When we work with alienated children we should know what we are working with in order to avoid treating the wrong thing. In my clinical experience, the problem we are treating, in families where a child is alienated, is not about high conflict and it is not about contact between children and their parents. Neither is it about abuse or about poor parenting by the parent who is being rejected. When working with children who align with a parent and reject the other and particularly when that presentation lasts over long periods and becomes entrenched and highly defensive, including perhaps allegations which escalate, the problem we are treating is alienation in and of children, from their own sense of self.  It is the role of the court to determine the cause of the harm and it is the role of psychotherapists who understand the problem and can demonstrate capacity to work within the legal framework to to determine the most effective treatment. Increasingly, it is social workers with statutory power, combined with psychotherapeutic input, that provides the most effective treatment intervention.

Successful resolution for alienated children is the resolution of the splitting defence. Whilst the goals of therapy fall broadly into those set by Johnstone, Walters and Friedlander (2001), the work of the Family Separation Clinic goes one step further than a focus upon child/adult relationships, seeing those as a projection of the internal state of mind of the child. In working with alienated children, FSC seeks to enable the child to recover the whole sense of self which is, in cases of hyper-alignment and rejection, impacted by ego splitting, a primitive defence strategy which is recognised as a response to trauma. (Winnicott, 1965; Van Der Kolk, 1994; Schore, 2010; Fisher, 2017). This trauma, which is the result of the violation of the usual boundaries within a family system, places children in a position within a family which is inappropriate, causing them to be in relationship with adults as if they are equal or in some cases, as if they have executive powers they do not possess. These boundary violations, which were termed parentification and spouseification by Minuchin (1974), are reversals of the normal and healthy parent/child relationship, causing the child to meet the needs of a parent rather than the reverse, as such these violations are recognised as emotional and psychological child abuse.

Working therapeutically with alienated children provides a longitudinal view of the internal experience of the child, both in recovery from alienation and over the developmental phases which follow. This means that the cycle of alienation can be understood from the clinical case material and the longer term harms to the child’s psychological and emotional wellbeing, can be measured and monitored. This is valuable when building treatment routes which can be replicated so that others can understand and treat the right problem. This clinical focus is very different to the academic research because it provides a case study of each unique family being treated, which, over time, provides an evidence base for depth psychotherapeutic work. It is this internal study of the alienated child, which demonstrates that the origin of the drama which unfolds when a child hyper aligns and rejects, is the child who is returned to and stuck in the paranoid/schizoid position of early infancy.

We are British Psychotherapists. At FSC, our work draws upon Object Relations Theory to enable understanding and Structural Therapy which is combined with the contemporary literature on Psychoneurobiological Theory (Schore, 2002) for treatment. In building our understanding of how to treat alienation in a child, we know that, at its core, the problem we are working with arises from ego splitting due to the onset of primitive defences in a child who has been pushed back into the paranoid/schizoid position articulated by Melanie Klein.

Paranoid/Schizoid Position

The term ‘paranoid-schizoid position’ refers to the anxieties, conflicts and defences and internal and external object relations that Klein considered to be present in the infant’s early months and years and which continue to a to play a role in childhood and adulthood to some extent. Contemporary understanding is that paranoid-schizoid mental states play an important part throughout life. The chief characteristic of the paranoid-schizoid position is the splitting of both self and object into good and bad, with at first little or no integration between them. (Melanie Klein Trust).

What this means for children of divorce and separation, is that their internal world is as impacted as their external world when their parents separate and for those with a parent who is unable to cope with their own internal conflicts and anxieties, there is an additional burden to carry which is that psychological and emotional baggage which belongs to that parent. Some children are compelled to take up this burden by maladapting their attachment relationship to each parent and by carrying the burden of parental internal conflicts via hyper-alignment and rejection. This leaves the child in thrall to the parent who is unable to resolve their own internal conflicts and anxieties and rejecting of the other parent. In order to do this however, the child must go through the process of fragmentation of the ego, in order to protect their sense of self and prevent complete dissociation.

Ego Splitting-APA Definition

In the object relations theory of Melanie Klein and British psychoanalyst W. Ronald D. Fairbairn (1889–1964), fragmentation of the ego in which parts that are perceived as bad are split off from the main ego as a mechanism of protection.

Working with alienated children

Clinical work with alienated children offers a unique insight into the ways that internal attachment maladaptations interact with the external world dynamics. In my experience, the failure to treat the problem fully, often lies in the way that the external world dynamics are impacted by the child’s behaviours. What I mean by this is that the behaviours seen in a child who is alienated, are confusing to those who do not understand what is causing them. For example, alignment between a child and a parent may look like a close loving bond to those who do not recognise the pathological signs of enmeshment or parentification. Understanding what enmeshment presents like as well as recognising the long term harm this emotionally incestuous relationship does to a child, is an essential part of skill development in this area of work.

Emotional incest is a boundary violation. It occurs, for example, when a parent shares information with a child about adult matters with an underlying intent to bind the child to their own world view and in doing so, receive regulation and reassurance from the child that they are aligned with them. This behaviour strips a child of their own independent right to parental care and support which is separate from the adult relationship of their parents. It also requires the child to disavow their own feelings in order to regulate a parent who often feels frighteningly out of control. When children are in this position they can be seen and heard to reflexively repeat, almost mantra like, the narrative of a parent who is violating boundaries, children in these circumstances become over burdened with the inter-psychic conflicts of the parent who is influencing them. Such children are being controlled by a parent who is unable to contain their own intra-psychic conflicts and who is using the child to regulate their anxieties.

Attachment maladaptations in divorce and separation occur in children because they are unable to cope with the demands a parent is making of them. Those attachment maladaptations include rejecting a loved parent in order to regulate the other and/or because a child has re-entered the paranoid/schizoid position in which primitive defences hold sway over their behaviour. Such children behave omnipotently and are often contemptuous of those who try to intervene. Children in such a state of mind are not psychologically or emotionally safe because they are outwith the capacity of either parent to provide good enough care, as such, children in this position are considered to have met the welfare threshold for significant emotional and psychological harm. This is when public law (in the UK) is required to intervene and when social workers are engaged in the work to restore health to the child.

Treatment of the Problem Using a Social Work Pathway

The Social Work Intervention Pathway for Alienated Children, is based upon the principles above which are conversant with child protection in social work. In this pathway, identification and differentiation is undertaken by a Clinical Psychologist or Psychiatrist and the Court provides the overarching framework for management. Using the concept of non accidental injury, the capacity of parents to respond to psychological guidance, behaviour change requirements and psychotherapy, is tested over time and the relationships between the alienated child and both parents are observed. Where a parent shows lack of insight and/or disguised compliance, the child protection route is activated and the parent is constrained from further harming the child. Only when the child is in a safe and protected space, is therapeutic work undertaken.

This pathway to treatment is necessary because the problem we are working with is relational in nature, it arises from the child’s attachment maladaptations and it responds to structural therapeutic intervention which is tailored to the specific dynamics arising in the family. The goals of the clinical trial are to determine whether a parent to whom the child is hyper aligned, has the capacity to show insight and change their behaviours and to determine whether the child can resolve the split state of mind in situ (without structural changes such as a residence transfer – which is either temporary or permanent).

In some situations, direct work with those children is the focus, in other situations, enabling parents to provide healthy care for their children, is the best route to help the child. In every situation, the purpose of our work at FSC is to enable the child to recover what Donald Winnicott called the true self, which is the self which does not suffer from ego splitting. In doing so, our close work with children allows us to understand exactly how these ego splits are caused by divorce and separation and what can be done to assist the child to recover the whole self.

Working Therapeutically With alienated Children

Alienated children suffering ego splits operate internally and externally from different parts of self. The concept of parts of self is one which is well understood in the contemporary literature on trauma, from where interventions can be built which are tailored to the needs of individual children. In my experience, all alienated children respond effectively to the language of parts, in which they are invited to work from the different split off parts of self. For example, all alienated children have an ashamed part of self which is denied and split off from consciousness and the purpose of the angry behaviours seen in children is, in my experience, a drive to keep the ashamed part of self out of consciousness. This is because if the child feels shame for the rejection of a parent, they also feel the love that they have for the parent which is also denied and split off from conscious awareness. One of the goals of therapy therefore, is to enable the child to process the shame they are denying because in doing so they also re-encounter the love that they have for the parent who is rejected. This is about integrating the child’s internal experience of self and in doing so, enabling external integration of their external relationships. What happens to a child who is integrating internally is that they will experience the external relationship as being somehow changed. Many children in recovery from alienation will say that they can now love the rejected parent because that parent has changed. What has really changed, is the intra-psychic world of the child, who no longer has to deny and split off experiences in order to cope. When this happens, children often spontaneously reveal the actions of the influencing parent, this is because when the child is integrated internally, the healthy part of self can fully recognise the harmful behaviours they have been subjected to.

Working with alienated children requires a particular approach, it is not something which can be done in a once-each-week session in therapy but must be done in the moment, often intensively and over significant lengths of time. Therapists doing this work must be able to work symbolically with children (many of the early phases of work are done in silence with children who have no language for what has happened to them). Symbolic working is often done whilst walking or moving together in some way. This is because the traumatic impact upon a child of having to make attachment maladaptations, causes an over reaction in the amygdala, meaning that the child cannot self regulate easily and is often, in the early stages, hyper alert. This hyper alert state of mind, is not caused by the parent the child is rejecting but by the conveyance in the inter-psychic relationship with the aligned parent, that the parent the child is rejecting is somehow dangerous or not to be trusted. Thus, the earliest stages of work with alienated children are focused upon helping them to self soothe and self regulate, ensuring that the internal state of mind is calm before encountering the split off and denied object relationship in the form of the parent in the rejected position. This work is intensive but it is necessary as a foundation stone for what follows which is the encounter with the parent in the rejected position. When that parent has been trained in therapeutic parenting skills, they are alert to all of the ways that a child with attachment maladaptations may react and are thus able to respond from a place of therapeutic care rather than reactive anxiety. In such circumstances, the goal of holding the child in an integrated position internally and externally in the relationship with the parent in the rejected position is achieved more readily.

When the first phase of work with the alienated child is complete and integration of splitting is seen to be sustained, work to test the child’s capacity to encounter the formerly aligned parent is undertaken. This is a more difficult phase of work however, especially if that parent lacks insight and continues to behave as if the child is in a dangerous predicament. In the UK, as elsewhere in the world, where campaign groups are often seen to uphold the distorted beliefs of an influencing parent, therapeutic work is often very difficult with such parents. Where a parent continues to lack insight, the relationship between the child and that parent has to be constrained and supervised over time to prevent the child from being pressured back into the defence of splitting. In all cases, protection of the child must be the first concern because ego splitting is a trauma response and boundary violations will continue to harm the child. In such situations, just as a child is protected from parental boundary violations such as sexual abuse, (which often causes dissociative splitting), a child must be protected in the longer term from boundary violations such as emotional and psychological incestuous abuse, (which causes ego splitting).


Fisher J. (2017). Healing the fragmented selves of trauma survivors : overcoming internal self-alienation. Routledge. https://doi.org/10.4324/9781315886169

Schore, A. N. (2010). Relational trauma and the developing right brain: The neurobiology of broken attachment bonds. In T. Bardon (Ed.), Relational trauma in infancy: Psychoanalytic, attachment and neuropsychological contributions to parent-infant attachment (pp. 19-47). London: Routledge.

Schore, A. N. (2002). Clinical implications of a psychoneurobiological model of projective identification. In S. Alhanati (Ed.), Primitive mental states: Psychobiological and psychoanalytic perspectives on early trauma and personality development, Vol. 2, pp. 1–65). Karnac Books.

Schwartz, R. (2001). Introduction to the internal family systems model. Oak Park, Ill.: TrailheadPublications.

Van der Kolk, B. A, Hostetler, A, Herron, N, Fisler, E. (1994) Trauma and the Development of Borderline Personality Disorder,
Psychiatric Clinics of North America,Volume 17, Issue 4

Winnicott, D. W. (1965). The Maturational Process and the Facilitating Environment. New York: Int. Univ. Press.

Training for Parents in the Rejected Position

Listening and Learning Circles Summer 2023

The Circles for Summer 2023 are now avaiable for booking here please note that the Circle due to be held on May16th has been cancelled due to my work in the High Court, the next circle is therefore 30th May at 18:00 UK time.

Higher Level Understanding Course

This course is for those who have completed the Holding up a Healthy Mirror Course with me and is a depth experiential course which examines attachment, working with parts, using symbolism for the child without language, communication with alienated children, understanding the recovery route of the alienated child as well as focused mentalisation skills to enable parents to rebuild relationships with children which repair the maladaptations a child has had to make. The course will be useful for those who wish to help themselves and others. There are a few places left and you can book here

Please note that if you are on the list for a concessionary place, you will receive a link to pay by the end of this week.