Karen Woodall – Psychotherapist, Writer, Researcher, Trainer

In recent years I have been focused upon developing an adapted form of therapeutic parenting for alienated children which I have come to call Structural Therapeutic Parenting (1). Whilst therapeutic parenting is, within itself, a useful approach to supporting abused children with disorganised attachments, for alienated children, who have a distinct trauma response to the dynamics around them, an adaptation to therapeutic parenting is necessary.

The distinct trauma response seen in alienated children is psychological splitting, which is an unconscious defence arising in the face of overwhelming events, in addition to the pressure from projective entanglements which erupt around the child in divorce and separation. Splitting interrupts the development of a coherent sense of self,  due the child’s triangulation into adult feelings at a time when they should be focused on making their own sense of the world (2). As the child loses the opportunity to develop personality and internal coherent narratives about self and other, regression occurs in their behaviour and their relational capacity.

In working with alienated children, it becomes apparent that disorganised attachment behaviours not only herald the onset of splitting in children of divorce and separation, they indicate the potential for longer term harm.  In working with children and young people through the recovery process beyond splitting, which involves achieving not only a reconnection a lost parent but a lost part of self, is characterised by a cluster of symptoms which form part of the diagnostic criteria for complex post traumatic stress disorder which is referred to in the ICD-11 as disturbance in self organisation (3).

Self-organization refers to an individual’s ability to maintain coherence in thoughts, emotions, and behaviors, enabling them to function effectively in various life domains (4). Disturbances in self-organization can manifest as psychological distress, emotional dysregulation, identity fragmentation, and maladaptive behaviors. Such disturbances are commonly seen in individuals experiencing trauma, personality disorders, and neuro-developmental conditions (5). People with disturbed self-organization often report a range of distressing experiences, including – emotional dysregulation which manifests as extreme mood swings, impulsivity, and difficulty managing stress (6).Individuals may also struggle with a coherent sense of self, experiencing shifts in sense of self which appear as unstable personality and difficulty maintaining long-term goals or relationships (7). Persistent negative thoughts, paranoia, or dissociation often accompany disturbances in self-organization along with unstable relationships due to fear of abandonment, trust issues, or difficulty with emotional intimacy (8).Physical manifestations such as chronic pain, gastrointestinal issues, and fatigue can result from prolonged psychological distress (9).

When we are considering the journey that the alienated child takes through this trauma response during family separation, we might  hope that there would be a coherent understanding of the problem amongst professionals, especially those who consider themselves to be ‘trauma informed.’ Sadly, that is not the case and, perhaps because this subject is as hotly contested as a high conflict divorce, the reality of what is happening to children both before AND after the onset of this trauma, as well as far into their later years, remains both poorly understood and perhaps as a result of that, ignored.

Most children traverse the journey through splitting and the developmental interruptions and delays that this brings, eventually seek proximity to the parent they have rejected. Many children who have travelled this path will be reconnected to the parent they have rejected by the age of thirty (10), the time of life when the brain is fully developed and perspective on life has, as a result, grown (11). What becomes apparent however, from the reports of parents whose child has returned, is the lasting legacy that this journey leaves, as their children often remain emotionally distant, appearing dissociative at times and struggling with adult relationships. Some parents report that despite the reconnection, their child continues to show patterns of behaviour conversant with splitting, being unable to tolerate ambivalence and living in a world in which friendships and relationships appear as fragile threads which are easily broken.

Therapeutic approaches to assist young people in recovery from splitting in divorce

Since 2020 I have been developing an adapted form of therapeutic parenting for alienated children, which has involved a great deal of research into what is currently available to help young people with disturbance of self organisation. What is currently available, is largely based upon forms of child abuse which are already understood such sexual or physical abuse.  Interventions available include Dialectical Behaviour Therapy (DBT), developed by Marsha Linehan  which is is particularly effective for individuals experiencing emotional dysregulation and self-destructive behaviors,  DBT focuses on providing individuals with tools to stabilize their internal states(12). Mentalisation Based Therapy (MBT), proposed by Bateman and Fonagy helps individuals improve their ability to understand and interpret their own and others’ mental states and is particularly beneficial for those with borderline personality disorder (BPD) and attachment-related issues (13). Somatic Experiencing (SE), developed by Peter Levine focuses on processing trauma stored in the body. It helps individuals release physiological tension and reintegrate fragmented aspects of their experience, promoting holistic self-organization (14), whilst  EMDR, developed by Francine Shapiro, is effective for trauma-related disturbances, by facilitating adaptive processing of distressing memories, to restore emotional regulation and cognitive coherence (15). Stephen Porgesintroduced polyvagal theory, which emphasizes the role of the autonomic nervous system in self-organization (16).

All of these therapies are useful in helping children who have grown up with an unresolved trauma to address the issues which continue to affect them long after the event. However, when the person with the trauma is unable to identify the source of the that and the therapist does not have any sense of how that trauma impacts upon a person internally, application of each of these approaches is a somewhat hit and miss affair.

The key to a therapy tailored for alienated children therefore, must, in my view, match the internal experience of the child eand in understanding how this trauma is actually caused. As Janina Fisher explains in her book ‘healing the fragmented selves of trauma survivors (17), the barriers to therapy facing people with a lack of coherent sense of self, are not interpersonal (between the self and other) but internal (existing inside of the self). The child is alienated from their own integrated sense of self and this difference is, in my view, critical when thinking about how children who have been through the journey of alienation, can make sense of their experience in a therapeutic framework which meets their needs.

The final part of the puzzle in putting together a therapeutic framework for young people who have gone through this journey is the shift back into an integrated sense of self. Integration in what is called ‘Interpersonal Neurobiology’ (IPNB) (18), refers to the process of linking different aspects of the brain, mind, and relationships to create a more harmonious and flexible system. Siegal emphasizes that well-being arises when different brain regions—such as the emotional limbic system and the rational prefrontal cortex—work together rather than in isolation. This idea extends to interpersonal relationships, where integration fosters deeper connections and resilience. His work highlights how practices like mindfulness and secure attachments help promote integration, leading to greater emotional regulation, self-awareness, and overall mental health. 

The Journey of the Alienated Child

The journey of the alienated child can be broken down into four distinct stages.

1. Onset of disorganised attachment behaviour
2. Disappearance into psychological splitting
3. Emergence into disturbance of self organisation
4. Integration of a holistic sense of self.

Working with a synergised approach which I have called ‘right action at the right time‘, a combined use of these therapeutic modalities can provide significant shifts for children as they move through the journey of alienation. When the journey itself is properly understood, the principle of right action at the right time, becomes both understandable to parents and meaningful in the lives of their children, because parents are responding to the child’s actual need as well as capacity for and openness to receiving what they need. This is the structural element of my adaptation of therapeutic parenting, which enables parents to recognise where their child is at each stage of the journey and connect with their child in ways which create powerful change.

When parents of reconnecting children understand that the behaviours they see when their children return home, are the impact of disturbance of self organisation, which has been caused by having been diverted away from normal developmental processes, they can learn how to respond to the unpredictable behaviours and trauma burdens their children carry. When therapists understand that what we are working with in children of divorce and separation, is NOT about interpersonal relationships but an intra-psychic trauma, which has caused a disturbance in self organisation, the goals of therapy become much clearer and young people will feel better understood.

Which is why I believe that it is time to call this what it really is, which is a recognised trauma response called self alienation, or in attachment terms an induced false or alien self, terms used by D W WInnicott, (19) and Peter Fonagy (20), respectively, to describe what happens when a powerless person avoids dissociation via defensive splitting. Self alienation in this scenario. arises in the child, when they are overwhelmed by the childhood trauma of family separation. 

When young people finally have a name for the reality of their trauma, which is about their own internal experience, not parental divorce or even about their relationship with their parents at all, but about their own relationship with self, they and others will deeply understand what they are working with and have the skills to treat it. And then, the path home to an integrated sense of self, finally becomes within the collective reach of the survivors of this hidden form of child abuse.

References

1.Woodall K, (in press) The Journey of the Alienated Child. Centre for Childhood Relational Trauma.

2. Burland JA. Splitting as a consequence of severe abuse in childhood. Psychiatry Clin North Am. 1994 Dec;17(4):731-42. PMID: 7877900

3. Code 6B40. Table 1. Disorders Related to Stress and Trauma  According to the ICD-11, the ICD-10, and the DSM-5.

4. Kelso JA, Fuchs A. Self-organizing dynamics of the human brain: Critical instabilities and Sil’nikov chaos. Chaos. 1995 Mar;5(1):64-69. doi: 10.1063/1.166087. PMID: 12780157.

5. Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. Guilford Press.

6. Fonagy, P., Gergely, G., Jurist, E. L., & Target, M. (2002). Affect regulation, mentalization, and the development of the self. Other Press.

7. Chapman J, Jamil RT, Fleisher C, et al. Borderline Personality Disorder. [Updated 2024 Apr 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430883/

8Therapeutic presence: Neurophysiological mechanisms mediating feeling safe in therapeutic relationships. Journal of Psychotherapy Integration, 24(3), 178–192.

9.van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Viking.

10. Baker, Amy J. L., Adult Children of Parental Alienation Syndrome: Breaking the Ties that Bind, 2007, W. W. Norton.

11. Siegel, D. J. (2012). The developing mind: How relationships and the brain interact to shape who we are (2nd ed.). The Guilford Press.

12. Chapman AL. Dialectical behavior therapy: current indications and unique elements. Psychiatry (Edgmont). 2006 Sep;3(9):62-8. PMID: 20975829; PMCID: PMC2963469.

13.Mentalization-Based Treatment for Personality Disorders: A Practical Guide ( Oxford , 2016; online edn, Oxford Academic, 1 June 2016)

14 Levine, P. (2010) In an Unspoken Voice: How the Body Releases Trauma. North Atlantic Books, Berkeley.

15 Shapiro, F. (1993). Eye movement desensitization and reprocessing (EMDR) in 1992. Journal of Traumatic Stress, 6(3), 417-421

16 Porges, S. W. (2011). The polyvagal theory: Neurophysiological foundations of emotions, attachment, communication, and self-regulation. W W Norton & Co.

17 Fisher, J. (2017). Healing the Fragmented Selves of Trauma Survivors: Overcoming Internal Self-Alienation. Taylor & Francis.

18  Siegel, Daniel J. (1999). The Developing Mind: Toward a Neurobiology of Interpersonal Experience. Guilford Press 

19.Ehrlich, R. (2021). Winnicott’s Idea OF The False Self: Theory as Autobiography. Journal of the American Psychoanalytic Association, 69(1), 75-108. https://doi.org/10.1177/00030651211001461

20.Duschinsky, Robbie, and Sarah Foster, ‘Conceptualizing the ‘self’’, Mentalizing and Epistemic Trust: The work of Peter Fonagy and colleagues at the Anna Freud Centre (Oxford
, 2021; online edn, Oxford Academic, 1 June 2021), https://doi.org/10.1093/med-psych/9780198871187.003.0007, accessed 9 Feb. 2025.