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Parental Alienation Syndrome
Forensic Psychologist, Deirdre Conway Rand, Ph.D.
AMERICAN JOURNAL OF FORENSIC PSYCHOLOGY. VOLUME 15. NUMBER 3 1997 / 23
THE SPECTRUM OF PARENTAL ALIENATION SYNDROME
( PART I )
Deirdre Conway Rand, Ph.D.
The Parental Alienation Syndrome, so
named by Dr. Richard Gardner, is a distinctive family response to divorce
in which the child becomes aligned with one parent and preoccupied with
unjustified and/or exaggerated denigration of the other, target parent. In
severe cases, the child's once love-bonded relationship with
rejected/target parent is destroyed. Testimony on Parental Alienation
Syndrome (PAS) in legal proceedings has sparked debate. This two-part
article seeks to shed light on the debate by reviewing Gardner's work and
that of others on PAS, integrating the concept of PAS with research on
high conflict divorce and other related literature. The material is
organized under topic headings such as parents who induce alienation, the
child in PAS, the target/alienated parent, attorneys on PAS, and
evaluation and intervention. Part 11 begins with the child in PAS. Case
vignettes of moderate to severe PAS are presented in both parts, some of
which illustrate the consequences for children and families when the
system is successfully manipulated by the alienating parent, as well as
some difficult but effective interventions implemented by the author, her
husband Randy Rand, Ed.D., and other colleagues.
Dr. Richard Gardner
was an experienced child and forensic psychiatrist conducting evaluations
when, in 1985, he introduced the concept of Parental Alienation Syndrome
(PAS) in an article entitled " Recent Trends in Divorce and Custody
Litigation " (1). His work with children and families during the
1970s led him to write such books as Boys and Girls Book of Divorce, The
Parents Book About Divorce and Psychotherapy with Children of
Divorce. He knew from experience that the norm for children of
divorce was to continue to love and long for both parents, in spite of the
divorce and the passage of years, a finding replicated by one of the first
large scale studies of divorce (2). With this background, Gardner
became concerned in the early 1980s about the increasing number of divorce
children he was seeing who, especially in the course of custody
evaluations, presented as preoccupied with denigrating one parent,
sometimes to the point of expressing hatred toward a once loved
parent. He used the term Parental Alienation Syndrome to refer to
the child's symptoms of denigrating and rejecting a previously loved
parent in the context of divorce.
Copyright 1997 American Journal of
Forensic Psychology, Volume 15 Issue 3. The Journal is a publication of
the American College of Forensic Psychology, P.O. Box 5870, Balboa Island,
CA 92662.
24 / RAND: THE SPECTRUM OF PARENTAL ALIENATION SYNDROME
Gardner's focus on PAS as a disturbance of children in divorce is
unique, although from the mid-1980s on there has been a proliferation of
professional literature on disturbing trends in divorce/custody disputes,
including false allegations of abuse to influence the outcome. At
least three other divorce syndromes have been identified. In 1986,
two psychologists in Michigan, who were as yet unaware of Gardner's work,
published the first of several papers on the SAID syndrome, Blush and
Ross's acronym for sex abuse allegations in divorce (3). Drawing on
their experience doing evaluations for the family court, and the
experience of their colleagues at the clinic there, these authors
delineated typologies for the falsely accusing parent, the child involved
and the accused parent. Two of the divorce syndromes named in the
literature focus on the rage and pathology of the alienating or falsely
accusing parent. Jacobs in New York and Wallerstein in California
published case reports of what they called Medea Syndrome (4, 5).
Jacobs discussed Gardner's work on PAS in his 1988 study of a Medea
Syndrome mother, as did Turkat when he described Divorce Related Malicious
Mother Syndrome in 1994 (6). Fathers, too, can be found with this
disorder, as one of the case vignettes below indicates, but for some
reason Turkat has not encountered any.
In addition to articles
specifically on PAS and literature which refers to it, there is a body of
divorce research and clinical writings which, without a name, describe the
phenomenon. The literature reviewed here comes from a number of
sources including: practitioners who like Gardner are seeking to improve
the diagnostic skills and intervention strategies of the courts and other
professionals who deal with high conflict divorce; attorneys and judges
who come in contact with PAS cases; researchers like Clawar and Rivlin who
reference Gardner's work on PAS in their large scale study of parental
programming in divorce (7) and Johnston whose work on high conflict
divorce (8) led her to study the problem of children who refuse
visitation, including a discussion of PAS (9). When PAS is viewed
from the standpoint of parts and subprocesses which create the whole, the
literature which pertains increases exponentially, for example:
psychological characteristics of parents who falsely accuse in
divorce/custody disputes; cults who help divorcing parents alienate their
children from the other parent; and psychological abuse of children in
severe PAS including Munchausen Syndrome by Proxy type abuse.
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PAS AND
ITS CONTEMPORARY SOCIAL CONTEXT
The trends identified by Gardner and
others are the result of important social changes which began to take root
and flower around the mid 1970s. The legal treatment of divorce and
child custody shifted from the preference for mothers to have sole custody
and the " tender years presumption " to the preference for joint custody
and " best interests of the child ". This gave divorce fathers more
legal options for parenting their children and increased the quantity and
intensity of divorce disputes as parents vehemently disagreed over the
numerous custodial arrangements now possible. By the late 1970s,
rising concern about parental programming of children to influence the
outcome of disputes led the American Bar Association Section of Family Law
to commission a large scale study of the problem. The results of
this 12 year study were published in 1991 in a book called Children Held
Hostage (7). Clawar and Rivlin found that parental programming was
practiced to varying degrees by 80 percent of divorcing parents, with 20
percent of engaging in such behaviors with their children at least once a
day. Further discussion of this book appears below.
At the same
time as new divorce trends have been emerging, sweeping social changes
have been occurring in society's treatment of child abuse. Mandated
reporting became the law of the land in the 1970s and the procedures for
making reports were simplified such that anonymous reports are now
accepted and acted upon in some states. As the number of suspected
abuse reports practically doubled, so did the number of false and
unsubstantiated reports, according to statistics compiled by the National
Center for Child Abuse and Neglect in 1988 which showed that nonvalid
reports outnumbered cases of bona fide abuse by a ratio of two to one (
10).
According to some observers, false allegations of abuse in
contested divorce/custody cases have become the ultimate weapon. Judge
Stewart wrote that " Family Courts nationwide are feeling the effects of a
new fad being used by parties to a custody dispute-the charge that the
other parent is molesting the child...The impact of such an allegation on
the custody litigation is swift and major...The Family Court judge is apt
to cut off the accused's access to the child pending completion of the
investigation " (11, p. 329). In response to concerns such as these,
the Research Unit of the Association of Family and Conciliation Courts
obtained funding for a study on sex abuse accusations in divorce/custody
disputes (12). Data for 1985-1986 were gathered from family court
sites across the country. At that time, the incidence of sex abuse
allegations in divorce was found
26 / RAND: THE SPECTRUM OF PARENTAL
ALIENATION SYNDROME
to average two percent, but varied from one
percent to eight percent depending on the court site. Results of
this study suggest that sex abuse allegations in divorce may be valid only
about 50 percent of the time. Many of the court counselors and
administrators interviewed believed they were seeing a greater proportion
of such cases than in previous decades.
Ten years later in 1996,
Congress amended the Child Abuse Prevention and Treatment Act to eliminate
blanket immunity for persons who knowingly make false reports, based on
information that 2,000,000 children were involved that year in nonvalid
reports, as opposed to 1,000,000 children who were genuinely abused (13).
In addition, many states have already enacted laws against
willfully making a false child abuse report. In California where the
author and her husband practice, the Office of Child Abuse Prevention
revised their manual for mandated reporters several years ago to include a
section on false allegations in which the coaching of children during
custody disputes is described as a major problem and Gardner's work on PAS
is referenced ( 14).
In the meantime, the 1980s saw a massive campaign
to train social workers, police, judges and mental health professionals in
such concepts as " children don't lie about abuse ". To make up for
society's blind eye to child abuse in the past, professionals are
encouraged to unquestioningly " believe the child " and to reflexively
accept all allegations of child abuse as true. Widespread media
attention and a proliferation of popular books and movies on child abuse
continues to suggest that the problem is widespread and insidious.
Parents and professionals alike are enjoined to be vigilant for what are
touted as " behavioral indicators " of sex abuse. These include the
common but vague symptom of poor self esteem, conflicting " indicators "
such as aggressive behavior and social withdrawal, and child behaviors
which may be developmentally normal such as sexual curiosity and
nightmares. Little attention is paid to the fact that children may
develop the same symptoms in response to other stressors, including
divorce and father absence.
Children, too, are being sensitized to
abuse, taught about " good touch/bad touch ". At the end of such a
lesson in school, they may be asked to report anyone who they think may
have touched them in a bad way. Although some instances of
legitimate abuse are detected in this manner, children sometimes
misunderstand the lesson such that a kindly grandfather going to scoop up
his young grandson in his arms, as he had done many times before, may find
the child pulling back from him in horror and accusing him of " bad touch
".
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/ 27
Adults conducting these classes are sometimes so eager to find
abuse that in one Southern state, the parents of over half the class were
arrested.
The foregoing outline of recent social changes is not meant
to imply that Parental Alienation Syndrome and false allegations of sex
abuse in divorce are synonymous. PAS can occur with or without such
abuse accusations. Although false allegations of sex abuse are a
common spin-off of severe PAS, other derivative false allegations may
include physical abuse, neglect, emotional abuse, or a fabricated history
of spousal abuse. In addition, there seems to be an increase in PAS
type cases of accusations by the alienating parent that it is the
alienated parent who is practicing PAS, a tactic which tends to confuse
and neutralize interveners.
PARENTAL ALIENATION SYNDROME
According
to Gardner, PAS is a disturbance in the child who, in the context of
divorce, becomes preoccupied with deprecation and criticism of one parent,
which denigration is either unjustified and/or exaggerated. Gardner
sees PAS as arising primarily from a combination of parental influence and
the child's active contributions to the campaign of denigration, factors
which may mutually reinforce one another. Gardner distinguishes
between Parental Alienation Syndrome and the term " parental alienation
". There are a wide variety of causes for parental alienation,
including bonafide parental abuse and/or neglect, as well as significant
deficits in a rejected parent's functioning which may not rise to the
level of abuse. From Gardner's perspective, a diagnosis of PAS only
applies where abuse, neglect and other conduct by the alienated parent
which would reasonably justify the alienation are relatively
minimal. Thus Gardner conceives of PAS as a specialized subcategory
of generic parental alienation. Since introducing the concept of PAS
in 1985, Gardner has written two books on the subject ( 15, 16), and
included a chapter on it in his book entitled Family Evaluation, in Child
Custody Mediation, Arbitration and Litigation (17).
Depending on the
severity of the PAS, a child may exhibit all or only some of the following
behaviors. It is the cluster of these symptoms which prompted Gardner to
consider them as a syndrome.
1) The child is aligned with the
alienating parent in a campaign of denigration against the target parent,
with the child making active contributions;
2) Rationalizations for
deprecating the target parent are often weak, frivolous or absurd;
28
/ RAND: THE SPECTRUM OF PARENTAL ALIENATION SYNDROME
3) Animosity
toward the rejected parent lacks the ambivalence normal to human
relationships;
4) The child asserts that the decision to reject the
target parent is his or her own, what Gardner calls the "independent
thinker" phenomenon; 5) The child reflexively supports the parent with
whom he or she is aligned ;
6) The child expresses guiltless disregard
for the feelings of the target or hated parent;
7) Borrowed scenarios
are present, i.e., the child's statements reflect themes and terminology
of the alienating parent;
8) Animosity is spread to the extended
family and others associated with the hated parent.
In Gardner's
experience, born out by the clinical and research literature reviewed
below, mothers are more frequently found to engage in PAS, which is
likened by Clawar and Rivlin to psychological kidnapping (7). Where
PAS with physical child abduction occurs, however, Huntington reports that
fathers are in the majority (18). Gardner recognizes that fathers, too,
may engage in PAS and gives examples in his books. For consistency
and simplicity, though, he refers to the alienating parent as "mother" and
target parent as "father."
According to Gardner, the brainwashing
component in PAS can be more or less conscious on the part of the
programming parent and may be systematic or subtle. The child's active
contributions to the campaign of denigration may help to create and
maintain a mutually reinforcing feedback loop between the child and the
programming parent. The child's contributions notwithstanding,
Gardner views the alienating parent as the responsible adult who elicits
or transmits a negative set of beliefs about the target parent. The
child's loving experiences with the target parent in the past are replaced
with a new reality, the negative scenario shared by the programming parent
and child which justifies their rejection of the alienated parent.
In light of these observations, Gardner warned that children's statements
in divorce/custody about rejecting one parent should not be taken at face
value and should be evaluated for PAS dynamics. According to
psychologist Mary Lund, this insight is one of Gardner's most important
contributions because it alerted the legal system, parents and mental
health professionals dealing with divorce to an important possibility
which can have disastrous effects if unrecognized (19).
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Gardner
emphasizes the importance of differentiating between mild, moderate and
severe PAS in determining what court orders and therapeutic interventions
to apply. In mild cases, there is some parental programming but
visitation is not seriously effected and the child manages to negotiate
the transitions without too much difficulty. The child has a
reasonably healthy relationship with the programming parent and is usually
participating in the campaign of denigration to maintain the primary
emotional bond with the preferred parent, usually the mother. PAS in
this category can usually be alleviated by the court's affirming that the
preferred or primary parent will retain primary custody.
In moderate
PAS, there is a significant degree of parental programming, along with
significant struggles around visitation. The child often displays
difficulties around the transition between homes but is eventually able to
settle down and become benevolently involved with the parent he or she is
visiting. The bond between the aligned parent and child is still
reasonably healthy, despite their shared conviction that the target parent
is somehow despicable. At this level, stronger legal interventions
are required and a court ordered PAS therapist is recommended who can
monitor visits, make their office available as a visit exchange site, and
report to the court regarding failures to implement visitation. The
threat of sanctions against the alienating parent may be needed to gain
compliance. Failure of the system to apply the appropriate level of
court orders and therapeutic interventions in moderate PAS may put the
child at risk for developing severe PAS. In some moderate cases,
after court-ordered special therapy and sanctions have failed, Gardner
states that it may be necessary to seriously consider transferring custody
to the allegedly hated parent, assuming that parent is fit. In some
situations, this is the only hope of protecting the child from progression
to the severe category.
The child in severe PAS is fanatic in his or
her hatred of the target parent. The child may refuse to visit,
personally make false allegations of abuse, and threaten to run away,
commit suicide or homicide if forced to see the father. Mother and
child have a pathological bond, often based on shared paranoid fantasies
about the father, sometimes to the point of folie a deux. In severe
PAS, Gardner has found that if the child is allowed to stay with the
mother the relationship with the father is doomed and the child develops
long-standing psycho pathology and even paranoia. Assuming the target
parent is fit, Gardner believes that the only effective remedy in severe
PAS is to give custody to the alienated parent. In 1992 he suggested
that courts might be more receptive to the change of custody option if the
child was provided with a therapeutic transitional placement such as
hospitalization, an intervention employed with success by the author and
her husband ( see case vignette in Part II ).
30 / RAND: THE SPECTRUM
OF PARENTAL ALIENATlON SYNDROME
Gardner's original conception of PAS
was based on the child's preoccupation with denigration of the target
parent. It was not until two years later when he published his first
book on PAS that he addressed the problem of PAS with false allegations of
abuse. Gardner prefers to view such allegations as derivative of the
PAS, observing that they often emerge after other efforts to exclude the
target parent have failed. Some of the literature reviewed below,
however, indicates that false allegations of abuse may also surface prior
to the marital separation, symptomatic of a pre-existing psychiatric
disorder of the alienating parent which may not be diagnosed until there
is further mental deterioration after the divorce. Gardner was among
the first to recognize that involving a child in false allegations of
abuse is a form of abuse in itself and indicative of serious problems
somewhere in the divorce family system. Insofar as PAS with false
allegations of abuse can result in permanent destruction of the child's
relationship with the alienated parent, it can be more harmful to the
child than if the alleged abuse had actually occurred.
Gardner
supports joint custody for those parents who can sincerely agree on it and
have the ability to fulfill this ideal. Research by Maccoby and
Mnookin suggests that about 29 percent of divorced parents are
successfully to-parenting three to four years after filing (20).
Gardner opposes imposing joint custody on parents in dispute and between
whom there is significant animosity. For these families, Gardner
recommends that a thorough evaluation be conducted to develop a case
specific plan with the right combination of court orders, mediation,
therapeutic interventions, and arbitration.
HIGH CONFLICT DIVORCE AND
PAS
High conflict divorce is characterized by intense and / or
protracted post separation conflict and hostility between the parents
which may be expressed overtly or covertly through ongoing litigation,
verbal and physical aggression, and tactics of sabotage and deception.
Clinical and research literature suggest that Parental Alienation
Syndrome is a distinctive type of high conflict divorce which may require
PAS specific interventions, just as the problems of divorced families have
been found to respond to divorce specific interventions rather than to
traditional therapies. In their book on children caught in the
middle of high conflict divorce, Garrity and Baris treat PAS as a
distinctive divorce family dynamic, devoting two chapters to PAS,
one on understanding it and the other on a comprehensive intervention
model (21 ).
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In high conflict divorce without significant PAS,
the parents do most of the fighting while the children manage to go back
and forth between homes, maintain their own views and preserve their
affection for both parents. They cope by developing active skills
for maneuvering the situation or by adopting a survival strategy of
treating both parents with equal fairness and distance (8).
Periodically, children may exacerbate parental conflicts by embellishing
age appropriate separation anxieties, telling each parent things the
parent wants to hear and shifting their allegiance back and forth between
the parents. Nevertheless, they avoid consistent alignment with one
parent against the other and are able to enjoy their time with each parent
once the often difficult transition between homes has been accomplished.
In high conflict divorce with significant PAS, the children are
personally involved in the parental conflict. Unable to manage the
situation so as to preserve an affectionate relationship with both
parents, the child takes the side of one parent against the other and
participates in the battle as an ally of the alienating parent who is
defined as good against the other parent who is viewed as
despicable. In a study of 175 children from high conflict families,
Johnston found that chronic hostility and protracted litigation between
the parents contributed to the development of PAS among older children
(9). In other words, where the system is unable to settle and
contain parental divorce conflicts, the children may be at increasing risk
for developing PAS as they get older. Johnston acknowledges that her
findings support Gardner's contention that as many as 90 percent of
children involved in protracted custody show symptoms of PAS.
A large
scale study of patterns of legal conflict between divorce parents three to
four years after filing contained them significant finding that the most
hostile divorce couples were not necessarily those engaged in the most
contentious legal battles (20). This suggests that PAS may occur not
only in the context of litigation but may develop after litigation has
ceased, or proceed a new round of litigation after many years, supporting
what Dunne and Hedrick found in their clinical study of severe PAS
families (22).
According to Johnston, high conflict divorce is the
product of a multilayered divorce impasse between the parents (8). Often,
the impasse has its roots in one or both parents' extreme vulnerability to
issues of narcissistic injury, loss, anger and control.
32 / RAND: THE
SPECTRUM OF PARENTAL ALIENATION SYNDROME
These vulnerabilities prevent
a satisfactory divorce adjustment and feed an endless, sometimes
escalating cycle of action and reaction which promotes and maintains
parental conflict. The parents are frozen in transition,
psychologically neither married, separated or divorced, a pattern which
may pertain even when only one parent is significantly disturbed.
Using Johnston's model, PAS can be viewed as an effort by one parent, with
the help of the children, to " resolve " the divorce impasse with a
clear-cut understanding of who is good , who is to blame and how the
parent to blame should be punished. The following vignette
illustrates this. Like the other case examples interspersed
throughout this article, it is a composite scenario synthesized from real
cases encountered by the author and her colleagues.
Mr. L had adopted
his wife's child from her previous marriage and he and Mrs. L. had a child
of their own, a girl who was six years old when Mr. L. moved out of the
family home. During the six months leading up to this precipitous
event, Mrs. L. was living in one part of the house with the older child
while Mr. L. and his daughter had rooms together in a separate part of the
house. The parents hardly spoke to one another but the children visited
back and forth freely with each other and with both parents. Under
the circumstances, Mr. L. did not think his wife would object to his
leaving, but just in case there was a scene he decided to move out first
and then work out the practical issues with Mrs. L. He left a letter for
her and another one for the children, explaining his decision and
affirming his desire to make arrangements for visitation and child
support. Mrs. L. was furious. She immediately had the locks changed
and successfully blocked her husband's efforts to contact the children by
phone or to see them. Both children probably felt betrayed by father
and Mrs. L. amplified such feelings by telling the children their father
had abandoned them and did not-care about them at all. She also
alleged that he had had numerous affairs during the marriage although Mr.
L. always denied that. These allegations may have sprung from the
fact that Mrs. L. found out six weeks after her husband left that he was
dating someone. Outraged, she told Mr. L. that he would never see
the children again. She and the children began calling Mr. L. and
his girlfriend at all hours, screaming accusations and obscenities over
the phone until a restraining order was obtained. When efforts by
father's attorney to arrange for mediation between Mr. and Mrs. L. were
stonewalled, Mr. L. got a court order for visitation. Three months
had passed when his first opportunity to see his children since moving out
was scheduled.
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On the eve of this visit, Mrs. L. called child
protective services and accused Mr. L. of sexually molesting their
daughter. According to the social worker's notes which were obtained
during subsequent litigation, Mrs. L. told the social worker that she "
knew " while she and her husband were still living together that he was
molesting their daughter.
The family law judge ordered a custody
evaluation which was very thorough and took months to complete. The
evaluator documented a number of instances in which the girl's statements
about abuse and hat mg. her father seemed to be strongly influenced by
mother's overwhelming anger and that of the older half sibling, who was
strongly aligned with the mother. Mrs. L. was diagnosed with a
severe narcissistic personality disorder with antisocial features, while
Mr. L. was seen by the evaluator as rather passive by comparison and as
ambivalent and conflict avoidant. The evaluator was able to hold one
meeting with father and daughter together, during which their loving
attachment to one another was apparent. This was the little girl's
first opportunity to talk to her father about the feelings engendered by
his leaving. As it turned out, it was also her last
opportunity. The PAS intensified such that efforts to convene
further father/daughter sessions failed when the child threw tantrums in
the waiting room and ran screaming into the parking lot where her mother
was waiting.
Seven months after the marital separation, the custody
evaluator's report was released. It stated that the alleged abuse
had in all probability not occurred but failed to diagnose severe PAS with
false allegations of abuse. The evaluator recommended that the
mother retain primary custody and that the girl and her parents each
become involved in individual therapy to facilitate father/daughter
reunification. Not surprisingly, Mrs. L. arranged for the child to
see a therapist/intern who never saw the custody evaluator's report.
Based on input from the mother alone, the therapist treated the girl for
abuse by her father instead of providing divorce specific therapy aimed at
helping the little girl to adjust to her parent's divorce and to establish
a post divorce relationship with her father. The girl's anger at
her father became more extreme with each passing month and defeated the
visitations planned by the family mediation center. Finally, a year
after the separation, the custody evaluator was prepared to testify as to
the PAS and to make the strong recommendations needed to remedy the
situation.
34 / RAND: THE SPECTRUM OF PARENTAL ALIENATlON SYNDROME
By that time, the father was convinced that nobody could do anything
about his daughter's continued expressions of hatred toward him. He
also felt daunted by the prospect of further litigation and an even
greater financial drain. He decided to let go, hoping that one day
when his daughter was older she would understand and seek him out.
CHILDREN HELD HOSTAGE: DEALING WITH PROGRAMMED AND BRAINWASHED
CHILDREN
By the late 1970s, judges, parents, and mental health
professionals involved with divorce were so concerned about parental
programming that the American Bar Association Section on Family Law
commissioned this 12 year study of 700 divorce families (7). Clawar
and Rivlin found that the problem of parental programming was indeed
widespread and that even at low levels it had significant impact on
children. Data from multiple sources was analyzed including: written
records such as court transcripts, forensic reports, therapy notes and
children's diaries; audio and video tapes of interactions between
children, their parents and others related to the case; direct
observations, such as children with parents and clients with attorneys;
and interviews with children, relatives, family friends, mental health
professionals, school personnel, judges and conciliators.
Gardner's
work on PAS is referenced at the beginning of Clawar and Rivlin's book
(7), but the authors take issue with what they represent as his position,
that less severe cases need not be a cause of great concern. They
found that PAS can result from a variety of complex processes, whether or
not one parent engages in a systematic programming campaign and whether or
not alienation is the programming parent's goal. Parental alienation
is only one of a number of detrimental effects. According to this
study, even well meaning parents often at tempt to influence what their
children say in the custody and visitation proceedings. Mild levels
of parental programming and brainwashing seem to have significant effects.
Clawar and Rivlin anchor their work in 30 years of literature on
social psychology and the processes of social influence, variously
referred to in the literature as thought reform, brainwashing,
indoctrination, modeling, mimicking, mind control, re-education, and
coercive persuasion. These terms describe a variety of psychological
methods for ridding people of ideas which authorities do not want them to
have and for replacing old ways of thinking and behavior with new
ones. For the purposes of research, Clawar and Rivlin ascertained
the need for more precisely defined terminology. They selected the
words " programming " and " brainwashing ". They defined " program "
as the content, themes, and beliefs transmitted by the programming parent
to the child regarding the other parent.
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" Brainwashing " was
defined as the interactional process by which the child was persuaded to
accept and elaborate on the program. Brainwashing occurs over time
and involves repetition of the program, or code words referring to the
program, until the subject responds with attitudinal and behavioral
compliance.
According to Clawar and Rivlin, the influence of a
programming parent can be conscious and willful or unconscious and
unintentional. It can be obvious or subtle, with rewards for
compliance that were material, social or psychological.
Noncompliance may be met with subtle psychological punishment such as
withdrawal of love or direct corporal punishment, as illustrated in the
case vignette of S in Part II. The author encountered another case
in which the alienating mother handcuffed her son to the bedpost when he
was 12 years old and the boy asserted he was not willing to continue
saying his father had physically abused him. The Clawar and Rivlin
study found that children may be active or passive participants in the
alienation process. As the case of the 12- year-old boy suggests,
the nature and degree of the child's involvement in the PAS may change
over time.
This study identifies the influential role of other people
in the child's life, such as relatives and professionals aligned with the
alienating parent, whose endorsement of the program advances the
brainwashing process. In a general way, these findings appear to
replicate Johnston's research on high conflict divorce which identified
the importance of third party participants in parental conflicts
(8). Rand noted the influence of so-called " professional
participants in Munchausen Syndrome by Proxy type abuse which in divorce
can overlap with PAS (23).
Clawar and Rivlin identify eight stages of
the programming/brainwashing process which culminates in severe Parental
Alienation Syndrome (7). Recognizing the power imbalance between
parent and child, they view the process as driven by the alienating parent
who induces the child's compliance on step by step basis:
1 ) A
thematic focus to be shared by the programming parent and child emerges or
is chosen. This may be tied to a more or less formal ideology
relating to the family, religion, or ethnicity;
2) A sense of support
and connection to the programming parent is created;
3) Feeling of
sympathy for the programming parent is induced;
36 / D. RAND: THE
SPECTRUM OF PARENTAL ALIENATION SYNDROME
4) The child begins to show
signs of compliance, such as expressing fear of visiting the target parent
or refusing to talk to that parent on the phone;
5) The programming
parent tests the child's compliance, for example, asking the child
questions after a visit and rewarding the child for " correct " answers;
6) The programming parent tests the child's loyalty by having the
child express views and attitudes which suggest a preference for one
parent over the other;
7) Escalation/intensification/generalization
occurs, for example, broadening the program with embellished or new
allegations; the child rejects the target parent in a global, unambivalent
fashion;
8) The program is maintained along with the child's
compliance, which may range from minor reminders and suggestions to
intense pressure, depending on court activity and the child's frame of
mind.
CLINICAL STUDIES OF PAS
According to Gardner and seconded by
Cartwright, Parental Alienation Syndrome is a developing concept which
clinical and forensic practitioners will refine and redefine as new cases
with different features become better understood (24). This section
reviews the work of practitioners who, like Cartwright, seek to elaborate
on Gardner's work by contributing their own knowledge and experience from
work with moderate to severe PAS cases.
Dunne and Hedrick
Practicing in Seattle, Washington, Dunne and Hedrick analyzed sixteen
families who met Gardner's criteria for severe PAS (22). Although
the cases show a wide diversity of characteristics, the authors found
Gardner's criteria useful in differentiating these cases from other
post-divorce difficulties, lending support for the idea that PAS has
distinctive features which differentiate it from other forms of high
conflict divorce. Among the severe PAS cases examined, some involved
false allegations of abuse and some did not. Children in the same
family sometimes responded to the divorce with opposing adjustments.
For example, the oldest child in one family, a 16-year-old girl, aligned
with her alienating mother while her 12-year-old brother's desire for a
relationship with his father led to the mother finally rejecting the boy.
AMERICAN JOURNAL OF FORENSIC PSYCHOLOGY, VOLUME 15, NUMBER 3. 1997
/ 37
In another case, failed separation between mother and daughter,
age 4 at the time of the marital break up, was shown to contribute to an
escalating pattern of the girl rejecting her father. The onset of PAS in a
given family was found to occur before the parents separated, during the
actual divorce proceedings, or years after the divorce decree. Dunne and
Hedrick describe a two-and-a-half year-old girl whose parents were
disputing custody where there had been a long series of allegations by the
mother since the early months of her pregnancy. Some of the teens
in this sample had enjoyed a lengthy and positive post-divorce
relationship with a parent prior to rejecting that parent as part of a PAS
scenario.
Lund
Psychologist Mary Lund examined factors in addition
to parental programming which can contribute to estrangement between the
child and a rejected parent (19). She wrote that the methods Gardner
advocates, such as court orders for continued contact, fit many cases and
may help prevent the child developing the kind of phobic-like reaction to
the rejected parent which can occur when contact is discontinued during
long, drawn out legal proceedings. Such legal interventions often form the
cornerstone for treatment. In treating these families, Lund integrates
Gardner's work with that of Janet Johnston. She assesses the family
in terms of developmental factors in the child which may be contributing,
such as normal separation problems among pre-schoolers and oppositional
behavior during preadolescence and adolescence. Deficits in the
noncustodial parent's parenting may also contribute to the problem.
In her experience, the hated parent, usually the father, often has a
distant, rigid, even authoritarian style which contrasts with the
indulgent, clinging style of the loved parent, who may also need help with
appropriate parenting. These are risky generalizations,
however. In the experience of this author and others, alienating and
target parents exhibit a wide variety of personality patterns which do not
lend themselves to this type of generalization. In addition, where
the father is the alienating parent, it is sometimes he who uses an
overindulgent and materially lavish parenting style to overwhelm and
override the children's healthier psychological bond with the mother.
According to Lund, PAS may also develop when the stress for the child
of ongoing high conflict divorce becomes too much and the child seeks to
"escape" being caught in the middle by aligning with one parent.
Therapists, especially individual child therapists, can unwittingly become
part of the system maintaining the PAS, such that a court order is
required to break up the therapist's polarizing influence. Ultimately, a
combination of strategic legal and therapeutic interventions are required
to mitigate the PAS and keep the case manageable.
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Cartwright
A Canadian
psychologist, Cartwright makes eight points about PAS:
1 ) PAS can be
provoked by conflicts other than custody matters, e.g., child support and
relatively trivial differences;
2 ) alienation is a gradual and
consistent process that is directly related to the time spent alienating;
3) time is on the side of the alienating parent, who may engage in a
host of delay tactics;
4) slow judgments by courts exacerbate the
problem;
5) alienating parents sometimes use the hint of sexual abuse
to discredit the other parent, what Cartwright calls "virtual" allegations
of sexual abuse;
6) judgments by the court which are clear and
forceful are required to counter the force of alienation;
7) children
subject to excessive alienation may develop mental illness and
8)
successful parental alienation has profound, long term consequences for
the child and other family members which are only beginning to be
appreciated (24).
As an example of "virtual" allegations abuse,
Cartwright describes a mother who insinuated sexual abuse by the father by
alleging that he had shown the child a pornographic videotape which in
fact was just a Hollywood comedy rented from a family video store.
Regarding risk to the child of developing mental illness,
Cartwright
gives the example of disintegrating behavior by an alienated son,
presumably latency age, who tried to poison his father by slipping air
freshener into his stomach medicine. Later, the boy ran away during
a visit with the father and the police had to be called. The folie a
deux literature includes a report in 1977 of a 10-year-old boy who
allegedly attempted to burn down his father's house two years after his
parents divorced, apparently as a result of his folie a deux relationship
with his disturbed mother (25). Such cases suggest that severe PAS can be
indicative of significant emotional disturbance in the alienating parent
with a proportionately disturbing effect on the child.
Cartwright
poignantly describes the psychological effects on the child of being
involved in severe PAS. "The child...experiences a great loss, the
magnitude of which is akin to death of a parent, two grandparents, and all
the lost parent's relatives and friends...Moreover...the child is unable
to acknowledge the loss, much less mourn it" (24). The child's good
memories of the alienated parent are systematically destroyed and the
child misses out on the day-to-day interaction, learning, support and love
which, in an intact family, usually flows between the child and both
parents, as well as grandparents and other relatives on both sides.
AMERICAN JOURNAL OF FORENSIC PSYCHOLOGY, VOLUME 15 NUMBER 3 1997 / 39
The child may encounter insurmountable obstacles if, later in life, he
or she seeks to reestablish relations with the lost parent and his family.
The lost parent may be unable or unwilling to become reinvolved. The
parent or grandparents may have died. Some of these children eventually
turn against the alienating parent, and if the target parent is lost to
them as well, the child is left with an unfillable void.
PARENTS WHO
INDUCE ALIENATION
Gender
Gardner's observation that mothers seem
to engage in PAS behavior with significantly greater frequency than
fathers is born out by divorce research, as well as by the clinical PAS
literature. The California Children of Divorce Study found that in a
nonclinical sample, mothers were twice as likely as fathers to form PAS
type alignments with their children (2). When false allegations of
abuse arise, as in more severe manifestations of PAS, mothers also seem to
comprise the majority (3, 26-28). Mothers constituted 67 percent of
the accusers in the nationwide study which revealed that allegations of
abuse in divorce/custody disputes were found to be invalid about 50
percent of the time (12). Fathers were the accusers in 22 percent of
cases while third parties such as relatives and professionals were the
adult initiators 11 percent of the time. Where a third party was the
initiator of the allegation, a parent might also believe there was
abuse. The numbers reverse when it comes to physically abducting the
child, with fathers the abductors from 60 percent to 70 percent of the
time (18). There may be gender differences in how men and women go
about gaining control of their children and taking revenge on an
ex-spouse, with men more inclined to physical kidnapping and women more
inclined to social / psychological abduction, which is how Clawar and
Rivlin characterized severe PAS (7).
Never Married
Parents may
engage in PAS behavior even if they were never married. In Johnston's
study of children who refuse visitation, she found that from 6 percent to
15 percent of the high conflict parents she studied were not married
(9). In the author's experience, one of the contributing factors to
PAS with some of these couples is the mother's anger and resentment over
the father's refusal to marry her, an effect which is exacerbated if the
father becomes involved with a new partner. A mother in this
position may have particularly strong proprietary feelings, similar to
what Clawar and Rivlin describe (7), infuriated by the unfairness
40 /
RAND: THE SPECTRUM OF PARENTAL ALIENATlON SYNDROME
of joint custody
laws which grant the father rights to a relationship with his child
without his having fulfilled his obligations with respect to the mother.
New Partners
Johnston found that the new partner of either parent
could be the primary instigator of efforts to gain custody of the child
(8). Something similar happens when a divorcing parent joins a cult which
actively strives to get the child from the noncult member parent, with the
cult fulfilling the role of new partner in a sense, as shown in one of the
case vignettes to follow.
Narcissistic Vulnerability
Johnston
found that to varying degrees, one or both of the parents in high conflict
divorce may be narcissistically vulnerable, lacking a well-established
self identify and relying on primitive defenses such as externalization,
denial and projection (8). The need of one or both parents to
protect and defend themselves against narcissistic injury is at the root
of many high conflict divorces. This may be a motivating factor for
PAS in some cases, a dynamic described by Wilhelm Reich almost 50 years
ago (29) when he foretold how parents of certain character types would
seek to defend themselves against narcissistic injury in divorce by
fighting for the child, using the technique of defaming the partner in
order to alienate the child from that parent ( italics added ).
Need
to Conceal Parental Deficits
According to Clawar and Rivlin, the
campaign to alienate the child from the other parent is sometimes used to
deflect unwanted scrutiny of the programming parent's personal problems,
for example alcohol, drugs, neglectful parenting, physical and sexual
abuse, criminal involvement, or socially unaccepted life-style (7).
Sometimes parents engage in PAS behavior out of fear that they will be
found wanting when compared to the more loving and capable target.
The literature on false allegations in divorce/custody disputes often
makes the point that the accusation helps the accuser level the playing
field, so to speak.
Vulnerability to Separation and Loss
A factor
in some high conflict divorces is the presence in one or both parents of
specific underlying vulnerabilities to loss and conflicts around
attachment and separation (8). A PAS scenario can develop when a
troubled parent who was rejected in the divorce copes with loss and
loneliness by turning to the child to full
AMERICAN JOURNAL OF
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fill emotional
needs, resulting in what Wallerstein calls the "overburdened child " ,
discussed in Part II. For some parents, the divorce reactivates
separation issues from earlier losses such as previous divorce, kidnapping
or death of a child, or the loss of other family members. Such a parent
may engage in PAS to defend against further "loss," that of having to
share the child with the other parent. Some parents have long standing
personality problems with separation and individuation. The ongoing
conflicts over the child engendered by PAS help ward off feelings of loss
and abandonment by maintaining the relationship with the ex-spouse.
PAS can also be used by keep the other parent hostilily engaged, as in
Medea Syndrome (4, 5) and Divorce Related Malicious Mother Syndrome (6,
30).
Revenge Clawar and Rivlin found that revenge was one of the most
common and powerful reasons for parents to engage in alienating behavior
(7). The personality makeup of some parents is such that revenge seems
like their only viable option in response to feeling wounded by the
divorce. The desire for revenge can be further kindled if infidelity
is discovered, the alienating parent is left for someone else, or finds
themselves immediately replaced by a new love object in the life of the
parent who left.
Need for Control and Domination
Some alienating
parents are driven by overriding needs for power, influence, domination
and control (7). Engaging in PAS may provide the dual gratification
of maintaining power, influence and control over the child and vicariously
over the ex-spouse whose visitation and relationship with the child is
frustrated by the alienating parent's control maneuvers. Needs for
domination and control are sometimes acted out by abducting the child and
using it to taunt and torment the frantic target parent. In addition
to mothers and fathers, a new partner can be the one with inordinate needs
for power, domination and control. For example, a mother may become
involved with a new partner who first seduces her away from her relatively
weak husband and then acts as a sort of one-on-one cult leader to mother
and child, who are both programmed and brainwashed into compliance and
submission.
Medea Syndrome
The need for revenge is taken to an
extreme in Media Syndrome (4, 5). "Modern Medeas do not want to kill their
children, but they do want revenge on
42 / RAND: THE SPECTRUM OF
PARENTAL ALIENATION SYNDROME
their former wives or husbands-and they
exact it by destroying the relationship between the other parent and the
child...The Medea syndrome has its beginnings in the failing marriage and
separation, when parents sometimes lose sight of the fact that their
children have separate needs [and] begin to think of the child as being an
extension of the self...A child may be used as an agent of revenge against
the other parent...or the anger can lead to child stealing" (5). The
"embittered- chaotic" parents described earlier by Wallerstein and Kelly
may also fall in the revenge category (2). These parents act out their
intense anger in a disorganized
but chronically disruptive way which
bombards the children, rather than protecting them, with the raw
bitterness and chaos of the angry parent's feelings about the ex-spouse
and the divorce.
Divorce Related Malicious Mother Syndrome
Turkat
would have done better to call this disorder "Malicious Parent Syndrome,"
but be that as it may, this disorder describes a special class of
alienating parents who engage in a relentless and multifaceted campaign of
aggression and deception against the ex-spouse, who is being punished for
the divorce (6, 30). Contrary to Turkat, the author has encountered
several cases in which the father was the malicious parent, as illustrated
in the case vignette at the end of this section. Discussing PAS by name,
Turkat classified PAS as a moderate form of visitation interference as
compared with Divorce Related Malicious Mother Syndrome. The parent with
the latter disorder uses an array of tactics including excessive
litigation, alienating the child from the target parent, and involving
the child and third parties in malicious actions against the ex-spouse.
Lying and deception are routinely used. A malicious parent might arrange
to have the ex-spouse investigated for use of illegal drugs at work or
file a complaint with authorities against the ex-spouse's new partner.
Malicious parents are often successful in using the law to punish and
harass the ex-spouse, sometimes violating the law themselves but often
getting away with it. Their efforts to interfere with the target parent's
visitation are persistent and pervasive, including attempts to block the
target parent from having regular, uninterrupted visitation with the child
and from having telephone contact, as well as trying to block the target
parent from participating in the child's school life and activities.
Mr. C's suspiciousness and verbal attacks on his wife finally drove
her to file for divorce. As on previous occasions, Mr. C. threatened that
if she would not reconcile he would win custody of their four-year-old
daughter and make sure the mother never saw her again. In the past, Mrs.
AMERICAN JOURNAL OF FORENSIC PSYCHOLOGY VOLUME 15 NUMBER 3 1997/ 43
C. had relented, fearful that Mr. C. would fulfill his threats, but
this time she stood firm. Mr. C. filed for sole custody based on false
allegations that the mother was unfit. When these allegations were not
upheld, the father made up new ones. Within a year of filing, Mrs. C.
became engaged to another man. Mr. C. succeeded in breaking up the
engagement by accusing the fiance of sexually abusing the child. He had
the police arrest the fiance at the mother's home. When child protective
services informed the mother that they would take her daughter away for
failure to protect, the mother canceled her engagement, terrified that Mr.
C. would make good on his threat to take her daughter away. When police
and child protection investigation of the sex abuse allegations resulted
in a finding that no abuse occurred, Mrs. C. proceeded with her wedding
plans. Father raised allegations of sex abuse against Mrs. C.'s new
husband in family court and succeeded at one point in gaining temporary
custody. Primary custody was returned to the mother after the court
ordered evaluation found the allegations to be without merit and the
father to be emotionally disturbed and pressuring the child to report
abuse. During his visitation time, the father and a male friend continued
to interrogate the girl about abuse by the stepfather and as time went by
she felt increasingly pressured to meet their expectations. Away from the
father's influence, however, the girl enjoyed her family with her mother
and stepfather. She stated to several different therapists that she had
only accused her stepfather of molesting her to please her father and his
friend.
In the meantime, Mr. C. and friend continued to make abuse
reports against the stepfather, creating significant distress for Mrs. C.,
her new husband and the child. Eventually, when the girl was 10, the
father succeeded in getting the juvenile court to take jurisdiction and
give him custody, although medical examination of the child did not
support the increasingly serious accusations. Mrs. C. was not allowed to
see her daughter. When she tried to contact the therapist who was now
seeing the girl for sex abuse by Mrs. C.'s new husband, the therapist was
rude and a refused to speak with her. The mother was tortured by reports
from a series of child protection workers which indicated that her
daughter was acting out in bizarre and often self-destructive ways. At the
age of twelve, she was picked up by the police for prostitution and had to
be psychiatrically hospitalized. Several professionals who were involved
44 / RAND: THE SPECTRUM OF PARENTAL ALIENATlON SYNDROME
when the
mother had custody wondered if Mr. C. was deliberately destroying his
daughter so as to get revenge against the mother. Mr. C. was able to
retain custody, however, by focusing the attention of authorities on
allegations of sex abuse against the stepfather.
Long before Divorce
Related Malicious Mother Syndrome was identified by Turkat, a male
psychologist, whose ex-wife undoubtedly exhibited the disorder, wrote a
book about his ordeal (31 ). Accusing him of sexually abusing their young
daughter, the mother arranged for the police to arrest him at his office
in front of his clients and staff. She also arranged for newspaper
reporters to be present so that pictures of the shocked psychologist being
handcuffed and hauled off to jail were widely broadcast. The father fought
back and eventually obtained joint custody after the court found that
mother's extreme efforts to sever the father's relationship with his child
were detrimental and stripped her of sole custody.
Personality
Characteristics of Parents Making False Accusations of Sexual Abuse in
Disputes
Wakefield and Underwager undertook a systematic review of
divorce / custody case files to examine and compare the characteristics of
72 false accusers, 103 falsely accused parents and a control group of 67
parents disputing custody but without allegations of abuse (28).
Criteria for determining whether a parent had falsely accused included a
finding by the justice system that there had been no abuse. Of the
three groups, the falsely accusing parents were much more likely to have
been diagnosed by a professional as exhibiting a personality disorder
including mixed, unspecified, histrionic, borderline, passive-aggressive
or paranoid. Approximately one-fourth of the false accusers did not
exhibit significant pathology, while most of the parents who were
disputing custody without abuse allegations were assessed as normal. Some
of the false accusers were so obsessed with anger toward their estranged
spouses that this became a major focus of their lives. They continued to
be obsessed with abuse despite negative findings by mental health
professionals and the courts, similar to what is found in cases of
delusional disorder and Munchausen Syndrome by Proxy. The
relationship of falsely accusing parents with their children was often
characterized in the record as extremely controlling and symbiotic.
Two were Qiven a formal diagnosis of folie a deux between parent and
child. Several exhibited extremely serious dysfunction, such as
unpredictable bizarre behavior, belief that they possessed supernatural
powers and delusions of grandeur. These authors found more
similarities than differences between mothers and fathers who falsely
accused, with mothers very much in the majority.
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SAID Syndome
Blush and Ross have come up with three psychological profiles for
mother false accusers and a typical profile of father accusers (3, 26,
27). Mothers tend to present as "fearful victim," "justified
vindicator," or to some degree psychotic. The "fearful victim"
presentation involves manipulation of social image around a specific theme
to which others respond with sympathy and support, such as child abuse or
spousal abuse. The "justified vindicators" initially present as
intellectually organized with a knowledgeable, even pseudo-scientific
sounding agenda, similar to what Clawar and Rivlin report regarding self
righteousness as an important motivation of some programming parents.
Women in the third group present with a combination of borderline and
histrionic features, which interact with the stress of the divorce to
impair the mother's reality testing and significantly interfere with her
functioning, sometimes to the point of a psychotic or quasi-psychotic
presentation. Similar to Wakefield and Underwager's findings (28),
mothers in all three categories tend to be histrionic in presentation, so
emotionally convinced of the "facts" that no amount of input, including
from neutral professionals, can dissuade them from their
perceptions. According to Blush and Ross, the typical profile for
father accusers is one of intellectual rigidity and a high need to be
"correct," possibly male counterparts of the "justified vindicator"
presentation among mothers. By history, these men were hypercritical
of their wives while the marriage was still intact, quick to suspect them
of negligence and to accuse their wives of being unfit mothers.
Gardner's work is referenced in the second and third SAID syndrome
articles by these authors (26, 27). Accuser and Accused Dyads
Important information about a programming parent using false allegations
of abuse is to be found in the particular choice of accused. The
study reported by Thoennes and Tjaden showed that the battle goes beyond
simply mothers against fathers and vice versa (12). Parents were
found to accuse not only each other but the other's new partner, or
relatives such as grandparents or the new partner's teenage son. A
parent who accuses the ex-spouse's new partner may fulfill a number of
goals simultaneously, expressing feelings of jealousy, revenge, and trying
to keep the child from forming a positive attachment with the new parent
figure. Accusations against the target parent's relatives may
provide a combination of revenge, allegations that are difficult for the
ex-spouse to defend since they are not directly against him or her, and a
means to exclude the relatives from post-divorce involvement in the
child's life. The accuser can set up a devastating
46 / RAND: THE
SPECTRUM OF PARENTAL ALIENATION SYNDROME
conflict for the target
parent by accusing his teenage son from a previous marriage or the new
partner's teenage offspring from a previous union. This has the effect of
forcing the target parent to "choose" between his child involved in making
the allegation and another child whom he loves and is responsible for.
This enhances the alienating parent's ability to convince the child that
daddy does not care.
The Delusional Parent
Rogers refers to PAS in
her report on five divorce/custody cases in which the falsely accusing
parent, all mothers in this sample, suffered from delusional disorder
(32). The children were subjected to undue influence to get them to accept
the accusing parent's psychotic belief and concomitant rejection of the
other parent in a severe PAS scenario. Where the child succumbed, a
diagnosis of shared paranoid disorder, otherwise known as folie a deux
might also be made. According to Rogers, the first stages of the mother's
delusional disorder were present to some degree during the marriage and
exacerbated parental conflicts prior to the separation. However, these
subtle signs were not immediately discernible as a psychiatric illness and
were only recognized in retrospect, as the mother's symptoms became worse
in the course of the divorce and its attendant disputes. One of the severe
PAS cases reported by Dunne and Hedrick appears to be an example of the
mother developing delusional disorder. The "subtle signs" were expressed
as suspicions during her pregnancy that the father would molest the child,
similar to a case encountered by the present author in which suspicions
harbored by the mother even before the child was born prompted her to
abduct the child a few months later. According to Rogers, the mothers who
became delusional were usually the main caretakers for the children. In
two cases they were awarded custody during the first round of custody
litigation, before more noticeable deterioration in their parenting
capabilities had occurred. With continued custody litigation, the
intractable nature of their mental illness became apparent and the court
gave custody to the father in four of the five cases.
Munchausen
Syndrome by Proxy
Some cases of PAS, especially those with false
allegations of abuse, may have important features in common with
Munchausen Syndrome by Proxy (MSP) in which parents fulfill their needs
vicariously by presenting their child as ill (23). In cases of "classical"
MSP, parents repeatedly take their children to doctors for unnecessary,
often painful tests and treatments which the physician is
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induced to
provide based on the parent's misrepresentations. "Contemporary-type" MSP
occurs when a parent fabricates an abuse scenario for the child and
welcomes or actively seeks out repeated abuse interviews of the child by
police, social workers and therapists (23). The concept of
contemporary-type MSP elaborates on the idea put forth by Sinanan and
Houghton that new types of MSP behavior will evolve in parallel with the
evolution of new medical and social services, e.g., the child protection
system (33). MSP parents may change or come up with new "symptoms" for the
child so as to better elicit the desired response from a particular care
provider or an institution offering specialized services. Thus, the same
child may be receiving attention simultaneously for fabricated physical
symptoms from several medical providers and for fabricated sex abuse from
therapists and public agencies who specialize in abuse. Careful evaluation
and thorough investigation of sex abuse allegations which turn out to be
questionable or false will sometimes bring a parent to the attention of
authorities for practicing "classical" as well as "contemporary- type" MSP
(34).
As with PAS, MSP is most often practiced by mothers, although
fathers and other caretakers are sometimes found to engage in the
behavior. MSP parents maintain their psychic equilibrium through control
and manipulation of external sources of social gratification, including
the child and care providers who serve children. Medical and other care
providers are sometimes referred to as the "third party participants" in
the MSP, because of their importance in carrying out the parent's agenda,
including false allegations of abuse. There are at least four dif
ferent presentations where MSP and PAS overlap: 1) an MSP mother may,
during the marriage, add false allegations of abuse to the child's
fabricated physical symptoms, thus precipitating the divorce; 2) where the
MSP parent feels angry or rejected in divorce, manipulating the child's
medical care and involving the child in false allegations of abuse may
serve multiple functions including revenge, maintaining the symbiotic bond
with the child and preserving the freedom to continue the MSP behavior; 3)
a parent dealing with the losses and stress of divorce may respond with
MSP type behavior to obtain social support from the child and care
providers; 4) an alienating parent may exhibit MSP type behavior by
manipulating the child's medical care for the primary purpose of
furthering the alienation agenda (35).
In PAS with features of MSP,
the alienating parent may gain legal authority to control and determine
whom the child sees and what treatment is given. The child may be taken to
the doctor after visits with the target parent for fabricated or induced
symptoms which are attributed to abuse and neglect by the other
48 /
RAND: THE SPECTRUM OF PARENTAL ALlENATION SYNDROME
parent. The child
is likely present while the alienating parent makes this negative
presentation about the other parent to the doctor, who inadvertently lends
support to the denigrating account by listening to it, asking questions
and examining the child. The target parent may be rendered ineffective to
stop this cycle because providers retained by the alienating parent, and
who take her assertions at face value, often refuse to talk to the target
parent or allow the target parent access to child's medical records. The
result for the child is what Rand calls MSP type abuse. Rand expands
Meadow's formulation of MSP as a complex form of emotional abuse by
applying Garbarino's five types of psychological maltreatment. Research on
MSP shows that it sometimes overlaps with other forms of abuse and neglect
(36).
Parental Child Abductors
According to Huntington,
post-divorce parental child stealing has been on the increase since the
mid-1970s, paralleling the rising divorce rate and the explosion of
litigation over child custody (18). An abducting parent views the child's
needs as secondary to the parental agenda which is to provoke, agitate,
control, attack or psychologically torture the other parent. It should
come as no surprise, then, that post-divorce parental abduction is
considered a serious form of child abuse. Psychological
maltreatment may predominate or be accompanied by physical abuse and
neglect. Abducting parents take the idea that the child would be
better off without the other parent to an extreme. Clawar and Rivlin found
that would-be abductors often felt frustrated in their efforts to gain
access to their child through the legal system and felt "forced" to abduct
the child (7). Sometimes, they became so convinced of the terrible
scenario they were broadcasting about the target parent that they felt no
"choice" but to flee with the child and go into hiding. In order to
win the child's cooperation in maintaining concealment, the abductor must
continue to brainwash the child with fear of the target parent and what
would happen if the target parent should find the abducting parent and
child.
CONCLUSION TO PART I
Review of this first portion of relevant literature and research
indicates that Gardner's concept of PAS has been increasingly discussed
and referred to since he introduced the term in 1985. Research on
divorce since the early 1980s has been progressively converging with
Gardner's work. Johnston's studies of high conflict divorce in
particular suggest that it is not sufficient to lump PAS with
AMERICAN
JOURNAL OF FORENSIC PSYCHOLOGY VOLUME 15, NUMBER 3 1997 / 49
high
conflict divorce in general. In its more severe forms, PAS is
clearly distinctive. It is also more destructive for children and
families and can be irreversible in its effects. As the section on
alienating parents indicates, the divorce population includes a
significant proportion of parents who have' psychological problems and
disorders. The degree to which such problems are expressed in
efforts to alienate the child from the other parent has to be evaluated in
the total divorce context, including psychological factors of the child
and character and conduct of the target parent. Severe PAS is
destructive irrespective of the gender of the alienating parent.
Part
II attempts to integrate Gardner's work on PAS with the relevant
literature and research under the following topic headings: The Child in
PAS; The Target/Alienated Parent in PAS; PAS and its Third Party
Participants; Attorneys on PAS; Forensic Evaluation and PAS; and
Interventions for PAS, including strategic combinations of court orders
and therapeutic interventions, appointment of a Special Master,
appointment of a Guardian ad Litem, changing custody, use of
hospitalization and other transitional sites to facilitate custody
changes, and the appropriate application of sanctions to help certain
programming parents to better act in their children's best interests.
Whether or not one chooses to use Gardner's terminology, the problems
posed by these cases to families, professionals and the courts are very
real. Reluctance to consider Parental Alienation Syndrome by name,
along with the diagnostic and interventions it entails, tends to
contribute to the perpetuation of the problem in a variety of ways.
Like any other label, that of PAS has the potential to be misapplied and
misused. Whether or not it is the appropriate diagnosis in a given
instance must be determined based on facts of the case, corroborated
historical evidence and data from multiple sources. An appropriate
diagnosis of PAS, including level of severity as Gardner recommends, can
make the difference between allowing a case to go beyond the point of no
return or intervening effectively before it is too late.
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ABOUT THE AUTHOR
Deirdre Conway Rand, Ph.D. practices
clinical and forensic psychology in Mill Valley, California. She
specializes in complex forms of emotional abuse, such as severe Parental
Alienation and Munchausen Syndrome by Proxy. She is the author of articles
on the latter and of two chapters in the book, Spectrum of Factitious
Disorders, published by the American Psychiatric Association.
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