As many readers already know, the term “parental
alienation” (PA) refers to a parent-child situation and to the explanation of
that situation by proponents of the PA belief system. PA describes a situation
in which the child of a divorced couple rejects one of the parents and resists
or refuses contact with that parent but there appears to be no serious reason
(like experiences of abuse) for the child to take that position. The
explanation put forward by PA proponents for this scenario is that the child’s
preferred parent has worked in various ways to manipulate the child’s feelings
and to make him or her afraid of or angry at the nonpreferred parent.
Human beings do some very peculiar things, so this
could certainly happen. However, to know that it had happened—to “diagnose” PA—you
would need to have clear assurance that the child had no serious reason for
rejection, AND evidence that the preferred parent had acted in ways that
persuaded the child that the other parent should be avoided. You would also
need to have good evidence that the child had once liked and associated with
the now nonpreferred parent.
Unfortunately, courts around the world have fallen for
the argument that PA is present in a child’s reluctance for contact with a parent—and
they have fallen for the claim without demanding the evidence described in the
previous paragraph. The consequences that follow such decisions are serious
ones for children and families. Family court judges are asked by PA proponents
to order a complete change of custody from the preferred to the nonpreferred
parent, prohibition of contact with the preferred parent, and child attendance
at non-evidence-based treatment programs that are to be paid for by the
preferred parent. Young adults who earlier went through these programs have
reported their own distress and the potential for harm to be done by the
programs.
Because of these and other problems, in spite of
lobbying by PA advocates, PA was not accepted for inclusion as a diagnosis in
DSM-5 in 2013. Now, efforts are being made to include a reference to PA in a
volume that may be less familiar to some readers in the U.S., the International
Classification of Diseases (ICD), issued at intervals by the World Health
Organization. ICD lists both physical and mental disorders, and there is
currently discussion about what will be included in the next volume, ICD-11.
There is no question of including PA as a diagnosis in
ICD-11. However, PA advocates are pressing to have it included as an index
term; this means that if a person were to look for PA in the index it would
appear but would be linked to a legitimate diagnosis. People who are concerned
about the potential harmfulness of PA concepts and practices object strongly to
this, feeling that indexing the term would lend PA spurious respectability and
allow PA advocates to claim that PA is “in ICD-11” when this will not be true
in any real sense, Linking PA to a real diagnosis may also suggest to some ICD
users that the two terms actually mean the same thing, when they do not.
Here are some reasons why PA should not be included as
an index term in ICD-11:
1. 1. PA
has never been operationally defined. That is, no one has outlined the measures
or observations needed in order to identify PA. There is neither a way to
identify the quality of behavior that would indicate PA nor a way to quantify
PA (and thus to be able to see whether treatments are beneficial). One author
who has looked at the effects of a treatment program, Richard Warshak,
identified the children participating in the program as having been found to
have PA by a family court judge—certainly a new approach to diagnosis of mental
disorders.
2. 2. PA
advocates label preferred parents as abusers and claim that the child’s
rejection of one parent is a sign of mental illness that has been caused by the
preferred parent, who is therefore abusive and should not have contact with the
child. In spite of this claim, PA advocates rarely if ever report this notional
abuse to child protective services even though they may be mandatory reporters
of abuse.
3. 3. PA
principles and practices are pseudoscientific. The mechanism PA advocates
propose for persuasion of the child by the preferred parent, “brainwashing”, is
a legal concept and not a psychological one. The language proponents choose for
discussion of PA is obfuscatory, using the same terminology to refer to a child’s
feelings and to efforts a parent might have made to change those feelings.
Irrelevant information is often brought in to discussion of PA, as when
problems of critical thinking are claimed without evidence to be responsible
for a child’s resistance to contact with a parent. Claims of an evidence basis
for PA treatments are based on research designs that are too weak to indicate
the actual outcomes of the treatment. As Washburn et al. commented in a 2019
article in Professional Psychology: Research and Practice, “Entire fields can
be regarded as pseudoscientific when there is a seemingly wholesale absence of
systematic safeguards against confirmation bias (e.g., randomized controlled
trials, blinding of observers…” (p. 80). Although this comment was not directed
at PA in particular, it is an excellent description of PA and the reasons it
can be described as pseudoscientific despite claims to the contrary
.
4. 4. PA
has the potential for harming children and their families both directly and
indirectly. Children have reported being taken under duress, even in handcuffs,
to PA treatment sites, having their money and phones taken away, and being
prohibited from contacting people they trusted. This would be frightening and
distressing for all children but is especially so for any who have special
vulnerabilities like autism or like previous experiences of abuse. As for
indirect harm, preferred parents who have to pay large sums for these
treatments will find themselves without the funds to pay for needed services or
even to maintain their home. Parents who work with children as teachers,
pediatricians, day care providers, and so on, may lose their jobs if labelled
child abusers in the course of PA claims.
Now, what about the woozle part? That's the reason for being particularly concerned about what seems to be a trivial matter of indexing. It is understandable that PA advocates want to get a
toehold in ICD-11, even if only having PA as an index term. Although in the
past few psychologists had ever heard of PA, more and more now recognize the
term and understand the reasons for rejecting it. Unfortunately, however, for
those who come across PA only in passing or are never exposed to any of the
related issues, the term PA has the makings of a “woozle”—an idea
that seems to refer to something real only because it has become familiar as it
is mentioned repeatedly. Including PA as an index term would help push forward
the “woozle” process which adds to the obfuscation and muddled thinking already
associated with PA ideas. Rampant woozles make it easier for alternative psychotherapists to persuade people that they are legitimate-- and in the case of PA, being persuaded can lead to very disturbing consequences.
