Kaja Perina Editor in Chief Psychology Today [email protected]
I am a family physician and a member of Fathers and Families. This letter is in regard to a Psychology Today blog article entitled "Parental Alienation Syndrome:' Another Alarming DSM-5 Proposal by Paula J Caplan, Ph.D
It"s not surprising that someone who is an avowed feminist and has gained professional notoriety from previous denouncements of the American Psychiatric Association"s Diagnostic and Statistical Manual of Mental Disorders (DSM) would assail the concept of Parental Alienation Syndrome (PAS). However, Psychology Today editors owe its readers a less blatantly biased and more accurate perspective on the facts and controversies surrounding PAS.
To begin, Dr. Caplan has misrepresented the American Psychological Association"s stance on the validity of PAS. In its most recent position statement regarding Parental Alienation Syndrome, the APA said flatly: "… we have no official position on the purported syndrome¹.' Dr. Caplan contradicts this by saying: "Major professional bodies, including the American Psychological Association, have discredited PAS on the grounds that it is misused in domestic violence cases and that there is no scientific evidence of such a 'syndrome.'"
In contrast to what Dr. Caplan would like your readers to believe, there is a very large amount of credible scientific evidence establishing that PAS does indeed exist. The knowledge base supporting PAS has rapidly evolved since Dr. Gardner"s original description in 1985. Beyond the science, the concept of PAS has struck a loud chord of recognition by a large and ever increasing number of parents, children, attorneys, judges, and mental health providers, and they now have a name for a behavior pattern that they have either personally experienced or encountered professionally.
To be sure, much remains to be learned about PAS, especially in regard to its treatment. Knowledge gaps exist, which produce controversy, and PAS is acknowledged to be a very emotionally charged issue since it arises within the context of a divorce and disrupted family relationships. Professional medical and psychological organizations, such as the American Psychological Association, are smart to refrain at this time from taking an official stance on the validity of PAS to avoid upsetting and polarizing their membership. When a threshold of knowledge is obtained and a consensus reached by experts, only then will this disorder be endorsed by professional organizations and the DSM committee. When will this occur? It"s anyone"s guess. The process for characterizing and validating a new psychological disorder is a long and complicated. But, in the meantime it is erroneous and misleading to suggest, as Dr. Caplan does, that a lack of endorsement by the APA constitutes an invalidation of PAS.
There are several other problems with Dr. Caplan"s article. First, I note that one of Dr. Caplan"s references is a non-profit advocacy organization (The Leadership Council), which contains an annotated review of research regarding allegations of sexual abuse of a child in the context of custody disputes². There are 23 journal articles in this list with an average publication date of 1994. The knowledge base regarding PAS at the time that a majority of these studies were conducted was small and immature in relation to today. In addition, Dr Gardner"s initial conceptualization of PAS differs in significant ways from its current conceptualization. If one is going to discredit the validity of a contemporary psychological disorder, you really should use more contemporary research and its current conceptualization. Secondly, Dr. Caplan stated in her article that Dr. Paul J. Fink, past president of the American Psychiatric Association and president of the Leadership Council on Mental Health Justice, and the Media had discredited PAS and its lack of scientific basis. This is true, but convenient to her argument, left out the fact that he later unequivocally recanted his remarks in this regard³. He stated in his retraction: "I hope we can all come to an agreement about what constitutes alienation, how to deal with PAS, and how to proceed in court hearings when someone alleges that one or another parent is an alienator or an abuser.'
Finally, I certainly share Dr. Caplan"s concern that PAS may occasionally be used inappropriately as a legal strategy by an abusive parent to successfully gain custody or unsupervised visitation. Mistakes are made as a result of ignorance, bias, malevolent intent, poor judgment, or the best of intentions, producing egregious outcomes every day – and not just within the realm of domestic violence and child custody disputes. In this discussion, we must bear in mind that PAS occurs often within contexts completely unrelated to child sexual abuse or domestic violence – and the outcomes in these situations may result in a child"s loss of an essential resource (a parent) and similar egregious outcomes for the child.
Failures within the justice system should not discredit the overall concept of PAS, but should instead condemn our misunderstanding and misapplication of this disorder as a legal strategy in our court system, especially when allegations of child abuse or domestic violence have been made by either parent. In other words, Dr. Caplan"s efforts may likely achieve better outcomes for children and their mothers by a shift in focus from disseminating misinformation and disinformation about PAS to advocating expanded research of PAS and educating mediators, custody evaluators, psychologists, judges, attorneys, and guardian ad litems how to make better decisions and judgments about child custody determinations, while incorporating accurate knowledge regarding PAS and domestic violence.
Les Veskrna, MD Lincoln, Nebraska
¹http://www.apa.org/news/press/releases/2008/01/pas-syndrome.aspx ²http://www.leadershipcouncil.org/1/pas/ap.html ³http://www.clinicalpsychiatrynews.com/index.php?id=2407&cHash=071010&tx_ttnews[tt_news]=40955