This article is based on the keynote address that Dr. Gardner presented to the International Conference on the Parental Alienation Syndrome (PAS) held in Frankfurt/Main, Germany, October 18-19, 2002

The Parental Alienation Syndrome:
Past, Present, and Future

Richard A. Gardner, M.D.

I began working in the field of psychiatry in 1957 when I started my residency training. I began conducting evaluations in the context of child-custody disputes in 1963. In the early 1980s I began seeing a new disorder, a disorder previously unseen. This was after working intensively with families over 25 years. Accordingly, I was in a good position to observe differences and new developments. Prior to that time, I saw children who had been alienated from their parents for a variety of reasons: emotional abuse, verbal abuse, physical abuse, sexual abuse, and neglect. I wrote about them in many publications (Gardner, 1971a, 1971b, 1972a, 1972b, 1972c, 1974a, 1974b, 1975a, 1975b, 1976a, 1976b, 1976c, 1977a, 1977b, 1977c, 1978a, 1978b, 1978c, 1978d, 1979a, 1979b, 1979c, 1979d, 1979e, 1979f, 1980a, 1980b, 1981a, 1981b, 1981c, 1982a, 1982b, 1983a, 1983b, 1984a, 1984b). None of these publications described the disorder that I refer to as the parental alienation syndrome. I just had not seen it before.

In this new disorder, I not only saw programming ("brainwashing") of the child by one parent to denigrate the other, but also self-created contributions by the child in support of the alienating parent’s campaign of denigration against the alienated parent. Because of the child’s contribution I did not consider the terms brainwashing, programming, or other equivalent words to be sufficient. Furthermore, I observed a cluster of symptoms that typically appear together, a cluster that warranted the designation syndrome. Accordingly, I introduced the term parental alienation syndrome to encompass the combination of these two factors that contributed to the development of the syndrome (Gardner, 1985a). In accordance with this use of the term I have suggested this definition of the parental alienation syndrome:

In the PAS, the alienating parent programs into the child’s brain circuitry ideas and attitudes that are directly at variance with the child’s own previous experiences. In addition, PAS children add their own scenarios to the campaign of denigration, from the recognition that their complementary contributions are desired by the programmer. The child’s contributions are welcomed and reinforced by the programmer, resulting in even further contributions by the child. The result is an upwardly spiraling campaign of denigration. Schuman (1986) refers to this aspect of the phenomenon as a "positive feedback loop." In mild cases the child is taught to disrespect, disagree with, and even act out antagonistically against the targeted parent. As the disorder progresses from mild to moderate to severe, this antagonism becomes converted and expanded into a campaign of denigration. The PAS diagnosis is based on the symptoms exhibited by the child, but the problem is clearly a family problem in that in each case there is one parent who is an alienator, another parent who is the alienated parent, and one or more children who exhibit the PAS symptomatology. Many PAS children respond to the programming in such a way that it appears that they have become completely amnesic for any and all positive and loving experiences they may have had previously with the targeted parent.

The term PAS is applicable only when the target parent has not exhibited anything close to the degree of alienating behavior that might warrant the campaign of vilification exhibited by the children. Rather, in typical cases the victimized parent would be considered by most people to have provided normal, loving parenting or, at worst, exhibited minimal impairments in parental capacity. It is the exaggeration of minor weaknesses and deficiencies that is the hallmark of the PAS. When bona fide abuse does exist, then the child’s responding alienation may be warranted and the PAS diagnosis is not applicable. The term parental alienation would be applicable in such cases and justifiably so. However, without specifying the particular cause of the alienation, the term is not particularly informative.

In association with this new disorder I also saw something else that I had not seen before, namely, a false sex-abuse accusation. As far back as 1957 I saw children, adolescents, and adults who had been sexually abused. Up to the early 1980s, there was little reason for me to believe that these patients weren’t telling me the truth. This was especially the case because their descriptions sounded credible. PAS children, however, provided incredible scenarios of their alleged sexual abuses, some of which were so preposterous that I considered them impossible.

In 1985, after three or four years’ experience with PAS children (some of whom exhibited the false sex-abuse spin-off), I published my first article on the subject, an article that is generally considered a seminal contribution (1985a). In that article, I described the basic symptoms of the PAS and also made reference to the false sex-abuse derivative. There was little reaction then to my comments about the PAS in my early articles and lectures. Nobody in the audience got up and screamed, "It’s not a syndrome!" But people did get up from the audience and scream about the sex-abuse element. "Children never lie!" and "Believe the children," they shouted. My response usually was:

There were already studies at that time confirming the fact that children do lie, and do so consciously and deliberately.

"Well, then," my critics said, "children wouldn’t lie about such a terrible thing as sexual abuse, and no good parent would ever do such a terrible thing as program a child to profess sex abuse when it never happened." My response to these critics was:

It was then that I began to develop criteria for differentiating between true and false accusations of sex abuse, and the criteria that I first used were published in my 1987 volume, The Parental Alienation Syndrome and the Differentiation Between Fabricated and Genuine Child Sex Abuse (Gardner, 1987a). The criteria were expanded and refined over the years in subsequent publications (1987b, 1988, 1989a, 1989b, 1991a, 1991b, 1991c, 1992a, 1992b, 1992c, 1993a, 1993b, 1993c, 1993d, 1993e, 1993f, 1993g, 1994a, 1994b, 1994c, 1994d, 1994e, 1994f, 1995a, 1995b, 1995c, 1995d, 1995e, 1996a, 1996b, 1997a, 1998a, 1999a, 2001a, 2002a).

With regard to the criteria for differentiating between true and false sex-abuse accusations, because of the possibility that the examiner could conclude that the allegation was false, I was accused of being soft on pedophiles and not really caring about sexually abused children. In addition, new criticisms emerged related to the PAS. I was accused of being sexist, because my early publications stated that women were much more likely than men to be the programmers, even though I did occasionally see a father who was a programmer. Again, when I was criticized about this gender disparity my response was:

In my publications, I began to describe the reasons for the gender disparity. I concluded that the reasons were primarily the result of two recent developments in the realm of child-custody litigation, namely, the replacement of the tender-years presumption with the best-interests-of-the-child presumption and the increasing popularity of the joint-custodial concept. Under the tender-years presumption, the assumption was made that mothers, by virtue of the fact that they are female, are intrinsically superior to men as child rearers. Accordingly, the father had to provide compelling evidence of serious maternal deficiencies before the court would even consider assigning primary custodial status to the father. Under its replacement, the best-interests-of-the-child presumption, courts were instructed to ignore gender in custodial considerations and focus on parenting capacity, especially factors that related to the best interests of the child. This change resulted in a burgeoning of custody litigation as fathers now found themselves with a greater opportunity to gain primary custodial status.

Soon thereafter, the joint-custodial concept came into vogue, reducing even further the time that custodial mothers were given with their children. This change also brought about an increase and intensification of child-custody litigation (Gardner, 1982, 1985a). In association with the burgeoning of child-custody litigation, we witnessed a significant increase in situations in which one parent programmed a child to become alienated from the other, often with the hope that this would enhance that parent’s position in the course of the litigation. Other factors were certainly operative in motivating the programming process, but the goal of strengthening one’s position in the custody litigation is the primary one. And the false sex-abuse accusation was clearly another method of gaining leverage in a court of law, especially if one could convince the court that the hated parent was not only noxious and dangerous (in association with the PAS) but a sexual abuser as well. Even though I subsequently published articles describing the more recent development in which men were as likely as women to program children, I still was labeled sexist (Gardner, 1994h, 1998b, 2001a, 2001b, 2002b, 2002c).

THE PRESENT

At this point, controversy rages. In fact, it may be more intense now than it has ever been before. As the years have progressed, more and more people have come forth to support my position, and more and more have come forth to criticize me vigorously. There are publications completely devoted to criticizing PAS and me, to the point where PAS and I have become inextricably combined. Just one example of the many I could provide to demonstrate the degree to which the controversy has escalated is the Family Court Report of the California division of the National Organization of Women (NOW) which includes a section specifically devoted to criticism and even denial of the existence of PAS (National Organization for Women, 2002). In the section entitled "Legislative Solutions" the report recommends:

California NOW is recommending here that legislatures pass laws that make it a crime to use the term PAS. It follows then, that such legislation would have to include the specific punishments to be meted out to those who break this law, e.g., fines or even imprisonment.

In the next section, "Judicial Solutions," the report recommends:

These four proposed causes of action share in common procedures by which men are given the opportunity to share parenting time with their former spouses. California NOW would outlaw these procedures. By making them unconstitutional, those who make the PAS diagnosis or mandate the aforementioned procedures would be breaking the law and subject to punishment, e.g., fines or incarceration. They could also be sued for damages and declaratory relief.

There is no question that throughout history women have been victimized terribly by men. There is no question, also, that the Women’s Liberation Movement has been a very constructive force, rectifying many of these evils. Unfortunately, there are women within the movement who are overzealous and therefore do the movement more harm than good. California NOW is an example of such a group. By taking extreme positions such as these, the group is giving the women’s movement a bad reputation. Many mothers, who have been alienated from their children because of their husbands’ PAS indoctrinations of their children, have complained to me bitterly that women’s rights groups such as NOW have spurned them, claiming that there is no such thing as PAS. We see then how the denial of PAS by these extremists results in a betrayal of the very women they are purporting to represent, support, and protect. I have elaborated on this point in my article, "Denial of the Parental Alienation Syndrome Also Harms Women" (Gardner, 2002b).

SOURCES OF THE CONTROVERSY OVER
THE PARENTAL ALIENATION SYNDROME

There are some who claim that because there is such controversy swirling around the PAS, there must be something specious about the existence of the disorder. Those who discount the PAS entirely because it is "controversial" sidestep the real issues, namely, what specifically has engendered the controversy, and, more importantly, is the PAS formulation reasonable and valid? The fact that something is controversial does not invalidate it. But why do we have such controversy over the PAS?

With regard to whether PAS exists, we generally do not see such controversy regarding most other clinical entities in psychiatry. Examiners may have different opinions regarding the etiology and treatment of a particular psychiatric disorder, but there is usually some consensus about its existence. And this should especially be the case for a relatively "pure" disorder such as the PAS, a disorder that is easily diagnosable because of the similarity of the children’s symptoms when one compares one family with another. Why, then, should there be such controversy over whether or not PAS exists? Why all the Sturm und Drang? Why all the rage and fury that goes above and beyond the issues? Why all the personal vilification directed at me? Why all the slanderous and libelous criticisms?

It is very important to know the causes of this formidable controversy, which is raging in the U.S., Canada, most of western Europe, and many other countries. First, it is important to listen to one’s critics to see if they, perhaps, have some good points. Furthermore, it is important to know the roots of the controversy in order to decide what is best to do about it. Those who are denying the existence of PAS are causing great damage to many families. By understanding better the causes of their denials and criticisms of PAS, a PAS evaluator is in a better position to reduce the controversy and help these families. I provide here what I consider to be some of the more important explanations. I do not maintain, however, that I know them all.

The PAS and the Adversary System

The PAS is very much a product of the adversary system (Gardner, 1985a, 1987a, 1987b, 1989b, 1992b, 1998c, 2001c). Furthermore, a court of law is generally the place where clients attempt to resolve the PAS. Most newly developed scientific principles inevitably become controversial when they are dealt with in the courtroom. It behooves the attorneys—when working within the adversary system—to take an adversarial stand and create controversy where it may not exist. In that setting, it behooves one side to take just the opposite position from the other if one is to prevail. Furthermore, it behooves each attorney to attempt to discredit the experts of the opposing counsel. A good example of this phenomenon is the way in which DNA testing was dealt with in the OJ Simpson trial. DNA testing is one of the most scientifically valid procedures for identifying perpetrators. Yet the jury saw fit to question the validity of such evidence, and DNA became, for that trial, controversial. I strongly suspect that those jury members who concluded that DNA evidence was not scientifically valid for OJ Simpson would have vehemently fought for its admissibility if they themselves were being tried for a crime of which they were innocent. I am certain, as well, that any man in that jury who found himself falsely accused of paternity would be quite eager to accept DNA proof of his innocence.

A parent accused of inducing a PAS in a child is likely to engage the services of a lawyer who may invoke the argument that there is no such thing as a PAS. The reasoning goes like this: "If there is no such thing as the PAS, then there is no programmer, and therefore my client cannot be accused of brainwashing the children." This is an extremely important point, and I cannot emphasize it strongly enough. It is a central element in the controversy over the PAS, a controversy that has been played out in courtrooms not only in the United States but in many other countries as well. And if the allegedly dubious lawyer can demonstrate that the PAS is not listed in DSM-IV, then the position is considered "proven" (I say "allegedly" because the lawyer may well recognize the PAS, but is only serving his client by this ruse). The only thing this proves is that in 1994 DSM-IV did not list the PAS. The lawyers hope, however, that the judge will be taken in by this specious argument and will then conclude that if there is no PAS, there is no programming, and so the client is thereby exonerated. The lawyer’s substituting the term PA circumvents this problem. No alienator is identified, the sources are vaguer, and the causes could lie with the mother, the father, or both. In fact, it is one of the most important reasons why the term syndrome is eschewed by many people in custody litigation. PAS requires the identification of a perpetrator. PA does not. PAS is more threatening. It lessens the likelihood that the attorney representing the PAS programmer will be able to "muddy the waters," obfuscate the issues, and therefore blind the court to what is really going on. Evaluators who do not use the term are likely to be depriving the court of proper information about the cause of the children’s alienation. It lessens the likelihood, then, that the court will have the proper data with which to make its recommendations.

The Possible Dilemma of Guardians ad Litem
and Children’s Attorneys

The terms guardian ad litem (GAL) and attorney for the children are sometimes used interchangeably, especially because both are generally lawyers and both focus directly on serving the best interests of the children in their charge. Strictly speaking, there is a difference between the two roles. Guardians are generally appointed by the court or their appointments are approved by the court. In contrast, children’s lawyers are more likely to be chosen jointly by the parents, with less likelihood of input by the court. Children’s lawyers generally do not have free and unilateral access to the judge. They are similar to the parent’s lawyers in this regard. In contrast, GALs are viewed as the court’s "right arm" and usually have direct access to the judge, access not enjoyed by the parents’ attorneys nor usually enjoyed by children’s attorneys either. Guardians usually have greater freedom than children’s attorneys to speak to any and all parties involved in the litigation, especially each of the parents’ attorneys. In the courtroom, children’s attorneys are more likely to be conducting direct and cross-examinations, whereas the guardians are more likely to be sitting silently observing the proceedings.

Attorneys for the children and GALs have learned in law school that their primary obligation to their clients is to support vigorously their position and/or cause, even if they do not have conviction for the client’s situation. Some lawyers have problems with this dictum, for example, with clients who are murderers, criminal psychopaths, or pedophiles. They not only feel they will compromise their own values if they defend such clients, but if the case is brought to public attention, they may suffer stigma in family and community for representing such clients. Other attorneys do not have guilty consciences when representing such clients and claim that they are only doing what they have learned in law school, namely, that every accused party deserves zealous legal representation, no matter how repulsive the crime. PAS children are often like psychopaths and many of them are very psychopathic. This is especially the case with regard to their guiltless disregard for the feelings of the targeted parent. A GAL who recognizes the depravity of the PAS child may feel discomfort, and even suffer inner conflict, about zealously representing a client who would be so cruel to another human being, in this case a loving parent. One way of reconciling this dilemma is to substitute PA for PAS, with the implication that there could be other causes for the child’s alienation, including bona fide abuse and/or neglect by the alienated parent. Using PA diffuses the situation, muddies the waters, and opens up the possibility that the court too will not recognize the specific psychopathic disease suffered by the client child. This dilemma-alleviating value of the term PA, then, may contribute to the rejection of the PAS diagnosis by GALs.

The Possible Dilemma of
Family Law Attorneys

The same principle may hold for the attorney who represents the alienating parent. Acceptance of the fact that a PAS is operative in the case practically demands that one look very quickly for the indoctrinator, i.e., the perpetrator. Acceptance of the fact that the syndrome is present necessitates the search for the programmer. The analogy to AIDS is applicable here. Once the AIDS diagnosis is made one cannot deny that a specific category of virus is operating. In most PAS cases, it is not hard to ascertain who is at fault. An attorney who is reluctant to represent a client who is a PAS indoctrinator, a parent who would perpetrate the abominable act of programming his (her) own children against a loving ex-spouse, may be able to diffuse this dilemma by embracing the PA explanation. Such an attorney cannot deny that the children are alienated because all agree that this is the case. Substituting the PA alternative confuses the situation, lessens the likelihood that the indoctrinator will be easily identified, and may raise the hope that some abuse may be found on the part of the alienated parent to explain the children’s campaign of denigration.

The Possible Money Factor

It is a well-known fact of life that the poorer the client, the shorter the trial. The OJ Simpson case ("the trial of the century") is a good example of this principle. If, at that time, a poor black man were to have murdered two white people in Los Angeles, he would not have been represented by an extremely expensive "dream team" of attorneys, and he would not have had an eight-month trial. Rather, he would have been assigned a legal-aid lawyer, most likely someone just out of law school and/or with limited experience, and his trial probably would have taken a week, or even less time. One of the proverbial light-bulb jokes is applicable here:

The same principle holds with regard to child-custody disputes. The more money the clients have, the longer the trial. In fact, litigated child-custody disputes are generally a prerogative of the rich and not something that most poor people can afford. Many (I did not say all) attorneys are ever sensitive to their clients’ financial resources and monitor their efforts accordingly. When the clients’ resources run low, they reduce their efforts. For very wealthy clients, there is no limit to the amount of work they are willing to expend in the service of working "for the best-interests-of-the-children." When the money runs out, many attorneys could not care less about what happens with the children. The PA label is likely to confuse issues and thereby lengthen the trial. In contrast, a PAS diagnosis is more specific and is likely to shorten the trial. Although not publicly stated, I believe this is one of the important factors operative when attorneys vigorously deny the existence of the parental alienation syndrome. If PAS becomes listed in DSM-V it will result in a significant loss of money for attorneys.

It would be an error if the reader were to conclude that I believe that all lawyers are as mercenary as those described here. This is not the case. There are lawyers who take on pro bono cases; there are lawyers who accept clients at reduced fees; and there are lawyers who will continue to represent clients long after their financial resources have been depleted. Many of the attorneys in this category recognize well the validity of the aforementioned criticisms I have of their colleagues. Over the 38-year time span in which I have been involved in custody litigation, I have seen such attorneys. However, I have seen many more of the venal type, so many that the aforementioned comments about them as a group still hold. The mercenaries are the ones who most vigorously argue against the utilization of the PAS diagnosis and so enthusiastically embrace the PA explanation.

"PAS is Not a Syndrome"

This has been a central element in the PAS controversy. There are some who claim that the PAS is not really a syndrome. This criticism is especially seen in courts of law in the context of child-custody disputes. It is an argument sometimes promulgated by those who claim that PAS does not even exist. The PAS is a very specific disorder. A syndrome, by medical definition, is a cluster of symptoms, occurring together, that characterize a specific disease. The symptoms, although seemingly disparate, warrant being grouped together because of a common etiology or basic underlying cause. Furthermore, there is a consistency with regard to such a cluster in that most (if not all) of the symptoms appear together.

Accordingly, there is a kind of purity that a syndrome has that may not be seen in other diseases. For example, a person suffering with pneumococcal pneumonia may have chest pain, cough, purulent sputum, and fever. However, the individual may still have the disease without all these symptoms manifesting themselves. The syndrome is more often "pure" because most (if not all) of the symptoms in the cluster predictably manifest themselves. An example would be Down’s Syndrome, which includes a host of seemingly disparate symptoms that do not appear to have a common link. These include mental retardation, Mongoloid-type facial expression, drooping lips, slanting eyes, short fifth finger, and atypical creases in the palms of the hands. There is a consistency here in that the people who suffer with Down’s Syndrome often look very much alike and most typically exhibit all these symptoms. The common etiology of these disparate symptoms relates to a specific chromosomal abnormality. It is this genetic factor that is responsible for linking together these seemingly disparate symptoms. There is then a primary, basic cause of Down’s Syndrome: a genetic abnormality.

Similarly, the PAS is characterized by a cluster of symptoms that usually appear together in the child, especially in the moderate and severe types (Gardner, 1998). These include:

1. A campaign of denigration

2. Weak, absurd, or frivolous rationalizations for the deprecation

3. Lack of ambivalence

4. The "independent-thinker" phenomenon

5. Reflexive support of the alienating parent in the parental conflict

6. Absence of guilt over cruelty to and/or exploitation of the alienated parent

7. The presence of borrowed scenarios

8. Spread of the animosity to the friends and/or extended family of the alienated parent

Typically, children who suffer with PAS will exhibit most (if not all) of these symptoms. This is almost uniformly the case for the moderate and severe types. However, in the mild cases one might not see all eight symptoms. When mild cases progress to moderate or severe, it is highly likely that most (if not all) of the symptoms will be present. This consistency results in PAS children resembling one another. It is because of these considerations that the PAS is a relatively "pure" diagnosis that can easily be made. Because of this purity the PAS lends itself well to research studies because the population to be studied can easily be identified. Furthermore, I believe that this purity will be verified by inter-rater reliability studies. As is true of other syndromes, there is an underlying cause: programming by an alienating parent in conjunction with additional contributions by the programmed child. It is for these reasons that PAS is indeed a syndrome, and it is a syndrome by the best medical definition of the term.

Campbell’s Psychiatric Dictionary (1989) provides this definition of syndrome:

PAS certainly satisfies this definition. Campbell also states:

With regard to level (1), in PAS we are not dealing with isolated signs and symptoms, even isolated, unrelated psychiatric signs and symptoms. With regard to level (2) we are certainly seeing grouping of signs and symptoms in the PAS. The eight symptoms I described are the primary ones that I have observed and I do see them grouped together. PAS has also satisfied level (3), in that the identifiable etiological agent is the programming parent.

There are some who claim that PAS is not a syndrome, but merely the expected reaction of a parent in the context of a divorce. PAS is not an expected reaction. It is an unusual reaction. Most separated or divorced parents recognize the importance of the child’s ongoing relationship with their estranged spouse. PAS indoctrinators blind themselves to the importance of this bond.

"PAS Does Not Exist
Because It’s Not in DSM-IV"

There are some, especially adversaries in child-custody disputes, who claim that there is no such entity as the PAS, that it is only a theory, or that it is "Gardner’s theory." Some claim that I invented the PAS, with the implication that it is merely a figment of my imagination. The main argument given to justify this position is that it does not appear in DSM-IV. The DSM committees justifiably are quite conservative with regard to the inclusion of newly described clinical phenomena and require many years of research and publications before considering inclusion of a disorder. This is as it should be. The PAS exists! Many lawyers involved in child-custody disputes are encountering it. Mental health and legal professionals involved in such disputes are observing it. They may not wish to recognize it. They may refer to it by another name (like "parental alienation"). But that does not preclude its existence. A tree exists as a tree regardless of the reactions of those looking at it. A tree still exists even though some might give it another name. If a dictionary selectively decides to omit the word tree from its compilation of words, that does not mean that the tree does not exist. It only means that the people who wrote that book decided not to include that particular word. Similarly, for someone to look at a tree and say that the tree does not exist does not cause the tree to evaporate. It only indicates that the viewer, for whatever reason, does not wish to see what is right in front of him (her).

It is important to note that DSM-IV does not frivolously accept every new proposal. Their requirements are quite stringent, 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.

DSM-IV states specifically that all disorders contained in the volume are syndromes, and they would not be there if they were not syndromes. Specifically, DSM-IV states:

Once accepted into DSM, the name syndrome becomes changed to disorder. However, this is not automatically the pattern for nonpsychiatric disorders. Often the term syndrome becomes locked into the name and becomes so well known that changing the word syndrome to disorder might seem awkward. For example, Downs’ syndrome, although well recognized, has never become Downs’ disorder. Similarly, AIDS (Acquired Immune Deficiency Syndrome) is a well-recognized disease but still retains the syndrome term.

"Dr. Gardner’s Publications on the
PAS Have Never Been Peer-Reviewed"

"Parental Alienation (PA) Does Exist,
but Parental Alienation Syndrome (PAS) Does Not"

Both exist. There are many causes of parental alienation, e.g., physical abuse, emotional abuse, verbal abuse, sexual abuse, and neglect. But there is another reason why children can become alienated from a parent, namely, being programmed into a campaign of denigration by an alienating parent. The disorder so produced, which I call parental alienation syndrome, is also a form of parental alienation. In short, the PAS is one subtype of parental alienation. To call PAS PA cannot but produce confusion. One of the reasons why medicine advances is that we become ever more discriminating about the various subtypes that exist for any particular disorder. One of the reasons why Hippocrates is known as the father of medicine is that he started to make such differentiations. Prior to his time, people suffered with "fits." It was he who recognized that there were different kinds of fits, each requiring a different form of treatment. One form of fits he referred to as epilepsy. Another he referred to as hysteria. His group was astute enough to recognize the differences between these different kinds of fits and provided different kinds of treatment. Three hundred years ago people suffered with heart disease. Now, we know that there are many different kinds of heart disease, each requiring its own form of treatment. One would not want to go to a doctor today who makes the diagnosis of fits and heart disease and not go any further. We want specifics. Similarly, saying that a child has parental alienation gives very little information. Anyone can observe that—the clients, the mother, the father, both lawyers, the guardian ad litem, and the judge. We want to define specifically the subtype of the alienation, and PAS is just one possible type. We are then in a far better position to provide specific treatment. Those who eschew the term PAS, for whatever reason, but embrace the term PA, are equivalent to those who would diagnose fits and heart disease. This does not represent progression, it represents regression.

There are many evaluators who fully recognize that PAS exists but will still use PA in a court of law. They recognize that they have an easier time with the PA than the PAS. No one is going to deny PA. Many people will deny PAS. Accordingly, they may have an easier time getting their reports admitted into court and there will be less argument against such admission. Such evaluators are being short-sighted. Using the term PAS indicates a specific programmer. In contrast, using PA clearly indicates that the children are alienated and that either parent could have exhibited behavior that could have resulted in the alienation. The term, then, removes the court’s focus away from the alienator and redirects attention to what might be only minor parental deficiencies exhibited by the alienated parent. Substituting PA for PAS is, therefore, a disservice to the targeted parent and lessens the likelihood that the court will be given the proper information upon which to make its decision. Furthermore, such evaluators are losing sight of the fact that they are impeding the general acceptance of the term in the courtroom, and possibly inclusion in some future edition of DSM.

There is, however, a compromise. I use PAS in all those reports in which I consider the diagnosis justified. I also use the PAS term throughout my testimony. However, I may also make comments along these lines, both in my reports and in my testimony:

"Although I have used the term PAS, the important questions for the court are: Are these children alienated? What is the cause of the alienation? and What can we then do about it?" So if one wants to just use the term PA one has learned something. The question is what is the cause of the children’s alienation? In this case the alienation is caused by the mother (father) and something must be done about protecting the children from the programming."

Elsewhere, I have discussed in greater detail the PA vs. PAS controversy (Gardner, 2002a, 2002e).

"Dr. Gardner’s PAS Has Given Abusing Parents
the Weapon to Use Against Their Accusers.
Specifically, They Deny Their Abuse and
Claim that the Children’s Animosity is the
Result of the Accuser’s PAS Programming"

Significant controversy swirls around this complaint. I do not deny that some bona fide abusers are doing this. I do not deny that some bona fide abusers are claiming that the children’s animosity has nothing to do with their reprehensible behavior, but is the result of the other parent’s programming a PAS into them. In fact, in recent years, with increasing recognition of the PAS, it has become the in-vogue excuse of the bona fide abuser. By 1998 this problem had become so widespread, that I devoted a whole chapter in my book on the parental alienation syndrome to the differentiation between PAS and bona fide abuse/neglect (Gardner, 1998). Furthermore, there is no question that such abusers gain support in this diversionary maneuver from their attorneys. It is also the case that some judges, especially those who are not properly knowledgeable about the PAS, have "bought into" this argument, failing thereby to recognize the bona fide abuse that was actually taking place in the case.

The implication of this criticism, however, is that I somehow am responsible for such misrepresentation of the PAS by these abusers. PAS exists, as does child abuse. There will always be those who will twist a contribution for their own purposes. Chapter nine in the second edition of my book The Parental Alienation Syndrome (Gardner, 1998c) provides evaluators with detailed criteria for differentiating between true abusers and PAS indoctrinators.

"Dr. Gardner’s PAS Work Has Been Misinterpreted
and Misapplied by Some Mental Health and Legal
Professionals with the Result That Some Parents
Have Been Inappropriately Deprived of Primary
Custodial Status"

I do not deny that some legal and mental health professionals are indeed misinterpreting and misapplying my work, much to the detriment of the client so affected. Again, the implication of this criticism is that somehow I am responsible for such misinterpretation of my contributions. There will always be those who will oversimplify a complex phenomenon and who will misrepresent a contribution for their own purposes. There will always be those who will not properly understand what they are reading and, hence, misapply it. When writing, whether it be on the PAS or on any other subject, I painstakingly attempt to be clear and try to correct in advance possible misinterpretations.

Whenever something becomes an in-vogue diagnosis, there will always be those who misinterpret it and misuse it. Blaming the person who originally described the disorder is the equivalent of blaming Henry Ford for automobile accidents or the Wright Brothers for airplane fatalities. Nor do we prohibit the production of automobiles and airplanes because of such misuse.

"The PAS Blames One Parent for the
Children’s Alienation and Exonerates the Other"

This is true. The implication of that statement is that I am irrationally and unjustifiably blaming the programming parent. As mentioned, when bona fide/neglect is present, then the children’s alienation is justified and the PAS diagnosis is not warranted. When the PAS diagnosis is warranted, then the programming parent should be blamed because that parent is abusing the child. I am sure that the same criticizers would have no problem blaming an abusive or neglectful parent for the primary source of the children’s alienation.

Those who promulgate this criticism are often women who claim that the PAS is basically a manifestation of my bias against women. They claim that PAS victim fathers most often bring about the children’s alienation by their own reprehensible behavior. In short, they claim, "He brought it upon himself and he deserves what he got." Often they will use as justification the claim that he doesn’t "respect the children’s boundaries," "He harasses them to visit with him," and "He doesn’t respect their needs." The father’s attempts to see his children are converted into psychopathological manifestations that justify their animosity.

My experience has been that when the PAS diagnosis is operative, the target parent is usually an innocent victim. Even though he (she) may have certain qualities that may have at times irritated or even temporarily alienated the children, the target parent does not deserve the campaign of denigration, the ongoing scorn, the complete rejection, and the decision never to see him (her) again. The animosity, then, goes far above and beyond what might be expected from these minor parental weaknesses (if present at all). The one quality that I do see target parents to have that might be contributing to the alienation is their passivity and fear of asserting themselves, lest the children be even more angry at them. Elsewhere, I have elaborated on this phenomenon in detail (Gardner, 2001c).

"The PAS Conforms to the Medical Model"

Those who criticize me for using the medical model claim that I ignore the family systems model. First, there is hardly a page in any my books on the PAS that does not involve the family systems model. I am constantly referring to the interactions and interrelationship between the alienating parent, the alienated parent, and the PAS child. Accordingly, this aspect of the criticism has absolutely no justification.

With regard to the criticism that PAS conforms to the medical model, the implication here is that the medical model is somehow improper and that PAS has nothing to do with the medical model. Each diagnosis in DSM-IV follows the medical model. In order to make a diagnosis, a physician must compare the patient’s symptoms with those listed in the appropriate medical book. The DSM-IV committees have repeatedly rejected family systems diagnoses because they are often nebulous and speculative. They are almost impossible to subject to controlled studies, especially studies in which statistical verification is warranted. I am certain that those who promulgate this criticism would want their doctor to follow the medical model when diagnosing any illness they may have.

I suspect strongly that there is a "turf war" element operative here. Whether justified or not, in recent years medical doctors have enjoyed greater prestige than mental health professionals such as psychologists, social workers, pastoral counselors, and nurse practitioners. The word syndrome triggers medical analogies and implies that PAS is very much within the domain of doctors and that we jealously covet the right to make this diagnosis. The term syndrome implies to some that they may be considered less qualified to use the term, especially in a court of law. If the word syndrome is dropped, then the problem is "up for grabs" to anyone who works with these families. The word syndrome, then, may be interpreted by some nonphysicians to mean that they will not be able to make the diagnosis, especially to a court of law.

Furthermore, a syndrome indicates a disease, and no one likes to be called "sick." Critics of the word will be surrounded by those who help them deny that they have an illness. For such people the word syndrome has a sinister connotation. It’s merely a "family problem" or "problem in family relationships." A PAS child is a sick child (especially in the severe level). There is no question about it. PAS children are suffering with a severe psychiatric disorder that might result in permanent damage to themselves. I am not referring here simply to the loss of their relationship with a loving parent, but the ultimate consequences to themselves after going around for many years with irrational hatred in their brain circuitry. Future studies, I am certain, will confirm the many types of detrimental effects of this sickness. An expert who uses the word syndrome is basically saying to the indoctrinating parent that he (she) is making the child sick, and parents do not want to hear that. PAS indoctrinators do not want to be confronted with the fact that they are causing a serious psychiatric disturbance in their children.

There are some who equate psychiatric disease with craziness. They do not consider the mild forms of psychiatric disturbance to justify the term "disease." What such people fail to realize is that the indoctrination of a PAS into a child against a good, loving parent is both "stupid" and "crazy." Parenting is an enormously complex and burdensome job, its gratifications notwithstanding. To turn away another person, most often a biological parent, and refuse to allow that individual to participate in a child’s upbringing is plain stupid. It turns away free labor. No other business in the world would do such a stupid thing. In addition, it is crazy, because it corrupts the brain of an innocent child. It is the equivalent of the daily injection of poisons into the brain of a child, and can result in lifelong psychiatric disturbance. It also drives the children crazy. And sadly, it is one of the most preventable and treatable forms of craziness. One can also argue that it is stupid and crazy not to do the things that are likely to change the course of this illness, namely, reducing the children’s access to the injector of the poisons.

Furthermore, some who deny that it is a disease will argue: "How can it be a disease if it can be cured simply by transferring custody of the child from the home of one parent to the home of the other parent." The implication here is that there are no diseases that cannot be cured by simple measures and that all cures involved Herculean and/or Draconian measures. Pneumococcal pneumonia will be cured with antibiotics in 95+ percent of cases. A person with a benign tumor can be completely cured by simple excision. Yet all would agree that they are diseases. My follow-up study provides compelling proof of this principle in that all 21 PAS children who were transferred from the home of the alienating parent to the home of the alienated parent enjoyed a very quick evaporation of the PAS symptomatology (Gardner, 2001d).

Anything that alludes to the medical model may make judges feel that they have less power. If they have medical experts, then it is harder for them to ignore their testimony. They may recognize that ignoring an expert’s medical testimony is more appealable than ignoring the more diffuse nonmedical testimony. There seems to be some carryover here from medical experts in other fields whose contributions to the court may be more formidable and whose testimony may be more powerful than the experts in the mental health professions. By eschewing the word syndrome, judges do not have to deal with a medical illness, and this gives them greater flexibility in overruling the testimony of experts.

For many people, the word syndrome automatically indicates that we are talking about a medical disease. A disease requires scientific proof in a court of law. If one avoids the word syndrome, then one does not have to give medical proof. This is probably another factor operative in the rejection of the word syndrome and its medical implications.

The Gender War

PAS has become a gender issue. In fact, it is more accurate to say that it has become the focus of a gender war. Women claim that the whole concept discriminates against women, and that any evaluator who concludes that PAS is present must be sexist. As stated, this position derived from the fact that in the 1980s and early 1990s I did observe women to be much more likely than men to be programming their children into PAS campaigns of denigration. It was then that I first heard this criticism. Even though I pointed out that my early publications noted that about ten percent of the indoctrinators were men, the label was applied to me. And this situation persists, even though in the last few years I have repeatedly stated that the ratio of male to female indoctrinators is about 50/50. Elsewhere, I have described what I consider to be the reasons for this gender shift (Gardner, 2001b). And this label has still been applied to me, even though I have repeatedly pointed out that the denial of PAS harms women because now they comprise about half of the victims (Gardner, 2002b).

Every group has its combination of people who are sane and sober, and those who are more fanatic. This is true of men’s rights groups as well as women’s rights groups. There is no question that the feminist movement has made important advances for society and, in general, I am fully supportive of the movement. However, I do observe overzealous members doing the movement more harm than good. The aforementioned position statement of California NOW is a good example of those who claim that PAS is sexist, and persist in that view in spite of all the evidence that women have equally become PAS victims. This has contributed to the genderization of PAS. And there are women who work in child protection who are similarly overzealous with regard to their removing fathers from access to the children, with the claim that the children’s professions of hatred must be valid, and the victim father is the abuser they profess he is. My experience has been that they are less quick to remove children from PAS indoctrinating mothers with the claim that there is no evidence for sexual or physical abuse. Yet they do not require that evidence to conclude that the father is a physical or sexual abuser—especially if the children say he is.

People who refer to themselves as "child advocates" are often similarly comprised of women who are biased against men and use their profession as a vehicle for expressing it. My experience has been that their advocacy for the child rarely involves supporting a man who is a victim of PAS. Rather, they deny its existence and reflexively support the mother. We see then here a merging of overzealous feminists and child advocates (Kopetski, unpublished ms.)

A related phenomenon is the pathological empowerment of children that we have witnessed in recent years. We see this in child protection workers, school personnel, and mental health professionals. Many sanctimoniously describe themselves as "really listening to children" and protecting them from a wide variety of allegedly noxious influences. There is no question that child abuse is widespread, and there is no question that children need protection from those who abuse them. However, when such protection goes too far, then this empowerment is doing them more harm than good. People like myself, who are alleged "not to really listen to children" who do not take at face value what they say, who claim that children’s professions of hatred are not to be believed automatically, are viewed as "not really caring about children." This empowerment contributes to the development and perpetuation of the PAS. I mention it here, because it overlaps with the gender issue in that the overzealous child-protection people are far more likely to empower children when they are professing hatred of their fathers, than they are likely to empower children when they are professing hatred of their mothers. Elsewhere, I have elaborated on this issue (Gardner, 2002f).

The gender issue has also, I am certain, affected judges. Women judges are afraid to recognize PAS and order the custodial transfers sometimes warranted because of the fear that they will be viewed as disloyal to the plight of women. And male judges are similarly fearful that they will be labeled sexist if they take children away from a mother.

The Overuse of the Word Syndrome

One factor operative, a factor that I do not believe to be primary, is the overuse of the term syndrome. It is often frivolously applied to situations that for a variety of reasons do not warrant the term. For example, some will use the term sex-abuse syndrome. There is no such thing as a sex-abuse syndrome. Sex abuse does not necessarily cause symptoms. However, when it does (the more common situation) it can produce a wide variety of symptoms covering most of the symptoms known to psychiatry. The battered child syndrome also has little specificity. Summit’s child sex abuse and accommodation syndrome (CSAAS) was very much a source of controversy, especially 10 to 15 years ago (Summit, 1993). Many courts have rejected it and other courts have espoused it. But the whole controversy gives the syndrome concept a bad name. Premenstrual syndrome (PMS) has been the center of great controversy, especially objected to by some feminists. It was not, per se, accepted into DSM-IV, but is to be found at the end of the book in the category, "Other Conditions that May Be a Focus of Clinical Attention," and given the name, Premenstrual Dysphoric Disorder. There are no code numbers for disorders in this section and, presumably, may not allow for insurance coverage. Then there is the Shaken Baby Syndrome, again, a term of dubious value. I recently read about a red wine syndrome, so termed because of the headaches some people get after drinking red wine. Obviously, this is not a true syndrome. It is one, single, symptom (not a cluster).

It is probably the case that the frivolous use of the term syndrome has given real syndromes a bad name, and the rejection of PAS may in part be a result of the bad reputation that the term syndrome has gotten. That said, there is generally no objection to the use of the term, Down’s Syndrome or Acquired Immune Deficiency Syndrome (AIDS). When a syndrome becomes well-established and well-recognized it does not suffer the bad reputation associated with the utilization of the term.

The Passivity Factor

My experience has been that passive people are probably overrepresented in the population of therapists. Specifically, people who are afraid to take action may find attractive the field of psychotherapy because they can sit, listen, shake their head up and down, occasionally say a few words of sympathy and empathy, and end up doing nothing. This they consider to be "therapy." In medicine, the field I know best, the types who become emergency room physicians are very different from the types who become psychiatrists, especially in the days of my training when psychiatry had few medications to offer and was much more "talk therapy."

And the same is true for the psychologists and social workers who become psychotherapists. They sit, deliberate, consider both sides of the story, and work under the principle that talking about it long enough will ultimately result in "things working out." Although their experience may really have been that things most often don’t work out under those circumstances, they still subscribe to this principle, in part because they would not be comfortable taking action.

Such therapists can easily be manipulated by PAS indoctrinating parents and they are easily taken in by the programmers’ claims that the other parent is indeed abusive and neglectful. Alienators know that such therapists are uncomfortable with being authoritarian and dictatorial and giving clear direction to clients. These are the qualities that are necessary for being an effective therapist for PAS children and their families. Accordingly, therapists who would accept as valid my more nontraditional recommendations would be required to take action and this is something that they had not planned for when they chose to be psychotherapists. Empowering the children and claiming that they really respect children, and really listen to them (unlike people like myself) can serve as a rationalization for their passivity.

These same personality qualities may interfere with evaluators’ recognizing the PAS. They are uncomfortable making a recommendation that would involve custodial transfer and the disruptions entailed in that recommendation. Rather, they recommend therapy and working things out. They don’t want anybody to get upset with them. They want people to sit down rationally and talk things out in a civilized way. However PAS families—especially in the moderate and severe levels—are way beyond that. The indoctrinators have become irrational and do not sit down and "work things out." Passive evaluators and therapists then recommend even more of the therapeutic approach to the courts, who are happy to comply with such experts’ recommendations. Such evaluators and therapists are comfortable with these passive approaches, especially because they are less likely to get people angry. They claim that they will be able to work things out in a civilized fashion with the PAS family and not have to resort to what they believe to be the Draconian procedure of custodial transfer or court-enforced reduction of access to the children by the programming parent.

My experience has been that judges as well are similarly passive. They do not want to "make waves." They do not want people protesting their decision. Many judges have told me that they will not transfer custody, because it would be too disruptive to the children’s lives. The children would have to change schools, change neighborhoods, as well as accommodate to living in the other parent’s home. What judges do not appreciate is that such a position is short-sighted. What they do not appreciate is that the long-term trauma of total destruction of the child’s bond with the allegedly alienated parent is far more traumatic than the trauma of the immediate disruption of that bond with the alienating parent by forced transfer. Spending one’s life permanently alienated from a loving parent is a chronic trauma that inevitably results in a wide variety of psychiatric problems. In contrast, removing the child from the alienating parent is an acute trauma, because of the aforementioned changes in school, neighborhood, etc. Children will generally make such adjustments without long-term psychological sequelae. Furthermore, the transfer removes the child from the stress and trauma of being programmed to believe things that never occurred, especially things about the alienated parent that never happened.

There is an analogy here with the case of Elian Gonzalez, the Cuban boy who was held hostage by his relatives in Miami. Although the custody dispute over Elian Gonzalez was between his Miami relatives and his father, the relatives were still attempting to indoctrinate a PAS in him. Relevant to my point here is the issue of the comparison of the acute trauma of his dramatic capture, vs. the chronic trauma of permanent alienation from his father. Elian had already suffered the trauma of his mother drowning on the same boat from which he had survived. (I don’t know whether he actually observed the drowning.) Then he found himself being programmed to hate his father (whom we had good reason to believe was dedicated and loving, divorced status with his mother notwithstanding). It was quite apparent that Elian was being used as a political pawn between the anti-Castro and the pro-Castro forces. It was clear that Elian was being programmed into a parental alienation syndrome and that the relatives were overzealous and even fanatic PAS programmers, who were using the political arguments as their primary weapons in the programming process. Although Janet Reno’s "invasion" of the home in the early hours of the morning, and her use of soldiers and machine guns was certainly frightening and traumatic, that acute trauma was, I am convinced, far less dangerous to Elian than the long-term trauma of his being programmed to fear and even hate his loving father. Although family court judges certainly do not have Janet Reno’s power, they should look to her as a model for decisive intervention in dealing with PAS.

Judges, in my experience, are also afraid of the overzealous segment of the women’s liberation movement. They fear that if they rule against mothers they will be viewed as sexist. And female judges similarly fear that if they rule against women they may be viewed as politically incorrect. My experience has also been that there are some women, who are biased against men, who gravitate toward the judiciary because it gives them the opportunity to vent (almost with impunity) their rage against men. Men and their lawyers well know that they "don’t stand a chance" in such judges’ court.

The-Protection-of-Women Factor

Another factor operative in the PAS controversy is what I consider to be the genetic protectionism of women by men. Over the long course of history, men have traditionally been the hunters, warriors, and food gatherers, and women the child-rearers. Over hundreds of thousands of years this has resulted in a selective survival of those female genes that are involved in the child-rearing process (hugging, cuddling) and the selective survival of those genes necessary for survival (hunting, food-gathering, and protection of women from enemies). The attraction, and even persistence, of the fantasy of the knight in shining armor rescuing the damsel in distress is an excellent example of this phenomenon. Farrell (1993) considers this an important factor in understanding the relationship between men and women. Farrell (2002) believes that this is also an important factor in the resistance to the acceptance of PAS, because in those cases in which women were found to be "guilty" of being PAS indoctrinators, the court would cause them grief by reducing their access and even removing the children from them. Judges and mental health professionals feel comfortable protecting women from men and will deny women’s reprehensible behavior in the service of this protectionism principle, even if the reprehensible behavior is a PAS indoctrination.

The protection of women factor is well-demonstrated by the fact that between 1976 (the year the Supreme Court allowed capital punishment to resume) and 1998, 430 men and only one woman were executed. In 1984, Velma Barfield was put to death in North Carolina for lacing her boyfriend’s food with rat poison. In 1998, Carla Faye Tucker faced execution in Texas for hacking a man and a woman to death during a 1983 break-in. There was worldwide publicity over Tucker’s case, including pleas for mercy from Pope John Paul II and TV evangelist Pat Robertson. When she was executed on February 3, 1998, she was the first woman executed in Texas since the Civil War, and the first nationwide since the Barfield execution in 1984. Tucker herself, stated that she did not want this help, that she had committed the murder, and deserved the punishment. We see here an excellent example of this protection-of-women phenomenon operating. Although there are fewer women murderers than men, the ratio is not 430 to 1. Streib collected statistics on female offenders from January 1, 1973 through June 30, 2002 (Streib, 2002). He found that women accounted for 10 percent of murder arrests, but only 1.9 percent had death sentences, 1.5 percent are currently on death row, and only 1.1 percent have been actually executed in that time frame. Looking at the same figures in another way, we see how men accounted for 90 percent of murder arrests but 98.1 percent of death sentences. We see here confirmation of Farrell’s and my own belief that the protectionism factor has been operative in the denial of PAS. Farrell (1993) also states that 100 percent of juveniles on death row are boys, even though juvenile girls are more likely to kill their children.

A related factor is the notion that women are generally viewed as more tenaciously committed to protecting their children than men. There is no question that in lower animals the mother will fight to the death in order to protect her offspring from predators. It may very well be that in the human species, women have a stronger drive to protect their children than men, but there is no question that men too will fight to the death to protect their children. Whatever the actual strength of these forces in humans, there does appear to be the general view that women will more tenaciously protect their children from outside danger than men. A derivative of this view is that there is something that goes against nature to forcefully remove children from a mother. Judges are not immune to this notion, a notion that may be playing a role in their reluctance to transfer custody from a mother to a father.

Relevant here is a case I was involved in, in which the mother, age 30, was a school teacher. She was accused by the parents of a 14-year-old boy of having engaged in sexual fondling with him. The parents had called the police, and there was a police investigation. Both the mother and the boy admitted to the same degree of sexual fondling on approximately six occasions. The school told her "not to do it again" and did nothing else. The police said that the matter was under continuing investigation, but never reached the point of conclusion. The father, after learning of the fondling, decided to divorce the mother, having tolerated in the past a number of sexual involvements on her part with other men. He told me that this was "the last straw." After the mother learned that the father wanted to divorce her, she accused him of sexually abusing their 14-year-old daughter. Although at first the daughter denied that she was abused, she subsequently "remembered" that there had indeed been some fondling. Immediately, a restraining order was issued and the father was forced out of the house. After evaluating the family, I concluded that the daughter’s accusation was fabricated, and there was absolutely no evidence that she had ever been sexually abused by her father. We see here a very good example of a phenomenon by which the police and the courts are likely to take quick action against a man who is accused of sexual abuse—even in situations in which the accusation is highly suspect—and may do absolutely nothing when the accusation is against a woman.

The Politically-Incorrect Factor

Often one cannot fully explain why things shift in and out of vogue. In one year something may be "in," and the next year the same thing is "out." Of course, the forces that I describe in this section are often operative in determining how the pendulum will shift, but one of the factors is what is best referred to as the "keeping-up-with-the-Joneses" factor. That the Jones’s position may not be justifiable, and even rational, is often less important than the dictum that one doesn’t want to be an outsider, a maverick, and viewed as an oddball. Going along with the crowd is a very important factor in human behavior. Atypicality is generally viewed with suspicion. The general consensus is there must be something wrong with the person who is different. The word "gregarious" is derived from the Latin word grex, which means sheep. The Romans recognized that those who went along with the crowd are justifiably compared to sheep. One doesn’t want to be viewed as someone who is not in touch with the latest trends. Human beings are very suggestible and feel much more comfortable moving with the mainstream, even if the mainstream is moving in a direction that may not be in its best interests.

The history of the world provides many examples of the grief suffered by mavericks, mavericks who subsequently are viewed as very brave people who were able to stand up for their principles even though they were very much in the minority. There is an old Chinese proverb: "He who sticks his head above the crowd is bound to get hit with rotten eggs." And this is the position of many people who recognize that PAS very much exists, but recognize also that if they say so publicly, they may find themselves the target of significant criticism. I have heard this repeatedly from judges, lawyers, psychiatrists, psychologists, social workers, and others involved in working with PAS families. Many people have said to me: "I am in full agreement with you on PAS and admire you very much for speaking out so strongly and vociferously." I have sometimes asked such people: "Why aren’t you speaking up?" Some of the answers: "I’m afraid. People might get upset with me," "I’ll never get any advancement in my facility if I were to talk about PAS," and "If I used the term PAS, I might lose my job." Others just walk away sheepishly and give me no answer. The strength of a politically-incorrect factor cannot be overestimated.

It may very well be that another factor operative here relates to the fact that the judge was brought up in a world in which mothers took care of children and fathers went out to work. The notion that a father might be the primary caretaker goes against this preconceived notion of what a family should be. Transferring custody, then, involves the creation of a very strange kind of family arrangement, just the opposite of what the judge has in mind as to what a proper and acceptable family structure should be like. Such notions are not easily altered and PAS threatens its alteration in those cases where the judge is being asked to take custody from a mother and transfer the children to the father.

The Gardner-PAS Identification

Another source of the controversy relates to the strong identification between my name and the PAS. I believe that some of the anger (and I do not hesitate to use this word) directed at the PAS is really anger directed at me. The question then is, why the anger? I believe one source relates to the fact that for many years I have been very critical of the legal profession, especially those who involve themselves in adversarial proceedings in the context of child-custody disputes. I believe, however, that my criticisms have been basically constructive, because I have always described ways of changing and improving the system, going back all the way to the training of lawyers (Gardner, 1982a, 1985b, 1989b, 1992b, 1995a, 1998c). For example, I have repeatedly described how adversarial proceedings are just about the worst way to attempt to resolve child-custody disputes. I have repeatedly recommended mediation as the more humane and civilized method for dealing with such conflict. Mediation, of course, is far less expensive than protracted litigation, so there are many attorneys who are very unhappy about the utilization of this alternative method of dispute resolution. The comments I have made above in "The Possible Money Factor" section is likely to make many attorneys angry, and their anger is likely to be directed not only at me but toward any of my contributions.

I have also been critical of many mental health professionals with regard to the way they have conducted child-custody and sex-abuse evaluations. If PAS is taken seriously, especially my statements that therapy does not help as long as the children are living with the alienating parent, then many mental health professionals, especially psychologists and social workers, will lose a lot of money. Many PAS children are currently in treatment, often ordered by the court. Generally, they are just labeled "alienated" children, and the PAS diagnosis is ignored. The potential loss of money that might result from the recognition of PAS, is also a factor that is operative in the refusal to recognize the disorder. The criticisms that I have directed at other mental health professionals are multiple and longstanding. My reports have described incompetence, negligence, and various forms of unethical behavior. On occasion, these reports have been included in complaints to ethics committees, licensing bureaus, and even malpractice suits against them, with my reports being used in evidence. I have always taken the position that my first obligation is to my patients, and if criticizing another mental health professional will serve the best interests of my patients I will do so. I have never "covered" for them, nor have I ever taken the position that it is not proper of me to criticize another professional in a court of law.

I have been very critical of some of the assessment instruments used by many mental health professionals. I was one of the earliest to write about anatomical dolls as a terrible interview contamination. But without those dolls many evaluators, especially in the child protection realm, felt helpless. I have pointed out to psychologists the futility of using standard tests such as the Rorshach, MMPI, MCMI, and TAT in custody and sex-abuse evaluations. These instruments were not designed for such purposes, and they are of extremely low yield for providing the court with useful information. Without them, however, many evaluators have felt like surgeons whose scalpels have been taken away. They do not know what else to use. They have little training, experience, or expertise in clinical interviews, which are the best sources of information when conducting child-custody/sex-abuse evaluations. My criticisms over the years have often provided important information for clients, attorneys, judges, and juries involved in such litigation. However, I am certain that many of those whose work I have criticized harbor significant resentment against me, resentment that is then directed at the PAS as well as other contributions of mine. Accordingly, mental health professionals who use the term PAS may find themselves the targets of such criticism. Elsewhere I have elaborated on this point (Gardner, 2001d). Warshak (2001) has also addressed himself to the sources of the PAS controversy.

THE FUTURE

Making predictions about the future is always a risky business. The more data one has for extrapolation, the greater the likelihood that one’s future predictions will be valid. In the PAS situation there is a war going on between the pro- and the anti-PAS forces. In some wars it is easier to predict who will ultimately prevail; in this one, I cannot say. I do know, however, that certain things could be done to increase the likelihood that the PAS forces will "prevail." The question is whether these measures and recommendations will indeed take place.

The Role of PAS Alienated Women

There is no question that women are increasingly becoming victims of their spouses’ PAS indoctrinations. With widespread awareness of the PAS, more men have read my books and have utilized the same techniques that women alienators used in earlier years. The denial of the PAS has left these PAS alienated women feeling even more helpless. Whereas the women who deny PAS are well organized, the women who recognize its existence are not. PAS alienated women must work together. They must organize. They must be vocal. They must let judges know that when they deny PAS they are ignoring the pleas of women who are victims of their spouses’ PAS indoctrinations. At this point, many judges believe that the denial of PAS protects them from being labeled sexist by the overzealous members of the women’s movement. They don’t appreciate how much rage and indignation they have engendered in those women whose cries of PAS have been ignored. PAS alienated mothers must place pressure on women’s groups to listen carefully to them and to appreciate how they are betraying their own gender by the denial of PAS. If women’s groups form a consensus that women can also be the victims of PAS, and hence recognize its existence, a great step will have been taken toward reducing the controversy and decompress, if not evaporate, the false gender issue that is such an important factor in the controversy. I list this as the number one thing that must be done in the PAS realm.

Education

There are many myths circulating and even believed about PAS that have no basis in reality, e.g., that I hate women, that I support pedophilia, that I don’t care about abused children, and that I am supportive of abusing men. Myths have a way of becoming deeply engrained in people’s psyches and believed as if they were true. Those who consciously and deliberately circulate misinformation know quite well that the greater the number of people one can get to believe a lie, the greater the likelihood that most people will accept it as a truth. And these truths may perpetually travel down the generations. All of us learn in school about the Trojan War, the Trojan horse, how Helen eloped with a Trojan prince, and the Greeks went to war for 10 years to get her back. We know this because Homer—who probably lived around 800-900 B.C.—told us about these events in The Iliad, events which occurred about 400 years previously. We know how good record-keeping was between 1200 and 800 B.C. What is not generally appreciated, is that there is absolutely no evidence that there ever was a Trojan War, especially a war lasting 10 years that was waged because a 12-year-old girl abandoned her Greek husband, Menelaus, for the foreigner, Paris. Heinrich Schliemann (1822-1890), the German archeologist who excavated the sites of Troy, found absolutely no evidence for a Trojan War at any of the excavated levels. In fact, if we are to believe in Helen, we must believe also that her father was the god Zeus, who transformed himself into a swan and impregnated her mother, Leda, Queen of Sparta.

Everyone knows that Richard III of England was ugly, deformed, and had a hunchback. How do we know this? Because William Shakespeare said it in his play. Actually, none of this was true. He was a good looking man, was not deformed, and did not have a hunchback. But the deformity made for better theater, and Shakespeare knew it. The transformation served political purposes because it pleased Queen Elizabeth I (House of Tudor) to see her predecessor, Richard III (House of York) so transformed. The transformation was politically judicious, not because Richard III was the queen’s predecessor (she would not have been pleased at having his name smeared if that were the case), but because it helped reinforce the legitimacy of the dethroning of Richard III by Elizabeth’s grandfather, Henry VII, and his subsequent establishment of the House of Tudor.

When I was a boy, I read about Catherine the Great. My father told me that she died having sexual intercourse with a horse. In subsequent years, I also heard about this alleged depravity of hers from others. The best evidence is that she did indeed have about 10 lovers—all of whom were human. She also died in bed, with no horses present. But I believed that for many years because my father had told me this.

The myths that circulate around PAS are similarly preposterous, yet believed by thousands. Psychologists must be educated about PAS in graduate school. Right now, to the best of my knowledge, nothing is taught about it, or they are being told that it is a "discredited theory," that it’s "Gardner’s brainchild," "that there are no peer-reviewed articles in the literature on it," that "it is not accepted in any courts of law," that "Gardner never makes any diagnosis other than PAS" that "Gardner doesn’t believe in true sex abuse," etc. Judges have to learn about it. They have to learn to recognize it and they have to become comfortable putting its name in their rulings. Many judges have told me privately that they recognize the PAS but, for many of the aforementioned reasons, do not use the full term in their rulings. Judges have to recognize that they are abandoning tens of thousands of women by denying PAS. Family court judges who see it before them every day, but do not appreciate what they are seeing, have to be educated about its existence.

Future Studies

Probably the best way to determine whether or not I am correct when I say that PAS is a syndrome is to conduct inter-rater reliability studies. One of the problems with conducting such studies is to find people who are truly neutral, who have absolutely no position one way or the other regarding whether PAS is indeed a syndrome. I strongly believe that if such studies are properly done, they will provide compelling confirmation that PAS is a syndrome in every sense of the word.

In addition, follow-up studies need to be done. I know of only three: Clawar and Rivlin (1991); Dunne and Hedrick (1994), and my own (Gardner, 2002d). Studies need to be done to delineate the specific kinds of psychopathology that emerge in people who are permanently alienated from a loving parent as a result of PAS indoctrination. Such studies, I am certain, will provide compelling evidence that PAS is a form of child abuse and can result in lifelong psychopathology.

We cannot wait until all the data is in before testifying about PAS in courts of law. PAS victims are suffering now, and they need help now. This is the same situation that has prevailed with regard to my testimony regarding the false sex-abuse allegation spin-off. Judges have to make decisions now; juries have to make decisions now; and they cannot wait until all the studies are in. The have to rely upon the best evidence at this point.

In May 2002, the Journal of the American Medical Association (JAMA) published an article describing 22 cases of Anthrax (Inglesby, T.V. et al., 2002). These were patients who died recently when Anthrax spores were sent through the mail, particularly to the Washington D.C. area. Anthrax has always been a rare disease, and very few cases were studied. Details were not to be found in the medical literature. The JAMA does not usually publish articles in which the total number of patients studied is 22, studies that do not allow rigorous statistical analysis. However, in this article they made an exception—and justifiably so. They could not wait until more studies had been done, especially those with statistical analysis. Patients needed the information now, as did their doctors. I am certain that lawyers or mental health professionals who argue that my testimony on differentiating between true and false sex-abuse accusations should not be admitted into courts of law, because there have not been enough scientific studies, would not give the same argument about the JAMA article, especially if any of their close friends or relatives received such an envelope. They would be among the first to welcome this study of "only 22 patients." They would not argue that they would not see their doctors until all the data was in. They would be most happy that their doctors read the article, or if the doctor had not done so, might even bring it to the doctor’s attention.

The Issue of PAS in DSM-V

The parental alienation syndrome is not listed in The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Critics of PAS are quick to point this out and consider its absence to support arguments that PAS does not exist. The facts are that DSM-IV was published in 1994. When committees were meeting in the early 1990s, there were too few articles in peer-review journals, and too few rulings in courts of law that had recognized PAS, to warrant a submission. Accordingly, I did not submit a proposal at that time. Nor, to the best of my knowledge, did anyone else.

DSM-V committees are scheduled to start meetings in 2006, and the projected date of publication of DSM-V is 2010. The DSM-V program coordinator at the American Psychiatric Association has informed me that a PAS file has been set up. This, of course, is good news in that it indicates that the APA is taking PAS seriously. The bad news is that the file includes highly biased submissions and even sensational newspaper articles that do not provide a balanced view of PAS. I have good reason to believe that critics of PAS have been much more active than its supporters in sending submissions to that file. Accordingly, I am suggesting that therapists who have seen PAS patients write the APA describing their experiences with such patients, with particular focus on the number of patients they have seen who exhibit specific symptoms of the syndrome (e.g., campaign of denigration, frivolous excuses, lack of ambivalence, etc.).

I am also suggesting that alienated parents write—again with particular focus on the specific syndrome symptoms they have observed in their children. I am recommending that lawyers who represent alienated parents also write. I emphasize to lawyers that if PAS is not accepted into DSM-V, their position in courts of law will be seriously weakened. I am also suggesting that other interested parties, such as relatives of PAS families, and older children who subsequently came to appreciate that they had been programmed to become PAS victims, also write to the APA. When people ask me what they can do to help PAS families, I advise them to write the APA. I suggest to all writers to focus on the specific syndrome symptoms that they have observed. The address:

Last, I recommend that people write at this point, rather than waiting until 2006. Critics are sending information now, and delay would be a serious error.

A Well-Known PAS Victim
Who Is Also Very Wealthy

In 1992, I saw little hope that there would be any general recognition of my claims that there were many false accusations of sex abuse being promulgated—especially in the context of child-custody disputes. Then Woody Allen was accused by Mia Farrow of having sexually abused their child. Soon thereafter, he stated at a news conference (in words to this effect): "My lawyers tell me that the false sex-abuse accusation is a recent phenomenon in child-custody disputes." At that point my life changed. Soon thereafter, I was invited to write an op-ed editorial on the subject for The Wall Street Journal (Gardner, 1993h). Then, in early 1994 a young man claimed that, while in repressed memory therapy, he uncovered a memory of his having been sexually abused by Cardinal Bernardin. Shortly after that he retracted his accusation, publicly claiming that he had learned that memories emerging under such circumstances may not be true, and he had no actual recollection of his alleged sexual abuse. Within the next few days I was invited to appear on Crossfire (March 1, 1994), The Charlie Rose Show (March 2, 1994), and Nightline (March 4, 1994). Subsequently, I was invited to appear on Larry King Live (May 8, 1994). I believe that these public statements, involving people in high places, had a dramatic influence on increasing recognition of the false sex-abuse accusation phenomenon.

PAS needs a victim in a high place, a well-known person who will announce to the world that he/she has been a victim. This will add important credibility to the claims of all the other victims. This has not happened yet. It would be even better for PAS if the victim was very wealthy—so wealthy that a foundation could be started. This foundation would be in a position to implement the various programs that are necessary, e.g., especially research and education. The philanthropist who is a PAS victim would be more likely to have a commitment to such a foundation, especially the commitment to set up a foundation in such an atmosphere of controversy.

The German philosopher, Georg Wilhelm Friedrich Hegel (1770-1831) emphasized the concept of dialectical logic. Specifically, he had theorized that social and intellectual progress comes first from the presentation of a concept (thesis). This is followed by general opposition (antithesis). What ultimately emerges is a new concept (synthesis). I am very dubious that we will ultimately reach synthesis with my PAS critics. I cannot imagine that my thesis that PAS is a syndrome will ultimately be diluted in some sort of synthesis. I cannot imagine, as well, that my belief that the best hope for PAS children comes from a reduction of access by the PAS alienator will reach synthesis. Accordingly, I do not see the Hegelian philosophical concept to be applicable to the PAS controversy at this point.

More relevant are the views of another German philosopher, Arthur Schopenhauer (1788-1860), who lived here in Frankfurt and is buried in its Hauptfriedhof. He said, "All truth passes through three stages: Firstly, it is ridiculed. Secondly, it is violently opposed. Thirdly, it is accepted as self-evident." I believe that the guidelines that I have described here for what PAS needs in the future will ultimately result in people saying that "it was all self-evident." The big question is: How long is that going to take?

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