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SATURDAY EARLY AFTERNOON CASE PRESENTATION 1 (S2CP1): 2.15 PM - 3.45 PM 

Schema Therapy Treatment of Child-Parent Attachment

by Florian Ruths, Tara Cutland-Green, and Lorraine Gordon

Abstract: 

A Theoretical Model Based on Two Case Studies from Clinical Practice

Florian Alexander Ruths

Background:

Encouraging a child to disown a parent by making them suppress their attachment to the rejected parent, is a serious form of emotional abuse, also known as Parental Alienation Syndrome (PAS, Gardner 1988). The author prefers the term ‘Factitious Child-Parent Attachment Suppression’ (F-CPAS) as a more precise and less emotive term, instead of PAS. F-CPAS is complex and remains contentious among mental health professionals and legal experts alike.

The attachment suppression has been induced (‘factitious’) by an alienating (or ‘favoured’) parent, who commonly displays cluster B personality traits. The subsequent development of adult emotional disorders and personality disorders in the abused child can be conceptualized in schema terms: a range of childhood unmet emotional needs arise while growing up with a cluster B parent. In combination with the absence of the rejected, often stable and protective parent, this may lead to adult emotional disorders.

In the treatment of adult survivors of F-CPAS, the ongoing suppression of attachment to the alienated parent, can sometimes be observed. We make suggestions how to heal the attachment suppression and how to reunite the (now adult) child with the alienated parent, within a schema model framework.

Methods:
Conceptualising factitious child-parent attachment suppression (F-CPAS) as a form of emotional coercion can be helpful for schema therapists and for adult patients receiving schema therapy alike:
1. It makes the painful experience of growing up with only one parent (F-CPAS) more understandable for the patient.
2. It may make the fact of attachment suppression towards the rejected parent more acceptable as not being the patient’s (child’s) fault. 3. The role of the inducing parent may have to be scrutinized and understood emotionally.
4. It can help the patient to see themselves as a victim of emotional abuse.
5. It may help to see that the rejected parent is also a victim of emotional abuse, rather than a perpetrator (which the patient was previously made to believe).
6. Schema therapy may be instrumental to actively promote and facilitate the re-unification of patient and rejected parent.
7. It may be helpful for the patient to be less likely to subconsciously re-produce the same coping mode of inducing attachment suppression within their own children;
8. In a last step, it may help the patient to develop reasonable understanding of the alienating parent.

The author presents a couple of case studies of patients with emotional disorders, who were victimized as children by a parent with personality disorder, and disowned the rejected parent through (induced) attachment suppression.

Results:

The phenomenology of factitious attachment suppression and its framing in schema terms are being presented in detail through case studies.
The above 8-step approach to reunite the patient with the rejected parent are being described in case examples. Difficulties in facilitating this process are being highlighted. A schema framework for this healing process is outlined.

Discussion:
Factitious Child-Parent Attachment Suppression (F-CPAS), better known as Parental Alienation Syndrome (PAS), can have devastating long-term effects, reaching into adulthood, such as emotional disorders or personality problems.
We conceptualise F-CPAS in a schema framework as an induced attachment suppression, and as a form of emotional coercion. For the patient, it can be helpful to see the distant relationship with a currently rejected parent in a new light.
Schema therapy can be instrumental in promoting a re-unification with the rejected parent as a means to heal childhood trauma, re- access human parental connection and support, and re-establish a crucial attachment link. Schema therapy can take an active role in this re-unification process.
From a perspective of prevention and schema reduction in cluster B patients, compassion and understanding for all parties can be found in a schema-based approach. It can help the children of a victim of this form of abuse to be less likely to subconsciously re-exposed to this same maladaptive parenting style.

Expected Points of Discussion: 

  1.   'Parental alienation' in schema terms

  2.   Impact of Factitious child-parent attachment suppression on adult

  3.   Narcissistic personality and factious child-parent attachment suppression

  4.   treatment of F-CPAS in adult patient with schema model

  5.   Re-unification of parent with adult child

Discussant 1

Name: Dr Tara Cutland-Green

Discussant 2

Name: Dr Lorraine Gordon

Discussant 3

Name: Florian Alexander Ruths

This class presents a brief overview of research about affairs and the difficulty of definition. The seven different types of affairs will be explained. Schema Therapy offers a rich model for understanding affairs in terms of mode dynamics, for example considering which mode(s) is driving the affair and how this can determine effective interventions. The use of chair-work to externalize the affair and how to encourage the couple to align with the therapist against the affair will be demonstrated. The Mode Cycle Clash Card will be demonstrated and then practiced. Also, the theme of exploring emotional learning, related to domains of schemas, will be illustrated using sentence completion, “I went into this affair because...” Finally, the question of forgiveness will be addressed. When? How?

Level of Experience Required for Participants: 

Everyone

About the Presenters:

Florian Ruths:

coming soon

Tara Cutland-Green: 

Dr Cutland Green was trained in Schema Therapy by Jeffrey Young at the New YorkInstitute of Schema Therapy and is now an ISST Certified Supervisor-Trainer and a Director of Schema Therapy Associatesʼ Certification Programme, delivering training in the UK,Poland and Bulgaria. Together with Dr Gill Heath, she co-authored the chapter Schema Therapy in the The Handbook of Adult Clinical Psychology - An Evidence Based PracticeApproach(2016, Carr & McNulty) and developed the Schema Therapy Tool kit training videos resource that has been well received worldwide. She is also an author in the forthcoming book Creative Methods in Schema Therapy: Advances andInnovation in Clinical Practice(Routledge, in press).Dr Cutland Green is a Consultant Clinical Psychologist in private practice in London andBedford, having previously been a professional lead in the NHS. She has also lived in NewZealand, where she worked in a personality disorder team and served on New ZealandʼsNational Personality Disorders committee

Lorraine Gordon:

Dr Lorraine Gordon is a chartered psychologist and associate fellow of the British Psychological Society, a Health and Care Professions Council registered Counselling Psychologist, an accredited member of the British Association of Behavioural and Cognitive Psychotherapy, and an advance accredited individual schema therapist with the International Society of Schema Therapy. She works as a Consultant Counselling Psychologist in the NHS and is psychology lead and Head of Service for a borough-wide integrated psychological therapies team in a secondary care mental health service based at the Maudsley Hospital in London. Lorraine currently works with adults with complex and severe mental health needs including mood, anxiety, trauma and personality difficulties. Lorraine has previously enjoyed working with psychosis having led psychology in an early intervention in psychosis service whilst working in East London.

Lorraine has taught on a number of post-graduate clinical and counselling psychology programmes for a number of years on the topics of culture and diversity. She is regularly involved in teaching at the local Recovery College as well as contributing to teaching on post-graduate courses offered by the Institute of Psychiatry Psychology and Neuroscience on Cognitive Behaviour Therapy and affective disorders. Lorraine was recently a therapist in a multi-national randomised controlled trial looking at Group Schema Therapy where she provided group and individual schema therapy with supervision from the founders of the Group Schema Therapy approach. Her other interest is in the professional development of staff.



Why Schema Therapy?

Schema therapy has been extensively researched to effectively treat a wide variety of typically treatment resistant conditions, including Borderline Personality Disorder and Narcissistic Personality Disorder. Read our summary of the latest research comparing the dramatic results of schema therapy compared to other standard models of psychotherapy.

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