This week’s Parliamentary debate on Family Court Reform and CAFCASS, contained statements from one side of what is a heated and often toxic debate. Claims that children are being purchased by wealthy fathers, using legal loopholes and that children are routinely given to abusive men were made without any substantiating evidence, demonstrated how far one area of public discourse is, from the reality of what happens in the family court.
To be clear, children are not removed from parents as a punishment, they are not removed from a parent because that parent has been accused of parental alienation, children are only removed from a parent, where the Court, having made all of the deliberations and having considered all of the evidence before it, in cases which often stretch over many years, consider that the harm done to the child, has met the Welfare Threshold in the Children Act 1989. In other words, children who are removed from a parent in divorce and separation, are removed due to significant emotional and psychological harm, which is being caused by the behaviours of a parent with control over them. The removal to a parent who has hitherto been rejected, is undertaken when that parent is assessed and evaluated as having the capacity to provide safe, kinship care.
Legislation in England and Wales is very clear that behavioural patterns in parents and the complex dynamics which cause a child to align and reject, are recognised as causing serious emotional and psychological harm. Clarity in the process by which harmful behaviours are identified by the Court, was recently provided in F v M (3):  EWFC 89 meaning that the decision about a child being caused emotional and psychological harm is always made by the Court. In my experience, this has always been the case.
Away from the public debate, the work to protect children of divorce and separation continues. with increasing understanding in social work, of the underlying behavioural patterns in parents who cause emotional and psychological harm to their children. The issue of children’s alignment with a parent and rejection of the other in divorce and separation, being a structural problem of power and control over a child, (Ieading to exposure to further behaviours which cause attachment maladaptations), is properly placed in public law. This is because protecting children from all harms, is the role of the state and social workers, having statutory power, are best placed to provide the child protection interventions when emotional and psychological harm meets the Threshold.
FSC works with social work teams in private and public law, delivering structural therapeutic interventions in serious cases of emotional and psychological harm, with mothers as well as fathers in the rejected position, to help children to recover an integrated sense of self through the treatment of attachment maladaptations. This work, which is being evaluated, provides the foundation for a model of statutory intervention in cases where the pathological behaviours in parents have caused serious harm to children. This is the future of this work, where children are protected from harm first before therapy is provided and therapists are protected from harassment and successful outcomes can therefore be achieved rapidly due to the structural social work intervention.
The unsubstantiated claims made by MPs this week, are unfortunate. These contributions are based not on the reality of what happens in Court but on a one sided public discourse. This can cause great suffering to parents who are already coping with the loss of their children after divorce and separation.
To reassure those families affected by this problem however, what lies beneath, is increasing understanding and continued progress in enabling protection of children in divorce and separation. Some of the work being done, will be presented to MPs, ensuring that any ongoing debate is properly evidenced.
Despite the noise, work to protect children of divorce and separation from emotional and psychological harm, does not and will not stop.
Family Separation Clinic News
FSC works with Local Authority Social Work teams in cases of serious emotional and psychological harm of children. This work is being independently evaluated to provide a model for statutory intervention when children are removed from parents who cause harm. Results from this evaluation are due in 2024/5.
Evaluation of outcomes for children in Private Law cases, who were moved from parents who caused emotional and psychological harm between 2009 and 2021 continues.
Spring/Summer Schedule of Parent Support Services
Listening Circles, Higher Development Course and Saturday Seminars will be published next week.
Instructing the Family Separation Clinic
Due to an intensive development phase, the Clinic cannot accept any instructions for therapeutic interventions until mid September 2023.
Yes. That’s what happened.
My 4 daughters were cloaked in the affluence of their father after I left him and made to believe that trading their mother in for a Louis Vuitton purse was desirable.
What you state in your first paragraph is exactly what happened…and there are many more mothers in the same situation.
In my opinion, it is not a gender issue, but rather the parent with the higher income has the more influence, control and authority over the kids. This is exactly what took place in my situation with the mother of my children after a three-year of the children services and having to ask her to leave the home to get help for her alcoholism and anger mgmt issues. Turning everything around by false allegations and imprisonment.
Dark Personalities and Induced Delusional Disorder, Part I:
The Research Gap Underlying a Crisis in the Family and Domestic Violence Courts
Melanie B. Greenham and Craig A. Childress
Department of Psychology and Political Science, Eastern New Mexico University
Children are negatively impacted by high interparental conflict following divorce. The most acrimonious cases involve pathological parental behaviors which constitute psychological child abuse. Parents with narcissistic, borderline, or dark personalities are known to decompensate into psychotic states featuring non-bizarre encapsulated persecutory delusions when experiencing severe stress and interpersonal instability. Research indicates children are at significant risk for developing an induced delusional disorder imposed by psychotic parents, and dark personalities are prone to manipulating children and government agencies to inflict damage on ex-partners through family and domestic violence courts. These phenomena were detailed a decade ago by Childress (2013) and subsequently cited in family court literature (Walters & Friedlander, 2016). This literature review evaluates the scientific community’s progress in researching, detecting, identifying, and treating this severe form of parent-child psychopathology transmission and intimate partner violence. Based on this review, it appears little to no progress has been made and both the etiology and epidemiology of this court-involved form of induced delusional disorder continues to be grossly under-recognized and misunderstood. Research focusing on how primary inducing parents’ non-bizarre encapsulated persecutory delusions are imposed on secondary inductee children in high conflict family and domestic violence courts cases is warranted.
Click to access Dark-Personalities-and-Induced-Delusional-Disorder-The-Research-Gap-Underlying-a-Crisis-in-the-Family-and-Domestic-Violence-Courts.pdf
Dark Personalities and Induced Delusional Disorder, Part III: Identifying the Pathogenic Parenting Underlying a Crisis in the Family and Domestic Violence Courts
Melanie B. Greenham, Craig A. Childress, and Dorcy Pruter
Approximately 10% of post-divorce custody cases become extended high conflict custody litigation in the family courts. Coincidentally, research suggests that approximately 10% of the population has narcissistic borderline-dark personality pathology. Both narcissistic and borderline personalities use virtuous victim narratives to manipulate others for self-serving agendas and decompensate into encapsulated persecutory delusions under stress, and these delusions can then be imposed on the child through manipulative parental psychological control.
If not accurately diagnosed, the child’s persecutory delusions induced by the narcissistic borderline-dark personality parent can mislead the court into making damaging decisions.
Relying on the established professional knowledge from attachment, personality disorder pathology, and family systems therapy, Childress (2015) identified a set of three diagnostic indicators (DI) and 12 associated clinical signs (ACS) that are predicted to reliably identify psychological child abuse by a narcissistic-borderline-dark personality parent who is creating a shared persecutory delusion and factitiously imposed attachment pathology in the child. The three DI are predicted to always be present, while the 12 ACS are predicted to often be present as symptom indicators. This study examined the prevalence of the 12 ACS in a data set drawn from high-conflict custody litigation. At least five ACS were evident in every family, and 41 of the 46 families had nine or more ACS. The prevalence rates for each individual ACS ranged from 30% to 100%, with nine ACS present in over 80% of the families. Further research using clinical interviews rather than archival data to identify the DI and ACS is recommended.
Trauma-Origin Delusional Disorder
Narcissistic-borderline-dark personalities are known to decompensate into non-bizarre, encapsulated delusions under stress while otherwise maintaining adequate levels of everyday functioning (Barnow et al., 2010; Bechdolf et al., 2010; Joseph & Siddiqui, 2022; Millon, 2011; Thompson et al., 2010; Ulzen & Carpentier, 1997). Such delusions are associated with the use of ego defense mechanisms (e.g., reaction formation, projection, denial) to solve intolerable feelings of social isolation, envy, distrust, suspicion, and low self-esteem (Beck et al., 2015; Joseph & Siddiqui, 2022; Ritunnano et al., 2022).
The diagnostic definition for a persecutory delusion is provided by the American Psychiatric Association (2000): “delusions that the person (or someone to whom the person is close) is being malevolently treated in some way” (p. 239). The development of shared delusions surrounding family court custody conflicts is described by Walters and Friedlander (2016):
In some RRD [resist-refuse dynamic] families, a parent’s underlying encapsulated delusion about the other parent is at the root of the intractability. When alienation is the predominant factor in the RRD, 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. (p. 426)
Within the context of high conflict child custody litigation, persecutory delusions are often misunderstood, misdiagnosed, and believed as true by the surrounding mental health and legal professionals who lack professional competence in the diagnostic assessment of thought disorders (Childress, 2015). When surrounding professionals fail to recognize a shared delusion and incorrectly believe it is true, they contribute to creating and maintaining the shared delusion and they become part of the pathology. When the pathology is psychological child abuse by a pathological parent, professionals who believe a shared delusion participate in the psychological abuse of the child by a narcissistic-borderline-dark personality parent. In all cases of severe attachment pathology displayed by a child, a proper risk assessment for possible child abuse must be conducted for the appropriate differential diagnosis as to each parent.
Virtuous Victim Signaling
The association between dark personalities and frequent virtuous victim signaling was identified by Ok et al. (2020) and explained as an individual emitting social signals indicating they are (a) highly virtuous, and (b) a victim in some regard. Virtuous victim signaling represents the act of amoral manipulation through exaggerated and false claims of virtuous victimization to obtain resources and help from others for the purpose of achieving the dark personality’s hidden and self-serving agendas (Baughman et al., 2014; Jonason et al., 2014; Ok et al., 2020). The virtuous victim effect has been shown to inflate others’ positive perception of a supposed victim’s honorable moral character and need for assistance, while simultaneously increasing their adverse views of and desire to harshly punish the alleged “perpetrator” (Jordan & Kouchaki, 2021).
Virtuous victim signaling is highly problematic in the family courts due to the numerous strategies used by the narcissistic-borderline-dark personality to create distractions during the decision-making process by manufacturing, concealing, or distorting evidence, especially with false abuse/neglect claims, allegations that a normal-range parent is unfit or psychologically unstable, and convincing denials of their own abusive behaviors (Champion, 2022a, 2022b; Champion & Trane, 2020; Clemente & Padilla-Racero, 2020; Greenham & Childress, 2022; Gutowski & Goodman, 2020; Saunders & Oglesby, 2016; Silberg & Dallam, 2019; Spearman et al., 2022).
“Effective altruism requires the ability to differentiate between false and true victims.
Credulous acceptance of all virtuous victim signals as genuine can also enable and reward fraudulent claims, particularly by those with antisocial personality traits” (Ok et al., 2020, p. 25).
Increased professional understanding about the spectrum of narcissistic-borderline-dark personality pathology is needed in the family and domestic violence courts to prevent pathological manipulation by abusive parents (Greenham & Childress, 2022).
Induced Delusional Disorder
When a dominant individual’s delusional belief (primary case; inducer) provides the content for a delusion adopted by a more submissive individual (secondary case; inductee), this is known as an induced delusional disorder (a.k.a., shared delusional disorder, shared psychotic disorder, folie à deux, folie à plusieurs, folie à famille; APA, 2000, 2013; WHO, 2019). A shared delusional disorder is particularly prone to developing in families (Walters & Friedlander, 2016).
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. (APA, 2000, p. 333)
It has been argued in the professional literature that delusional disorders have historically been under detected, underdiagnosed, and underreported (APA, 2000). This is likely nowhere more true and in need of correction than in the 10% of high conflict cases where exaggerated or false allegations of abuse (i.e., false claims of malevolent treatment), and denials of authentic abuse are regularly encountered (Arnone et al., 2006; Champion, 2022a, 2022b; Champion & Trane, 2020; Clemente & Padilla-Racero, 2020; Gutowski & Goodman, 2020; Horesh et al., 2021; Saunders & Oglesby, 2016; Silberg & Dallam, 2019; Spearman et al., 2022).
Diagnostic Indicators and Associated Clinical Signs
Through the application of established professional knowledge from attachment research, personality disorder pathology, and family systems constructs, Childress (2015) identified a set of three Diagnostic Indicators (DI) displayed by a child who is being psychologically abused by a narcissistic-borderline-dark personality parent thereby creating a shared persecutory delusion and false attachment pathology in the child. DI-1 identifies the domain of pathology as a problem in attachment (i.e., child’s rejection of a normal-range parent). DI-2 identifies significantly elevated protest behavior by the child toward a normal-range parent through either (a) high-anger (operationally defined as five narcissistic personality traits), or (b) phobic anxiety. DI-3 identifies a persecutory delusion displayed by the child toward a normal-range parent. Childress (2015) also identified a set of 12 Associated Clinical Signs (ACS) which are sometimes, but not always, present with the pathology. The a priori predicted DI and ACS are provided with a brief outline for the most prominent constructs leading to the predicted ACS (see Table 1).
Diagnostic Indicators and Associated Clinical Signs
DI 1 Attachment Suppression: suppression of the child’s attachment bonding motivations toward a normal-range parent (a child rejecting a parent).
DI 2 High Protest Behavior: significantly elevated child protest behavior toward a parent, either (a) and/or (b):
a) High anger protest behavior toward a parent, operationally defined as five specific narcissistic personality traits displayed by the child: grandiosity, lack of empathy, entitlement, arrogance, splitting.
b) High anxiety protest behavior toward a parent, operationally defined as a phobic-level fear of a normal-range parent.
DI 3 Persecutory Delusion: the child displays an encapsulated persecutory delusion about a parent.
Associated Clinical Signs
ACS 1 Use of the word “forced.”
The pathology of concern is the trans-generational transmission of trauma from the allied parent to the child. The use of the word “forced” emerges from the internal working models of the allied parent’s own childhood attachment trauma transferred to the current relationships. The use of the word “forced” is also a manipulative use of language to disempower efforts to engage the child in treatment.
ACS 2 The child is empowered to reject a parent.
The empowerment of the child to reject a parent is a manipulative product of the cross-generational coalition with the allied parent, and it represents the symptom feature of an inverted family hierarchy in which the child is empowered by the coalition with the allied parent to judge the adequacy of the other parent. In an inverted hierarchy, the child assumes a position of power and authority over the targeted parent as if the parent is the child and the child is a parent.
ACS 3 The child excludes a parent from their activities and milestone events.
Children love attention and always enjoy parents, friends, and family attending their events. The demand from the child to exclude the targeted parent from the child’s activities is the product of the child’s role as a regulatory object for the pathological allied parent. It is the allied parent who becomes stressed by the other parent’s presence at the child’s events, and it is the allied parent who wants to exclude the other parent from the child’s activities. The child is acting from the motivations and psychological control exerted by the allied and pathological parent.
ACS 4 The child rejects “ownership” of a parent, or a parent is “replaced.”
Rejecting people as expendable is a narcissistic personality trait from superficial and avoidant attachment bonding. The attachment system is a predator-derived primary motivational system that strongly motivates children to bond to a specific person (e.g., “my” mom/dad) for protection from predators. Rejecting ownership of a parent (e.g., calling a parent by their first name) or parental replacement (e.g., calling someone else “mom”/“dad”) reflects the allied parent’s narcissistic personality pathology which engages in attachment relationships in a shallow manner and views those relationships as replaceable.
ACS 5 The child uses an “unforgivable” past event to justify rejecting a parent.
A delusion starts with the conclusion as fixed and then constructs the supposed “evidence” to match the pre-established belief. The child’s fixed conclusion that the targeted parent somehow deserves to be rejected for supposedly bad behavior requires the child to then generate a reason for the rejection (i.e., the “unforgivable” past event). There is no current cue to elicit the child’s hostility and rejection, so the child offers the reason for all current and future rejection is an unforgivable past event.
The child’s rigidly held belief that things once defined do not change reflects the allied parent’s symptom feature of splitting, a characteristic symptom of narcissistic and borderline personality pathology.
ACS 6 The child uses the words “liar” or “fake” to describe a parent.
The attachment system is a goal-corrected primary motivational system of the brain that always maintains the set goal of forming an attachment bond to the parent. When the targeted parent offers affectionate overtures to the child for bonding, the child’s motivation for bonding increases. To cope with the increased motivation to bond to the targeted parent, the child must then deny the authenticity of the parent’s affection to continue rejecting that parent in opposition to their strongly motivated desire to reestablish an affectionate bond.
ACS 7 The child uses characteristic “themes” to justify rejecting a parent (e.g., too controlling, too angry, too irresponsible, too neglectful, insufficiently apologetic, has new romantic partner, etc.).
The attachment pathology displayed by the child is not an authentic response to the stimulus cue presented by the normal-range targeted parent. As a result of the inauthentic (uncued) conflict, the child must construct current justifications and “reasons” for their rejection of the parent where none exist. These “reasons” for rejecting a parent are typically co-constructed with the support of the pathological allied parent and reflect the spousal grievance themes of the allied parent.
ACS 8 The parent or child uses the word “abuse” in an unwarranted manner.
All allegations of abuse should receive a proper risk assessment. The use of the word “abuse” to describe events is inherently inflammatory. Most normal-range people tend to use less inflammatory characterizations when there has been no abusive behavior. Borderline personality pathology, however, perceives and alleges minor emotional discomfort as “abusive” to manipulatively elicit a protective response from others. Unwarranted use of the word “abuse” by the child reflects the borderline-dark-personality-pathology in the allied parent.
ACS 9 The child engages in excessive communication by text, telephone, email, messaging, etc. with one parent while in the care of the other parent.
The pathology in the family courts involves the trans-generational transmission of trauma from the childhood of the allied parent to the current family relationships. The allied parent becomes exceedingly anxious when separated from “the child” due to their own reactivated unresolved childhood trauma pattern. The high frequency of parent-child texting, emails, and phone calls serve two functions in the allied parent’s emotional regulation: 1) reassuring parental anxiety during separations from the child, and 2) intrusions to prevent the child from developing an affectionately bonded relationship with the targeted parent.
ACS 10 The child displays a role-reversal with a parent (e.g., “It’s not me [the allied parent], it’s the child who…”).
Narcissistic and dark personality pathologies manipulate and exploit others for personal gain. The allied parent is using their psychological control of the child to manipulate and exploit the child’s verbally expressed wishes, which are the allied parent’s wishes transferred to the child through enmeshment and psychological control. Once the allied parent has psychological control of the child, the parent then exploits their psychological control of the child.
ACS 11 The parent or child asserts that a parent “deserves” to be rejected.
The belief that a person “deserves” to suffer is the justification used for intimate partner violence (e.g., “Of course I hit her, she deserved it, my dinner was cold.”). The narcissistic value is that it is okay to be cruel to people (absence of empathy) if they “deserve” it due to some failing, and the abuser then develops reasons justifying why the victim “deserved” cruelty. The healthy value system is that we are not nice to other people because of who they are, we are nice to them because of who we are.
ACS 12 The parent or child disregards court orders as to custody, visitation, etc.
The disregard of authority is a characteristic feature of narcissisticpsychopathic-borderline-dark-personality-pathology. This spectrum of personality pathology does not recognize the influence of authority in limiting their behavior and they feel entitled to disregard discomforting limits and rules placed on them. The disregard of judicial authority by the parent or child prominently suggests narcissistic-psychopathic-borderline-dark-personality pathology in the allied parent manifesting in the child’s defiance of court orders.
Click to access Dark-Personalities-and-Induced-Delusional-Disorder-Part-III-Identifying-the-Pathogenic-Parenting-Underlying-a-Crisis-in-the-Family-and-Domestic-Violence-Courts.pdf
Child Abuse and Neglect Attachment, Development and Intervention by David Howe
Psychological Maltreatment: Emotional Abuse, Neglect and Rejection
Not feeling loved by your parent is deeply painful. Your attachment figure is the person to whom you instinctively turn at times of need, but all you find is indifference, or in more extreme cases loathing. Children are seen by their parents as worthless, irritating, bothersome, flawed, unwanted and inconvenient. But of course it is not just hurtful to feel that your well-being and safety are not uppermost in the mind of your carer, it is also frightening. If a parent rejects you, particularly when you are in a state of need or distress, then where might you find comfort and understanding? For the young child, there is nowhere else to go other than inwards with the anxiety and hurt. The developmental consequences of rejection are often severe. Self-esteem is assaulted.
Emotional intelligence is damaged. Even growth can be affected when children experience severe emotional stress. This is dramatically seen in cases of psychosocial and hyperphagic short stature syndrome.
Elements of psychological maltreatment are present in most forms of abuse and neglect, although it can occur on its own. When it does occur discretely it is less likely to be reported or come to the attention of the child welfare authorities, certainly in cases of younger age children. Incidents of emotional abuse and neglect that do come to the notice of the authorities increase with age, not because the abuse does not occur in early childhood, but rather because its damaging psychological consequences accumulate over the years, until a critical point is reached when the child is drawn to the attention of a schoolteacher, neighbour or health worker. Indeed, even then it tends to be the presence of some other feature of abuse or neglect (bruising or hunger) that first alerts the child health and welfare services.
Emotional abuse, rejection and neglect are all captured by the more generic term ‘psychological maltreatment’. In this chapter, the focus is on parents who perceive distress in their child but either fail, wilfully or defensively, to respond to it, or react in a hostile, dismissing way. Carers who fundamentally damage their children’s self-worth are guilty of such maltreatment. Within the context of the caregiving relationship, children feel unloved and unwanted. Their only value is the extent to which they meet other people’s needs – to fetch and carry, to allow carers to be eligible for social security benefits, to make the parent feel worthy (Hart, Brassard and Karlson 1996: 73).
Hart, Brassard and Karlson (1996) see psychological maltreatment as the absence of most, if not all of a child’s basic developmental needs:
It is readily seen that … psychological maltreatment … is in direct opposition to the fulfilment of basic needs as described by Maslow: physiological needs, safety needs, love and belonging needs, and esteem needs. By virtue of its opposition to these basic needs, psychological maltreatment has the power to produce maladaptive deviances.
Iwaniec (1995: 14) defines emotional abuse as:
hostile or indifferent behaviour which damages a child’s self-esteem, degrades a sense of achievement, diminishes a sense of belonging, prevents healthy and vigorous development, and takes away a child’s well-being.
In milder forms, carers might interpret their children’s expression of need or upset as exaggerated or unnecessary. It certainly does not warrant a response, implying children should care, soothe or protect themselves, even if they are very young. To respond to a distressed child might ‘spoil’ them, so an agitated baby is ignored. There is a sense that these parents feel uncomfortable with emotions, with the implication that children should learn to contain their arousal. Beyond rejection, but closely linked to it in the psychology of the hostile carer, is physical abuse. Indeed, it has been estimated that psychological maltreatment occurs in over 90 per cent of cases of physical abuse (Claussen and Crittenden 1991). The distress engendered by a demanding child leads not just to a rejection of attachment behaviour, but its active suppression. Much of what is to be considered in this chapter therefore feeds into the previous one on child physical abuse.
The content of this chapter makes for bleak reading. The family landscape is cold. It is a place of suffused tension. Warmth and spontaneous expressions of love and delight are rare. There is wariness. But lurking beneath the taut surface of everyday relationship dealings, there is also anger. Under increased stress, anger can suddenly erupt without warning into violence.
Characteristics of the Caregiving Environment
Parents who psychologically maltreat their children typically suffered emotionally harsh childhoods themselves. However they are rarely inclined to tell professionals much about their history and background. The tendency is to keep authority figures at a distance. Indeed, the parents’ tense and hostile dealings with those whom they see interfering gives the professional a sense of what family life might possibly feel like for young children.
Often polite, but wary and distant at first, carers either become disengaged from professional help, or react aggressively, threateningly and with intimidation. They avoid doctors and health visitors, fail to visit antenatal clinics when pregnant, and often leave hospital early with their babies in spite of medical and midwifery advice to the contrary. When social workers or health workers make home visits, parents tend to be out, miss appointments, ignore treatment advice, fail to give medication (saying it is not necessary), and move without leaving any forwarding address. Socially, parents appear isolated. Some suffer depression. Contact with the outside world is reduced.
Curtains are drawn, children are not allowed to play outside, and young children stop attending nursery or school (Reder, Duncan and Gray 1993: 99).
The frequent failure to attend school might be explained by an increasing and unlikely list of illnesses and injuries – diarrhoea, migraine, pulled muscle, cycle accident. Professionals are diverted from seeing the child. There is therefore a danger that an ‘at risk’ child is not actually seen for months at a time – he or she is said to be ‘asleep upstairs’, ‘staying with their granny’, ‘playing outside’. Fathers, if they are on the scene at all, remain shadowy and under-involved in family life. Reder and Duncan (1999:18; Reder, Duncan and Gray 1993) call these types of behaviour ‘closure’ and ‘flight’:
when the family shut themselves away from contact with the outside world and with members of the professional network by refusing to open their front door to them, failing to keep appointments and keeping the child away from school or nursery…. Another way in which families closed off from the outside world was through ‘flight’, in which they moved home repeatedly, often at short notice and without notifying anyone.
These behaviours are the result of psychologically maltreating parents feeling anxious and agitated whenever they have to deal with their children’s attachment behaviours (upset, need, fear, distress). Defensively, they deal with their anxiety by ‘deactivating’ their caregiving. They therefore fail to provide care and protection at the very moment their child needs it. Deactivation of caregiving can be achieved in a number of ways:
• Whenever the child makes demands on the carer, the parent becomes emotionally unavailable, unresponsive and cold. Caregiving is withdrawn when it is required. The parent might even walk away from the child at such times.
• Alternatively, the parent might insist that the child is removed and isolated. Children in need and distress might be locked in their bedrooms for long periods, shut outside or left with other adults. When the child is not in sight, he/she can be kept out of mind. In this way, carers can avoid activating their caregiving system and thus avoid feeling distressed and agitated. Of course, this action leaves the child alone and frightened, but without the presence of an attachment figure, their arousal goes unregulated. Reder, Duncan and Gray (1993: 107) recognize a similar phenomenon and call it a ‘not existing’ pattern, in which the child is allegedly ‘upstairs asleep’ or ‘ill’ and therefore cannot be seen by the professional.
• Another way of trying to suppress a child’s attachment behaviour is to treat any need or upset as contemptible. Good children should not display hurt or fear; they certainly should not make demands on their parents. A child who does appeal for safety or comfort is dismissed as weak, pathetic and unworthy of attention.
• In extreme cases, some parents become so averse to responding to the normal demands and upsets of children that they terrorize them into a state of subdued, fearful silence. They might achieve this by threatening to harm them or their pets in some brutal way.
• Subtler are carers who give out strong signals that they resent ever having become parents. They find the whole business of meeting children’s needs to be dreary, irritating and a waste of time. They might tell their child that they wish he’d never been born and that his appearance was the worse thing that had ever happened to the parent.
On first meeting, many families may not strike the visitor as maltreating. It is the accumulation of a number of seemingly minor observations that might provide the first clues. Children do not risk crossing their parents. It soon becomes apparent there are rules for when and how to behave. There are jobs to be done, and everyone has a role. Spontaneous touch and cuddles are absent. There is a hint of wary formality and brittleness of behaviour. Children are rewarded with material things rather than laughter, praise and hugs. In some cases, the overall appearance – of home and children – might be one of order and ordinariness.
Little that the child does seems to please or satisfy the parents. Children, typically from a very young age, are rebuked and criticized, threatened and humiliated, dismissed and disparaged. Children are forever at fault and treated harshly. Their efforts are berated; they are constantly hassled – ‘Hurry up, for God’s sake!’,‘You stupid idiot, can’t you do anything right!’ A three-year-old is told to go and get his own drink from the kitchen and not be so pathetic or presumptuous as to expect the parent to make it. ‘What did your last slave die of?’ hurled at the toddler who asks for orange juice. And when the child accidentally spills the drink on the carpet he is shouted at and accused of making the mess deliberately, simply to annoy and inconvenience the parent. (Iwaniec 1995: 34) paints a painful and vivid picture of the care received by a two-year-old twin, Wayne:
On the edge of the room, like a stranger, stood Wayne, his posture rigid, staring fixedly.… Observations of his interactions with his mother confirmed that she never smiled at him, never picked him up, never sat him on her lap, never played with him, and never showed satisfaction when he did something praiseworthy.… She told him off for minor misdemeanours, and persistently criticised and shamed him.… When she approached him he appeared to be frightened and occasionally burst into tears. He never came to her for comfort or help.… From the time of his babyhood, Wayne was difficult to feed, cried a lot, slept badly, and was difficult to comfort and to distract.… As time went on, she formed the opinion that his behaviour was deliberately calculated to hurt and to annoy her, and furthermore, he did not like her.
Five-year-old Ellie also experienced severe punishment and rejection:
Ellie’s mother had been working in a casino before she had her unplanned pregnancy. She told her daughter that she wished she’d never been born and that she had ruined her looks, figure and career. For much of the day Ellie was locked in her bedroom in which there was only a mattress on the floor. Whenever Ellie upset her mother, she was told to stand in a cold shower until she had learned to behave. This punishment could last up to twenty minutes. She was rarely touched by her mother, never received cuddles, and was dressed in old jumble sale clothes. At home, Ellie barely spoke. If her mother did speak to her, it was to shout at her, humiliate her, or ridicule her distress.
More generally, family life feels stressful. In some households, conflict, violence, and constant arguments generate a climate of fear, anxiety and tension. In other cases, the emotional maltreatment can be more low-key and insidious:
When eight-year-old Connor returned from school, he saw a bonfire in his garden. As he got closer, he noticed a number of his toys in the flames. His mother said she had had enough of his clutter and that it was about time he grew up. She told him he was too old for such play. He couldn’t expect her to keep the house tidy with all his mess everywhere. When Connor went to his bedroom, every last single toy and game he owned was gone. He cried. His mother told him to ‘grow up’ and ‘stop being such a baby’.
Psychological maltreatment is a complex phenomenon capable of a wide variety of expressions. Bifulco et al. (1994), for example, recognize two dimensions of emotional maltreatment: parental antipathy (rejection), and psychological abuse (cruel and sadistic acts). In a further elaboration, Hart, Brassard and Karlson (1996: 74; also see Glaser 1993, 2002) recognize six major subtypes, each with a number of subcategories:
1. Spurning which includes hostile rejection and degrading put-downs of children. Parents constantly belittle, shame, ridicule and humiliate their children. This form of maltreatment is most likely to happen when the child attempts to show need, affection, distress and dependent behaviours.
It is as if anyone, including children, who is so misguided as to allow him or herself to trust, love, or expect care and protection must be stupid.
People who expose themselves to the imagined goodwill of others will not only be disappointed, they will be hurt. Anyone naïve enough to expect love and protection is viewed with contempt. In response to a three-year-old who has fallen over and hurt herself, a mother might shout, ‘Don’t expect any sympathy from me. I told you not to play on the driveway. It’s your own fault, you pathetic whinger.’ This same mother, reflecting on her own childhood, recalled:
I’d had a row with my mother before I’d gone to school that morning. She said I was getting too big for my boots and if I thought I was going to get the better of her, I had better think again. When I got home from school she said she was sorry that we had argued and that she was thinking of buying me a new top to make up for it. I was gobsmacked. She said, ‘Go upstairs and get that blue top that you like and let’s think about something similar.’ So like a fool I went up and got it and she took it off me and got the scissors and cut itup into shreds. I couldn’t believe it. ‘That’ll teach you to get smart with me,’ she said. It was my favourite top. I just felt sick and numb.
Mothers who experienced rejection by their own mothers seem to be at particular risk of rejecting their infants. Nevertheless, these parents are very reluctant to reflect on their childhoods. They tend to offer a broad, vague, even idealized description of childhood that lacks detail. Being vulnerable and dependent as a child is either denied or glossed over. Only occasionally does the carer leak that he or she felt unloved and profoundly devalued (Main and Goldwyn 1984).
2. Terrorizing in which the parent threatens to abandon, hurt, maim or even kill the child unless he or she behaves or stops being needy. A child might even be placed in a frightening or dangerous situation. ‘Right, that’s it. I’ve had enough. You’re sleeping outside tonight and I don’t care if them wild dogs come and eat you.’ Some carers threaten their child with torture or violence. Here, psychological maltreatment and physical abuse are inextricably mixed. A sibling or favourite pet might be assaulted ‘to teach the child a lesson’ or frighten him/her into submission. For example, a child might be made to watch a father drown a puppy, a pornographic videotape, domestic violence, or a parent’s attempt at suicide.
3. Isolating the child from other children or everyday activities, particularly if those activities might be fun. Children are denied the chance to go on school outings, the opportunity to play outside with their friends, the pleasure of beginning playgroup. They might be confined to one room all day.
4. Exploiting and corrupting parenting that encourages children to develop anti-social, self-destructive or criminal behaviours.
5. Denying the child emotional responsiveness. Carers who refuse to respond with warmth or pleasure, especially when their children show some success in a task, deprive children of both affection and recognition. In particular, it seems that when children are most deserving of praise, their parents are most loath to give it. A toddler’s first steps might go unacknowledged, or even trigger a hostile reaction: ‘Oh God, Jamie’s walking! He’ll be into every bloody thing. As if life wasn’t bad enough without him crashing around the place.’ Nothing the child achieves or accomplishes seems to bring the carer pleasure. Moans, sighs, resentment and anger greet the first clumsy attempts to draw, dress or discuss. A lack of emotional responsiveness when children are in a state of need can also be associated with under-stimulation and physical neglect, including malnutrition, untreated injuries and ignored illnesses.
6. Failing to meet the child’s medical and health needs. Pregnant women avoid going to antenatal clinics. Mothers refuse to take their babies for postnatal health checks. Children might not be taken to be immunized against disease. When children are injured or ill, parents refuse to take them to hospital for treatment. They delay seeking medical attention, possibly until the child is very ill or even at the point of death. Health visitors and home nurses are denied entry to monitor milestones and carry out routine checks. Health professionals are typically dismissed as ‘useless’ or ‘intrusive and interfering’, liable to make matters worse.
The child’s health needs are underplayed or denied. These reactions are consistent with the anxiety that very avoidant parents feel when their children are in an increased state of need or distress, causing them to react aggressively, denying and dismissing both their children’s dependence and need for protection.
Barnett, Manly and Cicchetil (1993), approach the matter of defining emotional abuse by looking at what a developing child should expect from a competent, caring parent. If a parent fails to recognize, respect or value these basic psychosocial and developmental needs, then some form of emotional abuse or neglect is likely to result. So, a child’s very existence and right to life should be respected. His or her individuality, including personal attributes and characteristics, thoughts and feelings, should be appreciated and valued.
It is in a child’s nature to be dependent and vulnerable – this should not pervasively offend, irritate or anger the caregiver. And increasingly with maturation, a child should be allowed and encouraged to become a full, interactive, communicating social being. In the case of emotionally maltreating carers, one or more of these ‘rights’ is abused. For example, some parents seem to resent their child’s actual existence. Others are irritated and angered by attachment behaviour, and displays of need and vulnerability.
More recent findings suggest that parents with high ‘expressed emotion’ place their children at risk of maltreatment, disorganization and dysregulation.
‘Expressed emotion’ refers to the strong, intrusive and regular expression of criticism, hostility and disapproval towards other family members, including children. For example, Calam et al. (2002) found that mothers particularly prone to make hostile comments about their children were most likely to maltreat them emotionally.
Moreover, parents displaying high levels of expressed emotion often have experienced unresolved childhood losses and traumas that appear to be activated during parent–child interactions (Jacobvitz and Hazen 1999; Schuengel, van IJzendoorn and Bakerman-Kranenberg 1999). While engaging with their children, parents with unresolved feelings typically shout or speak in ways that appear odd and disconcerting. They grimace; or loom suddenly, threateningly and frighteningly into their child’s physical and visual space (a hand might silently and menacingly slip round the child’s throat) (Green and Goldwyn 2002: 838). Or they might ‘dissociate’ and switch off into a trance-like state in the middle of changing their baby’s nappy or as their toddler approaches them in tears with a cut finger. The child experiences all of these behaviours as odd, unpredictable and alarming, and seemingly without any obvious cause, save they often occur whenever the child displays attachment behaviour and has need of the parent.
Although emotionally abusive carers generally resist involvement with the health and social services, occasionally they may present the child as in need of treatment. The distinct message to the professional is, ‘there is something wrong with this child and I want you to sort it out and fix it.’ As the child is described, the tone is one of blame and irritation. However, many emotionally stressed children relax once out of the threatening environment and cease to display some of their more extreme symptoms, such as soiling, headbanging or sleep disorders. For psychologically maltreating parents, the child’s ‘sudden’ change of behaviour is further evidence of the wilfulness of their poor, slow or difficult behaviour. The demand is that the child is returned home where he or she might expect to be treated harshly for ‘showing up’ the parents and getting the family involved with professional child care agents.
Underpinning the whole of this caregiving pattern is deactivation of attachment (and caregiving) as an unconscious defence whenever the parent experiences attachment-saturated events. This includes most of what children do when they are simply being children. As infants they can only communicate needs and distress behaviourally. By their nature, young children are vulnerable and dependent. And yet it is these very states that activate anxiety in emotionally harsh and disengaged carers as old, unresolved feelings of danger, fear and attachment arousal are unconsciously evoked. These attachment feelings are defensively handled by excluding them from consciousness.
The carer does not reflect on them or subject them to cognitive appraisal reflection.
The effect of deactivating attachment-related information is that the carer either avoids or disengages from the child in need, or he or she dismisses, derogates or verbally punishes the child’s attachment behaviour and vulnerability.
Either way, by excluding attachment-related experiences from consciousness, the carer keeps the emotionally dysregulating information out of mind and so avoids becoming distressed. The problem from the young child’s point of view is that it is impossible not to present the parent with attachment-related experiences. By their very nature, then, infants and young children activate the parental defence, which in a further perverse irony denies the child an opportunity to regulate and explore his/her emotionally aroused state, which causes further distress.
It is not unusual for professionals who work with parents who psychologically maltreat their children themselves to feel intimidated. Initially, while the parent is weighing up the professional, interaction might be conducted in a cool but polite fashion. The parent is keen to know the reasons for the involvement. Feeling most safe when they are on top of the rules of engagement, carers might become very knowledgeable about the legislation that underpins the practitioner’s work. Woe betides the worker who does not know to the letter his or her own statutory powers.
The parent’s wish is to keep childcare authorities out of his or her life.
Health and welfare workers evoke caregiving and attachment issues that will be dealt with defensively using highly dismissing strategies. The professional has to justify every action. Contracts will be demanded, any breach of which will indicate incompetence. Unannounced home visits will be resisted. Only prior appointments will be tolerated. Inevitably, the parent will find some fault or failure in the professional’s practice. This will result in an official complaint to a higher authority, a politician or a lawyer. The practitioner will be derided as hopeless or unprofessional. If the parent has the ability, he or she will seek a new GP, request another health visitor, refuse to see a social worker, ‘sack’ a lawyer for a more competent one, leave hospital prematurely and against medical advice, fail to keep health appointments, and move home without telling anyone of the new address. Most professionals feel a degree of anxiety and stress working with such difficult and intimidating parents.
Psychosis, Trauma and Dissociation Evolving Perspectives on Severe Psychopathology Second Edition
Childhood Experiences and Delusions Trauma, Memory, and the Double Bind
Andrew Moskowitz and Rosario Montirosso
Parent–Infant Communication and the Double Bind Theory of Schizophrenia
The Double Bind Theory of Schizophrenia
In essence, the double bind theory claims that a regular pattern of disturbed communication between mother (typically) and child, from infancy on, leads to later disturbed ‘schizophrenic’ thinking and behaviour. The researchers did not think that childhood traumatic experiences (in the usual sense) were to blame for the schizophrenic symptoms, but that ‘characteristic sequential patterns’ of interaction (p. 253), over, and over again, were at fault.
They describe ‘double binds’ as arising from repeated interactions in an intense relationship, such as a parent–child relationship, in which it is ‘vitally important’ that communication be ‘discriminated accurately’, so that there may be an appropriate response (p. 253). The essential conditions consist of:
1) A primary negative injunction – a punishment or threat of punishment: ‘either the withdrawal of love or the expression of hate or anger – or most devastating – the kind of abandonment that results from the parent’s expression of extreme helplessness’ (p. 253, italics added)
2) A secondary injunction denying the first, usually expressed non‐verbally via posture, gesture, tone of voice, etc.
3) A tertiary injunction prohibiting comment on the contradiction or escape from the relationship. The authors note, however, that a formal prohibition from commenting on the situation might be unnecessary, since the other two levels involve ‘a threat to survival’; further, if the double binds are imposed during infancy, ‘escape is naturally impossible’. (p. 253)
4) Over time, once the person learns to perceive his or her world in double bind terms, only a part of the double bind ‘sequence’ is necessary to ‘precipitate panic or rage’, and thus, schizophrenic symptoms.
The authors provide a vivid example in the text from their observational data:
A young man who had fairly well recovered from an acute schizophrenic episode was visited in the hospital by his mother. He was glad to see her [it is assumed] and impulsively put his arm around her shoulders, whereupon she stiffened. He withdrew his arm and she asked, ‘Don’t you love me anymore?’ He then blushed, and she said, ‘Dear, you must not be so easily embarrassed and afraid of your feelings’. The patient was able to stay with her only a few minutes more and following her departure he assaulted an aide (p. 259).
Consistent with the above example, the authors argue that these patterns of communication arise because the mother feels threatened when approached by her child and manifests hostile or withdrawing behaviour. But she cannot acknowledge these behaviours (or would be a ‘bad parent’), so must simulate affectionate and loving behaviour. Thus, in order to maintain closeness with the parent, the child must deny (some of ) his perceptions, as well as suppressing the rage or anger he would likely feel. Ongoing interactions of this form lead to confusion not only between what is real and what is imagined (see Chapter 23 of this book), but also between what is part of me and what comes from other people (i.e. a blurring of the public/private boundary), a key aspect of Schneider’s first‐rank symptoms of schizophrenia (see Chapter 4 of this book). One example of this is seen in a brief vignette from the paper in which a mother, who feels hostile toward her child, says ‘Go to bed, you’re very tired and I want you to get your sleep!’ The underlying hostility is expressed non‐verbally but is contradicted by the expressed concern of the mother for the child’s welfare, which includes her telling the child what (she claims) he is feeling (he may, or may not, have actually been tired).
While the authors of the double bind paper are primarily arguing that disturbed language and thinking in schizophrenia may be an expression of the double bind (‘he must live in a universe where … events are such that his unconventional communicational habits will be in some sense appropriate’, p. 253),3 the genesis of bizarre behaviour and delusions can occur in the same way. For example, the authors describe an incident with a mother, grandmother, and seven or eight‐year old daughter, in which the grandmother threw a knife in rage which barely missed the young girl. The mother did not respond to the grandmother, but ushered her daughter out of the room, saying, ‘Grandmommy really loves you!’ As a young adult, while psychotic, the daughter appeared to take ‘great delight’ in throwing objects at her mother and grandmother, while they ‘cowered in fear’ (p. 260).
The bind that the child is in is ‘doubled’ because they are ‘punished’ if they respond to one message and not the contradictory message, and because they are not allowed to comment on the initial bind in which they have been placed. The researchers themselves wondered whether psychosis may develop partly as an attempt to deal with double binds, to ‘overcome their inhibiting and controlling effect’ (p. 261). Indeed, one can well wonder whether psychosis, and in particular delusions, could subvert the double bind by, as in the last example above: i) allowing for the expression of forbidden affect and forbidden behaviours while ii) allowing the person to deny intent because of the psychotic state.
Family Communication and Psychosis
While the double bind theory has been disparaged and ignored for most of the past half‐century, similar concepts, such as that of expressed emotion, have been the focus of research. The concept of ‘expressed emotion’ generally refers to the notion that higher levels of expressed emotion in a family (typically, hostile communication from the parents to the adult psychotic child) lead to worse outcome and more frequent relapses into psychosis (Butzlaff & Hooley, 1998). The research in this area generally does not look at the initial onset of psychosis, and thus avoids consideration of the possibility that such patterns of interaction may play an etiological role in psychosis.
An alternate concept, parental communication deviance (CD), which is similar to the double bind, does however consider this possibility. A meta‐analysis of research on CD and psychosis, which was conducted largely in the 1970s and 1980s, was published a few years ago (de Sousa, Varese, Sellwood, & Bentall, 2014). In that paper, CD is defined, with reference to Wynne (1981), as: ‘a form of intrafamilial communication that is vague, fragmented, and contradictory and that compromises the development and sharing of meaning between the parent and the offspring, leading to the consequent breakdown in communication’ (p. 756). The authors analysed 20 studies utilizing a range of methodologies that met their inclusion criteria and found a ‘large’ overall pooled effect size (Hedges’ g = 0.97) indicating that CD was ‘highly prevalent’ in the parents (mother more than father) of psychotic offspring. They also argued that it was more likely that CD was a cause of psychosis rather than vice versa, as prospective and adoption studies demonstrated that ‘CD in the parent precedes the development of psychosis in the offspring by many years’ and – even more impressively – that high‐risk children did not develop psychosis when exposed to ‘healthy communication’ styles in their adoptive families (p. 763, italics added). The authors speculated that ‘continuous exposure’ to CD in early childhood might lead to the ‘internalization’ of these communication patterns, resulting in later psychotic experiences (p. 757).
Thus, while research focusing on family communication styles as a cause of psychosis have fallen out of favour, a review of the literature supports their importance. Such research is consistent with the notion that the concept of the double bind may have validity and could lead to the later expression of psychosis.
The Role of Double Binds, Reality Testing, and Chronic Relational Trauma in the Genesis and Treatment of Borderline Personality Disorder
Ruth A. Blizard
Attachment relationships with caregivers who are dissociative, psychotic, or sociopathic involve thousands upon thousands of frightening, double‐binding interactions that may impair the development of reality testing in a more pervasive and insidious manner than discrete traumatic events. Such contradictory relationships lead to disorganized attachment in infants, a condition that predicts dissociation from childhood into young adulthood (Carlson, 1998; Lyons‐Ruth, Bronfman, & Atwood, 1999; see also Chapters 7 and 8 of this book, for links between disorganized attachment, double binds, and schizophrenia). The child may need to form dissociated, i.e. split, mental representations of the good and bad aspects of the self in relationship to the caregiver (Blizard, 1997a, 2001, 2003; Liotti, 1992, 1999). These contradictory attachment patterns cannot be integrated into whole self and object representations, impairing the interpretation of people’s appearance, intentions, and behaviour. During stress‐induced, acute dissociative episodes, these distortions may be intensified and interact with traumatic memories to cause loss of contact with reality.
A parent’s distorted or fragmented model of reality may actively discourage the use of important modes of reality testing needed to construct an integrated view of the world.
Children need repeated interactions with adults who can articulate and empathize with the child’s experiences as well as differentiate them from their own. Otherwise, these experiences remain as disconnected, implicit knowledge, and cannot be cognitively and emotionally integrated (Lyons‐Ruth, 1999, 2001). When caregivers do not perform this reflective function, children are unable to be aware of their own experiences and begin to dissociate their sense of self (Schwartz, 2000). When the parental relationship is pervasively abusive and lacking in empathy for the child’s perceptions, the child may develop a narcissistically closed system of self‐nurturance (Howell, 2005). Afraid to look outside the self for care and protection, the child turns to an internalized representation of a caregiver.
This prevents the child from engaging in consensual reality testing and lays the groundwork for the elaboration of distorted, idiosyncratic perceptions into full‐blown delusions.