Lowenstein (2007) in his book “Parental Alienation” asks the question: “Is PAS a mental illness?” As with any condition a mild form and perhaps even a moderate form will not be considered a mental illness. However, when it goes to extremes it certainly is a form of mental illness. The individual who is alienating the helpless obviously suffers from severe paranoid tendencies with little regard for the welfare of the child/children. The primary concern becomes seeking vengeance against an absent partner who will no longer be allowed to have contact with the child as a result of the alienation process. In addition to paranoia, delusions are frequently involved which border on a psychotic illness. It is for this reason that DSM-V should consider seriously placing pathological and severe cases of parental alienation on the new DSM-V classification. It is hard to explain why PAS is not already on DSM-IV but it is hoped to put this forward as a classification on DSM-V. Such a consideration is not dissimilar to the category of depression on DSM-IV, where individuals who suffer from mild depression are not categorised as a mentally ill but if it is severe depression then indeed they are considered so. It would therefore make sense that Gardner (1997) in his addendum IV recommends in the case of severe PAS that the legal approach should be: 1) court ordered transfer of primary custody to the alienated parent; 2) or court ordered transition site with a therapist monitoring a therapeutic programme with the child and anyone else who can be involved.