Parental alienation is a construct which describes a campaign of disenfranchisement from children on the part of one parent against another, particularly during divorce. It has been at the forefront of child custody research aimed at explaining its short- and long-term effects on the children affected by it. During a time when tension between parents is at its highest and conflict regarding parenting responsibilities and parenting time arises, parents resort to parental alienation in an effort to control and hinder the emotional relationship the children would otherwise forge with the other parent. This paper is a review and integration of established ambivalence and parental alienation theory incorporating clinical examples. The clinical examples are cited from real interviews conducted by the authors from 2010 to 2016. The purpose and diagnostic utility of the examination of this subject matter is to exemplify the need for making a fine grain clinical analysis of ambivalence in order to most accurately assess the existence of parental alienation in a clinical situation with children. Specifically, the expressed lack of ambivalence as manifested by the alienated child serves as an observable defining characteristic of the presence of parental alienation. The understanding of this phenomenon provides predictive criteria for clinicians and forensic experts to establish or rule out the existence of parental alienation in clinical and forensic settings with implications for treatment and custody recommendations.