology – I guess at all those conferences you all like to get together at… to “study” the pathology.

Mind you, “study” refers to them all sitting around a table at their conferences and talking about it to each other, and this PAS “parental alienation” idea-thing has been around for 40 years, so they’ve pretty much talked themselves out.  Unless someone like Karen starts to decompensate and begins “discovering” new things – things she didn’t discover for the past 40 years but is now miraculously “discovering” – some sort of boost in her mental capacity I suppose.

So PASG is inert.  It will not do anything to advocate for change.  Bill won’t let them.  And he refuses to collaborate unless I accept that PAS is a real form of new pathology – which it isn’t… that’s a poison pill to our collaboration.  I could find ways around our disagreement if we wrote a joint article (we wouldn’t look too close at our differences).  But I will not wander into a false reality because Bill finds it warm and comforting.

We are solving this attachment-related family conflict pathology by returning to the established knowledge of professional psychology, Bowlby, Minuchin, Beck.

Karen Woodall is the most active obstructionist.  This is because she has her personal finances at stake.  She’s put all of her professional status into her Separation Clinic and drives the clinic’s marketing (her making money) by her being an “expert” in this new form of pathology.  Apparently her husband, Nick, is in on this too, so it’s a whole family affair.  If we return to the established knowledge of professional psychology – she’s no longer an expert and there goes all her marketing of herself and her clinic – and if we actually solve the pathology – there goes her entire clinic.  Her entire world is built on her being an “expert” in a “new form” of pathology.

Neither one is true.

So she’s been the most active in scrambling to remain relevant by obstructing and creating confusion.  To do this, she picks up on words or phrases I’m using and then mimics them, – but without meaning.  She doesn’t really understand actual psychology – so she uses the terms but then kind of twists and distorts them into what she wants them to be.  Sort of a, “Truth and reality are what I assert them to be” relationship with actual reality.

But recently I’ve been seeing a series of pictures come across my newsfeed for Karen’s Blog, and it has me worried.  I’m a clinical psychologist.  We look at multiple layers of stuff… like the possible symbolic meaning in the choices Karen is making for her pictures.  I know, she thinks the pictures relate to her blog article… but both the blog article AND the pictures are also – also – reflections of her.  It’s called projection.  All of us do it all the time.

Even me, even now.  I’ve got projective material wrapped up in this blog.  Because it’s impossible not to.  We all live in a brain, this brain has patterns, these patterns get imprinted on EVERYTHING we do.  That’s the whole principle of Gestalt therapy.  Gestalt therapy picks anything we do and then unravels it into everything we are.  It’s really powerful.

So I have my projective nonsense wrapped up in everything I do as well… it’s just that I’m a clinical psychologist, so I remove a lot of my personal nonsense beforehand, maybe 10%, and then I hide as much of my personal material as possible from public display, maybe another 10%, and then the rest is unconscious and it just goes spilling out into whatever I’m doing.  I don’t have huge nonsense, so it tends to be transparent.

Karen, though, doesn’t seem to be as sophisticated at not displaying her personal material.  Because I’m a clinical psychologist (I trained as a Gestalt therapist in my younger days), I see a lot of it.  She doesn’t realize she’s doing this, because she’s not very sophisticated, so her projective stuff is just all over the place.  That’s one of several reasons I don’t read her stuff, it feels a little intrusive into her privacy, I see deeper than I think she’d like me to see, so I just don’t pay attention.  Besides, as long as she’s holding onto Gardnerian PAS, she’s making herself entirely irrelevant.  

But recently it’s gotten concerning recently.  It’s the pictures.

Recently she started a descent into self-exposure with a gateway picture, the Fairy Tales picture.  I commonly refer to her Slide1stuff as unicorns and mermaids – make believe fairy tales.  So she’s announcing that shes going to enter her world of Fairy Tale beliefs.  Interestingly, she adds this picture to another different title for her actual blog – something about this “splitting” kick she’s on.  So this Fairy Tale addition is just that… an addition.  That’s always significant, when something sticks out like that.  There was no need for this… why did she add it… because it’s her material.

So this Fairy Tales signpost signals that we’re on a descent into her own material here, she is going to display her stuff.  Please don’t, Karen.  Too late.

The next picture shows the descent.  It’s a puzzle and all the pieces are put together, the Slide2pieces of her psychological makeup are all organized… except there’s big missing holes.   She presents as all put together, but if you know where to look, somethings missing, something’s not right.  What do those missing pieces represent?  Well, guess what, in this psychological process, that’s coming next.  We’re going to drop into those missing pieces next.

The next picture will show us the missing pieces, so imagine we’re going to enter one of those missing pieces, to see what’s underneath the puzzle.

The next one is not unexpected, but it is concerning.  Her actual psychological state is Slide3fractured.  So while she gives the outward appearance of all the puzzle pieces put together, except for missing places, when we penetrate her surface presentation we find that the structure is an illusion and that the entire picture, her entire psychological state, is fractured.  That shouldn’t be – especially for a mental health person.  Our inner psychological state should NOT be this.

But now she’s entered too deeply.  Beneath the cracked glass is a chaotic abyss, the glass is fragile, the glass will break, she has to return to the structured world of reality, to recompensate from her descent.

So the next picture returns to the world of everyday, announcing upcoming conferences Slide4of her being an “expert” – she is recompensating her ego, she got too close to her material and the glass threatened to break beneath her.  So she came out and re-asserted – “I’m an expert.”  Notice how this picture isn’t of the same type as the others, it’s a flyer, the others were graphics.  She has to get far away from the fractured inner material she came close to.  All the way back out, to an anchored world.

But then… the graphics are again, disturbing.  A frayed rope, almost at its breaking point.  So even while recompensating, she continues to express her troubling deeper material.  I’m worried.  If this is projective material she’s displaying, and it most likely is, she’s struggling.

Now Karen will have all sorts of real-world “explanations” for her choices in pictures.  In clinical psychology, we understand that we all have a lot of choices – about everything… but we only choose one.  Why that one?

Oh… okay.  Whatever you say.

But are you familiar with the unconscious, and how that guides our actions?

So with her recompensation, as tentative as that is, we have nearly completed our journey.  Karen has bounced down to her material, it threatened to lead her into her chaos, her fracturing of structure, so she had to pop out and restructure – a return to the real world – the outside world -with the assertion of her inflated ego-structure, “I’m an expert – everybody needs to listen to me.”  the only thing left is the consolidation of the journey.  The next image she selects will be her integration of the psychological journey into her inner material that she just went on.

Uh-oh.  That’s not good.Slide5

I’m reminded of the dead at Pompeii.  That… is a disturbing image, and if that represents Karen’s normal-consolidated integrated state, that’s not good.

Karen’s world is collapsing, and she can’t find a way to stop it.  Her stable world of Gardnerian PAS and no solution is changing.   There will be no Gardnerian PAS anymore, and she’s not going to be an “expert” anymore.  She has a over-inflated ego of unjustified self-importance, that is collapsing.

Uh-oh.  Would someone go check on Karen, make sure she’s doing okay.  I know she’s trying to make all these positive and optimistic statements – but she’s in denial.  AB-PA exists, Dr. Childress exists, and she’s in denial about that.

Her denial will save her structure for the time being.  But not for long.  No one is ever going back to Gardnerian PAS.  That ship has sailed, in fact that ship has sunk.  Titanic at the bottom of the ocean.  We’re going to switch to jet airplanes, much more efficient.

Oh, I’m sure Karen will deny that she’s in any trouble psychologically.  But still… I’m a clinical psychologist, I’m worried about her.  From where I sit, I don’t think she’s holding up so well.  Would somebody just check in with her, make sure she’s doing okay.

Karen… word of advice… stop trying to be more than you are.  Once you release the psychological burden of having to be more, special, an expert – and just return to being ordinary, things will get a lot lot better.

I’m not an expert, Karen.  I’m just a clinical psychologist.  I’m a good clinical psychologist, but that’s all I am.

Being “more” creates a false-self presentation that is absolutely nasty on the inside.  For an understanding of what happens when the ego becomes over-inflated, I’d turn to Jung, Karen.  It’s not a good thing.  The unconscious will emerge to balance, and typically through the Shadow.  That’s that picture, the last one.  That’s the shadow emerging.

For integration, all the air has to be let out of the ego, pffffffffffffffffffffftttt.  It feels really empty at first.  But this become the “fertile void” – that’s a Fritz Perls construct, I really love it… the fertile void for growth of self-authenticity.  Just do your job.  There’s a kid in front of you, there’s a parent… make contact… stay focused…. bring empathy, genuineness, and unconditional positive regard and fix things – simple, with that one child, with that one parent.  That’s enough, it’s always enough.

That’s way enough for me.  I don’t want to be an “expert” – pfft.  I’m just a clinical psychologist.  I just want to fix that one kid, that one parent who is sitting in front of me.  But I can’t, because the systems are broken.  So… I guess I have to fix the systems so I can fix my kiddo… but the only reason I’m fixing systems… is because of that one child, that one parent.

The world is changing, Karen.  I’m not an enemy, I’m not someone to fight against and “stop”… I’m simply being a clinical psychologist, doing what I do.  I have a kid that needs fixing – I can’t fix my kid until I fix the systems that surround my kid.  Dang.  So back in 2010 I set about fixing systems, not because I’m special… but because my kid needs the systems fixed so I can fix my kid.

I think you’ve gotten lost, Karen.  Lost from why we do this.  It’s not for us.  Its not to make us big and wonderful.  It’s for that one kid sitting across from me, that one parent in tears.  That is the entire world, Karen.  We expand out from there to do what we need to do… to fix things for that child, and that parent.

I’m not from this world of forensic psychology, Karen.  I come from obscurity, from the foster care system.  No one ever becomes famous by working in the foster care system, that’s basic county-funded work.  These are the rejected and abandoned children, our unloved children.  That’s where I was, because they need me the most over there.

Look at my vitae.  That’s not a vitae for fame and fortune.  Once I left the clinic and entered private practice, I was happily on my way to retirement and writing books about curing ADHD.  I had zero, in fact negative, interest in “high-conflict” divorce.  But I had a child.  He was 10.  He said to me, well, not in words, but he said… “Can you help me, Dr. Childress.”  I’ll see what I can do, buddy.  So he took me by the metaphorical hand and led me over here, to “high-conflict” divorce.  Oh, it’s a nightmare over here.

Since then, I’ve met so many kids, and their parents.  A lot of parents.  We need to fix this.

But I didn’t come here to be a famous “expert” – I’m here for that one kid, that one parent, who is sitting across from me.  I’ve met more of them, so many more, since being over here.  This isn’t about us, Karen.

The world is changing because it has to.  In order to fix the systems, we have to return to the established knowledge of professional psychology – all of us.  Even you.  That way, we all can come together in agreement – ALL of professional psychology, on the ground foundations of established knowledge – Bowlby, Munuchin, Beck.

And from this foundation of knowledge, we can change how the systems work in response to this pathology.  We can get proper assessments and accurate diagnoses, and most importantly, we can get effective treatments… all by returning to the established knowledge of professional psychology, Bowlby, Minuchin, Beck.

We’re ordinary, Karen.  We’re not Bowlby, we’re not Aaron Beck.  Stop trying to be more than you are.  I’m just a clinical psychologist – I’m a really good clinical psychologist, personally I think I’m the best – but I’m the best, Karen, because I know a lot of stuff, not become I have some “special” expertise personally.  I just know stuff.  I know Bowlby, and Beck, and Millon, and Tronick… and so much.  Do you know why I know so much?

Because I’m from the foster care system… I’m from our abandoned, unloved, and brutalized children.  You need to know a lot for them, don’t ya think?  With all they have going on in their world… they need the best.  No fame, no fortune.  Just work, for each child and each parent that sits across from me, they are the world.

I’m worried about you, Karen.  The world is changing, that is a fact.  As I said, I’m a really good clinical psychologist, we create change.  I’m doing that.

Think about it, Karen.  Think about releasing into the change rather than fighting to stop the change.

Ohhh, but that will mean you’ll have to give up Gardnerian PAS entirely, to return entirely to the established knowledge of professional psychology – Bowlby, Minuchin, Beck, Tronick (yeah, there’s a neuro-social piece, ya gotta understand the brain).

Let go, Karen.  Just be normal.  Holding on is fighting the ocean, and the over-inflation of ego is not going to turn out well.  Ever try to fight an ocean wave?  Not a chance.  Release into change.  But that means you won’t be an expert anymore.

But you want to know something that’s so much better than being an “expert”?  Solving this pathology for all kids everywhere, now and into the future.   We do that by changing systems, and we change systems by returning to the standard and established constructs of professional psychology – all of us.  Even you.

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

 

 

 

 

 

Read More –>

Attachment and the Psychoanalytic School of Psychology

Court-Involved Clinical Psychology and Child Custody Decision-Making

Targeted parents are human beings.  They are people.  Psychologists are not allowed to hurt people.  Anyone.  Targeted parents qualify.

Psychologists are not allowed to hurt people.  We’re not allowed to do anything that would hurt the targeted parent.

Making professional recommendations that would limit the time that targeted parents share with their children to anything less than the maximum time possible, hurts the targeted parent.  It makes them sad, very sad, it takes away from them a fundamental self-identity role of mother or father, it takes from them life experiences with their ever-growing child that can never be recaptured or recovered, the child is only five once, only ten once, only fifteen once, never again.  Lost time is lost, and this hurts the targeted parent.

Psychologists are not allowed to hurt people, not even targeted parents.  They are people.

What is the maximum amount of time?  Following divorce, that would be 50-50% shared custody visitation.  We learn about sharing in preschool.  We take turns.  It’s a fundamental principle of social cooperation.  We share.  We take turns.

Following a divorce, that would a be 50-50% shared time.  A psychologist cannot advocate for anything other than that, because anything other than that will hurt one parent or the other, will make one or the other sad, very sad, and will take from them a fundamental life role, an important experience of self-identity, their role and experience of being a mother or father.  That would hurt them.  Psychologists are not allowed to hurt people.

But sometimes situations and limitations imposed by external factors make a shared 50-50% custody visitation schedule impractical or impossible.  What do psychologists do then?  We work to limit the harm.  We don’t make decisions as to who is harmed.

This is the APA ethics code on Avoiding Harm to the client, Standard 3.04a:

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

We’re not allowed to harm people, and if harm is unavoidable, we “minimize harm where it is forseeable and unavoidable.”

Sometimes the child’s need to attend a single school requires that the child has a school-week residence with one or the other parent.  This will hurt the less involved parent, it will make them sad and damage their life experience as a mother or father.  But it is unavoidable.  The child needs to be at a single school location during the school week, the child needs a single school residence.

If both parents can live close enough to each other that they can share custody visitation time with the child and the child can also have a single school, then this is the best option, then we share, we take turns, and a 50-50% shared visitation schedule is the best in “minimizing harm” caused by the divorce itself – the separation of the family structure.

But if that’s not possible, then an every-other-weekend to one parent and primary school-week custody visitation with the other parent becomes the next available option for a fair distribution of time with a minimization of the unavoidable harm to one parent or the other from divided custody time.

Giving one parent only every-other-weekend is a severe restriction on this parents time, and is less than the maximum possible.  The maximum possible would be every weekend.  If the limitation is the child’s need for a single school so that one parent is the school-week parent, then the more limited-time parent could be the weekend-parent, this would be the best outcome for the more-limited, and therefore harmed, parent.

But then the school-week parent is harmed in another way.  The school week is task oriented with homework and after-school activities, and coincides with the work-week schedule and stresses.  Weekends are a time of relaxing and quality bonding.  If we take all of these weekend times of bonding relaxation away from the school-week parent, this harms them because it harms the quality of their relationship with the child.  One parent, the weekend parent, would receive all the quality bonding time of relaxation, and the other parent would receive all the task-oriented time of schoolwork and activities.

We want to balance the quality bonding time of weekends, so we assign an every-other-weekend schedule for visitation.  But then this is less than the maximum time available for the limited-time parent, and an every-other-weekend schedules imposes a two-week absence between only brief visitation times.  We would like to provide additional time to this limited-time parent if possible, to maintain a consistent presence of contact and involvement.

Because the more infrequent time parent is being harmed, and because of the long period of absence between weekend visitations, we try to add some additional consistent time for this parent.   Typically this is through additional weekday time, often a Wednesday or Thursday dinner with the child every week, sometimes for a block of time, sometimes overnight if the infrequent time parent is able to maintain the child’s single school attendance the following day.

Psychologists, however, do not decide which parent is the school-week parent and which parent is the every-other-weekend parent.  That is not our role.  Ever.  It is not the role of a psychologist to decide who is harmed, who is sacrificed.  The second clause of Standard 3.04 says we “minimize harm” – it does not direct us to decide who is harmed.  The recommendations provided above regarding shared 50-50% custody visitation time, and an alternative every-other-weekend custody visitation schedule when the harm is “unavoidable,” meets this standard to “minimize harm where it is forseeable and unavoidable.”

We do not decide on who is harmed.

But what about the greater good?   If the child would benefit from more time with one parent than the other?

Two responses.  First, psychologists do not judge people to decide who deserves to have children and who doesn’t.  That is NOT our role.  Parents have the right to parent according to their cultural values, their personal values, and their religious values.  Psychologists should NOT assume a professional role of judging which parent is the “better parent” based on criteria that cannot be supported.  If there is no child abuse, then parents have the right to be parents.  If there is child abuse and child protection factors are a consideration, then there should be a corresponding DSM-5 diagnosis of child abuse.

Psychologists should not be in a role of judging who “deserves” to be a parent and who doesn’t.

Second, the “greater good” argument for causing harm is specifically prohibited by the APA ethics code.  Standard 3.04b prohibits psychologists from consulting for or collaborating with torture practices (enhanced interrogation) of terrorists.  Even terrorists, where there is a greater-good argument about the information they possess, psychologists are not allowed to harm terrorists.  The greater-good argument for causing harm is specifically prohibited.

Psychologists are not allowed to harm people.

Targeted parents are people.  We are not allowed to harm them.

The argument made by the allied parent is that the targeted parent “deserves” to be harmed, because they are a “bad parent,” and the allied  parent wants psychology and the court to judge the targeted parent, and to punish the targeted parent because they are a “bad parent” by limiting or restricting the parent’s time with the child.

It is not the professional role of psychologists to judge people to decide if the person “deserves” to suffer and be punished for some flaw or frailty.  That is never the professional role of psychologists.  If the court wishes to take up the matter of whether one parent deserves to be punished for bad parenting, that is a legal consideration of the court.  Psychologists are never in the role of judging someone’s frailty or vulnerabilities to decide if they should be a parent, or to decide if they need to be punished for their frailty.

Psychologists do not harm people.  Targeted parents are people.

If there are frailties, we fix them.  Parents have the right to parent according to their cultural values, their personal values, and their religious values.

Everyone can recognize how we do not override cultural or religious values in parenting rights, I want to highlight personal values.  Society has no authority to override parents in their right to parent according to their personal value system.  This provides a broad latitude to parents regarding their decisions as parents.  As long as there is no child abuse (documented with a corresponding DSM-5 diagnosis of child abuse), then parents have the human right to parent according to their personal values.

Personal values are embedded in cultural values, personal values are embedded in spiritual and religious belief systems.  Personal values are respected by professional psychology.  Psychologists do no judge who is the “better parent” who “deserves” to have a larger share of time with the child, psychologists do not judge who is a “bad parent” who deserves to be less involved with the child.

If there is no child abuse, then the rights of parents to parent according to their cultural values, their personal values, and their religious values is their human right and is respected.

If there is child abuse, then this needs to be documented by a corresponding DSM-5 diagnosis of child abuse, V995.54 Child Physical Abuse, V995.53 Child Sexual Abuse, V995.52 Child Neglect, V995.51 Child Psychological Abuse.  If there is no DSM-5 diagnosis of child abuse, then there is no justification for restricting a parent’s time and involvement with their child.

Custody Visitation Schedules

The practice of child custody evaluation is a professional abomination, psychologists should never be in the role of judging parents and parceling out pain and suffering based on some ill-formed and arbitrary criteria.

Psychologists do not harm people.  Anyone.  Ever.

Targeted parents are people.  They qualify.

Child custody decision-making following divorce is not complicated.  A shared 50-50% recommendation would be the default option in all cases because in minimizes harm to each parent created by the separated family structure and need to divide visitation time with the child.  We share, we take turns.  This is a foundational principle of social cooperation taught to all of us in preschool.  It applies in adult social cooperation as well.

We share.  We take turns.

If this is not possible, and harm must be done to one or the other parent by limiting their time and involvement with their child, then an every-other-weekend (and an evening during the week) custody visitation schedule becomes the second option.

This is not complicated.  That is the recommendation of professional psychology in all cases.  Professional psychology is not in the role of judging parents and parceling out pain based on who “deserves” to suffer because they are a “bad parent” (bad spouse).

Geographic Separation

In some cases, parents are geographically separated by long distances.  In these cases, neither the 50-50% shared visitation schedule nor the every-other-weekend visitation schedule is possible.  Additional harm is unavoidable.

In geographically separated families, the child’s need for a single school location requires that one parent be designated as the school-year parent, and the other parent will receive visitation time during the child’s school vacations.  As with the every-other-weekend schedule, the limited-time parent should receive all of the vacation time to maximize their available time with the child, but then this would harm the school-year parent by taking from them all of their relaxed bonding time with the child.

Similar to weekends, holiday and vacation bonding time is typically divided equally in geographically separated families, although sometimes additional time considerations are granted to the limited-time parent during summer vacations, and a strong argument can be made in favor of this compensation summer-bump to the limited-time parent’s custody visitation time with the child.

Move Aways

When a separated family structure occurs because of the parents’ divorce, the geographic location is established and the rights of each parent-spouse are established.  No move aways are permissible except in the most exceptional of circumstances.  Each parent’s individual rights are equally valid.  To take the child away from either parent would significantly harm the limited-time parent.

Psychologists are not allowed to harm people.  Any people.  Deciding if someone should be harmed is not the professional role of psychologists.  Once the home geographic location is established, if one of the spouse-parents wants or needs to move away from that region, for whatever reason, that is their choice.  Their choice, however, should not impinge on the liberties of the other spouse-and-parent, which include the right to be an active and involved parent with their child.

Life circumstances can be difficult and can impose difficult choices.  Personal life situations and choices, however, are not the responsibility of the ex-spouse following divorce, and the rights of the ex-spouse and parent to be an active and involved parent are not made void by the wants and needs of the other spouse-and-parent.

The court may decide that special extenuating circumstances exist that warrant allowing the move away of one parent with the child.  In these circumstances, the geographically separated custody visitation schedule of a school-year parent and a vacation-primacy parent becomes the recommended custody visitation schedule.

All Children – All Families

These recommended custody visitation schedules and the sequencing of their application applies to all children and all families.

Altering these schedules for child protection factors should be accompanied by a DSM-5 diagnosis of child abuse.

Psychologists are not allowed to harm people.  Anyone.  Targeted parents are people, they qualify.  Psychologists are not allowed to do anything that harms the targeted parent…. Standard 3.04 of the APA ethics code, Avoiding Harm.

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

Read More –>

picture of James M. Swanson

Karen, I have a quiz for you…

DSM-5 Narcissistic Personality Disorder Criterion 1:  “Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements).”



Karen Woodall, you assert that you are an “expert”… I have a quiz for you. 

You’re a mental health person, right?  So you should know symptom terms and definitions.  I have one for you.  I’ll describe the symptom and you give me the clinical term.  Ready, okay here:

The Symptom:  A fixed and false belief that is maintained despite contrary evidence.

What’s that called, Karen?

Right, a delusion.  I was pretty sure you’d get that one.  So here, let me give you a clinical application scenario and see how you do.

Say you have this person who thinks that they’re inventing something that will save the world, or that they’re making some earth-shattering new “discovery” but then it turns out that it’s not true.  It’s a false belief.  Other people have already invented the stuff or made the discoveries.  So the person’s belief that they are making great and grand new discoveries or inventing wonderful new inventions, well, it’s not true, it’s a false belief.

And then, the person is shown the contrary evidence, they are shown that someone else has already invented the things or made the discoveries, and there’s evidence that this is a false belief.  But the person ignores the evidence, the person goes into sort of fingers-in-the-ears la-la-la denial, and the person continues to insist that they are actually making these wonderful “new discoveries” that have already been discovered, despite being presented with the contrary evidence… is that a delusion?

That’s right, it is.  It is a fixed and false belief that is maintained despite contrary evidence, that’s the definition of a delusion in professional psychology.

Let me try one that’s a little harder.  If the person has a fixed and false belief, a delusion, the content of which is that they are inventing some sort of great and marvelous new invention or making some sort of historic “new discoveries,” what – TYPE – of delusion is that?  You can go ahead and think about that one for a moment.

It’s a grandiose delusion.  A false belief in being special, in being superior or above other – ordinary people – that someone has “special” talents or knowledge beyond that of other people is called a grandiose delusion.

Okay, final question, Karen… what are the main types of pathology that have grandiose delusions as a symptom feature?

Answer… ready?… there’s mania, a grandiose delusion would be considered a “mood congruent” psychotic feature of mania, and… that’s right, Karen, narcissistic personality disorder.  Delusional grandiosity is a symptom feature of narcissistic pathology.

DSM-5 Criterion 1:  “Has a grandiose sense of self-importance”

Karen, I want you to listen carefully… there is no such pathology in professional psychology called “parental alienation” – it is not a real pathology in professional psychology.  There is contrary evidence to your belief that this is a new form of pathology in professional psychology.  There is no new form of pathology, Karen.

(It’s just your ignorance showing, Karen.  You may want to tuck that away because everyone is seeing it)

Contrary Evidence 1: 

Minuchin, Bowen, and Haley all identified and fully described this pathology a full decade BEFORE Gardner proposed his new form of pathology he called “parental alienation” and in 1993 Minuchin even provided a structural family diagram for minuchin cross-genEXACTLY this pathology.  There is no “new form of pathology” – that is a false belief.

Here is the definition of a cross-generational coalition provided by Jay Haley in 1977 – a decade before Gardner and his proposal that there is a “new form of pathology” that Gardner called “parental alienation.”

From Haley:  “The people responding to each other in the triangle are not peers, but one of them is of a different generation from the other two… In the process of their interaction together, the person of one generation forms a coalition with the person of the other generation against his peer.  By ‘coalition’ is meant a process of joint action which is against the third person… The coalition between the two persons is denied.  That is, there is certain behavior which indicates a coalition which, when it is queried, will be denied as a coalition… In essence, the perverse triangle is one in which the separation of generations is breached in a covert way.  When this occurs as a repetitive pattern, the system will be pathological.” (Haley, 1977, p. 37)

Minuchin provided a clinical description of the pathology in his 1974 book, Families and Family Therapy.

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

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

From Minuchin:  “The boundary between the parental subsystem and the child becomes diffuse, and the boundary around the parents-child triad, which should be diffuse, becomes inappropriately rigid.  This type of structure is called a rigid triangle… The rigid triangle can also take the form of a stable coalition.  One of the parents joins the child in a rigidly bounded cross-generational coalition against the other parent.” (p. 102)

These are recognized expert people in families and family conflict – real ones – and Salvador Minuchin described this pathology in 1974.  Fully.  It is an established pathology in family systems therapy called a “cross-generational coalition” – you are not “discovering” anything, Karen.

A child’s rejection of a parent is called an “emotional cutoff” Karen.  It was described the the renowned family systems therapist, Murray Bowen in 1978, Karen.

From Bowen Center “The concept of emotional cutoff describes people managing their unresolved emotional issues with parents, siblings, and other family members by reducing or totally cutting off emotional contact with them.”

You are not “discovering” a new pathology, Karen.  You are simply ignorant of family systems therapy.  The pathology is fully and completely explained in family systems therapy and has been since the mid-1970s.   You are not “discovering” something, you are simply ignorant about how families work – Minuchin, Bowen, Haley, Madanes.

Contrary Evidence 2: 

In 2013, the American Psychiatric Association made a decision.  The DSM-5 Committee had fully and completely reviewed the construct of “parental alienation” as a pathology.  You, and Bill Bernet, and all the Gardnerian PAS “experts” had a full and complete opportunity to present all of your best evidence and arguments in favor of a “new form” of pathology called “parental alienation.”  What did the American Psychiatric Association say, Karen?

They said, “No” didn’t they.  The American Psychiatric Association, after reviewing all of the evidence, after you and Bill Bernet and all of your group of Garnerian PAS people had a full and complete opportunity to present all of your best arguments to the American Psychiatric Association… the APA made their judgement.   They said there is no such pathology as “parental alienation” – not a mention anywhere in the DSM-5.

If they had wanted to throw you a bone they could have included the term in their V-Code diagnosis of Child Affected By Parental Relationship Distress – a perfect spot to include the term “parental alienation” in the description.  They deliberately chose NOT to include the term, Karen.

Do you know why, Karen?  I have a YouTube series on the eight symptom features proposed by Gardner for a diagnosis of “parental alienation” – you should watch it.  Because those are all questions that you must address about your proposed “parental alienation” diagnostic model.  This is a professional critique of your work Karen:

Gardner PAS Series

The Gardnerian proposal of a “parental alienation” pathology is quite probably the WORST diagnostic model of anything ever.  It’d be up there with medieval diagnoses of “witchcraft” and “demon possession” for THE worst diagnostic models of anything ever.  That’s why the American Psychiatric Association pointedly EXCLUDED the term “parental alienation” from the V-Code diagnosis they added, V71.29 Child Affected by Parental Relationship Distress.  They were sending you a very clear message.

They created a new V-Code, and they deliberatly EXCLUDED the term “parental alieantion.”  They did that to send you a very clear communication.  There is something here… but your “parental alienation” new pathology is quite probably the WORST diagnostic model of anything ever – in the history of mankind.

No, Karen, there is no “new form of pathology” called “parental alienation” – it doesn’t exist.  The American Psychiatric Association, a lot of smart people, and the DSM diagnostic committees of the top-top people in diagnosis and pathology, they had a full and complete examination of your beloved Gardnerian PAS pathology and they said… there is no such thing. 

They made their decision, the “new pathology” of “parental alienation” doesn’t exist, you’ll will have to describe the pathology using standard and established constructs and principles.  That’s what the American Psychiatric Association told you, Karen.  Back in 2013.

Those are TWO pieces of contrary information, Karen.  The first is that the pathology is already – already – fully and entirely explained within family systems therapy, and has been fully explained since the mid-1970s.  There is no “new pathology” Karen – you are simply ignorant of family systems therapy and how families function.

And two, the American Psychiatric Association’s select DSM diagnostic committees had a full and complete review of your beloved Gardnerian “parental alienation” diagnostic model, and they quite clearly and quite pointedly, said… “No.”  There is no “new pathology” called “parental alienation” – that is the clear diagnostic decision made by the American Psychiatric Association after a full and complete review of your beloved pathology proposal.  They said no.

And all you were asking for was just a mention, somewhere, anywhere in the DSM-5. Y ou weren’t even seeking a diagnostic category, you just wanted them to use the term “parental alienation” somewhere, anywhere, in the DSM-5. They said, “No” – there is no such pathology as “parental alienation.” 

They created a V-Code for specifically this pathology – Child Affected by Parental Relationship Distress – AND they deliberately and pointedly did NOT include the term “parental alienation” in their description of this V-Code.  They could have dropped the term “parental alienation” directly into that V-Code description – and they deliberately chose NOT to.

You, and Bernet, and Miller, and Baker, all of you “parental alienation” people have received a clear communication from the DSM diagnostic committees of the American Psychiatric Association – there is no “new pathology” of “parental alienation.”  I live in reality, Karen.  The APA reviewed the evidence and made a decision.  It was the correct decision.  The diagnostic model you propose for a “new pathology” of “parental alienation” is probably the WORST diagnostic model in all of history.  That’s why the APA pointedly said, “No.”

You have two – irrefutable – pieces of contrary evidence to your false belief that there is a “new pathology” you are “discovering” and are somehow an “expert” in, that you are an important and special “expert” in this new form of pathology – that doesn’t exist – that you are simply making up.

But despite clear contrary evidence, you still believe that there is a “new form of pathology” that you’re “discovering,” don’t you Karen?  You still believe you’re making these special discoveries about this new pathology, and you still believe that you’re somehow this special “expert” in this new form of pathology… that actually doesn’t exist.  But you believe it exists – even though it doesn’t.

A fixed and false belief, Karen, that is maintained despite contrary evidence.  What’s that called again?  That’s right, a delusion.  A fixed and false belief that is maintained despite contrary evidence… that’s the definition of a delusion, Karen.  Not my definition, the clinical definition in professional psychology for a delusion.

And if the person has a delusion about being “special” – about being important and in a position of elevated status – like being a special “expert” in something – and believing that because of their “special” status that everyone should pay attention to what this person says, because the person believes they are making important “discoveries” – but none of it is true – that would be a classified as grandiose delusion, wouldn’t it Karen.  You’re a mental health person, you know how diagnosis works.

A fixed and false belief that is maintained despite contrary evidence that the person is somehow “special” – a special “expert” making grand “new discoveries” – that aren’t true… that would be a grandiose delusion. 

Final Question, Karen

Let me ask you one last thing, Karen, and remember, I’m a clinical psychologist. 

Two questions, actually.  First, is there a new form of pathology, this “parental alienation” thing you’re proposing, is that a real form of pathology?  

Second, do you believe that you are making special and important “discoveries” about this supposedly new form of pathology?

And, as long as I’m here, let me ask a final, third, question… do you believe that you have “special” knowledge about this pathology that other people, us ordinary people, don’t have?  Do you believe that you are a special “expert” Karen?

Your answers are – yes – yes – yes – aren’t they, Karen.  You know they are, I know they are, we all know you answered yes, yes, yes. 

Do you think this “new form of pathology” exists? – yes. 

Do you believe you are making important “new discoveries” about his supposedly new form of pathology? – yes.

And do you believe that you have “special knowledge” about this supposedly “new form of pathology” that you’re discovering that makes you an “expert” – someone important – who people should listen to, because you’re important? – yes.

Karen… you appear to be delusional.  It’s called a grandiose delusion. Now I’m not diagnosing you, Karen, because I have not personally conducted a clinical interview with you… but I’m just sayin’ – looks like a duck quacks like a duck.

Seriously.  A fixed and false belief that is maintained despite contrary evidence is the clinical definition and the contrary evidence to your belief in a “new form of pathology” that you are supposedly “discovering” is that Minchin, Haley, and Bowen a full decade BEFORE Gardner, fully and completely described the pathology – cross-generational coalition, emotional cutoff, multi-generational trauma – AND – AND – that the American Psychiatric Association said, after a full and complete review of your beloved “parental alienation” new pathology proposal, that there is no such pathology of “parental alienation” – contrary evidence, Karen.  The APA told you, it is a false belief.  That is contrary evidence to your belief, the American Psychiatric Association told you, “It is a false belief.”

If THAT is not evidence to convince you, Karen, the American Psychiatric Association directly rebuking the construct of a “new form of pathology” – what evidence would you need?  Seriously, Karen… there is no evidence EVER that would ever convince you, is there Karen?  Because it’s a delusion.  It’s a fixed and false belief that is maintained DESPITE contrary evidence.  That’s the definition.  There is no way to alter a delusional belief with evidence – evidence is completely ignored – that is the definition of a delusion – despite contrary evidence.

Tell us, Karen, what evidence WOULD convince you that there is no “new pathology” and that this thing you’re calling “parental alienation” is entirely describable using the already existing and already established constructs and principles of professional psychology? 

Bonus Points

One final question, Karen, for bonus points.  You’re a mental health person, but still, I’m not sure how much you know about psychotic disorders, so this might be a toughie for you… what is it called when two or more people share the same delusional belief?  

That’s right, it’s called a shared delusional disorder (ICD-10: F24).

So let’s see, you’re an “expert” in this “new pathology”- anyone else?  Bill Bernet, okay.  Anyone else believe that there is a “new form of pathology” and that they are a “special” expert with “special knowledge” about this “new form of pathology” their creating?  Anyone else have this fixed and false belief that and they are making important new “discoveries”?

Wait… you may have an out, Karen.  There is an escape clause to delusions if there are a shared belief system – it’s called a sub-cultural exception.  It’s like when a bunch of people go the wilderness and build a compound because they all believe space alien angels are going to lift them to heaven in rapture on a certain date, and then that date passes, but they just change the date.  Them.  We may not call them “delusional” and instead we call it a “sub-culture” belief system.  That’s the technical term.  The more common term is a cult.

So diagnostically, Karen, we appear to be looking at either a shared delusional belief system or your part of a cult if you claim the sub-culture exemption from a delusional diagnosis.  Did you know all this about diagnosis, Karen?  Do you realize that, diagnostically you are showing all the symptom features of a grandiose delusion, and that you appear to potentially be part of a cult – a “sub-cultural” exception to a shared delusional diagnosis.

Although, I might go with the shared delusional diagnosis for you all.  It would depend on the clinical interviews.  You’re all mental health people, you’re not supposed to be part of a cult, you’re supposed to be living in reality with the rest of us, so I’m not sure I’d allow the sub-cultural cult exception the a delusional diagnosis.

Reality Karen

There is no “new pathology,” Karen.  You are simply ignorant of family systems therapy.  You are not a special “expert” in any “new pathology,” Karen.  You are simply grandiose.  It’s called an encapsulated grandiose delusion, if you don’t have manic symptom in your history, I’d think about the potential for narcissistic pathology.  I’m not diagnosing you, Karen.  I haven’t interviewed you.  I’m just saying, that’s what I’m seeing.

DSM-5 Narcissistic Personality Disorder Criterion 1:  “Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements).”

You know what would be interesting, Karen?  To take a look at your vitae relative your your claims of achievements and talents – your being an “expert” – to see if they are exaggerated claims of achievements and talents – if you have a desire “to be recognized as superior” – as an “expert”… “without commensurate achievements.”  

Where did you receive your training in attachment pathology, Karen?  Where did you receive your training in family systems therapy, Karen?  And yet, you are claiming to be a special “expert” in attachment pathology occurring in the context of family conflict… “recognized as superior without commensurate achievements”… you have no training in either attachment pathology or family systems therapy.

It’d be interesting to see your vitae, Karen.  To see if substance matches assertion.

Oh, Karen… and just to give you a reference for what an expert looks like, this is the professional background description for Keith Nuechterlein.  I worked with Keith at UCLA for over a decade, you’ll see it listed on my vitae, the Aftercare Clinic.  Keith attended my wedding in Yosemite. 

Keith Nuechterlein is an expert in schizophrenia.  This is what an expert vitae background looks like.  Notice he has authored over 235 journal articles – and none of them are “opinion pieces” they are all NIMH major-journal research articles – over 235 of them.  When we’d send his vitae to NIMH as part of grant submissions, it’d be 25 pages long of major journal research studies.  This is what an expert in professional psychology looks like, Karen.

This is the standard you need to meet to be considered an “expert” Karen, in the real world of actual reality.

Keith Nuechterlein:  A Real Expert, Karen

From Nuechterlein UCLA Profile:  The Center is led by Keith H. Nuechterlein, Ph.D., Professor of Psychology at the University of California, Los Angeles, and Director of the Aftercare Program, a research clinic for schizophrenic patients, UCLA Semel Institute of Neuroscience and Human Behavior. Dr. Nuechterlein specializes in neurocognitive processes in schizophrenia, especially as they relate to both the developmental course of the disorder and to functional outcome. Dr. Nuechterlein’s ongoing longitudinal study of the early course of schizophrenia, “Developmental Processes in Schizophrenic Disorders”, has closely examined the influence of specific neurocognitive vulnerability indicators on the early course of first-episode patients, with an emphasis on occupational and educational outcome. He holds a joint appointment in the Department of Psychiatry and Biobehavioral Sciences and the Department of Psychology (Clinical and Behavioral Neuroscience areas) at UCLA.

From UCLA Profile:  Keith H. Nuechterlein, Ph.D., is a Professor in the Departments of Psychiatry and Biobehavioral Sciences and of Psychology at the University of California, Los Angeles. He serves as the Director of the UCLA Center for Neurocognition and Emotion in Schizophrenia, an NIMH-funded Translational Research Center in Behavioral Science.  He also is the Director of the UCLA Aftercare Research Program, a research clinic devoted to research and treatment with patients who have had a recent onset of schizophrenia.  Dr. Nuechterlein received his B.A. in psychology in 1970 and his Ph.D. in Psychology (Clinical) in 1978 from the University of Minnesota.  His expertise focuses on cognitive deficits in schizophrenia, their role as genetic vulnerability factors, their connections to functional outcome, and their remediation.  Dr. Nuechterlein has authored more than 235 journal articles and is among the scientists on the ISI Web of Knowledge Highly Cited list for Psychology/Psychiatry. He has been on the editorial boards of the Journal of Abnormal Psychology and Schizophrenia Bulletin and is currently on the editorial board of Psychological Medicine. He has received numerous research grants from NIMH and other sources. Dr. Nuechterlein served as the Co-Chair of the Neurocognition Committee for the NIMH-funded initiative, Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS). This group guided the development of the MATRICS Consensus Cognitive Battery, a standardized outcome measure for clinical trials to assess the impact of new interventions on core cognitive deficits in schizophrenia. Dr. Nuechterlein is a past-president of the Society for Research in Psychopathology.

Jim Swanson: A Real Expert, Karen

picture of James M. Swanson

I worked with Dr. Swanson at UCI when I was with Childrens’ Hospital of Orange County.  I was recruited by Choc specifically to work as the lead clinical psychologist on Dr. Swanson’s project for ADHD in preschool-age children. 

This is what an expert in pathology looks like, Karen.  In reality.  In the real world where I come from.  His research list on the website is just a smattering, his research vitae is also 25 pages long.  He was one of the principle investigator sites for the big MTA study of ADHD back in the 90s, and almost all of the school-based research on ADHD comes from his lab, the UCI Child Development Center.  He is the UCI Child Development Center. 

This is what an expert looks like, Karen.  Notice he’s a PhD psychologist yet sits as a full professor at the UCI School of Medicine.

From Swanson UCI Profile

Director, Child Development Center, Pediatrics
School of Medicine
Professor, Pediatrics
School of Medicine
Professor, Epidemiology
School of Medicine
PH.D., Ohio State University

Research Interests
ADD, ADHD, Child Development

Research Abstract

Dr. Swanson’s research focuses on hyperactivity, attention deficit disorder and conduct disorder in children. Through his research, Dr. Swanson has developed procedures for monitoring the cognitive effect of stimulant medication, the most frequent treatment for this group of patients. His research also focuses on biochemical and genetic factors related to these disorders

Dr. Swanson is also investigating the effect of intensive, early intervention for children with attention and conduct disorders through a school-based treatment program conducted in cooperation with the Orange County Department of Education. This program is carried out at the Child Development Center. In addition, he is evaluating the risk and protective factors for anti-social behavior of hyperactive children as they mature.

Publications

Swanson JM, Kraemer HC, Hinshaw, SP, Arnold, LE, Conners, CK, Abikoff, HB, Clevenger W, Davies M, Elliott, G, Greenhill, LL, Hechtman, L, Hoza, B, Jensen, PS, March, JS, Newcorn JH, Owens L, Pelham, WE, Schiller E, Severe, J, Simpson S, Vitiello, B, Wells, CK, Wigal, T, Wu, M. (2001). Clinical Relevance of the Primary Findings of the MTA: Success Rates Based on Severity of ADHD and ODD Symptoms at the End of Treatment. J. Amer. Acad. Child & Adolesc. Psychiatry, 40(2): 168-179.

Swanson JM, Posner M, Wasdell M, Sommer T, Fan J. (2001). Genes and Attention Deficit Hyperactivity Disorder. Current Psychiatry Reports, 3: 92-100.

Swanson JM, Hanley T, Simpson S, Davies M, Schulte A, Wells K, Hinshaw S, Abikoff H, Hechtman L, Pelham W, Hoza B, Severe J, Molina B, Odbert B, Forness S, Gresham F, Arnold LE, Wigal T, Wasdell M, Greenhill L. (2000). Evaluation of Learning Disorders in Children with a Psychiatric Disorder: An Example From the Multimodal Treatment Study for ADHD (MTA Study). In L.L. Greenhill (Ed.), Learning Disabilities: Implications for Psychiatric Treatment, 19(5): 97-125

Swanson JM, Volkow N. (2001). Pharmacokinetic and Pharmacodynamic Properties of Methylphenidate in Humans. In M.V. Solanto, A.F.T. Arnsten, F.X. Castellanos. (Eds.), Stimulant Drugs and ADHD: Basic and Clinical Neuroscience, (pp. 259-282). Oxford University Press.

Swanson, JM. (1992). School-based Assessments and Interventions for ADD students. Irvine, CA: K.C. Publishing.

Swanson JM, Riederer SA, Young RK. (1974). IMPS: Interactive Math Package for Statistics. Publication IM/18/8/23/74 of Project C-BE, University of Texas, Austin.

Malone MA; Kershner JR; Swanson JM. Hemispheric processing and methylphenidate effects in attention-deficit hyperactivity disorder. Journal of Child Neurology, 1994 Apr, 9(2):181-9.

Malone MA; Swanson JM. Effects of methylphenidate on impulsive responding in children with attention-deficit hyperactivity disorder. Journal of Child Neurology, 1993 Apr, 8(2):157-63.

Craft S; Gourovitch ML; Dowton SB; Swanson JM; Bonforte S. Lateralized deficits in visual attention in males with developmental dopamine depletion. Neuropsychologia, 1992 Apr, 30(4):341-51.

Forness SR; Swanson JM; Cantwell DP; Youpa D; Hanna GL. Stimulant medication and reading performance: follow-up on sustained dose in ADHD boys with and without conduct disorders. Journal of Learning Disabilities, 1992 Feb, 25(2):115-23.

Grant
National Children’s Study (NCS)

Professional Society
Senior Fellow, Sackler Institute at Cornell University

Research Center
Child Development Center



Your turn, Karen. 

You claim to be an “expert” in this attachment-related family conflict pathology.  Post your vitae, let’s have a look at the actual substance of your claimed “expertise” in attachment-related family pathology – or are you expecting to be “recognized as superior without commensurate achievements” – let’s have a look at your vitae, Karen.

You are the one who is so prominently claiming to be an “expert” – back it up, Karen, because I don’t believe you are an “expert” in anything – I suspect its simply a grandiose delusion.

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

 

 

 

Read More –>

Attachment and the Psychoanalytic School of Psychology

Attachment and the Psychoanalytic School of Psychology

I’m educating parents and legal professionals about professional psychology because the forensic psychology people are awful – just awful.  They have no knowledge, they apply no knowledge.  They just make things up.

They shouldn’t be doing that.  They should be applying the established knowledge of professional psychology to their assessment, diagnosis, and treatment of pathology.  They’re not.  That’s a big-big problem that currently sits unresolved with the APA,

APA: Complicity with Child Abuse

Forensic psychology is not doing their job, and in fact, is harming the consumers of their mental health services, their clients.  They are harming their clients because they are applying NONE of the knowledge from professional psychology from the past 100 years.  None of it.

Not psychoanalytic knowledge, that’s from the 1930s and 40s.  They are not applying the knowledge of cognitive-behavioral psychology (Skinner, Beck).  That’s from the 1940s to 60s.  They are not applying knowledge from family systems therapy.  That’s knowledge from the 1970s and 80s.  They’re not applying knowledge of the attachment system, that’s knowledge from the 1960s to 2000s.  They’re not applying knowledge from social constructionism and cultural psychology.  That’s knowledge from the 1980s to 2000s.  They’re not applying knowledge from psychometrics, that’s knowledge from the 1940s to 80s.  They’re not applying knowledge from complex trauma.  That’s knowledge from the 1990s and 2000s.  They are applying none of the neuro-developmental research on brain development during childhood, that’s from the 1990s to now. 

None of it.  They are applying none of it, none of the knowledge from the past 100 years in professional psychology.  None of it.

And their absence of knowing the knowledge of professional psychology, and their absence of applying the knowledge of professional psychology, are harming parents and their children.  The absence of knowledge is a violation of Standard 2.01a of the APA ethics code, the failure to apply knowledge is a violation of Standard 2.04 of the APA ethics code.

In order to protect the consumers of mental health services from the abject ignorance of forensic psychology and their failure to apply any knowledge from professional psychology to their assessment, diagnosis, and treatment of pathology, the parents who are seeking to protect themselves from IPV (Intimate Partner Violence) emotional spousal abuse and their children from Child Psychological Abuse will need to become more knowledgeable than their therapists about the established constructs and principles of professional psychology.

That’s not good.  That consumers of mental health services should need to know more than the mental health professional about pathology and its treatment should NEVER happen.  It is, however, the current reality.  So we have to deal with that.

Consumers of psychological services – you, the parents – will have to become more knowledgeable about professional psychology than your therapist is.  Family law attorneys who are assisting their clients achieve a solution through the courts will need to become more knowledgeable about professional psychology than the therapists are.

Ultimately, when professional psychology begins to apply knowledge to solve pathology, then the knowledgeable family law attorney, the knowledge court, and the knowledgeable mental health professional can effectively and efficiently guide the family conflict into solution.

Ignorance will create no solution.  It is only through the application of professional knowledge to the diagnosis and treatment of family pathology that we will create a solution.

But we’re not there yet.  Right now, the field of forensic psychology is applying NO knowledge from professional psychology in their assessments, diagnoses, and treatment.  They are simply making things up.  In this environment of gross professional negligence and incompetence, our first task is to protect parents and children from the emotional and psychological abuse emanating from the more emotionally fragile and pathogenic allied parent who is weaponizing the child into the spousal conflict.

I’m a clinical psychologist.  During this period right now, in which the goal is to stop the active ongoing emotional abuse and traumatization of parents and the psychological abuse of their children, part of my role as a clinical psychologist is to educate the public about matters of professional psychology, and the knowledge of professional psychology. 

For example, when I conduct a school-involved assessment and find a learning disability, part of my role is to educate the parents and the school about what a learning disability is, and what they can to do to help support the child’s healthy development.  Part of our role as clinical psychologists is to educate consumers and the public regarding the principles and constructs of professional psychology.

Consumers of mental health services – targeted parents and their children – are being harmed – in violation of Standard 3.04a of the APA ethics code – by the professionally negligent and irresponsible ignorance from their mental health provider, who is failing to apply any of the established knowledge from professional psychology to the assessment, diagnosis, and treatment of pathology in violation of Standards 2.04 and 2.01a of the APA ethics code.

As a clinical psychologist, it is incumbent upon my professional responsibilities to educate and empower the public, the consumers of mental health services who are being harmed by the ignorance and incompetence of their mental health care provider, regarding the professional knowledge that is NOT being applied but should be applied, and regarding professional standards of practice that are NOT being met, but should be.

My book, Foundations, is one tool in this education effort.  Handouts on my website are another resource for parents and legal professionals.  In this blog post, I will take a more direct instruction role regarding the extent and nature of the information that is NOT being applied, but should be.  We will be using bricks to build a structure, the bricks of knowledge will come from domains of professional psychology, each brick adds another piece to the overall structure of knowledge.

We will begin by orienting to the world of psychology generally, and then start with the psychoanalytic school of professional psychology – Freud, Klein, Erikson, Adler, Jung, Mahler, Masterson, Kernberg, Winnicott, Kohut, Bowlby, Stern, Fonagy, Tronick.

Orienting to Psychoanalysis

Rely on family systems therapy for now, .

With this court-involved family conflict pathology, we will start the solution by using family systems therapy as the foundation for solutions (for right now).  Family systems therapy (Minuchin, Bowen, Haley, Madanes) will solve everything.  Family systems therapy is THE appropriate school of professional psychology to apply to the resolution of family pathology.  Family pathology = family systems therapy (Minuchin, Bowen, Haley, Madanes).  The constructs of triangles, cross-generational coalition, emotional cutoff, and multi-generational trauma all come from family systems therapy – not from the psychoanalytic school.

However, each additional domain of knowledge that we add to family systems therapy adds immensely useful knowledge that can be applied to creating the solution.  The more knowledge we apply, the more fulsome and complete becomes our solution.

The down side to applying multiple domains of professional knowledge to the solution is that when we use a wide-range of ideas, such as including knowledge about narcissistic personality pathology or the attachment system, things can begin to sound confusing and ideas become scattered all over the place.

Parents and legal professionals… remain grounded in family systems therapy.  Family systems therapy will solve everything – cross-generational coalition, emotional cutoff, multi-generational trauma.  I will be educating about additional knowledge, but the core of the solution is found in family systems therapy.  Family systems therapy is THE school of psychology to apply to solving family conflict.

The first time we hear something, it’s new.  Hear it 10 times, it becomes old and familiar. The constructs of a cross-generational coalition and emotional cutoff will become oh-so-familiar over time.  Once this ground knowledge is applied, we will then expand the domains of additional knowledge we apply for more robust, easier, and more efficient solutions in the interface of professional psychology and the family courts.

In learning, it helps to have the boxes, the knowledge structures in our brain, to put stuff in, a context to organize all the different ideas.  The best content boxes for organizing professional psychology ideas are the four primary schools of psychotherapy – psychoanalytic, humanistic-existential, cognitive-behavioral, and family systems.  Nearly everything in professional psychology fits into one of these four boxes, and all the stuff that’s in the same box shares common characteristics. 

All the ideas in humanistic-existential psychology share basic core concepts.  All the ideas in cognitive-behavioral psychology share basic core concepts.  All the ideas in family systems therapy share basic core concepts.

The four schools of psychotherapy are psychoanalytic (Freud-Bowlby), cognitive-behavioral (Skinner-Beck), humanistic-existential (Rogers-Perls), and family systems therapy (Minuchin-Bowen).  To solve this court-involved family conflict pathology, remain within family systems therapy and you will solve everything, apply additional knowledge from the other schools and achieve a more robust and fulsome solution.

The Psychoanalytic School

Attachment (Bowlby, Ainsworth) is from the psychoanalytic school.  It is important that parents and legal professional understand and orient to the psychoanalytic domain of knowledge because that’s where the attachment system knowledge and… the neuro-developmental knowledge (Stern, Tronick)… is anchored.  The psychoanalytic field of professional psychology gave birth to our understanding of the attachment system (Bowlby, Ainsworth).

Psychoanalytic psychology emerged from Sigmund Freud and the couch.  The core of the psychoanalytic school is – meaning – determining what things mean, not just what they are in their external manifestation, and the interpretation of meaning is a big-big part of the psychoanalytic school.  Because of this, psychoanalysis is also called “depth psychology” because… well, it goes deep, way deep, into the psychological organization of our minds. 

Minchin, Bowen, Haley… they are all from the family systems school, a different school of psychology, not this one.  Family systems people organize multiple people interacting together in the here-and-now.  Psychoanalytic people organize one person way-deep, looking more toward childhood than the present.  Bowlby, Stern, Siegel, and Tronick are all from the psychoanalytic world of meaning.   Discovering meaning is the central question for the psychoanalytic school.

But in going deeper into meaning, psychoanalytic psychology goes to realms that rigorous mathematical models can’t go, psychoanalytic psychology sacrifices the scientific rigor of some research methodologies for the quality of information they return.  The psychoanalytic school doesn’t do the classic type of experimental design research – those come from the cognitive-behavioral people in professional psychology.  The psychoanalytic school relies almost entirely on case study research designs, which is a formal research methodology, and information is housed in their case study reports from psychoanalysis using basic established constructs within the field.

Freud opened doors to understanding many things, and we continue to hold many of ideas that Freud developed, such as the ideas of an “unconscious” and of our “defense mechanisms.”  But a lot of Freud’s specific insights and suggestions have been revised and modified, creating different, more evolved sub-domains of psychoanalytic thought than how Freud first organized our unconscious processes.

One of the primary sub-domains that has evolved within the psychoanalytic school is called the “object relations” school.  Bowlby and attachment theory are from the object relations sub-domain of the psychoanalytic school.

The term “object” in the psychoanalytic world is their word for “people.” A technical description is: people are “internalized objects” in our “representational networks” – the representational networks are the various categories of things, dog, chair, mother, you, the things of our mind.  We have ideas for things, chairs and trees, and we have ideas for special people – mothers, fathers, grandparents, spouses.   We internalize features of these special people in our lives – and these people become internal “objects” in our mind-space of meaning.  That’s the school of object relations, looking at our internalized representations for other, special, people. 

In common-speak, the sub-domain of object relations is “people relations” – as opposed to Freud’s emphasis on instinctual animalistic “drives” for sex and violence (bonding and conflict).  The object-relations school emphasizes people’s psychological motivation to bond to each other.  Bowlby and attachment are from this school of psychology.

Adult Object Relations

There’s a lot of adult object relations psychoanalysts who looked at relationships from the adult side of things, two of the most famous are Otto Kernberg who studied narcissistic and borderline pathology and Heinz Kohut who developed a function-oriented model of our inner relationship world.  Heinz Kohut is the current major kahuna in adult psychoanalysis, and most psychoanalytic psychotherapists work from a Kohutian approach. 

Kohut proposed that parents serve three “self-object” functions (roles) for children, and that these functions become internalized into the inside-the-head “representational networks” of the child.  Kohut’s identifies three “self-object” functions that parents serve for the child, and these self-object functions help organize the child’s sense of self-identity (called “self-structure”) and helps to regulate the child’s emotions.  The three self-object roles are broadly, empathy, bonding, and protection; called mirroring, twinship, and idealizing.

Otto Kernberg conducted depth psychoanalysis with adult narcissistic and borderline pathology.  You do NOT conduct depth psychoanalysis on the narcissistic and borderline personality.  Their personality self-structures are too fragile for the techniques of psychoanalysis and will collapse into what’s called a “psychotic transference” – that is not good. 

In psychoanalysis, the patient becomes neurotic (slightly crazy).  The patient imposes the trauma patterns from their past onto the analyst in the present, who then interprets the patient’s trauma reenactment narrative – called “the transference” – the patient’s transfer of childhood trauma patterns onto the current analyst. 

The techniques of psychoanalysis create a neurotic transference – the activation and transfer of past trauma patterns.  The patient – the “analysand” – goes a little crazy, called a “neurosis,” but remains in contact with actual reality.  They become disoriented and confused about who the analyst actually is and their own fears and hopes for who the analyst is that were created in their childhood experiences.  The techniques of psychoanalysis create neurotic transference which is then interpreted for the analysand by the analyst, leading to insight, empowerment, choice, and change.

But the narcissistic and borderline personality structure is too fragile for the depth-psychology techniques of psychoanalysis which loosen the boundaries of self-structure. In psychoanalysis, the narcissistic and borderline personality collapses into a psychotic transference – they lose touch with reality.  That’s not good.  We don’t want to create a psychosis in the patient.  So the general guidelines in psychoanalysis are… do not do psychoanalysis with a narcissistic or borderline patient.  They do something called psychoanalytic psychotherapy – a more structured form of the psychoanalytic approach than depth-psychoanalysis (psychotherapy not psychoanalysis;  different approaches).

Otto Kernberg was an exceptionally skilled psychoanalyst.  He conducted depth psychoanalysis with the borderline and narcissistic personality.  He returned with incredibly valuable information from psychoanalytic depth psychology regarding the deep-structure of the borderline and narcissistic pathology.  That’s what makes Kernberg one of the preeminent authorities on the pathology of the borderline and narcissistic personality.  Otto Kernberg literally wrote the book on the borderline and narcissistic personality:

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

Notice the date.  This is not new information. 

Childhood Object Relations

Our object relations (our patterns for relating to other people in intimate relationships) are created in childhood.  So another group of object relations psychoanalysts in the 1950s and 60s went off to study children directly – Winnicott and Bowlby are the two primary child object relations kahunas.  John Bowlby and attachment theory is from the object relations school of psychoanalysis, the child side.

Attachment theory as developed by Bowlby would have remained largely contained within the psychoanalytic world except that Mary Ainsworth developed a way to experimentally categorize different types of attachment bonding – as either secure or insecure, with three types of insecure attachment.

The moment we can bring something into the lab for experiments at the local university, more scientifically grounded research designs become available, and science is off and running.  So that’s why you’ll hear Bowlby and Ainsworth linked in professional discussions.  Bowlby developed the underlying description of what the attachment bonding system is, Mary Ainsworth made it available for scientific study.

This is a quote from Mary Ainsworth describing what the attachment system is.  It’s from an article published in THE professional journal of the APA, American Psychologist.  This quote serves as a foundational description for what the attachment system is.

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

From Ainsworth: “I define an “affectional bond” as a relatively long-enduring tie in which the partner is important as a unique individual and is interchangeable with none other. In an affectional bond, there is a desire to maintain closeness to the partner. In older children and adults, that closeness may to some extent be sustained over time and distance and during absences, but nevertheless there is at least an intermittent desire to reestablish proximity and interaction, and pleasure – often joy – upon reunion. Inexplicable separation tends to cause distress, and permanent loss would cause grief.” (p. 711)

From Ainsworth: “An ”attachment” is an affectional bond, and hence an attachment figure is never wholly interchangeable with or replaceable by another, even though there may be others to whom one is also attached. In attachments, as in other affectional bonds, there is a need to maintain proximity, distress upon inexplicable separation, pleasure and joy upon reunion, and grief at loss.” (p. 711)

For court-involved family conflict, this quote from Ainsworth is the foundational bedrock we are standing on when we talk about the attachment system.  This is a description of a normal and healthy attachment system – to achieve this description for the attachment system is ALWAYS our goal in professional psychology – we never accept  less.  Anything OTHER than this description of a child’s attachment bonding motivation… is pathological. 

Mary Ainsworth’s description is of a healthy attachment system.  Achieving a health attachment system in a child is ALWAYS the goal of professional psychology.

The attachment system is a primary motivational system of the brain, like for eating and sex – a primary motivational system of the brain.  It’s called a “goal-corrected” motivational system – meaning that it ALWAYS maintains the goal of forming an attachment bond to the parent.  Always.  A child who rejects a parent is eaten by a predator (or starves, or falls off a cliff).  Historically, throughout millions of years of evolution, children who rejected parents… died.  Children do not reject parents.

Children are motivated to seek the love of their parents – a primary motivational system of the brain.  The entire attachment system is organized around the child acquiring the love of the parent.  It’s called the attachment system.  It is extremely well researched and understood.

The attachment system functions in characteristic ways, and it dysfunctions in characteristic ways.  In response to bad parenting, the attachment system MORE strongly motivates the child to bond to the bad parent – to acquire the love of the bad parent. Children who rejected bad parents were eaten by predators.  Children who become MORE strongly motivated to bond to the bad parent had a chance of obtaining parental protection… they survived.

From Bowlby:  “The paradoxical finding that the more punishment a juvenile receives the stronger becomes its attachment to the punishing figure, very difficult to explain on any other theory, is compatible with the view that the function of attachment behavior is protection from predators.” (Bowlby, 1969, p. 227)

Notice the date, 1969, this is not new information

Bad parenting produces an “insecure attachment” – there are three types – three categories – of insecure attachment, high-protest, low-protest, disorganized.

Anxious-Ambivalent Attachment:  This is a high-protest display by the child of excessive anger or anxiety.  This type of child insecure attachment is caused by the inconsistent availability of the parent.  The treatment for high-protest anxious-ambivalent attachment is to increase the stability and consistency in the child’s bond to the parent, with more frequent displays of love and involvement from the parent. 

Court-Involved Family Conflict:  This is the type of insecure attachment pattern that is being mimicked – i.e., falsely portrayed – in court-involved family conflict.  In this high-litigation post-divorce family conflict, the child is presenting with high-protest emotional signaling of elevated anger and anxiety symptoms – called “high-protest signaling.” 

In authentic attachment, this high-protest signaling by the child is called an attachment behavior” and is designed to ELICIT the greater involvement of the inconsistently available parent.  Child protest behavior serves the attachment function of eliciting greater parental involvement with the child.

In court-involved family conflict, this child symptom display is a false display of attachment pathology.  Instead of seeking to bond to the parent, the protest behavior seeks to sever the parent child bond.  The attachment system NEVER seeks to sever the parent-child bond.  Children who rejected parents were eaten by predators.

In court-involved family conflict, the child’s emotional display mimics an insecure anxious-ambivalent attachment, but it is a false symptom – that is NOT how protest behavior works in an authentic child attachment system, that is NOT how the brain works.

AND… AND, the treatment for an insecure anxious-ambivalent attachment is to INCREASE the child’s time and involvement with the parent where there is protest behavior – i.e., the child should have MORE time and MORE involvement with the targeted parent – that’s the treatment for high-protest anxious-ambivalent attachment – which this isn’t but mimics.

There are multiple additional features to the child’s symptom display surrounding this court-involved family conflict that are clearly a false display representing a false, externally influenced, non-authentic conflict with the targeted parent… and even still the treament for insecure anxious-ambivalent high-protest attachment would be to provide the child with MORE time, MORE involvement, and MORE love from the targeted parent.

The treatment for an insecure anxious ambivalent attachement is NEVER to reduce the child’s time and involvement with the parent.  An anxious-ambivalent high-protest attachment is always caused by an INCONSISTENTLY available parent.  We want to INCREASE the availability of this parent – notNOTdecrease it.

Anxious-Avoidant Attachment:  This is a low-protest display by the child, in which the child is exceeding low-demand and overly self-sufficient, seeking limited to no emotional contact with the parent.  This type of insecure child attachment bond is caused by a parent who is emotionally overwhelmed and unavailable for the child.  The child learns that demands for parental involvement provoke rejection from the parent, the overwhelmed and rejecting parent goes FURTHER away when the child seeks involvement – the child’s demands for parental involve INCREASE the emotional distance of the parent.

The low-demand characteristics of an anxious-avoidant attachment are often misinterpreted by the public and non-knolwedgeable mental health people as being the child’s mature self-sufficiency.   That is NOT true.  The child is absent normal-range motivations for bonding, they are being suppressed, and the low-demand of the child actually represents a symptom of attachment pathology – an insecure attachment to an overwhelmed and rejecting parent.

Court-Involved Family Conflict:   The children in court-involved family conflict are clearly NOT low-demand, easy, and compliant with the targeted parent.  A low-demand, low-protest anxious-avoidant attachment is not the insecure attachment display of children in court-involved family conflict.

Anxious-Disorganized Attachment:  This category of insecure attachment is the most severely pathological.  In this type of insecure attachment, the child is unable to develop any coherent strategy for bonding to the parent.  The parent who creates a disorganized child attachment system is typically a parent who is simultaneously a source of danger AND a source of nurture to the child, creating a mixed double-bind for the child of both intense avoidance motivations regarding the dangerous aspects of the parent, and intense bonding motivations from the nurturing aspects of the parent.  In response to intense and competing motivations to simultaneously flee and to bond, the child is unable to develop any coherent strategy to form a secure attachment bond to the parent – resulting in the display of non-functional – disorganized – child relationship responses.

Court-Involved Family Conflict:  In court-involved complex family conflict, a disorganized attachment was likely the insecure attachment category for the current narcissistic-borderline parent during their childhood in their bonding to their parent, creating their narcissistic and borderline personality pathology as an adult.  Aaron Beck describes this type of parent-child bond that leads to disorganized attachment and personality disorder pathology,

From Beck:  “Various studies have found that patients with BPD [borderline personalty disorder] are characterized by disorganized attachment representations (Fonagy et al., 1996; Patrick et al, 1994).  Such attachment representations appear to be typical for persons with unresolved childhood traumas, especially when parental figures were involved, with direct, frightening behavior by the parent.  Disorganized attachment is considered to result from an unresolvable situation for the child when “the parent is at the same time the source of fright as well as the potential haven of safety” (van IJzendoorn, Schuengel, & Bakermans-Kranburg, 1999, p. 226).” (Beck et al, 2004, p. 191)

Note the citations by Aaron Beck to Fonagy and to IJzendoorn.   Both Fonagy and IJzendoorn are prominent researchers in attachment, and their body of work is essential reading for all court-involved mental health professionals working with complex attachment-related pathology surrounding divorce.

A child rejecting a parent is an attachment-related pathology.  The attachment system is the brain system that governs all aspects of love and bonding throughout the lifespan, including grief and loss.  A child rejecting a parent is a problem in the love and bonding system of the brain – the attachment system.  A child rejecting a parent is an attachment-related pathology.  The research by Fonagy and IJzendoorn is essential and required reading for all mental health professionals working with attachment-related family pathology.

All mental health professionals working with court-involved attachment-related family pathology MUST possess a professional-level knowledge for the attachment system, what it is, how it functions, and how it dysfunctions.   This knowledge includes reading: Bowlby, Ainsworth, Sroufe, Lyons-Ruth, Fonagy, and IJzendoorn – including the Handbook of Attachment: Theory, Research, and Clinical Applications by Cassidy and Shaver.

Ignorance about the attachment system when working with attachment pathology is NOT acceptable professional practice.   Ever.  Ignorance of autism pathology is not acceptable when working with autism, ignorance of schizophrenia is not acceptable when working with schizophrenia, ignorance of eating disorders is not acceptable when working with eating disorders.  Ignorance is a violation of Standard 2.01a of the APA ethics code – and it is NEVER acceptable professional practice.

To be entirely clear:  All mental health professionals working with attachment pathology must possess a professional level knowledge for the attachment system, what it is, how it functions, and how it dysfunctions.  This includes reading Bowlby, Ainsworth, Sroufe, Lyons-Ruth, Fonagy, and IJzendoorn – and the Handbook of Attachment: Theory, Research, and Clinical Applications by Cassidy and Shaver.  Professional ignorance is NOT acceptable professional practice, and is a violation of Standard 2.01a of the APA ethics code.

If harm is then done to the client parent or child because of professonal ignorance, this would represent a violation of Standard 3.04 of the APA ethics code.

Neuro-Development

The attachment system is a goal-corrected primary motivational system of the brain.  It  developed across millions of years of evolution because of the survival advantage to children provided by bonding to their parents.  The attachment system has its neurological origins in the “imprinting” systems of earlier species (Lorenz) – baby ducks follow mommy duck – that’s the attachment system in a duck – called “imprinting.”  Baby zebra gets close to mommy zebra for protection from hyenas and lions – that’s the attachment system in a zebra.

Bowlby describes all of this in his first volume: Attachment. 

Humans are more complex social animals with more complicated brains to wire-up than ducks and zebras.  Our attachment systems are more complex than the attachment systems of zebras and the imprinting of ducks, but its source is the same and it is a foundational – primary – motivational system in the brain; meaning at the same level as the other primary motivational systems for food and sex, a basic built-in motivational system to bond to the parent.  The attachment system confers significant survival advantage.  It functions in characteristic ways; it dysfunctions in characteristic ways.

The attachment system is a brain system, a neurologically based primary motivational system of the brain that evolved for protection of children from predators (and from other environmental dangers like abandonment and starvation).  Children do not reject parents.  Ever.

From Bowlby: “The biological function of this behavior is postulated to be protection, especially protection from predators.” (Bowlby, 1979, p. 3)

Research on Attachment

The basic neural wiring of the attachment system develops during childhood, after which we then use the wiring patterns of our attachment networks throughout our lifetimes to organize our basic expectations and our approach to relationships, our object relations, our internalized representations of ourselves and of others.

We acquire and use our attachment patterns in a similar way as we acquire and use the patterns in our language systems. 

Language Acquisition:  Our brains anticipate that we will be learning language and our brains have specific areas and networks already set up to receive language (called “experience-expectant” development).  We then acquire the grammar of language during the period of early childhood, ages zero to five, and the specific language we learn is based on what we hear, French, Chinese, English (that’s called “experience-dependent” development). 

We then USE language throughout the rest of our lives in our communication and regulation of our social interactions. 

Same for our attachment networks. 

Attachment Pattern Acquisition:  The brain is already prepared to form relationship bonds, with networks ready to receive patterns governing expectations about self and other – called our “internal working models” of attachment (experience-expectant brain development).  We then acquire the specific “grammar” of our attachment system during early childhood, the specific patterns of our attachment networks are created through the specific experiences of the parent-child bond during childhood (experience-dependent).

We then USE these patterns of attachment specific to our expectations and history to then guide all of our future intimate relationships throughout the rest of our lives.

The formative period for language is early childhood, we then use language throughout the rest of our lives to regulate our social interactions.  The formative period for our attachment system is early childhood, we then use our attachment patterns the rest of our lives to regulate our social interactions.

Because the attachment system is glowing active and white-hot during infancy and early childhood, the research people in professional psychology – led by Ainsworth and the experimental paradigm she created for studying attachment behaviors – went to work researching the attachment network’s development in infancy and early childhood.  The heavy-duty neurological research began in the 1980s, led by Stern and Tronick, with others (Trevarthan’s research is notable, as is Beebe’s on the dyadic coordination of psychological states).

While the study of the attachment system focuses on early childhood, what we learn is applicable across the lifespan.  Humans don’t suddenly “switch-out” our attachment networks at adolescence.   We live in the same brains as adults as were neuro-developmentally created in our childhood.  Same brain, same attachment structures.  What we learn about the attachment system’s development in early childhood research is applicable across our lifespans.  Same brain, same brain structures, same neural organizations.

Our “internal working models” for our expectations, and our “internal working models” for interpreting and responding to communications in intimate relationships, are engraved into the neural wiring of our brain’s attachment networks during childhood, in the same way as our language networks are, through a dance of experience-expectant and experience-dependent growth and development across childhood.

The two grand kahunas of this early childhood research are Daniel Stern (amazing research) and Edward Tronick (amazing research).  Their work dovetailed into what the adult object relations psychoanalysts were discovering (Kohut, Stolorow) regarding a shared psychological state and the key role of modulated failures in parental empathy in healthy child development.  The research by Stern and Tronick also merged into the neurological research that has been developing at an ever accelerating pace following the advent of PET scans and fMRIs in the 1980s.

Neuro-developmental research on attachment really started to take off exponentially around 2000.  In 1994, a psychoanalyst, Alan Shore, wrote a full and rich neurological treatise on the socially-mediated neuro-development of the brain’s networks for emotional regulation.

Schore A.N. (1994). Affect Regulation and the Origin of the Self: The Neurobiology of Emotional Development. Hillsdale, NJ: Erlbaum.

These advancing developments in the neuro-science of the parent-child relationship are summarized by Siegel in his book,  The Developing Mind: How Relationships and the Brain Interact to Shape Who We Are.  Notice in the title how he emphasizes that our brains are shaped by relationships.  Cozolino also provides another summary of this neuro-developmental relationship research in his book, The Neuroscience of Human Relationships: Attachment and the Developing Social Brain.  Notice again, how he also emphasizes the role of relationships in the developing “Social Brain.”

As the research on the attachment system grew in the 1980s, a second, related but distinct, relationship system was discovered.  It was called “intersubjectivity” because that’s the construct for the shared-mind state that’s used in the world of adult psychoanalysis (Stolorow). 

The research on attachment has identified a second relationship system, in addition to attachment. It is a psychological connection system that creates a shared-mind state, called an intersubjective field, or when there are multiple people, and intersubjective matrix of shared experience.

From Stern:  “Intersubjectivity is a condition of humanness.  I will suggest that it is also an innate, primary system of motivation, essential for species survival, and has a status like sex or attachment.” (Stern, 2004, p. 97)

From Stern:  “Our nervous systems are constructed to be captured by the nervous systems of others.  Our intentions are modified or born in a shifting dialogue with the felt intentions of others.  Our feelings are shaped by the intentions, thoughts, and feelings of others.  And our thoughts are cocreated in dialogue, even when it is only with ourselves.  In short, our mental life is cocreated.  This continuous cocreative dialogue with other minds is what I am calling the intersubjective matrix.” (Stern, 2004, p. 76)

Tronick referred to this shared psychological state as a, “dyadic state of consciousness”

From Tronick:  “When mutual regulation is particularly successful, that is when the age-appropriate forms of meaning (e.g., affects, relational intentions, representations) from one individual’s state of consciousness are coordinated with the meanings of another’s state of consciousness — I have hypothesized that a dyadic state of consciousness emerges.” (Tronick, 2003, p. 475)

The “intersubjective” state described in the neuro-developmental research of a shared psychological fusion of experience (a “dyadic state of consciousness”) is similarly captured by the the family systems construct of “enmeshment,” exactly the same constructs identified in a different school of psychology, now provided with a neurologically understood foundation.

Shared Constructs:  In the psychoanalytic school, the construct is “internal working models” of attachment (Bowlby); in the cognitive-behavioral school, the construct is “schemas” (Beck).

Internal working models (Bowlby) = schemas (Beck).  Same construct, different schools.

Shared Constructs:  In the psychoanalytic school, the construct is intersubjectivity – a “dyadic state of consciousness” (Stern, Tronick); in the family systems school, the same construct is described as “enmeshment” (Minuchin; Bowen).

Intersubjectivity, “dyadic state of consciousness” (Stern Tronick) = enmeshment (Munchin, Bowen)  Same constructs, different schools.

They are all identifying the same thing, it is a common, scientifically based, lots of research studies, neurologically identified pathways, understanding for how the brain works in forming relationships and regulating emotions.  Right orbital prefrontal cortex.

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

Mirror Neurons

Then, in the early 2000s, Italian researchers discovered a set of brain cells called “mirror neurons” that duplicate in us (mirror inside us) what someone else is experiencing. 

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

This discovery merged into the research on attachment and intersubjectivity – the “dyadic state of consciousness” described by Tronick, and it united with the neurological research described by Shore.

From Stern:  “We experience the other as if we were executing the same action, feeling the same emotion, making the same vocalization, or being touched as they are being touched.” (Stern, 2004; p. 79).

Of prominent note is that research on mirror neurons has found that they are designed to read the INTENTION of other people – what’s motivating their actions.

From Stern:  “The discovery of mirror neurons has been crucial.  Mirror neurons provide possible neurobiological mechanisms for understanding the following phenomena: reading other people’s states of mind, especially intentions; resonating with another’s emotion; experiencing what someone else is experiencing; and capturing an observed action so that one can imitate it — in short, empathizing with another and establishing intersubjective contact.” (Stern, 2004; p. 78)

The constructs in court-involved family conflict of “coaching” and “brainwashing” are more accurately and professionally described from the neurological research on intersubjectivity as the social “cocreation” of a “dyadic state of consciousness,” and the child’s mirror neurons reading the intention of the parent, i.e, what does the allied parent WANT the child to do – mirror neurons read the intention.

Siegel: Mirror Neuons in Depth Video

In the mid-2000s, it all came together, clouds parted and the angels sang.  We’ve got it.  We understand how things work – in the relationship systems, and extending out into the emotion regulation systems and the behavior regulation systems – a dyadic regulation of emotions and behavior in the intersubjective “breach-and-repair” sequence (Tronick).

Tronick: Still Face; breach-and-repair sequence

The breach-and-repair sequence identified by Tronick and described extensively through his research is the core central unit of analysis for parent-child conflict.  All mental health professionals dealing with any aspect of parent-child conflict MUST understand the breach-and-repair sequence.  It is essential to the healthy emotional and psychological development of the child.

From Tronick:  “Unlike many other accounts of relational processes which see interactive “misses” (e.g., mismatches, misattunements, dissynchronies, miscoodinations) as indicating something wrong with an interaction, these “misses” are the interactive and affective “stuff” from which co-creative reparations generate new ways of being together (Cohn and Troncik, 1989; Tronick 1989).  Instead there are only relationships that are inherently sloppy, messy, and ragged, and individuals in relationships that are better able, or less able, to co-create new ways of sloppily being together.” (Tronick, 2002c, d). (p. 477)

Parent-child conflict (the breach) is not a bad thing, and the absence of parent-child conflict (enmeshment) is not a good thing.  The critical feature of the parent-child relationship is that all breaches are REPAIRED.  Dr. Tronick compared the breach-and-repair sequence to the “good, the bad, and the ugly.”

The “good” is the everyday sort of flow to bonding and breaches, the “bad” is a breach caused by an empathic failure, the “ugly” is leaving a breach un-repaired.  The WORST possible thing we can do is leave a breach un-repaired – the “ugly” describted by Dr. Tronick.

So what does forensic psychology do?  Leave un-repaired breaches – the ugly – the WORST possible thing to do… they are doing it.  Because they are ignorant.  They know nothing about the attachment system, they know nothing about the neuro-development of the brain, they are doing EXACTLY the WORST possible thing they can do… leave an un-repaired breach to the parent-child bond.

Dr. Tronick’s research with the Still Face paradigm is an outgrowth of the attachment research, and his research would be considered to fall within the psychoanalytic school of professional psychology.

“Not Ready”

Parents and the court are repeatedly told by entirely ignorant mental health people that the child isn’t “ready” to receive the love of a parent, or that the child needs individual psychotherapy in order to be “ready” to recieve the love of a parent. 

That is complete rubbish.

That is ignorance of epic proportions, and that is EXACTLY the WRONG thing to do, to leave an un-repaired parent-child breach.  We want to fix the breach as quickly as possible.  A breach is fixed with the application of empathy – do you see how quickly the breach was fixed in the Still Face YouTube example provided by Dr. Tronick?  Immediately.

The attachment system is a goal-corrected motivational system – it ALWAYS maintains the goal of forming an attachment bond.  In the Still Face example, do you see how the child’s protest behavior was an “attachment behavior” designed to ELICIT the parent’s involement – NOT to sever the parent-child bond to punish the parent.  Protest behavior is an attachment behavior, the attachment system is a goal-corrected motivational system, it ALWAYS maintains the goal of forming an attachment bond.

The idea that the child is not “ready” to be loved by a parent is insane ignorant rubbish. 

Any mental health professional who says the child is not “ready” to be loved by a parent is an ignorant buffoon who should NOT be working with children.  It is a breach.  It is part of a vital – neuro-developmentally vital – breach and repair SEQUENCE – with three parents, the breach, the protest, and the repair… the good, the bad, and the ugly.

DO NOT leave the child in the ugly – in a non-repaired breach.  Repair the breach as QUICKLY as you possibly can. 

If you are a mental health professional and don’t know how to repair a breach in the parent-child relationship – you should NOT be working with breaches to the parent child relationship.  Learn attachment.  Learn Bowlby.  Learn Stern and Tronick.  Don’t work with children until you do.

Do NOT leave the child in an un-repaired breach to the parent-child relationship.  Ever.  Fix it.  As quickly as you can, preferably immediately.

If any mental health person says that the child is not “ready” to be loved by a parent or needs individual therapy in order to be “ready” to be loved by a parent, that mental health person is an ignorant buffoon who should NOT be working with children.

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

Read More –>