Robert O’Block, Publisher, Annals of the American Psychotherapy Association
Divorce affects one million new children every year. Of these children, approximately 20% of their parents remain in conflict, with little, if any, cooperation (Garrity & Baris, 1994; Kelly, 2005). When children get caught in the middle of parental conflict, they are at risk for many psychosocial problems, including alignment with one parent against the other (e.g., Amato, 1994; Johnston, 1994; Wallerstein, Lewis, & Blakeslee, 2001; Wallerstein & Blakeslee, 1996). Especially problematic is when the alignment becomes so entrenched that children join forces with one parent to completely reject and denigrate the other, once-loved parent (Darnall, 1998; Wallerstein & Kelly 1980; Warshak, 2001).
Parents who encourage such alignments employ parental alienation (PA) strategies designed to turn a child against the other, targeted parent. The alienating parent is often filled with hatred, blame, anger, and shame and lacks awareness of the separate and independent needs of the children to have a relationship with the other parent (Ellis, 2005; Gardner, 1998; Rand, 1997). Through various strategies such as bad-mouthing, limiting contact, belittling, and withdrawing love, the alienating parent creates the impression that the targeted parent is dangerous, unloving, or unworthy, thus compelling the child to reject that parent (Baker, 2007a; Baker & Darnall, 2006). At its most extreme, when a child completely rejects the targeted parent, the result is referred to as severe alienation or parental alienation syndrome (PAS) (Gardner, 1998).
Mental health providers are among the first professionals to whom the targeted parents of alienated children turn to for help for their children or to whom courts refer for answers to accusations of brainwashing (Ellis, 2000). These parents and courts count on therapists to help whether it is to prevent continuing litigation in clogged courtrooms, or to intervene with counseling, as well as to give the parents supportive tools to repair and sustain the parent-child relationship. Because therapists are one of the first resources courts and parents use, they must be knowledgeable in the field of parental alienation and high-conflict divorce. They must be able to tolerate conflicting data from parents and children while searching for emotional truth within the children being counseled (Vestal, 1999). Along the same lines, Wallerstein insightfully comments in her forward to Marquardt’s (2005) book Between Two Worlds that what is needed is “an honest recognition of the experience of children” (p. xvii). In order to more honestly recognize and understand the experience of these children, mental health professionals must begin with the available knowledge that they currently have, incomplete as it is. To delay treatment due to incomplete information would be akin to a medical doctor refusing to treat a bleeding patient because he or she did not know what had caused the wound, and thus, by his or her refusal to treat the wound, the patient bleeds to death.
As Sternberg (2006) noted, “Scientific evidence regarding prevention and intervention is clearly helpful, but it is not yet sufficiently precise [in this parental alienation arena] so as to provide an answer to every question a psychotherapist might need to ask…” (p. 270). Because there is no longitudinal research that matches interventions with outcomes, the current authors propose a way of approaching treatment using sound scientific principles and evidence-based interventions with these children, in spite of the uncertainty. Mental health professionals remain in the trenches where they have to differentiate false accusations from legitimate ones and deal with the confused realities of these children and their parents. Common wisdom, increasing professional exposure and demand, and mounting professional opinion is that parental alienation exists and must be addressed in order to optimize children’s development (Ackerman, personal communication, August 19, 2007).
The purpose of this article is to suggest sound practices about parental alienation (PA) and parental alienation syndrome (PAS) and to identify some key prevention and intervention issues so that mental health professionals who counsel children and families experiencing loyalty conflicts or parental alienation tactics will be better prepared to help this highly vulnerable population. Consideration of these practices should enhance mental health providers’ ability to approach these issues from a more informed and reflective position.
Recognizing Parental Alienation
Recognition of parental alienation is a critical first step. Whether the task before the counselor is to halt the deterioration of the parent-child relationship and prevent the further effects of parental alienation or to restore a ruined relationship, therapists must correctly analyze and interpret the family dynamics in order to differentiate a child’s rejection due to parental alienation from a child’s rejection due to other causes such as estrangement or abuse (Stoltz & Key, 2002; Warshak, 2002). Discerning alienation from legitimate estrangement must be first.
Unfortunately, therapists do not have widely accepted parental alienation tests and other diagnostic tools available, nor is there a consensus regarding tools to use to assist in the diagnosis. For example, a recent survey of custody evaluators revealed a lack of consensus regarding diagnostic and assessment tools (Baker, 2007b).
For a diagnosis of PAS, we recommend following the lead of Dunne and Herrick (1994) and making an assessment through determination of the presence of the eight behavioral manifestations of PAS (described below), while ruling out alternative explanations for the child’s behavior such as bona fide abuse of the rejected parent (Gardner, 1999). In a clinical setting this can best be achieved through observing the child, talking with the child, and observing the child with his/her parents, in order to determine whether the child is exhibiting the eight behavioral manifestations associated with PAS (Gardner, 1998). To aid in that process, they are described in some detail.
The first is a campaign of denigration. The child becomes obsessed with hatred of the targeted parent. Parents who were once loved and valued seemingly overnight become hated and feared. This often happens so quickly that the targeted parent cannot believe that a loving child has turned into a hateful, spiteful person who refuses to so much as share a meal.
The second manifestation is weak, frivolous, and absurd rationalizations for the depreciation of the targeted parent. The objections made in the campaign of denigration are often not of the magnitude that would lead a child to hate a parent, such as slurping soup or serving spicy food.
Third is a lack of ambivalence about the alienating parent. It is a truism of development that children are ambivalent about both of their parents. Even the best parents are imperfect or sets limits that cause resentment and frustration. A hallmark of PAS, however, is that the child expresses no ambivalence about the alienating parent, demonstrating an automatic, reflexive, idealized support. One parent becomes all good while the other becomes all bad.
Fourth, the child strongly asserts that the decision to reject the other parent is his or her own. This is what Gardner (1998) called the “Independent Thinker” phenomenon in which the child adamantly claims that the negative feelings are wholly his or her own. These children deny that their feelings about the targeted parent are in any way influenced by the alienating parent. An observer might conclude that the child has been brainwashed or unduly influenced, but, to the child, the experience is authentic and self-generated.
A fifth manifestation is absence of guilt about the treatment of the targeted parent. Gratitude for gifts, favors, or child support provided by the targeted parent is nonexistent. PAS children will try to get whatever they can from the targeted parent, believing that it is owed to them and that because that parent is such a despicable person, he or she doesn’t deserve to be treated with respect or gratitude.
A sixth manifestation of PAS is reflexive support for the alienating parent in the parental conflict. That is, there is no willingness or attempt to be impartial when faced with inter-parental conflicts. The PAS child has no interest in hearing the targeted parent’s point of view. As Gardner noted, PAS children often make the case for the alienating parent better than the parent does. Nothing the targeted parent could do or say would make any difference to the PAS child.
Seventh is the presence of borrowed scenarios. PAS children often make accusations toward the targeted parent that use phrases and ideas adopted wholesale from the alienating parent. One clue that a scenario is borrowed from an alienating parent is the child’s use of language and ideas that he or she does not seem to understand, such as making accusations that cannot be supported with detail or using words that cannot be defined.
And, finally, the hatred of the targeted parent spreads to his or her extended family. Not only is the targeted parent denigrated, despised, and avoided but so too are his or her entire family. Formerly beloved grandparents, aunts, uncles, and cousins are suddenly avoided and rejected.
Examination of the child’s behavior according to these eight components of PAS should help a therapist differentiate among possible causes for a child’s rejection, as it is unlikely that a child rejecting a parent due to abuse or poor parenting would exhibit these eight behaviors. For example, research and theory on abused and traumatized children consistently highlight that these child victims are quick to absolve the abusive parent of all blame and express quite strongly the wish to be reunified with that parent (e.g., Herman, 1992).
Further, research with targeted parents supports the presence of these eight symptoms in alienated children (Baker & Darnall, 2007). The 19 signs of PAS as identified by Clawar and Rivlin (1991) and expanded upon by Baker (2007b) can also be used as guideposts in assessment.
In addition to the lack of assessment tools for identifying PAS or parental alienation, therapists might have difficulty dealing with or identifying it due to concerns about the controversy surrounding it as a diagnosis, which is fueled by the fact that is has not yet been accepted into the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM). Some may be swayed by the critique that there is inconsistent data to support the theory or that it is not a theory at all (Dallam, 1999). Others may take exception with the notion that alienation is attributable to the brainwashing of the child, and contend that most, if not all, cases are accounted for by inadequate parenting (Bruch, 2001; Johnston, Walters, & Olesen, 2005). Yet another concern is that false allegations of PAS are made by abusive fathers in order to wrest custody away from the mothers (Dallam, 2008). We contend that none of these concerns provide compelling evidence that PAS does not exist in some cases—even if the diagnosis is not yet in the DSM, even if false allegations can be made, and even if it is difficult to differentiate alienation from estrangement.
Additionally, conscious and unconscious barriers may create resistance or avoidance of the therapist in approaching the possibility of PAS or parental alienation. These need to be brought into awareness in order to ensure that they do not interfere with appropriate assessments. For example, some alienating parents may be quite persuasive, intimidating, or charming, while some targeted parents may be unlikable, passive, anxious, or unable to articulate their perspective, combining to create a pull on the therapist to ally with one member of the triad and therefore miss the true dynamics at work (Weigel & Donovan, 2006).
Perhaps it is more useful for a therapist to simply ask, “Do I believe that the child is being manipulated by one parent to reject the other parent, who is not abusive or so inadequate as to deserve the child’s rejection?” Answering yes to this question is synonymous with concluding that the child is experiencing parental alienation. Some researchers and custody evaluators have developed elaborate systems and tools for assessing PAS in the context of formal evaluations (e.g., Kelly & Johnston, 2005) and might be reviewed for appropriateness of therapeutic fit.
Working with Targeted Parents and Alienated Children
Unfortunately, as Ellis (2000) noted, individual and family interventions with PAS cases have “met with dismal failure” (p. 228). At this point, the negative impact of parental alienation on children and families cannot be overstated due in part to the inability of the mental health community to provide adequate relief to these children. Targeted families and alienated children suffer from stress, loss, grief, anger, and fear among other intense and uncomfortable emotions (Baker, 2007a; Ellis, 2005; Gardner, 2001; Vassiliou & Cartwright, 2001). Below are some of the initial and primary concerns for therapists working with this population. These are based on clinical wisdom gained through our combined experience with the phenomenon of parental alienation and PAS in clinical practice and research and integrated with evidence-based therapeutic practices.
Working with Targeted Parents
Working with alienated children requires contact with targeted parents and can range from support or empowerment to necessary correction and improvement in parenting skill areas. Whatever the task, therapists and counselors must remember that the targeted parent’s pain and suffering is immense (Ellis, 2005; Gardner, 2001). A chief culprit of this pain from the parent’s point of view—apart from the loss of the child—is that of being blamed for the rejection of the child. Although some professionals and laypeople attribute the cause of the child’s rejection solely to the alienating parent—believing that without that parent’s use of parental alienation tactics, the child would not be rejecting that parent—another school of thought, one perhaps more widely accepted, attributes some responsibility to the targeted parent (e.g., Johnston, Walters, & Olesen, 2005). To this way of thinking, there are several factors, including parenting weaknesses or passivity within targeted parents that make the parent-child relationship vulnerable to alignment with the alienating parent.
In terms of working with targeted parents, it is vital to acknowledge their pain and loss without blaming them for the difficult situation in which they find themselves. Of course, at the same time, it will be useful to determine if there are ways to improve parenting skills and parent-child communication. Parent Child Interactive Therapy (PCIT) may be promising in this regard. PCIT uses in vivo coaching to correct and shape parent communications (Herschell & McNeil, 2005). Working with the parent in a nonjudgmental strengths-based manner can address any vulnerable areas and help to repair the relationship. Not only will it bring power back to the targeted parent, but it can also enhance trust between the child and parent and help to remove doubts and fears within the child about the parent’s ability to parent.
Some of the tasks of treatment for targeted parents include learning to manage the grief, loss, rage, and shame of being a targeted parent; learning to manage the constant frustration and struggle involved in typically chronic legal battles and confrontations; and finding some peace and happiness within such a painful situation. Baker (2007a) offers several useful starting places for therapists to consider in working with alienating parents who may or may not benefit from a referral to a separate therapist. Greenberg (2002) offers strategies for working with emotional complexity and for guiding toward adaptive functioning. In addition, cognitive behavioral therapy might be useful for challenging and overcoming assumptions of helplessness and hopelessness (Graham, 2004).
Working with Alienated Children
As stated earlier, alienated and at-risk children represent a large population of children in need. While parental alientation affects only a fraction of divorced families, the absolute numbers are mounting. Realistically, counselors cannot defer treatment until effectiveness research has identified a list of psychotherapeutic interventions. In keeping with sound therapeutic practice, foremost in importance is the building of trust and therapeutic alliance. Alienated children are being programmed at various intensities to distrust primary attachments (Clawar & Rivlin, 1991). Thus, they may have difficulty trusting yet another “caring” adult. An essential task for the therapist will be to acknowledge the child’s reality without validating the negative view of the targeted parent. Making reflections on the child’s feelings using or modifying tools and techniques proposed in Greenberg (2002) is one way to build trust and create a therapeutic alliance. Another is through the use of play. Modifications of play interventions proposed in Reddy et al.’s (2005), Empirically Based Play Interventions for Children, most notably, the chapter on fostering resilience following divorce, might also provide ideas and guidelines.
Acknowledging that the therapist and child patient/client do not have a completely shared understanding of the situation while maintaining an empathic stance for the bind the child is in can also help establish therapeutic alliance. Though not to be rushed, once trust is established, important work can be accomplished. Ideally, the work would help the child develop a more balanced view of both parents and help the child develop critical thinking skills that can be employed in the face of the emotional manipulation of the alienating parent (Baker, 2007a; Gardner, 1998; Warshak, 2001). Integration of exit counseling strategies used with former cult members (e.g., Clark, Giambalvo, Giambalvo, Garvey, & Langone, 1993) with standard cognitive behavioral therapy for adjusting distorted thinking styles (Ronen, 2007) would probably be useful to explore.
For children who are severely alienated from the targeted parent, more active interventions may be called for, including reunification therapy. For example, Weitzman (2004) describes a one-way-mirror-based protocol for reuniting children with an estranged/alienated parent. Drawing on desensitization theory, Weitzman developed a procedure for bringing the child into successive proximity to the feared parent, only after clinical and forensic work is done to ensure cooperation of both parents (often through court orders).
Regardless of level of alienation, key issues in therapy with alienated children, in addition to difficulty with trust, will likely be to de-enmesh with the alienating parent. Johnston and Campbell (1988) observed in their study of aligned children that the mechanisms of “denial, distortion, and splitting” were present. Their finding suggests that it may be useful to look for these supporting defense mechanisms and then, if present, to rely on effective treatment strategies for refuting or treating them. There are other key issues to keep in mind:
- Self esteem—these children have come to believe that one of their parents does not love them, is unworthy of their love, and is someone with whom it is unwise to identify.
- Corrupted moral compass—they have been encouraged to be disrespectful, ungrateful, entitled, and parentified.
- Lack of independence—they have been encouraged to be overly dependent on the alienating parent’s acceptance.
- Relapse prevention—they are under constant pressure to behave a certain way in order to avoid the rejection of the alienating parent.
- Loss of identity—if it is unsafe to identify with the rejected parent then certain parts of the self identity may become lost as well. The alienating father who denigrates the mother for her academic abilities will create difficulty for a child embracing her own academic interests and talents.
Similarly, there may be family members who have not yet or may never “buy into” the alienation scenario. For example, in a multi-sibling family, not all children may become alienated from the targeted parent. It is also possible that an extended family member of the targeted parent is not fully rejected, or an extended family member of the alienating parent does not endorse the denigration of the targeted parent. Each of these individuals offers to the knowledgeable and attuned therapist windows of opportunity for helping the child adjust his or her perceptions and experiences of both the alienating and the targeted parent.
Throughout, therapists should be reflecting on their own feelings, experiences, and assumptions about parental alienation in order to avoid bias and projections onto patient therapeutic work. For example, therapists with their own histories of loyalty conflicts and alignments may hold hidden assumptions that could interfere with their ability to discern the realities of any specific case (Feinberg & Greene, 1995). Pickar (2007) points out that it is especially important for custody evaluators to engage in self-inspection during “best interest of the child” evaluations. The therapist is likely to experience the same confusing pull between the parents as the child does—as each parent tries to make his or her case to the therapist—which needs to be examined and tolerated. Otherwise, the therapist may rush to resolve the dilemma by aligning against the targeted parent, thus, allowing for a shared—albeit false—reality with the child. Weigel and Donovan (2006) suggest a similar attunement to one’s own issues for family and marriage counselors working with alienation cases.
To navigate these complex family dynamics, therapists should stay abreast of current knowledge and techniques in the field, stay attuned to their clinical intuitions, and seek support and advice as needed.
Next Steps For the General Public
Of primary importance for society in addressing this problem is to increase the awareness of the general public, including parents who may become targeted for parental alienation. Too often these parents do not know what is happening until it is too late. At that point they are left with a broken relationship and a severely alienated child. Awareness among the general public could serve to protect future generations of children and families and can provide much-needed support and guidance for those affected by it today. At a minimum, awareness could stop the blaming of targeted parents, which adds an additional level of pain and suffering.
One recent development is the creation of Web sites/organizations devoted to this issue, including one particularly prominent group established by a grassroots collection of targeted parents (parental alienation awareness organization). This and similar efforts can provide the general public with basic information and several avenues for further education and support. For example, through the Parental Alienation Awareness Organization’s efforts, governors in nine states have declared April 25 Parental Alienation Awareness Day.
For Mental Health Professionals
The large numbers of children suffering from or at risk for alienation suggest a need for expanded training of mental health professionals. As courts order custody evaluations, dictate mandatory mediation, and order parent education classes, there is an even greater need for trained professionals who can recognize alienation and work with families dealing with it. They need to be taught how to think about alienation in sound clinical ways and to integrate what is known about alienation with evidence-based treatments that are appropriate for this population.
Additionally, other mental health professionals who routinely interact with children and families need to be included in such trainings as well. School psychologists and school social workers, for example, are likely to come into contact with families facing parental alienation. If they are not aware of this phenomenon, they will be missing an important piece of the child’s context affecting school performance and behavioral adjustment. They also could function as consultants to teachers and guidance counselors in schools. School staffs traditionally try to maintain neutrality in the face of inter-parental conflict. Unfortunately, this can work to the advantage of an alienating parent. Thus, mental health professionals working within schools could support children’s relationships with targeted parents and function as a sounding board for teachers seeking clarity about alienation cases, so that they do not unwittingly get pulled onto the side of an alienating parent.
As training opportunities are expanded, research techniques such as single participant designs for tracking patient progress (Goodheart, 2006, p. 44) might be included in training education.
For Legal Professionals
Too often, law enforcement, divorce attorneys, mediators, guardian Ad Litems, and judges are unfamiliar or undereducated about the phenomenon of parental alienation. Some may be biased against the label PAS (Gardner, 2002). Thus, a child claiming to want nothing to do with one parent may be perceived to be acting out of a healthy self-interest rather than out of an unhealthy alliance with an alienating parent. Understanding severe parental alienation can provide much-needed legal support aimed at protecting the child’s relationship with the targeted parent rather than inadvertently fostering rejection.
Conclusion
Just as no one situation produces the alienated child, no one psychotherapeutic intervention or prevention strategy works for all. Mental health professionals need to be able to recognize parental alienation and to strategize treatments based on sound scientific practice. Counselors also need to be ready to confer with experts, to work with professionals from other disciplines, to apply strategically and appropriately evidence-based practices, and then to do what can be done to free the alienated and at-risk child from the short- and long-term damaging effects of the loyalty conflicts of PAS and parental alienation.
No comments:
Post a Comment