Really Bad Clinical Psychology

To:  Clinical psychologists who are assessing, diagnosing, and treating attachment-related pathology surrounding divorce (AB-PA)

Re:  Professional Competence


I am appalled that clinical psychologists are not recognizing and diagnosing a psychotic pathology that is sitting right in front of you in your office – an encapsulated persecutory delusion.

A psychotic pathology.   Right in front of you.  And you are totally missing recognizing it and diagnosing it.

Wow.  You know what?  You are a really bad clinical psychologist.  Just awful.

We’re not talking some strange esoteric form of pathology.  We’re talking psychotic pathology, right in front of you.  And you are entirely missing it.

I mean, seriously… psychotic pathology.  Wow.  You are a really bad clinical psychologist if you can’t even recognize and diagnose psychotic pathology when it’s sitting right in front of you.

The child is displaying an encapsulated persecutory delusion – a fixed and false belief that the child is being malevolently treated – being “victimized” – by the normal-range parenting of the targeted parent.

Here, let me take you by the hand and lead you through this…

Does the child believe that he or she is being malevolently treated – being “victimized” – by the targeted parent? – Yes.

Persecutory belief.

Is this true? – No.

False belief.

Does the child evidence the ability to change this false persecutory belief in response to the actual reality that the child is NOT being malevolently treated – is not being “victimized” – by the normal-range parenting of the targeted parent?  – No.

Persecutory delusion.

Does the child evidence delusions in other areas of life? – No.

Encapsulated persecutory delusion.

See how this diagnosis thing works?  Jeez Louise, you’re supposed to be a clinical psychologist.  This is your job.  Holy cow.

But you are looking squarely at a psychotic pathology – an encapsulated persecutory delusion – and you are totally missing it.

Wow.  I am absolutely floored.  You are a really bad clinical psychologist if you can’t even recognize and diagnose a psychotic pathology.

Does the child have an endogenous psychosis, like schizoprhenia?  No.  Wait… You can’t possibly be such an awful clinical psychologist that you would actually think that the child’s encapsulated persecutory delusion represents an endogenous psychosis originating in the child… can you?  I don’t know.  I’m so stunned that you can’t even recognize and diagnose psychotic pathology that I’m not sure quite how bad things are with you.

But no, the child does not have an endogenous psychotic pathology.  So if the psychotic pathology is not arising spontaneously to the child, then what is the source for the child’s encapsulated persecutory delusional belief that the child is being “victimized” by the normal-range parenting of the targeted parent?

Okay, take my hand again and let me walk you through this…

Can the normal-range parenting of the targeted parent create a delusion in the child – a false belief – that the child is being “victimized” by the normal range parenting of the targeted parent?  No.  Normal-range parenting cannot create a delusion.

Have you ever heard of any case in which a normal-range parent created a persecutory delusion in the child by normal-range parenting? – No.  Normal-range parenting cannot create a delusion.

Okay, then we can safely rule-out the targeted parent as the source of this delusional belief evidenced by the child.

So now we’ve ruled out the child having an endogenous psychosis (or are you still thinking that this might be childhood schizophrenia? – It’s not – but you’re such a bad clinical psychologist I don’t know what you’re thinking – but it’s not. There is no evidence to suggest that the child is independently psychotic).

And we’ve ruled-out the targeted parent as the source of the child’s encapsulated persecutory delusion.  Care to hazard a guess as to the next possible source to explore?  Right, the allied and supposedly “favored” parent.  Yay for you.

So, is it possible that the allied and supposedly “favored” parent has a false belief that the child is being “victimized” by the normal-range parenting of the targeted parent?  Yes, that’s possible.  Hmmm, how could we go about checking this out, to see if the allied and supposedly “favored” parent has the same beliefs as the child that the child is being “victimized” by the supposedly bad parenting of the targeted parent?

Hey, I know… how about we interview the allied parent and obtain this parent’s perceptions of the child’s supposed “victimization” by the parenting practices of the other parent.  Whaddya think?  Good idea?

And you know what, the allied and supposedly “favored” parent evidences exactly the same beliefs as the child.  Wow.  What a coincidence, eh?  They both share the same persecutory delusional belief surrounding the child’s supposed “victimization” by the normal-range parenting practices of the targeted parent.

Okay, now here’s a tough diagnostic question… what is the pathology called when two people (who live together and are closely related by blood, and are in a close relationship in which one of them is dominant over the other one) – what is the clinical psychology pathology called when these two people share the same delusion? — Right, a shared delusion.  Whew, I’m so proud of you.  You’re doing great.  When two people share the same delusion, the clinical pathology is called a shared delusion.

So we’ve now diagnosed a shared persecutory delusion – shared between the child and the allied and supposedly “favored” parent.

Okay, so we’re about to close out this diagnostic walk through, but before we do… you know what I find so amazing – and so incredibly appalling?  That you never-ever reached this point in the diagnosis of the psychotic pathology that is sitting right in front of you.  I am stunned.

You’re supposed to be a clinical psychologist, yet you entirely miss recognizing and diagnosing a psychotic pathology that’s sitting right in front of you with a flashing neon sign that says “Delusion – Encapsulated Persecutory Delusion” – and you’re just oblivious.  Wow.

You are a really bad clinical psychologist.  Really bad.

Okay, but let’s finish off this hand-holding diagnostic walk-through…

The child has an encapsulated persecutory delusion.  We’ve ruled-out that the child has an endogenous psychosis (like schizophrenia – you’ll agree with me on that, right?), and we’ve ruled-out the normal-range parenting of the targeted parent as a potential source for creating a persecutory delusion in the child, and we’ve identified that the child and the supposedly “favored” parent share the same delusion, so… what do we know about a shared delusion?

Let’s turn to the American Psychiatric Association in the DSM-IV TR.  Yes, I know we’re using the DSM-5 now, but for more than a decade the diagnosis of a shared delusion (which they call a Shared Psychotic Disorder) was acknowledged by the American Psychiatric Association, let’s just look at what they say about the pathology:

From the American Psychiatric Association: “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.”

So, who is “dominant” in this case?  A:  The allied and supposedly “favored” parent.

And did the child’s persecutory delusion toward the targeted parent develop gradually over time?  A: Yes.

So this would seemingly indicate that the allied and supposedly “favored” parent is the “inducer” and the child is “the more passive and initially healthy second person.”

From the American Psychiatric Association: “Individuals who come to share delusional beliefs are often related by blood or marriage and have lived together for a long time, sometimes in relative isolation.”

Are the child and the allied parent “related by blood”?  A: Yes.

Have they “lived together for a long time?”  A:  Yes.

So far the pathology fits perfectly.

From the American Psychiatric Association: “If the relationship with the primary case is interrupted, the delusional beliefs of the other individual usually diminish or disappear.”

Oh wow, here we’re getting some potentially useful treatment recommendations.  If we separate the child from the pathology of the parent, the child’s encapsulated persecutory delusion regarding the targeted parent will “diminish or disappear.”  Good to know, don’t ya think?

From the American Psychiatric Association: “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.” (p. 333)

“…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.”

Wow.  Sounds pretty much like an exact fit to me.

Does the American Psychiatric Association have anything to say about the course of a shared delusional belief?  Why yes they do.

From the American Psychiatric Association: “Without intervention, the course is usually chronic, because this disorder most commonly occurs in relationships that are long-standing and resistant to change.”

Pretty spot on, don’t ya think?  Does the American Psychiatric Association have anything to say about treatment?  Whaddya know, yes they do.

From the American Psychiatric Association: “With separation from the primary case, the individual’s delusional beliefs disappear, sometimes quickly and sometimes quite slowly.” (p. 333)

Well, there ya go… “With separation from the primary case, the individual’s delusional beliefs disappear…”

So, according the the American Psychiatric Association, the child’s persecutory delusional beliefs that the child is being somehow “victimized” by the normal-range parenting of the targeted parent will “disappear” with the child’s “separation” from the “inducer” of the allied and supposedly “favored” parent.

Wow.  From the American Psychiatric Association.  Shared delusional pathology fits exactly.  Seriously, I can’t imagine a more perfect diagnostic fit.  With treatment recommendations even.  American Psychiatric Association… the child’s symptomatic rejection of the targeted parent will “disappear” with the child’s “separation” from the allied parent.  Wow.  There ya go.

All that’s needed is a competent clinical psychologist.  Dang, instead we have you.  Dang, dang, dang.  Tough luck for the family then, because they have an ignorant and incompetent clinical psychologist who is going to sacrifice the child to a psychotic psychopathology because of flat out ignorance and incompetence.  Dang.

And did you also know that the diagnosis of Shared Psychotic Disorder is still in the ICD-10 diagnostic system (a diagnostic code of F24) of the World Health Organization, so you can still make that diagnosis if you want to, just use the ICD-10 diagnostic system.  The ICD-10 diagnostic system is a fully credible and accepted diagnostic system.  Internationally accepted.  World Health Organization.  All insurance companies in the U.S. require an ICD-10 diagnosis.  You’d be completely on solid ground making the ICD-10 diagnosis of F24 if you wanted to.

But you know what?  You are such a really-really bad clinical psychologist that this isn’t even an option for you because you can’t even recognize when you have a psychotic pathology sitting right in front of you.  Whoosh, nothing.  Completely oblivious to a psychotic pathology sitting right in front of you.

In Chapter 6 of Foundations I even describe in detail exactly the communication dynamic between the child and the allied parent that creates the child’s persecutory delusional belief, and in Chapter 7 of Foundations I describe in detail the origins of the delusional belief in the false trauma reenactment narrative contained in the internal working models of the allied parent’s attachment networks.  I explain it all for you in Foundations.

But here’s the thing… bottom line…

You’re supposed to be a clinical psychologist, but you can’t even recognize and diagnose psychotic pathology when it’s sitting right in front of you.  You seriously need to review your diagnostic skill set and you need to start to care about developing basic, minimal, standards of professional competence.

Start with the psychotic disorders – the really clear stuff.  Schizophrenia, hallucinations, delusions.  Then move to the mood disorder pathologies, major depression, anxiety disorders, panic attacks.  Don’t take on the subtler diagnostic stuff like PTSD or autism-spectrum disorders until you get the really clear and basic stuff down.  Get your feet under yourself first.

Seriously, if you cannot even recognize psychotic pathology when it’s sitting right in front of you, you shouldn’t be practicing clinical psychology – because you’re a really bad clinical psychologist – and when you’re such a really-really bad clinical psychologist, you are then directly responsible for destroying the lives of children and families who come to you for help.

You shouldn’t destroy the lives of children and families.  Go become a plumber or a shopkeeper, because you should not be a clinical psychologist.  If you cannot diagnose psychotic pathology that’s sitting right in front of you, then you are a really bad clinical psychologist who will destroy the lives of the children and families who come to you for help

 Then use our contact form down below. We will assist you, so the child gets the right Assessment, Diagnosis and Treatment, so no one will take the Bystander role in the mental abuse of a child.

Violent of the ethic code of professional psychologist . Our knowledge is establish in professional psychology

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Professional psychology is failing the family courts.

A child’s rejection of a parent surrounding divorce is a family therapy issue, not a child custody issue.

Child’s Best Interests

The family’s successful transition to a healthy and functional separated family structure following divorce is always in the child’s best interests.

Divorce ends the marriage, not the family.  A cutoff family structure is always pathological.  A cutoff family structure is NEVER a healthy post-divorce family.

It is always in the child’s best interests for the family to transition to a healthy and functional separated family structure following divorce.

The courtroom is not the proper venue to solve family pathology.  Family pathology cannot be litigated.  The resolution of family pathology is the domain of professional psychology.

The legal system therefore turns to  professional psychology for consultation on family pathology.

This request for consultation takes one of two forms, an order for something called “reunification therapy” or an order for a child custody evaluation by professional psychology.

In each of these, professional psychology is failing the court.

First, there is no such thing as reunification therapy.  This is important to understand.  There is no such thing as reunification therapy.  It’s an entirely made up thing.  There is no book, no article, no theorist who has ever described anything called “reunification therapy.”  It’s a sham construct designed to allow the “reunification therapist” to just make stuff up and do whatever they want, and just call it “reunification therapy.”

I’m a clinical psychology.  Psychotherapy is what I do, and I don’t think I’m being clear enough about this yet:

“Reunification therapy” is a snake-oil remedy of unknown contents that is more likely as not to kill you as to cure ya.  If any mental health person says they do “reunification therapy” – run.  There is no such thing as “reunification therapy.”

There, is that clear enough?

If any mental health professional disagrees, there is a Comment section to this blog.  Cite for me a single book or article that describes what “reunification therapy” is.

Crickets.  Nothing.

What the court and all parents want is family systems therapy; either Structural family systems (Minuchin) or Strategic family systems (Haley; Madanes).  Bowen has a foundational family systems model (Bowenian family systems therapy; The Bowen Center).  Satir has a model strong on family communication dynamics.

A competent family systems therapist is knowledgeable about all of these variations.  They all center around the same basic core constructs of Bowen; elaborated by Munichin and Haley.

Family systems therapy is one of the four primary schools of psychotherapy, the others are psychoanalytic psychotherapy (think Freud and his couch), cognitive-behavioral therapy (think lab rats pressing a lever), and humanistic-existential psychotherapy (think hot tub in Esalen).

Family systems therapy is the only school of psychotherapy that is designed to address and solve current family relationship conflict. Family systems therapy is the appropriate form of psychotherapy for addressing and resolving family-related conflict surrounding divorce.

The pathology of a child-rejecting a parent surrounding divorce is called an “emotional cutoff” (Bowen).  This is not Dr. Childress saying this. This is Murray Bowen saying this.  Standard family systems construct.

The pathology of an “emotional cutoff” is caused by disturbances in the process of “differentiation” within and among the family members.  Read:

Bowen Center: Eight Concepts
2. Differentiation of Self

This is not Dr. Childress.  This is Bowen.  Standard family systems therapy.  Disturbances in differentiation within family members can lead to the child’s “triangulation” into the spousal conflict to stabilize a parent’s vulnerability.

The child’s “triangulation” into the spousal conflict can take the form of a “cross-generational coalition” with one parent against the other parent, resulting in an “emotional cutoff” in the child’s relationship with the targeted parent.

Triangulation

Cross-generational coalition

Emotional cutoff

Differentiation of self

All standard family systems therapy stuff.  Bowen, Minuchin, Haley.

There is no such thing as “reunification therapy.”  No book.  No article.  No theorist.  The court and parents want family systems therapy.

Structural family systems therapy (Minuchin)

Strategic family systems therapy (Haley, Madanes)

Bowenian family systems therapy (Bowen)

Problem 1: Professional psychology is failing to provide the court with the proper professional knowledge and expertise needed to solve attachment-related family pathology surrounding divorce.  Instead, mental health persons surrounding the legal system are simply making stuff up willy nilly.

Problem 2: Child custody evaluations.

This is important to understand:  There is no scientifically established support for the validity of child custody evaluations.

Child custody evaluations violate every standard of professional practice regarding the development of an assessment procedure.  I discuss all of this more fully in:

The Child Custody Industry in Mental Health

There are multiple-multiple devastating problems with the practice of child custody evaluations, but I’ll focus here on just one, the most devastating one: No inter-rater reliability.

The conclusions and recommendations reached by child custody evaluations have no inter-rater reliability.  What this sentence means is that two different evaluators can reach two entirely different sets of conclusions and recommendations based on exactly the same data.

Well, that’s a problem.  According to the axioms of assessment, if an assessment procedure is not reliable (does not produce stable results), then the assessment procedure CANNOT – by definition – be valid.  The conclusions and recommendations from child custody evaluations are not valid.

If there is no inter-rater reliability, the conclusions and recommendations of child custody evaluations are simply the opinions of one person, that specific evaluator, perhaps based loosely on some psychological principles, perhaps based on no psychological principles whatsoever, just a matter of the individual opinion of the evaluator.

Don’t believe me?  There is a Comment section to this blog.  I challenge any mental health professional to cite for me a single study indicating the inter-rater reliability of the conclusions and recommendations reached by child custody evaluations.

Crickets.  Nothing.

The conclusions and recommendations of child custody evaluations are no more valid than a monkey throwing darts at a dart board, and a lot less entertaining – and, I might add, far more expensive.  Child custody evaluations are a very lucrative industry for professional psychology surrounding the family courts.

Child custody evaluations are a financial racket, pure and simple.  That is a strong professional statement to make, and I am absolutely prepared to back it up anytime, anywhere.  If any mental health professional wants to take exception to my statement, cite for me a single study identifying the inter-rater reliability of child custody evaluations.  If an assessment procedure is not reliable, it cannot, by axiomatic definition within professional assessment, be valid.  Child custody evaluations are a financial racket, pure and simple:

RICO

Do child custody evaluations actually do anything to solve the family pathology?  No.  Of course not.  They’re “evaluations” – not “therapy.”  For therapy, you’ll need “reunification therapy.”

See, right here in Recommendation 3 of the child custody evaluation, right after Recommendation 2 that custody time-share should remain exactly where it is right now (with the child rejecting one parent), see, a recommendation for “reunification therapy.”

Child custody evaluations don’t actually fix things, they just tell the court to keep things where they are right now (with the child rejecting one parent) and do “reunification therapy.”

And do you know what the “reunification therapist” is going to say?

“We need to go slowly and not rush the child.  We’ll start with 2 hours of supervised visitation and then increase it from there as the child decides they want to spend time with the parent.  We don’t actually want to solve the family pathology of a cutoff family relationship.”

“We need to go “slowly” – a consistent hour of “therapy” on my schedule every week.  Court-ordered, month after month, year after year.  But nothing actually changes, because “reunification therapy” isn’t really a form of therapy.  It’s just designed to give pablum to the court as if something was taking place.”

But the child never “decides” to spend more time with the targeted parent.  Surprise, surprise.  In fact, things get worse, and worse, and worse, throughout all of the “reunification therapy.”

Professional Responsibility

It is the responsibility of professional psychology to treat and resolve family pathology.  That’s our job.

Professional psychology is failing the family court system.  Professional psychology is not providing the court with the proper professional expertise required to solve the family conflict.

The court and parents don’t want or need a pointless child custody evaluation.  If you’re tempted to conduct a child custody evaluation I suggest you hire a monkey with darts instead; it’ll be more entertaining and equally as valid.

The court and parents don’t want a mythical “reunification therapy,” a snake-oil therapy that solves nothing, ever.

The court and parents want family systems therapy – real psychotherapy that will solve the family conflict and facilitate the family’s successful transition to a healthy and functional separated family structure following divorce, which is always in the child’s best interests.

It is time for professional competence based in the standard and established constructs and principles of professional psychology.

Family systems therapy: Bowen, Minuchin, Haley.

The finger that points at the moon is not the moon.

Children Are Not Weapons

Family conflict is not solved by litigation.  Family conflict is solved through professional psychology.

Divorce ends the marriage; it does not end the family.  Where there are children, there will always be a family.

In divorce, the child’s best interests are that the family successfully transitions to a healthy and functional separated family structure, united by bonds of shared affection with both parents.  It is the responsibility of professional psychology to ensure that this occurs.

Why?

Because it is in the best interests of the child.  Our client.  The person we work for.

It is up to professional psychology to solve this.  For the child.  For the family.  For the client.  For the Court.  That’s our job.  Professional psychology.

Professional psychology can absolutely 100% solve this, through the application of the standard and established constructs and principles of professional psychology.

There are four domains of knowledge – four data-sets from the constructs and principles of professional psychology – that need to be applied to the problem of family conflict in order to solve it:

The attachment system;

Personality disorder pathology;

Family systems therapy;

Complex trauma.

With attachment-related family conflict surrounding divorce, we start by applying the data-set from family systems therapy.

Triangulation,

Cross-generational coalition,

Inverted hierarchy,

Emotional cutoff.

Professional psychology can absolutely 100% solve the family issues surrounding divorce and the separated family structure through the application of the proper data sets from professional psychology.  It is the responsibility of professional psychology to solve this; that all families transition to a healthy separated family structure following divorce.

Family Therapy Surrounding Divorce

Principle 1:  Parents are not allowed to use the child as a weapon.  The child is not a weapon.

That is non-negotiable.  The child is not a weapon.

For all mental health professionals working with family conflict, if that is NOT currently your orientation to family therapy, it needs to immediately become your orientation to family therapy.  The child is not a weapon.

If the child is being “triangulated” into the spousal conflict through the formation of a “cross-generational coalition” with one parent against the other parent that is resulting in an “emotional cutoff” in the child’s relationship with the targeted parent (Bowen; Minuchin; Haley)… then the child is being used as a weapon.

The allied parent is using the child as a weapon.  That’s not okay in divorce.  You’re not allowed to weaponize the child.  That’s not healthy for the child.

And you know what,… Depending on the degree of child-weaponization, the parenting practices of turning the child into a weapon could rise to the level of psychological child abuse; creating severe psychopathology in order to weaponize the child in the spousal conflict is psychological child abuse.  Children are not weapons.  Ever.

Children have the right to love both parents, and children have the right to receive the love of both parents.

Children have the right to be loved by their grandparents and siblings, by their aunts and uncles and cousins.  Children have the right to be loved by friends, and teammates, and teachers, and coaches, and mentors.

Children have the right to be loved.  And it is up to professional psychology through family therapy to ensure that.  Because that’s in the best interest of the child, and the child is our client.

Professional psychology can solve this.  Professional psychology needs to solve this.  Because that’s in the best interests of the child, our client.

Professional psychology will need the support of the family court system based on the principle that children are not weapons.  The issue that AB-PA knowledgeable professionals, both legal and psychological, will be taking to the Court is that children are not weapons to be used in divorce.  Children are neutral; they’re off limits to the spousal conflict.

Children are not weapons.

For professional psychology, here are the professional constructs to apply:

Triangulation – cross-generational coalition – inverted hierarchy – emotional cutoff.

Source – cause – action – result.

The child is being used as a weapon in the post-divorce “spousal” conflict.

This is standard family systems therapy.

Bowen, Minuchin, Haley:  triangulation – cross-generational coalition – inverted hierarchy – emotional cutoff.

What is required is professional competence in the constructs and principles of family systems therapy when conducting family therapy.

Professional psychology can absolutely solve this.  We will need the support of the Court.  Children are not weapons.  With that support, professional psychology can absolutely solve this.

Craig Childress, Psy.D.

Clinical Psychologist, PSY 18857

 

 

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