Addendum III:* Recommendations for Dealing with Parents Who Induce a Parental Alienation Syndrome in Their ChildrenBy Richard A. Gardner*This statement is issued because of certain misinterpretations of the recommendations I make in my book on the PAS. Although these recommendations are stated in the book, there are situations in which they have not been implemented in the appropriate manner, sometimes with unfortunate and even disastrous results. In addition, I present here certain refinements and elaborations that I have come to appreciate since the publication of the original book in 1992. (These are summarized in Tables 1 and 2 at end of this addendum.) Because mothers are much more often alienators than fathers, I will refer to the parent who induces the PAS as the mother, and the parent who is the victim of the child's campaign of denigration as the father. Obviously, in situations in which the father is the one who is inducing the PAS in the child and the mother the victim of the campaign of denigration, then the recommendations made here for the mother should be applied to the father. Before one can make a decision regarding legal and therapeutic approaches to the PAS child it is important that a proper diagnostic evaluation be conducted in order to ascertain specifically in which category the child's symptoms lie: mild, moderate, or severe. Each type warrants a very different approach. Failure to make this discrimination may result in grievous errors, with significant psychological trauma to all concerned parties. This principle is in line with the ancient medical tradition that proper diagnosis must precede treatment. Furthermore, evaluators should appreciate that the category of PAS is not determined by the efforts of the programming parent, but by the degree to which the indoctrinating attempts have been successful. It is the resultant PAS manifestations in the child that determines the categorization, not the degree of parental efforts at indoctrination. MILD CASES OF PAS Manifestations Children in the mild category exhibit relatively superficial manifestations of the eight primary symptoms: campaign of denigration; weak, frivolous, or absurd rationalizations for the deprecation; lack of ambivalence; the "independent thinker" phenomenon; reflexive support of the loved parent in the parental conflict; absence of guilt; the presence of borrowed scenarios; and spread of the animosity to the extended family of the hated parent. Most often only a few of these eight symptoms are present. It is in the moderate type, and especially in the severe type, that most, if not all of them are seen. Visitation is usually smooth with few difficulties at the time of transition. Once in the father's home the children may be completely free of denigrating comments or, at most, such comments are intermittent and mild. The children's primary motive in contributing to the campaign of denigration is to maintain the stronger, healthy psychological bond that they have developed with their mothers. Legal Approaches In mild cases of PAS all that is usually needed is the court's confirmation that the mother will remain the designated primary custodial parent. In such situations the PAS is likely to alleviate itself without any further therapeutic or legal intervention. Psychotherapeutic Approaches Most often, psychotherapy for PAS symptoms in the mild category are not necessary in that they are likely to disappear once the court makes a decision to designate the mother the primary custodial parent. However, psychotherapy might be necessary for other problems attendant to the divorce. MODERATE CASES OF PAS Manifestations The moderate cases are the most common. It is in this category that the mother's programming of the child is likely to be formidable and she may utilize a wide variety of exclusionary tactics. All eight of the primary manifestations are likely to be present, and each is more advanced than one sees in the mild cases, but less pervasive than one sees in the severe type. The campaign of denigration is more prominent, especially at transition times when the child appreciates that deprecation of the father is just what the mother wants to hear. The children in this category are less fanatic in their vilification of the father than those in the severe category, but more than those in the mild category. The rationalizations for the deprecation are more numerous, more frivolous, and more absurd than those seen in the mild cases. None of the normal ambivalence that children inevitably have with regard to each of their parents is present. The father is described as all bad, and the mother as all good. The child professes that he (she) is the sole originator of the feelings of acrimony against the father. The reflexive support for the mother in any conflict is predictable. The child's absence of guilt is so great that the child may appear psychopathic in his (her) insensitivity to the grief being visited upon the father. Borrowed-scenario elements are likely to be included in the child's campaign of denigration. Whereas in the mild category there may still be loving relationships with the father's extended family, in the moderate cases these relatives become viewed as clones of the father and are similarly subjected to the campaigns of revulsion and denigration. Whereas in the mild cases transition times present few difficulties, in the moderate cases there may be formidable problems at the time of transfer, but the children are ultimately willing to go off with the father, while professing significant reluctance. Once removed entirely from their mother's purview, the children generally quiet down, relax their guard, and involve themselves benevolently with their fathers. This is in contrast to the severe category where visitation is either impossible or, if the children do enter the father's home, their purpose is to make his life unbearable by ongoing vilification, destruction of property, and practically incessant provocative behavior. The primary motive for the children's scenarios of denigration is to maintain the stronger, healthy psychological bond with the mother. Legal Approaches 1) In moderate cases I still recommend that the mother remain the primary custodial parent, her inducement of the PAS in her children notwithstanding. In moderate cases, she has usually still been the primary parent with whom the children have been most deeply bonded and it therefore makes sense for her to continue in this role. A court order finalizing this arrangement can contribute somewhat to the alleviation of the PAS, but it is not likely to evaporate entirely the symptoms, so deeply have they usually become entrenched by the time of this order. 2) Because in most cases the court has decided that the mother will remain the primary custodial parent, there is continued resistance to visitation. This is the result of the entrenchment in the brain-circuitry of both mother and children that the father is somehow despicable. Accordingly, a court-ordered therapist is often necessary who serves to monitor visits, use his (her) office as a transition site, and report to the court any failures to implement visitation. This therapist must be someone who is knowledgeable about the PAS and comfortable using the special, stringent therapeutic approaches necessary for successful alleviation of symptoms in both parents and children. 3) In most cases, recalcitrant mothers need to be warned by the court that if the children do not visit with the father, for whatever reason, court sanctions will be imposed. I generally recommend that the first level of such sanctions be financial, e. g., reduction of alimony payments. If this does not serve to bring about visitation, then house arrest for short periods should be ordered by the court. At this first level, the woman would merely be required to remain in her home throughout the prescribed time frame of the "sentence," with none of the traditional monitoring by police. If this fails, then a more formal arrangement should be made with electronic transmitters placed on the woman's ankle and telephone calls from the police to the home, randomly made throughout the 24-hour time frame. If this fails, then actual incarceration for limited periods should be utilized. I am not recommending that these women be placed in prison with hardened criminals. I am only suggesting short periods in a local jail. In most cases, the awareness of financial penalties and the possibility of incarceration is enough to motivate such mothers to get their children to the father's home, their resistance to such visits notwithstanding. A good "starter" for home confinement or jail incarceration might be a time frame equivalent to the length of time ordered for the particular visitation being attempted. For example, if the children refuse to visit with their father on a particular weekend, from 5:00 P.M. Friday to 7:00 P.M. Sunday, then the mother should be confined for that same length of time if the children do not visit. Often it is preferable that such confinement be implemented one week after the missed visitation in order that the proper preparations can be made. Unfortunately, my experience has been that courts are not generally willing to impose these sanctions, and so mothers in the moderate category have not been meaningfully deterred from continuing the promulgation of a PAS in their children. My general recommendation to courts is that they use the same methods that they would for a father who reneges on alimony and support payments. Although financial penalties are not usually imposed under such circumstances, short prison terms (especially on weekends), both at home and in jail, have proven quite effective. Inducing a PAS in a child is a form of child abuse, more specifically, emotional abuse. Reneging on alimony and support payments is also a form of child abuse, in that the children cannot but suffer from the privations generated by such withholding. The court has the power to induce both types of child abusers to reconsider their ways, and courts can do this much more speedily and effectively than can therapists. Psychotherapeutic Approaches It is important that the court order treatment by someone who is not only familiar with the PAS but who is comfortable using the stringent approaches necessary for successful treatment of this disorder. The therapist monitors visits, uses his (her) office as a transitional site, and reports to the court any failures to implement visitation. Without direct access to the court and without meaningful sanctions that the court is committed to implement, the treatment is likely to fail. Details of this therapeutic program are provided on pages 230-245 of this book. SEVERE CASES OF PAS Manifestations Children in the severe category are generally quite disturbed and are usually fanatic. They join together with their mothers in a folie a deux relationship in which they share her paranoid fantasies about the father. All eight of the primary symptomatic manifestations are likely to be present to a significant degree, even more prominent than in the moderate category. Children in this category may become panic-stricken over the prospect of visiting with their fathers. Their blood-curdling shrieks, panicked states, and rage outbursts may be so severe that visitation is impossible. If placed in the father's home they may run away, become paralyzed with morbid fear, or may become so continuously provocative and so destructive that removal becomes necessary. Unlike children in the moderate and mild categories, their panic and hostility may not be reduced in the father's home, even when separated from their mothers for significant periods. Whereas in the mild and moderate categories the children's primary motive is to strengthen the stronger, healthy psychological bond with the mother, in the severe category the psychological bond with the mother is pathological (often paranoid) and the symptoms serve to strengthen this pathological bond. Legal Approaches 1) In severe cases of PAS, which represent a very small minority of PAS cases (approximately five-to-ten percent, in my experience) more stringent measures must be taken. If there is any hope of alleviating the children's symptoms the first step must involve a transfer of custody to the home of the father. Whether this remains permanent depends upon the behavior of the mother. 2) Because the children typically will not cooperate In going to the father's home, the transitional site program should be utilized. (This program is described in detail on pages 334a-334h in this book.) It is not the purpose of this program to preclude the mother entirely from the children's lives. In fact, as described therein, it provides for expanding opportunities for access, depending upon the degree to which the mother can reduce her PAS-inducing indoctrinations. In most cases there will ultimately be varying degrees of maternal access, depending upon the mother's ability to reduce the PAS-inducing manipulations. Supervised visitations with the mother are often indicated in order to protect the children from her indoctrinations. This is similar to the supervision provided for abusing fathers. After all, inducing a PAS in a child is a form of abuse from which children need protection. The transitional program does not necessarily preclude the mother ultimately reverting back to the status of primary custodial parent, although this is not likely in the severe category because these mothers often suffer with significant psychiatric disturbances. It is important to emphasize that it is only in the severe cases of PAS (again, representing five-to-ten percent of cases) that primary custodial status should be shifted from the mother to the father. Psychotherapeutic Approaches The transitional site program should be monitored by a therapist who is not only familiar with the PAS but is comfortable with the kind of stringent approaches necessary for the implementation of the transitional site program. In short, this therapist must have the same qualifications as the therapist ordered by the court to implement the treatment of families in the moderate category. If the therapist does not have these qualifications, the transitional site program is not likely to succeed. Concluding Comments The differential diagnostic and treatment approaches are summarized in Tables 1 and 2. I cannot emphasize strongly enough that evaluators should never lose sight of the crucial medical dictum: diagnosis before treatment. Evaluators from nonmedical disciplines tend to lose sight of this important principle. One wants one's heart or brain surgeon to conduct the proper examinations and tests before opening up one's heart or head to operate. Most would not submit to such a procedure without such evaluations and tests. Yet, evaluators and courts are implementing PAS recommendations that are improper for the particular diagnostic category. Again, I cannot emphasize strongly enough the importance of accurately defining the category of PAS before implementing any therapeutic or legal measures. Not to do so is likely to result in grievous errors that will predictably cause significant psychiatric disturbances in all concerned parties. I have seen reports of mental health professionals and courts dealing with mild or moderate cases of PAS as if they were severe, injudiciously and erroneously, then, transferring custody to the father, and even putting women in jail whose level of indoctrinations are minimal and might even be reversed once they had the assurance that they would remain the primary custodial parents. I have seen cases in which courts and mental health professionals have assessed PAS on the basis of the mother's indoctrinations, and not the degree to which the programming process has been successful in the child. In such cases the children may have exhibited only mild PAS manifestations, but the mother was treated as if the children were in the severe category and thereby deprived of custody. Again, the diagnosis of PAS is not made on the basis of the programmer's efforts but the degree of "success" in the child.
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