When we assess a case of a child’s rejection of a parent we begin by looking at the outward presentation of the child.  Is the child refusing to see the parent partially or completely, is the child rejecting the parent vehemently or inconsistently, what is the narrative used by the child to explain their rejection of a parent and how does that echo the narrative used by the parent to whom the child is currently aligned?  As we dig deeper, alerted to the existence of psychological splitting by the child’s display of the signs of alienation, we encounter along the way those behavioural clues which tell us that a case of a child’s rejection may be a pure case of alienation in which the child has entered into a shared delusional mindset with the parent they are aligned to.  In such circumstances, which are in my experience, far less common than some would lead you to believe, the child will behave in a particular way.  Understanding how a child in shared psychotic delusion (sometimes called folie a deux ) lies is part of our differentiation of a case of parental alienation.  When shared psychotic delusion is seen, this is the situation where immediate removal from the parent with whom the delusion is shared is the answer.

I have a particular interest in case of shared psychotic delusional disorder, because I have worked with a number of children who have experienced it and I have seen first hand the manner in which these children lie and I have begun through this experience to understand why they lie.  I have also begun recently, through my research,  to more deeply understand the line over which the child crosses when they no longer know they are lying.  A child in this state of mind becomes very ‘infectious’ because they become very convincing, even when their stories are monstrously and manifestly untrue.  This is because, in my view, the lies they tell interact with the unconscious beliefs of those around them, causing those who hear the tales being told to suspend their rational faculties and along with that their disbelief.

I first fully understood shared delusional disorder back in 2009 in a case I worked in which is documented in Thomas Moore’s story of his struggle with the Family Courts ‘Please Let Me See My Son.’  In this case, the boy in question shared many beliefs with his mother about the damage his father had done to him.  On working to raise awareness of the dysfunctional presentation in the boy to social services, I understood how this phenomenon influences and causes others to suspend their ability to critically analyse facts, so much so that the courts had failed over many years to properly recognise the harm being done.

Since then I have worked with many children who have displayed shared delusional disorder and those who have, in my view, teetered on the edge of it.  I have also worked with many alienated children who lie and I have come to understand why they lie even when they are not in a shared delusion with a parent.

It never ceases to amaze me, how many parents can conveniently blind themselves to the reality of what is happening to their children.  Or how many become conveniently deaf when it comes to hearing the underlying meaning of what a child is saying.  Neither does it ever cease to amaze me how many parents enter completely and fully into the belief that the child feels EXACTLY the same as they do about the parent who is being put at distance.  Or how many bends and twists a parent will make to ensure that they are able to support their child’s entry into the psychologically split state of mind where one parent is designated an angel and the other a devil (no longer in disguise).

It is as if, in so many of these parents, a temporary delusional state of mind descends.  However, before the chorus of voices telling me it is always delusional state of mind pipes up, this presentation is seen in parents who turn out to have personality profiles as normal as mine or yours as well as those with diagnosed personality disorder and so it is simply impossible to make such blanket assumptions.

I cannot ever really fathom how a parent can bend their mind to the belief that the other parent is so bad that their child must reject them completely.  And I have worked with parents who have bent their mind, along with those of their children, to the belief that a parent has done the most extraordinary things.  On a spectrum however, there are parents who will believe that their child has been harmed by a parent and others who believe that the child has been inveigled into a child molesting cult even in the face of all evidence to the contrary.  The line between the two is defined when a parent is psychologically assessed.  Personality disorder in a parent is on one side of the line, temporary behaviours which uphold the child’s rejection are on the other.

Every so often in the UK we have an outbreak of ‘Satanic Panic’ that phenomenon where someone is accused of killing and eating babies and other such gruesome acts.  Regardless of evidence to the contrary, the belief in ritual satanic abuse in our society continues (of course ritual abuse does exist to some degree because one could easily consider the grooming and sharing of children as sexual objects in places like Rochdale to be such a ritual) and cases of spontaneous recalling by children of vile acts of depravity upon them erupts from time to time.  In such cases, parents appear able to believe that the other parent has sexually, physically and mentally and emotionally tortured the child, without any evidence to substantiate this at all.  In these circumstances, the lies that children tell in these circumstances are essential understand, because the nature of the true shared psychotic delusion, is the reason why they tell such lies.  This is the presentation of pure alienation, in which a parent has a personality disorder which has spiralled out of control into a shared belief that a parent has done great harm.

These cases of pure alienation where a parent has a personality disorder are, in my experience, the easiest of all to treat, because on removal from a parent, the delusion pops like a bubble and the child returns to being able to hold perspective and show all of the normal love for a parent that has been buried under the delusional belief.  What happens to the child over the longer term however is significant because in my follow up work with families, it is becoming ever more clear that the popping of the delusional bubble is only the beginning of the child’s recovery process.

Other cases of pure alienation, in which the parent does not have a personality disorder but the child has entered into a fixed false belief about a parent, are less easy to treat.  This is because the child tells lies and the parent believes the lies, being unable to see that the lies the child tells, are reflections of the parent’s belief about the parent who is being rejected.  In this state of mind, which is caused by enmeshment (the parent is unable to see that the child’s feelings are different to their own), the parent will really struggle to understand how the child is telling them what they want to hear about a parent and will become increasingly offended by the idea that their child is telling lies.  These are the parents who appear to find it comforting that their child has finally ‘understood the truth’ about the parent who is being rejected, the message being that the child has finally understood that the other parent is not to be trusted.  Children in these circumstances will not tell such fanciful lies as those trapped in shared delusional disorder, but will instead tell ‘confirmation lies’, which basically means they will confirm to the aligned parent those things they know the aligned parent believes about the other parent.

This kind of parental alienation case is more difficult to deal with because the lies are not sourced from a delusional belief in a parent but from an experience that parent has had.  Which means that when they hear from their child that the parent has been angry or has treated them unfairly, it confirms their sense of the other parent not being good enough and sets up a determination to ‘protect the child from what they went through’.

At the Family Separation Clinic we have treated cases of shared psychotic delusional disorder and cases of alienation with AND without personality disorder in a parent and we have come to know the difference and record the clinical markers of that difference.  In all of our work we have been guided by those who have done this work before us so that we can build upon that knowledge and develop the nuanced responses which are necessary.  In all such cases we aim to ensure that the child resolves the split state of mind and that they continue, as far as possible, in a relationship of some sort with both parents.  Almost a decade after my first encounter with shared psychotic delusional disorder, I still hear from Thomas Moore, whose son was removed from his mother’s care and who recovered his relationship with his father.  I hear how his son has a relationship with both of his parents and how in his ordinary everyday life he is absolutely healthy and well.  This is our aim, to restore the child to full health and capacity to relate to both sides of their family, even if for a time, the relationship with the previously alienating parent has to be supervised.

Understanding when children lie and why they lie and how to tell the difference between the child’s lies in a shared psychotic delusion and confirmation lying in enmeshed parenting is a critical skill for practitioners working in this field.  It is especially critical in an environment which is governed by the ‘we believe you’ movement and the focus upon a child’s expressed, rather than ascertainable wishes and feelings which is seen in social work these days.

All of this and more will be unpacked and explained and debated at the European Association of Parental Alienation Practitioners Conference in London on August 30/31st where we will hear case studies of shared psychotic delusional disorder from Linda Gottlieb and myself and about the route to treatment of the same.  This is an essential learning opportunity for anyone who practices in this field and we are increasingly excited about the interest being shown in this conference by policy makers and practitioners from around Europe.

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Check back for some more exciting announcements about the conference shortly.