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IN-PERSON PARTICIPANTS

SATURDAY MORNING CASE PRESENTATION 3 (S1CP3): 10.30 AM - 12.00 PM 

A Schema Model of Induced Child-Parent Attachment Suppression (I-CPAS) aka "Parental Alienation Syndrome"

- Reflections from Adult Clinical Practice

by Florian Ruths & Tara Cutland-Green



Presenter: Florian Alexander Ruths

Discussant: Tara Cutland Green

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 of this presentation prefers the term ‘Induced Child-Parent Attachment Suppression’ (I-CPAS) as a more precise and less emotive term, instead of PAS.  I-CPAS is complex and remains contentious among mental health professionals and legal experts alike.

The attachment suppression has been induced 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 previously stable and protective parent,  this may lead to adult emotional disorders.

In the treatment of adult survivors of I-CPAS, the ongoing suppression of attachment to the alienated (rejected) parent, can sometimes be observed. We make suggestions how to conceptualise the attachment suppression in schema terms. We propose some ideas how to reunite the (now adult) child with the rejected parent, within a schema model framework.

Methods:

Conceptualising induced child-parent attachment suppression (I-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 (I-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 alienation-inducing 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 induced attachment suppression and its framing in schema terms are being presented in detail through case studies.

The above 8-step approach to possibly 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:

Induced Child-Parent Attachment Suppression (I-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 conceptualize I-CPAS in a schema framework as an induced attachment suppression, and as a form of emotional coercion or abuse. For the patient, it can be helpful to see the distant relationship with a currently rejected parent in a new light.  

Schema therapy could 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. We hypothesize that Schema therapy can take an active role in this formulation and 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.

References

Baker, A.J.L.(2007). Adult children of parental alienation syndrome-breaking the ties that bind. W.W. Norton. New York & London.

Baker, A.J.L.(2010). “Adult recall of parental alienation in a community sample: Prevalence and associations with psychological maltreatment.” Journal of Divorce and Remarriage, 51, 16-35.

Irvine L.E. (2018). Seeing Parental Alienation Syndrome Through the Lens of Schema Therapy: Proposals for Treatment. Online Bulletin of the ISST Dec 2018.

Ruths, F.A. (2019). “A Schema-Based Model of Factitious Child-Parent Attachment Suppression (aka ‘Parental Alienation Syndrome’) in Parents with Cluster B Personality Traits”. Poster 925, 9th World Congress of Behavioural and Cognitive Therapies. Berlin.


About the Presenters:

Florian Ruths

Florian is a Consultant Psychiatrist at the Maudsley Hospital in London. He is also a trainer and supervisor in CBT.

Florian has been co-leading the Maudsley Schema Therapy Service (with Dr L Gordon) since 2014. He has been a Principal Investigator for the International Multicentre Randomised Controlled Trial of Group Schema Therapy for EUPD (CI: A Arntz, Amsterdam) for the UK sites.

Florian has an interest in investigating the impact of cluster B personality traits on child-parent relationships and has developed a schema-based model of attachment suppression. As Lead for the Maudsley Mindfulness Service, Florian has been delivering Mindfulness Based Cognitive Therapy Groups (MBCT) for patients with chronic depression and anxiety problems, and seeing the overlaps between schema and mindfulness approaches.

Florian teaches Cognitive Behavioural Therapy & MBCT on two MSc Courses in London and Kent. He has published in the areas of MBCT, anxiety and depression.


Tara Cutland-Green

Dr Cutland Green was trained in Schema Therapy by Jeffrey Young at the New York Institute of Schema Therapy and is now an ISST Certified Supervisor-Trainer and a Director of Schema Therapy Associates' 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 Practice Approach(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 and Innovation in Clinical Practice(Routledge, in press).Dr Cutland Green is a Consultant Clinical Psychologist in private practice in London and Bedford, having previously been a professional lead in the NHS. She has also lived in New Zealand, where she worked in a personality disorder team and served on New Zealand's National Personality Disorders committee.

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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