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.

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 preschoolers 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.

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 of 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.

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.