Carol S. Bruch (professoressa di legge presso l’univ. di Davies) viene ancora oggi menzionata da chi cerca di negare che alienare un bambino è un abuso per via di una polemica svoltasi nel 2001 con Richard Gardner (allora noto psichiatra infantile, nonché professore clinico di medicina presso l’università di Columbia).
Sebbene svoltasi sulle pagine della rivista Family Law Quarterly la polemica è scesa a livelli personali, ad esempio cadendo nel questionare il titolo accademico del prof. Gardner sottilizzando sulla differenza fra “Professore Clinico di Medicina” (Clinical Professor of Medicine) e “Professore di Medicina Clinica” (Professor of Clinical Medicine).
La professoressa di legge, nell’articolo completo disponibile a questo link, critica come non rigorosa l’analisi scientifica:
Parental Alienation Syndrome and Alienated Children
getting it wrong in child custody cases
Carol S. Bruch
This article examines mental health and legal responses when children resist visits with noncustodial parents. In Parental Alienation Syndrome and Alienated Children, it finds a lack of rigorous analysis that endangers children. The author concludes by suggesting better ways to evaluate new theories from the social sciences.
Lo psichiatra Gardner risponde come riportato nel seguito, elencando minuziosamente i punti in cui il suo pensiero è stato male interpretato dalla Bruch:
Family Law Quarterly 35(3):527-552, 2001
Comments on Carol S. Bruch’s Article
“Parental Alienation Syndrome and Parental Alienation:
Getting it Wrong in Child Custody Cases”
Richard A. Gardner. M.D.
All truth passes through three stages. First it is ridiculed.
Second it is violently opposed. Third it is accepted as self-evident.Arthur Schopenhauer (1788-1860)
Before addressing myself to the numerous misperceptions, distortions, and even fabrications that are to be found in this article, it is important to make a few comments about the author herself, especially with regard to her qualifications for writing this article. She is a research professor of law. From the biographical information provided about her on the University of California at Davis website, it is clear that she is a woman of accomplishment who has involved herself in many areas of the law. However, as important as her contributions may have been, there is nothing in her biographical information to indicate that she has spent significant time in family courts working directly with clients involved in child-custody disputes. Accordingly, she is very remote from the lawyers who are directly working with families involved in high conflict child-custody disputes. In short, she has not had significant experiences “in the trenches.”
In a footnote on the first page of the article (page 527) Bruch gives credit to three reference librarians at her law school. Again, we have three assistants who are operating in the cloistered environment of the law library, far from the reality of the outside world, especially the divorce courts, where the real PAS action is taking place. Furthermore, it is clear that she has not properly differentiated among the sources of her information, specifically, whether it be a learned journal or some newspaper article written by someone on assignment that day to become an “expert” on the subject. She has not properly concerned herself with the validity or credibility of her sources. Most important, the article is not balanced. Either she ignores a significant body of data that supports my work in the PAS realm, or dismisses it perfunctorily.
In footnote #2 she states:
“Errors or omissions are her own.”
Although the article appears in the reputable Family Law Quarterly and is written in a scholarly style, it is not a balanced article. Bruch makes consistent choices by quoting professionals and articles with only one point of view, and does not vary from this. She does not consider documents advancing a point of view that opposes her own, despite the widespread availability of these numerous articles and cases. Courts of law must deal with two sides of an issue. This article does not.
The number of misrepresentations in this article is so great that it would take an article of equal length, if not longer, to attempt to correct them all. What I will do here is comment on the most egregious of the various distortions, misrepresentations, and even fabrications.
First, Bruch focuses on false sex-abuse accusations in PAS and assumes that one equals the other. Nowhere in my writings is there any confirmation of this. What I do say in my writings is that a false sex-abuse accusation can be a spin-off of the PAS and my own experience has been that this occurs in about ten percent of cases. I have also stated that in my clinical experience the vast majority of these are generally false, but that still, on occasion, one sees a true sex-abuse accusation along with a PAS.
Page 528, footnote 3. Bruch quotes studies that describe one-to-two percent true sex-abuse accusations. What is misleading here is that these studies are dated 1990 and 1992, based on data from the 1980s, a time when the false sex-abuse accusation was not as generally appreciated. It is likely that studies from the same sources conducted today, 15 years later, would provide a higher percentage. That said, Bruch is still confirming the existence of the false sex-abuse accusation phenomenon. Our only difference is the percentage of cases in which this occurs. From the vantage point of the innocent victim, it does not matter whether he (she) is in the one-percent group, the twenty-percent group, or any other percent group; that individual is still being falsely accused and may very well be sentenced to jail (as some such unfortunate people actually are).
Page 528, footnote 3. Bruch quotes a single article by K. Faller that Bruch repeatedly references throughout her article. However, Bruch selectively ignores my response article, which was published in the next issue (Child Maltreatment, 3(4):309-312) (Gardner, 1998a). Furthermore, Bruch fails to mention that the Faller article was published after I had testified in support of the plaintiff in a malpractice suit against her in Michigan (see Champney v. Faller et al., Washtenaw County #95-4760-CK).
Bruch states (p. 528-529):
“Although Dr. Gardner sometimes states that his analysis does not apply to cases of actual abuse, the focus of his attention is directed at discerning whether the beloved parent and child are lying, not whether the target parent is untruthful or has behaved in a way that might explain the child’s aversion.”
This quote is another example of the limitations of Bruch’s research. She states that I “sometimes state” that my analysis (of PAS, presumably) does not apply to cases of actual abuse. In fact, I routinely state that the diagnosis of PAS does not apply to cases of actual abuse (Gardner, 1992a, 1998b, 1999). She continues with the criticism that I am not evaluating for any weaknesses in the target parent’s behavior. In every case I assess the target parent as to whether or not he (she) has abused or neglected the children, or exhibited any other behavior that might contribute to their alienation. Chapter Nine of my 1998 book on the PAS is devoted to my techniques for making this differentiation (Gardner, 1998b). In addition, I have been involved in many cases in which, after an evaluation, I informed the client engaging my services that I could not support his (her) position because the children’s rejection was grounded in real abuse/neglect that became apparent in the course of the evaluation.
In addition, it is important to note that prior to being retained by a client to conduct an evaluation, I require the prospective client to sign my contract which confirms recognition “that Dr. Gardner may not ultimately support my position in the litigation.” In practice, this is not an uncommon outcome. When it occurs, the client usually elects, in one way or another, not to have me testify or submit my findings to the litigation at hand and my involvement with the matter ends then and there. Accordingly, my negative findings (e.g. no PAS but rather abuse) remain effectively off the record.
What then is on the record are the cases in which my findings support and coincide with the client’s position. My detractors shrewdly exploit this by accusing me of being a “hired gun,” fully available to absolve anyone who is willing to pay me. This contention couldn’t be further from the truth, but the rules of doctor/patient confidentiality prevent me from countering this accusation by citing those cases in which my evaluations failed to support the clients allegations of PAS or failed to exculpate them from accusations of abuse.
Bruch states (p. 529, footnote 6):
“Two examples are his efforts to distinguish true from false allegations and his blanket advice to judges that they should refrain from taking abuse allegations seriously, even when supported by a therapist who has seen the child.”
Once again, Bruch overstates her thesis. Her use of the word blanket implies that she has comprehensively looked at every case in which I have testified, and that in every possible case of sex abuse that arises in the context of divorce, I recommend that judges ignore the sex-abuse accusation. This is simply not true. I have taken care to make the proviso that only after a thorough evaluation has been conducted can one determine whether or not sex abuse has occurred. The elaborate protocols I use, generally requiring three or four hours of interviewing with the child alone, are described in two of my books (Gardner, 1992b, 1995). They also describe the detailed evaluation I conduct of the accused party, especially with regard to the presence or absence of pedophilic tendencies. This inquiry, of course, takes even more time. If, after this extensive evaluation, I find that bona-fide sex-abuse is extremely unlikely and that the child’s complaints are not related to the target parent’s behavior, but to the alienating parent’s and the child’s behavior (PAS manifestations), then I do advise that the children’s complaints not be taken seriously, because they are the products of fabrications and/or delusions-a result of their programming.
Unfortunately there are therapists who take PAS children’s allegations seriously, much to the detriment of all family members. This does not mean that I do not first make the differentiation between true and false accusations. I do so in every case. Furthermore, I am very much aware of the fact that there are bona fide abusers who claim that they are innocent of abuse and that the children’s accusations are the products of the other parent’s PAS manipulations. As mentioned, Chapter Nine of my 1998 PAS book is devoted completely to differentiating the true from false accusations in such cases. One of the purposes of this chapter is to “smoke out” these bona fide abusers who try to claim that they are merely innocent victims of PAS indoctrinations.
Bruch states (page 530):
“First, Gardner confounds a child’s developmentally related reaction to divorce and high parental conflict (including violence) with psychosis.”
Again, we see another gross misrepresentation. What I do state is that my experience has been that severe PAS represents about ten percent of the cases I have personally seen. Furthermore, I state that in some of those cases we do see paranoia in the accusing parent, which is a form of psychosis. In such cases, what one most often sees is a circumscribed delusional system centering on the victim parent. The DSM-IV diagnosis Delusional Disorder is often applicable here. In those cases, I do consider the indoctrinating parent to be suffering with this circumscribed paranoid delusional system centering on the target parent-a delusion that warrants the term psychosis. The children get swept up in this delusion and the dyad justifiably warrants the DSM-IV diagnosis, Shared Psychotic Disorder (Folie-à-Deux). When an unskilled therapist does not recognize the PAS, he (she) may join in with the parent-child dyad. In such cases the folie-à-trois designation is warranted. I believe that most family court lawyers, as well as mental health professionals who work with these families, have seen this phenomenon.
Bruch states (page 531) that my work has the “practical effect of impugning all abuse allegations, allegations which Gardner asserts are usually false in the divorce context.” PAS children routinely allege physical, verbal, and emotional abuse. In the context of the PAS, such accusations are usually false. Furthermore, if my clinical findings are representative, about ten percent of PAS children may allege sexual abuse. Bruch is correct in stating that I consider most of these PAS derived sexual-abuse accusations to be false. (In contrast, I consider most intrafamilial accusations to be true). There is a vast amount of scientific literature describing the phenomenon of false accusations occurring in the context of child-custody disputes. These omissions reveal the bias that pervades Bruch’s argument.
Bruch states (p. 532):
“Worse yet, if therapists agree that danger exists, Gardner asserts that they are almost always man-hating women who have entered into a folie-à-trois with the complaining child and concerned parent.”
Once again, Bruch overstates her case. Her phrase “if therapists agree that danger exists, Gardner asserts…” is in itself misleading. She implies that whenever a therapist-any therapist, or group of therapists-concludes that abuse has taken place it must have happened. This is an overly credulous position. Those in the field know well that many errors are made in the typical evaluation, that there are many levels of evaluator competency, and that nothing conclusive can be said about their findings unless their findings have been thoroughly critiqued for proper evaluation methodology.
Moreover, the word always is a very dangerous word to use, especially in a learned document. I rarely use that word, whether in speaking or writing. Bruch will have a long search if she is looking to find that word in any of my publications, especially with regard to the folie-à-trois phenomenon. Yes, there are man-hating women who do join in with PAS programmers to victimize and scapegoat a target father. However, there are also male therapists who do this, and there are women therapists who do this who are not man-haters.
Bruch states (p. 534):
“In sum, children’s reluctance or refusal to visit noncustodial parents can probably be better explained without resorting to Gardner’s theory. Studies that followed families over several years, for example, report that visits may cease or be resisted when a variety of reasons cause custodial parents and children to be angry or uncomfortable with the other parent.”
Bruch would have the reader believe that I have no appreciation of alternative reasons for children’s alienation from a parent other than PAS. Such a statement is ludicrous. It indicates complete ignorance of my publications, books and articles that were written long before I wrote my first article on the PAS in 1985. I describe in these publications many other reasons why children are antagonistic toward one of the parents, reasons that have nothing to do with PAS. Even in my books on the PAS I advise examiners to be vigilant and explore alternative explanations for the children’s alienation. I have repeatedly stated that when bona fide abuse exists, the PAS diagnosis is not applicable. Furthermore, for each of the diagnostic criteria delineated in my books on sex abuse I detail the manifestations when the accusation is true and the manifestations when the accusation is false (Gardner, 1992b, 1995). Bruch completely ignores this pervasive principle in my diagnostic protocols.
Bruch continues (p. 534-535):
“First, Gardner is broadly (but mistakenly) believed to be a full professor at a prestigious university.”
Bruch is basically stating here that I misrepresent myself when I claim that I am Clinical Professor of Child Psychiatry at Columbia University, College of Physicians and Surgeons. If Bruch is correct here, then I have somehow duped the university and the medical school into listing my name for over 39 years on their rosters of faculty members, as well as convincing them to biannually reconfirm my appointment. And this occurs only after their review of extensive documentation, which I am required to submit to determine that I am still worthy of holding the appointment. The fact is that I was the first clinician in private practice to achieve full professorial rank in the Child Psychiatry Department at Columbia. In alleged confirmation of this fabrication, Bruch quotes from Newsweek (she has no hesitation using as references newspapers and magazines, giving them equal status with learned publications) that “the title Gardner enjoys indicates neither full faculty membership nor research accomplishment.” In reality, I had to satisfy the same rigorous qualifications as the full-time academicians to achieve full professorship rank at Columbia University Medical School, including: review of my peer-reviewed published articles, my books, comments by student evaluators, contributions to the field of child psychiatry, invited lectures throughout the U.S. and abroad, research accomplishments, and anonymous letters of recommendation from faculty members from other medical schools. Bruch would give the impression that the Columbia University Medical School frivolously dispenses its professorships. This is absurd, and is an important example of the kind of serious factual inaccuracies that underlie her scholarly style.
Bruch continues (page 535):
“Because this aura of expertise accompanies his work, few suspect that it is mostly self-published.”
This is a fabrication. As a research professor, Bruch knows full well that articles published in learned peer-review journals are not self-published. In contrast, books can be self-published. I have over 150 articles published in scholarly peer-review journals. In addition, prior to 1978 I published 16 books with major publishers (Doubleday, G.P. Putnam’s, Prentice-Hall, Avon Books, Bantam Books, and Jason Aronson) before I began publishing through Creative Therapeutics. I still get invitations from more well-known publishers to write books, and I last accepted an invitation from Bantam Books to do so in 1991.
Bruch states (p. 535-536):
“. . . receives referrals from the websites of fathers’ organizations, and provides packaged continuing education courses for professionals.”
It is true that I receive referrals from fathers’ organizations. The implication here is that there is something wrong with this. Many of these men have been victimized terribly by PAS accusations. However, I also receive many referrals from mothers, even mothers who belong to women’s organizations, who also have been victimized by PAS. And this has been even more the case in the last few years. Most of the PAS examiners with whom I have been in contact have observed, as have I, that men are now as likely to become PAS indoctrinators as women. Elsewhere I have described this gender shift (Gardner, 2001a, 2002a).
The statement that I “provide packaged continuing education courses for professionals” is a blatant fabrication. I do not provide packaged continuing education courses for professionals. Bruch does not provide the names of these so-called packages and/or courses. She cannot do this because they do not exist, either on my website or anywhere else. We see here yet another example of her irresponsibility. However, even if I did provide such packages, is there something wrong with that? Professional organizations are always encouraging their members to enhance their knowledge of their fields and continue their education.
Bruch continues (p. 536):
“Finally, he often inaccurately represents or suggests that PAS is consistent with or endorsed by the accepted work of others.”
My website (www.rgardner.com/refs) currently lists 137 peer-reviewed articles by over 150 authors. This indicates acceptance. On the same website I list 66 courts of law that have recognized the PAS. These important lists provide compelling proof that PAS is accepted by the professionals who wrote those articles and the peer reviewers who accepted them for publication. It also indicates that PAS was accepted by at least 66 judges in courts of law who saw fit to mention the full term PAS in their rulings and ruled accordingly. Therefore, there is nothing “inaccurate” about my representation. What is accurate is her misrepresentation of me.
Bruch states (page 537):
“…whenever child sexual abuse allegations or disrupted visitation patterns arise in the United States, one must now be prepared to confront a claim asserting that PAS is at work, not abuse or other difficulties.”
An unseverable part of any PAS evaluation is to assess for the presence of (parental) “abuse or other difficulties.” Her argument goes on to say that a database search of reported(emphasis mine) cases between 1985 and 2001 reveal numerous mental health professionals in addition to Gardner having testified as to the presence of PAS within a custody dispute, “although far fewer were willing to recommend that custody be transferred and contact with the primary (alienating) custodian terminated.” The author’s implication is that even evaluators advocating PAS are unwilling to follow Gardner fully by recommending a change of custody. This is a distortion, in that most PAS experts agree with me that change of custody is appropriate only in severe cases of PAS, and severe cases are but a small subset of PAS cases as a whole. I will agree, however, that I am more likely to recommend custodial transfer in the severe cases than many other evaluators, because they have more commitment to the therapeutic treatment of such cases than I. I believe, however, that my follow-up study of 99 children (Gardner 2001b) provides strong support for my position regarding these cases and that ultimately other such studies will confirm that reduction of access to the alienator is the only hope for children in the severe category of PAS.
Bruch than professes to be “profoundly disturbed” by the degree to which expert witnesses, judges and attorneys have been invoking PAS, and the almost total absense of inquiries into its scientific validity. She then launches into a footnote which asserts that a compiled list of PAS positive caselaw on the Gardner website is misleading because it consists “most(ly) of cases unchallenged as to scientific validity of PAS.” (fn39). Bruch’s footnote is itself misleading in its own right in that she then cites four cases as examples of how the list is misleading. She fails to point out that two of her four case examples are not even found on Gardner’s list (Crews v. McKenna and Loll v. Loll). Basically, what she has done here is claim that my list includes cases in which the court did not recognize PAS and then cites as examples of such cases two cases that were never on my list. Equally reprehensible is her claim that in the other two cases the court did not recognize the PAS. In actuality, the court did recognize the PAS in these cases: one is even an appellate ruling (Truax v. Truax). Again we see grossmisrepresentation.
Bruch would have the reader believe that in 66 different courts of law-spread across almost as many jurisdictions in the U.S., Canada, Australia and Germany-judges, attorneys, and mental health professionals, after careful review of the facts in the case, subscribe to PAS but that this trend is no measure of validity unless it has been subjected to a Frye or Daubert hearing.
With regard to PAS Frye tests, Bruch belies her underlying bias, devoting a substantial footnote (19 lines) to discussing an older case in which PAS did not survive the Frye challenge, and begrudgingly adding a passing reference (2 lines) to Kilgore v. Boyd, a more recent case in which PAS was found to satisfy the Frye Test requirements. The court’s decision followed a two-day hearing in which both Richard A. Warshak, Ph.D. and I testified. This case was appealed and the appellate court declined to even reconsider the trial court’s Frye test decision.
It may be of interest to the reader to know, that in January 2002 a court in Wheaton, Illinois-in a case in which I testified along with Christopher Barden, Ph.D., L.L.D.-ruled that the PAS does satisfy Frye Test criteria for admissibility (see Bates v. Bates, 18th Judicial Circuit, Dupage County Il. Case No 99D958, January 17, 2002). One cannot fault Bruch for not including the second Frye Tests decision because it was probably handed down too late for inclusion in her article.
Page 538. Bruch speaks here about reported cases in which the PAS has not been accepted and footnotes only one case to support her statement. She does not speak about reported cases in which the PAS has been accepted. In most of the cases in which I have testified on the PAS, the court has admitted my testimony and has not denied the existence of the disorder. However, more important, she would lead the reader to believe that reported cases represent the majority of, if not all, family court cases. This is not true. Only a small percentage of family court cases ever get reported. Most readers would not generally appreciate this misrepresentation. The word usually is important here. She gives no percentages.
With regard to my Sex Abuse Legitimacy Scale (SAL Scale) Bruch states (p. 539):
“Following considerable scientific criticism, Gardner withdrew the test he had constructed to determine whether sexual abuse had taken place.”
Again, Bruch is wrong here. The SAL Scale was published in 1987. I withdrew it in 1989, two years later, predominantly because too many evaluators were ignoring the requirement that it only be used when all three parties (mother, father, and alleged child victim) were interviewed. Bruch is again quoting here newspaper articles as her source of information, making no differentiation between learned publications and articles written by journalists-thus compromising her research.
Page 541. Here Bruch refers to the PAS as a “street myth.” I consider this a very revealing statement. It provides confirmation that Bruch has absolutely no experience “in the street,” “in the trenches,” where family lawyers and mental health professionals daily see the PAS. From her “ivory tower,” she somehow views it as a street myth. She would do well to go into the streets herself and see whether or not PAS exists.
On the same page, Bruch expresses some puzzlement and even amazement that the American Bar Association’s section on Alternate Dispute Resolution gave its annual prize to an article on the PAS. Apparently, the American Bar Association knows something she doesn’t. More importantly, as far back as 1991, the American Bar Association commissioned Clawar and Rivlin to write their now classic, Children Held Hostage: Dealing with Programmed and Brainwashed Children. The authors describe therein hundreds of cases of PAS, and references my book on the subject (Gardner, 1987). Lawyers all over the country and even abroad, continually refer to their seminal work.
Page 541ff Bruch makes reference to the work of Johnston, Kelly, and Sullivan. She somehow has the idea that these people have improved upon my work. A careful reading of their material and mine will confirm that we are both seeing the same cases, the same range of alienated children from mild, to moderate, to severe. The only difference is that they are giving the disorder a different name. This produces some confusion for Bruch who needs to maintain the delusion that PAS does not exist. Kelly and Sullivan even recommend custodial transfer in the severe cases, which is what I have been criticized for. Workers in the field know well that this is the only hope for children who have been severely alienated. Changing the name from PAS to PA does not cause the disorder to evaporate. PAS has been written on by professionals around the world. My website lists articles in English, French, Dutch, and German. At this point I am co-editing a volume completely devoted to the parental alienation syndrome. Submissions are coming in from authors in at least eight different countries: the U.S., Australia, Canada, The U.K., Sweden, Germany, The Czech Republic, and Israel. If we are to believe Bruch, all these people have been swept up in my delusion that PAS exists. Along these lines Bruch states (549):
“Until she provides further clarification, Johnston’s apparent support for forced contact between the members of high-conflict families should be construed narrowly, given her many publications questioning the wisdom of or need for such approaches.”
Johnston, for all her criticisms of me, has come to recognize that forced contact may be the only hope for children with severe PAS, whether or not she wants to call the disorder PAS. Since Bruch has cited her so frequently, she cannot dismiss Johnston’s work, but tries to minimize the direction her work has inexorably taken as Johnston continues to work “in the trenches.”
Page 547 Bruch quotes Wallerstein:
“Most dramatically, Wallerstein reveals that these children’s alignments were transient, with every child later abandoning his or her harsh position, mostly within one or two years and all before the age of eighteen.”
This is reported as having been stated in a telephone conversation with Judith Wallerstein. My own follow-up study of 99 PAS children, statistically analyzed and not anecdotally reported, provides very different conclusions. The study provides compelling evidence that the vast majority of severe PAS cases (91%) will not return to a good relationship with the target parent if the court does not force it. The summary of that article is found here: (http://www.rgardner.com/refs/ar8-excerpt.html. Bruch gratuitously dismisses this peer-reviewed article, giving it absolutely no credibility. This difference between Wallerstein’s experiences and my own is easily explained. Wallerstein saw her original group in the 1960s and 1970s. At that time, under the tender-years-presumption, mothers almost automatically gained custody of their children. High-conflict divorce, at that time, was less related to custody than to property and even as to whether or not divorce would be granted. In the 1970s, when the tender-years-presumption was replaced with the best interests of the child presumption, and preference for mothers was generally considered “sexist,” courts were required to be gender-blind with regard to assigning primary custodial status. It was in this setting that parents began to program their children to gain leverage in courts of law-thus the birth of the PAS. Therefore, comparison between Wallerstein’s population and my group is not possible, and the conclusions that Bruch presents here are therefore moot.
Page 547, footnote 73. Bruch again makes reference here to a telephone conversation with Dr. Judith Wallerstein on April 10, 2001. There was no telephone conversation with me, the person who is named on practically every page of her article, the person who is the primary target of her diatribe. We see here another example of Bruch’s extreme bias, her selectively ignoring data that might shake and even tumble the house of cards she has built in this article.
Page 549. Bruch states:
“It is puzzling that Johnston expressly endorses many coercive aspects of Sullivan and Kelly’s legal framework”
Although Johnston, Sullivan, and Kelly are very critical of my work, they are seeing the same children-so ubiquitous is the PAS, “out in the streets”-and recognize that in severe cases coercive techniques are the only hope for the children and the target parent. She is puzzled here because these authorities, whom she is citing to discredit me, are making recommendations that are strikingly similar to my own, and thus could be seen as supporting my position.
Page 550-551 Bruch refers to the specious argument that PAS is not to be taken seriously because it is not in DSM-IV. In response to the absurdity in this statement I quote here a segment from my article Parental Alienation Syndrome vs. Parental Alienation: Which Diagnosis Should Evaluators Use in Child-Custody Disputes (Gardner, 2002b) that addresses itself to this point:
To say that PAS does not exist because it is not listed in DSM-IV is like saying in 1980 that AIDS (Autoimmune Deficiency Syndrome) does not exist because it was not then listed in standard diagnostic medical textbooks. DSM-IV was published in 1994. From 1991 to 1993, when DSM committees were meeting to consider the inclusion of additional disorders, there were too few articles in the literature to warrant submission of the PAS for consideration. That is no longer the case. It is my understanding that committees will begin to meet for the next edition of the DSM (probably to be called DSM-V) in 2002 or 2003. Considering the fact that there are now at least 135 articles in peer-review journals on the PAS, it is highly likely that by that time there will be even more articles. (The list of peer-reviewed PAS articles is to be found on my website,www.rgardner.com/refs, a list that is continually being updated.)
It is important to note that DSM-IV does not frivolously accept every new proposal. Their requirements are very stringent with regard to the inclusion of newly described clinical entities. The committees require many years of research and numerous publications in peer-review scientific journals before considering the inclusion of a disorder, and justifiably so. Gille de La Tourette first described his syndrome in 1885. It was not until 1980, 95 years later, that the disorder found its way into the DSM. It is important to note that at that point, Tourette’s Syndrome became Tourette’s Disorder. Asperger first described his syndrome in 1957. It was not until 1994, 37 years later, that it was accepted into DSM-IV and Asperger’s Syndrome became Asperger’s Disorder.
Bruch criticizes PAS because it conforms to the “medical model” and ignores the family systems model. The implication here is that the medical model cannot be applied to family issues. Somewhat paradoxically, however, she believes that inclusion of PAS in DSM-IV would indicate that PAS has greater credibility as a disorder. Yet each diagnosis in DSM-IV follows the medical model. In order to make a diagnosis, the physician must compare the patient’s symptoms with those listed in the book. The DSM committees have repeatedly rejected family systems diagnoses because they are nebulous and speculative. They are almost impossible to subject to controlled studies, especially studies in which statistical verification is warranted. Again, the implication is that I do not concern myself with family interrelationships. An unbiased reader can examine any page of any of my books on the PAS and see mention of family relationships and family systems. Last, I am certain that Bruch would want her doctor to follow the medical model when diagnosing any illness that she may have.
There are many other criticisms I have of the Bruch article, which is not the disinterested, comprehensive survey of the material available on PAS that it represents itself to be. My final conclusion is that it is not I who am biased and misrepresenting the material; it is clearly Bruck herself.
Last, I believe that all of Bruck’s attempts to discredit and deny PAS will prove futile, her obvious great labors toward that goal notwithstanding. PAS exists, and corroboration of that is the 66 judges who have cited it, and the over 150 authors who have written about it. Whether one wants to call it alignments, PA or PAS, we are all describing the same phenomenon, and this alone argues for the fact that we are describing a problem that is real. It is a syndrome in every sense of the word. In fact, it is “purer” than many of the syndromes described in DSM-IV. The phenomenon whereby, in the context of a high-conflict child-custody dispute one parent programs the child against the other, and the child joins in with his or her own contributions, has repeatedly been seen in courts of law in the last twenty years. Mental health professionals, lawyers, and judges will ultimately agree that the only hope for most of the children in the severe category is significant reduction of the children’s access to the programming parent (now approximately 50 percent fathers) and that if this is not done, the vast majority of these children will suffer lifelong alienation from a good, loving parent.
Richard A. Gardner, M.D.
Clinical Professor of Child Psychiatry
College of Physicians and Surgeons
_______ (1999), Differentiating between the parental alienation syndrome and bona fide abuse/neglect. The American Journal of Family Therapy, 11127(2):97-107
_______ (2001b), Should courts order PAS children to visit/reside with the alienated parent? A follow-up study. American Journal of Forensic Psychology, 19(3):61-106.
_______ (2002a), Denial of the parental alienation syndrome (PAS) harms women also. (in press)
_______ (2002b), Parental Alienation Syndrome vs. Parental Alienation: Which diagnosis should evaluators use in child-custody disputes? The American Journal of Family Therapy, 30(2):101-123.
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