The Institute for Relational Harm Reduction & Public Psychopathy Education: Providing Research* Education * Treatment
Pathological Parenting Survey
NAMES will never be used in our material that is derived from our research. Gathering your personal info just allows us to get in touch with you if we need to about the info you have supplied for our research. Complete and email to saferelationships (at) yahoo (dot) com
Personal Contact Information
Your Name:
Your E-mail Address
Your City and State
Your Age
Personal History Information
The number of children you have total
Their ages
The number of children you have had or are parenting with a pathological
Their ages
How many years were you with this or other pathologicals (total)?
Have any of these partners been diagnosed with any disorders? If so, what is their diagnosis?
Are they addicts and if so, what do they use? (Sex, porn, drugs, alcohol, gambling,
Work, perfectionism, religiosity, etc.)
Page Two
Were you married to them or were you considered a common-law partner to them?
Were they violent to you?
If so check the kinds of behaviors they used against you or you have seen them use against other adults.
Put an ‘A’ next to any behavior used against your or other adults and a ‘C’ against any behaviors used against children (0-18 years old).
Some answers only require yes or no answers. If they don’t require an ‘A’ or a ‘C’ please answer with yes or no.
ABUSE BEHAVIORS
.
__ Yelling, screaming, loud voice, etc.
__ Hitting, smacking, slapping, with children--over-spanking, over-correcting with open hand, hair pulling
__ Beating with fists or objects
__ Withholding food, water, clothing, or housing
__ Withholding love or comfort
__ Hitting someone in front of you or children
__ Name calling, degrading statements about your or child’s self worth
__ Name calling, degrading statements about your or child’s body or sexuality
__ Restraining a person’s ability to leave their presence (withholding escape)
__ Breaking items or furniture in front of you or your child
__ Raging and hitting walls in front of you or your child
__ Sexual abuse (molestation, fondling, rape, forced witnessing of sex or porn)
__ Cruelty to animals
__ Fire setting or property destructive behaviors
__ Drunk driving with others in the car
__ Reckless driving with others in the car
__ Abduction or not returning the child on time
__ Out of town or out of state abductions
__ Fist Fighting with other adults in the presence of children
Page Three
NEGLECT & ‘AT-RISK’ BEHAVIORS
__ Allowing truancy in the children
__ Not involved in the children’s school or education (won’t go to teacher meetings, etc.)
__ Using drugs, alcohol, sex, or porn in front of children
__ Taking children to bars or places of drug use
__ Parades new or rapidly changing partners in front of children
__ Has unsafe people in the children’s presence
__ Drug dealing in the presence of others
__ Having children sell drugs for them
__ Not financially supporting the family
__ Does your child have adequate housing environment when they are with the pathological? (A safe and clean environment, a bed, toys, etc.)
__ Withholding child support
__ Is the pathological ‘parasitic’ and lives off of others and not on their own?
__ Do they quit their jobs to avoid paying child support?
__ Do they work under the table to avoid paying child support?
__ Do they make good money ($75+ a year)?
__ Do they have low income? (Under $35K a year)?
__ What is their profession?
COURT BEHAVIOR & LEGAL ABUSE
__ How many times has the pathological been arrested?
__ Are they constantly taking you to court?
__ Are you the one taking him/her to court for relief to stop his/ her behavior?
__ How many times have you been to court with them?
__ What have you been to court for?
__ How many times have rulings been in your favor compared to the pathologicals?
__ Did your children have to testify?
__ Was it traumatic to them and if so what was the child’s behavior following court?
__ How much have you spent in legal fees regarding the pathological?
Page Four
__ How many years have you been in legal battles with the pathological?
__ Does the judge recognize the manipulative behaviors or possible diagnosis?
__ Does your attorney recognize the manipulative behaviors or possible diagnosis?
__ Did your court evaluator recognize the manipulative behavior?
__ Did a child Guardian Ad Litem or Child Psychologist or Child Court Worker recognize the manipulative behavior or possible diagnosis?
__ What custody arrangement do you currently have with the pathological parent?
__ How many full 730 custody evaluations have you been through, if any?
__ Do the professionals in your case believe it is both of you?
__ Has a professional on your case ever said: “You picked each other…”
__ Has custody everbeen reversed in your case from you to pathological or vice versa?
__ Has the child been prevented from seeing you or the pathological parent by the court, if so why?
__ Have you ever withheld something you believe is happening to your child because you were afraid the court system would get it wrong and turn it against you?
__ Has the court system gotten it wrong and thought you may be pathological?
__ Is the court system"getting to the truth" in your case?
Be specific with these questions:
__ How is the court system protecting or not protecting your child?
Page Five
__ How is the court system protecting or not protecting you?
__ How is children’s services protecting or not protecting your child?
__ What is your greatest challenge in the case with a pathological parent?
__ In your opinion what areinadequaciesin the Family Court system? Be specific:
__ In your opinion what areinadequaciesin the Dependency Court system? Be specific:
__ What do you think could make a positive impact on the Family Court system? Be specific?
__ What do you think could make a positive impact on the Dependency Court system? Be specific:
The Use of Psychological Testing
__ What psychological tests have you taken?
__ What psychological tests has your pathological partner taken?
Page Six
__ What psychological tests has your child taken?
__ Do you have any comments about the psychological testing experience and/or outcome?
__ Did the psychological tester recognize the partner’s pathology or make any comments about the partner’s disorder?
Effects on Children
__ Is any of your children in counseling because of the pathological parenting?
__ How long has your child been in counseling?
__ If not, do they need it and you can’t afford it or can’t find suitable counselors?
__ Has your child been referred for social services by the state or school because of their relationship with the pathological? If so, what kinds of services?
__ Is your child’s school work suffering because of the relationship with a pathological? If so, how?
__ Is your child’s behavior effected by their relationship with the pathological? If so, how?
Be specific:
__ How is your child before a visit with the pathological? Be specific:
__ How is your child after a visit with the pathological? Be specific:
__ Has your child been diagnosed with any emotional disorders? If so, what?
Page Seven
__ Has your child been diagnosed with any medical disorders? If so, what?
__ Is the pathological parent trying to turn the child against you, if so how?
__ What steps are youtakingtoprotect your child’s emotional well being? Be specific:
SERVICES USED BECAUSE OF A PATHOLOGICAL RELATIONSHIP
__ What other services have you gotten as a result of your relationship with the pathological? (Counseling, treatment, medical care, a Private Investigator, attorney, social services, mediation, Restraining Orders, etc.)
__ Have you used Domestic Violence services in your community such as a shelter, group counseling, legal advocacy, legal advocate at court with you, children’s program?
__ Have you ever had a restraining order on them? If so, how many?
__ Was the pathological ever referred to Anger Management? If so, how many times and did they successfully complete it?
__ Was the pathological ever court ordered or recommended to Batterer Intervention? If so, how many times and did they successfully complete it?
__ If they attended batterer intervention, did they relapse following it? If so, how many times?
__ Were they ever court ordered to DUI School? If so, how many times?
__ Did they ever lose their drivers license for DUI or reckless driving?
__ Did anyone other than you have restraining orders against the pathological in the past? If so, how many?
Page Eight
PATHOLOGICAL’S FAMILY DYNAMICS
__ Does their family emotionally and verbally support his pathological behavior in front of the children (condoning it or participating in it)?
__ Has their family ever had a restraining order against them?
__ Does their family have their own arrest history?
__ Does their family have their own addiction history?
__ Does their family have their own violence history?
__ Do they often leave the children with unsuitable family members?
Your Support and Resources
__ Have you used any counseling resources? If not, why?
__ If you have used a counselor who understood the pathological love dynamics, please let us know who they are so they can be a resource for others. My counselor is:
__ Have you used any of The Institute’s products or services? If so, which ones?
__ What is lacking in services for you (for instance, legally, emotionally, etc.) that we can help express to the court system and other professionals?
__ Does your family and friends understand what is happening?
Page Nine
__ How has your relationship to the pathological affected your relationships with others?
TELL US YOUR THOUGHTS
What else would you like to tell us about the pathological’s parenting?
What else would you like to tell us about court and co-parenting with a pathological?
What are your greatest challenges in parenting with a pathological parent?
What services or products can The Institute develop that would help you most?
Page Ten
What are we doing well at The Institute?
What do you want to see happen in the future of The Institute?
What do we need to do better?
Thank you for taking the time to answer questions that could help the future of children. Please email this to saferelationships (at) yahoo (dot) com.