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Concerned About Unconventional Mental Health Interventions?

Concerned About Unconventional Mental Health Interventions?
Alternative Psychotherapies: Evaluating Unconventional Mental Health Treatments

Thursday, September 9, 2021

Not on the Levels: Harman Says She Evaluated Turning Points

 

Jennifer Harman, a proponent of the parental alienation belief system, has published an article that reports her attempt to evaluate Linda Gottlieb’s intensive parental alienation treatment, Turning Points for Families (TPFF). For those readers who are interested, the citation is

Harman, J., Saunders, L., & Afifi, T. (2021). Evaluation of the Turning Points for Families (TPFF) program for severely alienated children. Journal of Family Therapy. DOI: 10.1111/1467-6427.

In this post, I will discuss a number of issues of research design and analysis that argue against any conclusion that TPFF is a demonstrably effective treatment for parental alienation (PA). It’s notable that this conclusion, though not exactly reached, was possibly assumed in Harman’s plan, as she notes early in the paper that Gottlieb has provided “evidence-based treatment since 1994. (It is not clear what this means, as Gottlieb has stated that she did not formulate TPFF until 2015.)

My title for this post, “Not on the Levels”, is not a calumny against Harman’s integrity or her appropriate intentions in carrying out this piece of outcome research. I think it is most parsimonious to assume that Harman intended to do this work correctly but made some errors that closely resemble those of other PA proponents like William Bernet and Amy Baker. These errors can be described in terms of “levels” of various kinds – particularly levels of evidence and levels of measurement.

I.                    Levels of evidence

Harman et al. state in their abstract and essential points that they have shown that TPFF is an effective treatment. They have not concerned themselves, or reminded their readers, about the idea that not all outcome studies are equally meaningful. How much credence can be given to an outcome study depends on the way data were collected and the comparisons that were made (if any). (More about this concept is available at www.effectivechildtherapy.org and at www.cebc4cw.org, websites that evaluate outcome research on therapies for children and adolescents.) Reports of the effectiveness of a treatment can be said to be evidence-based when the outcome research has involved randomized controlled trials or careful clinical controlled trials; in both these cases, the word “control” signifies that treated individuals’ outcomes were compared to outcomes for similar individuals who received a different treatment.

Harman’s study did not involve any comparison group. It was essentially a study of events in a single group over a period of time, a level of evidence sometimes described (a bit deceptively) as “promising”. (“Of interest” might be a better description for treatments with these uncontrolled outcome studies.) Just as Harman could not correctly claim that Gottlieb has been doing evidence-based treatment for a long time, she and her colleagues cannot correctly state that this attempt at evaluation has shown the effectiveness of TPFF. In order to reach that conclusion, they would have needed to do similar observations on a matched group of children and parents who did not receive TPFF, and to show differences between the treated and untreated groups.

II.                 Levels of measurement

In 1946, the Harvard psychologist S. Smith Stevens (known to students at the time as “Shitty Smitty” for his rather unlovable personality) published a seminal paper in the journal Science, on the idea of levels of measurement and the kinds of statistical analysis that could be used for each one. The idea here is that we can and do measure events in different ways. If I look at a painting and say that it contains greens, blues, and pinks, I am measuring in a very simple way. If I say that this painting is greener than that one, I am measuring in a somewhat more complex way. And if I say I have counted 92 green one-inch squares in this painting and 95 green one-inch squares in that one, I am at the most complex level of measurement of all. If I can count how many green squares there are in different paintings, I can say, for example, that one painting has twice as many green squares as another one, or I can state the mean number of green squares in a group of paintings. I can’t do that kind of arithmetic if I am simply saying that one is greener than another, and if I can’t do that kind of arithmetic, I can’t use the various important parametric statistics like means, standard deviations, Student’s t, or ANOVA. Instead, I have to use some less refined statistics from a group called nonparametric statistics.

Harman’s statistical analysis falls by the wayside because she has ignored levels of measurement, just as Bernet and Baker have done elsewhere. She has performed what someone has called “quantitative alchemy” by trying to force measurements of what is “greener” (more desirable) into statistical procedures that are meant for measures that can be added, subtracted, multiplied and divided. This does not lead to meaningful conclusions.

Harman, Bernet, Baker, and other PA proponents have an unfortunate affection for Likert scales. These are the ubiquitous ways of measuring that ask people to rate an event or statement as “don’t agree at all”, “agree somewhat”, “totally agree”, or some version of that procedure. That is what Harman did in her study: observers of videorecordings rated events they saw on a Likert scale. This scale does not permit any of the arithmetical operations needed for parametric statistics, because it is not reasonable to claim (for instance) that a rating of 5 is 5 times a rating of one. Nevertheless, Harman and her colleagues (including the statistician who sees to have been given authorship for that reason) have gone merrily along and presented means and other parametric statistics as if they are appropriate.

Just for the sake of argument, however, let’s for a moment accept the use of the parametric statistics and look at how the rated behaviors changed over time. I would have assumed that the goal of TPFF was to improve the parent-child relationship quality. Harman et al say “we did not anticipate large changes in relationship quality in a short, 4-day intervention”, and they were apparently right not to anticipate such, as the t for this measure was -0.66, p=0.51. (I would ask, though, if you don’t anticipate a change in 4 days, why design a 4-day intervention?)

As a final point on measurement in this study, it was unclear to me why Harman did not just use a count of events, which could have been analyzed parametrically, and did not present any information about whether the observed behaviors were performed by the child or by the parent. Are any reported changes to be read as changes in the child’s behavior, the parent’s behavior, or both? Perhaps the moral of this story is that there should be a license required to use the SPSS package.

III.              Levels of severity and their implications for research design

Harman et al title their report as involving “severely alienated children”. Yet here is what they say about the children: “The majority of the children who [had] refused to have ay relationship with the alienated parent traveled significant distances across the country and spent several hours or days with them prior to the intervention…a large number of alienated children had transferred custody to the alienated parent for between a week and as long as 44 days after the order had been entered.” In other words, although these children had been said (by someone) to be severely resistant to contact with one parent, they now were not resisting at all even before the TPFF program began.

If it is true that the children were not resistant when they arrived at TPFF,  what confounding variables must we consider as possibly causing this change from the previously reported resistance? Is the court order alone the cause of any changes suggested as resulting from TPFF? Is TPFF to be praised as not having caused the children to become resistant again? Why is it appropriate to use an expensive and disruptive program if the children are already doing what was wanted, and why, in particular, should the preferred parent be ordered to participate in treatment with a TPFF-approved therapist? This would appear to be a good business model but a weak treatment model.

Beyond the issue of levels of severity, of course, there is the much larger issue of how PA is identified to begin with. The only consistency in the various treatment program outcome studies is that a court has decided there is PA present. On what basis that has been done remains unclear. Harman, unfortunately, states that the Parental Acceptance-Rejection Questionnaire, discussed by Bernet and colleagues as a way to discuss “splitting”, is a PA assessment tool! I hope her PA colleagues will talk to her about this point.

IV.              Levels of harm

The possibility that PA treatments can be harmful to children and adolescents, which I as well as other authors have considered, is of much concern to PA proponents. Harman et al, like other PA advocates, remark that my published discussion of this point is based on a small number of cases in which the children claiming harms were still alienated. There has been a gradual increase in the number of anecdotal claims of this kind, with at least one PTSD diagnosis, but I would be the first to acknowledge that they have never been investigated systematically, nor have the reports brought PA proponents to look for adverse effects of their programs. There are a number of lawsuits in the making as some affected children approach their 18th birthdays, and those will bring out some interesting information.

Anyone treating children and adolescents is bound to have concerns about very serious harms, self-injury, depression, suicidality or completed suicide, or running away and being trafficked or otherwise injured. Harman et al stated that no harms were caused by TPFF, as no children ran away or self-harmed during the intervention or some subsequent period. These measures are important but minimal. It may be that following the expected lawsuits we will see some evidence of harms that proponents of PA interventions will have to consider in the future.

 

Conclusion

On a number of different levels, the outcome research on TPFF reported by Harman et al fails to support the conclusions that TPFF is a safe and effective treatment for children in cases of parental alienation. In addition, the serious flaws of design and analysis in this work suggest that the critiques of Joan Meier’s work, recently presented by PA advocates, may be open to serious question.  

Friday, August 20, 2021

A New Book on Allegations of Parental Alienation for Parents and Professionals

 

A new book questioning claims about parental alienation is about to be published. Here are the citation and the Table of Contents.

Mercer, J., & Drew, M. (2022, in production). Challenging Parental Alienation. Milton Park, OXON: Routledge.

Table of Contents

Foreword

Chapter 1        Introduction to Parental Alienation Concepts and Practices

Jean Mercer and Margaret Drew

Part 1:

When a Child Avoids a Parent: Understanding the Problem

Chapter 2        History of the Parental Alienation Belief System

Julie Doughty and Margaret Drew

Chapter 3        The International Expansion of the Parental Alienation Belief System Through the UK and Australian Experiences

Julie Doughty and Zoe Rathus

Chapter 4              Experiences of Parental Alienation Interventions

Adrienne Barnett, Arianna Riley, and “Katherine”

Part 2:

When a Child Avoids a Parent: Identifying and Treating Problems

Chapter 5              Evaluations for the Courts in Child Custody Cases: An Attorney’s Perspective

Nancy Erickson

Chapter 6        Distinguishing alienation from child abuse and adverse parenting

Madelyn Milchman

Chapter 7        Comparison of Parental Alienation Treatments and Evidence-Based Treatments for Children

Sarah Trane, Kelly Champion, and Steven Hupp

Chapter 8        Gender Credibility and Culture: The Impact on Women Accused of Alienation

Margaret Drew

Chapter 9        Developmental Changes in Children and Adolescents: Relevance for Parental Alienation Discussions

Jean Mercer

Part 3:

When a Child Avoids a Parent: Scientific and Legal Analyses

Chapter 10      Parental Alienation Concepts and the Law: An International Perspective

Suzanne Zaccour

Chapter 11      Questioning the Scientific Validity of the Parental Alienation Label in Abuse Cases

Joan Meier

Chapter 12      Parental Alienation, Science, and Pseudoscience

Jean Mercer

Chapter 13      Conclusion: Current Issues About Parental Alienation

Jean Mercer and Margaret Drew

 

Thursday, August 19, 2021

When Parental Alienation Proponents Argue Biological Causes

 

It’s common nowadays for popular writers to claim biological or even specific genetic reasons for concerning behaviors. Any issues remotely connected to attachment are likely to get this highly speculative biological post hoc explanation. Until recently, though, I had not seen many proponents of the parental alienation (PA) belief system appeal to biological factors.

But I have seen this now, and not just from Craig Childress.

Linda Gottlieb, a rising PA proponent and increasingly frequent expert witness in PA cases, has now adopted biological arguments. She outlines these in her document Gottlieb, L. (n.d.) , Turning Points for Families: A Therapeutic Vacation. http://parentalalienationexpert.weebly.com/uploads/2/2/5/4/22545256/09-29-2016_treatment_protocol_for_sever_alieantion_2016_treatment_protocol_for_cases_of_severe_parental_rejection.pdf.

Gottlieb’s position is that it is “instinctive” for children to be attached to their parents. In making this claim, she ignores decades of discussion of the role of instinct in animal and human life. Many years ago, the term instinct was used to describe situations in which an individual’s behavior was completely controlled by inherited biological factors; he or she had not learned how to do something, and also could not learn how to refrain from doing it. In 1955, the renowned student of comparative animal behavior Frank Beach predicted accurately that the term instinct would soon disappear from discussion in the mainstream of psychology (Beach, F. (1955). The descent of instinct. Psychological Review, 62, 401-410.) Beach argued that the evidence pointed to the conclusion that all behaviors developed through a combination of genetically-regulated nervous system functions AND individual experiences. Accumulated evidence showed that behaviors did not develop solely as instincts (inherited behavior patterns shared by all members of a species).

More sophisticated discussions of human behavior patterns led to replacing the idea of instinct with two explanatory concepts. One was that human development in some areas was a matter of experience-dependent plasticity; the nervous system was “plastic” or malleable and changed (learned) as a result of experience. The second idea, the one more relevant to the concept of instinct, was called experience-expectant plasticity. This term applied to situations where experience could have a powerful effect, but was by far the most powerful at a particular period of life and might have little effect earlier or later. Experience-expectant plasticity is exemplified by emotional attachment to familiar people and also by the learning not just of a concept of language but of a specific language—both events that begin in the second half of the first  year for human beings. These two concepts (experience-expectant and experience-dependent plasticity) have taken the place of the old idea of instinct.

Nevertheless, we see Gottlieb in her document claiming that attachment to a parent is not only instinctual but permanent and invulnerable to normal experience. In making this statement, she ignores not only the changes that have occurred among psychologists in use of the term instinct, but also the fact that the toddler’s attachment behavior and motivation modulate with maturation and experience so that adolescents feel and behave very differently toward parents. She also ignores the fact that in cases of adoption or other changes, even toddlers lose their attachment for one person and develop it for a new caregiver.

But these points are irrelevant to Gottlieb, as she uses instinct as a rhetorical device. Rather than pursuing an argument about causes of a child’s avoidance of one parent, she wants to be able to claim that an avoiding child must have experienced some powerful malicious actions on the part of the preferred parent, because otherwise the “instinctive” love for the avoided parent could not have been undone. (To support this argument, she states, incorrectly , that children who are abused maintain their attachment to caregivers. This is only true of toddlers and not of the older children and adolescents who are usually the subjects of PA cases.)

If a child’s love for a parent were actually instinctual in the old-fashioned , all-biological sense, it would by definition be invulnerable to experience. If it is vulnerable to experience of any kind, it is not instinctual, but a characteristic that develops through a combination of experience-expectant and of experience-dependent plasticity. The real purpose of Gottlieb’s “instinct” argument would seem to be to imply scientific support for claims about PA. Curiously, Gottlieb, like other PA proponents, acknowledges that not all cases where a child avoids a parent are matters of alienation—a child might learn to avoid an abusive parent.

 But wait, what about the argument that abused children still want to be with the abusive parent? Can this work both ways? It seems that according to Gottlieb’s views about abused children, those who are abused should not avoid the abusive parent, but instead want even more to be with that person. Only those who were not abused (but something else happened, like persuasion by the preferred parent) can want to avoid one parent. Thus avoiding a parent becomes proof that the child was NOT abused, doesn’t it? And how convenient this is for a parent who wants to allege that the ex-spouse or the child is lying about abuse.

If someone wants to use scientific concepts for persuasive argument, it would pay to keep up with the science. Otherwise someone is likely to come along and point out a few errors.

 

 

 

Thursday, December 10, 2020

Eye Contact and Other Baby Milestones That Cause Worry

 When I started this blog ten years ago I was most interested in issues for infants and toddlers, and that remains my “first love”. In recent years I have gotten into the morass of “parental alienation” concerns and I have been spending a lot of time writing about that topic for publication.

However, I know there is still a need for discussion of baby matters, because I frequently get personal emails from young parents who are worried about whether their babies are developing normally. Many of them are terrified that some developmental glitch (as they see it) means autism. Others are just generally frantically worried about everything.

If people are worrying a great deal because of their own anxiety and depression following the birth of a baby, giving them information can only briefly reduce their anxiety. In those cases, they (and I mean, You, if you are like this) need to find someone to talk to and get some support and help as they work through this stage of life. Nowadays, obstetricians are supposed to screen patients for perinatal mood disorders (AKA postpartum depression) and to provide them with referrals for help. Not all do this—but if they do not, nevertheless they are the first line of help for patients who can bring themselves to ask for it.

For other people—ones who are only worried because of something they saw or read—just getting some better information can be helpful. Here are some thoughts about infant development that might save some people some distress:

VARIABILITY: Babies do not read the child development books or follow those milestones exactly! Here’s the deal. The age given as appropriate to a “milestone” like sitting unsupported is an average drawn from hundreds of babies. It’s a piece of arithmetic that produced that average from a long list of numbers. It might well be that no baby whose age at sitting was listed actually sat alone at the age that is calculated to be the average. Development is variable, with about half of babies doing something later than the average and the other half doing it earlier. How much later or earlier? That’s the question, and you will not be able to figure this out easily from most books you can get. There is a normal range of ages at sitting alone (or whatever) and all you need to know is that your baby is within that. There are no prizes given for earliest independent sitting or anything else. Yes, of course it is troubling and perhaps a problem if a skill is achieved very late, but if you are getting regular well-baby care that will be picked up.

Please note also that a particular baby can be early on one achievement and late on another. Some people have thought that those who walk early talk later and vice versa, but I don’t know if that’s really true. Certainly they seem to put one development on hold while they work on another one for a while.

SUPINE versus PRONE: When my children were babies, I and all the other parents put them down to sleep on their tummies (prone position). We were told this would prevent them from choking if they spat up.  In the late 1990s, some not very good research was interpreted to mean that all babies should be put down on their backs (supine position) to prevent SIDS. The baby’s sleeping position helps to determine the order in which muscles get stronger and come under control. Lying prone makes it easier to develop head control and strengthen arms and shoulders. Lying supine slows those achievements.

The list of milestones you see was developed when babies usually lay prone. The milestones that are listed as associated with particular ages are those that occur for babies who spend most of their time in prone. The list of ages and milestones is not the same for babies who spend their time supine. You probably put your baby in supine, as you have been told to do, and you probably don’t do much tummy time because the baby fusses when you do and you are afraid he or she will die right before your eyes from SIDS!

We do not at this time have a good list of ages and milestones for supine-lying babies. All I can tell you is, don’t panic when you see your baby is not doing what the list derived from prone babies says should be happening.

EYE CONTACT: I am sure you don’t gaze into other peoples eyes every chance you get. You look at another person, look away, even use your eyes to point out something you want the other person to look at. Babies don’t gaze into eyes much, either, and they do it when they feel like it. Nursing babies under 6 months usually shut their eyes and get on with the job. Older nursing babies often put their hands to the mother’s face, poke a finger up her nose, and generally look her over. Those photographs you see in advertisements, where a beautiful nursing mother is gazing into her baby’s eyes in a charming room with nice curtains and all--  I just wonder how many shots it took the photographer to get that picture!

Eye contact with very young babies (under perhaps three months) is complicated by a lot of things. They are often not fully awake unless they are upright. They cannot see things that are very close to their faces. They need bright light to see well, and if your face is in shadow as you bend over them, they don’t really see you. What’s more, just like you, they don’t do everything they can do, every time they get a chance to do it.

By the way, a young blind baby may appear to be making eye contract just in response to hearing a voice, so you really can’t always tell hat’s happening.

Does your baby of more than three months seem to be interested in people or pets and look at them more than at inanimate objects? That’s what you really want to know.

 

I am hoping these thoughts may help a little—but then parenthood is really about worrying—let’s just try not to let it get too uncomfortable, because that causes trouble for parents and babies alike.

Monday, October 5, 2020

An Ill-Judged Award Decision: Attachment Issues

 

Several weeks ago, my Russian colleague Dr. Yulia Massino alerted me to the fact that the American Psychological Association had given an award for international humanitarian achievements to the Danish psychologist Niels Peter Rygaard. Rygaard is the head of the Fairstart Foundation, an organization devoted to help and training for foster parents and others working with parentless children.

While fully recognizing and applauding the aims of Rygaard’s work, some of us were most concerned about recognition of an organization whose website and history show connections with some disturbing fringe beliefs about emotional attachment. These beliefs include the idea that children who have had little consistency of early care and have experienced many separations in infancy and toddlerhood will have antisocial tendencies. Such fringe beliefs are shown through the misinformation shown about characteristics of 5-7-year-old children and by a link given to the Attachment Disorder Network.

The ADN fosters, and has long fostered, the mistaken view that a problematic attachment history is expressed in hostility, cruelty, and a preoccupation with harm to others. That view has been responsible in the past for inappropriate treatments like “holding therapy” that have caused documented child deaths and probably undocumented psychological injuries to children. I hear from time to time to adults who recall and still suffer from the harms they experienced as a result of such fringe beliefs and practices.

Dr. Massino was especially concerned about the APA award because of the influence Rygaard and some of his associates have in Russia, where there is continuing discussion about appropriate rules for adoption, foster care, and orphanage care.

After hearing about the award to Dr. Rygaard, I contacted the co-chair of the APA committee that chose the recipient of this award. He was very pleasant and receptive and, I think, paid attention to the material I sent him and to my complaint that this was an ill-judged decision.. However, I soon received a message from APA to the effect that the award would stand.

This was not surprising, and I did not really expect any concrete result from my complaint. It would certainly be exceedingly awkward to retract an award of this kind, and I had not argued, nor did I think, that Rygaard  himself had done anything harmful to children. I was simply concerned that the APA committee had made the award without sufficient consideration of the background and with the groups that Rygaard was allied with since the publication of his 2006 book, if not before. Without at all wishing to assume guilt by association, I nevertheless did not want APA inadvertently to provide support to a view of attachment that is not only incorrect but potentially harmful to children. Although APA is not in the usual sense an international organization, it should take some responsibility for the effects of decisions on children in other countries.

I do not want to take away praise for the hard work of Dr. Rygaard and the Fairstart Foundation. It may seem to some readers that I am splitting hairs when I express concern about fringe beliefs in the background. But in fact decisions and practices often derive from background assumptions, and those assumptions can be strengthened by approval of groups that share them. I wish the APA awards committee had paid more attention to the background in this case.

Monday, June 22, 2020

Interview With Susan Gerbic About Parental Alienation

This is a little over an hour long:


https://youtu.be/pD4CTPG-HAI

ADHD, FDA, and Video Games


Recently the Food and Drug Administration approved a video game that is purported to be helpful as a treatment for attention deficit hyperactivity disorder (ADHD). Parents and teachers are often concerned about kids whose behavior indicates ADHD, as their inattentiveness and high activity level combine to cause problems for their learning at school and at home, and serves as distractions to their teachers and parents as well as to other kids. The adults are bound to find attractive the idea that having the children play a video game can help improve their focus and self-control.

I’m not going to state the manufacturer or name of the specific game that was approved by the FDA. It doesn’t really matter, and I’m not in the business of telling people what to buy or not to buy. What is important is that people always need to find out certain things before they decide to put their resources into a treatment.

An important question is, who paid for the research? Obviously, research funding can come from neutral, objective sources who have no reason to want one outcome or another. But it can also come from highly interested parties—and in this case that’s what happened. The manufacturer paid for the research and got the outcome they wanted. When we say that a treatment is evidence-based, however, we ask for two independent researchers both to show the beneficial effects of the treatment. If someone unconnected with the manufacturer got the same results as the people funded by the manufacturer, that would be something to encourage us to use the treatment.

A second important question is, what does the outcome have to do with the original problem? Lots of treatments have effects, and it can be seen that they make a difference of some kind. The question is whether the difference they make is relevant to the problem everyone was worried about. In this case, that has not happened. The kids played one video game and their attentiveness was measured. Then they played another game 100 times, went back to the first one, and their attentiveness had improved—voila, a desirable outcome. However, none of the ratings by their parents, of attentiveness and so on, were improved. If the wish had been to create a treatment that would help the kids play video games better, this one would be good, but of course that was not the point of treating ADHD.

Just because we (in general) always hope for a pill or a potion to “fix” problems of development and behavior, rather than to have to do any difficult work, there will always be offerings of this kind. I mentioned one a while ago: “Forbrain” , which according to its website “energizes” the brain when you speak using a bone conduction headset. How you know whether your brain has or has not been energized is not mentioned. That’s typical of devices offered to treat autism, speech and hearing problems, and attention difficulties—even some that seem highly plausible and were created by very knowledgeable people.

The difference between the ADHD video game and the others is that in the ADHD case the FDA has approved, suggesting that the game has been found both safe for use and effective. That last part is questionable, as I have pointed out. And this is a prescription game, sounding very impressive and encouraging parents and teachers to see it as worth a try, whatever it costs.

It all amounts to caveat emptor. Ask the right questions!

Wednesday, June 17, 2020

The "American Psychological Association Review"


A colleague recently called my attention to the website https://americanpsychologicalass.com/. This is one of many Internet sites that argue in highly personal terms against “parental alienation” and claim that a former spouse and a judge have interfered with the author’s relationship with his [usually] children. Kenneth Gottfried was told he could not have contact with his children following a psychological evaluation. The two teenage girls had stated that they did not want to see him, a situation that Gottfried attributed to “alienation” on the part of the girls’ mother.

This is a sad and all too common situation, and I would say nothing about it except for the fact that the unfortunate Gottfried has become a megaphone for spreading the questionable views of the “parental alienation” advocate Craig Childress. I think I am right in assuming that Gottfried has not spent his time studying the various aspects of psychology he mentions, but that he has picked up his claims from Childress, either directly or via Internet.

The thrust of Gottfried’s statement is that the American Psychological Association is responsible for “countless” deaths associated with judges’ decisions not to give custody of children to one of their parents.  The deaths he refers to are said to include a case of what he apparently means to call “self-immolation”.  Gottfried claims that he has personally witnessed 30 deaths of separated parents in the last 4 years, but does not provide any evidence for this statement. He also appears to think that such deaths would not occur if APA were to recognize “parental alienation”; he does not say how such recognition would affect courts or parents. It may be that Gottfried confuses the American Psychological Association with the American Psychiatric Association, both confusingly referred to as APA. The latter is responsible for DSM, the Diagnostic and Statistical Manual of Mental Disorders, and in preparation of the 2013 edition declined to include “parental alienation” as a diagnosis. No actions by the American Psychological Association would determine inclusion of a disorder in DSM.

Gottfried uses a letter written by APA to argue that the organization knows it is contributing to causing deaths. The letter, however, is on the subject of separation of immigrant children from their parents, and refers to suicides in that group. Although abuse of analogies is common in arguments about “parental alienation”, to conflate families where children avoid one parent with parents and children involuntarily separated (and poorly treated)  is surely the achievement of a new rhetorical low.

I am a member of APA (the psychology one) but hold no particular brief for the organization and would like to see quite a few changes in it. However, although I see no way APA can or should make the moves Gottfried proposes, I think I can guess why he thinks what he does. His positions stem from those of Craig Childress. It’s my opinion that these Gottfired charges against APA stem from the events two years ago when Childress and some of his adherents delivered a petition to the APA headquarters in Washington, DC. Childress had made excited announcements on the Internet about how they were going to do this and what APA might do in response. I wasn’t present at the delivery, but what I have gathered is that someone in the office took the petition and said “thank you” and the Childress group then left. That was, not surprisingly, the end of that. But Childress has been muttering about this for two years. He has also been muttering about the events involving his presentation at a conference of the Association of Family and Conciliation Courts group, which culminated in having APA cancel the continuing professional education units that had been planned for presentation attendees. This led to even more fulmination against APA, and more recently against AFCC, with some special personal remarks about the AFCC head Matthew Sullivan.

What do I see on americanpsychologicalass that makes me so sure that Childress is behind this? For one thing, there is the very fact that Childress is referred to. He is barely mentioned in the literature about “parental alienation”, although Jennifer Harman (not Harmon, that’s someone else) in 2018 said she thought there should be some empirical research into his ideas.  Gottfried did not come across Childress by picking up a professional journal article, but by seeing and being drawn into Childress’s and his followers’ large and noisy Internet presence.

I also see Childress in a number of references made by Gottfried. Anyone who has read Childress’s self-published work will recognize the tireless repetition of certain names: Bowlby, Bowen, Minuchin, Madanes--- and then more recently, van der Kolk and Tronick. The connection of specific ideas to Childress’s work is not elaborated  anywhere, and connections are made by jumping rather than step by step. For example, citing Bowlby’s discussion of attachment, Childress arrives quickly at the conclusion that a child who avoids one parent has had his or her attachment system suppressed.

There’s more Childress in this site, but I’ll just point to the lengthy and meaningless discussion of APA ethics guidelines by Gottfried. Childress rather specializes in describing how unethical other professionals are, especially with respect to the use of the best science. Those who disagree on various points with the “parental alienation” approach are said to be  outside the boundaries of their competence and therefore in violation of ethical guidelines.

It would be easy to look at americanpsychologicalass and conclude that it was the work of an individual angry and frustrated man, and of course it is. But there is more to it than that. On that site we see an amplification of the views of a psychologist whose claims about parents and children are recognized as concerning by many professionals but few laypeople. These views are potentially harmful to children and families because they encourage courts to order unnecessary separations and ineffective treatments. Please, readers, if you find yourselves confronted with the Gottfried site or anything like it, understand that there is more here than fury and goofy ideas. These arguments have the power to do harm and need to be countered.  





Attachment and "Parental Alienation"


When thinking about parental alienation (PA) issues in the United States, I usually think it makes sense to consider a child age range of about 9-17 years. It’s rare in the U.S. to have a child less than 9 who is claimed to show PA when he or she avoids one parent. This narrow age range is one in which issues about attachment—if any—are much different from those we see in infants and toddlers. Some PA advocates, like Craig Childress, propose that when a child avoids a parent this means that something has damaged her attachment to that parent, or even “suppressed” her whole attachment system [don’t ask me, I’m just reporting the news here], but this is hardly likely for 9-17-year-olds, whose social focus is less and less on their parents and more and more on their peers.

However, it does seem that in some cases PA concepts are applied to much younger children. My first introduction to PA occurred when I was contacted by the grandmother of two preschoolers who had been taken from the mother on the grounds that she had caused their avoidance of their father. Those children were certainly at ages when attachment to a familiar caregiver is the focus of a child’s life and when abrupt, long-term separation from that person causes deep distress, grief, and lethargy that may last for months.

Some European colleagues are also telling me that they see PA allegations in situations where toddlers and preschoolers are concerned. They express concern over the impacts on young children of being forcibly removed from a familiar parent and placed in the custody of one whom they essentially do not know (their biological relationship being of little import here). Others have argued, to the contrary, that one parent may prevent the child from having contact with the other on the grounds that their attachment will be harmed if that happens.

I want to comment on these highly fraught situations where parents are in enormous conflict over the custody or parenting of a preschool or younger child. First, though, I want to say that I am going to talk only about the role of attachment in parenting decisions when all else is equal. I mean: this is not about situations where there has been domestic violence, or physical or psychological child abuse, or child sexual abuse. Those all create their own unique dangers. I am going to talk only about situations where one parent wants more contact with the child , the child seems reluctant, and the other parent is resisting the change in contact--  but nothing else is wrong.

Point 1: How the child acts, and how parents can handle this, depends largely on how old the child is.

 A baby under 6 months of age is usually quite ready to socialize with whoever comes along and has not yet formed an emotional attachment to any individual. The young baby may object if handled clumsily by someone, or if someone fails to pick up on cues about what the baby needs, but this is not about attachment or about fear. However, even at 4 months or so, the baby may be quite distressed if someone stares blankly at her and does not change expression or move in response to the baby’s social signals.

After 6 months, but usually before 12 months, babies begin to form emotional attachments to people whom they see frequently and who behave toward them in sensitive and responsive ways. They often indicate that this developmental change is occurring by showing fear of strange things and even by being startled and frightened by some things that have happened before (noisy garbage trucks, jumping dogs). They try to stay near familiar people and avoid strangers—often, they will not look at a friendly stranger who approaches them, and will even cry if the person keeps looking at them. If left in a strange place without a familiar person, they cry and will not look around with interest or try to explore, even though they will explore the same place if a familiar person is there.

Babies of 10 or 12 months and toddlers also show a behavior called “social referencing”. If they meet a new person or a new kind of object, they look at the face of a nearby familiar person. If that person looks frightened and seems to be looking at the new person or object , the baby backs off and will not approach the unfamiliar thing. If the familiar person smiles and looks relaxed, the baby goes ahead to explore the new person or object.

As toddlers get to be two or three years old, and as they learn to understand and use language, they can cope much better with unfamiliar situations. They may go to child care or preschool, encounter new babysitters, and develop better social skills. If they are tired or hungry or sick, however, they still seek familiar people and reject everyone else. (Of course, when sufficiently cross they may reject a familiar person too!) If they cannot find the familiar person, or if their separation goes on for a long time (weeks), they may show serious distress and take many weeks to recover; even if reunited with the familiar person become clingy and anxious.

Some children are much more intense in their negative reactions than others. They have temperamental differences that are biologically determined. A child who takes a long time to adapt to child care or who is predictably seriously frightened of clowns or masks or large groups of people is also likely to show more intense reactions than others to separation or to strange people and places.

Point 2: Can knowing about attachment behavior help people?

 Yes, knowing these things helps parents know how to handle the distress of young children as they visit a parent they do not live with—if the parents give it some thought. The awareness that such distress is natural may (I hope) prevent suspicions or allegations that one parent is causing the child to hate or fear the other. Let’s look at possible things to do for different ages.

For the youngest babies, under 6 months, if the baby is getting distressed about clumsiness or a withdrawn expression, the solution is for the adult to learn to behave differently. More contact and more daily care will help the adult learn to engage the baby in care routines to the satisfaction of both. “Staring” or looking withdrawn is a different problem. Some adults can do better if they know they are looking a certain way, but others may be depressed, anxious, or distracted, and those things are harder to handle. It will be helpful to everyone to know that the baby is responding to the facial expression and not to the individual, however.

For older babies and toddlers, there are a lot of issues that may need work by the adults. If one parent is actually frightened of the other, a toddler doing social referencing may quickly catch on to this and also be frightened, even though the frightened person has no wish for this to happen. An older baby or toddler may also be frightened and resist a parent who is not often present and may become distraught when approached—and even more so if taken away from home. These are normal behaviors of typically developing children and are not taught or caused by one of the parents. There can be improvement if both parents behave calmly and give the child plenty of time to warm up; there can also be worsening if people are hasty, argue, or are demanding or rough. Toddlers are most comfortable in familiar places, so if it is possible for the child to stay at home and the parents to switch places for a time, the child will be more comfortable and will more quickly come to accept both parents as familiar attachment figures.

Times of transition, including bed time, are always the most difficult for toddlers and preschoolers to handle, even if there is no family separation or conflict going on. In perfectly happy families, young children may respond to a transition by pushing away one parent and saying they want the other; the next day they may reverse who they want. It’s the transition that’s the problem. So, when transferring a young child from one parent to the other after divirce, it would be surprising if everything always went smoothly. Crying when going from father to mother probably does not mean that father abused the child. Crying when going from mother to father probably does not mean that the mother has brainwashed the child to make her afraid of father.

The very difficult problem here is that in a few cases these things have happened, and it can be difficult to know what is distress caused by bad events and what is normal transition complaining. But following the “black swan” rule, our first assumption should be that things belong to the more frequent category of events. If parents are prepared to deal calmly with times of transition, knowing that they are likely to include child crying and distress, everyone will be able to do better—to the advantage of the child, who is not helped if adults feel and show their own upset. If this does not help, it's time to explore carefully to see whether there is something one or both parents are doing to distress the child.

 It’s true that one of the real difficulties of divorcing parents is the attachment-related reaction of young children. They cry, they cling, they demand attention, they avoid unfamiliar people even more than usual, they need a lot of emotional support as they struggle to feel secure with both parents. This is all occurring at a time when one or both of the parents may be completely stunned by what is happening and want nothing more than to pull the covers over their head and hide for a month. One of the natural problems of being a parent is that the less you want demands placed on you, the more demands your young child will place. You have “gone away” from your usual availability, and the child wants you back.

It's tough on everybody. But let’s be careful about interpreting normal child separation behaviors as “parental alienation” or thinking that somehow the child’s internal working model of attachment has been smashed by a visit or the lack of a visit. Jumping to those conclusions only makes things worse in the long run.