How should AB-PA be treated?

Childress emphasises that AB-PA requires specialist treatment by those with specialist skills. The diagnosis of AB-PA needs to be tackled swiftly in order to avoid further damage to the child, estimating a period of 6 months to complete the treatment.

The following 4 phase reunification plan is his recommended approach to treating a child subjected to AB-PA:

  1. Rescue the Child (Protective Separation)The child must be removed from the care of the NPD/BPD parent because they want to keep the child aligned with them. They will try to thwart therapy. If the child is not removed it will result in a tug of war between the therapist who is trying to help the child and the NPD/BPD parent who needs them to play the victimised child role. This may end up splitting the child psychologically, thus causing significant harm.Where the other parent has been assessed as being a normal range parent the child should reside with them whilst this treatment is being undertaken.It is likely that the child will initially experience distress and act out. Some of this behaviour may be dangerous e.g. running away or self-harm. It is important that the normal range parent is prepared for this and that the child receives sufficient support from their family, the therapist and the court. The more the child acts out the greater the degree of pathology and, therefore, the greater the damage that has been done by the NPD/BPD parent.Therapy will not be successful without removing the child from the influence of the NPD/BPD parent.
  2. Recover the Child’s Self-authenticityThe child needs specialised treatment to understand how they have been brainwashed. They need to be re-attuned to the other parent and misatuned to the NPD/BPD parent’s pathological distortions. The child needs to re-gain their empathy.
  3. Restoration of the Parent-Child RelationshipThe therapist needs to elicit a grief response and get the child to re-form their attachment bond to the rejected parent. The child needs to be encouraged to see that they are a normal range parent.
  4. Reintroduce the Pathology of the NPD/BPD ParentThe child loves the NPD/BPD parent. Just as it is not in the interest of the child to be cutoff from the normal range parent it is not in the child’s interest to be cutoff from the NPD/BPD parent, unless there is any indication that there is a risk to the child in the form of violence/sexual abuse/abduction/continued psychological abuse etc. This re-introduction needs to be monitored to ensure the progression of the child’s mental health. The child needs to be given mechanisms to cope with the NPD/BPD parent’s behaviour.

Childress warns that validating the child’s feelings is the absolute wrong thing to do because this is colluding with the pathology. Currently Courts and social workers in the UK give inappropriate weight to listening to the wishes and feelings of the child without undertaking proper investigation into the origins of those wishes and feelings i.e. checking for AB-PA/pathogenic parenting.

Under normal circumstances it would be appropriate to suggest both parents enter therapy. Unfortunately, those with NPD/BPD tend to resist therapy or seek to win the therapist over to their way of thinking. It often fails.

Other techniques to recover the child’s relationship with the rejected parent

More recently Dr Childress has been co-ordinating with Dorcy Pruter of the Conscious Co-parenting Institute in the US. Dorcy has developed a series of training programmes to teach parents how to co-parent and deal with a child’s resistance to see them with empathy of the child.

Unfortunately, where a child has experienced a complete emotional cutoff with a safe, loving parent, it is unlikely to be resolved without specialist input. There are a number of solutions that are effective in reuniting children with parents they have previously rejected. In order to be effective they require an enforceable court order to ensure the child and alienating parent participate with the interventions.

What knowledge does someone treating a child subjected to AB-PA need?

Childress recommends that parents ask the courts to allow a Clinical Psychologist to assess the family in order to determine which parent is responsible for the failure of the child’s attachment system and to recommend a treatment plan. The Clinical Psychologist assessing and supporting the child needs to be someone with full knowledge of:

  • Attachment System – children who reject a normal range/safe parent are brainwashed and suffer pathological mourning
  • Family Systems – triangulation of child into parental conflict and cross-generational coalitions by a person whose goal is to annihilate the other parent
  • Complex Trauma – transgenerational transmission of attachment trauma through the creating of a false trauma-re-enactment narrative
  • Personality Disorders – NPD/BPD etc. and delusional beliefs.

Is AB-PA always the reason a child rejects a parent?

No. As explained previously it is necessary to perform an assessment and look at evidence to determine if the child has a neurological condition that stops them from having a relationship with their parent or if there has been any child abuse. The diagnostic model for AB-PA helps identify where there may be an NPD/BPD parent who is using coercive and controlling behaviours to manipulate the child to reject the other parent. The diagnostic signs are very specific in this case.

Childress estimates that in 25-30% of cases where a child has rejected a parent, the person reporting to be an unjustifiably rejected parent is in fact an NPD/BPD parent. On assessment it is clear they have no empathy for the child or how their behaviour has caused the alienation. They see themselves as a wonderful parent. In this case the child would not show symptoms of NPD/BPD and there would be no suppression of the Attachment System.

It is possible, that both parents have a personality disorder e.g. a father could have NPD and a mother BPD. Ordinarily people high on the narcissistic scale do not tend to attach themselves to other narcissists – there would be too much competition for getting their needs met. However, where this does happen it is a very difficult family situation for children to grow up in.

Diagnosis of AB-PA requires a specialist with a specific skills set. If it is not AB-PA a different treatment plan is required.