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