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Raising Parents

Helping troubled parents to raise their children adequately is of crucial

importance for parents, their children, and society at large. Distressed
parents have themselves often been endangered and, as a consequence,
sometimes endanger their children either through maltreatment or through
the effects of parental psychiatric disorder.
Raising Parents explains how that happens and clusters parents in terms
of the psychological processes that result in maladaptive childrearing. This
edition introduces DMM Integrative Treatment and demonstrates how to use
it with vulnerable families in terms of assessment, formulation, and
treatment. New formulations are offered for problems that have resisted
treatment, and cases demonstrate how the ideas can be applied in real
treatment settings. The book closes with ten suggestions for improving
professionals’ responses to troubled families and endangered children.
Raising Parents will be essential reading for clinicians from all disciplines,
including psychiatry and psychology, social work, nursing, and all types of
psychotherapy.

Patricia McKinsey Crittenden works cross-culturally as a developmental

psychopathologist at the Family Relations Institute, Miami, USA. She is
founding Chair of the International Association for the Study of Attachment
and Adjunct Associate Professor in Dalhousie University’s Department of
Psychiatry, Canada. She has held university appointments in Finland, Italy,
and Australia, as well as in the USA. She received a career achievement
award for ‘Outstanding Contributions to the Field of Child and Family
Development’ from the European Family Therapy Association in 2004. Dr
Crittenden has published widely in the field, with her most recent book
being Attachment and Family Therapy, and she has a forthcoming book
entitled Loving and Learning: Promoting attachment through baby play.
‘The DMM is the most clinically sophisticated model that attachment theory
has to offer at the present time. This book is the best introduction to the
DMM that there is. It could hardly be anything other than a brilliant
crystallisation of the model, given that the author is its originator.
Crittenden is one of the great writers on the clinical applications of
attachment theory. Almost all clinicians working with children and young
people, or with their parents, will benefit from studying this text carefully.’
—Peter Fonagy, Freud Memorial Professor of Psychoanalysis; Head of the
Research
Department of Clinical, Educational and Health Psychology,
University College London, UK; Chief Executive, Anna Freud
Centre

‘Patricia Crittenden’s Raising Parents: Attachment, Representation and

Treatment, Second Edition, is a book with a bold aim. It explains and
illustrates applications of a new underpinning theory (the Dynamic
Maturational Model or DMM) that sets out to enhance our understanding of
child development , refine our attempts to help parents whose behaviour
harms their children, and assist in testing new hypotheses in both child
development and treatment. The author draws on her vast clinical
experience to guide the reader through each of these complex topics and
offers us genuinely new insights on the way. Her compassion and sheer
intellectual curiosity shine through, making this a book not only to
enlighten but also to inspire.’
—Ruth Gardner, Advisor on Child Neglect at the National Society
for the Prevention of Cruelty to Children (NSPCC), UK

‘The first edition of Raising Parents by Patricia Crittenden has been an

essential text in an interdisciplinary graduate course I teach on development
and psychopathology. Students relatively unfamiliar with attachment theory
as well as those who felt they knew quite a bit were deeply engaged in
learning about the Dynamic Maturational Model of attachment and
adaptation, discussing the rich case material provided in Raising Parents,
and wrestling with the clinical implications and applications of the theory. It
is not an exaggeration to say that this book frequently changed how we all
thought about, empathized with, and worked with troubled families. These
students were hungry for more and I am pleased to say that the second
edition has addressed many of their questions, even while it poses others for
all of us to ponder. This is a brilliant piece of work and one that should be
studied and debated by all who believe in the enormous utility of
attachment theory to improve our understanding of adaptation, suffering,
and the healing power of relationships.’
—Susan J. Spieker, Professor of Family and Child Nursing; Director
of the Barnard Center for Infant Mental Health and Development,
University of Washington, USA

‘“Once we recognize that we (ordinary parents and professionals) aren’t

different in kind from parents who harm their children, then wondering why
they did what they did can elicit inquiry, not accusation.” Pat Crittenden in
this book offers a richness of ideas to help comprehend the actions of parents
who struggle and may inflict harm on their children. This quote above
illustrates how her perspective is not only “non-blaming” but dares to hold a
mirror to us all regarding our own actions as parents. All too frequently it is
very tempting to adopt a position of “them” and “us” in relation to parents
who appear to harm their children. Inviting us into this less than
comfortable self – reflection she also shows great compassion and also
incisive insight into how parents’ own childhood experiences may intrude
into their relationships with their children. To help children, she argues, we
must understand and offer help to their parents. This is not to make excuses
on their behalf but to develop a sophisticated understanding of the complex
mental processes that shape their feelings, thoughts, and actions. The second
edition of this book offers new treasures, including expansion of the
processes of intervention and in particular the complexities of the
“therapeutic relationship”. The therapist is described as becoming a
“transitional attachment” figure and the subtle processes of how this is
achieved are systematically detailed. This is an invaluable contribution to
what has repeatedly been found to be the cornerstone of successful
intervention in families. This book is essential reading for all therapists – not
just those working with children. It also offers a massive step towards a
genuine psychological formulation of a whole range of complex and severe
problems in families.’
 —Rudi Dallos, Professor and Research Director, Doctorate in
Clinical Psychology, University of Plymouth, UK

‘Dr Crittenden has done it again! With her updated version of the classic
Raising Parents, Dr Crittenden offers her vast wisdom and powerful clinical
experiences to explain the importance and challenges of early experiences to
human development. What sets Dr Crittenden, and her book, apart is her
treatment of attachment as inter-generational. Essentially, when we raise
children, we raise them to be parents of the next generation. Healthy caring
societies ensure that children are raised well, because we all benefit from
more healthy adults, raising evermore healthy children. This book should be
required reading for anyone who cares about family health and human
capital, who cares about how attachment strategies affect mental health and
development over generations, and who cares enough to want to help
improve the health of children, families, and societies.’
—Nicole Letourneau, Norlien & Alberta Children’s Hospital
Foundation Chair in Parent-Infant Mental Health, Professor,
Faculty of Nursing & Cumming School of Medicine (Pediatrics &
Psychiatry),
University of Calgary, Canada
Raising Parents
Attachment, representation, and treatment

Second edition

Patricia McKinsey Crittenden

First published 2008
By Willan Publishing
This edition published 2016
by Routledge
2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN
and by Routledge
711 Third Avenue, New York, NY 10017
Routledge is an imprint of the Taylor & Francis Group, an informa business

© 2016 Patricia McKinsey Crittenden

The right of Patricia McKinsey Crittenden to be identified as author of this work has been asserted by
her in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by
any electronic, mechanical, or other means, now known or hereafter invented, including photocopying
and recording, or in any information storage or retrieval system, without permission in writing from
the publishers.
Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are
used only for identification and explanation without intent to infringe.
British Library Cataloguing-in-Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging in Publication Data
Crittenden, Patricia McKinsey, author.
Raising parents: attachment, representation, and treatment / written by Patricia McKinsey Crittenden.
2nd edition.
p. ; cm.
Includes bibliographical references and index.
I. Title.
[DNLM: 1. Parent-Child Relations. 2. Parenting. 3. Child Abuse. 4. Child of Impaired Parents. 5.
Family Therapy. WS 105.5.F2]
BF723.P25
306.874--dc23
2014041632
ISBN: 978-0415-50829-2 (hbk)
ISBN: 978-0415-50830-8 (pbk)
ISBN: 978-1315-72606-9 (ebk)

Typeset in Sabon by
GreenGate Publishing Services, Tonbridge, Kent
This book is dedicated to parents – all parents, especially
on those occasions when things did not turn out as they
had hoped.
Contents

List of illustrations
Acknowledgements

PART 1
Yesterday’s children: today’s mothers and fathers

1 Cherishing parents

Helping professionals to help parents

The Dynamic-Maturational Model of Attachment and Adaptation
DMM Integrative Treatment
Important concepts and terms
Notes

2 A primer of DMM theory: twelve crucial constructs

The context of life: from genes to culture

Developmental possibilities: diversity and change
Treatment of maladaptation Conclusions
Important concepts and terms
PART 2
Growing up

3 Early childhood: learning to be safe at home

Protection, danger, and attachment figures

Infancy (birth to 1–2 years)
Preschool years (2–5 years of age)
 Important concepts and terms
Note

4 Going to school: coping with a complex world

School age (approximately 6–12 years)

Issues for children using a compulsive Type A strategy
Issues for children using a coercive Type C strategy
Issues for children using a Type A/C strategy
Adolescence (puberty–16 years)
Important concepts and terms

5 Becoming an adult: loving and leaving

Transition to adulthood (16–25 years)

Yesterday’s children
Important concepts and terms
PART 3
Information processing

6 Remembering the future: the process of mental representation

Seven transformations of information

Dispositional representations (DRs)
Selection of a dispositional representation upon which to act
Conclusions
Important concepts and terms
Notes

7 How do parents affect children’s representations?

Representation and protective strategies

Reorganization, trauma, depression, disorientation, and intrusions of
forbidden negative affect
How does perception of danger affect behavior?
How do parents’ strategies affect children’s strategies?
 Important concepts and terms

8 Representation and childrearing that endangers children

Why parents behave as they do

Interpersonal disorders in children
Assessing transformations of information and DRs
A hypothesis and questions for future research
Conclusions
Important concepts and terms
PART 4
Parents’ dispositional representations

9 Cluster 1 – distortions of normal child-protective behavior: under-

responding to children

Inconsistency from mixed dispositional representations (DRs)

Inconsistency from competing mother and father DRs
Inconsistency from distraction
Couples’ issues and inconsistency
Conclusions about Cluster 1
Outcomes
Important concepts and terms
Note

10 Cluster 2 – distortions of normal child-protective behavior: over-

responding to children

Fear of loss: impairments and imagined medical threats

Fear of children doing the wrong thing: punishment and child abuse
Immigrant populations
Outcomes for children
Conclusions
Important concepts and terms

11 Cluster 3 – distortions of perception: seeing yourself in your child

 Comfort me/you: paternal incest
Give me sugar: spousification
Oh, no! I can’t! Mother’s compulsive performance and postnatal
depression
Never again – the long reach of unresolved trauma
Conclusions
Important concepts and terms

12 Cluster 4 – obscured perceptions: the disappearing child

Depression and insufficient caregiving

Unpredictable and changing dangerous parental behavior
Triangulating parental behavior
Disoriented parental behavior
Important concepts and terms

13 Cluster 5 – distortions that substitute erroneous information for

accurate information: misconstruing children as being threatened

Kate and the Cutters: a hard rock in search of balance

Perceived on-going threat
Child death
Understanding Cluster 5
Important concepts and terms

14 Cluster 6 – distortions that substitute deadly delusional information

for accurate information: misconstruing the child as the threat

A Type A example
A Type C example
Child homicide
Understanding parents who intentionally kill their children
Preventing child deaths
Important concepts and terms
Note
PART 5
An integrative approach to treatment

15 DMM Integrative Treatment with families

A rationale for DMM Integrative Treatment

Beginning the process of DMM Integrative Treatment with parents
Using attachment to promote the goals of therapy
Adaptation
Important concepts and terms
Notes

16 When things fall apart

Problems in treatment
Alternatives to out-of-home placement
IASA Family Attachment Court Protocol
Foster care and out-of-home placement
Research to learn what we do not now know
Important concepts and terms

17 Assessment that is relevant to differential treatment

What sort of assessment is needed?

What we need to know before beginning treatment
What is assessment?
Assessing attachment and information processing
Contraindications: avoiding the wrong treatment
Ongoing assessment following formal assessment
Important concepts and terms

18 Functional formulation and the plan for treatment

Functional formulation
The components of a functional formulation
Constructing the functional family formulation
The role of professionals
Attachment, critical causes, and case planning
 Important concepts and terms

19 DMM Integrative Treatment: three cases

Mild and transient dysfunction (normal parenting)

Moderately severe dysfunction (Cluster 3)
Severe parenting dysfunction (Cluster 5)
Conclusions
Important concepts and terms
Notes

20 Do unto parents as you would have them do unto their children

DMM Integrative Treatment

Parenting, survival, and culture
Ten ideas
From survival through healing to living
Important concepts and terms

References
Index
Illustrations

Figures
1.1 Dynamic interplay of influences on adaptation
3.1 A Dynamic-Maturational Model of patterns of attachment in infancy
3.2 A Dynamic-Maturational Model of protective attachment strategies in
the preschool years
4.1 A Dynamic-Maturational Model of protective attachment strategies in
the school years
4.2 A Dynamic-Maturational Model of protective attachment strategies in
adolescence
5.1 A Dynamic-Maturational Model of protective attachment strategies in
adulthood
6.1 Eight memory systems: somatic, cognitive, and affective information
organized by developmental order and psychological complexity
8.1 Sequence of parental information processing leading to action or
inaction
14.1 Sequence of professional information processing leading to action or
inaction

Tables
2.1 Theories integrated into the Dynamic-Maturational Model of
Attachment and Adaptation
3.1 Coy and aggressive signals
3.2 Attachment behavior and sexual behavior
4.1 Parallel arousal systems
7.1 Type A versus Type C
Boxes
8.1 Parenting clusters: parental dispositional representations organized
around a gradient of psychological processes
17.1 Level of family functioning
17.2 Gradient of interventions
Acknowledgements

Before addressing the contributions of my colleagues to the second edition

of Raising Parents, I want to thank the parents and children whose
experiences are described here; each has been generous enough to allow me
and those who work with me to share their experience in order to help
others through what we have learned. Without their generosity in the face of
their personal adversity, this book could not exist. I am particularly
appreciative of the group of young parents with whom I worked in the 1970s
in Charlottesville, Virginia. They are my base for understanding other
people’s perspectives; I hope they are enjoying their grandchildren now – as
I enjoy mine. I hope that I have understood and related the experiences of all
these families with sufficient insight and compassion.
It takes a team to write a book, and my team has been exceptionally
helpful and encouraging. Each has brought particular skills that have
improved the book – and our dialogues about the ideas have made writing
the book a shared pleasure.
Clark Baim has contributed his compassion and experience with a wide
array of enacted treatments to many sections of this book. Further, he has
fostered my understanding of men who sexually abuse children. His astute
sense of English usage and prosody has been very helpful throughout the
writing.
Robbie Duschinsky’s study of the history and present state of attachment
research is a huge asset to the field; surely he knows my early work better
than I do. In addition, he has been immensely helpful regarding the
theoretical and practical coherence of Part 4 (parenting clusters) of the book.
Andrea Landini has been my companion in developing ideas about DMM
Integrative Treatment from the beginning. He gives me courage through
being the first to receive my new ideas, from hare-brained to common
knowledge to insightful. Together we sift through the ideas, finding the
residue that reaches publication. Landini has thought deeply about the role
of psychotherapists, particularly their personal motivations and
representational processes. His ideas and background in cognitive and family
therapy strengthened several chapters, especially those about treatment.
Nicola Sahhar has brought yet another dimension to DMM Integrative
Treatment from his expertise in psychoanalysis. He contributed thoughtful
discussions throughout the long development of the treatment chapters,
offering particular insight to the psychological functioning of troubled
people and to managing the therapist’s contributions to therapeutic
relationships.
Simon Wilkinson has brought his combined backgrounds in medicine,
psychology, and ethology, expansive knowledge regarding the bio-ecology of
functioning, and experience with family and milieu therapy to bear on the
treatment chapters, particularly on the relationship of therapists to the
families with whom they work and the systemic context of therapy. He has
helped me to understand that all functioning is embodied. His nuanced
understanding sharpened the core chapters of the book.
In addition, many others have assisted me by offering cases from our
work together, refining sections of the book with their expertise, or
commenting on the ten points that close the book in Chapter 20. I include
them together to avoid revealing the identity of anonymized cases: Varya
Anikina, Franco Baldoni, Mark Bauman, Rebecca Brown, Rebecca Carr-
Hopkins, Rudi Dallos, Martha Hart, Airi Hautamäki, Kasia Kozlowska,
Gunhild Kulbotten, Nicole Letourneau, Chris Purnell, Katrina Robson,
Myron Rowan, Andy Slukin, Gordon Sommerville, Susan Spieker, and
Arlene Vetere.
Of these, Kasia Kozlowska’s dedicated work with families with a child
with functional somatic symptoms or medically unexplained symptoms has
been particularly helpful; seeing treatment through her eyes has been a
privilege. Franco Baldoni also has contributed over many years to my
learning about somatic problems. Katrina Robson has been a special friend;
our discussion of cases over more than a decade has provided me with the
opportunity to try out ideas before writing about them. She is the source of
‘magic dust’, that special attribute of a mental health professional that
enables him or her to offer a new future to a distressed family. The dialogue
with Susan Spieker and the students in her courses that used Raising Parents
as a text has helped me to see how the book can communicate with the next
generation of mental health professionals. I’ve kept her students in mind as I
wrote.
In addition, several people have helped to free my time for this by filling
in on urgent tasks; without their help, I would still be hoping to find the time
to write. Therefore I’m grateful to Rodolfo de Bernart, Bente Nilsen, and
Steve Farnfield.
Finally, I am grateful to my husband, daughter, and granddaughter who
have each supported me and accepted my hours and hours – and hours! – of
sitting behind my computer. They trusted that this was a worthwhile task,
and I appreciate what it costs to let one’s wife, mother, or grandmother put
so much energy into one task.
Of course, no book is perfect, and the imperfections are mine. But my
hope and that of everyone who has contributed to this volume is that, in the
future, some families will feel themselves better understood and that that
will make it easier for them to face the challenges of their lives.
Part 1
Yesterday’s children
Today’s mothers and fathers
Chapter 1 Cherishing parents

‘If a community values its children, it must cherish their parents.’

These words were written by John Bowlby more than half a century ago and
are just as true today as they were then (Bowlby 1951, p. 84). Parents are
children’s primary attachment figures and, as such, they function to promote
children’s survival and well-being as well as to prepare children to become
attachment figures to their own children. As with any primary attachment
figure, they are irreplaceable (with loss of parents leading to intense
suffering) and more dedicated to their children than are any substitutes
(even when the substitutes are more competent parents). Supporting –
cherishing – parents is central to caring for their children. Doing so makes
emotional sense, functional sense, and economic sense; parents are the only
resource that is never cut back. Moreover they are the architects of society;
let’s value all parents and assist those who need help.

Talisha,1 her mother, and her 6-year-old daughter were in my office to be

evaluated following a complaint to child protection that Talisha often hit
her daughter abusively. Usually, this story would be told from her
daughter’s perspective, with discussion of the bruises, her mother’s sullen
withdrawal and refusal to admit to the abuse, the daughter’s vigilant
looks of concern to her mother, and the grandmother’s report of Talisha
beating her daughter.
Instead, one comment from Talisha highlights a different perspective.
When being asked yet again about the bruise and whether she had
inflicted it, Talisha looked with resentful eyes toward her own mother and
blurted out, ‘Yes, I did it! But nobody came to help me when she did the
same thing to me! I don’t understand why it’s abuse when I do it and just
punishment when she did it.’ Then, turning to me, Talisha said softly, ‘I
 love my daughter just as much as she loves me. I don’t see what I did
wrong.’ And Talisha cried.

Some parents are dangerous to their children. Stated more accurately, all
parents harm their children more or less, just as all are more or less
protective and comforting. All parents are mixtures of positive and negative
characteristics; they differ in their flexibility and the reversibility of the harm
that they cause. Moreover, the connection between parental behavior and
child outcome is clear in some cases and difficult to discern in others. In
general, child protection responds in cases of clear harm, whereas child
mental health services address child problems of complex or unknown
origin. That division, however, might be artificial, obscuring the similarities
among troubled families and constraining the ways in which we can
respond.
One of the contributions of this volume is to explore the developmental
processes through which parents learn to raise their children. Three
commonalities among parents stand out. One is that, even when parents
harm their children, they almost never intended to do so. Another is that
harmful parental behavior has roots in what parents learned in their
childhoods during early and uncomforted exposure to danger and threats to
reproduction. That is, parents who harm their children were once themselves
threatened and uncomforted in ways that jeopardized their reproductive
opportunity. Finally, almost uniformly, parents seek to raise their children
better than they were raised.
A second contribution is to explore how DMM Integrative Treatment can
facilitate professionals’ attempts to enable troubled parents to raise their
children in greater safety and greater comfort. The goal of DMM Integrative
Treatment (Crittenden and Dallos 2014; Crittenden, Landini and Kozlowska,
in press) as applied to parents is to help parents whose behavior harms their
children to be (just barely) good enough (Winnicott 1986) or, if that cannot
be managed, less harmful to their children than is placement in care. That is,
of course, a very modest goal compared to our usual goal of providing
children with healthy, happy childhoods. The evidence indicates that, once
children come to professionals’ attention, we rarely achieve that goal and, in
pursuit of it, we sometimes harm children through the care that we offer. Of
course, we do not intend harm …
 Preventing harm by bolstering parents’ role as attachment figures to their
children is a modest goal that might both produce more safety and happiness
overall and also risk fewer casualties from treatment that backfires. The
process of assisting parents to protect and comfort their children involves
placing professionals2 in attachment roles, usually for the parents. Several of
these roles are described in Part 4. Serving children in their families, as
opposed to through fostering or individual treatment of their diagnosed
psychiatric disorders, will have a cost, but it will be less than our current
practices. Cherishing troubled parents through understanding them is the
starting point.

Helping professionals to help parents

In order to help parents whose behavior harms their children, it is important
to consider the functioning and needs of the parents. Our treatment systems
are organized almost entirely around the needs of children and funded
almost exclusively to offer services for children or for parents about children.
Yet sometimes children’s needs would be met best by meeting their parents’
personal needs. Because children rarely live better than their parents,
parents’ suffering affects their children. To help parents, we need to
understand them as people who have children – as opposed to seeing them
as existing solely in terms of their ability to fulfill their children’s needs.
Only when we do this can we be accepted by parents as transitional or
auxiliary attachment figures. Talisha’s words remind us that there are many
sides to every story. If professionals can expand their perspective to
understand society’s interest in Talisha’s family, Talisha’s perspective, and
the children’s perspective (both Talisha’s daughter and Talisha’s as a child),
then we might be able to find ways to fulfill parents’ intentions and prepare
children to become the next generation of parents.
Learning to raise children. The transition from person to parent is one of
life’s most profound changes. Moreover, even though raising children is the
most important and complex task in life, as many have pointed out, there is
little or no formal training for this role. Instead, parents are assumed to
inherently ‘know’ what to do.
 How do parents know what to do and how did they get that information?
Part 2 of this book considers the process by which this inherent, implicit
knowledge comes to be. However, because not all parents raise their children
the same way, understanding individual differences in what parents do is
crucial. This book explores both the universal processes by which parenting
knowledge is acquired and also individual differences in the specific
information that is acquired. The focus is on those parents who find it
difficult to keep their children safe and comfortable.
Knowledge, however, is a complex concept. Sometimes we do what we
‘know’ we shouldn’t do. That is, there can be a difference between what
parents think they should do and what they actually do. To address this
discrepancy, we need to think of knowledge as having several forms such
that what parents know explicitly and in general may not be the same as
what they know how to do or how they feel. Part 3 of this book addresses
different ways of knowing what to do and the reasons why one sort of
knowledge might influence behavior more than another sort.
Individual differences in how parents raise children. Everyone has seen
parents treating their children in unacceptable ways and wondered why
they did that. Everyone has been horrified at the ‘inhumanity’ of parents
whose extreme abuse and neglect, even murder, of their children have
garnered media attention, and wondered how they could do those things.
Each of us who is a parent has, on occasion, acted in ways that appalled us –
and we wonder, even now, why we did that. A few examples can show the
range of variation.

Luke’s arm was broken. No one knew how it had happened and Luke at
19 months couldn’t tell. He simply curled up tightly in the hospital crib,
not talking or walking. He wouldn’t look at his parents when they came
to visit. He seemed grossly neglected and abused, and the hospital staff
were anxious to help him, believing that no child should have to live like
this.

On a crowded airplane, a family – mother, father, and 3-year-old boy –

squeezed into the aisle and waited to disembark. The boy hung limply on
his mother’s arm – while she tried to gather her bags. She tried to pull
him up to stand; he protested and slumped to the floor among the feet and
bags. His father barked, ‘Nick! Stop that! Stand up! Help your mother!’,
and, with raised hand, he threatened Nick with a slap. Nick ignored this,
while his mother pleaded, ‘Nick, please stand up like a nice boy. If you
stand nicely while they open the door, I’ll give you a piece of candy when
we are off.’ Nick only whined, cried, and kicked harder. The father looked
away, the mother scanned her audience of other passengers apologetically.
Nick began screaming.

Seven-year-old Nancy was failing in school. Everyone knew she was

bright, but she didn’t pay attention and she couldn’t get her assignments
done. The failing grades piled up. One evening her mother sat with her
and together they got every single division problem done, correctly. Her
mother used positive reinforcement throughout, then praised her for the
completed assignment and pointed out how today she would surprise the
teacher by having everything ready. The next morning, walking to school,
Nancy threw the homework in the neighbor’s trash can.

David, aged 10 years, cowered under his covers in bed, but the sounds of
his father’s accusations, his mother’s pleas, and the thuds and howls kept
coming. Then a door slammed and it was over. The next day, as he did
every day, David left home as early as possible and wandered as far away
as he could. Away from the sounds of families, away from the taunts of
other children, away from anything familiar and anyone who would
know him. He reached a seedy part of town where no one questioned him
and no one knew or cared who he was. Things seemed less intense, less
accusing, safer. That’s where the truant officer usually found him – when
there was time to go looking for him.

At 16, Jackson was on probation for knifing his father; he was living in a
homeless shelter and his girlfriend had dumped him. His mother? No one
knew where she was; she’d taken off when he was about 10. Since then,
he’d lived in all sorts of places. Today, like a lot of kids with a history of
multiple placements and no viable current placement, he had dropped in
unexpectedly on one of the professionals he used to know. She took time
with him, but he wasn’t on her client list and wouldn’t be; he was now
 too old. Jackson was tough, charming, egotistical, and self-negating. He
didn’t have much to lose and, under his cool surface, a frightened little
boy almost cried as he tried to find a guide to a life without committed
people or a permanent home.

Knowing how to raise children. Parents do what they think is right. Only the
most thoughtful are able to identify and think about the moments when
what they did was, in their own eyes, the wrong thing to do.
Strangely, when parents do the right thing, no one wonders why. But the
psychological processes that organize appropriate and inappropriate
behavior are the same handful of mental processes that all humans have
available. What differs is the context in which individuals, and their parents,
learned to use those processes and, therefore, the learned organization of the
processes. Differences in what they learn have immense implications for
their children.
Parents who do ‘the wrong thing’ began with the same genetically
maturing brains that we all have. And all of us occasionally behave in ways
that are dangerous to our children. Once we recognize that we (ordinary
parents and professionals) aren’t different in kind from parents who harm
their children, then wondering why they did what they did can elicit
inquiry, not accusation. Maintaining curiosity throughout this volume will
permit us to move beyond prescriptive, accusing, and judgmental answers
that don’t work to some fresh ideas that might work.
This book considers how parenting behavior is generated in terms of:

1 what information is brought to bear on the task;

2 how it is given meaning;
3 which aspects of the task have priority when not all can be managed or
when success is at risk.

These issues highlight the importance of protection and preparation for

reproduction as essential and universal components of parenting. They also
point to the paradox that these appear to be precisely the functions that are
distorted in cases of risk, i.e., cases of child maltreatment and parental
mental illness. For example, even biology responds to threats to reproduction
with neglected girls entering puberty earlier than others – as if time might
be short and they needed to have their children before it ran out (Belsky
2012). Moreover, whenever danger and sexuality appear together, the threats
to survival are increased.
If one considers only the effects of such parental behavior, one might
think the parents are misinformed (and, therefore, in need of information
and education) or malicious (and, therefore, in need of a judicial response).
But if one considers the developmental process through which adults have
learned to make meaning and organize their behavior, other explanations
become possible. In particular, many well-meaning, but endangering,
parents use overzealous attempts at reversal and correction of their
childhood experience (i.e., ‘pendulum parenting’) and over-application of
learned safety measures (i.e., compulsion). Many feel themselves to be
unsafe or uncomforted and act so as to protect or comfort themselves. This
book focuses on these and other explanations in the expectation that they
can lead to more helpful treatments.
Developmental pathways to parenthood. It is proposed here that dangerous
parental behavior can be seen as having comprehensible and self-protective
roots in adults’ early development and that this development is a continuing
process. That is, development is not determined at some early stage (Bowlby
1969/1983), but instead continues throughout life, with each new
accomplishment being built on the base of the past.
Nor is development linear. Each successive period of childhood has both
the advantage of greater maturity and the disadvantage of new, stage-salient
threats. In addition, unexpected events intervene. For example, a special
teacher, a divorce, an accident or a premature death, or the arrival of an
especially caring stepparent can alter the course of a child’s development. As
a consequence, what can be understood retrospectively cannot be predicted
prospectively.
Part 2 of this book describes the developmental pathways of those parents
who harm their children, addressing issues of child maltreatment,
psychological distress, psychiatric disorder, and criminality. Central to
understanding these pathways is the notion that, without adequate reflective
integration, (a) childhood strategies may be applied inappropriately to adult
contexts, (b) errors of thought and behavior may be carried forward without
awareness, and (c) new errors may be added in response to newly maturing
capacities. This combination of contextual errors, implicitly maintained
distortions, and newly acquired distortions can lead to inappropriate
parental behavior. These are described in Part 3.
The advantages of taking such a complex view of inappropriate and
dangerous parental behavior are that:

1 professionals can develop understanding of and compassion for parents;

2 professionals can talk to parents in terms that are meaningful to parents,
thereby increasing the probability of engaging the parents’ cooperation;
3 parental change may become more likely.

Why understanding parents’ experience is important. Often we act as though

simply becoming 18 or 21 years old or having a baby turned one into an
adult. Of course, we know that this is not the case, but when one works in
child protection, one can forget how development really occurs and focus
instead on how parents should behave.
To suggest how unrealistic this is, let me relay an incident that occurred
during a talk that I gave to therapists who treat sexual offenders. I was
describing, as compassionately as possible, the developmental pathway of a
typical incestuous sexual abuser. I had my audience with me, seeing how the
baby, the boy, and the young adolescent were victimized in a series of ways.
But when he became a young father and I described how he dressed, bathed,
and comforted his young daughter, the ‘temperature’ of the audience
suddenly shot up. People got agitated, began interrupting me, and felt urgent
distress. ‘He’s grooming her!’ ‘That’s sexual abuse!’
It took some time to cool the audience down a bit. Indeed, at the next
break, more people came up to me than at any other point in my two days of
presentation. ‘Didn’t I recognize …?’ ‘How could I condone …?’ It was only
when I asked, ‘On which day does a victim of repeated abuse – who should
be protected – become a perpetrator who should be punished?’, that my
audience paused. After some moments of silence, a hand went up. I nodded
and a man responded, ‘The day the report hits my desk.’
That is the point. We, the professional community, turn victims into
perpetrators – and we punish them accordingly. We strip a complex and
painful situation of its complexity, reducing it to a simple, albeit unrealistic,
dichotomy. Why? Because it makes our job easier.
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