The paradigm for defining the pathology of “parental alienation” is shifting. Gardner led everyone down the wrong path when he proposed that “parental alienation” represented a unique new form of pathology unrelated to any other form of pathology in all of mental health – a “new syndrome.” Gardner was wrong. The pathology of “parental alienation” […]
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Psychopathology and theconceptualisation of mental disorder:The debate around the inclusion of Parental Alienation in DSM-5
Content and Focus:
This paper will briefly consider the general conceptualisation of mental disorder before focusing on the specific case of Parental Alienation (PA), variously termed a disorder or a syndrome.By virtue of the recent debate surrounding its potential inclusion in the newest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), this is a topical example. A critical analysis of the petition for its inclusion within DSM-5 will both highlight the range of professionals’ views, and also consider ethical and practical issues inherent in the conceptualisation of a mental disorder and its classification within the evolving DSM. Following this general and specific conceptualisation of mental disorder, the tensions that diagnosis raises for counselling psychology will be briefly deliberated. The positive aspects of classification and diagnosis will be acknowledged, whilst highlighting the focus on the subjective experience of individual clients.
Despite the controversy about the concept, validity and reliability of PA, the evidence suggests that there is more agreement than disagreement among practitioners and professionals in the field. Whilst there is a general consensus that alienation exists within a distinct population who would benefit from intervention, there is no consensus on its inclusion in DSM-5. Irrespective of its inclusion in any nosology,the recent debate has highlighted the need for further research. A greater understanding of the processes,symptoms and behaviours involved in PA will enable the needs of children and families involved in high- conflict separation to be better addressed.
Some experts say the extreme hatred some kids feel toward a parent in a divorce is a mental illness
From an early age, Anne was taught by her mother to fear her father. Behind his back, her mom warned that he was an unpredictable and dangerous; any time he’d invite her to do anything—a walk in the woods, a trip to the art store—she would craft an excuse not to go. “I was under the impression that he was crazy, that at any moment he could just pop and do something violent to hurt me,” says Anne, who prefers that only her middle name be used to guard her family’s privacy. Typical of a phenomenon some mental-health experts now label “parental alienation,” her view of him became so negative, she says, that her mother persuaded her to lie during a custody hearing when the couple divorced. Then 14, she told the judge that her dad was physically abusive. Was he? “No,” she says. “But I was convinced that he would [be].” After her mother won custody, Anne all but severed contact with her father for years.
If a growing faction of the mental-health community has its way, Anne’s experience will one day soon be an actual diagnosis. The concept of parental alienation, which is highly controversial, is being described as one in which children strongly attach to one parent and reject the other in the false belief that he or she is bad or dangerous. “It’s heartbreaking,” says William Bernet, a child and adolescent psychiatrist and professor at Vanderbilt University School of Medicine, “to have your 10-year-old suddenly, in a matter of weeks, go from loving you and hiking with you…to saying you’re a horrible, ugly person.” These aren’t kids who simply prefer one parent over the other, he says. That’s normal. These kids doggedly resist contact with a parent, sometimes permanently, out of an irrational hate or fear.
Bernet is leading an effort to add “parental alienation” to the next edition of theDiagnostic and Statistical Manual of Mental Disorders, the American Psychiatric Association’s “bible” of diagnoses, scheduled for 2012. He and some 50 contributing authors from 10 countries will make their case in the American Journal of Family Therapy early next year. Inclusion, says Bernet, would spur insurance coverage, stimulate more systematic research, lend credence to a charge of parental alienation in court, and raise the odds that children would get timely treatment.
But many experts balk at labeling the phenomenon an official disorder. “I really get concerned about spreading the definition of mental illness too wide,” says Elissa Benedek, a child and adolescent psychiatrist in Ann Arbor, Mich., and a past president of the APA. There’s no question in her mind that kids become alienated from a loving parent in many divorces with little or no justification, and she’s seen plenty of kids kick and scream all the way to the car when visitation is enforced. But, she says, “this is not a mentally ill child.”
The phenomenon has been described for many decades, but it became a cause célèbre in 1985, when Richard Gardner, a clinical professor of psychiatry at Columbia University, coined the term “parental alienation syndrome.” As more dads fought fiercely for joint custody, he observed a surge in the number of children suffering from a distinct cluster ofsymptoms, including a “campaign of denigration” against one parent that sometimes included a false sex-abuse accusation and automatic parroting of the other parent’s views.
But sound research supporting a medical label is scant, critics say. The American Psychological Association has issued a statement that “there is no evidence within the psychological literature of a diagnosable parental alienation syndrome.” What’s more, concern has grown that “PAS” could be invoked by an abusive parent to gain rights to a child who has good reason to refuse contact, says Janet Johnston, a clinical sociologist and justice studies professor at San Jose State University who has studied parental alienation. In teens, she notes, parental rejection might be a developmentally normal response. Anecdotal reports have surfaced that some kids labeled as “alienated” have become suicidal when courts have ordered a change of custody to the “hated” parent, she says.
In any case, divorcing parents should be aware that hostilities may seriously harm the kids. Sometimes manipulation is blatant, as with parents who conceal phone calls, gifts, or letters, then use the “lack of contact” as proof that the other parent doesn’t love the child. Sometimes the influence is more subtle (“I’m sure nothing bad will happen to you at Mommy’s house”) or even unintentional (“I’ve put a cellphone in your suitcase. Call when everyone’s asleep to tell me you’re OK”). It’s important to shield kids from harmful communication, says Richard Warshak, a clinical professor of psychology at the University of Texas Southwestern Medical Center and author of Divorce Poison. If something potentially upsetting about an ex must be conveyed, he advises imagining how you would have handled the conversation while happily married; how would you have explained Mom’s depression, say?
“The long-term implications [of alienation] are pretty severe,” says Amy Baker, director of research at the Vincent J. Fontana Center for Child Protection
in New York and a contributing author of Bernet’s proposal. In a study culminating in a 2007 book, Adult Children of Parental Alienation Syndrome, she interviewed 40 “survivors” and found that many were depressed, guilt ridden, and filled with self-loathing. Kids develop identity through relationships with both their parents, she says. When they are told one is no good, they believe, “I’m half no good.”
Now 23, divorced, and a parent herself, Anne has recognized only recently that she was manipulated, that her long-held view of her father isn’t accurate. They live 2,000 miles apart but now try to speak daily. “I’ve missed out on a great friendship with my dad,” she says. “It hurts.”