SIX DEGREES OF ALIENATION: PARENTING & FAMILY CONFLICT A/PROF CAROLYN QUADRIO School of Psychiatry University of NSW SHARED PARENTING ORDERS ADELAIDE, UNIVERSITY OF SA APRIL 2008 1 OVERVIEW OF PRESENTATION Child trauma and abuse The spectrum of alienation Parenting patterns Case examples Breastfeeding Joint parenting considerations 2 PERSONALITY DEVELOPMENT & ATTACHMENT Personality develops from infant interaction with carer Critical interaction: infant’s needs/capacities and empathic responsiveness of carer (not time) Long term mental health outcomes and early attachment/trauma 3 CHILDHOOD TRAUMA & ABUSE Is common Mostly familial/carers CSA: 15-30% Severe CPA: 11% Witnessing DV: 14% Psychological trauma? Family conflict/violence FLC cases: expect higher rates 4 CSA IS COMMON Epidemiological data worldwide: 1 in 3 female:1 in 4 male children 36% Australian women (Mazza and Dennerstein, 2001) Most CSA is unreported (80%) Probably higher rates in FLC families: more dysfunctional group 5 Child Abuse& Neglect (CAN): Australian data 2004/5 Reports doubled last 5 years 700 new reports per day One new case/2 minutes Most abuse is intrafamilial Children in care 70% 10 yrs 6 DV IS COMMON: UN DATA Most widespread and socially tolerated form of HR violation Often prelude to coercive sex Kills + disables as many women as cancer; > MVA’s + malaria Single biggest health risk to Australian women of reproductive age ($6.3B pa) 20-30% of marriages 7 NEW LEGISLATION: PRESUMPTION EQUAL PARENTING Burden of proof on victim? Reality of CAN Prevalence of DV vs False allegations as strategy Breastfeeding as strategy 8 ATTACHMENT & FAMILY PATTERNS children attach to primary care figures not related to time children in long day care children in kibbutzim ‘traditional’ families vs children attach in spite of abuse may even cling (traumatic attachment) 9 ALIENATION ‘SYNDROME’ SYNDROME vs REALITY 90% allegations CSA CSA common/false PAS: ‘syndrome’ no scientific validity in FLC are false explains this process deliberate alienation (usually Mo) allegations not non-diagnostic no probative value dangerous assumption 10 ASSESSING CHILD ABUSE/NEGLECT Only medical evidence conclusive – but rare Equally reflective of disturbance of divorce and/or Most symptoms non-specific: Anxiety, regression, sleep disturbance, nightmares, acting out, depression, hyperactivity, school problems ongoing post separation conflict 11 INDICES OF SUSPICION: Stereotyped statements Same words as parent Language > development No contextual detail Minor issues in same vein Evoke sympathy – eg CSS Privy to details of legal process 12 MENTAL STATUS of ACCUSING PARENT Mental illness: Children more exposed to abuse Personality disorder: More prone to project BUT: More likely to be victim of abuse Less able to protect children from abuse 13 MENTAL STATUS of ACCUSED PARENT Limited if any assistance determining issue Normal or no psychological disturbance No perpetrator profile but some concerns: Previous violence D&A issues 14 ALIENATION AS PROCESS Alienation: dynamic/process NOT syndrome Common in all divorcing families, esp FLC No specific association with CSA Can only be assessed in context of family 15 SPECTRUM OF ALIENATION Motivation: altruism self-interest malice Psychology: normal anxious paranoid/deluded 16 FIRST DEGREE Altruism/protection: CSA is actual and/or sincerely believed Alienation = solely to protect child 17 SECOND DEGREE Hurt and/or depressed parent: cannot conceal feelings children exquisitely sensitive alienation unintended 18 THIRD DEGREE Immature/neurotic (> malicious): message to children: “take care of me” = immature/dependent or: “don’t blame me” = guilt prone depressive or passive aggressive adjustment 19 FOURTH DEGREE Hurt, depressed, angry parent: personality disorder: more/less malicious unable/unwilling adequately to conceal feelings poor affect regulation (trauma, often CSA) potential for projection 20 FIVE DEGREES Hurt/angry parent: declare feelings to children recruit them as support alienation is intentional to break bond with other parent vengeful behaviour or $ welfare of children disregarded deluded (ie genuine belief) 21 SIX DEGREES Wilful and intended alienation every effort to block contact malicious false allegations to gain advantage in FLC self-interest/manipulative sociopathic/malicious 22 NEW LEGISLATION Joint parenting Property in common? Best interests of child paramount? 23 PARENTING PRACTICES Intact families: women do most of the childcare even if employed Rationale for altered pattern post separation? Most divorced families negotiate – those in FLC the most acrimonious = my data Joint parenting requires high degree of cooperation 24 CHANGING PATTERNS Old style ‘access’: Dad as Santa Claus 25 CHANGING PATTERNS New style joint parenting: Mr Mom 26 CHANGED PATTERN: CASE EXAMPLE Fa: big business; no psychiatric Dx Financial control & domination Mo: 9 years exclusive childcare; anxious 3 children: 9, 5, 18 mos (breastfed) Attachments: equally strong and secure Fa now home based business Joint parenting? One plan for 3? Is change for the children or parent or $? 27 Breastfeeding & Parenting Orders best form of infant nutrition exclusive breastfeeding for first six months and continue first two years: WHO & UNICEF Australia: Dietary Guidelines; Federal Health; AMA; Dieticians Association; Colleges: Paediatrics & Midwives 28 Breastfeeding Benefits maternal recovery from pregnancy and childbirth contraception bonding and attachment improved vision psychomotor development prevention of chronic disease later in life: breast and ovarian cancer, cardiovascular disease, obesity 29 Risks of not breastfeeding gastrointestinal disease respiratory illnesses including asthma chronic otitis media sudden infant death syndrome. 30 Shared Parenting Orders & Breastfeeding separation affects breastfeeding contested cases unlikely to improve relationships not common pattern pre separation paramountcy of best interests of child? court orders for mothers to wean (Sweet & Power, 2008) 31 CASE EXAMPLE: DELUSION? Mo: anxious – fears seem exaggerated Overvalued idea? Deluded? Folie a deux? Fa: no psychiatric Dx Mo reports: child has range of symptoms Child’s disclosures to Mo+GMo (no one else) Court ordered supervision Mo continues to report abuse Supervisor alleged to be conspiring 32 Examples: Domestic Violence NESB Fa: no psychiatric Dx Mo: isolated and abused – depression, PTSD Finally leaves w children Agreed contact; Fa refuses to return Allegations to FLC: Mo depressed, suicidal Orders: limited contact w Mo; 50/50; split 33 QUALITY vs QUANTITY Quality of contact more important than time Joint custody negated by parental conflict, esp if children caught in ongoing conflict There is no one size fits all arrangement Risk of exposure to continuing conflict, DV, or abuse: contact needs to be limited 34 50/50 SHARED CARE Logistically complex, parents need to be: organised, structured, plan ahead cooperative amicable r’ship, keep children out of child focused arrangements commitment by all to make it work family friendly work practices degree of financial independence, especially Mo’s a degree of paternal confidence Geography (B Smyth, 2005) 35