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

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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

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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

 

 

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15 Books Perfect For Children Living With Abusive Parents

Parents often ask me for resources to help them support their children who are living with an abusive parent.  It can be such a difficult topic to explain as there are so many emotions involved.

I have therefore compiled this list, with the help of many of my clients, to offer you some guidance and words on how to best support the child.

It is broken down into age categories for ease but remember that a child’s physical age is not necessarily their emotional age so be mindful of where that child is at in terms of their own understanding.

Children aged 0 – 6

At this age children are learning that their behaviour effects the world around them and these early experiences form a blueprint for how they see their world. They may blame themselves for arguments and will be asking things like “why does mummy hate daddy?” or “what did I do wrong?”  Children will also begin to assert themselves in play and this can be aggressive.

Boys can “fall in love” with their mothers and girls with their fathers and so this stages forms a blueprint for relationships and how they view the opposite sex. Abusive parents can distort a child’s view of what the role of a mummy/daddy and man/woman is.

Therefore the books in this list focus on helping children to manage their emotions and understand anger better.

The Feelings Book by Todd Parr

Abusive parenting can result in emotions becoming very scary and distorted. The child may witness a parent happy one minute, angry the next with no trigger.  They won’t know what changed and so can be confused by not just their own emotions but also their parents.

Many children with abusive parents can also take ownership of their parent’s emotions and express them as their own.  Saying “I’m sad” or “I’m scared” but smiling and laughing.

This books helps children to identify what they are feeling on a range of subjects.

How are you feeling today Baby Bear By Jane Evans

Children who grow up in abusive homes often feel they did something wrong to cause the argument.  They regularly feel afraid, lonely, angry and tired.

This sensitive, charming storybook is written to help children who have lived with violence at home to begin to explore and name their feelings.

Kit Kitten and the Topsy Turvy Feelings by Jane Evans

Once upon a time there was a little kitten called Kit who lived with a grown-up cat called Kizz Cat. Kit Kitten couldn’t understand why sometimes Kizz Cat seemed sad and faraway and others times was busy and rushing about. Kit Kitten was sometimes cold and confused in this topsy turvy world and needed help to find ways to tell others about the big, medium and small feelings which were stuck inside. Luckily for Kit, Kindly Cat came along. Many children live in homes where things are chaotic and parents or carers are distracted and emotionally unavailable to them.

This storybook, designed for children aged 2 to 6, includes feelings based activities to build a child’s emotional awareness and vocabulary. A helpful tool for use by parents, carers, social workers and other professionals to enable young children to begin to name and talk about their feelings.

Two Homes by Claire Masurel

In this award-winning picture book classic about divorce, Alex has two homes – a home where Daddy lives and a home where Mummy lives. Alex has two front doors, two bedrooms and two very different favourite chairs. He has a toothbrush at Mummy’s and a toothbrush at Daddy’s. But whether Alex is with Mummy or Daddy, one thing stays the same: Alex is loved by them both – always.

This gently reassuring story focuses on what is gained rather than what is lost when parents divorce, while the sensitive illustrations, depicting two unique homes in all their small details, firmly establish Alex’s place in both of them. Two Homes will help children – and parents – embrace even the most difficult of changes with an open and optimistic heart.

Although not specifically centred upon parental mental health, divorce is an unsettling time for both parents and children and so this book may help ease the worry of how to explain what is happening to a child.

Grow Happy by Jon Lasser

“My name is Kiko. I’m a gardener. I grow happy. Let me show you how.” Kiko shows the reader how she grows happiness: by making good choices, taking care of her body and mind, paying attention to her feelings, problem solving, and spending time with family and friends. Kids will learn that they can play a pivotal role in creating their own happiness, just like Kiko. A Note to Parents and Other Caregivers provides more strategies for helping children learn how to grow happiness. Age range 4-8.

Anger is Okay, Violence is Not by Julie K Federico

Anger is OKAY Violence is NOT belongs on the desk of every child protective services case worker. This book has a hidden message for children who are living with violence and struggling with a domestic violence definition. This book is also a great resource for toddler’s struggling with temper tantrums. The book offers replacement behaviors children can do instead of getting angry. Anger is OKAY Violence is NOT teaches children about fish, feelings, families and anger control.

A Terrible Thing Happened by Margaret Holmes

Sherman Smith saw the most terrible thing happen. At first he tried to forget about it, but soon something inside him started to bother him. He felt nervous for no reason. Sometimes his stomach hurt. He had bad dreams. And he started to feel angry and do mean things, which got him in trouble. Then he met Ms. Maple, who helped him talk about the terrible thing that he had tried to forget. Now Sherman is feeling much better.

This gently told and tenderly illustrated story is for children who have witnessed any kind of violent or traumatic episode, including physical abuse, school or gang violence, accidents, homicide, suicide, and natural disasters such as floods or fire. An afterword written for parents and other caregivers offers extensive suggestions for helping traumatized children, including a list of other sources that focus on specific events.

Children aged 7 – 13 years

At this age, children are asking more questions and starting to understand right from wrong. This can be especially hard when they are being taught bullying and violence is wrong but witness this at home. It can be really difficult for them to process and they will struggle with their own identity as well as feeling alienated from others. They will begin to identify with their own gender and so can align themselves with the abusive parent of the same sex. They are also learning consequences and to push boundaries. Abusive parents can either have to strict or too lapse boundaries and so children struggle to feel safe. This can lead to them withdrawing or lashing out.

The books in this age bracket are therefore focused on developing their identity and managing behaviours.

Lizzy Lives In An Angry House: Learning to Thrive In the Midst of an Angry Environment by Karen Addison MSPH

Karen Addison, educator, author and speaker, has witnessed and experienced the devastating effects of emotional and verbal abuse. Many have not addressed this form of destruction in relationships because it is difficult to talk about and difficult to understand. Often people don’t realize they are in emotionally destructive relationships, and this is especially true of children. If they are living in a home where a parent is “scary angry” and emotionally destructive, chances are the other parent is struggling to cope with that person, as well as the negative dynamics in the home. With wisdom and practical experience, Addison gives readers young and old alike an empathetic approach to recognising emotionally destructive (scary angry) relationships and tools to help those living in “scary angry” homes overcome and break the cycle of abuse

The Invisible Boy by Trudy Ludwig

Meet Brian, the invisible boy. Nobody ever seems to notice him or think to include him in their group, game, or birthday party . . . until, that is, a new kid comes to class.

When Justin, the new boy, arrives, Brian is the first to make him feel welcome. And when Brian and Justin team up to work on a class project together, Brian finds a way to shine.

From esteemed author and speaker Trudy Ludwig and acclaimed illustrator Patrice Barton, this gentle story shows how small acts of kindness can help children feel included and allow them to flourish. Any parent, teacher, or counselor looking for material that sensitively addresses the needs of quieter children will find The Invisible Boy a valuable and important resource.

Includes backmatter with discussion questions and resources for further reading.

Angryman by Gro Dahle

There’s someone in the living room.

It’s Dad.

It is Angryman.

Boj’s father can be very angry and violent. Boj calls this side of his father’s personality “Angryman.” When Angryman comes no one is safe. Until something powerful happens…

Gro Dahle’s astute text and Svein Nyhus’s bold, evocative art capture the full range of emotions that descend upon a small family as they grapple with “Angryman.” With an important message to children who experience the same things as Boj: You are not alone. It’s not your fault. You must tell someone you trust. It doesn’t have to be this way!

Somebody Cares: a Guide for Kids Who Have Experienced Neglect by Susan Farber Straus

Somebody Cares explores the feelings and thoughts many kids have when they’ve had to look out for themselves or be alone much of the time. A useful book to read with a caring adult — such as a parent, foster parent, kinship parent, or therapist — Somebody Cares reassures children who have experienced neglect that they are not to blame for what happened in their family, and that they can feel good about themselves for many reasons. It takes time for kids to get used to changes in their family or living situation, even when they are good changes. This book will help kids learn some ways to feel safer, more relaxed, and more confident.

Teenagers

Teenagers are going through their own internal battle with hormone changes as well as having to make some life choices with regards to career. They often regress to toddler behaviour due to this pressure. For children with abusive parents the control between their own family and their friends can cause real confusion and disappointment or anger. They may, due to hormonal issues, start to lash out more and this can terrify them because they recognise themselves in their abusive parent. Equally they may see a passive parent and feel anger towards them for not doing anything. There may also be a physical risk to the child at this age as they talk back.

Children at this age will have a strong sense or morality though and so are more likely to want to speak out to others about the injustice they feel at home and perhaps even run away or move out as soon as they are old enough.

Therefore books for this age group are around managing their own emotions and feeling safe to speak up and gain some understanding about what is happening in their family.

Don’t let your emotions run your life by Sheri van Dijk

Let’s face it: life gives you plenty of reasons to get angry, sad, scared, and frustrated&mdashand those feelings are okay. But sometimes it can feel like your emotions are taking over, spinning out of control with a mind of their own. To make matters worse, these overwhelming emotions might be interfering with school, causing trouble in your relationships, and preventing you from living a happier life.

Don’t Let Your Emotions Run Your Life for Teens is a workbook that can help. In this book, you’ll find new ways of managing your feelings so that you’ll be ready to handle anything life sends your way. Based in dialectical behavior therapy, a type of therapy designed to help people who have a hard time handling their intense emotions, this workbook helps you learn the skills you need to ride the ups and downs of life with grace and confidence.

This book offers easy techniques to help you: Stay calm and mindful in difficult situations, Effectively manage out-of-control emotions, Reduce the pain of intense emotions and Get along with family and friends

My Anxious Mind: A Teen’s Guide to Managing Anxiety and Panic by Michael A. Tompkins, Ph.D., and Katherine A. Martinez, Psy.D

Learn strategies to help you take control of your anxiety. The authors share information about breathing, thinking, facing fears, panic attacks, nutrition, sleep, exercise, medication, and how to tell if and when anxiety is a problem.

The Truth about Love, Dating and Just Being Friends by Chat Eastham

Chad shines some much-needed light on these major issues for teens. Rather than let their feelings navigate them blindly through their tumultuous adolescence, Chad offers clarity, some surprising revelations, and answers to some of their biggest questions: How do I know who to date?  When should I start dating? How should I start dating? Is this really love? And, Why do guys I like just want to be friends?

Packed with humor that adds to the sound advice, this book will help teens make better decisions, have healthier relationships, and be more prepared for their futures. Just a few things girls will learn include: Five things you need to know about love; Eight dumb dating things even smart people do; Ten reasons why teens are unhappy; and Ten things happy teens do.

Any teen can live a happier, healthier life: they just need to hear The Truth

Forged By Fire by Sharon M Draper

Will Gerald find the courage to stand up to his stepfather? 

When his loving aunt dies, Gerald suddenly is thrust into a new home filled with anger and abuse. A brutal stepfather with a flaming temper and an evil secret makes Gerald miserable, and the only light in his grim life is Angel, his young stepsister. Gerald and Angel grow close as he strives to protect her from Jordan, his abusive stepfather, and from their substance-addicted mother. But Gerald learns, painfully, that his post can’t be extinguished, and that he must be strong enough to face Jordan in a final confrontation, once and for all…. 

This list is not exhaustive

I have just compiled some that I think resonate with my audience but please do your own research. You know what your child is ready for. Also remember that the ages are not cut off points and so be mindful of your own child’s capacity and choose the ones which best suit by the content, not the age.

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 –>

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

 

 

 

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Slide7

My goodness, Karen Woodall is full of… nonsense.

Karen recently posted a blog about Fairy Tales and splitting that was kind of all over the place, but the central premise is that she’s some sort of expert on “splitting” and she’s sort of simultaneously discovering splitting and reporting on her discovery.

There’s so much nonsense being put forth, I need to address it.  But there’s so much to address, I’m going to do it in multiple posts.  This first one on just the general nonsense of her grandiosity, and then I’ll devote the second one to the more specific nonsense of what she says. 

Fairy Tales from the Woodalls

In her blog, Karen seemingly admits that her approach to understanding complex family conflict surrounding divorce is to create a fairy tale – a make-believe fairy talesstory she creates about a new form of pathology she thinks she’s “discovering.”

How exciting that must be for Karen, she thinks she’s discovering something.

But, for starters, Karen, I’m unclear which is the title for your blog?

Is it, Fractured Minds: Kaleidoscopic Thinking in Parental Alienation or is it the bigger banner of, Fairy Tales for Unwanted Children.  Or perhaps it’s both?  I think it’s both.

Karen, you are familiar with projective processes, right?  You are aware that everything we do is a projective statement about ourselves, not an actual statement about the world.  You do understand projective process, right Karen?

So the phrase “fractured minds and kaleidoscopic thinking” – does that refer to you, Karen?  Does that represent your inner experience as you struggle to psychologically hold onto your collapsing world of “parental alienation,” and is the other, Fairy Tales title, does that refer to the mythical story of pathology you’re creating as the grandiose defense of self against your collapse into obscurity and irrelevance? 

Are both titles true, Karen?  The split inside you?  And what are you writing about?  Splitting.  You are familiar with projective processes, right Karen?

I suspect both titles are true, Karen.  You appear to be manifesting an inner splitting of yourself, right before our very eyes, Karen.  How cool is that, you’re talking about splitting at the same time you’re projectively manifesting your own split. 

Inside, your world is a kaleidoscope of fractured thinking, a fractured mind, and to cope, to hold your world together, you’re creating a psychological Fairy Tales of being an “expert” discovering a “new pathology” – how exciting for you, Karen… a new pathology.  Do you think you’ll get the Nobel prize for your discovery?  Seriously.  You’re discovering a whole new pathology, Karen.

Aren’t you?  Of course you are.  What do you call it?  Right, “parental alienation.”  Oh, you’re not inventing it?  This Richard Gardner guy discovered it, huh.  And now you’re on this fantastic journey of discovery too.  Wow.  That’s great, Karen.  A narcissistic paradise.  Can anyone play?  Can I play too?  Any rules, or can I just make up anything I want about this “parental alienation” thing?

Far as I can tell, there’s no rules here at all, are there Karen?  You just have to self-identify as an “expert” in this new pathology and, there ya go, you’re now an “expert” and can start making stuff up, whatever you want.  Or is there some sort of “experts” club that you have to join?  Is there a club, Karen?  Some sort of certificate you need to have bestowed on you before you become an “expert” – like the Free Mason’s or Shriners or something, some candlelight ceremony with people dressed in togas?

How is it that exactly, that you’re an expert?  Is that just a self-designation thing? 

Or is it sort of like wishing Tinker Bell back to life, “I do believe in fairies, I do believe in fairies…” is that the way it works?  I am an expert, I am an expert.  Is that how we develop new pathologies in professional psychology, Karen?  Somebody says, “I’m an expert” and proposes a new pathology, and then everyone goes, “Okay” and we have a new pathology.  Is that the way it works, Karen, in the Fairy Tales?

So how should we handle that, Karen?  When someone… like you or Gardner… propose the existence of a whole new form of psychopathology that is supposedly unique in all of mental health… how should we handle that?  In professional psychology, how should we handle that?

Should we just say, “Okay” to everyone who proposes a new form of pathology?  No, of course not.  So how do we handle that then, eh Karen?

Do you know how we handle that in professional psychology, Karen, when someone proposes a new pathology?  We say, “Show us the research base for the proposal.”  That’s what we say.  And when we say, “research base,” we mean like autism-level, ADHD-level, PTSD-level, attachment-level, schizophrenia level research.  If you’re asking for a whole new pathology… that’s an autism-level/schizophrenia level research base we’re looking for to support a “new pathology.”

So… do you have that research base for you’re pathology, Karen, this “parental alienation” thing your proposing?  Amy Baker and a smattering of poorly designed “studies”?  That’s it, Karen?  Okay, no worries, you keep working on it.  In the meantime, Karen… your pathology, your “parental alienation” thing that you’re proposing… it doesn’t exist as a real thing.

That’s how it works, Karen.  Oh… but your special.  We should skip all that for you, because you’re an “expert.”  So we should just do without the research base – and a coherent description of the pathology, and we should just accept whatever you say… because… you’re an “expert.”  I know your an “expert” because you say so, and that’s how we can tell who the “experts” are… they tell us they are.  That’s so helpful.

It’s a unicorn, Karen.  Your “parental alienation” pathology.  A Fairy Tale. I know you like your stories, your Fairy Tales.  They’re simple and easy to understand, because you just make up the story to be whatever you want it to be.

But Karen, just saying – “It’s a pathology, it’s a pathology” over and over like a petulant 3-year-old is not how we adopt new forms of pathology in professional psychology.  You can imagine the chaos that would create.

Why, somebody might come up with a Carrot Rejection Syndrome (CRS) for all we know.  The child engages in a campaign of denigration toward carrots, rejecting carrots for weak and frivolous reasons.  The child shows a lack of ambivalence regarding carrots.  Their rejection of carrots spreads to other related vegetables, like broccoli and peas.  Oh… and here’s a good one, the independent rejecter phenomenon, the child claims that their hatred of carrots is not being influenced by the other kids at school not liking carrots, that it’s the child’s own beliefs… carrots are yucky.  Carrot Rejection Syndrome.

And you know, Karen, kids with Carrot Rejection Syndrome show this splitting thing where carrots are all-bad and pizza is all-good.  Wow, you should look into that, Karen.  You’re an expert in splitting.  Carrots are all bad, pizza is all good.  Splitting, right?

But that’s silly, right Karen?  We don’t just go around making up new pathology at the drop of a hat for any old thing… Carrot Rejecting Syndrome, a campaign of denigration toward carrots for weak and frivolous research.  Sheesh, nobody is going to just make up a new syndrome like that, Carrot Rejection Syndrome.  Any real mental health professional will first do the work of collecting the research data – like for PTSD when they added that as a pathology. 

No one just goes around making up new forms of pathology entirely on their own with NO research support and expecting everyone to accept it, because then we’d have a thousand types of Carrot Rejection Syndromes.  Homework Refusal Syndrome – a campaign of denigration toward homework for weak and frivolous reasons, a lack of ambivalence toward homework, an absence of guilt about not doing homework, the presence of borrowed scenarios (the dog ate my homework).

So obviously, we can’t have that, right Karen.  I know my examples might seem outlandish – Carrot Rejection Syndrome, Homework Refusal Syndrome – I mean, seriously, no one would be so unprofessional and insane to propose something THAT stupid, but its the principle, Karen.  If people can just go around being self-proclaimed “experts” and making up any old pathology they want willy-nilly… things could get out of hand quickly.

So what was that pathology of yours again, Karen?  Parent Rejection Syndrome?  Was that it?  Parent Refusal Syndrome?  I forget.  Anyway, in order to have a pathology accepted in professional psychology… you need a research base for the proposal.  And that’s a research base like for autism, or PTSD, or attachment.

Now because professional psychology deals with real pathology, Karen, I’m going to ask you to please stop using your position as a mental health person to mis-inform people about professional psychology.  You are deceiving people, Karen.  There is no new form of pathology, Karen. 

“Yes there is”?  Well then, Karen, show me the research base for your “new pathology” proposal.  See how that works?  No Carrot Rejection Syndromes.  Research base, Karen.  Autism-level, attachment-level, PTSD-level research base.   Until then, Karen, your “new pathology” doesn’t exist.

You like Fairy Tales, Karen, don’t you Karen.  You remember Pinocchio, don’t you?

Remember the Fox and Cat at the crossroads, who convince Pinocchio to go to Pleasure Island instead of going to school, and the cricket says, “No, no, Pinocchio, go to school” but theSlide7 Fox and Cat tell Pinocchio, “Don’t listen to the cricket, Pleasure Island is wonderful.”  And then Pinocchio goes to Pleasure Island and gets turned into a donkey, and is sent to the salt mines and has to be rescued by the Blue Fairy.  You remember that Fairy Tale, don’t you Karen?

Well you and the Gardnerian “experts,” Karen, are the Fox and Cat at the crossroads.  You’re telling all these parents to go the bad way, the way of tragedy and no solution, telling them that they have to prove “parental alienation” to a judge, at court, at trial.  No, they don’t. 

I’m like the cricket, telling people to “Stay on the path of established knowledge, go to school Pinocchio; Bowlby, Minuchin, Beck – don’t go to “Parental Alienation” Island Pinocchio, you’ll be turned into a donkey and sent into the family court system, and then you’ll have to hope that the Dorcy will come to rescue you from the family courts.”

The Fox and the Cat never should have told Pinocchio to go to “Parental Alienation” Island.  The cricket was right.  Parents who went that way were turned into donkeys and sent to the family courts.  Lucky for Pinocchio that the blue fairy came.  I hope Dorcy’s able to get you out of the salt mines and turn you back into a person instead of a donkey.  But you shouldn’t have listened to the Fox and Cat.

Pinocchio should have gone to school, like the cricket said, and studied, and applied knowledge.  But instead he went running after the easy path, the one the Fox and the Cat told him would be a good thing.  They lied to Pinocchio. The Fox and the Cat did a very bad thing to Pinocchio.

They tell parents, “Don’t listen to the cricket, Pinocchio, don’t apply knowledge, come to “Parental Alienation” Island instead, you’ll play all day in the Funhouse of Experts.  You’re leading them astray, Karen, the parents.  That is a bad thing to do.  You know “Parental Alienation” Island is a sham, it just funnels parents and families into the family court system.  You know it offers no solution.  You know that, Karen.

Yet you tell people to go to “Parental Alienation” Island,  Shame on you Cat.  You know that “parental alienation” offers no solution to parents. 

But you know something, Cat?  AB-PA is designed to expose the allies of the pathology.  And it works.

All I’m advocating for is a return to Bowlby, Minuchin, Beck, the established knowledge of professional psychology.  You’re against that, “Don’t listen to Dr. Childress – don’t listen to that cricket on your shoulder telling you to apply the established knowledge of professional psychology.”

Who could possible argue AGAINST the application of established knowledge?  Someone who doesn’t want a solution, the pathogen’s hidden allies.  You, Karen.

Here, I’ll show you Karen… stop using the term “parental alienation” and rely ONLY on the established knowledge of professional psychology.  “No.”  See?   You.  You are arguing AGAINST the application of established knowledge.  Why are you doing that, Karen?  Oh, because you don’t actually want a solution, you just want to LOOK like you want a solution.

A Vanishing Expertise

Tell me, who says you’re an “expert” Karen?  You do. 

Wait, I’ll bet Bill Bernet does too, doesn’t he.  He says you’re an “expert.”  But wait, who says Bill Bernet is an “expert”?  Oh, you do.  I get it.  You all just go around anointing each other as “experts” and then just make stuff up.  Sweet.  You know that’s a scam, right?  You’re not a real expert in anything.  You know that, right?

You are?  You are really an “expert” for real?  Okay, show us.  On your vitae.  Post your vitae, Karen.  Show us how you developed your expertise. Where did you receive your training in the attachment pathology?  Where did you receive your training in family systems therapy? Where did you receive your training in personality disorder pathology?  Where did you receive your training in complex trauma? Where did you receive your training in the neuro-development of the brain during childhood?

You’re not an expert in anything, Karen, except in your own imagination and fantasies.  It’s a Fairy Tale, Karen.

I suppose in Fairy Tales that’s all it takes, isn’t it Karen, a wave of the magic wand and, presto-chango, Karen Woodall is an “expert” who goes to the royal ball in her magical carriage of “parental alienation” dressed in her beautiful “expert’s” dress– ahhh, if only… what a nice fantasy, isn’t it Karen.  If only everyone listened to you and did what you told them to do, then the world would be wonderful, wouldn’t it Karen?  If everyone just listened to you and did what you said.

Thank you from all of us, for your magnificence, Karen.  Whatever would we do without your magnificent brilliance.  We’re so lucky to have experts like you to guide us in our ignorance.  How’d you become an expert again?  Can we look at your vitae?  No?  How odd.

But alas, they don’t listen to you, do they Karen?  And never will, Karen. 

So I guess we will be lost forever in the wilderness, because no one is listening to Karen Woodall, our savior.  That’s the storyline, isn’t it Karen?  It’s the “If Only” story, isn’t it?  If only people listened to me, the world would be a better place.  That story.  You’ve also got the Star Wars mythos going too, right, the heroic rebel alliance fighting the evil empire, a never ending struggle of the heroic rebels fighting against the Death Star.  Isn’t that the one?  If only Karen Skywalker can destroy the Death Star in time to save us.  Save us, Karen.  We’re all counting on you, please save us Karen. 

Isn’t that the storyline your running?

If only everyone listened to your magnificence.  Ahhh, that would be lovely.

Your world of “parental alienation” is disappearing, Karen – it’s going to be solved.  Really.  We’re on the path to solving this family conflict pathology using Bowlby, Minuchin, and Beck… no Gardner.  Which means… no you. 

Uh-oh.  What will you do, Karen?  When there is no “parental alienation”?

Because… you’re not really an “expert” in anything except a pathology that you can simply make up, when that pathology goes away… you won’t be an “expert” anymore.  What will you do, Karen, once the pathology is solved? 

You’ve gotten locked into a rigidity that you can’t escape.  You must, at all costs, hold on to the term “parental alienation” or else you… cease to be an expert in anything.  Uh-oh Karen.  What are you going to do as “parental alienation” fades from relevance in professional psychology?

No one’s ever going to say, “Hey, we should give this Gardner PAS a new look.”  Read the writing on the wall, Karen.  You, Karen Woodall, are everything status quo – Gardnerian PAS – you are no change, just more of the same – 40 years of the same, Karen.  Forty years of no solution, Karen. 

Uh-oh when change comes and the status quo is washed aside.  What happens to you, Karen, when the source of your sole “expertise” disappears?

Dr. Childress is taking it away from you, isn’t he, your prized “expertise.”  I’m leading everyone back to Bowlby, and Kernberg, and Minuchin.  Away from you.  Fight back, Karen.  Hold on.  Stop him, Karen, stop him from leading people back to the established principles of professional psychology… because then they won’t listen to you, and you won’t be… important.

That must be hard for you, Karen.  To see your role as an “expert” vanishing along with the construct of “parental alienation.”  You have so much of your ego tied up in being an “expert.”  What happens when the pathology is solved?  What happens when it’s solved without the construct of “parental alienation”?

Will you be happy, Karen, when the pathology is solved using Bowlby, Minuchin, and Beck, will you be happy?  Or will you be sad and unhappy when the pathology is solved and families are reunited?  What will you do when you’re not an “expert” anymore, when no one listens to you? 

I tried to warn you, change is coming, we’re solving the pathology.  I told you, I’m taking the field of professional psychology back to the standard and established – already scientifically established – knowledge of professional psychology – Bowlby, Minuchin, Beck. 

Family systems therapy solves everything about this pathology, Karen.  Why aren’t you using family systems constructs?  Oh, because then YOU are not the expert, Minuchin and Bowen are.  Why do we need the construct of “parental alienation,” Karen?  What’s wrong with using cross-generational coalition and emotional cutoff from family systems therapy?  Oh, because then YOU are not the expert, Minuchin and Bowen are.

We MUST hold on to “parental alienation” – we MUST, we MUST.  No, Karen.  That construct is going away in professional psychology.  Oh, it will remain a construct in the general population, people prefer simple easy-to-understand things.  But in professional psychology… we’re returning to the established constructs and principles of professional psychology.

Dr. Childress isn’t going anywhere, Karen.  We are returning to Bowlby, Minuchin, Beck, that is a fact.  You will become irrelevant once we drop the construct of “parental alienation” and once we return to the established knowledge and constructs of professional psychology, that too is a fact.

Once we leave the make-believe world of “discovering” new pathology – once we leave the Fairy Tale world of Alice through the Looking Glass, where professional expertise is self-anointed, once we return to the real world of real pathology, we will solve the pathology.

No mermaids, Karen.  No unicorns.  I know you love your mermaids and unicorns, I’m sure they’re magical and make you feel warm and safe.  But that fantasy is not real, Karen.  There is no new pathology, Karen.  It’s a delusion of grandeur.  The world you’ve constructed for this new form of pathology, this “parental alienation” pathology you like so much… that’s not real.  It’s an illusion.  It’s a Fairy Tale, Karen.   A creation of your fantasy.

I know, it’s a beautiful fantasy, to be an “expert” – so important, everybody listens to you.  But the reality is, you’re not important, Karen.  You’re not an “expert” in anything, that’s simply your egoistic hubris and your unbridled grandiosity.  There is no new pathology you’re discovering.  You’re an ordinary person, ignorant in many ways, over your head, beyond your capacity.  The emptiness of your grandiosity will be deflating with the coming of reality.  I’m sure that’s hard on you, watching your world vanish.  I’m sure inside, it must feel like a kaleidoscopic and fracturing world.

You’re not an expert in anything, Karen. 

“Yes I am” – Okay, let’s see your vitae.  Post your vitae, Karen.  You’re the one asserting that you’re an “expert,” so, back it up, post your vitae.  My vitae is up online, where’s yours?

Dr. Childress Vitae

Dr. Childress YouTube Vitae Series

You are not an expert in anything, Karen.  You just want to be.  You want to be more than your are, more important, more special… everybody needs to listen to Karen… she’s important.

No, Karen.  You’re simply an ignorant person who thinks she’s “discovering” something.  You’re just making stuff up to hide your ignorance. 

Is it to hide your laziness, Karen?  Is that it?  Are you simply too lazy to learn and apply knowledge?  Or is it that you’ve tried to learn the material of Bowlby, Minuchin, Beck et al., and you don’t understand it?

Is that it, Karen?  Is it that you don’t comprehend the information from family systems therapy and complex trauma?  Personality disorders and attachment pathology?  Is it that you don’t comprehend the information?

That’s it, isn’t it?  That’s why your mind feels like a kaleidoscope of fractured thoughts.

Where did you receive your training in attachment pathology, Karen?  My vitae is available for all to see.  Where’s yours?  You’re an “expert” – let us marvel in your expertise.  Post your vitae, let’s have a look at exactly how much of an “expert” you truly are.

Hurting People

I wouldn’t have much of a problem with your grandiose arrogance, Karen, except that it hurts children and their parents.  Your ignorance and your misdirection of parents into paths that offer no solution whatsoever, hurts people.  You’re hurting people, Karen, by withholding the solution from them.

Are you diagnosing DSM-5 V995.51 Child Psychological Abuse, Karen?  It turns on Diagnostic Indicator 3, the persecutory delusion.  Is that present, Karen?  A persecutory delusion in the child?  If it is, that’s a DSM-5 diagnosis of V995.51 Child Psychological Abuse.  Add attachment system suppression and five personality disorder traits and the diagnosis of Child Psychological Abuse is a lock.  Are you diagnosing DSM-5 V995.51 Child Psychological Abuse, Karen?

You’re not are you?  Because you don’t want to assess for AB-PA because then Dr. Childress will be the “expert,” not you… so you are withholding the DSM-5 diagnosis of V995.51 Child Psychological Abuse – when it is an appropriate and warranted diagnosis – BECAUSE… you want to stay an “expert.”  That… is reprehensible professional practice for your clients, Karen. 

If you are not diagnosing V995.51 Child Psychological Abuse, Karen, please… tell us why you are not diagnosing this pathology as V995.51 Child Psychological Abuse?

You and I both know the answer, don’t we Karen.

Answer:  You are not diagnosing a DSM-5 V995.51 Child Psychological Abuse because the construct of “parental alienation” doesn’t actually support the DSM-5 diagnosis of Child Psychological Abuse, does it?   Because it is not a real pathology is it?  It’s only a pathology of your creation – you and Gardner, a Fairy Tale. 

The only way to reach a DSM-5 diagnosis of child abuse is through AB-PA, and you refuse to apply the established knowledge of professional psychology and you INSIST on using a made up form of new pathology, so the DSM-5 diagnosis is being withheld from your clients because of your ego and desire to be an “expert.”

That is morally reprehensible professional practice, Karen.

A Pathogenic Ally, A Split Mind

If you are the “fractured mind and kaleidoscopic thinking” of your title, which a reading of your blog with professional knowledge suggests, then I suspect your fracturing might be a response to stress, Karen.

The world of “parental alienation” – the world of your self-identify as an “expert” is disappearing, Karen.  You, as an expert, are disappearing too.  We all are.  Myself included.  The world of “experts” and “evaluators” is leaving, like the boats of elves leaving the world of men at the end of Tolkein’s Lord of the Rings, we’ll be sailing to the distant shores.  We won’t need “PAS experts” or “custody evaluators” anymore.  That’s a narcissistic approach that leads to no solution.

The world of clinical psychology is returning – Bowlby, Minuchin, Beck, van der Kolk, Tronick.  The real world.  No Fairy Tales anymore.

I’m leaving too, once my job here is done.  That’s what clinical psychologists do, we work ourselves out of a job by fixing things.  Dr. Childress never was an expert.  I’m just a clinical psychologist.  I’m solving the pathology.  I’m working, Karen.  You are watching a clinical psychologist at work.  In this blog too, I’m working.  I’m disabling an ally of the pathogen from causing further damage.

You are a pathogenic ally.  You know that don’t you, Karen?  Let me ask you this, who wants to stop Dr. Childress?  The allies of the pathology, right?  The allied parents, their attorneys, their flying monkeys.  And you.  You and Bill Bernet, and Amy Baker, Dr. Miller.  You, the Gardnerian PAS group, you want to stop Dr. Childress too right?   “How can we stop Dr. Childress,” you’ve had those discussions.

The pathogen wants to stop a return to established constructs and principles of professional psychology, and YOU want to stop a return to the established constructs and principles of professional psychology.  You and the pathology are on the same side, Karen.  You are allied with the pathology AGAINST a solution.

Here, I’ll prove it… Karen, stop using the construct of “parental alienation” and ONLY use the established knowledge of professional psychology.

Karen’s Response: “No, Dr. Childress.  I insist on creating a new form of pathology and advocating that everyone else adopt my new pathology, based on the work of my guru, Richard Gardner.”

Karen… you do understand how the projection thing works in psychology works, right?  Everything you do – everything, Karen… is a projection of your inside stuff.  I’m a clinical psychologist, Karen.  You know I can see your “inside” material, Karen.  That “guru” thing you accuse me of… well, reality is that I’m saying it’s not me, Karen, it’s Bowlby, Minuchin, Beck.  You’re the one saying it’s you – your the one claiming to be coming up with new forms of pathology and new forms of therapy.  You’re the guru, Karen. 

And your guru is Richard Gardner.  You think in terms of “experts”- that’s YOUR organizing cognitive-relational structure.  You see gurus, like Gardner, like yourself.  So when you look at me, you see your reflection.  You do understand how projection works, right Karen?

I’m a clinical psychologist.  I’m working.  I’m solving pathology.  When I’m done, I’ll be out of a job.  Yay.  Then I’ll move on to the next client.  I’m a clinical psychologist.  I fix things.  That’s my job.  It wasn’t my mind that organized a return to the established knowledge as some sort of “guru” thing – that’s your mind that sees that, Karen – mirror, Karen, mirror. 

Karen, I’d be worried if I ever found myself on the same side of something as this pathology.  If you’re on the same side of the pathology as the narcissistic-borderline parent in trying to delay and prevent a solution… then you are an ally of the pathology. See how that works?

AB-PA – a return to the established knowledge of professional psychology – Bowlby, Minuchin, Beck – is designed to identify the allies of the pathogen.  Did you know that, Karen?  Yes, it is.  Who could possible argue AGAINST applying the knowledge of family systems therapy and the DSM-5?  You.  It identified you as the ally of the pathology.  You do not want to solve this, you want to keep this endlessly in conflict… so you can remain an “expert.”

Prove me wrong, Karen.  Advocate for a return to the established constructs of professional psychology – stop using the construct of “parental alienation” and rely ONLY on the established knowledge of professional psychology.

You won’t do it.  Oh hi, there you are, pathogenic ally.  I almost didn’t see you there.  You do such an excellent job of hiding.  I must say, that false conflict you created as the “loyal opposition” was quite convincing… up to a point.

You… are not an expert in anything, Karen.  You are simply grandiose.

Prove me wrong, post your vitae.  Show us where you received your training in attachment pathology, in family systems therapy, in personality disorders, in complex trauma, and in the neuro-development of the brain.

Or do you think you don’t need to know things?   Do you believe you can be ignorant, and that’s okay?

You’re the one claiming to be an expert, Karen.  Post your vitae.  I posted mine.

You’re not an expert in anything, Karen.  You know it, and I know it.  The only people who don’t realize your level of ignorance are the parents.  They trust you.  You betray them.  That’s not good, Karen.  You and the other Gardnerian “experts” are the Fox and the Cat at the crossroads.  Shame on you, Karen.  What you are doing is a bad thing to do.  It hurts parents and children.

From Aaron Beck:  “The core belief of narcissistic personality disorder is one of inferiority or unimportance.” (Beck et al., 2004, p. 249)

I imagine things are starting to get difficult for you as you see your supposed “expertise” vanishing into the illusion that it always was.  We are going to solve this pathology, Karen, and it’s going to be solved without the construct of “parental alienation.”  Where does that leave you, Karen, once the pathology is solved?

Will you be happy, or unhappy, Karen, when the pathology is solved, solved without “parental alienation” as a pathology?  What happens to your self-importance?   I suspect being average is going to be a hard adjustment for you.  After all, in the Fairy Tales of your creation you’re a magnificent “expert” who is on a magnificent “journey to develop new approaches to family therapy” – oh thank you,, Karen.  God bless you Karen.  You’re so magnificent.

Thank God we have your magnificent “expertise” Karen, to lead us in the right way, your way, this new pathology thing that you think you’re “discovering.”

I’m sure it will solve everything… eventually… some day… maybe.

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

Read More –>

Fonagy & Tronick

Critique of Dr. Mercer Testimony: She is not an expert in anything.

About a year ago, a parent-advocate organized a seminar presentation from Dorcy Pruter and Dr. Childress to a group of family law attorneys in Southern California.  In introducing us, the parent-advocate spoke about the “armor of God.”  She had interesting things to say about this construct.

I had never heard of that construct before, the armor of God.  I listened, it seemed like a nice construct but not one I had ever thought about.  Since then, however, the construct makes complete sense, and is wise beyond measure for the fight with the pathogen.

This is a trauma pathogen, it creates high intensity conflict.  It enjoys conflict, it wants conflict, and it creates conflict.  It loves to create conflict and fighting.  How do you fight against fighting without succumbing to the fighting?  Don’t fight.

Gandhi said that the antidote is the opposite.  The antidote for fighting, is not to fight.  Wisdom.

But how do you not fight when Hitler invades France and the Netherlands?  How do you not fight when the cultural bushido of the Japanese threatens all of Asia and the Pacific with violence, and then attacks Pearl Harbor.  There are times when we must fight.

How do the Americans of African descent fight lynchings and segregation without fighting?  The Reverent Martin Luther King, Jr.  How do women fight mysogeny and oppression without fighting?  By speaking #metoo – standing together.

We don’t fight violence with violence, we fight violence by standing our ground, clothed in the armor of God.  We don’t fight fire with fire, we quench fire with water.

My tai chi instructor was magnificent with the power of water chi, it overwhelms, it’s impossible to stop.  Think of water, if you strike it the water just flows around your fist unimpeded, continuing on it’s force.  Water takes any shape, in flows through any crevice, any crack, any advantage and water floods in.  The ocean’s waves wear down and wash away mighty cliffs, the relentless rain wears down the highest mountains.  The force of water is unstoppable.  We quench fire with water.

The armor of God.  The parent-advocate described how we don’t need to fight evil, we just need to stand our ground against it.  We just need to don our armor of truth, of right, our armor of God, and stand our ground against the malevolence of evil, it’s attacks of slander and lies.  We don’t need to fight, we simply need to stand our ground.

Hitler took France.  He stood on the Eifel Tower surveying his captured city, they looted the Louvre of its historic treasures, they oppressed all of continental Europe, their wolfpack of U-boats wrecked havoc in the Atlantic and Britain barely maintained their stronghold island against fascism.

But hold they did.  They donned their armor of God in the skies over England as their Spitfires threw back the Nazi attacks in the Battle of Britain, they relentlessly hunted the U-boats in the Atlantic shipping lanes.  They held their ground.

America entered the war, but nothing much changed.  They had to prepare.  They stood their ground.  The U.S. navy had been decimated at Pearl Harbor, but the carriers weren’t in port, they survived.  America had to build and rebuild its war capacity.  General Doolittle took his air force bombers by carrier and he bombed Tokyo.  Symbolic, we’re here, and we are standing our ground.  At Midway, the carriers of the United States stood their ground.

The Russian’s donned their armor of God at the battle of Stalingrad.  They stood their ground.  Russian courage, Russian lives, and the Russian winter turned the tide of battle in the east.  They stood their ground.

Then courage reclaimed Europe on D-Day and began the relentless march across Europe.  Courage moved island-by-island across the Pacific, and Russian courage and sacrifice rolled relentlessly forward.

We simply need to don the armor of God and stand our ground against evil.  Wisdom.  We fight by standing our ground.

Court Testimony

I’m testifying in court as an expert witness.  I have great respect for our legal system. An independent judiciary is one of the foundational pillars of a free society.  I have great respect for the role our judges are asked to fill, it’s not an easy task to decide and dispense justice.

People are fallible, judges make errors, people make errors.  But our assumption within our system of justice is that our judges are honest and they act in good-faith to find truth and make correct and just decisions.  If errors in decision-making occur, then we must improve the quality of the evidence and arguments we offer.  It is our responsibility to provide the court with the evidence it needs to make proper decisions.

It is our responsibility to provide the information to the court needed for its decision-making. 

In providing expert testimony to the court, I am providing information from clinical psychology regarding pathology, family conflict, and treatment options for families.  That is my role in expert testimony for the court.

Since I am offering expert testimony for the court’s consideration, the court and all participants in the litigation have a right to fully examine my professional background for my foundation as a professional expert.  I am a clinical psychologist.   I am acting in the role of an expert witness.  My expertise is from my background as a clinical psychologist.

I have posted a YouTube series on my vitae, a stroll down memory lane with Dr. Childress.

YouTube: Childress Vitae Series

I’m not trying to be more than I am.  I’m a clinical psychologist.  I’m a good clinical psychologist, and I’m an old clinical psychologist.  Which means I know a lot of stuff about pathology and clinical psychology. 

We prepare for learning by our education, we learn from the pathology.  We learn the features of the pathology from assessment, we learn the core of the pathology through treatment. 

Typically, as we leave graduate school we have one specialty pathology.  Mine was ADHD and family therapy.  This expanded into school-involved psychology, learning disability assessments, and school behavior problems, which then expanded into court-involved juvenile justice areas.

Also, as I continued to work with the ADHD and school-involved pathologies, that expanded into high-functioning autism as a differential diagnosis, and as I dropped into early childhood (ages 0-5) tracking the neuro-development of ADHD in childhood, I dropped more fully into the autistic-spectrum pathology that emerges in early childhood.  Then, as I moved more fully into early childhood mental health and ADHD, I moved into trauma and complex trauma in the foster care system.

My knowledge is a function of my being an old clinical psychologist.  I’ve worked with a lot of different child and family pathologies over a lifetime of practice.  The pathology teaches.  I know a lot of pathologies, their assessment, diagnosis, and treatment.

At each step, I learned the pathology.   I read all the professional literature and research and then read journals to stay current, and in assessing and treating the pathology I learned its symptom features and how it responds to intervention. Whatever the pathology was, with each one, ADHD, school emotional and behavioral problems, family problems, autism-spectrum pathology, juvenile justice pathology, child abuse, trauma, and complex trauma in childhood, I learned the pathology directly from assessing, diagnosing, and treating the pathology.

I know a lot of pathology.  And I’m a good clinical psychologist.  I know a lot about assessment, diagnosis, and treatment of pathology. This is the knowledge I bring for the court’s consideration.

As Clinical Director for a three-university assessment and treatment center, I was responsible for coordinating the multi-disciplinary assessment, diagnosis, and treatment of children ages zero-to-five in the foster care system.  In San Bernardino County, when children ages zero to five years-old entered the foster care system, the Department of Children’s and Family Services (DCS) sent the children and families to me, to our clinic for assessment and treatment.  As the Clinical Director, I led that treatment team in the assessment and treatment of complex trauma in children.

I know a lot of stuff about pathology, its assessment, diagnosis, and treatment.  That’s the knowledge from professional psychology that I offer the court in my testimony.

I haven’t been working with court-involved families over the course of my career, I’m not from this forensic psychology world of litigation and family conflict.  I was happily on my way to retirement in complete obscurity when I left the childhood trauma center and entered private practice.  Instead, I found myself over here in high-intensity court-involved family conflict tracking one client. 

When I entered private practice, a minor’s counsel sent me a letter requesting I submit my vitae for consideration with a client. I decided yes.  I decided to submit my vitae because I was an old senior staff clinical psychologist who’d worked with nearly every pathology under the sun.  I had scrupulously avoided this “high-conflict divorce” pathology – it’s too dangerous, I’ll leave that to forensic psychology.  They have their ten-foot poles and bomb-proof suits for that kind of work, so throughout my career I offered the traditional clinical psychologist response, “I don’t work with high-conflict divorce.”

But hey, here I was nearing the end of my career, I’m experienced in a lot of pathologies, I was curious to see what the pathology is over here in “high-conflict” divorce.  I know going in that it’s likely going to involve narcissistic and borderline personality pathology in at least one of the parents, but I wanted to take a look and and see what’s up. 

At no time in my career did I ever set out to be an “expert” in something, or famous and cited about anything.  I was a working clinical psychologist, I’m working with kids in trouble in our school system, with kids in trouble with the juvenile justice system, and I’m working with kids in the foster care system who need our help most of all.

When I go to testify as an expert witness, I don’t need to fight.  I simply need to speak the knowledge of professional clinical psychology.  I simply need to don the armor of God, who I am as a clinical psychologist, and tell the court what I know about and do as a clinical psychologist, and stand my ground against evil.

Social Distribution: “Flying Monkeys”

This is evil over here.  The pathology here in court-involved family conflict is evil.  In my professional-level research on this pathology, I’ve read the professional literature on evil.  I would direct professional discussion to the Dark Triad personality and the Vulnerable Dark Triad.  An empirically validated character constellation which one of the researchers called, “The core of evil” – the Dark Triad personality.

Reference List: Dark Triad Personality

There’s a social distribution feature with this attachment-related pathology surrounding divorce.  All sorts of non-involved people become vicariously hooked to the enactment of the pathology, supporting the narcissistic pathology and the emotional abuse of the targeted-rejected parent by the narcissistic spouse. 

It’s such an odd feature of pathology.  Remember how I say that the pathology teaches?  This pathology has a social distribution feature that’s not found in other pathology, not ADHD, not autism-spectrum, not school behavior problems.

This court-involved attachment pathology draws non-involved people to intrude into the family conflict on the side of the narcissistic parent.  They claim to be “protecting the child” – but that’s betrayed as a lie by the fact that there is no child abuse to protect the child from, the targeted rejected parent is an entirely normal-range parent. 

The child is being used by the allied parent as a weapon of retaliation and revenge against the targeted spouse (and parent) for the failed marriage and divorce. The targeted-rejected parent is an entirely normal-range and loving parent.  The child is being weaponized by the allied parent into the spousal conflict.  The targeted parent is being emotionally abused by the other spouse, who is using the child as the weapon.

But these allies of the narcissistic-abusive pathology descend and intrude into matters – families – in which they have no involvement, to support the continuing emotional abuse of the ex-spouse using the child as the weapon.  In the process, they are supporting the continuing psychological abuse of the child by the allied narcissistic or borderline personality spouse-and-parent, who creates severe developmental, emotional, and psychiatric pathology in the child as a weapon of emotional abuse against the ex-spouse for the failed marriage and divorce.

The popular culture has recognized this social-distribution symptom feature of narcissistic pathology before it’s been recognized by professional psychology.  I had never encountered this social-distribution feature of trauma-pathology before entering court-involved practice with complex family conflict.  The popular culture labels these allies of the narcissistic abuse, “flying monkeys.” 

Wikipedia: Flying Monkeys

Urban Dictionary: Flying Monkeys

I’ve taken to calling these people “flying monkeys” partly to provoke my professional colleagues into recognition of this social-distribution feature of the complex trauma pathology.

Court Testimony

As I enter court-involved testimony as an expert witness, the courts, opposing counsel, and the world have the full right to examine by professional background to determine the scope and credibility of my testimony.  Scrutiny is invited and welcomed.  I am not trying to be more than I am.

What I am is a good clinical psychologist and a knowledgeable clinical psychologist, and if asked, I will make my knowledge as a clinical psychologist available for the court’s consideration in decision-making.  Courts make decisions on a variety of factors beyond my reports and testimony.  My reports and testimony are offered to be helpful in the court’s decision-making.

The pathology does not want to be exposed.  It wants to keep everything just the way it is.  The broken systems surrounding extensive-litigation family divorce is exactly to the pathogen’s liking.  It likes when the targeted parent alleges “parental alienation” – that’s exactly what the pathogen wants – because then the targeted parent has to prove that to a judge at trial.

The pathogen does NOT want to be returned to clinical psychology where we diagnose (i.e., identify) pathology, because then it will be exposed.  Instead, it wants the allegation of “parental alienation” from the targeted parent to move the litigated conflict into a child custody evaluation which will identify nothing and solve nothing.  The pathogen likes things just the way they are.

Through my court testimony, I am bringing the standards of practice and professional knowledge of clinical psychology back to court-involved consultation, and to the assessment, diagnosis, and treatment of pathology.

As I do this, another psychology person, Jean Mercer, has emerged from the cracks and crevices of her world to offer “counter testimony” to Dr. Childress.  She is not a licensed clinical psychologist – she never has been.  She has never been educated or trained in any aspect of any pathology.  She has never assessed, diagnosed, or treated any pathology.

She has a Ph.D. degree in experimental psychology.  She then taught general-ed psychology courses at a small college in New Jersey until 2006, when she retired from teaching.  She has not been involved in professional psychology for the past decade after her career as a teacher of general-education psychology courses at a local college.

She is now being offered by the counsel representing the allied parent as an “expert” to discredit the testimony of Dr. Childress.  As an expert witness for the court, she opens herself and her testimony to legitimate scrutiny.

Recently, Dr. Mercer testified in a case that I was involved in.  I had conducted nine-hours of clinical interviews with all of the involved family members and had rendered a DSM-5 diagnosis.  Dr. Mercer’s testimony was offered to the court by minor’s counsel prior to my scheduled testimony in order to undermine my testimony to the court.

I have posted Dr. Mercer’s testimony transcript to my website along with my critique and comment. 

Dr Childress Commentary on Dr. Mercer Testimony

She is not an expert in anything.  Her testimony as an expert was in violation of California state law.  Her testimony to the court was false and inaccurate, demonstrating broach swaths of professional ignorance, and she opined – incorrectly – about domains of clinical psychology about which she has zero education, zero knowledge, and zero background.

To the extent that Dr. Mercer’s testimony was seemingly in violation of Standard 2.01a of the APA ethics code, she will receive a letter from me personally in fulfillment of my professional obligations under Standard 1.04 of the APA ethics code.  To the extent that she continues to offer herself as an expert witness, the posting of my critique and commentary on her testimony represents my professional response under Standard 1.05 of the APA ethics code requiring additional steps when informal resolution efforts are not successful.

Minor’s Counsel

I will speak separately on the actions of minor’s counsel in presenting the testimony of Dr. Mercer to the court as an “expert” witness, and the possible conspiracy he engaged in using Dr. Mercer’s ignorance to present false and misleading information to the court.

At this time, however, I would simply like to note that the legal professional should strongly evaluate the role and duties of minor’s counsel in complex family conflict being litigated by the court.  The appointment of minor’s counsel is essentially appointing counsel to represent the pathology.  The goal of minor’s counsel in this matter was to discredit the testimony of a licensed clinical psychologist who conducted nine-hours of clinical assessment with the family by presenting false and misleading testimony to the court.

The legal profession needs to consider the nature and scope of the role performed by minor’s counsel. 

I would advocate for the appointment of an amicus attorney instead, who would be tasked with the responsibility of collaborating with the treating mental health professional on developing and implementing a written treatment plan for the family based on a clinical diagnosis of the family pathology.

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

 

 

 

 

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mother

How To Celebrate Mother’s Day As A Divorced Mom

mother's day as a divorced mom 

 

When Mother’s Day comes in the midst of divorce proceedings, there is not enough you can do for your divorcing friend. There are treats and cards. If the children are with their father then umpteen invitations will be showered upon the almost single mother. What about the next ten Mother’s Days after divorce? Some parents have put in their parenting plans that the kids spend Mother’s or Father’s Days with the parent that is being honored. Others do a trade for the day without a legal mandate.

My first Mother’s Day happened during a contentious divorce with my husband threatening to pull out of collaborative proceedings for a battle in court. It was very unsettling, and I barely remember that holiday. We did what we usually had done and went to an elaborative Mother’s Day brunch.

My mother made sure that I had a present from each son, so had taken them out shopping earlier in the week. She gave me something nice, too. Two years later we started new traditions to make the day seem more like it belonged to us. We exorcized the ghosts of Mother’s Day past and did not do anything like we did when I was still married. We shook up our routine and had a simple meal out followed by an anticipated movie. This year we will have a celebratory latte and lunch followed by Paul Blart’s film, “Mall Cop 2.” Celebrate in a new way, whether or not you have the kids with you.

How to Celebrate Mother’s Day As a Divorced Mom:

1. Have brunch at your place and invite other women, whether or not they are mothers. Make it extra festive with some champagne or Bloody Marys.

2. Ask your children for suggestions on how to celebrate this occasion in other ways.

3. If you have family nearby, get together with them and the kids will have fun with cousins.

4. When I was little, I treated my divorced mother at a reasonable family restaurant every Mother’s Day in a more rural area. It was a beautiful drive and the cost was within my allowance. Give your kids the chance to do something nice for you.

What do You do if You’re Alone on Mother’s Day? Below are 6 Ideas:

1. Consider taking a mini trip somewhere.

2. Do something to distract you that is interesting.

3. I know two divorced women with grown children who live in distant cities who are off to France this week on a packaged tour. These lucky ones will be celebrating Mother’s Day on the Riviera. There are travel agencies that have trips for singles in wonderful locales. It is nice to have the camaraderie of a group.

4. Some folks choose to give back to others which takes the focus off themselves. Volunteering is a way to feel fulfilled, particularly if the kids are with dad and a new stepmother.

5. My mother worked on this holiday as a nurse, when I had visitation with my father. If you can work on Mother’s Day and take a day off when you’ll be with your children, perfect!

6. Some nail salons are open on Sundays, so a manicure and pedicure can be just the ticket to raise up one’s spirits. Sometimes there are free concerts or craft fairs on this day which are fun to attend.

One thing to a avoid: Giving into the temptation of dulling the ache of loneliness by self-medicating. I know of a circumstance where the father was engaged in parental alienation and the daughter did not contact her mom on Mother’s Day. This woman had an accidental fatal overdose of medications, including combining anti-depressants along with alcohol. Over-imbibing does not get rid of a problem, it merely postpones doing something about it.

Decide if you want to stay busy, or laze around on the couch reading the latest bestseller. Whatever you decide to do, high-quality chocolate will make it even better!

The post How To Celebrate Mother’s Day As A Divorced Mom appeared first on Divorced Moms.

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Standard of Practice: 2007 Documentation of Court-Involved Case Management

Standards of Practice: 2007 Written Treatment Plans

I’ve opened my folder of teaching tools for teaching documentation of therapy.  It’s from 2007, long before I even knew that “parental alienation” existed.  I was in trauma world, working with kids in the foster care system. These documentation standards are from that time period.

This is a treatment plan form for the San Bernardino Department of Behavioral Health.  They were the county funding agency for mental health services in the foster care system.

SB-DBH Treatment Plan Form

The actual form is on blue paper, and it extends over several paper pages, so I just transcribed it to a Word table format and condensed redundancy. 

Those three empty boxes in the middle… that’s where all the action is on this form; Objectives, Clinical Interventions, and Outcomes.  It’s in those three empty boxes that we’d write our answers to those three important questions; goals, how are you going to get there, did it work?

Objectives – Clinical Interventions – Outcome

That’s the structural backbone of a written treatment plan.

What is the goal to be achieved by therapy (Objectives)?

How are you going to achieve those goals (Clinical Interventions)?

Did you achieve those goals (Outcome)?

I’ll go into each of these areas in a moment, but before leaving the form I want to point out a couple of other important features of a written treatment plan demonstrated by this county form.

First, notice that right above the Signatures box there’s a Frequency of Care Plan Review line, with boxes for 30 Days, 3 Months, 6 Month, and 12 Months.  Those time-frames are typically considered the standard of practice review points for treatment plans.  Treatment goals should typically be for a three- to six-month range for resolution of the pathology.  Short-term goals in the four- to six-week range are helpful progress milestones toward achieving the longer 3 to 6-month solutions. 

That’s what a treatment plan does, it lays out the course for solution, and that course is reviewed regularly; we’d hope for a treatment plan with a 3 to 6-month resolution of the pathology.

Notice too, the box off to the side of the signatures that says, “Client Received a Copy of the Care Plan” with a place for the client’s initials and date.  The written treatment plan is reviewed with the client, and the client gets a copy of it.  In fact, the Department of Behavioral Health wants to make certain that the client has a copy of the written treatment plan.  This documents that we reviewed the treatment plan with the client… at 3 months, and 6 months, and 1 year; each time the client initials a new signature line with a new date.

That’s considered standard of practice in county work in the foster care system.  Written treatment plan, review it with the client, client gets a copy of the written treatment plan.

Let’s take a closer look at those three empty boxes, and see what the county Department of Behavioral Health wants.

Objectives

OBJECTIVES: (Must be specific, measurable/quantifiable, attainable, realistic, time-bound.  Must be related to assessment, presenting problems/symptoms and functional impairment.  Include cultural/linguistic, co-occurring factors, if appropriate.  Include Med Support and Targeted Case Management, if appropriate)

Let me highlight a couple of things from this documentation requirement – measurable/quantifiable – time-bound.  Those features of the treatment plan are not optional, they are part of the list of required components.   Notice the instructions say “Must be” – not “Should be” – Must be… measurable and time-bound Objectives are requirements of the written treatment plan.

We must be able to measure treatment outcome, and our treatment goals must be time-bound.

Let me also highlight that the goals of treatment must be linked to the assessment information, to the presenting problem and symptoms, and to the impairment caused by the symptoms. The treatment plan describes what the problem is, and how to fix it.

Treatment plans link to the assessment data and describe a coherently organized approach to fixing the presenting problem – to solving things.

If a mental health professional cannot develop a written treatment plan for a pathology, then that mental health professional should not be working with that pathology.  Simple as that.

If I’m working with eating disorders, I must be able to develop an effective treatment plan for eating disorders.  If I am working with depression, I must be able to come up with an effective treatment plan for depression.  In professional psychology, that’s called “boundaries of competence,” that I only work with types of pathology that I know about, for which I am able to develop a written treatment plan.

If you know what you’re doing, then you have a plan for treatment. If you have a plan for treatment, write it down on a piece of paper and tell everyone what the plan is.   A written treatment plan.  A standard of professional practice – Department of Behavioral Health, San Bernardino County.

Clinical Interventions

CLINICAL INTERVENTIONS: (Must be related to objective. List clinical intervention for each group/individual service.  Includes Med Support and Targeted Case Management, if appropriate).

Tell us what you’re going to do.  This is the application of knowledge section of the treatment plan.  Objectives is being able to define goals in achievable and measurable ways, Clinical Interventions is knowing what to do about it.

Personally, I’d apply the scientifically established knowledge of professional psychology, in whatever domain of pathology I was working in, from geriatrics, to ADHD, or autism.  What’s the science say, that’s where I’ll be.  For this court-involved family conflict pathology, I apply the knowledge from attachment, and family systems therapy, personality disorders, complex trauma, and the neuro-development of the brain during childhood.  I think it’s tremendously relevant information that helps make sense of everything.

I’d recommend it; attachment, family systems therapy, personality disorders, complex trauma, and the neuro-development of the brain in childhood.

But everyone’s free to apply the knowledge they’d like.  A psychoanalytically oriented psychologist might apply Adler or Kohut, a humanistic psychologist might apply Rogers and Pearls, a CBT therapist will apply learning theory and Beck.  What knowledge is applied in this box, Clinical Interventions, is given broad latitude… but it is documented in the treatment plan.

It doesn’t matter what you do… just tell us what it is.

Because, you see, in telling us what it is your going to do to fix things, we’ll be able to tell if you know what you’re doing.  First, if you can’t tell us anything at all about how you are going to fix things (the clinical interventions), then you don’t know what you’re doing.  So that’s an easy one right there.

Then, for those therapists who do provide a description of their clinical interventions, we can look at their case formulation and applied knowledge to see what information and knowledge from professional psychology they used in their case conceptualization and treatment approach.  This will allow parents to make informed decisions regarding treatment, a requirement of informed consent to treatment.  It’s the informed part.

Don’t care what the answer is to this box, Clinical Interventions, just tell us what you plan to do.  After that, then we’ll care about what the answer is to this box.  But for right now, just tell us what you’re going to do to fix things.  Whatever you think is best.

Outcome

OUTCOMES/date/initials: To be completed at the end of the Care Plan Review timeframe, 30 days, 3, 6, 12 months or more frequently as appropriate

At every outcome review point specified in the treatment plan (typically 3-month and 6-month, and by then things should be substantially solved), the treatment goals and clinical interventions to achieve those goals are reviewed.  Remember, the treatment objectives are identified in ways that are “measurable” and “time-bound” – permitting review of goal accomplishment.

In child and family therapy, clinical impact is typically targeted for four to six-weeks.  Even in autism, significant measurable impact of clinical involvement should be evident by four to six weeks.  For autism, the clinical impact in six weeks would not necessarily be directly measurable in the child’s symptoms, but the caregivers should have substantially increased knowledge and skills in how to respond to the child (changes in caregiver stress and responding skills that are measurable).  The improved responding from the caregivers then leads to the more productive longer-range progress toward the treatment goals, gains which should become directly evident in the child’s symptoms on the 3-month and 6-month reviews of the treatment goals. 

So even with autism pathology, we would expect to see measurable gains in caregiver response competence in a four to six week period of initial intervention, leading toward longer-range goal achievement.

This is true for all pathology, from autism to oppositional defiant disorder.  It’s usually reasonable to expect a positive impact from intervention on some measurable area of functioning in four to six weeks, improvements moving toward a 3- to 6-month resolution of the presenting problem.

Does treatment with some childhood pathology take longer than six months to solve?  Of course.  But for each time-period longer than six months, professional concerns about the accuracy of the case conceptualization and treatment plan increase.   Treatment should solve things.  If treatment is not solving things within three to six months, we need to closely examine the diagnostic premise and clinical approach involved.

If we treat diabetes with insulin but the patient actually has cancer and needs chemotherapy, then the sooner we re-evaluate our diagnosis based on absence of treatment progress the sooner we will be able to get the proper diagnosis of cancer and the proper treatment of chemotherapy.  If things aren’t working, it’s time to look closely at possibly changing what we’re doing.

Does that mean that longer treatment is always due to earlier misdiagnosis?  No.  It just means that with each increment of time over six months, the review scrutiny of the case conceptualization, diagnosis, and clinical interventions used to achieve a solution becomes more exacting.

Even for chronic pathologies like autism that will require years of developmentally supportive intervention, we would want to achieve a stabilization of intervention where the child is receiving the proper intervention at the proper dosage level, and measurable progress from the intervention is continuing.  Continuing measurable gains from the consistent application of developmentally supportive intervention becomes a steady state treatment plan, measurable and time-bound review, and the same in its consistency of measurable effectiveness. 

This is the desired steady-state treatment plan we want for chronic pathology, always then closely monitoring scientific advancements that can improve the treatment plan for increasingly positive outcome.

If, however, the child ceases to make gains in a time-frame of review, then a reconsideration of case conceptualization and treatment plan is indicated.  When progress is not made, we develop a new treatment plan.  This may involve altering our case conceptualization, or altering the clinical interventions applied.

The important thing is that the progress is measurable, and that the treatment plan is time-bound to periods for review and modification.

School IEP

If an additional example is needed for a written treatment plan related to commonly occurring childhood pathology, I would refer to the school IEP (Individual Education Program).  The school IEP represents a written treatment plan surrounding a variety of possible issues, some possibly medical, some possibly emotional and psychological. 

What does the school do about the presenting problem referred for an individualized educational approach; the IEP referral?  The school develops a written treatment plan, discusses this written treatment plan with the parents, obtains the parent’s approval for the written treatment plan, and then then the school implements the treatment plan as described by the written treatment plan. 

Once implemented, this written treatment plan of the IEP is reviewed on a periodic schedule to ensure measurable gains from the education-related treatment plan described by the IEP.

The school IEP is an education-related treatment plan, but many of the issues addressed by the IEP are emotional and psychological disturbances of childhood, so often the educational intervention co-occurs within the context of the psychological intervention.

A written treatment plan is everyday standard of practice in the school system.  The county of San Bernardino Department of Behavioral Health mandated a written treatment plan as a requirement for funding treatment of children and families in the foster care system.  In the world I come from, a written treatment plan is common standard of professional practice.  No big deal.

What are the Objectives of treatment (measurable and time-bound), what are the Clinical Interventions to be used to achieve those Objectives, and did it work, what is the Outcome?

The standard of professional practice in clinical psychology is for written treatment plans.

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

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