Tuesday, July 26, 2011

Q & A: Challenging False Constructions of Meaning

This is a question I received through the Parental Alienation Awareness Organization:

How is a parent to respond when their child lets them know that the Alienating Parent is saying the Targeted Parent is doing bad things (false allegations) or is bad?  I realize age of the child is an issue.  If one does not respond (or defend one’s self) then the child is led to believe that the allegations are true. If the Targeted Parent defends one’s self, it will be twisted in court as bringing the child into the conflict.

This is one of the most difficult issues facing the targeted-Delta parent. 

The alienating-Beta parent typically lacks the empathy necessary to truly care for the child’s well being.  Because of the alienating-Beta parent’s narcissistically organized personality disorder processes, the alienating-Beta parent is typically unable to “attune” to the child’s inner experience, and instead they require that the child reflect the inner experience and meaning construction of the alienating-Beta parent. 

In healthy child development, the parent attunes to the child’s inner experience, which helps to bring organization and meaning construction to the authenticity of the child’s inner self-experience.  In the alienation process, this healthy parent-child processes is flipped on its head, so that it is the child who is resonating with the alienating-Beta parent’s inner experience, while the child’s authentic self-experience is invalidated through both subtle and overt communications from the alienating-Beta parent.

The meaning construction offered by the alienating-Beta parent is that the targeted-Delta parent is somehow inadequate or abusive.  Oftentimes, this communication is made within the context of the alienating-Beta parent presenting as the victim of the targeted-Delta parent’s abuse.  Sometimes this is presented as the emotional abandonment of the alienating-Beta parent by the “mean and abusive” targeted-Delta parent, and sometimes this is presented as the financial abandonment of the alienating-Beta parent by the “mean and abusive” targeted-Delta parent. The abandonment theme of the alienating-Beta parent reflects the borderline personality disorder processes of the alienating-Beta parent which involve an intense fear of abandonment.

Emotions have both internal signal functions, such as anxiety signaling threat, and social functions whereby each emotion provokes a particular type of response from others when it is communicated into the social field.  The emotion of sadness/hurt provokes a nurturance response in others when it is communicated into the social field. So the alienating-Beta parent’s communication of “injured victimization” provokes from the child a desire to nurture.  It’s just how the brain works. 

This is another example of the reversal of parent-child roles between the alienating-Beta parent and the child, whereby the child becomes the nurturer for the parent, rather than the parent for the child.

Over time, this social activation-provocation of nurturance from the child by the alienating-Beta parent’s assumption of the “injured-victimized” role relative to the targeted-Delta parent’s “mean and abusive treatment of the weak and helpless alienating-Beta parent” will provoke a protective response from the child toward the “weak and injured” alienating-Beta parent relative to the “mean and abusive” targeted-Delta parent. This is how the hostile-aggressive revenge motivation is transferred from the alienating-Beta parent to the child, through the initial provocation of a nurturing response from the child followed by the provocation of a protective response from the child for the “weak-injured victim” portrayed by the alienating-Beta parent.

Meanwhile, if the targeted-Delta parent tries to keep the child out of the spousal conflict by presenting as a capable and competent parent, a parent who is not “needy and vulnerable,” then this only feeds the child’s perception of the “strong and competent” targeted-Delta parent relative to the “weak and fragile” alienating-Beta parent.  This juxtaposition of parental responses to the family’s dissolution further encourages the meaning construction of the alienating-Beta parent as the “victim” of the “strong and abusive” targeted-Delta parent.

The alienating-Beta parent is also likely engaging in a subtle or overt campaign of denigration, which might include intruding into the independent life decisions of the targeted-Delta parent under the guise of “protecting the child” during the child’s visitations with the targeted-Delta parent.  The alienating-Beta parent may begin to complain in front of the child - but perhaps not directly TO the child - about discipline strategies being used by the targeted-Delta parent, about financial decisions being made by the targeted-Delta parent, about romantic relationships being engaged in by the targeted-Delta parent. These complaints may involve a level of distortion that constructs the meaning to be one of a “mean and abusive” targeted-Delta parent and a “weak and victimized” child (“you”), alienating-Beta parent (“me”), or child and alienating-Beta parent family unit (“us”).

The child may begin to raise these issues with the targeted-Delta parent, perhaps in a hostile-protective way, as a behavioral-relationship effort to check out the accuracy of this construction of meaning.  The construction of meaning being gradually imposed on the child (that the targeted-Delta parent is mean and abusive) is sharply discrepant from the child’s own authentic construction of meaning (the child loves the targeted-Delta parent and enjoys his or her time with the targeted-Delta parent).  Yet the child is experiencing the pull toward nurturance relative to the “weak and victimized” alienating-Beta parent, and is being offered an alternate construction of meaning by the alienating-Beta parent regarding the “mean-abusive” targeted-Delta parent.  The child’s confrontation of the targeted-Delta parent with allegations represents the child’s effort to obtain a degree of psychological orientation as he or she falls down the rabbit hole of the shared persecutory delusional process with the alienating-Beta parent.

However, if the targeted-Delta parent begins to defend and clarify the myriad of negative issues fed to the child by the alienating-Beta parent, then this only further triangulates the child into the middle of the spousal conflict, forcing the child to choose between competing constructions of reality and competing love-allegiances.  Yet if the targeted-Delta parent does not engage in a defense and clarification of the distorted facts being provided to the child by the alienating-Beta parent, then the child will ultimately be seduced-coerced by the alienating-Beta parent into the shared persecutory delusional disorder.

The choice for the targeted-Delta parent is to either make their child a battlefield for a hostile-aggressive spousal conflict, and in doing so to destroy the child emotionally and psychologically; or to refrain from further triangulating the child into the spousal conflict, but in doing so to lose the battle-for-the-child that is being imposed by the alienating-Beta parent’s use of the child as a weapon, since the alienating-Beta parent has no compunction about using the child as a weapon and destroying the child emotionally and psychologically.  So, in doing what is best for the child and not further triangulating the child into the spousal conflict, the targeted-Delta parent will ultimately watch as their child’s expressed love for them in the relationship is transformed, first into a hostile-mean-aggressive relationship, and then potentially into an empty, distant, and non-existent relationship.  Not a very good choice.

The solution is for the targeted-Delta parent to do what is best for the child, not to engage in compensatory defense-clarification, but to respond by summarily dismissing the false allegations and constructions of meaning as absurd and not accurate and then move on to the authentic and affectionate parent-child relationship the parent has with the child.  In this process, the goal is to give the child a general yet non-precise compensatory construction of authentic meaning that allows the child to recognize the challenge to the false construction of meaning being proffered by the alienating-Beta parent’s persecutory delusional disorder, but without drawing the child further into the spousal conflict by offering detailed clarifications.

However, this is not likely to be enough.  In my view, it is then up to the treatment team of the child’s individual therapist and the parent-child therapist to more actively challenge the false construction of meaning being offered by the alienating-Beta parent.  It is up to the professional therapists to offer more robust challenges to the delusional belief system.  This should be done with a pleasantly dismissive tone communicating that the accusations are absurd, false, or irrelevant, and then providing an alternate construction of meaning that is attuned to the child’s authentic experience.  Again, detailed clarifications that draw the child further into the triangulation should likely be avoided, but should be dependent on the issue raised by the child.  For example, detailed discussions of what constitutes appropriate parental discipline as opposed to “abuse” might be appropriate, whereas detailed discussions of financial considerations would not be appropriate.

Scenario 1
Child: “My dad doesn’t pay my mom enough child support.  He spends all his money on his girlfriend.”

Therapist: “Nawww, that’s not true.  The amount of child support your dad pays is set by the court.  Your dad’s doing okay with that.”

<note: on this type of issue the therapist needs to pre-verify outside of the session that the father is fully paying child support and that the payments are always on time.  If the child’s accusations are accurate, then we’re likely in an entirely different ballgame than parental alienation processes.  If the therapist is unsure of the accuracy of the child’s assertion, the therapist may want to respond, “Well, I’ll check into that” followed by the continuation below;>

Therapist:  Your dad loves you very much, and he will ALWAYS do everything he can to make sure that you and your mom are okay.

Scenario 2
Child: “My mom is too mean to me.  She makes me do the dishes when I don’t want to.”

Therapist: “Really?  You think doing the dishes is being mean to you?  I have my kids do the dishes all the time.  It’s part of their chores.  That’s not being mean, it’s being a parent.  Your mom loves you very much.  She’s your parent.  Doing chores is what kids do.  Kids may not always like to do their chores, but that’s just the way of things.  Your mom goes to work to pay the bills, you help out around the house.  That’s just normal family stuff.”

<note: this is the correction to the false belief and narcissistic entitlement expression that being asked to do household chores is “abusive.”  The next phase is to attune to and support the child’s authentic self-experience in this regard;>

Therapist: “But you don’t like to do dishes do you? <therapist attunement to authentic self-experience of the child>  How often do you have to do the dishes? <a therapist “intent-to-understand” the child’s inner experience from the child’s point of view.  An intent-to-understand brings organization to the child’s meaning construction of his or her self-experience.>  Well, that seems about right.  Do you have other chores around the house, what about like getting ready for bed and bedtime, that’s something you have to do, isn’t it? <therapist nesting of child’s chores into broader context of general life cooperation>  Do you get any allowance for doing household chores? <therapist opening of possible parent-child negotiation; offering the child influence with the targeted-Delta parent from an appropriate hierarchy status of parent-in-charge – but the child’s desired listened to, which challenges the “power-domination-abuse” construction of the child and restores the appropriate meaning construction of parent as nurturing legitimate authority>…

In my view, it is up to the therapist to challenge the child’s false constructions of meaning, not the targeted-Delta parent.  Yet I also recognize that this is not what many child therapists typically do.  Instead, many “non-directive” child therapists do not challenge the child’s false constructions of meaning, and may actually respond in ways that give credibility to the child’s false constructions of meaning.  This is a problem.

Even in situations where therapeutic support is absent, I would still propose that the targeted-Delta parent should not engage in compensatory justification-defense or in compensatory alienation directed toward the alienating-Beta parent. 

Yet, as a father of two children myself, I can understand how very hard it would be to abandon my children to a person who has significantly destructive psychopathology and who is willing to mangle the children psychologically by using them as weapons in the spousal conflict.  And the process of losing a loving relationship with my children would be unbearable.  For me, the unasked question from my children that I would always have in the back of my mind would be, “Dad, why didn’t you fight harder for us?  Why did you let us go?” (or “Mom, why didn’t you…” the alienation process knows no gender).

From my perspective, this is why it is imperative that mental health steps-up and stops debating the existence of the parental alienation process --- it exists --- and begin the productive discussion of how best to diagnose and treat alienation processes when they occur.  The targeted-Delta parent needs mental health to accurately diagnose and treat the process of alienation, and the courts need clarity from mental health in order to act to protect the child.  It is from the field of child and family psychotherapy, supported by the court, that we must begin the fight to restore the authentic child to his or her authentic life.

Saturday, July 23, 2011

Q & A: Locating Competent Therapists

This is a question asked of me in a radio interview with the Parental Alienation Awareness Organization:

"Is there a state by state list of therapists that targeted parents can get at?  I know Amy Baker has a list on her site but I know for a fact the therapists were drawn out of a hat because my therapist is a recommendation and she knows nothing about PA other than what she's learned from my case.  After 11 years in the court system I have yet to find that therapist in my area.

I am struck that this process continues in your life after 11 years.  In my view, therapy of parent-child relationship issues that do not involve neuro-developmental problems of the child (such as autism spectrum or ADHD issues) should be successfully resolved in no more than two years.  That 11 years have passed and you are still seeking effective therapy suggests a series of inadequate treatment plans earlier in the process. 

I am aware that parental alienation processes continue across decades with very little change, or even with growing deterioration in the issues, and in my view this reflects a failure of our current mental health and legal systems relative to the effective treatment of the issues.  You should not be continuing to look for a therapist after 11 years, because the issue should have been successfully resolved after no more than two years of appropriate therapy.

Unfortunately, I’m not aware of such a list of competent therapists, and I fully appreciate that appropriate therapy is typically not currently available for treatment of the alienation process. 

My background is not in parental alienation but in the treatment of “normal-range” clinical parent-child problems and I was brought into the parental alienation arena only after entering private practice and encountering the tragedy of the alienation process with a series of clients.  I was so struck by both the family tragedy and the immense wrong done to the child, and also by the nearly complete failure of the mental health and legal systems to stop the destructiveness of the process, that I was motivated to take up the issue from my background in the neuro-development of the brain in childhood and from my background as a graduate-level professor of child psychotherapy and mental health diagnosis and psychopathology.

From my perspective as a child and family psychotherapist, I believe the training of child and family therapists is inadequate to address the needs of the alienation community.  There are simply not the appropriately knowledgeable and trained therapists available to treat children who are victimized by the alienation process. 

In my view, in order to solve this problem of trained and competent therapists, we need to first move beyond the controversy of whether parental alienation exists, and instead move into a professional acknowledgement and recognition of the existence of parental alienation processes.  That has been the focus of my recent efforts, as I strive to define the parental alienation process within existing and accepted treatment and diagnostic frameworks, so that we can hopefully move beyond a discussion of whether it exists into a professional discussion of how do we diagnose and treat the alienation process.

The other element that needs to change, in my view, is that we need to hold mental health professionals accountable to a standard of professional practice that expects that they will be professionally competent in assessing and treating parental alienation processes.  The DSM-IV diagnosis of a Shared Psychotic Disorder exists as a bona fide psychiatric diagnosis and it is entirely appropriate for many of the cases of alienation that are out there.  Accurate mental health diagnoses should not be considered a stroke of good fortune, it should be an expectation of competent professional practice. 

One option for ensuring that all child and family therapists become competent in the identification of parental alienation processes is through the mandated child abuse reporting laws.  In California, where I practice, a requirement of licensure is that all therapists receive training in the mandated reporting of child abuse.  If the diagnosis of a Shared Psychotic Disorder was specifically included and referenced in the child abuse reporting laws as requiring a mandated report, then all therapists would need to be trained in the elements of making the diagnosis as part of their requirement for licensure. This would be one way to increase the availability of trained and knowledgeable therapists.

Q & A: Prognosis for Child

This is a question asked of me in a radio interview with the Parental Alienation Awareness Organization:

What will happen to the children if they do not have access to both parents? Boys without mothers and girls without mothers and vice versa what changes will take place and at what age do you see these changes, if there are any.

Predicting outcomes depends on so many factors that general statements need to be offered with a great deal of caution.

The brain is both experience-expectant and experience-dependent.  For example, with language, the brain is experience-expectant in that it expects to acquire language and it has brain networks already pre-wired to receive language, but the specific language the brain learns is experience-dependent; i.e., it depends on what language is spoken by the parents in the home.

The brain also acquires patterns for relationships, what Daniel Stern calls “schemas-of-being-with,” that are both experience-expectant and experience-dependent.  The brain expects relationships with a father-role and a mother-role, and these experience-expectant and experience-dependent representational networks organize relationship patterns in a variety of ways.  Broadly speaking, a boy’s sense of gender self-identity, i.e., what it means to be a man, a husband, and a father will be strongly influenced by the boy’s relationship with his father, while a girl’s gender self-identity of what it means to be a woman, a wife, and a mother will be strongly influenced by her relationship with her mother.  Future spousal relationships will similarly be influenced by the cross-gender relationships each child has with the opposite-gender parent.  So a boy’s future spousal relationship with his wife will be influenced by the boy’s relationship patterns developed with his mother, and similarly, a girl’s future spousal relationship with her husband will be influenced by the girl’s relationship patterns developed with her father.

This being said, however, children also grow up in a variety of family structures including single-parent households, step-families, and extended family arrangements without obvious systematic disturbances.  Far more important than the mere existence of the relationship is the quality of the relationships the child has with parental figures, and this is of far greater concern in parental alienation than the potential impact of gender related relationships.  The alienating-Beta parent usually has a serious degree of psychopathology, otherwise they wouldn’t be so insensitive to the significant degree of psychological injury they are inflicting on the child through the alienation process.  Conversely, the targeted-Delta parent is typically much healthier psychologically, which is why they tend to refrain from engaging in compensatory alienation measures of their own. 

But the healthier efforts of the targeted-Delta parent to refrain from engaging in their own compensatory alienation efforts toward the other parent only allow the pathological alienating-Beta parent, who has no conscience about harming the child psychologically, to have full sway in influencing the child.  It is the biblical story of Solomon and the disputed mothers of the infant.  When two women each claimed to be the mother of the child, Solomon instructed that the child be cut in half so that half a child could be given to each mother.  Upon hearing this judgment, the true mother couldn’t bear to see her child cut in half and she told Solomon to give the child to the other woman.  Solomon, in his wisdom, recognized the self-sacrifice of the true mother and awarded the child to her.

I wonder if Solomon’s judgment could be cited as legal precedent in court.  The alienating-Beta parent is fully willing to psychologically injure the child by triangulating the child into the spousal conflict as a weapon to be used against the other parent.  The targeted-Delta parent is unwilling to psychologically injure the child by triangulating the child into the spousal conflict, so the targeted-Delta parent does not actively fight back with compensatory alienation to counter the alienating-Beta parent’s triangulation of the child.  This results in the child feeling the pressure of alienation from only one side, so that the child is coerced-seduced into an alliance with the pathological alienating-Beta parent targeting the psychologically healthier parent for abuse and suffering.  The true parent, the parent who loves the child, is the one that sacrifices their love so that the child is not cut in half.  Based on Solomon’s wisdom, the child should be awarded to the targeted-Delta parent.  Instead, the child is typically given to the parent who would cut the child in half.  Would that our current courts possessed Solomon’s wisdom.

Of far more concern than the gender relationships of the child with parents is the psychological-developmental influence on the child of being in continual close relationship with a parent who has significant psychopathology and limited to non-existent empathy and compassion for the child’s developmental needs and healthy psychological development; and the simultaneous estrangement of the child from a relationship with a psychologically healthier and more loving parent, a parent who places the child’s psychological and developmental needs above the parent’s own emotional needs.

The prognosis and time frames for psychological injury are too dependent on the extent of pathology of the alienating-Beta parent and the degree of court and therapeutic support available.  Among the areas I would be concerned about include the child’s later development of significant depression (potential ages; 22-35), the child’s later development of alcohol problems (potential ages; 22-32), and the child’s later development of marital problems and divorce (potential ages; 30-40).  The triad of concern would be significant depression, alcohol problems, and marital problems in the child’s early to mid ‘30s.

Q & A: Origins of the Child's Anger

This is a question asked of me in a radio interview with the Parental Alienation Awareness Organization:

Where does the anger that these kids express really come from as they are in the process of alienation?  What creates such hatred and disrespect?

The alienation dynamic is a shared delusional disorder in which the authentic child is no longer present. 

Consider a ventriloquist and a puppet.  The puppet is not a real person.  The puppet is merely an inanimate piece of wood carved to look like a person.  The ventriloquist simply makes the puppet move while the ventriloquist actually speaks, and the ventriloquist cleverly masks his or her speaking from public perception so that it appears to everyone around as if the puppet were actually alive and speaking.

So complete is the ventriloquist’s creation of the illusion that the puppet is talking, that people on stage and in the audience will actually look at the puppet when the puppet appears to be talking, and bystanders will talk to the puppet as if the puppet was actually real.  But there is only the ventriloquist, throwing his or her voice and making the puppet appear to speak and interact.

In the alienation process, the authentic child is not present.  The targeted-Delta parent is simply interacting with the alienating-Beta parent (the ventriloquist) through the child’s words and actions (the puppet).  The anger and hatred do not belong to the child anymore than the words of the ventriloquist belong to the puppet.

So where is the authentic child?  Lost and buried, needing to be re-discovered.

The authentic child is not angry and does not hate the targeted-Delta parent, and in fact the authentic child actually loves the targeted-Delta parent very much.  It’s just that the authentic child is not present.  Who is present in the body of the child is the ventriloquist, the alienating-Beta parent.  The anger, hatred, and disrespect is coming from the alienating-Beta parent THROUGH the ventriloquist’s puppet; the child.  The targeted-Delta parent isn’t talking to the child, even when the child’s body is present; the targeted-Delta parent is actually talking to the alienating-Beta parent’s psychopathology.

Q & A: Forensic Evaluation and Diagnosis

This is my response to a parent who requested my advice regarding an upcoming forensic evaluation”
Hi Mark,

I'm so sorry that you're having to go through the many struggles you report with your children and family.

While I understand the situation that you related, I am prevented by standards of practice issues from commenting specifically on your situation, and there are also restrictions on professional activity through Internet communication in jurisdictions in which the psychologist is not specifically licensed to practice.

But let me offer some general thoughts.  

My approach to addressing alienation processes is from a clinical-treatment perspective, not a forensic-custody perspective.  My focus is on the children's symptoms involved with the parent-child conflict, which requires establishing a diagnosis to guide treatment.  The children present with a fixed-false belief system regarding the abusive-inadequate nature of the targeted-Delta parent, and treatment efforts that alter the responses of the targeted-Delta parent toward the child do not alter the children's behavior toward that parent (i.e., the child's behavior is not under the "stimulus control" of the targeted-Delta parent).  

Through the process of collecting information relative to making a treatment-related diagnosis, I sometimes come to the diagnosis of a Shared Psychotic (delusional) Disorder when that diagnosis is warranted by the symptoms meeting the diagnostic criteria, and once that diagnosis is made, treatment requires the separation of the secondary case (the child) from the "inducer" or primary case (the alienating-Beta parent) in order to effectively treat the child's induced ("imposed" DSM-IV TR) psychotic (delusional) disorder.  So separation of the child (the secondary case) from the alienating-Beta parent (the primary case) is not custody related, it's treatment related.  

If the Court decides not to accept the treatment recommendation for the child's separation from the alienating-Beta parent, and allows the child to remain in contact with the primary case ("the inducer" DSM-IV TR), then treatment of the dysfunctions in the child's relationship with the targeted-Delta parent that are a consequence of the child's psychotic disorder (i.e., the shared delusional disorder with the alienating-Beta parent) will likely be ineffective, and so continued treatment of the relationship dysfunctions between the child and the targeted-Delta parent become contra-indicated pursuant to Section 10.10 (Terminating Therapy) of the Ethics Code for the American Psychological Association which requires that "psychologists terminate therapy when it becomes reasonably clear that the client/patient... is not likely to benefit..."  Other therapists may decide to treat the relationship of the child and targeted-Delta parent, but I will decline/terminate treatment pursuant to Section 10.10 of the APA Ethics Code and my treatment-related diagnosis.

As long as a child with a Shared Psychotic Disorder remains in relationship with the source-origin of the delusional belief system (i.e., the primary case; the alienating-Beta parent) there is simply no point in treating the relationship distortions between the child and the targeted-Delta parent that occur as a consequence of the child's reality distortions that emerge from the delusional belief system that the child shares with the alienating-Beta parent.

I'd refer you to a handout I have posted on my website that quotes from the DSM-IV TR diagnoses involved, with my highlighting of particularly relevant segments.  Regarding the diagnoses, note that the definition of a "delusion" according to the National Institute of Health is "a false belief regarding the self or persons or objects outside the self that persists despite the facts."  The belief that the targeted-Delta parent is somehow abusive-inadequate and the children somehow need protection from the targeted-Delta parent is the "false belief" that "persists despite the facts" (i.e., by definition of the NIH; a delusion).

Also note that the diagnosis for a Delusional Disorder (the diagnosis given to the alienating-Beta parent) specifically requires that the delusion be "non-bizarre" (i.e., something that conceivably could happen, such as emotional abuse or neglect of a child), and the persecutory type identifies that "(...someone to whom the person is close) is being malevolently treated in some way" meaning that a parent's false and persistent belief that the child is being "malevolently treated in some way" meets the criteria for a persecutory delusion.

Also of particular relevance regarding the Shared Psychotic Disorder diagnosis (the diagnosis given to the child) is that the DSM-IV TR states in two separate sentences that separation from the primary case will generally resolve the delusion in the secondary case (i.e., the child).  This seemingly indicates the recommended approach to treatment.

So, when a forensic evaluation is scheduled to be conducted, the targeted-Delta parent may wish to provide the evaluator with the relevant diagnostic criteria and suggest that the evaluator may wish to consider the appropriateness of this set of diagnoses.  The targeted-Delta parent may wish to consider making this request in writing in hopes that formally documenting the request might encourage the evaluator to respond to this request in the report itself. 

If a child has a serious medical disorder, such as cancer, it is important to make an accurate diagnosis in order to treat the medical issue.  A physician who missed a diagnosis of cancer and thereby allowed the cancer to progress without treatment would be of serious concern, and the missed diagnosis may represent a case of professional negligence, professional incompetence, or even malpractice which might be actionable with the relevant regulatory boards.

If the criteria for a Delusional Disorder (persecutory type) are met for the alienating-Beta parent and the child shares this false belief system in the inadequacy/abusive nature of the targeted-Delta parent - resulting in the rejection-abandonment of the targeted-Delta parent, then a professional diagnosis of a Shared Psychotic Disorder appears warranted based on the diagnostic criteria being met.  The failure of a mental health professional to make the diagnosis of either the Delusional Disorder with the alienating-Beta parent when the criteria are met, or the Shared Psychotic Disorder for the child when the diagnostic criteria are met would be of serious professional concern.  

In cases where alienation processes are at least potentially possible, and particularly when one parent requests a specific evaluation for the potential diagnoses of a Delusional Disorder, persecutory type and Shared Psychotic Disorder, in my view the evaluator at least has the professional obligation to document his or her consideration of these diagnoses and the evidence that is not consistent with these diagnoses that led the evaluator to reject them as diagnostic possibilities, if indeed the diagnoses were rejected.

If it was my report in similar circumstances, I might document the diagnostic issue in the following way:

"Mr. XYZ requested consideration of a diagnosis of a persecutory delusional disorder with his ex-wife, Ms. ABC, and the possibility of a Shared Psychotic Disorder involving the potential shared persecutory delusion of Ms. ABC and the child.  Mr. XYZ suggested that it was the child's shared false belief in the abusive-inadequacy of Mr. XYZ as a parent that was resulting in the child's hostile rejection-abandonment of the relationship with Mr. XYZ.  This diagnostic possibility was considered within this evaluation, and the following evidence seemingly supported the diagnosis of a persecutory false belief system with Ms. ABC..."

"However, the following evidence suggested that the reported false belief that Mr. XYZ was emotionally abusive-inadequate as a parent (had a reasonable foundation in fact, and so would not represent a false belief relative to a diagnosis of a delusion) (was available to change based on contrary evidence presented to Ms. ABC, and so did not meet diagnostic criteria for a delusion) (was not a belief system that was also shared by the child, and was not involved in the child's rejection of a relationship with Mr. XYZ so that it would not represent a diagnosis of a Shared Psychotic Disorder)...."

"Therefore, based on a consideration of the available evidence, a diagnosis for the child of a Shared Psychotic Disorder involving a shared false belief of the child with Ms. ABC in the abusive-inadequate nature of Mr. XYZ as a parent, that is resulting in the child's rejection-abandonment of a relationship with Mr. XYZ (appears warranted) (does not appear warranted) at this time."

While I am a clinical psychologist, not a forensic psychologist, and I don't do custody evaluations, it would seemingly be important in a child custody evaluation to identify DSM-IV TR Axis I psychiatric diagnoses in the parents when the disorders are present.  And with regard to a possible presence of a persecutory delusion, repeated accusations, both formal and informal, of child abuse made by one parent toward the other which are not supported by the evidence should at least trigger an assessment by the evaluator of the potential for a persecutory delusional disorder that "someone to whom the person is close" (the child) is “being malevolently treated in some way."  And if a persecutory delusional disorder is identified with one of the parents, then a diagnosis of a Shared Psychotic (delusional) Disorder should at least be considered and evaluated relative to the child's motivations for rejection-abandonment of the targeted-Delta parent.

Best wishes in resolving your difficult family situation.