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Consultation: Draft Guidance on Responding to allegations of

alienating behaviour

August 2023

CONTENTS

Introduction and Scope of the Guidance

Litigation Journey Overview

Guidance Note on Case Management

Guidance Note on Welfare decisions

Guidance Note on Understanding hostility and psychological manipulation in cases in

which alienating behaviours are alleged

6. Guidance Note on the use of experts in cases in which alienating behaviours are

alleged

Consultation from Dr. Childress to Draft Guidance from FJC:

I am a clinical psychologist in the United States. I have six domains of specialized

knowledge supported by my vitae relevant to court-involved custody conflict and

attachment pathology displayed by the child:

1. Delusional thought disorders

Twelve years on a major UCLA research study on schizophrenia with annual

training in the diagnostic assessment of delusional thought disorders.

2. Attachment pathology

Early Childhood Mental Health specialization.

3. Child abuse and complex trauma

Clinical Director for a 3-university assessment and treatment center for children

ages zero-to-five in foster care.

4. Factitious Disorder Imposed on Another

Training and medical staff position as a pediatric psychologist at Childrens

Hospitals.

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5. Family systems

Specialized training track from Pepperdine University’s doctoral program and

lifelong practice as a family systems therapist

6. Court-involved custody conflict

Ten years in the family courts as a clinical psychologist and expert consultant to

attorneys and their client-parents in custody conflict.

•

Dr. Childress Domains of Specialized Expertise & Vitae

https://drcachildress-consulting.com/wp-content/uploads/2023/01/domains-

of-specialized-expertise-1-1-23-2.pdf

I currently serve as a consultant to attorneys and the Court in family law cases of child

custody conflict. I have provided consultation on both national and international cases. I

have testified as an expert witness in the U.S., Canada, Sweden, and South Africa, and I

have been involved in several matters in Great Britain.

I have had an invited meeting with representatives of the Dutch Ministry of Justice when

I presented at Erasmus Medical Center in the Netherlands, and I recently had an invited

presentation at the University of Novi Sad in Serbia.

I have a Consulting Website that describes more about my court-involved consultation

and the pathology of concern in the family courts.

•

Dr. Childress Consulting Website

https://drcachildress-consulting.com/

The FJC draft Guidance describes the professional expertise desired for the family courts:

From FJC Guidance:

“Given the complexity of these cases and the often-

interacting psychological factors at play in the adults and the children, it is likely

that assessments which will assist the court in determining welfare outcomes are

those offered by HCPC regulated Practitioner Psychologists with competence in

assessing adults and children, e.g., Clinical Psychologists/Counselling

Psychologists.”

I am a clinical psychologist with competence in assessing adults and children for a variety

of pathology, including the attachment pathology in the family courts.

From FJC Guidance:

“These assessments should not be undertaken by academic

psychologists or psychological researchers in the field of alienation. Only HCPC

Registered psychologists have the relevant clinical experience and training to

conduct psychological assessments of people and make clinical diagnoses and

recommendations for treatment or interventions, whereas, academic

psychologists, who should be Chartered, but who are not registered with the

HCPC, would not normally have the clinical experience and training in order to

complete psychological assessments or make clinical diagnoses.”

I am an applied practitioner, a licensed clinical psychologist, not an academic researcher.

My consultation feedback is from the domains of professional clinical psychology

recommended by the FJC draft Guidance.

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Introduction and scope of the Guidance

‘Parental alienation’ has for some time been a vexed and highly emotive concept with

polarised opinion in the research literature, and one which has gained significant publicity and

political attention internationally. It is also an allegation which the family courts in England

and Wales are increasingly asked to consider and act on.

Standards of Professional Practice

There is no such thing as

“parental alienation” –

there is no defined pathology in

clinical psychology of “parental alienation.”

It is a made-up thing.

The use of the construct of “parental alienation”

in a professional capacity is

substantially beneath professional standards of practice in clinical psychology and is

in violation of Standard 2.04 of the ethics code for the American Psychological

Association (APA).

2.04 Bases for Scientific and Professional Judgments

Psychologists' work is based upon established scientific and professional

knowledge of the discipline.

The established scientific and professional knowledge of the discipline required for

application with court-involved custody conflict is:

•

Attachment pathology - Bowlby & others

Family systems therapy - Minuchin & others

Child abuse and complex trauma

–

van der Kolk & others

Personality disorder pathology - Beck & others

Child development

–

Tronick & others

Psychological control

–

Barber & others

DSM-5 diagnostic system - American Psychiatric Association

Application of DSM-5

When the established scientific and professional knowledge of the DSM-5 diagnostic

system is applied to the attachment pathology that arises in high-conflict custody

litigation in the family courts, the pathology of concern is a shared (induced)

persecutory delusion and false (factitious) attachment pathology being imposed on

the child by the pathogenic parenting of an allied narcissistic-borderline-dark

personality parent for secondary gain to the pathological parent of manipulating the

court’s decisions regarding child custody, and to meet the pathological parent’s own

emotional and psychological needs.

Creating a shared (induced) persecutory delusion in the child that then destroys the

child’s attachment bond to the other parent is a DSM-5

diagnosis of V995.51 Child

Psychological Abuse. An additional dangerous pathology of concern is the possible

spousal emotional and psychological of the targeted parent by the allied parent using

the child’s induced pathology as the weapon (DSM-5

V995.82 Spouse or Partner

Abuse, Psychological).

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Risk Assessment

All mental health professionals have duty to protect obligations. A proper risk

assessment is required whenever a mental health professional encounters any of three

types of dangerous pathology, suicide, homicide, or abuse (child, spousal, or elder

abuse). The type of risk assessment depends on the type of danger involved, such as a

suicide risk assessment when the client expresses suicidal thoughts (i.e., an assessment

of prior history, current plan, recent loss, means, etc.), or a risk assessment for possible

spousal abuse when that is the concern.

There are four diagnoses of child abuse in the Child Maltreatment section of the DSM-5,

each of these child abuse diagnoses warrants a proper risk assessment; Child Physical

Abuse (V995.54), Child Sexual Abuse (V995.53), Child Neglect (V995.52), Child

Psychological Abuse (V995.51). All of these child abuse diagnoses are equally severe in

the damage they cause to the child, they differ only in the type of damage done, not in

the severity of damage done to the child. Psychological child abuse destroys the child

from the inside out.

Severe Attachment Pathology

The only possible cause of severe attachment pathology displayed by a child (i.e., a

child rejecting a parent) is child abuse range parenting by one parent or the other.

Other less severe forms of problematic parenting produce an insecure attachment that

has different symptom characteristics other than a severing of the parent-child bond.

The only possible cause of severe attachment pathology (i.e., a child rejecting a parent)

is child abuse range parenting by one parent or the other.

•

Targeted Parent Abusive:

Either the targeted parent is abusing the child in

some way, thereby creating the child’s attachment pathology toward that

parent (a 2-person attribution of causality),

Allied Parent Abusive:

Or the allied parent is psychologically abusing the

child by creating a shared (induced) persecutory delusion and false

(factitious) attachment pathology in the child for secondary gain to the

allied parent of manipulating the court’s decisions regarding child custody,

and to meet the pathological parent’s own emotional

and psychological

needs (a 3-person triangle attribution of causality).

•

In all cases of severe attachment pathology displayed by the child surrounding court-

involved custody conflict, a proper risk assessment for child abuse needs to be

conducted to the appropriate differential diagnoses for each parent.

Diagnostic Assessment of Thought Disorders

The clinical concern is the possible creation of a shared (induced) persecutory delusion

and false (factitious) attachment pathology imposed on the child as a result of the

allied parent’s

distorted and pathogenic

parenting practices, as described by Walters

and Friedlander (2016)

in the journal

Family Court Review,

Patho=pathology; genic=creation. Pathogenic parenting is the creation of significant

pathology in the child through aberrant and distorted parenting practices.

Walters, M. G., & Friedlander, S. (2016). When a child rejects a parent: Working with

the intractable resist/refuse dynamic.

Family Court Review, 54(3),

424–445.

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From Walters & Friedlander:

“In some RRD families [resist-refuse

dynamic], a

parent’s underlying encapsulated delusion about the other parent is at the root

of the intractability (cf. Johnston & Campbell, 1988, p. 53ff; Childress, 2013). An

encapsulated delusion is a fixed, circumscribed belief that persists over time

and is not altered

by evidence of the inaccuracy of the belief.”

(Walters &

Friedlander, 2016, p. 426)

From Walters & Friedlander:

“When alienation is the predominant factor in

the RRD [resist-refuse

dynamic}, the theme of the favored parent’s fixed delusion

often is that the rejected parent is sexually, physically, and/or emotionally

abusing the child. The child may come to share the parent’s encapsulated

delusion and to regard the beliefs as his/her own (cf. Childress, 2013).” (Walters

& Friedlander, 2016, p. 426)

The American Psychiatric Association provides the definition for a persecutory

delusion and indicates that a shared persecutory delusion often occurs in family

situations,

From the APA:

“Persecutory Type: delusions that the person (or someone to

whom the person

is close) is being malevolently treated in some way.”

(American Psychiatric Association, 2000)

From the APA:

“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… 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.” (American Psychiatric

Association, 2000)

The assessment for a possible delusional thought disorder is a Mental Status Exam of

thought and perception as described by Martin (1990),

From Martin:

“Thought and Perception.

The inability to process information

correctly is part of the definition of psychotic thinking. How the patient

perceives and responds to stimuli is therefore a critical psychiatric assessment.

Does the patient harbor realistic concerns, or are these concerns elevated to the

level of irrational fear? Is the patient responding in exaggerated fashion to

actual events, or is there no discernible basis in reality for the patient's beliefs

or behavior?”

Family Systems Pathology

When the construct of “parental alienation”

is used by the general public, the family

systems pathology of concern is the child’s

triangulation

into the spousal conflict

through the formation of an enmeshed

cross-generational coalition

with the allied

parent against the targeted parent, creating an inverted hierarchy and

emotional cutoff

Martin DC. The Mental Status Examination. In: Walker HK, Hall WD, Hurst JW, editors.

Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition.

Boston: Butterworths; 1990. Chapter 207. Available from:

https://www.ncbi.nlm.nih.gov/books/NBK320/

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in the child’s attachment bond to the targeted parent.

This family relationship pattern of triangulating the child into the spousal conflict is

described by Stone, Buehler, and Barber (2002),

From Stone, Buehler, and Barber:

“The concept of triangles “describes the

way any three people relate to each other and involve others in emotional

issues between them” (Bowen, 1989, p. 306). In the anxiety-filled

environment

of conflict, a third person is triangulated, either temporarily or permanently, to

ease the anxious feelings of the conflicting partners. By default, that third

person is exposed to an anxiety-provoking and disturbing atmosphere. For

example, a child might become the scapegoat or focus of attention, thereby

transferring the tension from the marital dyad to the parent-child dyad.

Unresolved tension in the marital relationship might spill over to the parent-

child relationship through parents’

use of psychological control

as a way of

securing and maintaining a strong emotional alliance and level of support from

the child. As a consequence, the triangulated youth might feel pressured or

obliged to listen to or agree with one parents’

complaints against the other. The

resulting enmeshment and cross-generational coalition would exemplify

parents’

use of psychological control to coerce and maintain a parent-youth

emotional alliance against the other parent (Haley, 1976; Minuchin, 1974).”

(Stone, Buehler, & Barber, 2002, p. 86-87).

The family dynamic of the child’s cross-generational

coalition with an allied parent

against the targeted parent and the

resulting emotional cutoff in the child’s attachment

bond to the targeted parent is depicted in a

Structural family diagram from Minuchin

and Nichols (1993).

Triangulation

The term

triangulation

refers to putting the

child in the middle of the spousal conflict,

which then turns the two-person spousal

conflict into a three-person triangle of

conflict involving the child. The Bowen

Center for Study of the Family

describes

the construct of triangles within families.

From Bowen Center:

“A triangle is a three-person

relationship system. It is

considered the building block or “molecule” of larger emotional systems

because a triangle is the smallest stable relationship system. A two-person

system is unstable because it tolerates little tension before involving a third

Stone, G., Buehler, C., & Barber, B. K.. (2002) Interparental conflict, parental

psychological control, and youth problem behaviors. In B. K. Barber (Ed.), Intrusive

parenting: How psychological control affects children and adolescents. Washington, DC:

American Psychological Association.

Minuchin. S. & Nichols, M.P. (1993). Family healing: Strategies for hope and

understanding. New York: Touchstone.

Bowen Center Triangles:

https://www.thebowencenter.org/triangles

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person. A triangle can contain much more tension without involving another

person because the tension can shift around three relationships. If the tension is

too high for one triangle to contain, it spreads to a series of “interlocking”

triangles”. Spreading the tension can stabilize a system, but nothing is resolved.”

Cross-Generational Coalition

cross-generational coalition

is when a parent creates an alliance with the child against

the other spouse/parent. This coalition between the allied parent and child against the

other parent provides additional power to the allied parent in the spousal conflict (two

against one). However, a cross-generational coalition is also extremely damaging to the

child who is being used by one parent as a weapon against the other parent in the

spousal conflict.

In mild cases, the arguing and conflict between the child and targeted parent is high,

but they maintain their relationship. In severe cases, the allied parent requires the

child to terminate (cutoff) the child’s relationship with the other parent out of loyalty

(Boszormenyi-Nagy & Spark, 1973)

to the allied parent in their coalition. When this

occurs, the emotional and psychological damage to the child is severe. Jay Haley (co-

founder of the

Strategic

school of family systems therapy), provides the professional

definition of a cross-generational coalition:

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)

Cloe Madanes (2018),

the co-founder of Strategic family systems therapy along with

Jay Haley, describes the development of cross-generational coalitions within families,

From Madanes:

“Cross-Generational

Coalition. In most organizations, families,

and relationships, there is hierarchy: one person has more power and

responsibility than another. Whenever there is hierarchy, there is the

possibility of cross-generational coalitions. The husband and wife may argue

over how the wife spends money. At a certain point, the wife might enlist the

older son into a coalition against the husband. Mother and son may talk

disparagingly about the father and to the father, and secretly plot about how to

influence or deceive him. The wife’s coalition with the son gives her power in

relation to the husband and limits the husband’s power over how she spends

Boszormenyi-Nagy and Spark (1973).

Invisible loyalties: Reciprocity in intergenerational

family therapy.

Harper & Row.

Haley, J. (1977). Toward a theory of pathological systems. In P. Watzlawick & J.

Weakland (Eds.),

The interactional view

(pp. 31-48). New York: Norton.

Madanes, C. (2018). Changing relationships: Strategies for therapists and coaches.

Phoenix, AZ: Zeig, Tucker, & Theisen, Inc.

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money. The wife now has an ally in her battle with her husband, and the

husband now runs the risk of

alienating his son.”

From Madanes:

“Cross-generational

coalitions take different forms in

different families (Madanes, 2009)…

These alliances are most often covert

and are rarely expressed verbally. They involve painful conflicts that can

continue for years. Sometimes cross-generational coalitions are overt. A wife

might confide her marital problems to her child and in this way antagonize

the child against the father… This child may feel conflicted as a result,

suffering because his or her loyalties are divided.” (Madanes, 2018)

Emotional Cutoff

The family systems construct of an

emotional cutoff

refers to any full-scale breach in a

family bond.

The child’s loyalty to a pathological parent in their cross-generational

coalition against the other parent (Haley,

1977; Madanes, 2018) leads to an

emotional cutoff (Bowen, 1978; Titelman,

2003)

in the child’s attachment bond to

the targeted parent.

Inverted Hierarchy

inverted hierarchy

in when the

child becomes over-empowered by the

coalition with the allied parent into an

elevated position in the family hierarchy,

above that of the targeted parent, from

which the child is empowered by the

coalition with the allied parent to judge the adequacy of the targeted parent as if the

parent was the child and the child was the parent.

Enmeshment

The term

enmeshment

refers to a parent’s

dissolution of psychological boundaries with

the child in which the child’s identity and the parent’s identity merge into one.

Minuchin (1974)

describes the construct of enmeshed relationships within families,

From Minuchin:

“Enmeshment and disengagement refer to a transactional

style, or preference for a type of interaction, not to a qualitative difference

between functional and dysfunctional… Operations at the extremes, however,

indicate areas of possible pathology. A highly enmeshed subsystem of mother

and children, for example, can exclude father, who becomes disengaged in the

extreme.” (Minuchin, 1974, p. 55)

Bowen, M. (1978).

Family Therapy in Clinical Practice.

New York: Jason Aronson.

Titelman, P. (2003).

Emotional Cutoff: Bowen Family Systems Theory Perspectives.

New

York: Haworth Press.

Minuchin, S. (1974).

Families and Family Therapy.

Cambridge, MA: Harvard

University Press

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Writing in the

Journal of Emotional Abuse,

Kerig (2005)

identifies the psychological

boundary violations that occur between parents and children, and the impact of the

enmeshed relationship with one parent on other family relationships,

From Kerig:

“Examination of the theoretical and empirical literatures suggests

that there are four distinguishable dimensions to the phenomenon of boundary

dissolution: role reversal, intrusiveness, enmeshment, and spousification.”

(Kerig, 2005, p. 8)

From Kerig:

“Enmeshment in one parent-child

relationship is often

counterbalanced by disengagement between the child and the other parent

(Cowan & Cowan, 1990; Jacobvitz, Riggs, & Johnson, 1999).” (Kerig, 2005, p. 10)

Standards of Professional Practice

Standard 2.04

of the APA ethics code requires the application of the “established

scientific and professional knowledge of the discipline as the bases for professional

judgments.

2.04 Bases for Scientific and Professional Judgments

Psychologists' work is based upon established scientific and professional

knowledge of the discipline.

The established scientific and professional knowledge of the discipline should be

applied first. If, after the application of established knowledge, some aspect of the

pathology remains unexplained, then new forms of pathology

(such as “parental

alienation”)

can be proposed, but only after the application of established knowledge.

The use of the construct of “parental alienation” in a professional capacity is

substantially beneath professional standards of practice in clinical psychology and is in

violation of Standard 2.04 of the APA ethics code.

There are reasons for ethical Standards. Unethical practice hurts people

–

a lot. The

failure to apply the established scientific and professional knowledge of the discipline

as the bases for professional judgments will lead to misdiagnosis of the pathology.

Participation in Child Abuse & Spousal Abuse

One of the prominent professional dangers of misdiagnosing a shared persecutory

delusion is that if the mental health professional misdiagnoses the pathology of a

shared persecutory delusion and believes the shared delusion as if it was true (and so

does not inform the Court of the child psychological abuse in the family), then both the

mental health professional and the Court become part of the pathology of the shared

delusion. When the pathology represents the psychological abuse of the child by an

allied pathological parent, then the mental health professional and the inadequately

informed Court become participants in the pathological

parent’s psychological abuse of

the child by validating to the child that the child’s false (delusional) beliefs

are true

when they are, in fact, symptoms of an induced persecutory delusion.

This guidance does not aim to explore the research literature into the concept of

‘parental

alienation’, the socio-political

context in which such allegations arise or to give an historical

Kerig, P.K. (2005). Revisiting the construct of boundary dissolution: A multidimensional

perspective.

Journal of Emotional Abuse,

5, 5-42.

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account. These are important and it is likely that these debates will continue, and our

understanding evolve. However, in the meantime it is necessary to consider how such

allegations are responded to by the courts and professionals in the wider family justice system.

For this reason, the focus has been to provide practical guidance as to how allegations of

alienating behaviours are responded to; recognising that they are allegations that can arise at

different points in the litigation journey and are likely to be made alongside other allegations

of harmful behaviour including domestic abuse or child abuse.

Differential Diagnosis for Severe Attachment Pathology

The only possible cause of severe attachment pathology displayed by a child (i.e., a

child rejecting a parent) is child abuse range parenting by one parent or the other.

Other less severe forms of problematic parenting produce an insecure attachment that

has different symptom characteristics other than a severing of the parent-child bond.

The only possible cause of severe attachment pathology (i.e., a child rejecting a parent)

is child abuse range parenting by one parent or the other.

In all cases of severe attachment pathology displayed by the child surrounding child

custody conflict, a proper risk assessment for child abuse needs to be conducted to the

appropriate differential diagnoses for each parent.

•

Targeted Parent Abusive:

Either the targeted parent is abusing the child in

some way, thereby creating the child’s attachment pathology toward that

parent (a 2-person attribution of causality),

Allied Parent Abusive:

Or the allied parent is psychologically abusing the

child by creating a shared (induced) persecutory delusion and false

(factitious) attachment pathology in the child for secondary gain to the

allied parent of manipulating the Court’s

decisions regarding child custody,

and to meet the pathological parent’s own emotional and

psychological

needs (a 3-person triangle attribution of causality).

•

It is hoped that this guidance will contribute to increased understanding, good practice, and

ultimately good welfare outcomes for children. The guidance includes sections on the

Litigation Journey, Case Management, Welfare decision, understanding hostility and

psychological manipulation in cases in which alienating behaviours are alleged and the use of

experts.

Standards of Professional Practice

There is no such thing as “parental alienation” – “alienation” – or “alienating behaviors”

and the use of those constructs in a professional capacity is substantially beneath

professional standards of practice in clinical psychology and is violation of Standard

2.04 Bases for Scientific and Professional Judgments of the APA ethics code.

Risk Assessment for Child Abuse

In all cases of severe attachment pathology displayed by the child surrounding child

custody conflict, a proper risk assessment for child abuse needs to be conducted to the

appropriate differential diagnoses for each parent.

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Targeted Parent Abusive:

Is the targeted parent abusing the

child in some way, thereby creating the child’s attachment

pathology toward that parent (a 2-person attribution of

causality)?

Allied Parent Abusive:

Or is the allied parent psychologically

abusing the child by creating a shared (induced) persecutory

delusion and false (factitious) attachment pathology in the child

for secondary gain to the allied parent of manipulating the

Court’s

decisions regarding child custody,

and to meet the

pathological parent’s own emotional and psychological needs (a

3-person triangle attribution of causality)?



yes



yes



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Mapping the litigation journey where Alienating Behaviours (AB) are alleged

NRP = Non resident parent

AB = Alienating Behaviours

DA = Domestic Abuse

* denotes area where guidance provided

We follow the

judgment of the PFD in

Re C (Parental Alienation)

[2023]

EWHC 345 (Fam) para 103

that the

court’s focus should be on the

identification of

ALIENATING

BEHAVIOUR (as defined)

and the

IMPACT

of that behaviour on the

RELATIONSHIP OF THE CHILD

with

either of his/her parents.

Note: not all journeys will look

like this, but the essential

requirements to establish and

respond to AB remain the same

Application made

District Judge/Legal Adviser

* Guidance note to good gatekeeping

AB alleged (often in conjunction

with alleged DA)

No issues AB/DA

* Guidance note to good

CMH Duty to distill

alleged AB which

MUST

result in HOSTILITY

CMH

FHDRA

* Guidance note to when

an expert should be utilised

– assessment after fact-

finding rather than deciding

on existence of AB

* Need factual matrix to identify

* Guidance note what

Child’s resistance/hostility to a

the child does not want to see

What is the diagnosis?

does

HOSTILITY

look

parent

the parent and

whether this is

like?

JUSTIFIED

Is the diagnosis child abuse by the targeted-rejected parent, or is the diagnosis Child

Diagnosis guides treatment.

No resistance/hostility by the child

Psychological Abuse (DSM-5 V995.51) by the allied parent, i.e., a shared (induced) persecutory

delusion and false (factious) attachment pathology imposed on the child for secondary gain to

the pathological narcissistic-borderline-dark

personality parent of manipulating the court’s

* There will be cases

DA alleged and/or AB indicated

decisions regarding child custody, and to meet the pathological

No DA alleged no

parent’s own emotional and

DA alleged no AB indicated

where there is no obvious

which might explain hostility

indicated

psychological needs?

cause of

HOSTILITY

* Guidance note dangers

of limiting to wishes and

feelings

No AB

FFH DA/AB

FFH

DRA

No findings of AB

Findings of AB

No AB

Guide to use of experts

Welfare choices

Only where hostility is

the result of

PSYCHOLOGICAL

MANIPULATION

* Guidance to the options on spectrum of Local Authority of care and cessation of

contact with NRP; and on involvement between transfer in implementing orders.

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When a child displays severe attachment pathology surrounding court-involved

custody conflict, two separate societal systems are involved, the legal system

surrounding the custody conflict, and the healthcare system surrounding the

pathology. Both systems need to perform their respective functions, interacting

efficiently to the tasks of each system.

Doctors should not be deciding on custody. Judges should not be diagnosing the

cause of pathology.

3. Case Management Guidance Note for the Family Court: Cases in

which alienating behaviours are alleged

Standards of Professional Practice

There is no such thing as “parental alienation” – there is no such thing as “alienation” –

there is no such thing as “alienating behaviours” –

as defined constructs in clinical

psychology.

“Alienation” = unicorns:

both are mythical things.

There are shared delusional disorders. There are factitious disorders imposed on

another. There are cross-generational coalitions and emotional cutoffs. There are

narcissistic, borderline, and dark personality parents. There is Child Psychological

Abuse (DSM-5 V995.51). But there is NO defined pathology in clinical psychology called

“parental alienation” –

it is mythical thing that people just make up.

The use of the construct of “parental alienation”

in a professional capacity is

substantially beneath professional standards of practice in clinical psychology and is in

violation of Standard 2.04 of the APA ethics code.

2.04 Bases for Scientific and Professional Judgments

Psychologists' work is based upon established scientific and professional

knowledge of the discipline.

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The established scientific and professional knowledge of the discipline required for

competence with court-involved custody conflict is:

•

Attachment pathology - Bowlby & others

Family systems therapy - Minuchin & others

Child abuse and complex trauma

–

van der Kolk & others

Personality disorder pathology - Beck & others

Child Development

–

Tronick & others

Psychological control

–

Barber & others

DSM-5 diagnostic system - American Psychiatric Association

Psychological Control

The manipulative psychological control of the child by a parent is a scientifically

established family relationship pattern in dysfunctional family systems. In his book

regarding parental psychological control of children,

Intrusive Parenting: How

Psychological Control Affects Children and Adolescents,

published by the American

Psychological Association, Brian Barber and his colleague, Elizabeth Harmon, identify

over 30 empirically validated scientific studies that have established the construct of

parental psychological control of children. Barber and Harmon (2002)

provide the

following definition for the construct of parental psychological control of the child:

From Barber & Harmon:

“Psychological control refers to parental behaviors

that

are intrusive and manipulative of children’s

thoughts, feelings, and attachment to

parents. These behaviors appear to be associated with disturbances in the

psychoemotional boundaries between the child and parent, and hence with the

development of an independent sense of self and identity.”

(Barber & Harmon,

2002, p. 15)

The difference between behavioral and psychological control of the child is described by

Stone, Bueler, and Barber (2002),

Stone, Buehler, & Barber:

“The central elements of psychological control are

intrusion into the child’s psychological world and self-definition

and parental

attempts to manipulate the child’s

thoughts and feelings through invoking guilt,

shame, and anxiety. Psychological control is distinguished from behavioral

control in that the parent attempts to control, through the use of criticism,

dominance, and anxiety or guilt induction, the youth’s thoughts and feelings

rather than the youth’s behavior.” (Stone, Buehler, & Barber, 2002, p. 57)

Barber, B. K. (Ed.) (2002). Intrusive parenting: How psychological control affects

children and adolescents. Washington, DC: American Psychological Association.

Barber, B. K. and Harmon, E. L. (2002). Violating the self: Parenting psychological

control of children and adolescents. In B. K. Barber (Ed.), Intrusive parenting (pp. 15-52).

Washington, DC: American Psychological Association.

Stone, G., Buehler, C., & Barber, B. K.. (2002) Interparental conflict, parental

psychological control, and youth problem behaviors. In B. K. Barber (Ed.), Intrusive

parenting: How psychological control affects children and adolescents. Washington, DC:

American Psychological Association.

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Soenens and Vansteenkiste (2010)

describe the various methods parents use to

achieve parental psychological control of the child,

From Soenens and Vansteenkiste:

“Psychological

control can be expressed

through a variety of parental tactics, including (a) guilt-induction, which refers to

the use of guilt inducing strategies to pressure children to comply with a

parental request; (b) contingent love or love withdrawal, where parents make

their attention, interest, care, and love contingent upon the children’s

attainment

of parental standards; (c) instilling anxiety, which refers to the induction of

anxiety to make children comply with parental requests; and (d) invalidation of

the child’s

perspective, which pertains to parental constraining of the child’s

spontaneous expression of thoughts and feelings.” (Soenens

& Vansteenkiste,

2010, p. 75)

Stone, Buehler, and Barber (2002)

provide a description of the process of intrusive

psychological control of children surrounding divorce,

Stone, Buehler, and Barber:

“The concept of triangles “describes the way any

three people relate to each other and involve others in emotional issues between

them” (Bowen, 1989, p. 306).

In the anxiety-filled environment of conflict, a third

person is triangulated, either temporarily or permanently, to ease the anxious

feelings of the conflicting partners. By default, that third person is exposed to an

anxiety-provoking and disturbing atmosphere. For example, a child might

become the scapegoat or focus of attention, thereby transferring the tension

from the marital dyad to the parent-child dyad. Unresolved tension in the marital

relationship might spill over to the parent-child relationship through parents’

use of psychological control as a way of securing and maintaining a strong

emotional alliance and level of support from the child. As a consequence, the

triangulated youth might feel pressured or obliged to listen to or agree with one

parents’

complaints against the other. The resulting

enmeshment and cross-

generational coalition would exemplify parents’

use of psychological control to

coerce and maintain a parent-youth emotional alliance against the other parent

(Haley, 1976; Minuchin, 1974).”

(Stone, Buehler, & Barber, 2002, p. 86-87).

Alienating behaviours

Sir Andrew McFarlane P observed in

Re C (‘Parental Alienation’; Instruction of Expert)

[2023] EWHC 345 (Fam) that the disruption or undermining of a parent/child relationship is

often encapsulated in the term

‘parental alienation’

or alienating behaviours. A court would

need to be satisfied that three elements are established before it could conclude that

alienating behaviours had occurred:

Professional Standard of Practice

Soenens, B., & Vansteenkiste, M. (2010). A theoretical upgrade of the concept of parental

psychological control: Proposing new insights on the basis of self-determination theory.

Developmental Review, 30, 74–99.

Stone, G., Buehler, C., & Barber, B. K.. (2002) Interparental conflict, parental

psychological control, and youth problem behaviors. In B. K. Barber (Ed.), Intrusive

parenting: How psychological control affects children and adolescents. Washington, DC:

American Psychological Association.

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There is no such thing as “parental alienation.” There is no such thing as “alienating

behaviours.”

These are made-up

constructs without scientific or research support or

agreed-upon definition.

“Alienating

behaviours”

= unicorns: both are mythical things.

There are shared delusional disorders. There are factitious disorders imposed on

another. There are cross-generational coalitions and emotional cutoffs. There are

narcissistic, borderline, and dark personality parents. There is Child Psychological

Abuse (DSM-5 V995.51). But there is NO defined pathology in clinical psychology called

“parental alienation” –

it is mythical thing that people just make up.

The use of the construct of “parental alienation”

in a professional capacity is

substantially beneath professional standards of practice in clinical psychology and is in

violation of Standard 2.04 of the APA ethics code.

2.04 Bases for Scientific and Professional Judgments

Psychologists' work is based upon established scientific and professional

knowledge of the discipline.

The established scientific and professional knowledge of the discipline required for

competence with court-involved custody conflict is:

•

Attachment pathology - Bowlby & others

Family systems therapy - Minuchin & others

Child abuse and complex trauma

–

van der Kolk & others

Personality disorder pathology - Beck & others

Child Development

–

Tronick & others

Psychological control

–

Barber & others

DSM-5 diagnostic system - American Psychiatric Association

Application of Knowledge vs Lack of Knowledge

Do the authors of this Guidance know the established scientific and professional

knowledge of the discipline of professional psychology needed for professional

competence in working with the attachment pathology in the family courts? Are the

authors relying on problematic (made-up) constructs because they do not know the

actual established knowledge needed for professional competence?

Google ignorance:

lack of knowledge or information

a) the child is refusing, resisting, or reluctant to engage in, a relationship with a parent

or carer;

Attachment Pathology

A child who is refusing, resisting, or reluctant to engage in a relationship with a parent

represents an attachment pathology, i.e., a problem in the love-and-bonding system of

the brain. The attachment system is a primary motivational system of the brain that

governs all aspects of love-and-bonding throughout the lifespan (Bowlby; Ainsworth, and

others). A child rejecting a parent is an attachment pathology.

From Bowlby:

“No variables, it is held,

have more far-reaching effects on

personality development than have a child’s experiences within his family: for,

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starting during the first months of his relations with his mother figure, and

extending through the years of childhood and adolescence in his relations with

both parents, he builds up working models of how attachment figures are likely to

behave towards him in any of a variety of situations; and on those models are

based all his expectations, and therefore all his plans for the rest of his

life.”

(Bowlby, 1973, p. 369).

The only cause of severe attachment pathology (i.e., a child rejecting a parent) is child

abuse range parenting by one parent or the other. Other less severe forms of problematic

parenting produce an insecure attachment that has different symptom characteristics

other than a severing of the parent-child bond.

In all court-involved custody conflict involving severe attachment pathology displayed by

the child (i.e., a child rejecting a parent;

“refusing,

resisting, or

reluctant”

to bond to a

parent),

a proper risk assessment for child abuse needs to be conducted to the

appropriate differential diagnoses for each parent.

Differential Diagnosis for Targeted Parent:

Targeted Parent Abusive:

Is the targeted parent abusing the

child in some way, thereby creating the child’s attachment

pathology toward that parent?

If yes, identify the DSM-5 Child Abuse diagnosis involved:

•

Child Physical Abuse (V995.54)

Child Sexual Abuse (V995.53)

Child Neglect (V995.52)

Child Psychological Abuse (V995.51)



yes



yes



yes



yes



yes



Differential Diagnosis

–

Allied Parent:

Allied Parent Abusive:

Is the allied parent psychologically



yes

abusing the child (DSM-5 V995.51 Child Psychological Abuse) by

creating a shared (induced) persecutory delusion and false

(factitious) attachment pathology in the child for the secondary

gain to the parent

of manipulating the court’s decisions regarding

child custody, and to meet the allied parent’s own emotional and

psychological needs?

•

Persecutory Delusion (shared):

Does the allied parent have

a persecutory delusion surrounding the other parent, and

does the child share this persecutory belief (a fixed and false

belief that the child is being malevolently treated in some

way)?

Factitious Attachment Pathology:

Does the child have a

false (factitious) attachment pathology imposed on the child

by the pathogenic parenting of the allied parent (DSM-5

300.19 Factitious Disorder Imposed on Another)?

Spousal Psychological Abuse:

Is the allied parent using the

child’s

induced pathology

as a weapon of spousal emotional

and psychological abuse of the targeted parent (DSM-5



yes



•



yes



•



yes



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

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V995.82 Spouse or Partner Abuse, Psychological)?

b) the refusal, resistance or reluctance is not consequent on the actions of the non-

resident parent towards the child or the resident parent; and

Resist-Refuse and Induced Delusional Thought Disorders

Writing in the journal

Family Court Review,

Walters & Friedlander (2016) describe the

refusal and resistance of the child to be with the targeted parent (an attachment

pathology) as being caused by a shared persecutory delusion created by the distorted

parenting of a pathological parent,

From Walters & Friedlander:

“In some RRD families [resist-refuse

dynamic], a

parent’s underlying encapsulated

delusion about the other parent is at the root of

the intractability (cf. Johnston & Campbell, 1988, p. 53ff; Childress, 2013). An

encapsulated delusion is a fixed, circumscribed belief that persists over time and

is not altered by evidence of the inaccuracy

of the belief.”

(Walters & Friedlander,

2016, p. 426;

Family Court Review)

From Walters & Friedlander:

“When alienation is the predominant factor in the

RRD [resist-refuse

dynamic}, the theme of the favored parent’s fixed delusion

often is that the rejected parent is sexually, physically, and/or emotionally

abusing the child. The child may come to share the

parent’s encapsulated delusion

and to regard the beliefs as his/her own (cf. Childress, 2013).”

(Walters &

Friedlander, 2016, p. 426;

Family Court Review)

Diagnosis Guides Treatment

Diagnosis guides treatment, the treatment for cancer is different than the treatment for

diabetes.

Diagnosis = identify

Pathology = problem

Treatment = fix it

•

We must first

diagnose

what the

pathology

is before we know how to

treat it.

We must first

identify

what the

problem

is before we know how to

fix it.

Is the diagnosis child abuse by the targeted-rejected parent, or is the diagnosis Child

Psychological Abuse (DSM-5 V995.51) by the allied parent, i.e., a shared (induced)

persecutory delusion and false (factious) attachment pathology imposed on the child for

secondary gain to a pathological (narcissistic-borderline-dark personality) parent of

manipulating the Court’s

decisions regarding child custody, and to meet the pathological

parent’s own emotional and psychological needs?

The treatment and judicial response to child abuse by the targeted parent is different

than the treatment and judicial response to child abuse by the allied parent. In all cases of

severe attachment pathology surrounding child custody conflict, a proper risk

assessment for child abuse needs to be conducted to the appropriate differential

diagnoses for each parent.

Assessing Delusional Thought Disorders

The assessment for a possible delusional thought disorder is a Mental Status Exam of

thought and perception as described by Martin (1990),

From Martin:

“Thought and Perception.

The inability to process information

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correctly is part of the definition of psychotic thinking. How the patient perceives

and responds to stimuli is therefore a critical psychiatric assessment. Does the

patient harbor realistic concerns, or are these concerns elevated to the level of

irrational fear? Is the patient responding in exaggerated fashion to actual events,

or is there no discernible basis in reality for the patient's beliefs or behavior?”

The definition of a persecutory delusion is provided by the American Psychiatric

Association,

From the APA:

“Persecutory Type: delusions that the person (or someone to

whom the person is close) is being malevolently treated in some way.” (American

Psychiatric Association, 2000)

The American Psychiatric Association describes the development of a shared delusional

disorder that occurs within a family context,

From the APA:

“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… 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.”

(American Psychiatric Association, 2000)

Creating a shared (induced) persecutory delusion in the child that then destroys the

child’s attachment bond to the other parent, as described by Walters and Friedlander

(2016) in the journal

Family Court Review,

is a DSM-5 diagnosis of V995.51 Child

Psychological Abuse and a child protection response is warranted.

Response to Child Abuse

In all cases of child abuse, we always protect the child. In all cases of severe attachment

pathology displayed by the child, a proper risk assessment for child abuse needs to be

conducted. If a child abuse diagnosis is returned from a proper risk assessment, then

professional standards of practice and duty to protect obligations require the child’s

protective separation from the abusive parent.

In response to all dangerous pathology (suicide, homicide, or abuse), the professional

response begins with a Safety Plan to ensure everyone is safe in the situation. Then, once

everyone’s safety has been ensured, a treatment plan

is developed for the diagnosis with

Goals identified in measurable ways, Interventions specified for each Goal, estimated

Time Frames for achieving the Goal, and Outcome Measures to monitor treatment

progress and goal accomplishment.

Once the Safety Plan is enacted and the child is protectively separated from the abusive

parent, the child’s healthy and normal-range

development is then recovered through the

written treatment plan. When the child’s recovery has been stabilized, the child’s contact

with the abusive parent is reestablished with enough safeguards in place to ensure that

the child abuse does not resume when contact with the abusive parent is restored.

Diagnosis guides treatment. What is the diagnosis guiding the decision-making of the

mental health professionals and the Court?

Differential Diagnosis for Targeted Parent:

Targeted Parent Abusive:

Is the targeted parent abusing the

child in some way, thereby creating the child’s attachment

pathology toward that parent?



yes



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If yes, identify the DSM-5 Child Abuse diagnosis involved:

•

Child Physical Abuse (V995.54)

Child Sexual Abuse (V995.53)

Child Neglect (V995.52)

Child Psychological Abuse (V995.51)



yes



yes



yes



yes



Differential Diagnosis

–

Allied Parent:

Allied Parent Abusive:

Is the allied parent psychologically



yes

abusing the child (DSM-5 V995.51 Child Psychological Abuse) by

creating a shared (induced) persecutory delusion and false

(factitious) attachment pathology in the child for the secondary

gain to the parent of manipulating

the court’s decisions regarding

child custody, and to meet the allied parent’s own emotional and

psychological needs?

•

Persecutory Delusion (shared):

Does the allied parent have

a persecutory delusion surrounding the other parent, and

does the child share this persecutory belief (a fixed and false

belief that the child is being malevolently treated in some

way)?

Factitious Attachment Pathology:

Does the child have a

false (factitious) attachment pathology imposed on the child

by the pathogenic parenting of the allied parent (DSM-5

300.19 Factitious Disorder Imposed on Another)?

Spousal Psychological Abuse:

Is the allied parent using the

child’s

induced pathology

as a weapon of spousal emotional

and psychological abuse of the targeted parent (DSM-5

V995.82 Spouse or Partner Abuse, Psychological)?



yes



•



yes



•



yes



c) the resident parent has engaged in behaviours that have directly or indirectly

impacted on the child, leading to the

child’s

refusal, resistance, or reluctance to

engage in a relationship with the other parent.

Standards of Professional Practice

Making up new forms of pathology is professionally inappropriate. This Guidance would

not meet the ethical requirements for clinical psychologists required by Standard 2.04

Bases for Scientific and Professional Judgments of the APA ethics code:

2.04 Bases for Scientific and Professional Judgments

Psychologists' work is based upon established scientific and professional

knowledge of the discipline.

The established scientific and professional knowledge from clinical psychology required

for application with court-involved custody conflict as the bases for professional

judgments is:

•

Attachment pathology - Bowlby & others

Family systems therapy - Minuchin & others

Child abuse and complex trauma

–

van der Kolk & others

SOU, Alm.del - 2023-24 - Bilag 26: Henvendelse af 15/10-23 fra coach Kenneth Nielsen, Stenløse om familieret

•

Personality disorder pathology - Beck & others

Child Development

–

Tronick & others

Psychological control

–

Barber & others

DSM-5 diagnostic system - American Psychiatric Association

The only cause of severe attachment pathology is child abuse range parenting by one

parent or the other. In all cases of severe attachment pathology displayed by the child

surrounding court-involved custody conflict, a proper risk assessment for child abuse

needs to be conducted to the appropriate differential diagnoses for each parent.

Differential Diagnosis for Targeted Parent:

Targeted Parent Abusive:

Is the targeted parent abusing the

child in some way, thereby creating the child’s attachment

pathology toward that parent?

If yes, identify the DSM-5 Child Abuse diagnosis involved:

•

Child Physical Abuse (V995.54)

Child Sexual Abuse (V995.53)

Child Neglect (V995.52)

Child Psychological Abuse (V995.51)



yes



yes



yes



yes



yes



Differential Diagnosis

–

Allied Parent:

•

Allied Parent Abusive:

Is the allied parent psychologically

abusing the child (DSM-5 V995.51 Child Psychological Abuse)

by creating a shared (induced) persecutory delusion and false

(factitious) attachment pathology in the child for the

secondary gain of manipulating the court’s

decisions

regarding child custody, and to meet the allied parent’s own

emotional and psychological needs?

Persecutory Delusion (shared):

Does the allied parent have

a persecutory delusion surrounding the other parent, and

does the child share this persecutory belief (a fixed and false

belief that the child is being malevolently treated in some

way)?

Factitious Attachment Pathology:

Does the child have a

false (factitious) attachment pathology imposed on the child

by the pathogenic parenting of the allied parent (DSM-5

300.19 Factitious Disorder Imposed on Another)?

Spousal Psychological Abuse:

Is the allied parent using the

child’s

induced pathology

as a weapon of spousal emotional

and psychological abuse of the targeted parent (DSM-5

V995.82 Spouse or Partner Abuse, Psychological)?



yes



•



yes



•



yes



•



yes



Either parent could demonstrate alienating behaviours. Such behaviours can include (but

are not limited to) one parent:

Standards of Professional Practice

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There is no such thing as “parental alienation.” There is no such thing as “alienating

behaviours.” These are made-up

constructs without scientific or research support or

agreed-upon definition.

“Alienating behaviours” = unicorns: both are mythical things.

There are shared delusional disorders. There are factitious disorders imposed on

another. There are cross-generational coalitions and emotional cutoffs. There are

narcissistic, borderline, and dark personality parents. There is Child Psychological

Abuse (DSM-5 V995.51). But there is NO defined pathology in clinical psychology

called “parental alienation” –

it is mythical thing that people just make up.

No Established

Diagnostic Criteria for “Alienation”

What is the research support for the

“alienating

behaviours” listed by the authors of

this Guidance? I will challenge that the authors are simply making up this list of

behaviours from their imagination (and the imagination of others) without research

support. Citation support to the research is requested for the assertions made about

“alienating behaviors.”

If the diagnostic criteria (i.e., the behaviours) may or may not be present, and with no

set number of diagnostic behaviours needing to be present for the pathology to be

identified (diagnosed), then the diagnostic description for the pathology is entirely

arbitrary and subjective in both its development and its application and is entirely

worthless as a diagnostic model.

Ex: For a diagnosis of ADHD, six of nine identified symptoms must be present.

For a diagnosis of Major Depressive Disorder, five of eight symptoms of a

depressive episode must be present. The symptoms and the diagnostic criteria

for a diagnosis of ADHD and Major Depressive Disorder are derived from the

relevant research on the respective pathologies.

There is no research support for the selection of these

symptoms chosen as “alienating

behaviours,” and without establishing a set number of specified symptoms needed for

the diagnosis of “alienation,” the proposed diagnostic model for “parental alienation” is

not even a diagnostic model. It is arbitrary and subjective in both its development and

its application.

Ethical Standards of Professional Practice

The

child’s life hangs in the balance of the Court’s decision. The Court

and the children

deserve the highest caliber of professional services. Child abuse by one parent or the

other is a considered diagnosis based on the child’s display of severe attachment

pathology. When possible child abuse is a considered diagnosis, our diagnosis must be

accurate 100% of the time. Misdiagnosing child abuse is too devastating for the child.

In all cases of severe attachment pathology surrounding court-involved custody

conflict, a proper risk assessment for child abuse needs to be conducted to return an

accurate diagnosis, in order to develop an effective treatment plan to fix the pathology

in the family and restore a normal-range and healthy childhood to the child.

The use of the construct of “parental alienation” (“alienation”

“alienating

behaviours”) in a professional capacity is substantially

beneath professional

standards of practice in clinical psychology and is in violation of Standard 2.04 of the

APA ethics code.

2.04 Bases for Scientific and Professional Judgments

Psychologists' work is based upon established scientific and professional

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knowledge of the discipline.

The established scientific and professional knowledge of the discipline required for

competence with court-involved custody conflict is:

•

Attachment pathology - Bowlby & others

Family systems therapy - Minuchin & others

Child abuse and complex trauma

–

van der Kolk & others

Personality disorder pathology - Beck & others

Child Development

–

Tronick & others

Psychological control

–

Barber & others

DSM-5 diagnostic system - American Psychiatric Association

The failure of the authors to apply established scientific and professional knowledge

from any relevant domain of professional psychology as the bases for their

professional judgments, raises professional concerns that the authors of this Guidance

may not know the established scientific and professional knowledge of the discipline

necessary for professional competence in working with the attachment pathology in

the family courts.

Google ignorance:

lack of knowledge or information

Apply knowledge to solve pathology. Ignorance solves nothing. The children and the

courts deserve the highest caliber of professional services.

•

repeatedly or constantly criticising or belittling the other.

Citation requested to the research support for this criterion behaviour.

How is “repeatedly” defined? How is “criticism” or “belittling” defined,

i.e., what are the

operational definitions for diagnostic purposes? Or is this diagnostic criterion

subjectively defined by each evaluator?

Psychological Control

Parental psychological control happens in a myriad of manipulative ways that do not

involve speaking negatively about the other parent.

From Soenens and Vansteenkiste:

“Psychological

control can be expressed

through a variety of parental tactics, including (a) guilt-induction, which refers

to the use of guilt inducing strategies to pressure children to comply with a

parental request; (b) contingent love or love withdrawal, where parents make

their attention, interest, care, and love contingent upon the children’s

attainment of parental standards; (c) instilling anxiety, which refers to the

induction of anxiety to make children comply with parental requests; and (d)

invalidation of the child’s

perspective, which pertains

to parental constraining

of the child’s spontaneous expression of thoughts and feelings.” (Soenens

Vansteenkiste, 2010, p. 75)

Evidence of Abuse

It is unrealistic to require that the private parenting behavior of a pathological parent

be directly observed when that parent is alone with the child. Making it a requirement

to observe parenting behaviors when the parent is alone with the child will prevent the

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diagnosis of Child Psychological Abuse since the pathogenic parenting episodes are

rarely presented to others. There are no witnesses to the psychological abuse of the

child (i.e., to the psychological murder

of the child’s bond to the

other parent) except

the abusive parent and the child. Psychological abuse leaves no outside bruises or

marks, its impact is in the specific child symptoms created by the child abuse.

The pathology is a psychological murder, the death in

the child’s relationship with a

parent. Which parent is the perpetrator? There is no eyewitness to the murder of the

relationship except the perpetrator and victim. The perpetrator of the psychological

murder denies the crime, and the victim cannot speak. But there is other evidence,

there are fingerprints on the murder weapon, there is DNA at the crime scene, there

are telephone records placing the perpetrator at the crime scene at the time of the

murder.

To require eye-witness evidence to convict on the murder is unrealistic to achieve,

since only the perpetrator and victim are at the scene of the crime. If

the victim can’t

speak, for example if the victim is under the psychological control (Barber) of the

pathological parent, that leaves only the perpetrator to speak. Child abuse leaves

symptoms of the child abuse. Diagnosis involved identifying the symptoms in a

pattern-match to diagnostic criteria, professionals need to diagnose the child abuse

and protect the child.

It is unrealistic to require an eyewitness to diagnose physical abuse when the child

presents with bruises and broken bones without a credible explanation. Psychological

abuse will be evident in the pathology created, in the specific symptoms created in the

child

–

i.e., a shared persecutory delusion and Factitious Disorder Imposed on Another;

either and both of which are a DSM-5 diagnosis of Child Psychological Abuse

(V995.51).

In all cases of severe attachment pathology displayed by the child surrounding court-

involved custody conflict, a proper risk assessment for child abuse needs to be

conducted to the appropriate differential diagnoses for each parent.

Diagnosis in Healthcare

The National Academy of Sciences describes the diagnostic process in a paper on

Improving Diagnosis in Healthcare

(2015),

From Improving Diagnosis:

“The working diagnosis may be either a list of

potential diagnoses (a differential diagnosis) or a single potential diagnosis.

Typically, clinicians will consider more than one diagnostic hypothesis or

possibility as an explanation of the patient’s symptoms and will refine this list as

further information is obtained in the

diagnostic process.” (National Academy of

Sciences, 2015)

From Improving Diagnosis:

“As the diagnostic process proceeds, a fairly broad

list of potential diagnoses may be narrowed into fewer potential options, a

process referred to as diagnostic modification and refinement (Kassirer et al.,

2010). As the list becomes narrowed to one or two possibilities, diagnostic

refinement of the working diagnosis becomes diagnostic verification, in which

Improving Diagnosis in Healthcare

(2015). National Academies of Sciences, Engineering,

and Medicine; Institute of Medicine; Board on Health Care Services; Committee on

Diagnostic Error in Health Care; Erin P. Balogh, Bryan T. Miller, and John R. Ball, Editors

https://www.nap.edu/catalog/21794/improving-diagnosis-in-health-

care?fbclid=IwAR2ht8JZQGHLWElqlBjwqPqx6qtmgc9JYpI8mSRUJaLZFdzljAubk2MkOAI

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the lead diagnosis is checked for its adequacy in explaining the signs and

symptoms, its coherency with the patient’s context (physiology, risk factors),

and whether a single diagnosis is appropriate.” (National Academy of Sciences,

2015)

From Improving Diagnosis:

“Throughout the diagnostic process, there is an

ongoing assessment of whether sufficient information has been collected. If the

diagnostic team members are not satisfied that the necessary information has

been collected to explain the patient’s health problem, or that the information

available is not consistent with a diagnosis, then the process of information

gathering, information integration and interpretation, and developing a working

diagnosis continues.” (National Academy of Sciences, 2015)

From Improving Diagnosis:

“In addition, the provision of treatment

can also

inform and refine a working diagnosis, which is indicated by the feedback loop

from treatment into the information-gathering step of the diagnostic process.

This also illustrates the need for clinicians to diagnose health problems that

may arise during

treatment.” (National Academy of Sciences, 2015)

Diagnosis guides treatment. An accurate diagnosis is needed to guide the development

of an effective treatment plan. If we treat cancer with insulin, the patient dies from the

misdiagnosed and mistreated cancer. The only cause of severe attachment pathology is

abusive range parenting by one parent or the other, the diagnostic question is, which

parent?

Instead of applying the established scientific and professional knowledge of the

discipline toward the goal of making an accurate diagnosis of the pathology in the

family, the authors of this Guidance appear to be proposing a new form of pathology

from their imagination, with arbitrary and subjective diagnostic criteria.

The allied parent criticizing the other parent is not how the shared persecutory

delusion is created. The other parent is discussed often, but in critical ways by the child

to the allied parent. The allied parent does not criticize the other parent, the allied

parent elicits the criticism of the other parent from the child through directive and

motivated questioning, and then the allied parent offers “support” for the child’s

expressed grievances,

entering the coveted role as the supposedly “protective” parent.

From Soenens and Vansteenkiste:

“Psychological

control can be expressed

through a variety of parental tactics, including (a) guilt-induction, which refers

to the use of guilt inducing strategies to pressure children to comply with a

parental request; (b) contingent love or love withdrawal, where parents make

their attention, interest, care, and love contingent upon the children’s

attainment of parental standards; (c) instilling anxiety, which refers to the

induction of anxiety to make children comply with parental requests; and (d)

invalidation of the child’s

perspective, which pertains to parental constraining

of the child’s spontaneous expression of thoughts and feelings.” (Soenens

Vansteenkiste, 2010, p. 75)

Does the child have a persecutory delusion? Does the allied parent share this

persecutory delusion? That would be a shared persecutory delusion. Creating a shared

persecutory delusion in the child that then destroys the child’s attachment

bond to the

other parent is a DSM-5 diagnosis of V995.51 Child Psychological Abuse.

The assessment for a delusional thought disorder is a Mental Status Exam of thought

and perception.

From Martin:

“Thought and Perception.

The inability to process information

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correctly is part of the definition of psychotic thinking. How the patient

perceives and responds to stimuli is therefore a critical psychiatric assessment.

Does the patient harbor realistic concerns, or are these concerns elevated to the

level of irrational fear? Is the patient responding in exaggerated fashion to

actual events, or is there no discernible basis in reality for the patient's beliefs

or behavior?”

•

unjustifiably limiting or restricting contact or undermining contact.

Citation requested to the research support for this diagnostic criterion.

What is the difference between “justified” limitations and restrictions

on contact and

“unjustified” limitations and restrictions on contact? Is this arbitrarily and subjectively

determined by each evaluator?

How is “undermining contact” defined for diagnostic purposes, or is this also arbitrarily

and subjectively determined by each evaluator?

Standards of Professional Practice

Making up new forms of pathology is not professionally appropriate. All professionals

should apply the established scientific and professional knowledge of the discipline

–

first.

The established scientific and professional knowledge of the discipline required for

application with court-involved custody conflict are:

•

Attachment pathology - Bowlby & others

Family systems therapy - Minuchin & others

Child abuse and complex trauma

–

van der Kolk & others

Personality disorder pathology - Beck & others

Child Development

–

Tronick & others

Psychological control

–

Barber & others

DSM-5 diagnostic system - American Psychiatric Association

forbidding discussion about the other parent.

Citation requested to the research support for this criterion behavior.

Are these

merely criterion behaviors from someone’s imagination?

Pathogenic Parenting

That is not how the shared persecutory delusion is created (Barber; psychological

control). The other parent is discussed often, but in negative and critical ways by the

child to the allied parent. The allied parent does not criticize the other parent, the allied

parent elicits the criticism from the child by directive and motivated questioning, and

then the allied parent merely

offers “support” for the child’s expressed grievances.

The allied parent presents as

simply “listening to the child’s” grievances that were

manipulatively elicited by the parent through motivated and directive questioning with

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the child.

Do the authors of this Guidance know the necessary established scientific and

professional knowledge of professional psychology needed for professional

competence in working with the attachment pathology in the family courts.

Google ignorance:

lack of knowledge or information

Psychological Control

The manipulative psychological control of the child by a parent is a scientifically

established family relationship pattern in dysfunctional family systems. In his book

regarding parental psychological control of children,

Intrusive Parenting: How

Psychological Control Affects Children and Adolescents,

published by the American

Psychological Association, Brian Barber and his colleague, Elizabeth Harmon, identify

over 30 empirically validated scientific studies that have established the construct of

parental psychological control of children. Barber and Harmon (2002)

provide the

following definition for the construct of parental psychological control of the child:

From Barber & Harmon:

“Psychological control refers to parental behaviors

that

are intrusive and manipulative of children’s

thoughts, feelings, and attachment to

parents. These behaviors appear to be associated with disturbances in the

psychoemotional boundaries between the child and parent, and hence with the

development of an independent sense of self and identity.”

(Barber & Harmon,

2002, p. 15)

The difference between behavioral and psychological control is described by Stone,

Bueler, and Barber (2002),

Stone, Buehler, & Barber:

“The central elements of psychological control are

intrusion into

the child’s psychological world and self-definition

and parental

attempts to manipulate the child’s

thoughts and feelings through invoking guilt,

shame, and anxiety. Psychological control is distinguished from behavioral

control in that the parent attempts to control, through the use of criticism,

dominance, and anxiety or guilt induction, the youth’s

thoughts and feelings

rather than the youth’s behavior.” (Stone, Buehler, & Barber, 2002, p. 57)

Soenens and Vansteenkiste (2010)

describe the various methods parents use to

achieve parental psychological control of the child,

From Soenens and Vansteenkiste:

“Psychological

control can be expressed

through a variety of parental tactics, including (a) guilt-induction, which refers

Barber, B. K. (Ed.) (2002). Intrusive parenting: How psychological control affects

children and adolescents. Washington, DC: American Psychological Association.

Barber, B. K. and Harmon, E. L. (2002). Violating the self: Parenting psychological

control of children and adolescents. In B. K. Barber (Ed.), Intrusive parenting (pp. 15-52).

Washington, DC: American Psychological Association.

Stone, G., Buehler, C., & Barber, B. K.. (2002) Interparental conflict, parental

psychological control, and youth problem behaviors. In B. K. Barber (Ed.), Intrusive

parenting: How psychological control affects children and adolescents. Washington, DC:

American Psychological Association.

Soenens, B., & Vansteenkiste, M. (2010). A theoretical upgrade of the concept of parental

psychological control: Proposing new insights on the basis of self-determination theory.

Developmental Review, 30, 74–99.

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to the use of guilt inducing strategies to pressure children to comply with a

parental request; (b) contingent love or love withdrawal, where parents make

their attention, interest, care, and love contingent upon the children’s

attainment of parental standards; (c) instilling anxiety, which refers to the

induction of anxiety to make children comply with parental requests; and (d)

invalidation of the child’s

perspective, which pertains to parental constraining

of the child’s spontaneous expression of thoughts and feelings.” (Soenens

Vansteenkiste, 2010, p. 75)

Stone, Buehler, and Barber (2002)

provide an description for the process of

psychological control of children surrounding divorce,

Stone, Buehler, and Barber:

“The concept of triangles “describes the way any

three people relate to each other and involve others in emotional issues

between them” (Bowen, 1989, p.

306). In the anxiety-filled environment of

conflict, a third person is triangulated, either temporarily or permanently, to

ease the anxious feelings of the conflicting partners. By default, that third

person is exposed to an anxiety-provoking and disturbing atmosphere. For

example, a child might become the scapegoat or focus of attention, thereby

transferring the tension from the marital dyad to the parent-child dyad.

Unresolved tension in the marital relationship might spill over to the parent-

child relationship through parents’

use of psychological control

as a way of

securing and maintaining a strong emotional alliance and level of support from

the child. As a consequence, the triangulated youth might feel pressured or

obliged to listen to or agree with one parents’

complaints against the other. The

resulting enmeshment and cross-generational coalition would exemplify

parents’

use of psychological control to coerce and maintain a parent-youth

emotional alliance against the other parent (Haley, 1976; Minuchin,

1974).”

(Stone, Buehler, & Barber, 2002, p. 86-87).

Standards of Professional Practice

Making up new forms of pathology (“parental alienation” – “alienation” – “alienating

behaviours”) is professionally inappropriate and degrades the quality of professional

services received by children and the Court.

The use of the construct of “parental

alienation” in a professional capacity is substantially beneath professional standards of

practice in clinical psychology and is in violation of Standard 2.04 Bases for Scientific

and Professional Judgments of the APA ethics code.

2.04 Bases for Scientific and Professional Judgments

Psychologists' work is based upon established scientific and professional

knowledge of the discipline.

The established scientific and professional knowledge of the discipline required for

application with court-involved custody conflict are:

•

Attachment pathology - Bowlby & others

Family systems therapy - Minuchin & others

Child abuse and complex trauma

–

van der Kolk & others

Stone, G., Buehler, C., & Barber, B. K.. (2002) Interparental conflict, parental

psychological control, and youth problem behaviors. In B. K. Barber (Ed.), Intrusive

parenting: How psychological control affects children and adolescents. Washington, DC:

American Psychological Association.

SOU, Alm.del - 2023-24 - Bilag 26: Henvendelse af 15/10-23 fra coach Kenneth Nielsen, Stenløse om familieret

•

Personality disorder pathology - Beck & others

Child Development

–

Tronick & others

Psychological control

–

Barber & others

DSM-5 diagnostic system - American Psychiatric Association

Apply knowledge to solve pathology.

•

creating the impression that the other parent dislikes or does not love the child, or

has harmed them or intends them harm.

Citation requested to the research support for this behavioral criterion.

Persecutory Delusion

Creating the impression in the child

is called “inducing,”

- and inducing a false belief that

the other parent has harmed the child or intends to harm the child is the definition of

creating a shared (induced) persecutory delusion in the child.

From the APA:

“Persecutory Type: delusions that the person (or someone to

whom the person is close) is being malevolently treated in some way.” (American

Psychiatric Association, 2000)

Walters and Friedlander describe the shared delusion that presents in the family courts,

From Walters & Friedlander:

“In some RRD families [resist-refuse

dynamic], a

parent’s underlying encapsulated delusion about the other parent is at the root of

the intractability (cf. Johnston & Campbell, 1988, p. 53ff; Childress, 2013). An

encapsulated delusion is a fixed, circumscribed belief that persists over time and

is not altered by evidence of the inaccuracy of the belief.”

(Walters & Friedlander,

2016, p. 426;

Family Court Review)

From Walters & Friedlander:

“When alienation is the predominant factor in the

RRD [resist-refuse

dynamic}, the theme of the favored parent’s fixed delusion

often is that the rejected parent is sexually, physically, and/or emotionally

abusing the child. The child may come to share the

parent’s encapsulated delusion

and to regard the beliefs as his/her own (cf. Childress, 2013).” (Walters

Friedlander, 2016, p. 426;

Family Court Review)

The American Psychiatric Association describes the development of a shared delusion in

family situations,

with the child adopting the parent’s delusional beliefs,

From the APA:

“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… 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.”

(American Psychiatric Association, 2000)

Professional Competence

The symptoms proposed by the authors of this Guidance appear to be randomly

developed from the personal imagination of the authors in an effort to create a new form

of pathology

(“parental alienation” – “alienation” – “alienating behaviours”).

The absence of applied professional knowledge by this proposed Guidance raises the

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question, do the authors of this Guidance even know the necessary established scientific

and professional knowledge of the discipline needed for professional competence in

working with the attachment pathology presenting in the family courts?

Google ignorance:

lack of knowledge or information

Apply knowledge to solve pathology. The established scientific and professional

knowledge of the discipline needed for professional competence in working with the

attachment pathology in the family courts is:

•

Attachment pathology - Bowlby & others

Family systems therapy - Minuchin & others

Child abuse and complex trauma

–

van der Kolk & others

Personality disorder pathology - Beck & others

Child Development

–

Tronick & others

Psychological control

–

Barber & others

DSM-5 diagnostic system - American Psychiatric Association

In all cases of severe attachment pathology displayed by the child surrounding court-

involved custody conflict, a proper risk assessment for child abuse needs to be conducted

to the appropriate differential diagnoses for each parent.

Differential Diagnosis for Targeted Parent:

Targeted Parent Abusive:

Is the targeted parent abusing the

child in some way, thereby creating the child’s attachment

pathology toward that parent?

If yes, identify the DSM-5 Child Abuse diagnosis involved:

•

Child Physical Abuse (V995.54)

Child Sexual Abuse (V995.53)

Child Neglect (V995.52)

Child Psychological Abuse (V995.51)



yes



yes



yes



yes



yes



yes



Differential Diagnosis

–

Allied Parent:

Allied Parent Abusive:

Is the allied parent psychologically

abusing the child (DSM-5 V995.51 Child Psychological Abuse) by

creating a shared (induced) persecutory delusion and false

(factitious) attachment pathology in the child for the secondary

gain of manipulating the court’s

decisions regarding child

custody, and to meet the allied parent’s own emotional and

psychological needs?

•

Persecutory Delusion (shared):

Does the allied parent have

a persecutory delusion surrounding the other parent, and

does the child share this persecutory belief (a fixed and false

belief that the child is being malevolently treated in some

way)?

Factitious Attachment Pathology:

Does the child have a

false (factitious) attachment pathology imposed on the child

by the pathogenic parenting of the allied parent (DSM-5



yes



•



yes



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300.19 Factitious Disorder Imposed on Another)?

•

Spousal Psychological Abuse:

Is the allied parent using the

child’s

induced pathology

as a weapon of spousal emotional

and psychological abuse of the targeted parent (DSM-5

V995.82 Spouse or Partner Abuse, Psychological)?



yes



•

denying emotional responsiveness to the other parent or spurning, terrorising,

isolating, corrupting, or exploiting them.

Citation requested to the research support for this feature.

These appear to be random symptoms developed from the personal imagination of the

authors. These parenting behaviors also sound like potentially abusive range

parenting, and this spectrum of concerns would warrant a proper risk assessment for

possible child abuse be conducted to the appropriate diagnoses of concern.

•

Terrorising: Concerns that a parent may be terrroising the child should

receive a proper risk assessment for possible Child Psychological Abuse

(V995.51).

Isolation: Isolating the child may be a feature of child abuse to isolate the

child from reporting and from rescue.

Any concerns for the child’s well-

being involving child isolation should receive a proper risk assessment for

possible child abuse.

Corruption: Concerns that a parent may be corrupting the child should

receive a proper risk assessment for possible child abuse, dependent upon

the nature of the

“corruption”

concerns involved.

Exploitation: Concerns that a parent may be exploiting the child should

receive a proper risk assessment for possible child abuse.

•

How are these various terms operationally defined for diagnostic purposes? Or are

they arbitrarily and subjectively defined by each evaluator?

This Guidance Note will use the terms ‘non-resident parent’ and ‘resident parent’ when

referring to alienating behaviours. While it is accepted that either parent can engage in

alienating behaviours, for the sake of brevity this Note will assume the allegations are made

against a resident parent. The court must however remain mindful that examples of a non-

resident parent engaging in alienating behaviour can and do occur.

Citation to the research support is requested for the statements about prevalence and

frequency of the “alienating behaviours”

displayed by each party in the family courts.

Or are these

prevalence estimates for “alienating behaviours”

merely statements from

the imagination of the authors?

Standards of Professional Practice

There is no such thing as “parental alienation.” There is no such thing as “alienating

behaviours.” These are made-up

constructs without scientific or research support or

agreed-upon definition.

“Alienating behaviours” = unicorns: both are mythical things.

The use of the construct of “parental alienation” in a professional capacity is

SOU, Alm.del - 2023-24 - Bilag 26: Henvendelse af 15/10-23 fra coach Kenneth Nielsen, Stenløse om familieret

substantially beneath professional standards of practice in clinical psychology, it

degrades the quality of mental health services received by children and the courts,

and it is in violation of Standard 2.04 Bases for Scientific and Professional Judgments

of the APA code.

2.04 Bases for Scientific and Professional Judgments

Psychologists' work is based upon established scientific and professional

knowledge of the discipline.

the authors wish to propose a new form of pathology called “parental alienation” –

“alienation” – “alienating behaviors” –

it still remains incumbent upon them to first

apply the established scientific and professional knowledge. If the authors still need

to create a new form of pathology after the application of established professional

knowledge, then they can make their new pathology proposal.

However, to make up new forms of pathology (“parental alienation” – “alienation” –

“alienating behaviours”)

and NOT apply the established knowledge from

professional psychology would seemingly represent negligent professional practice.

Google negligence:

failure to take proper care in doing something.

Apply the established scientific and professional knowledge first.

The established scientific and professional knowledge of the discipline required for

application with court-involved custody conflict is:

•

Attachment pathology - Bowlby & others

Family systems therapy - Minuchin & others

Child abuse and complex trauma

–

van der Kolk & others

Personality disorder pathology - Beck & others

Child Development

–

Tronick & others

Psychological control

–

Barber & others

DSM-5 diagnostic system - American Psychiatric Association

Terminology for Parents

–

Family Systems

In family systems therapy (Minuchin, Bowen, Haley, Madanes, Satir, and others), the

traditional terms used to designate the parents

are the “allied” parent

who has

formed a

cross-generational

coalition

with the child against

Allied parent

the “targeted” parent

(i.e., the

allied parent is in an alliance

with the child against the other

parent, who is the target for the

generated hostility of the child.

This family system pathology is

depicted in a Structural family

diagram from Minuchin and

Nichols (1993).

Targeted parent

This Guidance Note will be of assistance to the court at whatever stage of the proceedings

the issue of alienating behaviour is to be considered.

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Standards of Practice

There is no such thing as “parental alienation.” There is no such thing as “alienating

behaviours.” These are made-up

constructs without scientific or research support or

agreed-upon definition.

The proposed “alienating behaviours” are without a professional-level

definition that

would allow for their diagnostic identification, they are arbitrary and subjective in

their development and in their practical application because they do not exist in actual

clinical psychology.

“Alienating behaviours” =

unicorns: both are mythical things.

The proposed “alienating behaviours”

are without research support and are

constructions of the imagination of the authors.

Citations are requested to the

research support for the proposal of “alienation” or the

offered “alienating behaviours.”

The Burden of Proof

Whilst alienating behaviour can be subtle and insidious, a parent alleging alienating

behaviours must discharge the burden of establishing that such behaviour has occurred.

This will be nearly impossible to prove since the proposed “alienation”

(the induction of

a shared delusion) occurs out of view of other people. This Guidance will allow Child

Psychological Abuse to continue un-diagnosed and un-treated.

Eyewitness evidence is not necessarily needed for a murder if there is fingerprint

evidence on the murder weapon found at the crime scene, DNA evidence indicting the

perpetrator, evidence of motive and opportunity, and large amounts of circumstantial

evidence.

A child rejecting a parent is an attachment pathology that requires a diagnosis as to its

cause. Diagnoses aren’t proven, diagnoses are given based on a pattern-match

of the

symptoms to the diagnostic criteria. Diagnosis of pathology is the domain of doctors and

the healthcare system.

Attachment pathology is a healthcare issue for the doctors to diagnose and treat. In

healthcare, diagnosis always guides treatment. The treatment for cancer is different than

the treatment for diabetes. The treatment for child abuse by the targeted parent is

different than the treatment of child psychological abuse by the allied parent.

Is the diagnosis child abuse by the targeted parent, or is the diagnosis child psychological

abuse by the allied parent?

Diagnosis of Pathology

Diagnosis is a pattern-match of the symptoms to the diagnostic criteria.

The National Academy of Sciences describes the diagnostic process in a paper on

Improving Diagnosis in Healthcare

(2015),

Improving Diagnosis in Healthcare

(2015). National Academies of Sciences, Engineering,

and Medicine; Institute of Medicine; Board on Health Care Services; Committee on

Diagnostic Error in Health Care; Erin P. Balogh, Bryan T. Miller, and John R. Ball, Editors

SOU, Alm.del - 2023-24 - Bilag 26: Henvendelse af 15/10-23 fra coach Kenneth Nielsen, Stenløse om familieret

From Improving Diagnosis:

“The working diagnosis may be either

a list of

potential diagnoses (a differential diagnosis) or a single potential diagnosis.

Typically, clinicians will consider more than one diagnostic hypothesis or

possibility as an explanation of the patient’s symptoms and will refine this list as

further

information is obtained in the diagnostic process.” (National Academy of

Sciences, 2015)

From Improving Diagnosis:

“As the diagnostic process proceeds, a fairly broad

list of potential diagnoses may be narrowed into fewer potential options, a

process referred to as diagnostic modification and refinement (Kassirer et al.,

2010). As the list becomes narrowed to one or two possibilities, diagnostic

refinement of the working diagnosis becomes diagnostic verification, in which the

lead diagnosis is checked for its adequacy in explaining the signs and symptoms,

its coherency with the patient’s context (physiology, risk factors), and whether a

single diagnosis is appropriate.” (National Academy of Sciences, 2015)

From Improving Diagnosis:

“Throughout the diagnostic

process, there is an

ongoing assessment of whether sufficient information has been collected. If the

diagnostic team members are not satisfied that the necessary information has

been collected to explain the patient’s health problem, or that the information

available is not consistent with a diagnosis, then the process of information

gathering, information integration and interpretation, and developing a working

diagnosis continues.” (National Academy of Sciences, 2015)

From Improving Diagnosis:

“In

addition, the provision of treatment can also

inform and refine a working diagnosis, which is indicated by the feedback loop

from treatment into the information-gathering step of the diagnostic process. This

also illustrates the need for clinicians to diagnose health problems that may arise

during treatment.” (National Academy of Sciences, 2015)

The only cause of severe attachment pathology is child abuse by one parent or the other.

All mental health professionals have duty to protect obligations. In all cases of severe

attachment pathology surrounding court-involved custody conflict, a proper risk

assessment for child abuse needs to be conducted to the appropriate differential

diagnoses for each parent.

•

Targeted Parent Abusive:

Either the targeted parent is abusing the child in

some way, thereby creating the child’s attachment pathology toward that

parent (a 2-person attribution of causality),

Allied Parent Abusive:

Or the allied parent is psychologically abusing the

child by creating a shared (induced) persecutory delusion and false (factitious)

attachment pathology in the child for secondary gain to the allied parent of

manipulating the court’s decisions regarding

child custody, and to meet the

pathological parent’s own emotional and psychological needs (a 3-person

triangle attribution of causality).

•

The assessment for a possible delusional thought disorder is a Mental Status Exam of

thought and perception as described by Martin (1990),

From Martin:

“Thought and Perception.

The inability to process information

correctly is part of the definition of psychotic thinking. How the patient perceives

and responds to stimuli is therefore a critical psychiatric assessment. Does the

https://www.nap.edu/catalog/21794/improving-diagnosis-in-health-

care?fbclid=IwAR2ht8JZQGHLWElqlBjwqPqx6qtmgc9JYpI8mSRUJaLZFdzljAubk2MkOAI

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patient harbor realistic concerns, or are these concerns elevated to the level of

irrational fear? Is the patient responding in exaggerated fashion to actual events,

or is there no discernible basis in reality for the patient's beliefs or behavior?”

Professional Duty to Protect

Professional duty to protect obligations are legally obligating duties placed on the

involved mental health professionals. Failing to conduct a proper risk assessment when a

dangerous pathology is encountered (suicide, homicide, abuse) would represent a

negligent failure in professional duty to protect obligations.

Google negligence:

failure to take proper care in doing something.

Cornell Law School Definition of Negligence:

‘Negligence is the failure to

behave with the level of care that a reasonable person would have exercised

under the same circumstances. Either a person’s actions or omissions of actions

can be found negligent. The omission of actions is considered negligent only when

the person had a duty to act (e.g., a duty to help someone because of one’s own

previous conduct).

The negligent

failure would be in the mental health professional’s duty to protect the

child from child abuse by failing to use reasonable care in their assessment.

Was a proper assessment conducted for a possible persecutory thought disorder

(shared) in the family? Was a proper risk assessment for child abuse conducted to the

appropriate differential diagnoses for each parent?

Risk Assessment

There are four diagnoses of child abuse in the Child Maltreatment section of the DSM-5,

each of these child abuse diagnoses warrants a proper risk assessment; Child Physical

Abuse (V995.54), Child Sexual Abuse (V995.53), Child Neglect (V995.52), Child

Psychological Abuse (V995.51). All of these child abuse diagnoses are equally severe in

the damage they cause to the child, they differ only in the type of damage done, not in the

severity of damage done to the child. Psychological child abuse destroys the child from

the inside out.

Whenever there is concern for possible child abuse from anyone for any reason, a proper

risk assessment for child abuse needs to be conducted to the appropriate concerns.

Participation in Child Abuse & Spousal Abuse

One of the prominent professional dangers of misdiagnosing a shared persecutory

delusion is that if the mental health professional and/or the Court misdiagnoses the

pathology of a shared persecutory delusion and believes the shared delusion as if it was

true, then the mental health professional and/or the Court become part of the shared

delusion, they become part of the pathology. When that pathology is the psychological

abuse of the child by an allied pathological parent, then the mental health professional

and/or the Court become participants

in the parent’s psychological abuse of the child by

validating to the child that the child’s false (delusional) beliefs are true when they are, in

fact, symptoms of an induced persecutory delusion.

When that pathology is also the psychological spousal abuse of the targeted parent by the

allied parent

using the child as the weapon

, then the mental health professional and/or the

Court become participants in the spousal psychological abuse of the targeted parent

because of their misdiagnosis of the pathology in the family.

https://www.law.cornell.edu/wex/negligence

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When possible child abuse is a considered diagnosis, our diagnosis must be accurate

100% of the time. Misdiagnosing child abuse is too devastating for the child. The decision

of the Court will have a life-changing impact on the child. Misdiagnosing child abuse will

destroy the child’s life.

When child abuse is a considered diagnosis, as it is in all cases of severe attachment

pathology displayed by a child, the Court (the legal system) should refer the question to

the doctors (the healthcare system) for a diagnosis, and the doctors need to do whatever

is required to ensure that the diagnosis they return is accurate.

There are ways for doctors to do that once the doctors set themselves the task to do that.

However, the continued use of made-up

new pathologies like “parental alienation”

degrades the quality of mental health services provided to children and the Court.

Apply knowledge to solve pathology.

The established scientific and professional knowledge of the discipline required for

application with court-involved custody conflict are:

•

Personality disorder pathology - Beck & others

Child Development

–

Tronick & others

Psychological control

–

Barber & others

DSM-5 diagnostic system - American Psychiatric Association

Attachment pathology - Bowlby & others

Family systems therapy - Minuchin & others

Child abuse and complex trauma

–

van der Kolk & others



yes



Differential Diagnosis for Targeted Parent:

Targeted Parent Abusive:

Is the targeted parent abusing the

child in some way, thereby creating the child’s attachment

pathology toward that parent?

If yes, identify the DSM-5 Child Abuse diagnosis involved:

•

Child Physical Abuse (V995.54)

Child Sexual Abuse (V995.53)

Child Neglect (V995.52)

Child Psychological Abuse (V995.51)



yes



yes



yes



yes



yes



Differential Diagnosis

–

Allied Parent:

Allied Parent Abusive:

Is the allied parent psychologically

abusing the child (DSM-5 V995.51 Child Psychological Abuse) by

creating a shared (induced) persecutory delusion and false

(factitious) attachment pathology in the child for the secondary

gain of manipulating the court’s

decisions regarding child

custody, and to meet the allied parent’s own emotional and

psychological needs?

•

Persecutory Delusion (shared):

Does the allied parent have

a persecutory delusion surrounding the other parent, and

does the child share this persecutory belief (a fixed and false

belief that the child is being malevolently treated in some



yes



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way)?

•

Factitious Attachment Pathology:

Does the child have a

false (factitious) attachment pathology imposed on the child

by the pathogenic parenting of the allied parent (DSM-5

300.19 Factitious Disorder Imposed on Another)?

Spousal Psychological Abuse:

Is the allied parent using the

child’s

induced pathology

as a weapon of spousal emotional

and psychological abuse of the targeted parent (DSM-5

V995.82 Spouse or Partner Abuse, Psychological)?



yes



•



yes



Evidence of alienating behaviours

Where alienating behaviours are alleged, the court should require those making the

allegation to identify the evidence upon which they rely.

Diagnoses should be made by qualified and competent mental health professionals

who are trained in the diagnostic assessment of 1) attachment pathology, 2) child

abuse and trauma, 3) delusional thought disorders, 4) Factitious Disorder Imposed on

Another, and 5) family systems pathology.

Failure to possess the required professional knowledge necessary for competence

would represent practice beyond the boundaries of competence in violation of

Standard 2.01 Boundaries of Competence of the APA ethics code.

APA Standard 2.01 Boundaries of Competence

(a) Psychologists provide services, teach, and conduct research with populations

and in areas only within the boundaries of their competence, based on their

education, training, supervised experience, consultation, study, or professional

experience.

Legal System

–

Healthcare System

The Court should not be asked to diagnose subtle and sophisticated psychopathology

based on evidence presented at trial.

With due respect to the Court’s legitimate authority in custody matters, neither is the

Court competent by its education and training for the diagnosis of complex family

psychopathology, i.e., a complex interaction of attachment pathology, delusional

thought disorders, parental personality pathology, and factitious disorders imposed on

the child. Courts should decide on matters of the law’s

application. Doctors should

decide on matters of diagnosis of psychopathology.

The legal system is an adversarial system. The diagnosis returned from professional

psychology will likely be disputed by one party or the other. The appellate system in

healthcare for a disputed diagnosis is second opinion. In all cases of court-involved

attachment pathology, a second (or even third) opinion consultation should be sought

by the involved mental health professionals at the time of the initial diagnostic

assessment.

The National Academies of Science, Engineering, and Medicine recommend second

opinion consultation to improve diagnoses in Health Care,

From Improving Diagnosis in Health Care: “Clinicians

may refer to or consult

with other clinicians (formally or informally) to seek additional expertise about a

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patient’s health problem. The consult may help to confirm or reject the working

diagnosis or may provide information on potential treatment options. If a

patient’s health problem is outside a clinician’s area

of expertise, he or she can

refer the patient to a clinician who holds more suitable expertise. Clinicians can

also recommend that the patient seek a second opinion from another clinician to

verify their impressions of an uncertain diagnosis or if they believe that this

would be helpful to the patient.”

Developing a standardized diagnostic assessment and treatment protocol would also

help considerably in reducing (eliminating) the fighting among professionals

surrounding the child’s diagnosis and treatment.

For decision-makers surrounding the family courts, I recommend that a pilot program

for the family courts be initiated with university involvement for evaluation research, to

develop a standardized and agreed upon diagnostic assessment and treatment protocol

of the highest professional quality, reliability, and validity for the differential diagnoses of

concern.

Differential Diagnosis for Targeted Parent:

Targeted Parent Abusive:

Is the targeted parent abusing the

child in some way, thereby creating the child’s attachment

pathology toward that parent?

If yes, identify the DSM-5 Child Abuse diagnosis involved:

•

Child Physical Abuse (V995.54)

Child Sexual Abuse (V995.53)

Child Neglect (V995.52)

Child Psychological Abuse (V995.51)



yes



yes



yes



yes



yes



yes



Differential Diagnosis

–

Allied Parent:

Allied Parent Abusive:

Is the allied parent psychologically

abusing the child (DSM-5 V995.51 Child Psychological Abuse) by

creating a shared (induced) persecutory delusion and false

(factitious) attachment pathology in the child for the secondary

gain of manipulating the court’s

decisions regarding child

custody, and to meet the allied parent’s own emotional and

psychological needs?

•

Persecutory Delusion (shared):

Does the allied parent have

a persecutory delusion surrounding the other parent, and

does the child share this persecutory belief (a fixed and false

belief that the child is being malevolently treated in some

way)?

Factitious Attachment Pathology:

Does the child have a

false (factitious) attachment pathology imposed on the child



yes



•



yes



National Academies of Sciences, Engineering, and Medicine; (2015).

Improving

Diagnosis in Healthcare

(2015). Institute of Medicine; Board on Health Care Services;

Committee on Diagnostic Error in Health Care; Erin P. Balogh, Bryan T. Miller, and John R.

Ball, Editors

https://www.nap.edu/catalog/21794/improving-diagnosis-in-health-

care?fbclid=IwAR2ht8JZQGHLWElqlBjwqPqx6qtmgc9JYpI8mSRUJaLZFdzljAubk2MkOAI

SOU, Alm.del - 2023-24 - Bilag 26: Henvendelse af 15/10-23 fra coach Kenneth Nielsen, Stenløse om familieret

by the pathogenic parenting of the allied parent (DSM-5

300.19 Factitious Disorder Imposed on Another)?

•

Spousal Psychological Abuse:

Is the allied parent using the

child’s

induced pathology

as a weapon of spousal emotional

and psychological abuse of the targeted parent (DSM-5

V995.82 Spouse or Partner Abuse, Psychological)?



yes



Alienation involves an act or acts by a parent, that must be evidenced, resulting in the

psychological manipulation of the child and the

child’s

unjustified rejection of the other

parent. Such behaviours must be evidenced just as other acts of abuse are evidenced.

The evidence needed for conviction of murder is not necessarily having an eyewitness to

the murder.

The diagnosis of child

physical abuse is often made based on the child’s

physical

symptoms of bruising and broken bones without a credible explanation. Psychological

child abuse will produce specific child symptoms.

Diagnosis in Healthcare

Diagnosis is made by doctors in the healthcare system based on a pattern-match of the

symptoms to the diagnostic criteria. When child abuse is a concern surrounding court-

involved custody conflict, two systems are involved, the legal system and the healthcare

system.

The family pathology involved is complex. Identifying the problem (diagnosing the

pathology) in the family is the role of the doctors in the healthcare system. A child

rejecting

a parent is an attachment pathology. What is the cause of the child’s

attachment pathology? This is a diagnostic question.

The evidence of psychological child abuse is found

in the child’s symptoms. Does the

child have a shared persecutory delusion with the allied parent and a false (factitious)

attachment pathology? There is only one possible cause of a child having a shared

persecutory delusion and factitious attachment pathology, pathogenic parenting by the

allied parent.

The targeted parent cannot produce a delusional thought disorder or factious

attachment pathology toward themselves. There is no pathway for that to happen. The

only explanation for a delusional thought disorder and factitious attachment pathology

displayed by the child is a shared (induced) persecutory delusion and a Factitious

Disorder Imposed on Another for secondary gain to the pathological parent.

There are multiple ways that the pathology in the family can be diagnostically

determined, 1) by a direct Mental Status Exam of thought and perception conducted

with the allied parent and child, 2) from a Response-to-Intervention (RTI) trial with

treatment designed to resolve the provisional diagnosis, 3) through an Applied

Behavioral Analysis that identifies the cue structure for the child’s

resistant behavior.

The National Academies of Science, Engineering, and Medicine describe the diagnostic

process in health care,

From Improving Diagnosis in Healthcare:

“The

working diagnosis may be

either a list of potential diagnoses (a differential diagnosis) or a single potential

diagnosis. Typically, clinicians will consider more than one diagnostic hypothesis

or possibility as an explanation of the patient’s symptoms

and will refine this list

as further information is obtained in the diagnostic process.”

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From Improving Diagnosis in Healthcare:

“As

the diagnostic process proceeds,

a fairly broad list of potential diagnoses may be narrowed into fewer potential

options, a process referred to as diagnostic modification and refinement

(Kassirer et al., 2010). As the list becomes narrowed to one or two possibilities,

diagnostic refinement of the working diagnosis becomes diagnostic verification,

in which the lead diagnosis is checked for its adequacy in explaining the signs

and symptoms, its coherency with the patient’s context (physiology, risk factors),

and whether a single diagnosis is appropriate.”

From Improving Diagnosis in Healthcare:

“Throughout

the diagnostic process,

there is an ongoing assessment of whether sufficient information has been

collected. If the diagnostic team members are not satisfied that the necessary

information has been collected to explain the patient’s health problem or that the

information available is not consistent with a diagnosis, then the process of

information gathering, information integration and interpretation, and

developing a working diagnosis continues.”

From Improving Diagnosis in Healthcare:

“When

the diagnostic team

members judge that they have arrived at an accurate and timely explanation of

the patient’s health problem, they communicate that explanation to the patient as

the diagnosis. It is important to note that clinicians do not need to obtain

diagnostic certainty prior to initiating treatment; the goal of information

gathering in the diagnostic process is to reduce diagnostic uncertainty enough to

make optimal decisions for subsequent care (Kassirer, 1989; see section on

diagnostic uncertainty).

From Improving Diagnosis in Healthcare:

“In

addition, the provision of

treatment can also inform and refine a working diagnosis, which is indicated by

the feedback loop from treatment into the information-gathering step of the

diagnostic process. This also illustrates the need for clinicians to diagnose health

problems that may arise during treatment.”

Routine second and even third opinion (telehealth) consultation can also improve the

accuracy of diagnosis.

From Improving Diagnosis in Health Care:

“Clinicians

may refer to or consult

with other clinicians (formally or informally) to seek additional expertise about a

patient’s health problem. The consult may help to confirm or reject the working

diagnosis or may provide information on potential treatment options. If a

patient’s health problem is outside a clinician’s area of expertise, he or she can

refer the patient to a clinician who holds more suitable expertise. Clinicians can

also recommend that the patient seek a second opinion from another clinician to

verify their impressions of an uncertain diagnosis or if they believe that this

would be helpful to the patient.”

When possible child abuse is a considered diagnosis, as it is in all cases of severe

attachment pathology, the returned diagnosis must be accurate 100% of the time. The

consequences of misdiagnosing child abuse are too devastating for the child.

Participation in Child Abuse & Spousal Abuse

One of the prominent professional dangers of misdiagnosing a shared persecutory

delusion is that if the mental health professional and/or the Court misdiagnoses the

pathology of a shared persecutory delusion and believes the shared delusion as if it was

true, then the mental health professional and/or the Court become part of the shared

delusion, they become part of the pathology. When that pathology is the psychological

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abuse of the child by an allied pathological parent, then the mental health professional

and/or the Court become participants

in the parent’s psychological abuse of the child by

validating to the child that the child’s false (delusional) beliefs are true when they are, in

fact, symptoms of an induced persecutory delusion.

When that pathology is also the psychological spousal abuse of the targeted parent by

the allied parent

using the child as the weapon

, then the mental health professional and/or

the Court become participants in the spousal psychological abuse of the targeted parent

because of their misdiagnosis of the pathology in the family.

When possible child abuse is a consideration, it is vital to the Court’s

decision-making

that the returned diagnosis from healthcare be accurate 100% of the time. There are

two parties in litigation, both have their concerns. In all cases of severe attachment

pathology displayed by the child surrounding court-involved custody conflict, a proper

risk assessment for child abuse needs to be conducted to the appropriate differential

diagnoses for each parent.

Differential Diagnosis for Targeted Parent:

Targeted Parent Abusive:

Is the targeted parent abusing the

child in some way, thereby creating the child’s attachment

pathology toward that parent?

If yes, identify the DSM-5 Child Abuse diagnosis involved:

•

Child Physical Abuse (V995.54)

Child Sexual Abuse (V995.53)

Child Neglect (V995.52)

Child Psychological Abuse (V995.51)



yes



yes



yes



yes



yes



yes



Differential Diagnosis

–

Allied Parent:

Allied Parent Abusive:

Is the allied parent psychologically

abusing the child (DSM-5 V995.51 Child Psychological Abuse) by

creating a shared (induced) persecutory delusion and false

(factitious) attachment pathology in the child for the secondary

gain of manipulating the court’s

decisions regarding child

custody, and to meet the allied parent’s own emotional and

psychological needs?

•

Persecutory Delusion (shared):

Does the allied parent

have a persecutory delusion surrounding the other parent,

and does the child share this persecutory belief (a fixed and

false belief that the child is being malevolently treated in

some way)?

Factitious Attachment Pathology:

Does the child have a

false (factitious) attachment pathology imposed on the child

by the pathogenic parenting of the allied parent (DSM-5

300.19 Factitious Disorder Imposed on Another)?

Spousal Psychological Abuse:

Is the allied parent using the

child’s

induced pathology

as a weapon of spousal emotional

and psychological abuse of the targeted parent (DSM-5

V995.82 Spouse or Partner Abuse, Psychological)?



yes



•



yes



•



yes



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The behaviour of a child is not evidence of the behaviour of an adult, so the behaviour of a

child should not be used to evidence adult behaviours.

That is an incorrect statement.

The child’s symptoms bear the imprint of their cause.

The diagnosis of concern is a shared (induced) persecutory delusion created by the

pathogenic parenting (psychological control

–

Barber) of the child by a pathological

(narcissistic-borderline-dark personality) parent. The pathology of the child is being

created (induced) by the parent’s distorted parenting behavior.

The

child’s symptomatic behavior IS

evidence of the pathogenic parenting that created

that specific pattern-set of symptoms.

•

The diagnosis of concern is a shared (induced) persecutory delusion.

If a persecutory delusion is present in the child and is also shared by the

allied parent, there is only one possible cause

–

the pathogenic parenting of

the allied parent is creating a shared (induced) persecutory delusion.

•

The diagnosis of concern is a Factious Disorder (a false attachment

pathology) Imposed on Another

–

DSM-5 300.19.

If a Factitious Disorder Imposed on Another (a factious attachment or

anxiety pathology) is present in the child, there is only one possible cause

–

the pathogenic parenting of the allied parent who is creating a Factitious

Disorder Imposed on Another (DSM-5 300.19).

Either diagnosis, a shared (induced) persecutory delusion or FDIA, separately or

together, represents a DSM-5 diagnosis of V995.51 Child Psychological Abuse.

The act of psychological child abuse will not be observed directly, it is done in private

and in a variety of manipulative ways. The pathological parent (narcissistic-borderline-

dark personality) is highly manipulative, and the hidden parental interactions with the

child cannot ever be adequately documented except by their consequence of false

symptoms.

From Soenens and Vansteenkiste:

“Psychological

control can be expressed

through a variety of parental tactics, including (a) guilt-induction, which refers

to the use of guilt inducing strategies to pressure children to comply with a

parental request; (b) contingent love or love withdrawal, where parents make

their attention, interest, care, and love contingent upon the children’s

attainment of parental standards; (c) instilling anxiety, which refers to the

induction of anxiety to make children comply with parental requests; and (d)

invalidation of the child’s

perspective, which pertains to parental constraining

of the child’s spontaneous expression of thoughts and feelings.” (Soenens

Vansteenkiste, 2010, p. 75)

This Guidance, if followed, will prevent the diagnosis of Child Psychological Abuse by a

pathological parent who is creating an induced persecutory delusion and factitious

attachment pathology in the child for the secondary gain to the pathological parent of

manipulating the court’s decisions regarding

child custody, and to meet the

pathological parent’s own emotional and psychological needs.

Diagnosis Guides Treatment

The only thing that causes severe attachment pathology (i.e., a child rejecting a parent)

is child abuse by one parent or the other.

The child’s attachment pathology by itself

indicts the parenting of one parent or the other as being abusive.

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Less severely problematic parenting creates a different pattern of symptoms (insecure

attachment in various patterns) but does not create a complete severing of the parent-

child bond. The only thing that causes a complete severing of the parent-child

attachment bond is abusive parenting by one parent or the other. The diagnostic

question to be answered is, which parent is abusing the child?

Saying that

the child’s

symptoms are not proof of the parental cause for that behavior

is not accurate.

•

Targeted Parent Abusive:

Either the targeted parent is abusing the child in

some way, thereby creating the child’s attachment pathology toward that

parent (a 2-person attribution of causality), Document what the abuse is, put

it on a treatment plan and fix it. Then restore a healthy attachment bond.

Allied Parent Abusive:

Or the allied parent is psychologically abusing the

child by creating a shared (induced) persecutory delusion and false

(factitious) attachment pathology in the child for secondary gain to the allied

parent of manipulating

the court’s decisions regarding child custody, and to

meet the pathological parent’s own emotional and psychological needs (a 3-

person triangle attribution of causality). Diagnose the Child Psychological

Abuse, put it on a treatment plan and fix it. Then restore a healthy

attachment bond.

•

Breach and Repair

We always restore a healthy attachment bond.

Recommended Reading:

Tronick and Gold (2020)

: The Power of Discord

From Tronick & Gold:

“We prefer to capture the range of a child's experience

with a different set of terms:

the good, the bad, and the ugly. Good stress

is what

happens in typical everyday interactions, what we have seen in our videotaped

interactions as moment-to-moment mismatch and repair.

Bad stress

is the

stress represented in the still face experiment by the caregiver’s sudden

inexplicable absence…

Ugly stress

occurs when the infant has missed out on the

opportunity for repeated experiences of repair, as in situations of emotional

neglect, and’ thus cannot handle any sort of bigger stressful event.” (Tronick &

Gold, 2020, p. 134)

From Tronick & Gold:

“Children growing up with insufficient experiences of

mismatch and repair are at a disadvantage for developing coping mechanisms

to regulate their physiological behavioral and emotional reactions. We use the

term

regulatory scaffolding

to describe the developmental process by which

resilience grows out of the interactive repair of the micro-stresses that happen

during short lived, rapidly occurring mismatches. The

caregiver provides “good-

enough” scaffolding to give the child the experience of overcoming a challenge,

ensuring there is neither too long a period to repair nor too close a match with

no room for repair.” (Tronick &

Gold, 2020, p. 135)

The worst possible thing we can do is leave a breached attachment bond un-repaired

–

the Ugly of Tronick and Gold. In healthcare, diagnosis guides treatment. The treatment

for abusive-range parenting by the targeted parent is different from the treatment for

Tronick, E. & Gold, C. (2020).

The Power of Discord: Why the Ups and Downs of

Relationships Are the Secret to Building Intimacy, Resilience, and Trust.

New York : Little,

Brown Spark, 2020.

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abusive-range parenting by the allied parent.

Consultation in Healthcare

The doctors, the clinical psychologists in the healthcare system, should diagnose what

the pathology in the family is. The diagnostic assessment should be to the differential

diagnosis appropriate for each parent. If the diagnosis is disputed, which it likely will

be, then obtain a second opinion on the diagnosis from another qualified psychologist,

or even a third opinion.

Since the diagnosis is likely to be disputed, rather than consecutively seeking second

(and third) opinions which delays decision-making and creates professional disputes,

obtaining the second (and third) opinion should be sought concurrently with the initial

diagnosis. Doctor-to-doctor professional consultation on complex pathology occurs all

the time in healthcare. Second opinion consultation should occur routinely in the

assessment and diagnosis of attachment pathology in the family courts.

From Improving Diagnosis in Health Care: “Clinicians

may refer to or consult

with other clinicians (formally or informally) to seek additional expertise about

a patient’s health problem. The consult

may help to confirm or reject the

working diagnosis or may provide information on potential treatment options.

If a patient’s health problem is outside a clinician’s area of expertise, he or she

can refer the patient to a clinician who holds more suitable expertise. Clinicians

can also recommend that the patient seek a second opinion from another

clinician to verify their impressions of an uncertain diagnosis or if they believe

that this would be helpful to the patient.”

When possible child abuse is a considered diagnosis, our diagnosis must be accurate

100% of the time. Misdiagnosing child abuse is too devastating for the child. The goal is

to protect all children from all forms of child abuse all of the time.

That can be done, once that becomes the goal.

This Guidance is problematic in development and will be problematic in

implementation. Following the recommendations of this Guidance will lead to un-

diagnosed and un-treated Child Psychological Abuse in the family courts by

pathological parents (narcissistic-borderline-dark personality parents).

The only thing that causes severe attachment pathology is child abuse by one parent or

the other. The diagnostic question to be answered is which parent is abusing the child?

In all cases of severe attachment pathology displayed by the child surrounding court-

involved custody conflict, a proper risk assessment for child abuse needs to be

conducted to the appropriate differential diagnoses for each parent.

•

Targeted Parent Abusive:

Is the targeted parent abusing the child in some

way, thereby creating the child’s attachment pathology toward that parent

(a 2-person attribution of causality)?

Allied Parent Abusive:

Or is the allied parent psychologically abusing the

•

National Academies of Sciences, Engineering, and Medicine; (2015).

Improving

Diagnosis in Healthcare

(2015). Institute of Medicine; Board on Health Care Services;

Committee on Diagnostic Error in Health Care; Erin P. Balogh, Bryan T. Miller, and John R.

Ball, Editors

https://www.nap.edu/catalog/21794/improving-diagnosis-in-health-

care?fbclid=IwAR2ht8JZQGHLWElqlBjwqPqx6qtmgc9JYpI8mSRUJaLZFdzljAubk2MkOAI

SOU, Alm.del - 2023-24 - Bilag 26: Henvendelse af 15/10-23 fra coach Kenneth Nielsen, Stenløse om familieret

child by creating a shared (induced) persecutory delusion and false

(factitious) attachment pathology in the child for secondary gain to the allied

parent of manipulating the court’s decisions regarding child custody, and to

meet the pathological parent’s own emotional and psychological

needs (a 3-

person triangle attribution of causality).

The diagnostic assessment for a delusional thought disorder is a Mental Status Exam of

thought and perception as described by Martin (1990),

From Martin:

“Thought and Perception.

The inability to process information

correctly is part of the definition of psychotic thinking. How the patient

perceives and responds to stimuli is therefore a critical psychiatric assessment.

Does the patient harbor realistic concerns, or are these concerns elevated to the

level of irrational fear? Is the patient responding in exaggerated fashion to

actual events, or is there no discernible basis in reality for the patient's beliefs

or behavior?”

From Martin:

“Of

all portions of the mental status examination, the evaluation

of a potential thought disorder is one of the most difficult and requires

considerable experience. The primary-care physician will frequently desire

formal psychiatric consultation in patients exhibiting

such disorders.”

A rating for the delusional thought disorder can be made using Item 11 Unusual

Thought Content of the Brief Psychiatric Rating Scale (BPRS),

“one of the oldest, most

widely used scales to measure psychotic symptoms” (Wikipedia:

BPRS).

All potential risk factors, such as domestic abuse, must be adequately and safely considered

when looking at the nexus between the behaviour of a parent and a child.

The authors of this Guidance appear to have an agenda related to mixing issues of child

abuse with issues of alleged spousal abuse. There is a bias in the development of this

Guidance in favor of the pathological parent.

This Guidance should not be followed.

Spousal Abuse Concerns

The spousal abuse (“domestic abuse”) of concern

for the attachment pathology that

develops surrounding divorce is the potential emotional and psychological abuse of the

targeted parent by the allied parent using the child and the child’s induced pathology

the weapon.

•

Spousal Psychological Abuse:

Is the allied parent using the

child’s induced pathology as a weapon of spousal emotional

and psychological abuse of the targeted parent (DSM-5

V995.82 Spouse or Partner Abuse, Psychological)?



yes



Martin DC. The Mental Status Examination. In: Walker HK, Hall WD, Hurst JW, editors.

Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston:

Butterworths; 1990. Chapter 207. Available from:

https://www.ncbi.nlm.nih.gov/books/NBK320/

Psychiatric Rating Scale (BPRS). Available from:

https://www.researchgate.net/publication/284654397_Brief_Psychiatric_Rating_Scale_E

xpanded_version_40_Scales_anchor_points_and_administration_manual

Brief

SOU, Alm.del - 2023-24 - Bilag 26: Henvendelse af 15/10-23 fra coach Kenneth Nielsen, Stenløse om familieret