APA Definition of Delusional Disorder
delusional disorder in DSM–IV–TR, any one of a group of psychotic disorders with the essential feature of one or more nonbizarre delusions that persist for at least 1 month but are not due to schizophrenia. The delusions are nonbizarre in that they feature situations that could conceivably occur in real life (e.g., being followed, poisoned, infected, deceived by one’s government). Diagnosis also requires that the effects of substances (e.g., cocaine) or a medical condition be ruled out as causes of the delusions. Seven types of delusional disorder are specified, according to the theme of the delusion: erotomanic, grandiose, jealous, persecutory, somatic, mixed, and unspecified. Criteria changes for delusional disorder in DSM–5 include the following: The delusions may be either nonbizarre or bizarre (i.e., implausible), and their potential presence as a result of an ingested substance, a medical condition, or another mental disorder sometimes associated with firmly held delusional beliefs (e.g., obsessive-compulsive disorder, body dysmorphic disorder) must be ruled out. Formerly called paranoid disorder.
An encapsulated delusion is a belief in one area of life which is fixed and unshakeable even in the face of evidence to the contrary. Encapsulated delusional disorder, is seen in cases of alienation of children, when a child is showing the signs of psychological splitting and is aligned with a parent who has an unshakeable belief that the other is harmful to the child’s wellbeing. Encapsulated delusions are extremely powerful and in their strongest display, will cause the holder to bend all evidence to shape their beliefs. Children in the care of a parent who is suffering from encapsulated delusions, become fearful, anxious and bound into the belief of the parent that the parent who is being rejected, is harmful. When a child suffers a fixed and unshakeable belief that a parent is harmful, where there is clear evidence that the parent is not, the child is considered to be suffering from significant emotional and psychological harm. In such circumstances, removal from the care of the parent who is suffering the delusion is often necessary.
Encapsulated delusions occur in people who in many other areas of life appear to be normal. The fixation of the delusion, which is not accompanied by hallucination, is the key symptom. The person suffering from such delusions, is unusually obsessed by the focus of the delusion, believing that they have discovered something or know something that others do not know. This belief is often accompanied by a grandiosity which is narcissistic in nature and which causes the sufferer to believe that they are better than others, because they know a truth that others don’t. Efforts to dissaude the sufferer are futile and in fact can escalate the fixed nature of the belief. Unfortunately, for children in the care of someone who suffers encapsulated delusion, there is no choice but to enter into the shared persecutory belief that the other parent is harmful.
Children who grow up believing that a healthy parent is dangerous to them when they are not, suffer significant harm. In some cases of encapsulated delusion, the beliefs are so fixed and so harmful, that a parent will demand that a child is medically examined, for example, for signs of sexual abuse. In the absence of evidence that the child has suffered sexual abuse, to make such a demand is, by any measure of responsible and healthy parenting, itself, abuse. Sadly, in too many cases of encapsulated delusional disorder, this is one of the outcomes and this is often the point at which the threshold for significant harm is considered to be crossed and the state in the form of local authority child protection services step in.
Encapsulated or shared persecutory delusions, are uncommon in alienation cases, but they are one of the range of reasons why, children are removed from the care of a parent. Such a persecutory belief arises from behaviours which are defensive in nature and which are usually fear and anxiety based. The belief that the other parent is seeking to do harm, simply by wanting to have a relationship with the child, appears to stem in many cases, from unresolved childhood abuse in the parent suffering the delusion. The projection of the unresolved issues onto the child, especially during the period post divorce or separation, when anxiety is already high, is often the beginning of an episodic reaction in the parent who is suffering the delusion. Over time, the child becomes bound into a process by which, the rejected parent’s love begins to be experienced as persecutory and something to be afraid of. This causes serious emotional and psychological harm.
In my experience of working with families where encapsulated delusional disorder has been present, the suffering parent will bend all incoming evidence which contradicts the delusion they are suffering, to ensure their belief is upheld. So, for example, anyone who presents evidence that the rejected parent is not persecutory, but is healthy and well, becomes aligned in the mind of the sufferer to the rejected parent and becomes persecutory simply by their existence. In such circumstances, where the Court itself is also often experienced as persecutory, the parent binds the child tighter into the sharing of this encapsulated delusion, making it impossible to protect the child without removal from the parent. It must be recognised, that even where a child is removed in such circumstances, every effort is made by the Court to maintain a relationship between the child and the parent they have been removed from, in a way that is safe.
A good example of a shared persecutory delusion is where a parent believes that a child has been abused, during a period of time when the person being accused of abuse, could not have been responsible. A belief that abuse is taking place when a parent is not in the country, for example, which leads to the construction of an explanation of how the supposed abuser returned to the country without others knowing, to abuse the child and then left, again without anyone being aware of it, other than the parent suffering the delusion. When a child echoes the beliefs of the parent, in a situation where there is clear evidence to the contrary, especially when this leads to the parent wanting to have the child medically examined, action has to be taken to protect the child.,
The current climate in the UK, in which there is an almost mantra like repetition, that all allegations of parental alienation are used by abusive men to control protective mothers, is ignorant of the reality of the serious underlying psychological and mental health conditions which cause alienation reactions in children. The idea that a parent can go into Court and claim that a child is being alienated and that this automatically overrides existing evidence of domestic abuse, is simply not upheld by the reality of how cases of alienation in children are managed.
Cases of alienation of children are serious and taken very seriously. A finding of fact of domestic abuse would preclude a case being considered as alienation at the Clinic, as this is considered to be a contributory factor to the child’s rejection. In the absence of any such finding, psychological and psychiatric assessments are sought, in order to determine the presence or absence of mental health problems, ruling in or out serious conditions such as shared encapsulated persecutory delusions, is part of the differentiation process. Only when there has been a long process of observation, clinical assessment and differentiation, where a parent is demonstrating an incapacity to recognise harmful behaviours, does removal of the child on the basis of safeguarding occur and when it does, it is always the Court which makes that decision. The current popular narrative about alienation, which is promulgated by ideological researchers and a group of parents supporters, who are themselves, likely to be on the spectrum of fixed and unshakeable thinking, is a huge distortion of what really happens in Court.
Which is why it is so important to pull apart what we mean by alienation of children in divorce and separation and to recognise and acknowledge that, however unpalatable it may seem, removal of children to protect them from harm, is sometimes necessary. As in all child protection work, careful differentiation takes place before intervention. Believing that someone can simply say a child is being alienated and that overrides everything else, including proven domestic abuse, is, so far from the truth as to represent a shared delusion in itself.
Alienated children are in need of protection because they are being abused. Protecting them is our primary responsibility because of the seriousness of the harm that they are suffering. The Court is the place in which those matters are recognised and addressed. Of course, some will claim alienation when it is nothing of the sort, however, the stringent court processes, ensure that those cases are identified. Alienation is not something which is taken lightly and what lies beneath genuine cases, should be of serious concern to anyone who cares about the wellbeing of children.
With all of the documented history, research and evidence of it’s existence; why then do the Court’s hesitate to act in cases, where alienation is found, by removing the child from the harmful parent?
Because removing a child has been considered to be draconian in situations where emotional and psychological abuse has not been recognised for the harm that it does over the child’s lifetime. Over the past ten years it has been increasingly recognised however. When the wider world understands the harm that alienation does to the child, it will join the other categories of abuse such as sexual and physical and will be recognised for the serious harm it causes. For a child who is alienated, which itself is about the child being forced to develop a false self in order to survive, the emotional and psychological impact is overwhelming. A child cannot identify that abuse, they can only suffer its consequences, there are no marks upon the child which identify the abuse, only the signs of alienation, which are demonstrated by a well recognised defence of psychological splitting. When psychological splitting is seen, further investigation becomes necessary to identify the cause of that. Until now none of this has been widely recognised, but it is being recognised and over the coming months and years, will be increasingly known and acted upon. K
Is there any data on adults who were alienated as children? How they function? Their mental health? Does reconciliation occur after 18-20 yrs of alienation?
Yes it does Kathleen, never give up hope. My doctoral thesis is with these adult children and we are about to undergo an evaluation which will include our work with adult children over ten years so data will be forthcoming over the coming months. K
LikeLiked by 1 person
Where a parent who is implacably hostile beyond residence being transferred by the court and who’s narrative and behaviour continue to cause relational trauma then what more can be done? The impact on the family of an individual who presents with disordered behaviours can be catastrophic for both the child and the healthy parent. If the disordered parent is unwilling or indeed unable to acknowledge their negative behaviours despite overwhelming evidence from experts, guardians and judges over many years, then emotional harm is likely to continue.
In such cases the child is extremely vulnerable and I agree it is catastrophic for chlld and healthy parent and family. Often a parent with such personality issues cannot understand what is wrong and so if the system cannot free the child, the child is abandoned to the suffering and the rejected parent and family are helpless bystanders watching abuse. This is why the project to raise awareness of the harm that alienation does to a child is so essential and this, in my view, is why there is such a fight to hide it by mischaracterising it – one day however, this abuse, like sexual abuse and physical abuse, will be recognised for the harm it does and we will not allow it to continue in this way. Can you imagine anyone in the world, on the evidence that a child is being physically or sexually abused, saying ‘oh well, the child is to far gone…the parent is too hostile?’ One day, and it won’t be long, the same disgust and drive to protect the child will exist for alienation. We just have to keep going on educating people on what is really going on in alienation of children in divorce and separation. K
I have the opportunity to ask a psychologist some questions about her findings about the other parent and her findings relate to a delusional disorder. What things can I ask in relation to co-parenting?
My 4 year old lives with me and has supervised contact with her mum.
LikeLiked by 1 person
Hi C. If there is a delusional disorder in play then mother needs to be supervised in her contact with the child because she will cause the child to enter into the shared psychotic delusional state of mind if not. You say this is in place which is good. You need to ask the psychologist what the treatment is for delusional disorder and then if you are still in court, ask the court to put in place a protective order which says that unless mother completes the treatment, contact must continue to be supervised. The problem with delusional disorder is it is likely encapsulated, meaning that she is not delusional in any other aspect of her life. Delusionally disorderded parents cannot and should be be co-parenting, they should be having supervised contact. K
LikeLiked by 1 person
Yes, as it stands, my little one has supervised contact for 2hrs per week at a YMCA centre with Mum. This is the only contact there is with Mum (other than indirect via solicitors) and this has been the case since January 2020. I think this is how it will continue, although Mum is not happy with that.
The psychologist thinks a delusional disorder is likely but also suggested autism as a potential factor. Mum still disputes the findings from January 2020 and insists all of her allegations against me 50+ are true but isn’t prepared to accept the serious findings against her & will tell seek out professionals who will listen about this, and how unjust the family court is, despite the concrete evidence to the contrary. – conveniently leaving out any narrative that would make her look questionable.
I am constantly promoting a positive relationship and will always do this yet it appears that Mum can only see me as bad and our little girl as a child in danger. Again, despite evidence to the contrary and the evidence being considered by the court on a number of occasions.
Any questions I can ask the psychologist that are relevant to delusional disorder or otherwisw will be useful. Thank you! I also enjoyed the Webinar and made some notes. 🙂
Thank you for your work on this – it has been a beacon during a dark journey for many!
I am curious as to your opinion is about a 13-year old child who is severely alienated to the point of being willing to call her father’s attorney and outright lie about what goes on at her mother’s home and tell that same attorney that she never wants to see her mother again. Previous mother/daughter relationship was very close and loving/no abuse (interestingly, the father was a verbal/emotional abuser, but he is the alienator).
The courts are so very slow and the process painfully long. The mother has legal rights to take the child (who lives primarily with the alienating father and his alienating wife/stepmother) for a weeklong vacation – but this child is combative, refuses to engage at all and hostile on weeknight/weekend visits which are rarely overnight.
Aside from screaming and physical outbursts, what are the mental/psychological risks to the child to be taken on a week-long vacation out of state with the rejected parent?
Is this risky from a perspective of the child’s psychological well-being? The mother is certainly at risk for physical abuse from this child, and it is not likely to be pleasant – but is this a concern or not so much?