Last week I wrote about understanding induced psychological splitting in children. Today I am writing about assessing it.
Induced psychological splitting in children is, in our clinical experience, the underlying cause of what is popularly called parental alienation. It is our experience that the splitting in the child, which is caused by the pressures placed upon them in the external and internal world, is the trigger for everything that comes afterwards.
In addition, our clinical experience tells us that the trigger for the child entering into the adoption of splitting as a defence, is caused along a spectrum of behaviours in the adults around the child, most often the parent with most control over the child, but sometimes in coalitions between parents and grandparents or other family members.
At one end of the spectrum of causes is shared delusional disorder, which has been used in diagnosis in cases where alienated children are removed from a parent for some years in the UK. Dr Ludwig Lowenstein, was writing about this and folie a deux in 2006.
At the other end of the spectrum are behaviours from parents which have culminated in a child reaching a level of vulnerability in which they can no longer tolerate the pressure to align with one reality over the other.
In between are different presentations, come conscious, some unconscious in parents and differing vulnerabilities in the child. The rejected parent, during all assessments, is screened to determined that they are able to provide good enough parenting and for their capacity to utilise therapeutic parenting when receiving their child into their care.
The child’s entry into the use of psychological splitting as a defence is mapped through narrative interviews with both parents and child.
As therapists we are well aware of how personality disorder presents and if necessary we will draw upon the clinical skills of psychologists for a diagnosis of PD. As therapists however, we also use relational testing and combinations of assessment tools to determine whether or not the child’s split state of mind is integrated by confrontation with the split off ‘object’ in the form of the parent they are rejecting.
In assessment terms, we have not completed our work until we have seen the child with the parent they are rejecting and in the UK, this requires permission from the court to undertake this work. If the child’s use of splitting is integrated in clinical observation then structured intervention is possible. If it is not, then further consideration of the reasons why a child is in a fixed and fused position with the parent they are aligned to is undertaken. If necessary a psychological evaluation is undertaken to rule in or out the presence of an encapsulated delusional disorder. It is this which most often determines the need to remove the child from the parent they are aligned to in order for treatment to take place.
In all of our assessments we are seeking to understand the level of splitting in the child and the circumstances in which this may be ameliorated. This is in order to provide the child the very best chance of maintaining relationships with both of their parents. In some circumstances this is simply not possible however. Even then we continue to protect the child from splitting by enabling the child to build resilience to the influencing parent so that supervised relationships can be maintained.
Assessment which is undertaken from the perspective of whether or not the child is utilising splitting as a defence, protects against false positives. As some parents claim they are alienated when in fact they are not, this is an essential part of any assessment.
Research evidence demonstrates that children who are using the defence of psychological splitting will show that by a number of means. One of the ways of examining this is the use of the Parental Acceptance and Rejection Questionnaire in which children respond to a set of questions about their parents. This test has been shown in research to be 99% accurate in distinguishing severe alienation from non alienation. When combined with the rest of the thirty hour assessment undertaken by the Family Separation Clinic, this provides a powerful use of the splitting defence as the core diagnostic criteria which leads into treatment.
The purpose of a detailed and depth assessment is to prepare a plan for treatment which is as closely tailored to the needs of the family as possible. During assessment, some of the initial treatment can be undertaken for example in clinical observation where testing of whether the splitting defence is ameliorated when the child encounters the rejected parent in protected space. Protected space, is that which is not under the control of the influencing parent or child but under the control of the court. This is the space that the court gives permission for the clinical observation to take place in. As such it is a space which is freed from the power and control dynamic because that is held by a higher power than the family.
When assessment is complete a detailed plan of work is ready to guide intervention. This includes the costs for all predicted work and a timescale with milestones which are reported back into the court.
All of the milestones are guided by the goal of integrating the split state of mind in the child and maintaining this. The work of therapy is not undertaken with the family as a whole until the child has been able to integrate the splitting of parents into good/bad. This denotes that the split within the child has also integrated and the projection onto the parents has been withdrawn. During the subsequent therapeutic work, the child spends increasing time with the parent they were previously rejecting (now called the receiving parent in our programmes) in protected space. The family then undergoes an adapted form of family therapy which includes trans-generational, psycho-genealogical and structural themes.
In the coming week, I will write about treatment routes which are delivered after clinical observation, and use of protected space, for resolution and maintenance of the split state of mind in the child. I will also write about therapeutic work with adults alienated as children.
Family Separation Clinic News April 2020
The Third Conference of EAPAP – Zagreb 2020
Parental Separation, Alienation and Splitting: Healing Beyond Reunification
This conference was due to take place in June and has been postponed due to the Coronavirus Pandemic which has restricted lives around the world and will continue to do so for the foreseeable future.
Plans to reschedule the conference to late summer are made, this will of course depend upon the situation in different countries around the world.
The organising committee are committed to ensuring that this important conference, which has almost 400 practitioners already booked to attend, is delivered.
Updates will be given regularly on the dates of rescheduling.
Online Therapeutic Parenting Course
This course is being completed and tested now and will be available in the coming weeks. To register your interest and receive notification of when it is ready for download please click here.
Training Schedule 2020
Unfortunately due to the current situation we have had to postpone training in Poland, Croatia, Malta and the USA so far this year. We hope to be able to deliver in Germany, Northern Ireland, Malta and Croatia later in the year but training in the USA has definitely been rescheduled to May 2021.
Details of practitioner training and parent workshops online, will be available soon.