Conference report

Parental separation, alienation and splitting: Healing beyond reunification

Separacija roditelja, otuđenje i oporavak djeteta: Razvoj standarda dobre prakse

 

The third conference of the European Association of Parental Alienation Practitioners (EAPAP) was held, online, between 16-18 September 2020. This year, the three-day practitioner event was hosted by the Child and Youth Protection Centre of Zagreb (Poliklinika za zaštitu djece i mladih Grada Zagreba) and featured presenters from 13 European countries, as well as a number of guest speakers from the United States and Canada. The Zagreb Centre was chosen to host the event as it is a key partner in the EAPAP project which aims to bring together practitioners from across Europe who are responding to post-divorce relationship trauma in children. Previous conferences have been held in Prague and London.

 

The City of Zagreb graciously supported the conference and the event was officially opened by Zagreb City Mayor, Milan Bandić, and the Director of the Zagreb Centre, Prof. Dr. Sc. Gordana Buljan Flander, who noted that the theme of the conference was the promotion of new clinical insights, and theoretical approaches to working with alienated children. This sentiment was echoed by EAPAP Board member Nick Woodall who, in his opening remarks, identified that the work of the Association was driven by the clinical experiences of practitioners working with the problem and by academics who were seeking to strengthen the research base within the field. As well as its main theme, the conference also explored specific issues including attachment, transgenerational transmission of trauma, power and control dynamics in relationships and parental psychopathology, together with risk assessments and the interlock between mental health and legal approaches to the problem.

 

EAPAP Board member, Dr. Wilfred von Boch-Galhau MD, who is a specialist in psychiatry, neurology, psychosomatic medicine and psychotherapy and is one of the world’s pioneers in the field, took the participants on an historical journey through the concept of parental alienation. He described how the dynamic has been recognised in both academic literature and clinical practice for many decades, but often with different theoretical conceptualisations and using different terminology. He argued that, whilst alienation does not exist as a diagnosis in the current classifications (ICD and DSM), other diagnostic criteria, such as the diagnosis of emotional abuse, are adequate to identify the problem that the child is suffering, and that the lack of a specific diagnostic category must not prevent recognition of this dynamic as a child protection issue.

 

Nick and Karen Woodall, psychotherapists from the Family Separation Clinic in London, gave a keynote presentation on the use of psychoanalytic approaches to understanding children’s relational trauma in divorce and separation. Nick Woodall began by suggesting that the term parental alienation was, largely, unhelpful in clinical work and argued that the predominance of diagnostic approaches to the problem may have held back more nuanced ways of understanding and treating the problem. He said that the Clinic did not accept that alienation is a mental condition in the child, as many have proposed (i), but is a maladaptive defence that the child utilises in a relational landscape that has become frightening and overwhelming. He also argued that, rather than the eight signs of alienation curated by Richard Gardner (ii), clinicians needed to identify only one core marker in the child, that of defensive splitting which, he said, the Clinic recognised as being at the heart of the child’s inter and intra psychic difficulties.

 

Mr Woodall noted that understanding alienation from a psychoanalytic perspective was not new and referred, particularly, to the work of Johnston, Roseby and Kuehnle (iii). He suggested that whilst the problem appeared to be the child’s rejection of one parent, in reality, the rejection was a symptom of the child’s pathological alignment to the other parent. Referring to splitting, he reminded the conference that, whilst the external manifestation of the defence was the idealisation of one parent and the demonisation of the other, Melanie Klien had maintained that the ego was incapable of splitting internal or external objects without a corresponding splitting within the ego’ (iv). He argued that approaching the dynamic with an understanding of psychoanalytic theories such as splitting, identification with the aggressor, projective identification and transgenerational transmission of trauma allowed clinicians to understand the unique configuration of each case.

 

Karen Woodall described the kind of therapeutic approaches that were utilised at the Clinic. She told the conference that families in which alienation was present needed intensive interventions which were in real-time and which flowed around their real lives. She said that activity based therapy involving the child and the rejected parent were key to reunification work and that reunification work should take place at the earliest point in an assessment. She argued that waiting until the child was able to agree to see the parent they were rejecting before commencing therapeutic work, was contraindicated as the child is constrained by the existing power dynamic and, therefore, unable to agree. Mrs Woodall stated that the purpose of treatment must be the healing of the splitting defence in the child and that, whilst the removal of the child from a parent that is causing the child to split may be absolutely necessary, it should not be seen as an end in itself, adding that a failure to successfully deal with the splitting defence is likely to lead to long-term problems for the child.

 

The conference welcomed researcher and EAPAP Board member Dr. Sietske Dijkstra from the Netherlands and Jennifer Jill Harman, Ph.D. from the Department of Psychology, Colorado State University, who addressed the conference of the subject of power and control in cases of alienation. Dr. Dijkstra presented her study on the impact of coercive control on post-divorce relationships between mothers and children (v) and her therapeutic coaching work with rejected parents, whilst Dr. Harman explored asymmetric power relationships and coercive control in cases of alienation, arguing that it was important to understand how power was used. Dr. Dijkstra suggested that professionals working with alienation often lose crucial time by offering interventions that don’t help, ignoring the malevolent intentions of the aligned parent and overlooking the coercive control dynamic.

 

Since many conceptualise alienation as an attachment problem, one section of the conference was devoted to how attachment theory can help practitioners understand and resolve alienation cases. Prof. Dr. Gordana Buljan Flander, Director of the Zagreb Child and Youth Protection Centre, clinical psychologist and psychotherapist with a PhD in attachment theory, and Council of Europe expert in child protection, presented a lecture on attachment and the errors that are often made in family assessment. In particular, she pointed out that, since attachment is an innate characteristic, we should not assess its persistence but, rather, the attachment quality and style. She also noted that psychological splitting is not related to abuse by the rejected parent but to abuse by the alienating parent. Mirela Badurina, PhD, psychotherapist and child and adolescent psychotherapist, presented a case on working with attachment issues in a psychologically split child and its parents via online services during the COVID-19 crisis. She proposed that, although virtual contact can never replace a face-to-face work, it still offers the practitioner the opportunity to proceed. Ass. Prof. Vanja Slijepčević Saftić, M.D., PhD, paediatrician and sub-specialist of child neurology, gave a lecture on toxic stress in childhood, and its devastating impacts on later life which, she argued, made induced splitting a public health and child protection issue.

 

Assist. Prof. Bruna Profaca, Ph.D., clinical psychologist, lecturer and writer, specialising in child trauma and grieving, presented several models and case studies exploring the theme child emotional abuse and trauma. She argued that, in the sense that children who are suffering induced psychological splitting are alienated from their own sense of self and their own ability to regulate their feelings, there was no question that they should be recognised as being traumatised children. And Prof. dr. sc. Marina Ajduković, psychologist, sociologist, and Head of the Department of Social Work at the University of Zagreb, presented an innovative project on early detection of possible parental alienation in Social Welfare Centres, currently being conducted in partnership with UNICEF and the Croatian Government. The conference also heard from Danijel Crnkovic, PhD. and Assistant Professor in forensic psychiatry at the University of Zagreb, on the psychopathology of parents in alienation cases who argued that professionals should not be passive observers but act to protect children. And Dr. Marina Walter, a forensic medical specialist in psychiatry and psychotherapy for children and adolescents, and Dr. Thomas Demessence, both from Switzerland, discussed diagnoses associated with parental alienation in child custody dispute forensic investigations.

 

The conference heard a number of presentations offering clinical perspectives on working in the field. Inbal Kivenson Bar-On, Phd, who lectures at the Child Disorder Department of the University of Haifa, and Dr. Benjamin Bailey, social worker, psychotherapist and faculty member in the Department of Criminology at Western Galilee College, both presented clinical experiences from Israel. They suggested that the Supreme Court's validation of parental alienation is a crucial step towards the establishment of good practice, something that later confirmed by Croatian Supreme Court judge Renata Šantek. Prof. Dr. Milica Pejović Milovančević, a child psychiatrist and professor at the Department of Psychiatry in Belgrade, offered a psychiatric explanation of splitting and its consequences, whilst Ass. Prof. Vlatka Boričević Maršanić, M.D., PhD, specialist in psychiatry and a sub-specialist of child and adolescent psychiatry demonstrated that, according to research and clinical practice, both the short and long-term consequences of parental alienation correspond to the consequences of all other forms of abuse. Karen Woodall moderated a panel discussion that included Dr. Bailey, Claire Francica, an existential counselling psychologist and psychotherapist from Malta, and Joan Long, a counselling psychologist from the republic of Ireland. Karen Woodall also hosted a discussion with Dr. Kelley Baker, a psychotherapist from Texas, on the legal, reputational and physical threats faced by practitioners working in this field.

 

The presence of unresolved transgenerational trauma as a causal factor in cases of alienation is increasingly recognised and the conference was, therefore, delighted to be able to welcome as its special guest speaker, Jill Salberg, PhD, ABPP who is Associate Professor of Psychology at the New York University Postdoctoral Program in Psychotherapy and Psychoanalysis, and who has written extensively on transgenerational trauma. Dr. Salberg’s conference paper, The shadow of our ghosts: Generations of ruptures, explored both the mechanisms and effects of unresolved trauma and its transmission between parent and child, and across the generations. She suggested that what is too much for the mind to process becomes dissociated and unknown and that we protect ourselves, psychologically, by banishing from awareness those things that are unbearable. She argued that it was these dissociative processes that lie at the heart of transgenerational transmissions of trauma and that minds that become overwhelmed by fear, terror or uncertainty, while also feeling helpless, can be ripe for dissociative trauma reactions.

 

Dr. Salberg referred to the research around disorganised attachment and argued that transmission happens within the atmosphere or texture of the attachment process. She noted that children are hungry for emotional contact with their parents, whether that was conceptualised as being compelled to seek safety or as a kind of attachment imperative, and said that she believed that the child will seek out not only the healthy parts of the parent but also the parent’s traumatised self. She added that, in the absence of a fully emotionally vital and present parent, the child, nonetheless, attaches not only to parts of the parent that are present but also to what is absent. Pointing to attachment and mentalisation theory, Dr. Salberg referred to the bi-directional regulation and modulation of affect between infants and their mothers that takes place in the inter-subjective relationship that develops from birth. EAPAP Board member and psychotherapist, Karen Woodall, expanded on Dr. Salberg’s clinically and theoretically rich presentation and provided examples of how transgenerationally transmitted trauma may be manifested in cases of alienation, where the child’s splitting defence may be recognised as a displaced trauma from the influencing parent and that what appears to be a problem in the here-and-now is, in reality, a result of dysregulation in the aligned parent due to a past narcissistic injury.

 

One conference session was dedicated to legal case management of alienation cases and how that needed to interlink with therapeutic interventions in order to address the underlying power dynamics. Sandra Inês Feitor, PhD, a lawyer and family mediator from Portugal, stated that fundamental human and children’s rights cannot be met if a child is denied a loving relationship with both parents. Brian Ludmer, Canadian attorney, author and respected educator in the field, provided practical strategies for working with alienation cases in court and suggested that the most abused word in English language is the word 'abuse' itself. Prim. Domagoj Štimac, M.D., psychiatrist with a sub-specialty certification in child and adolescent psychiatry and forensic psychiatry, presented a lecture on false allegations of abuse. He pointed out that the incidence of false and unfounded allegations in the general population ranges from 2 to 10%, but in problematic divorces goes up to around 50%. Dr Simona Vlădică, a psychologist and author from Bucharest and a member of the EAPAP Board described how seriously the problem is treated in the Romanian courts and presented a number of case examples.

 

Finally, a regional panel, with representatives from the judiciary, social welfare system, lawyers, therapists and ministries’ representatives, was keenly attended and participants asked many questions through the interactive forum. The panel was moderated by Judge Lana Peto Kujundžić and included Danica Ergovac, Eleonora Katić, Ana Hrabar, Teodora Minčić, Sara Jerebić and Kolinda Kolar. It became clear that many experts are unaware of their responsibilities and limitations and the capacity for co-operation with other experts. One esteemed member of the panel was Renata Šantek, Judge of the Supreme Court of the Republic of Croatia. She stated, very clearly, that the concept of parental alienation was accepted but noted that, whilst expert witnesses could provide evidence to inform the process, it is the judge's responsibility to make decisions and determine what is in the child’s best interests.

On the final day of the conference, therapists Karen and Nick Woodall hosted a parallel workshop for rejected parents. The event was moderated by psychologist Mia Roje Đapić who facilitated a question and answer session in which parents were able to ask questions about how they may best be able to respond to psychological splitting in children and ways of managing their own experiences of the complex family dynamic and the painful experience of rejection by a child.

 

This third conference of the Association which was attended by more than 400 mental health and legal professionals from across Europe, and addressed by over 30 specialists in the field, marked a transition away from the focus on diagnostic approaches to the problem of children’s rejection of a parent, and towards a recognition that the dynamic referred to as parental alienation is, at its core, induced psychological splitting in the child and a relationship trauma that may be understood within the context of accepted psychological and psychoanalytic theories, and treated using existing therapies that are adapted for this particular cohort of children. The conference also demonstrated the interest in responding to the dynamic as well as the benefit of multi-discipline collaboration in the field. It is anticipated that the fourth annual conference will be held in Israel in 2021.

 

 

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i. See, for example, Lorandos, D., Bernet, W. & Sauber, S. R. (2013). Parental alienation: The handbook for mental health and legal professionals. Springfield, IL: Charles C Thomas.

 

ii. See, for example, Gardner, R. A. (1985). Recent trends in divorce and custody litigation. Academy Forum, 29(2), 3–7.

 

iii. See, for example, Johnston, J., Roseby, V. & Kuehnle, K. (2009). In the name of the child: A developmental approach to understanding and helping children of conflicted and violent divorce (2nd Edition). New York: Springer.

 

iv. Klein, M. (1946). Notes on some schizoid positions. The International Journal of Psych-Analysis, 27: 99-110.

 

v. Dijkstra, S. (2019) ‘I did not see my daughters for years:’ The impact of coercive control on post-divorce relationships between mothers and children. Theme Intimate Partner violence, E-book, Second European Conference on Domestic Violence, Porto, 50-56.