A/PROF CAROLYN QUADRIO School of Psychiatry University of NSW SHARED PARENTING ORDERS

1. A/PROF CAROLYN QUADRIO School of Psychiatry University of NSW SHARED PARENTING ORDERS ADELAIDE, UNIVERSITY OF SA APRIL 2008 SIX DEGREES OF ALIENATION: PARENTING & FAMILYCONFLICT

2. OVERVIEW OF PRESENTATION • Child trauma and abuse • The spectrum of alienation • Parenting patterns • Case examples • Breastfeeding • Joint parenting considerations

3. 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

4. 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

5. 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

6. 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

7. 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

8. NEW LEGISLATION:PRESUMPTION EQUAL PARENTING • Burden of proof on victim? • Reality of CAN • Prevalence of DV vs • False allegations as strategy • Breastfeeding as strategy

9. 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)

10. 90% allegations CSA in FLC are false PAS: ‘syndrome’ explains this process deliberate alienation (usually Mo) CSA common/false allegations not no scientific validity non-diagnostic no probative value dangerous assumption ALIENATION ‘SYNDROME’ SYNDROME vs REALITY

11. ASSESSING CHILD ABUSE/NEGLECT • Only medical evidence conclusive – but rare • Most symptoms non-specific: • Anxiety, regression, sleep disturbance, nightmares, acting out, depression, hyperactivity, school problems • Equally reflective of disturbance of divorce and/or ongoing post separation conflict

12. 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

13. 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

14. 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

15. 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

16. SPECTRUM OF ALIENATION • Motivation: • altruism • self-interest • malice • Psychology: • normal • anxious • paranoid/deluded

17. FIRST DEGREE • Altruism/protection: • CSA is actual and/or sincerely believed • Alienation = solely to protect child

18. SECOND DEGREE • Hurt and/or depressed parent: • cannot conceal feelings • children exquisitely sensitive • alienation unintended

19. 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

20. 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

21. 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)

22. SIX DEGREES • Wilful and intended alienation • every effort to block contact • malicious false allegations to gain advantage in FLC • self-interest/manipulative • sociopathic/malicious

23. NEW LEGISLATION • Joint parenting • Property in common? • Best interests of child paramount?

24. 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

25. CHANGING PATTERNS • Old style ‘access’: Dad as Santa Claus

26. CHANGING PATTERNS • New style joint parenting: Mr Mom

27. 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 $?

28. 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

29. 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

30. Risks of not breastfeeding • gastrointestinal disease • respiratory illnesses including asthma • chronic otitis media • sudden infant death syndrome.

31. 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)

32. 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

33. 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

34. 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

35. 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)