The issue with labels is that whilst they may be useful in raising public consciousness of a problem, for example, parental alienation (PA) or the newest label for a child’s rejecting behaviour, child and mother sabotage (CAMS), they do not help when it comes to treatment routes. The same is true of the labels used by the AFCC such as resist/refuse dynamics or parent-child contact problem, when you use labels as a lens through which you think about the problem of a child’s strong alignment with a parent who is abusing them, you move further away from the problem rather than closer to it. In my experience this problem is not about child contact, it is not about the refusal or resistance to the parent in the rejected position, it is not about high conflict separation, it is about the child’s psychological response to the pressures around them and their entry into a trauma bond with an unpredictable and/or frightening parent in circumstances where they cannot ameliorate the power that parent has over them.
I stopped using labels in 2019 when I began to focus on developing a relational therapy approach to working with the problem of a child’s hyper alignment to an abusive parent. What I had come to understand during the previous five years was that as a psychotherapist working with alienated children, I was not interested in proving whether the problem exists or not, what I wanted to do was treat the problem as it presented in children and harness the power of the best person possible to do that – which is a healthy parent in the rejected position.
Over the past fifteen years I have worked with well over a hundred severely alienated children who were trauma bonded to a parent who was abusing them. Some of those children were trauma bonded to their mother, some to their father, the by product of that trauma bond being the rejection of a parent who could provide healthy care. In recovering the whole child, by which I mean enabling the child to integrate the internal fragmentated sense of self, I have always been aware that the parent in the rejected position is the most valuable asset that a therapist can possess.
I view children who cling to parents who are found to be emotionally or psychologically abusive in the family court process, in exactly the same way as I view all children abused by parents. Their first need is for protection from the abuse, their second need is for the treatment of the blocked trust which interrupts the caregiving circle of reciprocity between them and a parent who is found to be healthy. Treating blocked trust requires a particular approach in the scenario where a child is trauma bonded to an abuser and, whilst all cases are different because all abuse dynamics will configure around the child differently, the principles of treatment are always the same – ie –
a) protection from the abuser
b) proximity to the parent the child is blocking
and
C) highly attuned parenting which is capable of absorbing the child’s initial projections whilst continuously reflecting back boundaried high levels of focused nurturing.
We dewcribe this process as ‘constrain, protect and treat’ and we apply this principle in every case we work in, utilising the attachment relationship between the parent in the rejected position and the child as a conduit through which to deliver the help that the child needs to recover from the attachment maladaptations they have been forced to make.
The reality is that children who strongly align to a parent who is found to be abusive in circumstances where the other parent is found to be healthy or good enough in terms of their care, is that they are coping with the dynamics which labels might describe at the top level but which beneath that there is little guidance on how to assist the child. This is true whether you use PA, CAMS, Resist/Refuse or Parent-Child Contact problems as a label, the issue is that when it is proven that one of these labels applies to a child’s situation, what then, what do practitioners actually do and why do they do it? There is very little written anywhere about how to actually treat the problem and whilst we have some knowledge about reunification programmes, the actual psychological rationale and therapeutic approach to delivery is missing.
The reality of this behavioural display in children is however clearly articulated in the psychological literature and for those with eyes to see and a willingness to investigate, everything that is necessary to help alienated children is set out in the decades of research into why vulnerable people are manipulated and how coercive control works to strip agency and a sense of self. Contemporary attachment and trauma literature gives us a wealth of understanding about how children become trauma bonded and the impact of that upon their developing selves. It also gives us the necessary tools to respond to their attachment maladaptations so that the unblocking of the caregiving circle becomes easier.
Beyond binary thinking and the use of labels to prove or disprove this problem exists is an evolutionary approach to treating children who align with abusive parents, an approach which utilises the parent in the rejected position to build back the relational health that a child has experienced until the crisis of dynamics unfolded around them. We have been trialling therapeutic parenting for this situational attachment trauma since the pandemic with increasing evidence of success and this work will be our focus for the coming years to ensure that the next generations of children at risk of this childhood relational trauma are better protected.
Family Separation Clinic News
International Symposium 2024
Our Symposium, which will be held on September 12th 2024 at Cambridge University in the UK will be open for booking next week. With a gathering of practitioners involved in relational trauma work, the sharing of information about understanding how to treat the problem of children’s alignment with abusive parents will be of interest to many. The day will be centred around the lived experience of children who have been removed from abusive parents in ‘residence transfer’ in the UK, with live testimony and analysis. With tickets for streaming and for attendance in person, the day promises to be filled with information, insight and learning. Look out for the details here next week.
Therapeutic Parenting Training for Parents
We are currently in an intensive development phase in which we are completing handbooks for parents and professionals and recording our watch on demand videos for parents. Our courses and resources for the Summer term (both live and watch on demand) will be announced later this month. So far we have delivered training in therapeutic parenting to over a thousand parents around the world through seminars and courses and our therapy group which is called the Lighthouse Keeping Group. The feedback on the efficacy of this approach to helping parents in the rejected position to help their children has been wonderful, with many testimonies of rebuilding of relationships and successful reconnections. We know that this is the right response to children who have been abused in family separation because it is replicable and it is successful. Our work towards an academy for parents and professionals continues and we look forward to welcoming many more parents and wider family members to work with us very soon.
Choosing Yourself When Your Parents Separate – A Handbook for Young People
This handbook for young people which has been written by a now adult child who was removed from a parent in residence transfer is in press and will be available to order shortly.
Therapeutic Parenting Newsletter
The next newsletter with information about our courses and resources for parents and families will be sent out very soon, if you would like to receive it please email karen@karenwoodall.blog with the words ADD ME in the subject line.
Karen Woodall - Psychotherapist, Writer, Researcher, Trainer 
Blocked Trust: Stress and Early Brain Development
To survive very poor care, children learn to fend for themselves by developing a strategy to meet their physical needs for food, warmth, and protection from the elements (self-provisioning); protect themselves from untrustworthy caregivers (self-defense); and manage the emotional pain of being on their own in a dangerous world without a comforting other (self-regulation of social pain). In the process, the child must heighten those aspects of brain functioning that support chronic defensiveness while suppressing those emotions that normally support social engagement and attachment, including separation pain, pleasure of companionship, empathy, and remorse—emotions that would prompt the child to move toward an untrustworthy caregiver and get hurt even more. In the process of heightening defensiveness and suppressing social emotions, the child also has to suppress the development of his inner life, that inward-looking default mode system that eventually enables reflective functioning to emerge in typical development. Poorly cared-for children don’t feel safe enough in the presence of a caregiver to look inside; instead they are compelled to constantly monitor the external environment for threats. Blocked trust is the combination of these different processes that constitute the child’s survival strategy, his or her tool kit for getting by largely through self care, for maintaining a “me” orientation to life in the absence of a healthy “we” (Siegel, 2012).
Let’s look at how this developmental trajectory affects the five core brain systems we discussed in Chapter 1. Then we consider the processes of heightening self-defensiveness and suppressing social emotions and reflective functioning. Last, we describe three types of blocked trust strategies commonly seen in a clinical setting.
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Blocked Trust and the Five Core Brain Systems
In terms of the core brain systems discussed in Chapter 1, the maltreated child has to suppress the social engagement system and the social pain system while activating and strengthening the self-defense system. To do this as an infant, the child has to rely on the bottom-up, primarily subcortical brain systems in which the amygdala takes the lead. The child has to use the amygdala-driven neuroception system to rapidly detect threats and keep the self-defense and the stress systems up and running, basically on 24/7 duty. The child also uses the ability to release pain-suppressing chemicals, mostly opioids, into the amygdala and the anterior cingulate cortex (ACC) to dampen the subjective pain of having to deal with poor care. This requires the child to use the social pain management system for self-defense rather than experiencing the co-regulation of separation distress by a trusted caregiver. This forces the child prematurely to develop a self-regulation strategy at a time in brain development when there is no other option besides the automatic, unconscious use of the opioid-driven pain suppression system, an emotion regulation strategy that promotes chronic disengagement and dissociation. Meanwhile, the need to stay hypervigilant toward the outer world interferes greatly with the development of the child’s inner life, making the child doubly unsafe: unsafe looking outside and unsafe being inside. This lack of external and internal safety underlies the disorganized style of attachment most of these children develop and goes to the heart of blocked trust. Understanding these dynamics informs us, as therapists and caregivers, that we need to target both levels of safety to help these children recover from this developmental trauma.
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Heightening Self-Defense Processes Hypervigilance
Defensive living requires the ability to rivet attention on the signs of impending threats to safety in the behavior of other people. This includes the art of reading other people’s intentions, of “minding their minds” to see harm on the rise, catching threats emerging before they actually materialize in various forms of abuse, neglect, invalidation, or rejection. Chronic mistrust requires a strong negativity bias, a constant hyperfocusing on the subtlest shifts in other people’s faces, voices, body language, and interactions that reveal anger, disgust, or apathy. This early threat detection process is sufficient in highly defensive children to trigger defensive action: evasion, preemptive aggression, a charm offensive, or some form of frantic excitement that distracts everyone, including themselves. Based on this quick appraisal of impending harm, some kids become tigers, others opossums, other chameleons, different styles of blocked trust all serving the function of keeping others at a physical and emotional distance.
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⦁ Implicit Memories, False Alarms, and Over-the-top Reactions
⦁ Safety Blindness
⦁ Deer in the Headlights: The Automatic Orienting Response
⦁ Heightened Need for Control
⦁ Resisting “Authority”: Saying No!
⦁ Provisioning: Seeking and Seizing Opportunities to Meet Basic Needs
⦁ Suppressing Social Emotions and Reflective Functioning
⦁ Suppression of Social Pain and Empathy
⦁ The Insula: The Visceral Cortex Involved in Social Feelings
⦁ Suppression of Guilt and Remorse: Shame
⦁ Suppression of Curiosity and Wonderment
⦁ Suppression of “Reality Testing”: Telling Tall Tales and Believing Them
⦁ Suppression of Complexity: Black and White Thinking
⦁ Three Survival Strategies: Tigers, Opossums, and Chameleons
Blocked Care: The Parenting Brain and the Role of the Caregiver
Young children are at the mercy of their caregivers’ states of mind toward them and have to adapt accordingly to survive. The ability of a parent to develop and sustain a compassionate state of mind or attitude toward the child—embracing the whole child—is, in our clinical experience, the most important factor contributing to a child’s recovery from blocked trust.
Parents who can resist the natural tendency to respond defensively to a child’s defensiveness and can recover effectively from inevitable moments of losing empathy with a mistrusting child are the trust builders these children need to have.
Developing and sustaining this kind of resilient compassion is no easy task—far from a no-brainer. One parent described it as “hugging a cactus.”
Indeed, parenting a chronically defensive child takes all of the brain power an adult can muster, demanding the use of instinctual aspects of caregiving we share with other mammalian parents and the highest executive powers we access by turning on our most uniquely human brain regions in our prefrontal cortex. To make it even more challenging, these higher brain regions are the very ones most likely to shut down when a parent is experiencing great stress.
In brain terms, the ability to be a nurturing parent over time depends heavily on the social engagement system (that smart vagal circuit we described in Chapter 1) (Porges, 2012), the brain–body system that enables people to stay open and engaged with each other even when there is tension or misattunement in the relationship. Parents who stay open, mindful, and engaged with their children over time in spite of the stresses and strains of parenthood are relying on their good vagal tone to stay parental in an enriched way that supports a child’s healthy brain development. Parents with good vagal tone can keep defensive reactions at bay and recover more quickly from lapses into defensiveness than can parents with poor vagal tone. Fortunately, a growing body of research shows that parents can strengthen their capacity to be open and engaged in their relationships with their children (Tang et al., 2010). (We discuss this in Chapters 8 and 11.)
As we discussed in our previous book, Brain-Based Parenting (Hughes & Baylin, 2012), parenting well actually calls on at least five different brain systems that enable us to (1) feel safe being very close to our children; (2) derive pleasure and joy from taking care of and interacting with our kids; (3) attune to our kids’ inner lives using our powers of empathy and “mindsight”; (4) construct positive, affirming stories or narratives about being parents; and (5) control our negative, uncaring reactions sufficiently to stay parental most of the time, to be the adult in the room. We call these systems the Approach, Reward, Child Reading, Meaning Making, and Executive Systems. When a parent can access all five systems and keep them up and running over time, a child gets to interact with an open-minded, empathic, attuning other in ways that we now know enhance a child’s brain development and build strong bonds of trust between parent and child. A parent’s ability to access and sustain this open state of engagement depends on the parent’s visceral sense of safety, physically and emotionally, in the relationship with the child. Having supportive, secure relationships with other adults and freedom from chronic stress over issues of daily survival are also essential for a parent to interact in an open, engaged way.
Normally, when parents go through the experience of pregnancy and then are present to be trust builders in a child’s first year of life, there is a mix of joy and stress in which the joy outweighs the stress, enabling the parents to hold on to their loving feelings and compassion for their child and gain the child’s deep trust in their care. The hormonal changes during pregnancy, especially the rise in oxytocin and prolactin levels around the time of birth, prime the caregiving system in the mother, while expectations of fatherhood may have similar priming effects on the father-to-be, including the suppression of testosterone and other hormones that would normally inhibit a dad’s more nurturing, empathic potential (Bridges, 2008). With the birth of the child and the beginnings of face-to-face, voice-to-voice, touch-to-touch interactions, oxytocin and dopamine are triggered in parents and children, helping create strong emotional bonds that pave the way toward secure attachment and sustained caregiving (Fleming & Li, 2002).
This emotional bonding process helps build a strong foundation of trust that enables parents and children to weather the inevitable tensions that accompany the next stage of development when the child is mobile and the parents have to engage in more socializing functions, including saying “no” and helping the child learn to accept limits and rules. Once children deeply trust their parents’ intentions in setting limits and directing behaviors, the children are free to turn their attention to what is really important to them— play, discovery, delight, adventure, learning interesting things. The parents can do the heavy lifting regarding basic issues of safety and the child is free to be a child.
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Common Characteristics of Blocked Care
Shifting between states of social engagement and self-defense is normal in the give-and-take of parent-child relationships. Blocked care sets in when the parent gets stuck in defensiveness and cannot shift out of this negative state of mind towards the child. In this scenario, the parent’s brain is using the defense system to protect the parent from the pain of perceived rejection.
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Mutual Defense Societies: When Blocked Trust Meets Blocked Care
Having to be a socializer without the benefit of first being a comforter and trust builder has much to do with why foster and adoptive parents of older children experience great challenges as they try to combine trust-building with socialization, “connection with correction.” Under the inevitable stress of parenting hurt children, parents are at risk for blocked care (Hughes and Baylin, 2012). The concept of blocked care refers to a scenario in which too much stress suppresses the higher brain functions needed for caregiving, engendering a self-defensive stance toward a child. In blocked care, the parent’s nurturing capacities are suppressed, temporarily out of commission. Caregiving is supported by the social engagement system, not the defense system; defensive states of mind inhibit the caring process. When a parent gets stuck in a defensive state of mind, this puts the parent–child relationship in jeopardy because, in effect, there is no caring mind “in the room.”
We readily understand how an adult is likely to begin to experience “blocked care” when an adult partner does not respond to expressions of interest and care for a period of time. Rejection by our child is likely to trigger the same social pain system activated by adult rejection. Although we may be able to see the difference between our child’s and our partner’s hurtful actions, it is still challenging to manage feelings of rejection and sustain caring feelings for our child. The risk that our care will weaken and may even become blocked, is still present.
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Blindsided by a Child’s Blocked Trust
Adults who are used to being trusted and to making people feel safe in their presence may experience being deeply mistrusted for the first time when they try to get close to a child with blocked trust. If these caregivers don’t see this coming, if they are blindsided by the child’s intensely negative reactions to their offerings of love, they may experience the intense pain of perceived rejection and recoil to protect themselves from this awful feeling. This can be the beginnings of a process in which a caregiver takes the child’s defensiveness personally, not understanding that this habitual defensiveness is really not at all personal but an overgeneralized, nondiscriminating response that lumps this adult together with all past adults who have mistreated the child.
When a child’s blocked trust meets a parent’s blocked care, the parent–child relationship becomes a mutual defense society that keeps reinforcing defensiveness in both parent and child. In blocked care, the parent tends to be in survival mode, parenting reactively rather than proactively. In brain terms, survival-based, defensive parenting is generated from the more primitive limbic and self-defense circuitry, without much use of higher brain functions that support the processes of reflection, mentalization, flexibility, and self-regulation. When the parent is in a “narrow-minded” self-protective state, the child and the relationship are at risk for chronic misattunement. Parents in this stressed-out state of mind do not respond empathically to the child’s distress, do not engage in repair operations, and do not reflect on their parenting to make changes and do a better job. Parents who enter parenthood with high levels of stress are more at risk for developing blocked care than are parents who embark on parenthood with emotional resilience, a secure adult attachment style, and a well-developed capacity for self-regulation and self-reflection.
Preventing blocked care, whenever possible, is a primary task in attachment-focused treatment. Addressing blocked care when it has already set in is also an essential component of treatment, because there is little possibility of helping a mistrusting child learn to trust if the adults trying to care for him are not able to approach him nondefensively, indeed, with compassion. Helping caregivers recover from blocked care and then strengthen their capacity for sustaining a compassionate state of mind toward their mistrustful child is a major part of the therapeutic process in attachment-focused treatment.
It behooves therapists to understand the dynamics of parental rejection sensitivity and to be prepared to work empathically with parents like Carol who are experiencing this distressing conflict between their personal reaction to their child’s mistrust and their goal of being a loving parent.
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Minding the Whole Child
We believe that the most powerful intervention for helping mistrusting children learn to trust trustworthy caregivers is to help caregivers embrace the child’s mistrust. Rather than trying to redirect the child and eliminate mistrust, the caregiver who can approach and welcome the child’s mistrustfulness, greeting this part of the child with empathy and compassion, can create a window of new learning for the child, an opportunity to experience the crucial difference between past experiences with caregivers and the experience of being with a truly safe caregiver. If a parent can shift from a corrective stance toward the child’s mistrust to embracing the mistrust, change becomes possible, whereas before, in a mutually defensive relationship, no change could occur.
By using reflection, the parent can get her mind around seemingly opposite parts of the child, including the sweet part and the angry, oppositional, defensive part. When the parent can construct an integrated working model of the child that embraces all of the child rather than taking a polarizing stance, they construct an internal representation of the child that can promote the same process in the child. In other words, when the parent can build in her or his mind this integrative, coherent model of the child, the model becomes the basis for relating to the child in a more empathic, holistic, integrated, coherent way, in a way that the child will feel, will sense, and will mirror. This mirroring of the parent’s holistic way of relating can promote psychological integration in the child, a key aspect of helping a child develop emotional resilience and a capacity to love herself, all of herself, not just her “nice” part.
Reflecting about your child changes your relationship with the child in your mind, in the mental space where you hold the image of the child. This is why Siegel and Bryson (2011), the dyadic developmental psychotherapy (DDP) model (Hughes, 2011), and Fosha (2000) in her work on “minding the child” place so much emphasis on the parent’s reflective process. Parental reflection about a child strengthens the ability to develop and sustain a more holistic, multidimensional, integrated image of the child to use as a template for guiding the way to relate to the child. Reflective functioning also helps the parent update her image as the child grows and changes and as the parent–child relationship changes over time.
When a parent adopts a welcoming, empathic, compassionate approach to the child’s wild side or worst self, that part that the child typically calls bad or even evil, the parent is communicating to the child that this “dark side” is understandable and even lovable. When the parent truly gets it that the child’s angry self enabled her to survive in a toxic environment, this is key to the process of helping the child heal, integrate her different parts, create a sense of wholeness, of being ok with who she is, safe with all of her feelings and internal states. This internal safety with one’s full range of emotions is the core of being a secure, resilient, empathic person.
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Helping the Child Feel Safe When Parents Shift from Companionship Mode to Parental Authority Mode
Mistrusting children learned to resist parental authority rather than depend on it. They had to be on guard about relinquishing control, giving power over themselves to an adult who would abuse this power or abdicate parental power through neglect. The hardest part of learning to trust a new caregiver is learning to feel safe with relinquishing control to the parent. To do this, the child has to experience the adult as a benevolent authority figure, not a malevolent or indifferent one. This means that the child has to unlearn his core strategy for staying safe enough around authority figures and stop reflexively resisting parental control.
Parents of mistrusting children often experience an abrupt shift in their relationship with their child when the interaction shifts from a playful one during which there is no real power differential to a parental one in which the parent starts to exert control by giving a directive, such as saying, “Ok, Susie, it’s time to get ready for bed.” This seemingly innocuous relational shift is a huge change for the child because the parent is implicitly saying to the mistrusting child, “Trust me now with being in charge because my intentions toward you are good and I’m not going to abuse the power that you relinquish to me.”
Understanding the difference in a child’s experience of us when we shift the relational dynamic from playfulness to authority is an extremely important aspect of the process of gaining a child’s trust. The process of making these relational transitions is the source of many of the meltdowns in the parent–child relationship. It is often the parent’s innocent exertion of parental authority that triggers what one child called “the Incredible Hulk.” This is when the parent needs to really stay empathic with the child’s struggle to accept you as a kind boss, a benevolent authority figure whose intentions are good.
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(Baylin, 2016)
Reference:
Baylin, J., & Hughes, D. A. (2016). The Neurobiology of Attachment-Focused Therapy: Enhancing Connection & Trust in the Treatment of Children & Adolescents (Norton Series on Interpersonal Neurobiology). WW Norton & Company.
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