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A/PROF CAROLYN QUADRIOA/PROF CAROLYN QUADRIO

School of PsychiatrySchool of Psychiatry

University of NSWUniversity of NSW

SHARED PARENTING ORDERS SHARED PARENTING ORDERS

ADELAIDE, UNIVERSITY OF SA ADELAIDE, UNIVERSITY OF SA

APRIL APRIL 20082008

SIX DEGREES OF SIX DEGREES OF ALIENATION: PARENTING & ALIENATION: PARENTING &

FAMILYFAMILY CONFLICTCONFLICT

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OVERVIEW OVERVIEW OF PRESENTATIONOF PRESENTATION

Child trauma and abuse Child trauma and abuse

The spectrum of alienationThe spectrum of alienation

Parenting patterns Parenting patterns

Case examplesCase examples

BreastfeedingBreastfeeding

Joint parenting considerationsJoint parenting considerations

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PERSONALITY PERSONALITY DEVELOPMENTDEVELOPMENT

& ATTACHMENT & ATTACHMENT Personality develops from Personality develops from

infant interaction with carer infant interaction with carer

Critical interaction: infant’s Critical interaction: infant’s

needs/capacities and empathic needs/capacities and empathic

responsiveness of carer responsiveness of carer

(not time) (not time)

Long term mental health outcomes Long term mental health outcomes

and early attachment/traumaand early attachment/trauma

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CHILDHOOD TRAUMA & ABUSECHILDHOOD TRAUMA & ABUSE

Is commonIs common Mostly familial/carersMostly familial/carers CSA: 15-30%CSA: 15-30% Severe CPA: 11%Severe CPA: 11% Witnessing DV: 14%Witnessing DV: 14% Psychological trauma?Psychological trauma?

Family conflict/violenceFamily conflict/violence FLC cases: expect higher FLC cases: expect higher

ratesrates

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CSA IS COMMONCSA 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%)Most CSA is unreported (80%)

Probably higher rates in FLC Probably higher rates in FLC

families: more dysfunctional groupfamilies: more dysfunctional group

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Child Abuse& Neglect (CAN):Child Abuse& Neglect (CAN):Australian dataAustralian data 2004/5 2004/5

Reports doubled last 5 Reports doubled last 5

yearsyears

700 new reports per day 700 new reports per day

One new case/2 minutesOne new case/2 minutes

Most abuse is intrafamilialMost abuse is intrafamilial

Children in care Children in care 70% 10 70% 10

yrsyrs

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DV IS COMMON: UN DATADV IS COMMON: UN DATA Most widespread and socially Most widespread and socially

tolerated form of HR violationtolerated form of HR violation

Often prelude to coercive sexOften prelude to coercive sex

KKills + disables as many women ills + disables as many women

as cancer; > MVA’s + malariaas cancer; > MVA’s + malaria

Single biggest health risk to Single biggest health risk to

AustraliaAustraliann women of women of

reproductive age ($6.3B pa)reproductive age ($6.3B pa) 20-30% of marriages20-30% of marriages

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NEW LEGISLATION:NEW LEGISLATION:PRESUMPTION EQUAL PRESUMPTION EQUAL

PARENTINGPARENTING Burden of proof on victim?Burden of proof on victim?

Reality of CANReality of CAN Prevalence of DVPrevalence of DV

vsvs

False allegations as False allegations as strategy strategy

Breastfeeding as strategyBreastfeeding as strategy

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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)

ATTACHMENT & FAMILY PATTERNS

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ALIENATION ‘SYNDROME’ALIENATION ‘SYNDROME’

90% allegations CSA 90% allegations CSA in FLC are false in FLC are false

PAS: ‘syndrome’ PAS: ‘syndrome’ explains this processexplains this process

deliberate alienationdeliberate alienation

(usually Mo)(usually Mo)

CSA common/false CSA common/false allegations notallegations not

no scientific validity

non-diagnostic

no probative value

dangerous assumption

SYNDROME vs REALITYSYNDROME vs REALITY

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ASSESSING CHILD ASSESSING CHILD ABUSE/NEGLECTABUSE/NEGLECT

Only medical evidence conclusive – but rareOnly medical evidence conclusive – but rare

Most symptoms Most symptoms non-specific: non-specific:

Anxiety, regression, sleep disturbance, Anxiety, regression, sleep disturbance,

nightmares, acting out, depression, nightmares, acting out, depression,

hyperactivity, school problems hyperactivity, school problems

EEqually reflective of disturbance of divorce qually reflective of disturbance of divorce

and/or ongoing post separation conflictand/or ongoing post separation conflict

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INDICES OF SUSPICION:INDICES OF SUSPICION:

SStereotyped statementstereotyped statements

Same words as parent Same words as parent

Language > developmentLanguage > development

No contextual detailNo contextual detail

Minor issues in same veinMinor issues in same vein

Evoke sympathy – eg CSSEvoke sympathy – eg CSS

Privy to details of legal processPrivy to details of legal process

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MENTAL STATUS of MENTAL STATUS of ACCUSING PARENTACCUSING PARENT

Mental illness: Mental illness: Children Children moremore exposed to abuse exposed to abuse

Personality disorder: Personality disorder: More prone to project BUT:More prone to project BUT: More likely to be victim of abuse More likely to be victim of abuse Less able to protect children from Less able to protect children from

abuseabuse

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MENTAL STATUS of MENTAL STATUS of ACCUSED PARENTACCUSED PARENT

Limited if any assistance determining issueLimited if any assistance determining issue

Normal or no psychological disturbanceNormal or no psychological disturbance

No perpetrator profile but some concerns:No perpetrator profile but some concerns:

Previous violencePrevious violence D&A issuesD&A issues

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ALIENATION AS PROCESSALIENATION AS PROCESS

Alienation: dAlienation: dynamic/process NOT ynamic/process NOT syndromesyndrome

Common in all divorcing families, esp FLCCommon in all divorcing families, esp FLC

No specific association with CSANo specific association with CSA

CCan only be assessed in context of familyan only be assessed in context of family

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SPECTRUM OF ALIENATIONSPECTRUM OF ALIENATION

Motivation: Motivation: altruism altruism self-interestself-interest malicemalice

Psychology: Psychology: normal normal anxious anxious paranoid/deludedparanoid/deluded

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FIRST DEGREEFIRST DEGREE

Altruism/protection: Altruism/protection:

CSA is actual and/or CSA is actual and/or

sincerely believedsincerely believed

Alienation = solely to Alienation = solely to

protect childprotect child

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SECOND DEGREESECOND DEGREE

Hurt and/or depressed Hurt and/or depressed parent: parent:

cannot conceal feelings cannot conceal feelings

children exquisitely children exquisitely sensitive sensitive

alienation unintended alienation unintended

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THIRD DEGREETHIRD DEGREE Immature/neurotic (> malicious): Immature/neurotic (> malicious):

message to children: message to children:

““take care of me” = take care of me” =

immature/dependent immature/dependent

or: or:

““don’t blame me” = guilt prone don’t blame me” = guilt prone

depressive or passive aggressive depressive or passive aggressive

adjustment adjustment

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FOURTH DEGREEFOURTH DEGREE

HHurt, depressed, angry parent:urt, depressed, angry parent:

personality disorder: more/less personality disorder: more/less maliciousmalicious

unable/unwilling adequately unable/unwilling adequately

to conceal feelingsto conceal feelings

poor affect regulation (trauma,poor affect regulation (trauma,

often CSA)often CSA)

potential for projectionpotential for projection

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FIVE DEGREESFIVE DEGREES

Hurt/angry parent: Hurt/angry parent: declare feelings to childrendeclare feelings to children recruit them as supportrecruit them as support alienation is alienation is intentionalintentional to to

break bond with other parent break bond with other parent vengeful behaviour or $ vengeful behaviour or $ welfare of children disregardedwelfare of children disregarded

deluded (ie genuine belief)deluded (ie genuine belief)

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SIX DEGREESSIX DEGREES

Wilful and intended alienationWilful and intended alienation

every effort to block contactevery effort to block contact

malicious false allegationsmalicious false allegations

to gain advantage in FLCto gain advantage in FLC

self-interest/manipulativeself-interest/manipulative

sociopathic/malicioussociopathic/malicious

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NEW LEGISLATIONNEW LEGISLATION

Joint parentingJoint parenting

Property in Property in common?common?

Best interests of Best interests of child paramount?child paramount?

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PARENTING PRACTICESPARENTING PRACTICES

Intact families: women do most of the Intact families: women do most of the childcare even if employedchildcare even if employed

Rationale for altered pattern post Rationale for altered pattern post separation? separation?

Most divorced families negotiate – Most divorced families negotiate – those in FLC the most acrimonious = those in FLC the most acrimonious = my datamy data

Joint parenting requires high degree of Joint parenting requires high degree of cooperationcooperation

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CHANGING PATTERNSCHANGING PATTERNS

Old style ‘access’: Dad as Santa Claus

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CHANGING PATTERNSCHANGING PATTERNS New style joint parenting: Mr MomNew style joint parenting: Mr Mom

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CHANGED PATTERN:CHANGED PATTERN:CASE EXAMPLECASE EXAMPLE

Fa: big business; no psychiatric Dx Fa: big business; no psychiatric Dx Financial control & dominationFinancial control & domination Mo: 9 years exclusive childcare; anxious Mo: 9 years exclusive childcare; anxious 3 children: 9, 5, 18 mos (breastfed) 3 children: 9, 5, 18 mos (breastfed) Attachments: equally strong and secureAttachments: equally strong and secure Fa now home based businessFa now home based business Joint parenting? One plan for 3?Joint parenting? One plan for 3? Is change for the children or parent or $? Is change for the children or parent or $?

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Breastfeeding & Parenting OrdersBreastfeeding & Parenting Orders

best form of infant nutritionbest form of infant nutrition

exclusive breastfeeding for first six exclusive breastfeeding for first six months and continue first two years:months and continue first two years:

WHO & UNICEFWHO & UNICEF Australia: Dietary Guidelines; Federal Australia: Dietary Guidelines; Federal

Health; AMA; Dieticians Association; Health; AMA; Dieticians Association; Colleges: Paediatrics & Midwives Colleges: Paediatrics & Midwives

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Breastfeeding Benefits Breastfeeding Benefits

maternal recovery from maternal recovery from pregnancy and childbirth pregnancy and childbirth contraception contraception

bonding and attachment bonding and attachment improved visionimproved vision psychomotor developmentpsychomotor development prevention of chronic prevention of chronic

disease later in life: breast disease later in life: breast and ovarian cancer, and ovarian cancer, cardiovascular disease, cardiovascular disease, obesity obesity

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Risks of not breastfeeding Risks of not breastfeeding

gastrointestinal diseasegastrointestinal disease

respiratory illnesses respiratory illnesses including asthmaincluding asthma

chronic otitis media chronic otitis media

sudden infant death sudden infant death syndrome. syndrome.

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Shared Parenting OrdersShared Parenting Orders& Breastfeeding & Breastfeeding

separation affects breastfeedingseparation affects breastfeeding

contested cases unlikely to improve contested cases unlikely to improve

relationshipsrelationships

not common pattern pre separationnot common pattern pre separation

paramountcy of best interests of child? paramountcy of best interests of child?

court orders for mothers to weancourt orders for mothers to wean (Sweet & Power, 2008)(Sweet & Power, 2008)

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CASE EXAMPLE: DELUSION?CASE EXAMPLE: DELUSION? Mo: anxious – fears seem exaggeratedMo: anxious – fears seem exaggerated Overvalued idea? Deluded? Folie a deux?Overvalued idea? Deluded? Folie a deux? Fa: no psychiatric Dx Fa: no psychiatric Dx Mo reports: child has range of symptomsMo reports: child has range of symptoms Child’s disclosures to Mo+GMo (no one Child’s disclosures to Mo+GMo (no one

else)else) Court ordered supervisionCourt ordered supervision Mo continues to report abuseMo continues to report abuse Supervisor alleged to be conspiringSupervisor alleged to be conspiring

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Examples: Domestic Violence Examples: Domestic Violence

NESBNESB Fa: no psychiatric DxFa: no psychiatric Dx Mo: isolated and abused – depression, Mo: isolated and abused – depression,

PTSDPTSD Finally leaves w childrenFinally leaves w children Agreed contact; Fa refuses to returnAgreed contact; Fa refuses to return Allegations to FLC: Mo depressed, suicidalAllegations to FLC: Mo depressed, suicidal Orders: limited contact w Mo; 50/50; split Orders: limited contact w Mo; 50/50; split

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QUALITY vs QUANTITYQUALITY vs QUANTITY

Quality of contact more important than timeQuality of contact more important than time Joint custody negated by parental conflict, Joint custody negated by parental conflict,

esp if children caught in ongoing conflictesp if children caught in ongoing conflict There is no one size fits all arrangementThere is no one size fits all arrangement

Risk of exposure to continuing conflict, DV, Risk of exposure to continuing conflict, DV,

or abuse: contact needs to be limitedor abuse: contact needs to be limited

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50/50 SHARED CARE50/50 SHARED CARE Logistically complex, parents need to be:Logistically complex, parents need to be: organised, structured, plan aheadorganised, structured, plan ahead cooperative amicable r’ship, keep children out ofcooperative amicable r’ship, keep children out of child focused arrangements child focused arrangements commitment by all to make it work commitment by all to make it work family friendly work practices family friendly work practices degree of financial independence, especially degree of financial independence, especially

Mo’sMo’s a degree of paternal confidence a degree of paternal confidence GeographyGeography

(B Smyth, 2005)(B Smyth, 2005)