Unpublished Manuscript
Submitted for Publication



Richard A. Gardner, M.D.

There has been general acceptance in both the legal and mental health literature of the three levels of parental alienation syndrome (PAS) children. There has also been general recognition that the three levels refer to the degree to which the children have become alienated. However, the degree to which alienating parents have indoctrinated the children has not generally been specifically quantified. The purpose of this article is to provide criteria for dividing alienating parents into similar levels, namely, mild, moderate, and severe. Just as the delineation of the children’s levels is important if evaluators are to make proper recommendations to courts with regard to therapy and custodial placement, a similar differentiation among alienating parents can be similarly useful, if not crucial.

The history of medicine is, in a sense, the history of our ability to make refinements in diagnostic discriminations. What may be considered one disease by one generation may be considered two or three by the next. One of the main reasons why Hippocrates is considered to be the "Father of Medicine" is that he had the unique capacity to make such discriminations. Prior to his time, people suffered with "fits." He recognized that there were different kinds of fits. Those who had traveled through stagnant marshes and breathed in what he considered to be "bad air" were considered to be suffering with malaria (mala, aria). Others were considered to have been possessed by forces from outside the body. These people were diagnosed with epilepsy, that is, they had seizures (lepsis) from above (epi). Still others (especially women) were considered to have fits related to the wandering of their uteruses (hysteros). Such women were given the diagnosis hysteria. The greater one’s ability to differentiate among the various subtypes of a disease, the better one’s position to treat the disease. Here, I apply this principle to the PAS alienator, a principle that I have applied previously to PAS children.

I am certainly not the first to attempt to make this differentiation. Darnell (1) has described three types of alienators: The naïve alienator, the active alienator, and the obsessed alienator. I have not found his categorization useful. Even before finding out what the three types were, I was dubious that there are only three types. What he has done is the equivalent of saying that there are three types of women, three types of men, three types of boys, and three types of girls. There are many types. In fact, the types probably run into the hundreds with significant overlap. Accordingly, I have not attempted to divide PAS alienators into specific types. Rather, I divide them into levels, with full recognition that there can be a progression from the mild to the moderate to the severe, just as there may be similar progression for the levels seen in PAS children.

Whereas the diagnosis of PAS is based on the child’s symptom level (Table 1), the court’s decision for custodial transfer should be based primarily on the alienator’s symptom level (Table 2) and only secondarily on the child’s level of PAS symptoms. Accordingly, just as it is crucial that the evaluator make an accurate assessment of the PAS child’s level of alienation, it is equally crucial that the evaluator properly differentiate among the three levels of PAS alienators. As is true for the child, evaluators do well to view the alienator’s symptoms as lying on a continuum: from the mild, to the moderate, to the severe. They should also recognize that there may be fluctuations back and forth along this continuum. This is especially the case as the court hearings become imminent. At those times, the alienating parent may shift back from severe to moderate, and even to mild, from the recognition that the alienating maneuvers are more likely to be brought to the attention of the court. Evaluators who are aware of this phenomenon should bring this to the attention of the court and emphasize the fact that in the past the alienator was at the moderate or the severe level and the present mild level of alienation is not to be trusted. Following the court hearing, it is highly likely that the alienator will revert back to the more intense level and even upgrade further the indoctrinational maneuvers.

General Personality Characteristics
of PAS Alienators

When I first began seeing PAS patients in the early 1980s, most of the indoctrinators were mothers. However, in the mid-1990s I began to see a gender shift, with more fathers becoming alienators. Elsewhere (2), I have described the reasons for this shift. In the last few years my experience has been that fathers are as likely as mothers to become PAS indoctrinators. Accordingly, the personality characteristics described in this section apply, for the most part, to both mothers and fathers. However, there are a few (which will be identified) that may have a gender predominance.

First, it is important to note that the characteristics described here may exhibit themselves to a minimal degree in the mild level of alienators but, over time, there is likely to be a progression from the mild, to the moderate, to the severe level. During this progression there is likely to be an elaboration and intensification of these qualities and the addition of new characteristics that may not have previously manifested themselves. The more characteristics present, the greater the likelihood that the parent has progressed into the moderate and even severe levels of PAS indoctrinator. The reader may note that the same principle applies to PAS children, who are likely to progress down the track from mild to moderate to severe, and the most important factor producing such progression is the duration of the indoctrinational maneuvers, especially in the course of protracted child-custody litigation.

PAS Indoctrinators Are Child Abusers

It is important also to emphasize that a parent who would indoctrinate a child against another parent is a deficient parent, an abusing parent. Inducting a PAS into a child is a form of child abuse because it can result in permanent destruction of a psychological bond with the good loving parent. In many cases it may be worse than physical abuse because children subjected to such abuses ultimately grow old enough to flee and even fight back. Even sexually abused children ultimately reach an age when they can remove themselves from the abuser, even though they may suffer permanent scars. In PAS, however, the scars may be lifelong and my follow-up study of 99 PAS children provides compelling evidence for this (3). Although the PAS indoctrinators are the true abusers in the family, they generally are successful in getting the children to reverse the situation entirely and to actually believe the alienated parent is the true abuser and that the alienating parent the victim of the alienated parent’s abuses. Accordingly, the children become convinced that they must continually protect themselves from the target parent’s alleged abuses. In actuality, the true victim is the target parent, and the PAS children are also victims because their brains have been poisoned by the indoctrinations of the alienating parent. Such conversion, such "turning things upside down," is typical of the PAS.

The Deceitfulness of PAS Indoctrinators

PAS indoctrinators are very comfortable with being deceitful. Most often they fully recognize that they are inculcating into their children lies about the victim parent. For them, fabrication is "the name of the game." For them, the end justifies the means. Generally, they have little guilt over the grief that their deceitfulness causes the alienated parent. Typically, they have no sympathy and no empathy for the pain suffered by the victim parent as a result of their duplicity. And this is one of the factors that justifies the Antisocial Personality Disorder diagnosis for some PAS alienators (see below). Also, they serve as a model for, as well as teach, their children to be similarly deceitful. In this way they engender PAS children’s guiltless disregard for the feelings of the victim parent.

My experience has been that most PAS indoctrinators are not full-blown psychopaths in spite of the pervasiveness of their deceitfulness. In most cases their deceitfulness is confined to issues that relate to the inculcation of a parental alienation syndrome in their children. Accordingly, they lie to their children with regard to the alleged depravities of the victim parent. They lie to their children with regard to the dangers that might befall them if they are to have close contact with him (her). And they generally lie about the allegedly noxious behavior of the friends and extended family of the victim parent, people who previously might have had loving relationships with the children. Because their deceitfulness is generally confined to this small group of people, they usually do not qualify for the antisocial personality disorder diagnosis. In the context of the PAS indoctrinations they can reasonably be referred to by the lay term "pathological liars." But even here the term may not be applicable to other people whom they encounter.

Typically, they are deceitful to their lawyers, who generally accept as valid their most preposterous complaints. Lawyers typically willingly suspend disbelief, because it serves the purposes of zealously representing the client. If they were to express their dubiety about their clients’ ludicrous deceptions, it is possible they might lose the client, who could hire another attorney who foregoes questioning the obvious inconsistencies and absurdities in the campaign of deception being perpetrated by the alienating parent.

The Grandiosity of PAS Indoctrinators

PAS indoctrinators consider themselves superior parents. Actually, they are inferior parents and one usually sees other examples of parenting deficiencies unrelated to the PAS. The examiner does well to look for the presence of these other deficiencies, deficiencies not directly related to the defect of being a PAS indoctrinator. The greater the number of these, the greater the likelihood the indoctrinator would be considered to warrant the designation of severe PAS indoctrinator. Of course, the examiner does well to bring the court’s attention to these additional deficiencies.

There is often grandiosity associated with such feelings of superiority and the belief that the child not only would lose nothing if the target parent were to be totally eliminated from the child’s life, but would be better off. The target parent is now viewed as an abuser, even though before the separation he (she) might have been viewed as a good, loving parent and, in many cases, an exemplary parent. Associated with the grandiosity is the notion that there will absolutely be no loss to the children if they never have any contact at all with the target parent. The only parent the children need is the alienator. The rage of alienators is often so great that they blind themselves to the obvious fact that child rearing is an enormous job and that good parents generally need all the help they can get. Indoctrinating a PAS, then, is a very stupid (and I do not hesitate to use the word) thing to do because alienators are depriving themselves of a person who is, more than anyone else in the world, dedicated to being of help in the child-rearing process. This grandiosity, when present with associated factors, may justify the Narcissistic Personality Disorder diagnosis (see below).

Often, overprotectiveness is associated with such grandiosity. Alienators often consider themselves perfect parents and, by contrast, view the victim parent as significantly defective. Associated with overprotectiveness is the notion instilled in the children that the world is a dangerous place, and only by staying ever at the side of the overprotective parent can the children be safe. Such indoctrinations contribute to the children’s belief that when alone with the alienated parent they are in danger.

The Utilization of Denial Mechanisms

PAS indoctrinators must be comfortable with the utilization of the mechanism of denial, as well as comfortable believing things that have no basis in reality. In extreme cases, PAS indoctrinators are delusional (see below).

The mechanism of denial is operative when the alienating parent does not appreciate how detrimental PAS indoctrinations are to the children, both in the present and in the future. The indoctrinators deny the confusion, the tension, the anxieties, the impotent rage, and the wide variety of other psychopathological mechanisms engendered in the children by their being subjected to the abuses perpetrated upon them by the indoctrinating parent. In severe cases, indoctrinators are daily injecting toxins into their children’s brains, toxins that may poison their children’s brains for life because the poison becomes ever more deeply embedded in the brain circuitry (4). Powerful denial mechanisms must be operative in the PAS indoctrinators, mechanisms that enable them to blind themselves to the terrible thing they are doing to their children.

The Rage of PAS Indoctrinators

PAS indoctrinators are angry people and they use their children as their weapons. I often compare them to the dog owner who, with morbid gratification, selects a dog (such as a pit bull or vicious German shepherd) that is predictably going to frighten other people. Such people may overtly or covertly revel when the beast attacks some innocent victim. PAS indoctrinators convert their children into vicious animals. And the target parent becomes their primary victim. PAS indoctrinators are angry, bitter, and mean-spirited people. The bitterness is vented on the scapegoated target parent in the course of an ongoing campaign to demean, humiliate, and even destroy him (her). In many PAS parents, vengeful gratification is clearly operative, especially in situations when the target parent has initiated the separation, and even more especially when the target parent has found a new partner and the programmer has not. Central to the notion of scapegoatism is the notion that all will be well with the world and that all problems will be solved if only the scapegoat is obliterated from the face of the earth. This is a central element in prejudice and is present in spite of the fact that elimination of the scapegoated individual(s) never results in the anticipated nirvana. There is a deep-seated need in humans to utilize this mechanism on a grand scale. Wars are an excellent example of this phenomenon, especially when the "ethnic cleansing" element is operative. In the PAS, one sees the same mechanism operative on a small scale, specifically, focus on one particular individual: a targeted, scapegoated parent. The rage described here make fuel the antisocial acting out that may justify the Antisocial Personality Disorder diagnosis (see below). And when the children are used to act out the rage (the usual case in the PAS) they may justifiably warrant the Conduct Disorder diagnosis.

The Power Element in PAS Indoctrinators

The power element is often operative in the PAS. On the one hand, the alienator disempowers the children by making them robots. At the same time they are used as weapons and spies and thereby empowered as ammunition against the alienated parent. This factor may be the most important alienating tool for some indoctrinating fathers, especially those who are rich, powerful, and aggressive. Their life pattern may have been to take total control of every situation they possibly can and use money to enhance their power and control over people. Although these qualities have made them very rich, they are used destructively to lure the children away from a mother who has far less money and far less power—especially with regard to the attorneys she can afford to hire to defend herself against the "barracudas" who represent her husband.

The power element may also be operative in PAS indoctrinating mothers. More commonly, they have more bonding with the children than the fathers and may exploit this in their efforts to gain power over the children and empower them to serve as weapons against the father. The PAS, in a sense, involves a power struggle in which the children are used as ropes in the parental tug of war. The more powerful parent becomes "the winner" and, in extreme cases, is successful in destroying completely the children’s bond with the target parent. Although the alienated parent may then be considered "the loser," the children are also "losers" because their bonding with a loving parent has been destroyed.

The Gullibility of PAS Indoctrinators

Although PAS indoctrinators are often extremely cunning and creative with regard to the exclusionary maneuvers that they utilize (some of them bordering on "ingenious"), they are at the same time very simpleminded. This is especially the case with regard to their gullibility when their children describe improbable, preposterous, and even impossible experiences with the target parent. One sees here the proverbial "willing suspension of disbelief" that enables them to accept as valid all criticisms of the target parent, no matter how ludicrous. PAS children learn that the more such "stories" they provide their alienators, the more they will endear themselves to them. This is an important factor in the development of the children’s own contributions to the PAS campaign of denigration. The children recognize that if they describe healthy, happy experiences with the target parent, they will suffer the displeasure and even rejection of the programmer. The programmer’s desire to add to the list of indignities that they all suffer at the hands of the alienated parent is so great that the most ludicrous scenarios are reflexively accepted as true. Of course, there is studious avoidance of the input from the target parent, lest the bubble be burst.

Another manifestation of alienators’ litigiousness is their absolute refusal to communicate directly with the victim parent. Rather, they insist that every communication go through lawyers. Such refusal not only causes immediate frustration for the victim parent, but inevitably results in unnecessary legal expenses. A short telephone conversation, often lasting no longer than it takes to say "Yes" or "No" with regard to a simple question, may cost hundreds of dollars, because the alienator insists that all communications go through attorneys. Of course, lawyers are happy to comply here because it provides them with yet another excuse to fatten their wallets. In some cases, the lawyers have advised the clients to communicate only through them. They may even provide legal rationalizations for this advice. My experience has been that in most cases, their primary purpose is to justify charging their clients more money. Such advice is readily seized upon by the litigious parent, and will be refused by the nonlitigious and healthier parent.

Overprotection of the Child

My experience has been that the majority of PAS indoctrinators have been overprotective of their children long before the separation. In fact, I have seen many cases in which the overprotectiveness goes back to the birth of the child. Implicit in overprotectiveness is the communication to the child that the world is a dangerous place, and that only the protecting parent (more often the mother than the father) can ensure that the child will not be exposed to the dangers of the world. I recall one PAS case in which the mother did not trust the father to hold their infant. She feared that he would drop the baby, causing it significant injury. The facts were that this father was a professional football player who was particularly skillful as a receiver. When this was pointed out to her she rationalized her fears by pointing out how frequently even he did not catch the ball or on rare occasions even fumbled and dropped it.

At the time of the separation the overprotection becomes accelerated exponentially, and the dangers to the children of having any contact at all with the target parent are repeatedly emphasized. Not only is the world a dangerous place for the children, but the most dangerous person of all is the estranged parent. It is for this reason that there are great similarities between the separation anxiety disorder and the parental alienation syndrome. In comparing their descriptions, all one need do is substitute the word school with the words alienated parent and one will see similar psychodynamic mechanisms operative. In the separation anxiety disorder the child is afraid to separate from an overprotective parent (usually the mother) and fears going to school. In the PAS the child fears separating from the indoctrinating parent and fears going off with the alienated parent. In both cases, the overprotection element is central.

Pathological Identification with the Child

PAS indoctrinators have a pathological identification with their children. In extreme cases they develop a symbiotic relationship with the child. They act as if the targeted parent’s attempt to spend time with the child is at the same time removing part of their own bodies. It may manifest itself with comments like, "He left us, "He divorced us," "He harasses us," and "He abuses us." This particular quality of the PAS programmer is more common in mothers than fathers. A precursor of this may be a lifelong pattern of overprotectiveness and the view that the father is not possibly capable of properly caring for the child. In such cases, he has always been viewed as inadequate, "klutsy," and basically incompetent to rear the child. In some cases he is viewed only as a sperm donor and after the last child has been provided, his services can be dispensed with. Such mothers may also become excessively dependent on the child, so strong is the need to maintain the symbiotic tie. This mechanism facilitates the maneuver whereby the parent (usually the mother) convinces the children that they all need to protect themselves from the target parent because they are basically his victims. As mentioned, the reality is that he is their victim. This mechanism is particularly operative in those cases in which the Shared Psychotic Disorder diagnosis is warranted (see below).


Paranoids have delusions of persecution. They see around them evil and malevolence, especially emanating from the focus of their hatred. Individuals who may have been preparanoid prior to the divorce may progress down the paranoid track in association with the stresses of divorce litigation. And this becomes even more likely if the individual becomes embroiled in a child-custody dispute. When a PAS indoctrinator is paranoid, the paranoia is often circumscribed to the spouse, but it may spread and manifest itself elsewhere. Under such circumstances it is not surprising that the PAS child may exhibit paranoid symptomatology.

Typically, the paranoid system becomes illogical and preposterous, so much so that the paranoid believes that persecutors are so compelled to persecute them that they will do so in situations in which they might be immediately discovered, e.g., that the father would perpetrate abusive behavior—and even sexual molestation—in front of court-ordered supervisors. The presence of paranoia will sometimes factor in to the justification for the diagnosis of Shared Psychotic Disorder, Delusional Disorder, Paranoid Personality Disorder, and Borderline Personality Disorder (all of which will be described below).


I have by no means exhausted all the personality qualities of PAS indoctrinators. Others will be described below in the section devoted to DSM-IV diagnoses that may be applicable to them. I believe that the reader can now see how dividing PAS indoctrinators into a specific number of personality categories is quite simplistic. Using the continuum: mild, moderate, and severe is more consistent with the reality of the situation, the problems attendant to such differentiation notwithstanding. Again, it is important to emphasize that there is generally a progression and that as programmers progress from the mild to the moderate to the severe levels, they increasingly exhibit these personality qualities. From the point of view of the evaluator, the greater the number of these qualities present, the greater the likelihood the parent can be diagnosed as severe. Obviously, there is no numerical score here, no cut-off point, only the continuum.

DSM-IV Diagnoses Often Applicable
to Some Alienating Parents

A parent who is disturbed enough to induce a PAS indoctrination in a child must be suffering with some kind of psychological disturbance. To turn a child’s love for a good, dedicated parent into hate is a very sick thing to do. Accordingly, it is not surprising that the greater the severity of the PAS-indoctrinating behavior, the greater the likelihood the parent is suffering with a serious psychiatric disorder. In this section I describe some of the more common ones, especially those applicable to severe levels of PAS indoctrinators.

The same diagnoses are often applicable, but to a lesser degree, to the moderate levels of PAS indoctrinators. It is important to note that DSM-IV requires a minimum number of symptoms to be present before a diagnosis is applicable. However, life is not that simple. There are many people who may satisfy a few of the criteria, yet would not warrant the label, because too few criteria are satisfied. I often say, "God forgot to read DSM-IV before he put people down on earth." Accordingly, examiners do well to note in their reports that a particular indoctrinator does not satisfy all the requirements for a particular diagnosis, but may satisfy enough of them to use the word incipient when alerting the reader to the presence of many—if not the required number—of the symptoms necessary for the diagnosis.

297.3 Shared Psychotic Disorder (Folie à Deux)

    1. A delusion develops in an individual in the context of a close relationship with another person(s), who has an already-established delusion.
    2. The delusion is similar in content to that of the person who already has the established delusion.
    3. The disturbance is not better accounted for by another Psychotic Disorder (e.g., Schizophrenia) or a Mood Disorder with Psychotic Features and is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

The PAS programming parent, especially at the severe level, often entertains delusions about the target parent. These deeply established delusions are likely to be transmitted to the child, who clearly satisfies the "close relationship" proviso of this criterion.

The PAS child’s incorporation of the alienating parent’s delusions are to be seen in the child’s campaign of denigration and the borrowed-scenario phenomenon, whose presence confirms the programming process.

My experience has been that the Shared Psychotic Disorder is the most common form of severe psychopathology seen in the PAS (5). The term folie à deux (folly for two) makes specific reference to the delusional elements shared by both parties.

297.71 Delusional Disorder

    1. Nonbizarre delusions (i.e., involving situations that occur in real life, such as being followed, poisoned, infected, loved at a distance, or deceived by spouse or lover, or having a disease) of at least 1 month’s duration.

Of the various subtypes of delusional disorder, the one that is most applicable to the PAS:

Persecutory Type: delusions that the person (or someone to whom the person is close) is being malevolently treated in some way

This diagnosis is generally applicable to the PAS indoctrinator who may initially recognize that the complaints about the behavior of the alienated parent are conscious and deliberate fabrications. However, over time, the fabrications may become delusions, actually believed by the programming parent. And the same process may ultimately be applicable to the child. Specifically, at first the child may recognize that the professions of hatred are feigned and serve to ingratiate the child to the programmer. However, over time the child may come to actually believe what were originally conscious and deliberate fabrications. When that point is reached the delusional disorder diagnosis is applicable to the child. Generally, this diagnosis is applicable to relentless programmers who are obsessed with their hatred of the victim parent, by which time the child will have probably entered the severe level of PAS. It is to be noted that when the PAS is present, one most often observes a circumscribed delusional system, confined almost exclusively to the target parent. This diagnosis may also be applicable to the PAS child, especially the child who is in the severe category. A severe category PAS child is likely to have been indoctrinated by a severe category PAS indoctrinator.

301.0 Paranoid Personality Disorder

    1. A pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:

    1. suspects, without sufficient basis, that others are exploiting, harming, or deceiving him or her
    2. is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates
    3. is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her
    4. reads hidden demeaning or threatening meanings into benign remarks or events
    5. persistently bears grudges, i.e., is unforgiving of insults, injuries, or slights
    6. perceives attacks on his or her character or reputation that are not apparent to others and is quick to react angrily or to counterattack
    7. has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner

PAS programmers who warrant this diagnosis would often satisfy these criteria before the marital separation. A detailed history from the victim parent as well as collaterals may be important because the programming parent is not likely to directly reveal such symptoms. They may, however, reveal them in the course of the evaluation, because they are such deep-seated traits, and are so deeply embedded in their personality structure, that they cannot be hidden. Most people involved in protracted child-custody litigation become "a little paranoid," and this is often revealed by elevations on the paranoid scale of the MMPI. After all, there are indeed people who are speaking behind the patient’s back, are plotting against them, and are developing schemes and strategies with opposing lawyers. This reality results in an elevation of the paranoid scale in people who would not have manifested such elevations prior to the onset of the litigation. We see here how adversarial proceedings intensify psychopathology in general, and in the case of PAS, paranoid psychopathology especially (6). The PAS child is less likely to warrant this diagnosis. When the severe level is reached, PAS children may warrant the Shared Psychotic Disorder (Folie à Deux) diagnosis. On occasion, the diagnosis Schizophrenia, Paranoid Type (295.30) is warranted for the programming parent, but such patients have generally exhibited other manifestations of schizophrenia, especially prior to the separation. It goes beyond the purposes of this article to detail the many symptoms of schizophrenia, which should be investigated if the examiner has reason to believe that this diagnosis may be applicable.

It is important for the examiner to appreciate that there is a continuum from delusional disorder, to paranoid personality disorder, to paranoid schizophrenia. Furthermore, in the course of protracted litigation, a patient may move along the track from the milder to a more severe disorder on this continuum.

301.83 Borderline Personality Disorder (BPD)

A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

    1. frantic efforts to avoid real or imagined abandonment.
      Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.
    2. a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation
    3. identity disturbance: markedly and persistently unstable self-image or sense of self
    4. impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). Note Do not include suicidal or self-mutilating behavior covered in Criterion 5.
    5. recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior
    6. affective instability due to a marked reactivity of mood (e.g. intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)
    7. chronic feelings of emptiness
    8. inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)
    9. transient, stress-related paranoid ideation or severe dissociative symptoms

Some alienators may exhibit some of these symptoms prior to the separation. However, as a result of the stresses of the separation, the symptoms may progress to the point where the diagnosis is applicable. Criterion (1) is likely to be exhibited soon after the separation because dissolution of the relationship is generally associated with deep-seated feelings of abandonment. Criterion (2) is often seen when there is a dramatic shift from idealization of the spouse to extreme devaluation. The campaign of denigration is the best example of this manifestation of the BPD. Criterion (3) may be very difficult to assess objectively because it relies primarily on the patient’s comments about their own subjective feelings about themselves, especially their self-worth. Furthermore, such feelings of inadequacy are so widespread that they are likely to be found in any person justifying any of the diagnoses in DSM-IV. Accordingly, it is a very poor differentiating criterion.

Criterion (4) may manifest itself by excessive spending, especially when such spending causes significant stress and grief to the alienated parent. Following the separation, alienating parents may satisfy Criterion (6) with affect instability, irritability, and intense episodic dysphoria. Although such reactions are common among most people involved in a divorce, especially when litigating the divorce, patients with BPD exhibit these symptoms to an even greater degree. Chronic feelings of emptiness (Criterion [7]) go beyond those that are generally felt by people following a separation. Criterion (8) is extremely common among PAS programmers. The tirades of anger against the target parent serve as a model for the child and contribute to the development of the campaign of denigration. The stress-related paranoia, an intensification of the usual suspiciousness exhibited by people involved in litigation, may reach the point that Criterion (9) is satisfied.

The examiner should note which of the symptoms are present and comment: "Five criteria need to be satisfied for the BPD diagnosis. Ms. X satisfies four. Although she does not qualify for the diagnosis at this point, she is at high risk for its development." Furthermore, when one lists diagnoses at the end of the report one might note the DSM-IV diagnosis and add in parenthesis "incipient."

301.81 Narcissistic Personality Disorder

A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

    1. has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements
    2. is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
    3. believes that he or she is "special" and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)
    4. requires excessive admiration
    5. has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations
    6. is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends
    7. lacks empathy: is unwilling to recognize or identify with the feelings and needs of others
    8. is often envious of others or believes that others are envious of him or her
    9. shows arrogant, haughty behaviors or attitudes

My experience has been that most PAS indoctrinators do not satisfy enough criteria (five) to warrant this diagnosis. However, many do exhibit three or four of them, which is worthy of the examiner’s attention and should be noted in the report.

Criterion (5) is especially common in PAS indoctrinators. They act as if court orders have absolutely nothing to do with them, even though their names may be specifically spelled out in the ruling. PAS indoctrinators have a sense of entitlement and believe that they are entitled to full possession of the children. The notion of sharing them with the target parent is outside of their scheme of things. Unfortunately, they often violate these orders with impunity because courts are typically lax with regard to implementing punitive measures for PAS contemnors. As will be elaborated upon below, the failure of courts to take action against PAS programmers is one of the most common reasons why the symptoms become entrenched in the children.

Criterion (6) is often frequently satisfied by the programmer’s ongoing attempts to extract ever more money from the victim parent, but feels little need to allow him (her) access to the children. There is no sense of shame or guilt over this common form of exploitation. The programmer’s lack of empathy and sympathy for the victim parent is quite common and easily satisfies Criterion (7). Typically, they exhibit absolutely no sympathy and empathy for the grief they are visiting upon the target parent. Rather, they exhibit morbid gratification in the suffering they have caused. Associated with their lack of sympathy and empathy is greed, which results in their litigating for as much support and alimony payments they can extract from the target parent without appreciation that the demand for money associated with the refusal to allow that parent to see the children is cruel and inhumane. (Unfortunately, courts often support this morbid quality in PAS indoctrinators.) The PAS, by definition, is a disorder in which a programmer tries to destroy the bond between the children and a good, loving parent. In order to accomplish the goal, the alienator must have a serious deficiency in the ability to empathize with the target parent. They must also have a formidable impairment in their ability to sympathize with the children who are also being victimized by their indoctrinations. Although they profess great love for their children, what they do to them belies this. Criterion (9) is often seen in that PAS indoctrinators are often haughty and arrogant and this symptom goes along with their sense of entitlement. Again, if warranted, the diagnosis can be listed as "incipient."

Other Types of Severe Psychopathology

Mention has already been made of the deceitfulness of the PAS indoctrinator. A parent cannot be a PAS indoctrinator without being deceitful. It is one of the requirements if one is to "successful" in indoctrinating a PAS in a child. It is necessary to lie in order to convert a child’s love into hate. It is necessary to lie to get a child to believe that a good, loving parent is actually noxious and dangerous. Although sometimes the alienator’s lies regress down the track to become delusions, at first they are usually conscious and deliberate lies that are being perpetrated. As mentioned, the term pathological liar is applicable to such parents when one confines oneself to the maneuvers utilized to indoctrinate the child into a PAS. In some cases the lying pattern has been operative prior to the separation and the parent may very well qualify for the DSM-IV diagnosis, Antisocial Personality Disorder, but most often they do not.

In addition, although one often sees PAS parents who are delusional and who may satisfy the aforementioned diagnoses Delusional Disorder, Paranoid Personality Disorder, and Borderline Personality Disorder (which often includes paranoid features). It is not common that such parents satisfy the DSM-IV diagnosis of the subtypes of schizophrenia. I am not claiming that one never sees schizophrenic indoctrinators (I certainly have), I am only saying that my experience has been that they represent only a small percentage of alienating parents.

Differential Diagnosis of the
Three Levels of PAS Alienators

In this section I focus on the primary behaviors, i.e., symptomatic manifestations of the alienator that can help the evaluator decide which of the three levels is applicable. Although DSM-IV diagnoses may be useful here, especially with regard to the assessment of the tenacity and the irreversibility of the programming propensities, the behaviors per se should be the primary indicators of level assignment. The examiner does well here to refer to Table 2 for guidelines regarding such designation.

When assessing for the presence of these symptoms, the evaluator does well to attempt to objectify responses by eliciting numbers, e.g., "What percentage of your calls would you say have been returned?" "What percentage of the visits have been cancelled?" "In what percentage of the visits has your visitation time been eroded, at either end, for a variety of frivolous reasons?" "In the last six months how many times have the children called you from their mother’s (father’s) home?" Although most people do not keep accurate records of these events, one can still get best guesses and best estimates. Such statements are far more valuable than vague terms like "often," "frequent," etc. Most interviewees are not used to being asked questions by an examiner who wants them to give numbers. However, without numbers one is seriously compromised with regard to getting accurate information in this realm.

Some parents, especially PAS alienators, will be very reluctant to give the numbers that provide information about the frequency of an event. This would be a typical interchange with such a parent:

Mother: He’s always calling Billy "stupid."

Gardner: The word always is kind of vague. About how many times would you say you’ve actually heard your husband call Bill "stupid?"

Mother: Doctor, I couldn’t possibly tell you.

Gardner: I know you don’t keep careful notes about this. I know you don’t have a diary in which you jot down every time he calls Billy stupid, but what is your best estimate as to how many times you’ve actually heard him call Billy stupid.

Mother: Doctor, I can’t even begin to tell you.

Gardner: Was it more than a hundred times?

Mother: I really can’t tell you.

Gardner: Was it less than a hundred times?

Mother: I don’t know.

Gardner: Was it more than a thousand times?

Mother: It might be—I can’t tell you.

Gardner: Was it less than a thousand times?

Mother: As I told you, I can’t tell you.

Gardner: Was it more than ten times?

Mother: Maybe. I don’t know.

By that time I will "get the point" and recognize that further inquiry along these lines is futile. I will however, make a statement in my report along these lines:

Ms. X claimed that her husband "always" called Billy "stupid." However, she absolutely refused to provide any estimate at all regarding the approximate frequency of the use of such epithets—whether it was in the range of ten times, or the range of a thousand times. My experience has been that such refusal to give even a vague approximation suggests that the allegation is false or exaggerated enormously.

Other parents can, however, be pinned down to ranges like "less than 10 times," "between 10 and 25 times," and "between 25 and 50 times, but not more than 50 times." The examiner who fails to attempt to get such indications of frequency will compromise significantly their report.

Presence of Severe Psychopathology Prior to the Separation

Indoctrinating a PAS into a child is a very sick thing to do. Accordingly, the sicker a person is prior to a separation, the greater the likelihood that person will become a PAS indoctrinator. My experience has been that the most common forms of psychopathology that antedate the PAS are Delusional Disorder, Paranoid Personality Disorder, Borderline Personality Disorder, and Narcissistic Personality Disorder. Obviously, future research will have to be done in order to substantiate or refute these initial conclusions. As mentioned, the Antisocial Personality Disorder diagnosis can, in many cases, justifiably be added to this list. This is not surprising, because PAS indoctrinators must be comfortable with deceit if they are to be successful.

It would be an error for the reader to conclude that the vast majority of PAS indoctrinators fall into one of these categories. Most of them do not. My main point here is that when such psychopathology is present then it is likely that the individual will quickly become a severe alienator. Accordingly, the evaluator does well to assess for the presence of one of these severe disorders in assessing the alienator’s level, mild, moderate, or severe. More specifically, the presence of such psychopathology is most often absent in mild alienators, may or may not be present when the alienator is in the moderate category, but is most often present for alienators in the severe category.

Frequency of Programming Thoughts

Obviously, one cannot objectify the assessment of this differentiating criterion. We don’t have any instrument which could, like the EEG, print out a person's thoughts. Sometimes written material, e.g., letters written back and forth between the parents, can give the evaluator some information for assessing this criterion. One can also get some idea about the frequency of programming thoughts by assessing the alienating parent’s degree of PAS preoccupation in the course of the evaluative interviews. Some alienators can indeed be said to be obsessed with thoughts about the target parent’s depravities and the grief he (she) has presumably visited upon the children. Furthermore, if the children are obsessed with the campaign of denigration, then it is quite likely that the alienating parent is so as well. Programming children with a PAS can be a full-time undertaking, requiring frequent "booster shots" in order to be sure that the toxins keep circulating in the children’s brains. The victim parent also is likely to be able to provide information that can be useful for the evaluator’s assessment of this criterion. It is also reasonable to assume that a thought is associated with comments and behaviors. It is also reasonable to assume that there are more thoughts than comments and alienating behaviors. The assessment of these more objectifiable alienating manifestations should give the evaluator useful information regarding the alienator’s frequency of programming thoughts. Of course, numbers here are not too meaningful, only whether the evaluator can reasonably state that the parent falls in the mild, moderate, or severe category.

Frequency of Programming Verbalizations

Frequency of programming involves direct verbalizations and behaviors that serve to program in the children a campaign of denigration against the target parent. Accordingly, it is somewhat easier to objectively assess for the presence of this symptom than for the aforementioned frequency of programming thoughts. Programming parents who are obsessed are likely to be programming persistently. One not only considers direct attempts to denigrate the target parent to the children, but also exposing the children to criticisms of the alienated parent. In the severe category, the parent doesn’t have a good word to say about the victim parent. It is as if he (she) is in the incarnation of all the evil that ever existed in the history of the world. In the clinical interviews as well, one can get some assessment of the frequency of programming in the course of interviewing the programmer, the victim parent, and the children.

It is important for the examiner to appreciate that programming does not simply occur when a parent sits down and tells a child lies about the victim parent. Programming occurs when the parent accepts as valid any preposterous complaint the child makes about the victim parent. Programming occurs when the programmer conducts a detailed inquiry into the events of the visit and attempts to make negative judgments about the events that transpired, e.g., "He took you to McDonald’s again? When is he going to stop feeding you junk food?" "Big sport, he took you to Disney World," and "I hope he remembered to give you a bath." Programming often occurs during telephone conversations while visitation is taking place—especially when the calls are made frequently. Inquiries may be conducted with messages implying that the child is in a dangerous situation, e.g., "I hope he doesn’t leave you kids alone at the swimming pool," "I really get scared when he takes you to the beach. I can just see him sleeping on the sand while you kids are being swept away by the waves," and "I’m always scared when he drives you someplace, especially on those big, dangerous highways."

Frequency of Exclusionary Maneuvers

This criterion can be even more readily assessed objectively. The main principle here is to identify behaviors that obstruct and/or prohibit the child’s involvement with the target parent—with the effect of attenuating the bonding between the two. Visitation obstruction and refusal is probably the most common way to accomplish the attenuation and even destruction of such bonding. This can most frequently be observed at transition points, when both parents are present. At such times, the indoctrinating parent will usually actively or passively facilitate blockage of visitation. Rigidity vs. flexibility regarding changing the visitation schedule can also give useful information regarding the scoring of this item. Assessment of telephone access can be particularly useful here. Is there total blockage of telephone access and, if so, how long has such blockage been going on? Is the answering machine being used as a screening device to distinguish between calls from the target parent and calls from others. Is the target parent given information about visits to the doctor, dentist, and therapist? Inquiry into the programmer’s receptivity to giving the target parent information about school activities, both curricular and ex-curricular, is very useful for scoring this criterion.

Frequency of Complaints to the
Police and Child Protection Services

When assessing this criterion for the alienator’s level, one does well to review past reports, especially police documents and complaints to child protection services. Mild alienators will only occasionally resort to such tactics. Moderate alienators are more likely to do so more frequently. And severe alienators will repeatedly bring in these authorities. In fact, the severe alienators are generally known to these agencies as registering frivolous complaints, yet agencies are required to investigate each complaint. Unfortunately, courts do very little to discourage such repeated complaints, and they are often done with impunity. There being no consequences, there is little to discourage the an alienator from making repeated complaints. The police and child protection agencies cannot say, "Look, this is the tenth time in three weeks you have called us and the other nine times we found no basis for your complaint, so we are not going to investigate this tenth one." Each time they have to look into the matter as if it were a new complaint.


PAS indoctrinators are typically litigious. In fact, many are extremely litigious. They are quick to call their lawyers, who can be relied upon to serve as enablers and supporters of the PAS campaign of denigration. Of course, lawyers love them because they are good business. They are easy prey for greedy and unscrupulous lawyers, types that are, unfortunately, not hard to find. All such lawyers have to do is blind themselves to their participation in the corruption of the client’s children when representing such a client. I have never accepted as valid the rationalization that it is a lawyer’s obligation to zealously support the client’s position, even if the lawyer has no conviction for it. In order to do that one must obliterate one’s sense of values, morality, and guilt. Unfortunately, there are many lawyers who have no problem obliterating from their psyche these important civilizing qualities, especially after long years of being "successful" divorce litigators. The more the lawyer has been involved in the profession, the greater the ease with which he can do this. Elsewhere, I have elaborated on this issue (7-9)

Litigiousness can be assessed by the degree to which the alienator reflexively calls in the attorney. The greater the number of times the alienator brings in an attorney to deal with an issue, the greater the degree of litigiousness. This is especially the case when the issue could easily be resolved by a single telephone call, email, or letter. The alienator who says: "I refuse to communicate with you directly; everything must go through my attorney" is most likely to be a severe alienator. Some alienators are not satisfied with one attorney, but will have two or three. They hire all the attorneys money can buy. What comes to mind here is the lightbulb joke:

Question: How many lawyers does it take to unscrew a dead lightbulb?

Answer: How many can you afford?

When the alienator is a mother and the victim father is rich, the mother may know that the more attorneys she hires, the greater will be the father’s legal bills and the more grief, then, she can visit upon him.

The brand of adversarial proceedings utilized in the United Kingdom, Ireland, and some of England’s former colonies lends itself well to this form of exploitation. There are the solicitors who deal directly with the client, and there are the barristers who argue in the courtroom. Accordingly, each parent may have two lawyers. It is not uncommon for the solicitor, and/or the barrister, to have an assistant there, as if two were not enough. A divorce conflict is a war, and the more soldiers, weapons, and ammunition you have, the greater the likelihood of prevailing. The litigious person waves the banner "Victory at all costs," even if the cost is financial ruin of the victim parent and even the alienator himself (herself). Many alienators are so enraged that they blind themselves to the fact that financial ruin of the victim parent means financial ruin to themselves because they may have little, if any, income of their own. In short, the more lawyers, solicitors, barristers (both senior and junior), the greater the likelihood the alienator is to be in the severe category.

Episodes of Hysteria

These are the primary characteristics of hysteria: Emotional outbursts, overreaction, assumption of danger when it does not exist, dramatization, attention-getting behavior, impairment of judgment, release of anger with scapegoatism, capacity for spread, and intensification of symptoms in the context of lawsuits. Many PAS indoctrinators exhibit hysterical symptomatology. The greater the number of hysterical symptoms manifested, the greater the likelihood the PAS indoctrinator will be moving down the continuum to the severe level. Elsewhere, I have described in detail the ways in which PAS indoctrinators exhibit hysterical symptoms (10-12). Hysteria and paranoia are on a continuum. In hysteria a person can come to appreciate that the danger is exaggerated and the emotional reactions may be reduced. In contrast, in paranoia the individual has delusions that the dangers are real. Often, the alienator’s reactions to minor errors or indiscretions on the part of the victim parent are hysterical, especially the emotional outbursts and the assumption of danger when it does not exist. This is commonly seen in situations in which normal and/or benevolent behavior is distorted into malevolent behavior. It is also seen when an abuse accusation is brought in as a PAS spin-off—especially sexual abuse. In recent years, divorced fathers know well that it can be dangerous to bathe one’s children—especially ages three to four. PAS indoctrinators will interrogate the children with such questions as: "When he bathed you, did he touch your private places?" "Why are you touching yourself there? Did anybody touch you there?" An affirmative answer immediately brings in the police and child protection services, who may evince similar hysteria. We are living in an age which can justifiably be referred to as the age of sex abuse hysteria, which I have described elsewhere (13). The greater the degree of hysteria, the greater the degree of frequency of hysterical outbursts, the greater the likelihood the parent is in a severe category of PAS alienator.

Frequency of Violation of Court Orders

This symptom can be assessed even more objectively. In most cases one can get an exact number. Often, the violations involve the failure of the alienating parent to comply with the visitation schedule stipulated in the divorce decree and/or court orders. There may be violation of court orders to provide telephone access, information about medical care, school information, or to consult with the other parent with regard to important decisions in the children’s lives. A common area of violation is to fail to provide the target parent with the right of first refusal when the alienating parent is not available to take care of the children. Specifically, instead of giving the victim parent the right to take the children during such periods, other people are utilized. In extreme cases it is as if there are hundreds and even thousands of people who would be viewed as preferable to the target parent to care for the children during such times. As one moves down the continuum from mild, to moderate to severe, one sees a greater likelihood that the violating parent does so without any feelings of guilt, remorse, or fear of court reprisals. Unfortunately, the latter is the result of the failure of the judicial system to take action against such contemnors. My experience has been that the vast majority of PAS indoctrinators know very well how to "work the system." They know they can rely upon court delays, and even court inaction, that will enable them to violate court orders and to do so with impunity. Elsewhere, I have elaborated on this point (9, 11, 12).

Success in Manipulating the Legal
System to Enhance the Programming

Most often the alienator can rely on court delays to enhance the programming. Time is on the side of the alienating parent. Both alienating parents and victim parents know this well, and courts, unfortunately, appear to be oblivious to this particular factor in PAS development. Our founding fathers guaranteed us that courts would act with "deliberate speed." The fact that the founding fathers saw fit to put in this requirement indicates that even then the courts operated with snail-like slowness. I do not know whether the situation is worse now than it was then, but I do know that the slowness of the courts is one of the important factors operative in the development, perpetuation, and even "success" of the PAS. Even worse is the court’s reluctance to penalize the alienator with such measures as posting a bond, fines, community service, probation, house arrest, incarceration, and custodial change. I personally have never been successful in convincing a court to implement any of these measures, with the exception of custodial change for severe alienators. I genuinely believe that a weekend in jail would be the "cure" for 95+ percent of all alienators. I generally hesitate to use the word "cure" in the field of psychiatry, but I do not hesitate to use it for this specific form of "treatment" for PAS alienators. This cure would be especially effective if they were put on notice that if there was repetition of the alienating maneuvers the next jail sentence would be longer. Alienators know they can "work the system" and, of course, their attorneys are trained to assist them in this regard. I have heard it said that the most successful attorneys are those who work most slowly. Such attorneys and their alienating clients know well that they can exploit the advantage of courtroom delays and this can be their most powerful weapon in the custody dispute.

Risk of Intensification of Programming if Granted Custody

The evaluator must assess the risk of intensification of the programming if the alienating parent gains primary custody. This risk is usually very low for mild alienators because once they gain custody, they can cease and desist from alienating maneuvers because their indoctrinations have been successful in getting the court to grant them primary custodial status. As one moves down the continuum from mild to moderate to severe, the greater the likelihood the alienating propensities will become embedded in the alienating parent’s and the child’s brain circuitry and develop a life of their own. Whereas originally the programming may have been designed to gain leverage in a court of law, over time the programming propensities develop a life of their own and persist beyond the time of the court hearing—so deep-seated has become the obsession. If this happens, it is extremely unlikely that there will be a reduction of the programming following the trial, especially if the programmer retains primary custody. I refer to this as the "embedment-in-the-brain-circuitry phenomenon" (4).

Court Recommendations for Each of
the Three Levels of PAS Alienators

The title of this article does not use the term, "Diagnosis and Treatment," which is the usual combination that most legal and mental health professionals are used to. Rather, I use the term, "Diagnosis and Management." The reason here is simply that there is no psychotherapeutic treatment for PAS indoctrinators, especially those who have reached the moderate and severe levels. It is probable that some people at the mild level are candidates for treatment, but I have not personally encountered them. The management, then, must involve reducing significantly the alienator’s access to the PAS child and only the courts have the power to do this. In order for a patient to be a proper candidate for treatment, two provisos must be satisfied: 1) The individual have insight into he fact that he (she) is suffering with psychological problems and 2) The individual be motivated to alleviate them. Most often, PAS indoctrinators do not satisfy either of these criteria.

I have often said that there is a treatment for PAS indoctrinators, a treatment that would probably cure the vast majority of them in a very short period. The treatment: a weekend in jail. Although I have made this recommendation in many of my writings, and although I have recommended it on occasion in courts of law, I personally have not been successful in convincing one judge to implement this treatment program. However, one cannot call this psychotherapy; one can call it "jail therapy."

Below, I present the recommendations I make to courts for dealing with each of the three levels of the PAS alienators. The reader does well to refer to Table 3 when reading the material for each of the levels. I cannot emphasize too frequently the importance of the principle that the diagnosis of PAS is based upon the level of symptoms in the child, but the court’s decision for custodial transfer should be based primarily on the alienator’s symptom level, and only secondarily on the child’s level of PAS symptoms.

Alienators in the Mild Category

If children are in the mild category and the alienator is in the mild category, then the court can usually feel safe allowing primary custody to remain with the alienating parent. The alienator’s goal of using the children as leverage in the custody dispute has been reached and the alienating is likely to be reduced. Under such circumstances, treatment may not be initially necessary, at least for the PAS. Obviously, therapy may be necessary for other problems.

There are situations in which an alienator may very well be in the severe category, but the children are in the mild category, or may not even exhibit PAS symptoms at all. The most common reason for this is that the target parent’s bond with the children has been so strong that it has served as a powerful antidote to the toxins being injected into their brains by the alienating parent. However, that deep bond is generally not enough to work as an antidote if the victim parent does not have significant access to the children. This is most likely possible when the target parent has access to the children at least 50 percent of the time, or in those situations in which the parents are still living in the home together, their impending separation and divorce notwithstanding. In such situations, there is a high risk that the children will shift to more severe levels of PAS if the target’s parent’s access is reduced. The examiner must give serious consideration to this risk when making recommendations to the court, especially regarding which parent should be given primary physical custodial status following the trial.

Alienators in the Moderate Category

With regard to children in the moderate level, as can be seen in Table 3 there are two plans: Plan A is for alienators who are in the moderate category and Plan B is for alienators in the severe category. In Plan A (children in the moderate category, alienators in the moderate category) the evaluator may still recommend that the court grant primary physical custody to the alienating parent. However, the recommendation should also include family therapy with a therapist who is very familiar with the special treatment techniques necessary for therapy with PAS families. Such a therapist must be comfortable using authoritarian techniques, does not overly empower the children, and recognizes that PAS children must be forced to visit with the alienating parent—their professions of hatred notwithstanding. Other details of the therapeutic techniques necessary to utilize in such cases have been described elsewhere (11, 12). Furthermore, the evaluator does well to recommend that the court put the alienating parent on notice that he (she) will be held responsible for the children’s failure to visit and that if visitation does not take place, the alienating parent will be considered to be in contempt of court and the following sequence of court sanctions will be utilized: posting a bond, fines, community service, house arrest, probation, and even short-term incarceration. Unfortunately, I have not yet had one case in which a judge has actually implemented any of these sanctions.

In Plan B (children in the moderate category, alienators in the severe category), the first step must be transfer of the children to the primary custody of the alienated parent. This plan is highly likely to succeed if the children are in the moderate category of PAS. However, it is less likely to succeed if the children are in the severe category. In such cases, the transitional-site program (discussed below) may be necessary. Again, the court should appoint a therapist knowledgeable about the special techniques necessary for the treatment of PAS families.

Most important here is extremely restricted access of the alienating parent to the children. Often I recommend a 30-day "cooling off period" before visitation is resumed. This provides the children with the opportunity for living experiences with the target parent which confirm that he (she) is not noxious and dangerous as they were programmed to believe. Once visitation is resumed, it must be monitored. By monitoring, I do not mean supervised. Supervised visitation is of little value for most alienating parents. So deep-seated is the anger that it oozes out of every pore in the alienator’s body. The supervisor cannot stop the subtle communications that can communicate the hatred to the child. A loving mother says, "How’s your father?" The intonation is one of interest and concern. A hateful mother says, "How’s your father?" in such a way that anger and scorn is communicated. By monitored visitation I mean progressive expansion and/or contraction of the PAS children’s access to the alienating parent, depending on the degree to which the alienator can cease and desist from attempting to poison the children’s minds. Such monitoring can be done by the PAS therapist. Some judges feel comfortable designating such authority to a PAS therapist, others will not, considering this a court function. Sometimes a guardian ad litem might be designated to perform this task. However, there is a great risk here, because my experience has been that guardians ad litem tend to pathologically empower children, because they believe it is their role to zealously support their client’s position, no matter how young and no matter how severe their PAS may be (6, 7, 11, 12).

I recognize that these recommendations are complex. But that is the reality of the world and there are many other examples of situations that are not simple. However, if the evaluator carefully follows the guidelines described here, a reasonable recommendation to the court can be made.

Alienators in the Severe Category

When there is a combination of PAS children in the severe category and an alienator in the severe category, direct transfer to the home of the alienated parent may not be possible. The children have become so alienated that they are delusional with regard to their fears and/or hatred of the victim parent. Accordingly, it may be impossible to place them in the home of the alienated parent. They may jump out the windows or run into the streets, and thereby endanger themselves. Or they may be so hostile that they may make life intolerable for the target parent. Destruction of person and property, attempts to poison the target parent, set fires, and wreak havoc in the home of the alienated parent is sometimes seen. Under such circumstances, a transitional site is necessary, such as another home or even a hospital. This site serves as a transition from the home of the alienator to the home of the alienated parent. The alienator, by court order, must have absolutely no contact with the children in that facility. Otherwise there will be a continuation of the alienation. The basic principle is this: there will be progressive expansion of the target parent’s visits to the transitional site so that the children may become increasingly comfortable with him (her). Next, there is a gradual shift from the transitional site to the home of the target parent, with expanding visits and then final placement there.

I know of many situations in which a court has removed the children from the home of the alienating parent and placed them in another facility (such as a foster home) in order to protect them from the indoctrinating parent. However, the court (somewhat paradoxically) has then ordered the children to return to the home of the alienator. Predictably, nothing is accomplished with this maneuver, because the alienator, once again, reprogrammed the children. We see here, once again, a good example of the enormous resistance on the part of courts to transfer custody. Elsewhere, I have described the devastating effect on children when courts refuse to place them with the target parent, or at least reduce the children’s access to the alienator (3).

With regard to the severe alienator, after the initial "cooling off period" there can be some visitation, but this must be monitored by a PAS therapist who will expand and contract the visits, depending upon the alienator’s ability to cease and desist from programming the children. Unfortunately, at the time I write this, I have no experience with this kind of program in that I have not been successful in getting courts to order it. In addition, even in situations in which such placement in a transitional site facility is warranted, I know of no facilities at this point that have been set up to provide such a program. I am confident, however, that they will be set up because they certainly make sense, and the need for such facilities is very great.

Concluding Comments

Just as it is important that the evaluator assess PAS children regarding whether they are in the mild, moderate, or severe category, it is equally important that the evaluator assess the programmer for similar categorization. Without such categorization the evaluator’s ability to make meaningful recommendations to the court is seriously compromised. Each level of PAS child and each level of PAS programmer warrants special management, both legal and therapeutic. My purpose here has been to provide guidelines necessary for the implementation of these recommendations. Without the court’s active intervention, little will be done to help PAS children. The PAS is very much a product of courtroom adversarial proceedings and it is only in the courtroom that steps can be taken to its reversal.


  1. Darnell D: Divorce Casualties: Protecting Your Children from Parental Alienation. Dallas, Texas: Taylor Publishing Company, 1998.
  2. Gardner RA: The recent gender shift in PAS indoctrinators. News for Women in Psychiatry (A publication of the Association for Women Psychiatrists) 2001; 19(4):11-13.
  3. Gardner RA: Should courts order PAS children to visit/reside with the alienated parent? A Follow-Up Study. The American Journal of Forensic Psychology 2001; 19(3):60-106.
  4. Gardner RA: The embedment in the brain circuitry phenomenon (EBCP). Journal of the American Academy of Psychoanalysis 1997; 5(1):151-176.
  5. Gardner RA: Does DSM-IV have equivalents for the parental alienation syndrome (PAS) diagnosis? The American Journal of Family Therapy, 31(2) (in press)
  6. Gardner RA: Child Custody Litigation: A Guide for Parents and Mental Health Professionals. Cresskill, New Jersey: Creative Therapeutics, Inc., 1986
  7. Gardner RA: Family Evaluation in Child Custody Mediation, Arbitration, and Litigation. Cresskill, New Jersey: Creative Therapeutics, Inc., 1989
  8. Gardner RA: Testifying in Court. Cresskill, New Jersey: Creative Therapeutics, Inc., 1996
  9. Gardner RA: The judiciary’s role in the etiology, system development, and treatment of the Parental Alienation Syndrome (PAS). The American Journal of Forensic Psychiatry (in press)
  10. Gardner RA: Psychotherapy with Sex-Abuse Victims: True, False, and Hysterical. Cresskill, New Jersey: Creative Therapeutics, Inc., 1996.
  11. Gardner RA: The Parental Alienation Syndrome (2nd Edition). Cresskill, New Jersey: Creative Therapeutics, Inc., 1998
  12. Gardner RA: Therapeutic Interventions for Children with Parental Alienation Syndrome. Cresskill, New Jersey: Creative Therapeutics, Inc., 2001
  13. Gardner RA: Sex Abuse Hysteria: Salem Witch Trials Revisited. Cresskill, New Jersey: Creative Therapeutics, Inc., 1991