Annals of Case Reports (ISSN: 2574-7754)

Article / case report

"Parental Alienation: A Serious Form of Child Psychological Abuse - A Worldwide Health Problem"

Wilfrid von Boch-Galhau*

Specialist in psychiatry, Department of Psychosomatic Medicine & Psychotherapy, Würzburg, Germany

*Corresponding author: Wilfrid von Boch-Galhau, Wilfrid von Boch-Galhau, Department of Psychosomatic Medicine & Msychotherapy, Würzburg, Germany

Received Date: 29 October, 2020; Accepted Date: 13 November, 2020; Published Date: 19 November, 2020

Abstract

Parental alienation is a serious mental condition that professionals in the field who work with children, adolescents and adults should know. Parental alienation is to be found mainly in situations of high conflict separations and divorce, however it exists also in some other contexts. In this article one case example with two siblings is presented. It shows parental alienation in a high conflict divorce situation, which could be overcome through a determined intervention by the child protection services and the family court in cooperation with a specialized psychologist. Although about thou¬sand three hundred professional articles, book chapters and books, and also empirical studies exist in the meantime (see website https://ckm.vumc.org/pasg) from all over the world, there is still not enough awareness or even denial of parental alienation in professional practice.

Keywords

Child psychological abuse; Family violence; High conflict separation/divorce; Parental Alienation

Introduction

Parental Alienation - In the Meantime an Endemic, Worldwide Health Problem

The lack of recognition of parental alienation as a serious relational problem in professional practice makes it difficult to adequately deal with it in parent-child law. A lack of awareness of the problem in the political arena, in society, and among professionals increases the risk for the child to develop externalizing or internalizing psychological symptoms. These may be conduct disorders, anxieties, eating disorders, addictions, posttraumatic stress disorders, depressive episodes, or attachment - and identity disorders, personality disorders and other psychiatric and psychosomatic disorders [1,2].

Definition of PA

• Parental alienation is an interactional process where systematically one parent’s role, for the children, is eroded. The concept of parental alienation is defined by three elements [3].

• Rejection or denigration of one parent that reaches the level of a campaign, i.e. persistent behaviour rather than occasional episodes.

• The hostile attitude of rejection is irrational, i.e. alienation is not an appropriate response to the behaviour of the rejected parent and not based on actual negative experiences with the rejected parent. It is partially the result of influence of the alienating parent [and/or other important attachment figures].

Symptoms of PA

• Irrational campaign of denigration and hatred

• Absurd rationalisations (unjustified, absurd reasons given for the attitude of rejection)

• Lack of normal ambivalence (idealisation of one parent and demonisation of the other, black-and-white thinking)

• Reflexive support of the programming parent

• Denigration not just of the targeted parent but also of that parent’s extended family and friends

• The “Independent-Thinker” phenomenon (the child’s “Own Opinion” and “own will” are stressed)

• Denial of guilt over the cruel treatment of the alienated parent (the alienated parent is rejected with apparent lack of feeling or emotion)

• Use of “Borrowed Scenarios” (same accusations as those voiced by the alienating parent)

For validation see, for instance.

Differentiation of PA on a Continuum of Three Levels of Severity - Each Level Requires Specific Treatment Methods

Parental alienation is usually found in the context of highly acrimonious separation or divorce of the child’s parents, in toxic or in “aggressor-victim relationships” in family violence cases with an inequality of power. In such cases, the child is - consciously or unconsciously - instrumentalised and controlled by one parent against the other, i.e. s/he suffers psychological abuse [4,5,6-12].

In mild cases of PA the child refuses contact with the nonresident parent, but enjoys it when contact has been made. The child can still distance himself/herself from the denigrations of that parent made by the alienating parent.

In moderate cases of PA the symptoms are strongly manifest, with considerable problems in contact and handing over of the child: the child will stubbornly refuse contact, but respond positively once contact is made and when the alienating parent is absent.

In severe cases of PA the child will radically and without objective reasons refuse contact with one parent (father or mother) with whom s/he previously had a loving attachment, because s/ he has internalised a false negative image of the rejected parent. The attitude of rejection and level of negativity vary considerably between the mild/moderate and severe forms. The child manifests an extremely polarized view of his/her parents (black and white). In such a case, the family court in collaboration with a specially trained expert psychologist or therapist will be the final authority who can either interrupt the alienation process (with sanctions or a believable announcement or possibly implementation of custody transfer) or ensure its permanence (through passive waiting: “If the child does not want to, there is nothing we can do.”) [13,14].

In some cases of severe parental alienation unsubstantiated sexual abuse allegations by alienating parents and their alienated children are found. Fabricated allegations have been considered, to be a weapon used by a separating parent, to effectively end the child’s relationship with the other parent. Similar dynamics can be found in the Stockholm syndrome, in cases of hostage taking and in the Munchausen by proxy syndrome, a disorder that involves parents artificially inducing or exaggerating symptoms of illness in their children. The affected children depend upon outside help [6,11,15-17].

Important Alienation Techniques in PA

Significant alienation techniques are, among others, denigration, reality-distorting, negative presentation of the other parent, boycott of visitation, rupture of contacts, planned misinformation, suggestive influence, and confusing double-bind messages. Sometimes direct psychological threats (such as withdrawal of love, suicide threats) or physical threats (hitting, locking in) are used against children. Two documentaries by G. Gebhard show the problem from the point of view of formerly alienated children (I recommend these two films [18]). The dysfunctional family dynamic enhances the severe conflict in the child. Fear, dependence on, submission of the child, making him/her pliable, and his/her identification with the alienating party play an important role.

Case Example from Psychiatric-Psychotherapeutic Practice:

Interview situation (tape recorded transcript) with two formerly severely alienated children (4 ys., girl and 8 ys., boy). Follow up after nine years, then the adolescents were 13 ys. and 17 ys. (at the time of the interview/abridged extract).

The two “Children” live today as advanced students abroad; they are in a psychologically stable and autonomous condition and have a regular, good contact with both their parents.

Diagnostic Procedure

The actual textbook on “Parental Alienation: Science and Law”, edited by Lorandos and Bernet [19] explains the diagnostic methods and various interventions for families, that experience PA. A reliable diagnostic includes considering the actions and attitudes of all parties (the child, both parents and other important attachment figures). The conclusion that the child is alienated (as opposed to estranged, that means justified rejection of one parent following a real history of neglect, physical or sexual abuse) can only be drawn if the following factors are met [20]:

Factor 1: The child actively avoids, resists, or refuses a relationship with a parent.

Factor 2: Presence of a prior positive relationship between the child and the now rejected parent.

Factor 3: Absence of abuse or neglect or seriously deficient parenting on the part of the now rejected parent.

Factor 4: Use of multiple alienating behaviours on the part of the favoured parent.

Factor 5: Exhibition of many of the eight behavioural manifestations of alienation by the child (irrational campaign of denigration; absurd rationalisations; lack of normal ambivalence; black-andwhite thinking; reflexive support of the favoured parent; use of „borrowed scenarios“; „independent-thinker“ phenomenon, etc.)

The case study shows that both children previously had a positive relationship with their father. The father did not show any abnormalities in his parenting behaviour. With regard to the mother the children describe considerable parental alienation behaviours which was transferred to the children by conveying a negatively distorted image of the father (“I trusted my mother and believed her when she said that my dad was bad”) and finally led to a radical rejection of the father by both children. All five diagnostic criteria were available here.

Intervention

Warshak [12-14,21] who describes the serious fallacies, that can compromise decisions in court and therapy, explains the different levels of severity of parental alienation (mild, moderate and severe) and how to intervene and manage these cases. He developed an intervention program, called Family Bridges, a structured, court-ordered, evaluated, four-day, educational workshop in which the rejected parent and children participate together without the favoured parent and other family members. The workshop materials are drawn from universally accepted research in social, cognitive, and child developmental psychology, sociology, and social neuroscience about how to create a safe atmosphere for alienated children and their rejected parent to be together and work on healing the relationship. After running through this intervention program, the percentage of resisting compliance by alienated children with the court-ordered contact with the alienated parent dropped from 85 % to 6 %.

Another example in Europe is the intervention program of the Family Separation Clinic, London, U. K., directed by Karen and Nick Woodall. They also use a child protection approach. Where alienation is identified, they utilise a legal and mental health interlock (in which the legal intervention deals with the power and control element through the threat of sanctions and the mental health intervention deals with the issue within the family) to produce the conditions in which dynamic change for the child becomes possible, and implement a structured intervention based on immediate relief of splitting in the child. This typically involves an immediate reconnection with the rejected parent through in situ therapeutic interventions where possible or, where determined by the court, a change of residence with a therapeutic bridging plan. This approach seeks protect the child as a matter of priority by constraining the alienating parent’s behaviours, where possible, or protecting the child from the source of harm where constraint is not possible. Further, it always seeks to protect the child’s right to a relationship with both parents and supports a permanent resolution of child’s defensive splitting [22].

In the case study it was crucial that at a certain point child protection service, guardian ad litem and court made a clear decision to transfer the two children to the father. The transfer process ordered by the court was psychologically accompanied. Once the children were safely removed from the influence of the alienating parent, soon they started to form emotional ties again with the parent they had previously rejected.

Concluding Remarks

In view of the tragic experiences and of the psycho-traumatic long-term effects of pathological alienation and contact loss as shown in the above example, the development of parental alienation cannot be viewed as a private family affair. In cases of high-conflict separation, divorce battles and other conflictual contexts where children are used and manipulated, there is thus a risk of parental alienation development. The early active and interdisciplinary collaboration of all professions involved is essential. The special psychological issue of alienating behaviour needs to be considered in depth. Compulsory psychological counselling, directive or confrontational interventions and structural family court actions are required (sanctions or custody transfer with psychological support). Parental alienation is a custody issue but also a child protection issue. The supervisory bodies of the child welfare office and the family court should in this case be required to act accordingly [7,8,23,24]. Diagnostic and intervention must occur as promptly as with all other forms of abuse (sexual abuse, physical abuse and neglect) by an experienced professional in the field [2,6,12-14,17,19,21-24].

It is unethical practice to ignore parental alienation as a form of psychological child abuse and family violence. Reducing the severe and substantial harm to children, parents and extended family members caused by parental alienation should remain the main focus of professional interventions. Stopping parental alienating behaviours is imperative for the promotion of the best interests of children and the health of families [23]. The ultimate authority who can either stop the alienation process or perpetuate it, is the family court in cooperation with a specialized psychological/psychiatric family court expert.


v. Boch-G:

As you know, I frequently see divorced families. I have known your father since 1999. When parents divorce, a situation often arises where children all of a sudden radically reject a loved parent who they are not living with and no longer want to see him or her. Often there is no apparent reason for this. So we are not talking about situations where the father or mother has maltreated or even sexually abused the child. This phenomenon, which frequently occurs with conflict-ridden divorces, is very painful for the parent concerned. Experts often hold the opinion that "the child does not want to see the parent, so there is nothing we can do" and that "the child needs to settle down". As a result, the child loses contact with one parent for years, sometimes even permanently.
I think it is important for children who are experiencing or have experienced such a situation to be able to reflect on it later, to realise what happened. I am very glad that you N. and R. have agreed to participate in this interview and report on your experiences at the time from your point of view looking back now.
You, R. (abbreviated girl's name), are now 13 years old and you, N., are 17 years old. When I met your father 9 years ago, you had not seen him for two years and you were 4 and 8 years old. You lived with your mother after your parents separated, didn't you?

N.

It all started with a lot of arguing. As far as I could tell, it was always my mother who started the arguments. Well and when my father then moved out, that was quite weird. From that day onwards, he sort of became the "arsehole".

R.

She would then call him "the arsehole".

v. Boch-G.

Was your father that bad in your experience? Or was that your mother's perspective and what she said?

N.

Mostly it was what mother said. I didn't talk about it much.

R.

Well, you learn from your parents. I trusted my mother and believed her when she said that my dad was bad. I can still remember lying to myself sometimes. I'd tell myself: "You mustn't miss your dad because your dad is bad!"

v. Boch-G.

Did you do that to comfort yourself?

R.

Whenever I missed him, I'd tell myself: "No, you mustn't, dad is bad!" I can still remember when we were finally at a police station, I hadn't seen my dad for a long time then. And when I saw him there I said to him: "You arsehole!" Then I burst into tears and fell into his arms.

v. Boch-G.

What a contradiction, feeling both of those emotions.

R.

Yes!

N.

As far as I can tell today, it was even more extreme with me than it was with her. She was still a child, but I had already more of a set opinion. I protested vehemently. When we were then removed from my mother, I stood there and protested for several hours, so as not to have to go and live with my father. - And then we went anyway.

v. Boch-G.

That was the situation where the court had decided that you should go and live with your father.

N.

I can't remember exactly when that decision came, I can't really say now. It was when we were still living in XX and before we moved to YY.

v. Boch-G.

In XX you were both at the stage where you didn't want any contact with your father.

N.

We'd already more or less refused contact when we were still living in ZZ, which was earlier. At the Catholic meeting (meaning the meeting at the Catholic advisory service) - can you remember, R.?

R.

No idea!

N.

That was even before we moved to XX with our mother. We were supposed to meet up with our father for a few hours.

v. Boch-G.

With the help of a social worker from the Catholic advisory service, contact was to be introduced?

N.

Yes, exactly!

R.

When I was a small kid, I was really into lego. That made it easier for dad. I just got some lego and then dad was good again in my eyes. It wasn't so easy for N.

N.

Immediately after we were separated from our mum, R. would play with that stuff all day.

v. Boch-G.

If things go smoothly, the parents tend to cooperate with an arrangement in which the children can live with either the father or the mother and visit the other parent. Why do you think you radically rejected your dad - in some situations it is the mum? How did that happen?

R.

I think it's simply because you learn almost every step from your parents, and if one parent says "this is bad" you believe them. Because you trust them. Because you love your parents. If your parents tell you that the wolf is bad, you believe them. You believe everything your parents tell you.

v. Boch-G.

You copy it, because at that age you can't yet distinguish.

N.

Well our mother always used to look after us a lot. My father would go to work early in the morning and wouldn't come back until 7 in the evening, so we spent far more time with my mother than with him. She was off work in the afternoon. I don't know, maybe that's why we had a closer relationship with our mother.

R.

Initially we would spend some weekends with our father and then we'd tell her about the things we didn't like there (like cobwebs and other little things). She would immediately change that to "Your dad is unhygienic." etc. and we'd of course believe her straight away.

v. Boch-G.

Is the effect of this negative perspective that you eventually believe it?

N.

Yes!

v. Boch-G.

Normally every mum and every dad has good sides and not so good sides, and initially you were still visiting your dad. Then you saw what he was really like, his good sides and his bad sides. But how come all that gets completely blanked out and all of a sudden you see everything as all black or white?

N.

Maybe it's just that we only wanted to see the bad sides.

R.

Many things that happened were also distorted. For example, once I was taking a walk with my mum. I don't remember exactly what happened. My dad asked me to go to his and my mum changed that to: "Your dad pulled you off the bike and wanted to take you away from me." I fully believed her version, because I thought he was bad and I couldn't remember the event so well myself.

v. Boch-G.

Things were "distorted", you said, R. Is it true then that you are no longer able to clearly tell "what's what?"

R.

Yes! And everybody around us, i.e. my mother's friends, told us the same. And then you believe it, of course.

N.

Yes, exactly! You could say that it was a kind of brainwashing. There was no longer anything good about him. All of my father's positive characteristics were directly portrayed as negative.

v. Boch-G.

Was it like in a sect?

N.

I don't know if you could compare it to a sect. But it was almost like that. Us, a group of three, were the better people, and on the other side there was our dad with the police. The way my mother always presented it, the police and the judges would listen to him because he had a lot of money, and we would have to distance ourselves from him.

v. Boch-G.

The goodies are at home, and the baddies are the others.

N.

Yes, I see it a bit like that. Then there were a few women who were my mother's friends, who chimed in with her. There was nobody who would oppose that view.

v. Boch-G.

Do you think the situation was particularly extreme in your case? Because often the parents manage to come to some agreement. Why is it that events took such a radical turn?

N.

It happened overnight.

v. Boch-G.

Yes, and it was so radical that one parent was all black and the other all white.

N.

Well we just saw our dad in the way that our mother presented him.

R.

I don't think that parents do that out of spite. Maybe it just seemed so natural to us because it was what she actually believed. She wasn't play-acting.

v. Boch-G.

She was convinced that your father was bad?

N.

Maybe another thing was that I had a very close relationship with my grandma and my grandad, and they, of course, also believed that dad wasn't such a brilliant person. I didn't have that many close relationships with my father's family or friends.

v. Boch-G.

One could almost say you were faced with a superior power that had a certain image of dad. And you tend to accept that.

N.

Yes, it was like that. Everybody said that dad was bad, grandma and grandad also said it.

R.

But my mother said bad things not just about my father but also about other people we liked. Later she even turned against her own parents. And we would always go along with her and adapt. We were totally behind our mother.

v. Boch-G.

I see, one could say you copied it from her.

R.

Yes, I can remember this, for example: we were in Turkey and she was terribly arguing with her parents who were with us. The only word I could write was AA (poo) so I would write that on a piece of paper and push it underneath their door to annoy them. And mum would then say: “That’s very good!”, “You’re doing that very well!” And I would then, of course, think my behaviour was right.

N.

Yes, that was completely stupid. The arguing with our grandparents escalated at that time. You could say that my mother "took control" of us. Everybody had fallen out completely. We had the car and my grandparents had to get home on public transport. We drove on ahead and we had the key. I took everything I wanted - and my mother encouraged me in that and then - totally mad - I took a piece of paper and wrote on it: “See you, you arseholes”.

N.

I don’t know what went through my father’s mind when he found out. Just the fact that I did something like that still makes me blush today.

R.

I think the fact that we got praise for these actions made us feel really good.

v. Boch-G.

So you were encouraged?

R.

Yes! Mother would always present everything in a good light. Even when the situation was “crap” she would still say that it was good. Take my first communion: she said it was the most beautiful day of my life, although that wasn’t true at all. It was just “crap”! She had argued with everybody on that day, and still I ended up being convinced that it had been the most beautiful day of my life.

v. Boch-G.

As you know, I first met your father during that time and he was trying to legally enforce contact with you. He wanted you to live with him because it all seemed strange to him. Do you think he was right?

N.

Yes!

v. Boch-G.

How did you experience that?

N.

I didn’t really take it in at the time. There was the following situation, for example: even before our mother was admitted to the psychiatric hospital, she was often drunk. My father had already noticed that she was completely plastered in the evenings. He would then come round every day - not to tell her off, but to not let the situation get out of hand completely. And one night, things were so bad that my father and I had to carry her upstairs. I think R. was still playing, but the next morning, R. and I were again on my mother's side.

v. Boch-G.

Did you realise at the time that your mother was sick?

N.

We didn’t even realise that she was drunk every day. That night was the first time I actually realised.

v. Boch-G.

Your dad then started legal proceedings to obtain custody and access rights for you. That’s very stressful for a child. What is your perception of that now? Should he have stepped back to let things calm down? Because you were vehemently opposed to living with him.

N.

I’m totally convinced that we have developed better here. The atmosphere in the terraced houses where my mother lives is still bad today. Every neighbour has some kind of problem and my mother was arguing with all of them - almost all of them. They’re all divorced, have an anorexic child, or something else. 5

v. Boch-G.

Should you intervene or should you refrain, to let the child settle down?

N.

For a while it’s harder than it would normally be. But then it’s over! If my father had not got involved then, things would have just carried on as they were forever. My mother was a complete wreck. She would have been admitted to hospital later anyway.

R.

At the police station they asked me: “Would you rather live with your dad or in a children’s home?” So I said: “In a children’s home.” That’s not normal, is it, that a child who normally loves their father suddenly wants nothing to do with him and hates him.

v. Boch-G.

What do you think of a question like that?

R.

I think it’s totally rubbish, because I was only 5 years old at the time.

N.

As I remember, my sister could be in a real sulk 5 minutes earlier, and then 5 minutes later she’d be back to normal.

v. Boch-G.

So what would you recommend in a situation like that? The intention is to make the right decision, which is in the child’s interest.

N.

My mother drummed it into us at the time that we should always say we didn’t want to live with our father. But the judge didn’t ask us that question. He asked us how old we were.

v. Boch-G.

So your judge didn’t get you into that kind of awkward situation at all?

N.

No, he asked us what our everyday life was like. What school was like, to get an idea.

v. Boch-G.

As you know, your mum was sick at the time, she wasn’t bad.

R.

Today I have a very close relationship with both my parents. I can talk to my mum about some things and to my dad about other things. I look forward to the holidays. Today it’s almost normal at our house.

v. Boch-G.

Do you have the impression that your father supports your regular visits to your mother?

R.

Yes, I do! His support is important, he makes sure we go!

v. Boch-G.

For me it is valuable to hear you, two young people, reflect on the experience you had as children. Thank you for your openness.

R.

I think children need a mum and a dad, because they learn from both of them. I can remember, when I was small, most of my friends were boys. And I always wanted to be a boy. Only later, when I had contact with my mother, that improved and I felt good as a girl. In my class there’s the opposite case: a friend of mine lives with her mother, she is afraid of everything and cries a lot. What you learn from your father is this self-confidence that allows you to take risks now and then. And she was lacking that. Now she sees her father again and things have improved.

v. Boch-G.

In your case, the court’s strong intervention was unpleasant and painful, but in retrospect it seems to have been the right thing.

N.

Yes it was the right thing! Things were happening so fast then - first mum was gone, and then we were told that we would go to YY. We both thought that mum would come back.

R.

Then, when we got to YY, we initially had no contact with our mother for several months. Not even on the telephone. As a young child, I would sometimes look whether she was listed in the phone directory. It was really hard for me not having any contact with her.

v. Boch-G.

You were given a legal representative. Did you find that useful?

R.

She was really bad in our eyes at the time.

N.

For my mother she’s still the devil incarnate today. She’s frightened by the sight of her - even today. She was very strict with my mother. Other than my father, she was the first person who saw things for what they were and would then get everything done properly.

v. Boch-G.

Another thing: didn't you have all this anger against your father when you still believed everything? How do you see that now?

N.

Today, I’m really sorry for everything, including how I insulted my father. When we got to YY, both of us initially didn’t trust him at all.

R.

Yes, I did!

v. Boch-G.

N., you weren’t sure whether things were OK the way they were?

N.

Exactly.

v. Boch-G.

So when did you feel: that gives me a sense of security, that's alright? Did that come bit by bit?

N.

I started feeling that at some point - very slowly. After about half a year. That was a difficult time - for my father too - all this to-ing and fro-ing. He would have real fits of temper then, and my mother took advantage of that and had the court case reopened.

R.

I didn’t know at all what to feel for my dad. Mother had told me he was bad, but when he was there in front of me, he was really nice to me. That was very confusing.

v. Boch-G.

Were you able to talk about that?

N.

We could've talked about it, but I don't think we did at the time. Later we talked a lot. We stuck together, but initially we didn't talk about things.

v. Boch-G.

So how did you get to now live with your dad but regularly visit your mum? That wasn't to be expected.

R.

First we had supervised meetings with my mother - with psychologists sitting in the room next door. Maybe our mother didn't say anything because of the CCTV.

v. Boch-G.

If you were to give some advice to a judge or an expert - what would you tell them?

N.

I would help prevent contact with one parent being broken off completely. Maybe there should be supervised meetings. I would certainly not recommend that one parent is no longer allowed to do anything. I would allow the writing of letters. The parent who has custody should be able to read the letters to make sure there's nothing bad in them - certainly with young children like we were then. I would not put the child in a situation where they have to decide who they want to live with.

R.

I think it's important for children to have both parents. For small children it's less awful than you'd think to visit one parent. Small children sometimes talk a lot of rubbish.

v. Boch-G.

One could say you had been forced into a solution that you both say today was right even if it was painful.

N.

It should've been made earlier!

v. Boch-G.

Does that mean leaving the decision to the child means placing too much of a burden on them?

N.

Yes, too much responsibility! I think the youth welfare offices and the courts take the easy way out.

R.

Children aren't able to judge, particularly when they're under the influence of one parent. That's why they believe what they're told.

v. Boch-G.

We have tried to gain an understanding of your situation at the time, of how you experienced things then and how you see them now from some distance. I found it very interesting that you said the authorities should have intervened earlier. That could be an important impulse for assessing complex situations such as the one you experienced.
Thank you very much for your willingness to participate in this interview and for your openness!

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Citation: Boch-Galhau W (2020) Parental Alienation: A Serious Form of Child Psychological Abuse-A Worldwide Health Problem. Ann Case Report 5: 566. DOI: 10.29011/2574-7754.100566

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