by Dahlia LithwickThe competition to get your favorite disease recognized in the bible of mental health, the Diagnostic and Statistical Manual of Mental Disorders, can be as fierce as the talent contest in the Little Miss St. Paul Contest. The American Psychiatric Association is contemplating adding something called "parental alienation syndrome" (PAS) to the new edition of the DSM, scheduled to be published in May 2013, and the question has launched a national lobbying and letter-writing campaign on both sides. That angry letters and editorials might play any part in a debate about mental health and custody disputes probably tells you most of what you need to know about the validity of PAS.
What is parental alienation syndrome? William Bernet, a professor of psychiatry at the Vanderbilt University School of Medicine and an advocate for its inclusion in the DSM-5, describes it as "a mental condition in which a child, usually one whose parents are engaged in a high conflict divorce, allies himself or herself strongly with one parent, and rejects a relationship with the other parent, without legitimate justification."* There is no doubt that an ugly divorce can affect kids' relationship with their parents or cause children to choose sides, often in anger. In fact, that probably happens more often than not. But Bernet and others who argue for adding PAS to the Sears, Roebuck catalogue of mental health want to see it recognized as a legitimate mental health disorder in order to "spur insurance coverage, stimulate more systematic research, lend credence to [the] charge of parental alienation in court, and raise the odds that children would get timely treatment."
They want, in other words, to affix a name, some blame, and also a price tag on a broad range of child responses to a custody fight—some perfectly justified and some not—in the hopes of expanding its use in court.
And what's the downside to including PAS in the DSM? Well, for one thing, with a minimum of three participants needed to diagnose it, PAS starts to look less like a mental health disorder than an epidemic. It assumes that one crazy person (the mother) brainwashes a second crazy person (the child) into telling lies about a third person (the father). Just because a lot of parents have experienced blocked visitation and unreturned phone calls doesn't make every instance of that conduct the result of a medical "syndrome." Joan S. Meier, a professor of clinical law at George Washington University School of Law, has explained it this way: "PAS is a label that offers a particular explanation for a breach in relationship between a child and parent, but insofar as that breach could be explained in other ways, it is not in itself a medical or psychological diagnosis so much as a particular legal hypothesis."
Read more:
