Coming to grips with reality, everyone has fought the good fight, but it does not appear that the PAS will be accepted into the DSM 5. Nevertheless, this does not signify that we cannot document for the courts the PAS family dynamic that is so clearly observed as a highly dysfunctional family interactional pattern so destructive to children.
I have always approached this heart-wrenching family situation from a dual perspective: if the lawyer for the targeted/alienated parent informed me that the judge on the case accepts the label of “alienation,” I would repeat that word as often as possible in my testimony. If, on the other hand, the word “alienation” raises the judge’s hackles, I would not use that word in my testimony. I describe, instead, the observable family situation of “parental interference by one parent with the relationship between the other parent and their child.” In most states, this language is already on the legal books and is generally accepted by most judicial districts as being so inimical to the best interests of the child that it is grounds for transfer of custody. Young v. Young, 212 A.D.2d 114; 628 N. Y. S.2d 957 (1995).
Because the PAS creates horrific symptoms in the child resulting from a process that eradicates a loving and fit parent from the child's life, I personally and professionally maintain and will continue to assert that the PAS is a syndrome. The mental health community----in particular the DSM 5 Task Force----must come to grips with and be mercilessly reprimanded for how it succumbed to self-interested pressures rather than by scientific research in its decision not to accept the PAS into the DSM 5. The Task Force’s alleged rationalization that it did not wish to stigmatize the child with another diagnosis is a canard. PAS children are already being labeled with much more stigmatizing diagnoses including the psychotic diagnosis of “folie a deux,” meaning shared psychotic disorder. The other suspicious objection is that the diagnosis will require treatment with medication. This is absolutely preposterous! Medication as the remedy is rarely recommended for most diagnoses in the DSM----at least not initially. Various forms of talk or interactive therapy are usually attempted first as the least invasive response. Trained as I was by the world-renowned and highly respected child psychiatrist, Salvador Minuchin, I virtually never support medication as a factor in treatment. Indeed, family therapy is based on the premise that dysfunctional family interactional patterns maintain and create symptoms. The remedy, therefore, must be to promote healthy family interactional patterns. Prescribing medication for the PAS child is as ludicrous as giving a patient with an infection antibiotics for the infection and then returning the patient to the germ-infested environment that had caused the infection. The dysfunctional family dynamic of the PAS is the “germ infested environment” that creates symptoms in the child. Treatment intervention that challenges the family dynamic of the co-option of the child by one parent in that parent’s conflict with the other parent is the only remedy for the PAS child’s symptoms.
Perhaps we can take our inspiration from Robert Frost, who wrote in his renowned poem, The Road Not Taken:
“I shall be telling this with a sigh
Somewhere ages and ages hence:
Two roads diverged in a wood, and I,
I took the one less traveled by,
And that has made all the difference.”
Those of us who care about the scourge of the PAS must find another path to enlighten those professionals who impact child custody----another path which will make all the difference.
Joan Teresa Kloth-Zanard says:
I agree with you 200% on this. The stance that it is another label is insane. 90% of these kids are already labeled worse as you say, as drug addicts, alcoholics, explosive children, ADD/ADHD, narcissistic, suicidal, bullies and more. I would think that a diagnosis of PAS would be far less toxic as it would give a reason for the behavior and a fairly easy solution if treatment is followed. And then this idea that PAS children need to be medicated is insane. In fact, that is like 10 years ago when the DSM did not believe in dual diagnosis's and instead often treated the symptom and not the problem, causing even more problems for people with mental illnesses. Prime example, drug addicts back then were treated for their impulse control issues with drugs and NOT what caused them to even go their, their FOO or family of origin issues or a traumatic event in their life. In other words, why would you medicate a symptom instead of correcting the cause of the symptom. I am beginning to wonder who they have up in the offices of this DSM Committee because excuses really are lame.