Help Get PAS Into DSM-V

This is a REALLY important thing, and there is enough time between now and when the next version comes out, about 2011, to rally a lot of support for including it. Basically, people need to write to the APA to support its inclusion.

<<THIS PAGE IS UNDER CONSTRUCTION>>

If you can help me write this page, please contact me, the webmaster -at- crnjapan.com.  Basically I want to summarize all the information below, provide information on how to contact the APA and the committee working on the DSM-V, and suggestions on what to talk about with them (i.e. specific details of your case and the symptoms that you observed, and contact info for any psychiatrists you have worked with, etc.) to make sure that your letter gets into their PAS file.  Please help me out on this!!

DSM-V Prelude Project: Research and Outreach

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• Submit suggestions for a new disorder to be considered for addition to DSM-V

Petition to add PAS into the DSM-V

Additional Information on why this is important is below:

From http://home.worldonline.nl/~csnel/jz/dsm5.html

To: PAS Network-2
From: Richard Gardner

As most of you are aware, 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 doesn't 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 legal 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 do so.

DSM-V committees are scheduled to start meeting in 2006 and the projected date of publication of DSM-V is 2010.

At this point, there are at least 143 articles in peer-review journals on the PAS http://www.rgardner.com/refs/pas_peerreviewarticles.html   Many countries are represented.
In addition, there are at least 72 rulings in courts of law that have recognized the PAS  http://www.rgardner.com/refs/pas_legalcites.html    Again, many countries are represented. These rulings include two successful Frye hearings (U.S.) and one successful Mohan hearing (Canada)
There is good reason to believe that these lists will be even longer by 2006.

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 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 that the supporters in sending submissions to that file.

Accordingly, I am suggesting that therapists who have seen PAS patients write the APA now 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 suggesting that alienated parents also write now, again with particular focus on the specific syndrome symptoms they have observed in their children.

Lawyers who represent alienated parents should also write.  If PAS is not accepted into DSM-V, their position in courts of law will be seriously weakened.

I am suggesting also that other interested parties also write now, people such as relatives of PAS families and older children  who subsequently came to appreciate that they had been programmed to become PAS children. Anyone who asks what she (he) can do to help PAS families should be advised to write the APA.  All those who write should focus on the specific syndrome symptoms that manifested themselves.

All those who write should keep in mind that the primary purpose of their letter is to help the committee make a decision as to whether the syndrome exists and hence justifies consideration for inclusion in DSM-V.

Although the committee will not meet until 2006, it is important that the members have input from both sides of the PAS controversy. The critics are sending in their criticisms now and I suspect will continue to do so. Those who recognize the PAS must similarly write now, and there must be continuing letters over the next 4 years if the committees are to have balanced input. 

Send your letters to:

                         DSM-V Coordinator
                         American Psychiatric Association
                         1400 K Street, N.W.
                          Washington, D.C. 20005
                          Fax 202-682-6850
                          e-mail dsm@psy.org

Request that your letter be put in the PAS file. 

Last, I suggest that people in the PAS Network give this latter the widest possible circulation.

From:  http://www.fact.on.ca/Info/pas/letterwrite.htm

The work on updating the Diagnostic and Statistical Manual of Mental Disorders ("DSM") is to start soon. This is a compilation of the "scientifically accepted" psychiatric diagnoses complied by the American Psychiatric Association. Missing from this compilation is Parental Alienation Syndrome (PAS) (which on its acceptance would be called a "disorder" rather than a "syndrome").

As a result of our knowing that PAS is real, we do want to see recognition of this damaging condition listed in DSM-V so that there will be protection of, and treatment for, children suffering from PAS. It is important that you write, and that you get your lawyers, doctors, family members, etc. to write to describe the cases that have been experienced. Dr. Richard Gardner has provided a call for action on this topic, including the addresses, which we have included here and which you should read.

Because of the nature of the DSM, if you are not familiar with the book, I would suggest that you talk about the symptoms of PAS that you have seen in your children, patients or your client's children. This outlines the collection of symptoms that defined the syndrome (the "etiology"). You should talk about the impact on the children (problems at school, behaviour problems, psychological issues, ability to form relationships, depression, etc.). Don't emotionally berate your ex-spouse (as tempting as that is since most of us know the sources of the problem). Don't talk about how nasty, bigotted or irrational the lawyers and judges were. Do talk about how it is necessary that society and the courts be made aware of the problem of PAS to both treat the existing cases and to prevent new cases.

We believe that a written paper letters that can be included in a file is the best way to seek any change. Emails, unless you are known, just don't cut it. Send you letters to:

DSM-V Coordinator
American Psychiatric Association
1400 K Street, N.W.
Washington, D.C. 20005
Fax 202-682-6850
e-mail dsm@psy.org

(Correction per Kevin and http://www.dsm5.org/)
DSM-V Coordinator
American Psychiatric Association
1000 Wilson Boulevard, Suite 1825
Arlington, Virginia 22209-3901
 

and ask for your letter to be "included in the Parental Alienation Syndrome file."

What are those symptoms you should identify? They are well documented in many of the articles in the FACT PAS section, but as a quick reminder:

 

• The Campaign of Denigration: the child has a campaign against the target parent

   

• Weak, Frivolous, or Absurd Rationalizations for the Depreciation: the problems the child quote are absurd or inappropriate for the reaction, eg. target parent chews too loudly, target parent is the devil's spawn

   

• Lack of Ambivalence: no half-way mark to the animosity -- it is simply full bore

   

• The "Independent-Thinker" Phenomenon: the child feels that all this thought and emotion is their own idea and that no-one else had anything to do with their thoughts

   

• Reflexive Support of the Alienating Parent in the Parental Conflict: the alienating parent can do no wrong, and there is never a need to question that

   

• Absence of Guilt Over Cruelty to and/or Exploitation of the Alienated Parent: no feeling that abusing the target parent has any sort of wrongness to it

   

• Presence of Borrowed Scenarios: use of what are obviously other people's memories in creating the hateful thoughts, e.g. quoting instances that before the child was born or was very young, that the child never saw, or that never happened

   

• Spread of the Animosity to the Extended Family and Friends of the Alienated Parent: involvement of all of the target parent's family.

If you have degrees and professional designations make sure that they are included in the letter. If you don't, still write. Designations help sometimes, solid letters always help.

We encourage you all to write, and to get as many others -- especially the professionals involved in family law who see a lot of cases -- to write in as well.

http://www.questx.com/pas/pashascome.html

Parent Alienation Syndrome: Its Time Has Come - by Dr. Andre
Published in The California Psychologist - included with permission from The California Psychologist and was first printed in the Sept/Oct issue 2005.

Most psychologists agree the least understood -- and often most destructive -- type of child abuse is emotional. Considered the most difficult abuse to diagnose and prevent, its scars are not physical but invisible, with profound, far-reaching consequences.

There is growing interest in a less-well-known type of emotional child abuse known as Parental Alienation Syndrome (PAS). “PAS is a serious form of child abuse” (Cartwright, 1998) with a general consensus regarding the most prominent behavioral symptoms (Gardner, 1989; Rand, 1997; Darnall, 2001; Kelly and Johnston, 2001; Warshak, 2001; Major, 2004; Andre, 2004) defining the mental illness.

This article seeks to increase awareness of PAS as a mental illness form resulting from emotional abuse, and to suggest PAS' inclusion in The Diagnostic and Statistical Manual of Mental Disorders-V (DSM-V).

PARENTAL ALIENATION SYNDROME (PAS)

History

PAS has been referenced by concept in the literature for at least twenty-five years. Wallerstein and Kelley (1980) first noted a pathological alignment between an angry divorcing parent and his/her child. Gardner (1985) further delineated this problematic alignment as occurring between a brainwashing parent with a contributing child, naming the alignment Parental Alienation Syndrome and articulating its symptoms.

Symptoms and psychological dimensions

In its mildest form, PAS may be observed as a child’s reluctance to visit a parent. In its severest form, PAS children “use extreme oppositional behaviors to reject and denigrate the previously loved parent. ... The children’s perceptions are black and white. The targeted parent …is hated for seemingly small or ridiculous reasons” (Andre, 2004).

PAS alienators lie about their brainwashing while empowering their children to behave irresponsibly toward the other parent. Alienators attempt to mislead evaluators, using deceitful accusation tactics to deflect intervention.

Discerning an alienator's true intent requires a trained professional. Just as child sexual predators “groom” their child victims, so alienators groom children by testing for compliance. Common themes are the other parent is crazy, bad, or to be feared (Clawar and Rivlin, 1991). The child endures scenarios in which “correct” responses are rewarded and “incorrect” responses punished.

Children aligned with alienators are taught to tell half-truths and lies. Bone and Walsh (1999) state PAS childrens’ lies are “survival strategies that they are forced to learn to …avoid emotional attacks from the alienating parent.”

Clawar and Rivlin's (1991) research indicates alienators use persuasive techniques and brainwashing tools to isolate children from other family members. Alienators promote denial of the child’s other parent by deliberately refusing to acknowledge the other parent at social events or in the child’s presence. Alienators also rewrite history, causing the child to doubt his/her perception of reality, making the child more vulnerable to the alienator's distortions.

PAS is emotional abuse

Cartwright (1998) stated, “PAS is a serious form of child abuse.” When an alienator isolates a child from another parent through programming techniques and control, harm and symptoms of mental illness result. Emotional abuse results when an alienator controls a child’s beliefs through rejection and fear.

Bone and Walsh (1999) state “healthy and established parental relationships do not erode naturally of their own accord. They must be attacked.” It is emotional abuse when an alienating parent attacks the other parent-child bond intending to destroy it.

Emotional abuse's consequences

Childhood abuse's emotional effects are well documented. Consequences include perpetuating abuse into the next generation for those who remain unaware, low self-esteem, self-destructive behaviors, anger, aggression, cruelty, depression, anxiety, and post-traumatic stress.

Emotionally abused children affect society's structure. They risk becoming mentally ill adults who hate, fear, lie, and engage in antisocial behavior. Kraizer (2004) writes, “Evidence is mounting that child mistreatment is the precursor to many of the major social problems in this culture.” The U.S. Advisory Board (1990) suggests our society's survival depends on protecting children from harm.

Clawar and Rivlin’s (1991) research indicates even mild PAS cases need intervention and “have significant effects.” Traditional talk psychotherapies are ineffective in severe cases, which require deprogramming therapies for successful intervention.

Occurrence

Conservatively, there are potentially 50,000 new PAS cases annually with half a million new children under age 18 experiencing or being at risk for PAS (Andre, 2004).

Interventions lacking

Despite the large number of divorce program interventions available in the literature, few are PAS-specific. The number of intervention programs tripled between 1994 and 1999 (Arbuthnot, 2002), suggesting rapidly growing interest in PAS.

PAS AND THE DSM-V

One reason for few PAS intervention programs may be its lack of inclusion in the Diagnostic and Statistical Manual (DSM-IV), an important diagnostic tool for naming disorders, determining differential diagnosis and diagnostic validity, and providing research uniformity.

Because PAS is not in the DSM-IV, there is no uniform diagnostic criteria or even an agreed-upon name. Rand (1997) pointed out there is a “body of divorce research and clinical writings which, without a name, describe” PAS.

DSM exclusion leads to misunderstanding

PAS' exclusion is sometimes considered evidence of its nonexistence by those lacking understanding of the DSM's evolution. Since its first publication in 1952, the DSM has undergone four major revisions, each attempting to reflect the time's accepted thinking. However, PAS' exclusion from the DSM does not mean it doesn't exist (Warshak, 2003).

Its time has come

Cartwright (2002) stated there were “133 peer reviewed articles, and 66 legal citations from courts of law” recognizing PAS. Articles continue to be added to the professional literature; there may already be a comprehensive database from which to answer a DSM-V workgroup's questions.

Conclusion

PAS is a form of child abuse with potentially severe consequences. A substantial body of peer-reviewed literature indicates PAS is a valid and distinct disorder. Inclusion in the DSM-V would provide the legitimacy PAS warrants, and clarify the conceptual framework, as well as the psychological and behavioral dimensions for diagnosis, research and treatment.

The American Psychiatric Association DSM-V Prelude Project committee has a website, www.dsm5.org/suggestions, for the user community to submit suggestions for the next DSM.

We must ensure our nomenclature systems reflect current understanding of mental illness by asking a workgroup review PAS for inclusion in the DSM-V.

References

Arbuthnot, J. (2002). A call unheeded: Courts’ perceived obstacles to establishing divorce education programs. Family Court Review, 40,371-382.

Andre, K. (2004). Parental alienation syndrome. Annals of The American Psychotherapy Association, 7, 7-11.

Bone, J.M. and Walsh, M.R. (1999). Parental alienation syndrome: How to detect it and what to do about it. The Florida Bar Journal. 73.44-48 [Retrieved electronically; www.fact.on.ca/Info/pas/walsh99.htm].

Cartwright, C. (1998). Brief to the special joint committee on child custody and access. [Retrieved from] www.education.mcgill/ ca/profs/cartwright/papers/pasbrf01.htm.

Cartwright (2002). The changing face of parental alienation. Paper presented at the symposium: the parliamentary report for the sake of the children. Ottawa.

Clawar, S. and Rivlin, B. (1991). Children Held Hostage. Chicago: American Bar Association.

Darnall, D. (1998). Divorce Casualties.Lanham, MD: Taylor Trade Publishing.

Duryee, M. (2003). Expected Controversies: Legacies of Divorce. Journal for the Center for Families, Children and the Courts. 149-160.

Gardner, R. (1985). Recent trends in divorce and custody litigation. Academy Forum. 29, 3-7.

Gardner, R. (1989). Family evaluation in child custody, medication, arbitration, and litigation. Cresskill, N.J.: Creative Therapeutics.

Gardner (2001). The empowerment of children in the development of parental alienation syndrome. [Retrieved electronically; http://rgardner.com/refs/arl4.lml].

Kelly, J. and Johnston, J. (2001). The alienated child: A reformulation of parental alienation syndrome. Family Court Review. 39, 249-266.

Kraizer, Sherryll (2004). Online; www.safechild.org/abuse.htm.

Major, J.A. (2003). Parents who have successfully fought parent alienation. [Retrieved electronically; www.breakthroughparenting.com/PAS.htm.1-15].

Rand, D. (1997). The spectrum of parental alienation syndrome (part I). American Journal of Forensic Psychology. 20,5-29.

Wallerstein, J. and Kelly, J. (1980). Surviving the break-up: How children and parents cope with divorce. NY: Basic Books.

Warshak, R. (2001). Divorce Poison. NY: Regan Books.

Warshak, R. (2003).Bringing sense to parental alienation. Family Law Quarterly, 37, 273-301.

About the author

Dr. Katherine C. Andre is a licensed psychologist in private practice in Lakeport. She chairs the Lake County Mental Health Advisory Board, is a Diplomat in The American Psychotherapy Association and in Division 12 of The American Psychological Association. For 10 years she worked as a Lake County Superior Court family mediator, where she encountered PAS firsthand.