Dr Childress Consulting – Blog

Diagnosis Guides Treatment

It is the responsibility of the involved mental health professionals to accurately identify what the problem is, and develop a treatment plan to fix your problem.

• Diagnosis = identify
• Pathology = problem
• Treatment = fix it

We must first diagnose what the pathology is before we know how to treat it.

We must first identify what the problem is before we know how to fix it.

Attachment Pathology

The problem is an attachment pathology, a problem in the love and bonding system of the brain; the attachment system.

The attachment system is a primary motivational system responsible for governing all aspects of love and bonding throughout the lifespan, including managing grief and loss.

All motivational systems have direction. We are motivated to approach pleasure and avoid pain. Motivational systems always have a single direction.

The attachment system is a primary motivational system of the brain. It ALWAYS motivates the child to bond to the parent. It is called a “goal corrected” motivational system because it ALWAYS maintains the goal of forming a bonded relationship to the parent.

When faced with a barrier to bonding from problematic parenting, the attachment system changes HOW it tries to bond to the parent, but the attachment system always tries to form an attachment bond to the parent because the other direction is death.

Predators and starvation await the child who breaches an attachment bond to the parent. Bonding to the parent is survival itself.

The attachment system is a motivational system, it always has a single direction of motivation – toward forming an attachment bond to the parent. The attachment system NEVER motivates a child to sever an attachment bond – that motivation results in death.

In response to problematic parenting, the child develops an “insecure attachment” in which the child is MORE strongly motivated to bond to the problematic parent. The child is never motivated to sever the parent-child bond.

Spouses reject spouses. That is a secondary attachment bond. Children don’t reject parents because that is a primary attachment bond necessary for child survival.

Child Abuse

The ONLY cause of severe attachment pathology (i.e., a child rejecting a parent), is child abuse by one parent or the other.

• Targeted Parent Abusive: Either the targeted-rejected parent is abusing the child in some way, thereby creating the child’s severe attachment pathology toward that parent,
• Allied Parent Abusive: Or the allied parent is psychologically abusing the child by creating a shared (induced) persecutory delusion and false (factitious) attachment pathology in the child for secondary gain to the pathological parent.

The clinical diagnostic concern surrounding severe attachment pathology (i.e., a child rejecting a parent) is child abuse range parenting by one parent or the other.

In all cases of severe attachment pathology displayed by the child (i.e., a child rejecting a parent), a proper risk assessment for child abuse needs to be conducted to the appropriate differential diagnoses for each parent.

All.

Treatment for Child Abuse

All cases of severe attachment pathology will result in a child abuse diagnosis one way or the other since child abuse range parenting by one parent or the other is the only thing that causes severe attachment pathology (i.e., a child rejecting a parent).

Diagnosis guides treatment. The treatment for cancer is different than the treatment for diabetes. If we treat cancer with insulin, the patient dies from the misdiagnosed cancer.

When possible child abuse is a considered diagnosis, the diagnosis needs to be accurate 100% of the time. The consequences of misdiagnosing child abuse are too devastating for the child

The treatment for child abuse is always to protect the child.

In all cases of a child abuse diagnosis, duty to protect and standard of practice obligations require the child’s protective separation from the abusive parent. The child’s normal range and healthy development is then recovered and stabilized.

Once the child’s healthy development has been recovered, the child’s contact with the abusive parent is restored with enough safeguards in place to ensure that the child abuse does not resume when contact with the abusive parent is reestablished.

Participation in Child Abuse

A prominent professional danger surrounding misdiagnosing a shared persecutory delusion is that if the mental health professional and/or the Court misdiagnoses the pathology of a shared persecutory delusion and believes the shared delusion as if it was true, then the mental health professional and/or the Court become part of the shared delusion, they become part of the pathology.

When that pathology is the psychological abuse of the child by an allied pathological parent, then the mental health professional and/or the Court become participants in the parent’s psychological abuse of the child by validating to the child that the child’s false (delusional) beliefs are true when they are, in fact, symptoms of an induced persecutory delusion.

DSM-5 V995.51 Child Psychological Abuse

Participation in Spousal Abuse

When that pathology is also the spousal psychological abuse of the targeted parent by the allied parent using the child as the weapon, then the mental health professional and/or the Court become participants in the spousal psychological abuse of the targeted parent because of their misdiagnosis of the pathology in the family.

DSM-5 V995.82 Spouse or Partner Abuse, Psychological

Risk Assessment

There are three dangerous pathologies, suicide, homicide, and abuse (child, spousal, and elder abuse). Whenever a mental health professional encounters a dangerous pathology, duty to protect obligations become active and the mental health professional must either conduct a proper risk assessment for the danger involved, or ensure that a proper risk assessment is conducted.

There are three possible dangerous pathologies involved in court-involved custody conflict, 1) possible child abuse by the targeted-rejected parent, 2) possible Child Psychological Abuse (V995.51) by the allied parent, and 3) possible Spouse or Partner Abuse of the targeted parent by the allied parent using the child as the weapon (V995.82).

In all cases of court-involved custody conflict involving severe attachment pathology displayed by the child (i.e., a child rejecting a parent), a proper risk assessment for child abuse and for spousal abuse using the child as the weapon needs to be conducted to the appropriate differential diagnoses for each parent.

Diagnosis Guides Treatment.

• In the absence of child abuse, parents have the right to parent according to their cultural values, their personal values, and their religious values.
• In the absence of child abuse, each parent should have as much time and involvement with the child as possible.
• In the absence of child abuse, to restrict either parent’s time and involvement with the child would damage the child’s attachment bond to that parent, thereby harming the child and harming the parent.

Is there child abuse?

Craig Childress, Psy.D.
Clinical Psychologist, CA PSY 18857