The article in the September 1 issue on parental alienation syndrome (PAS) includes some serious inaccuracies and omissions.

First, the way I have described PAS: Parental alienation syndrome (PAS) is a disorder that arises primarily in the context of child-custody disputes. Its primary manifestation is the child’s campaign of denigration against a parent, a campaign that has no justification. It results from the combination of a programming parent’s indoctrinations and the child’s own contributions to the vilification of the target parent. When true abuse and/or neglect is present, the child’s animosity may be justified, so the PAS explanation for the child’s hostility is not applicable.

These are the primary symptoms of PAS: campaign of denigration; weak, frivolous, and absurd rationalizations for the deprecation; lack of ambivalence; the "independent-thinker phenomenon"; reflexive support of the alienating parent in the parental conflict; absence of guilt over cruelty to and/or exploitation of the alienated parent; presence of borrowed scenarios; and spread of the animosity to the extended family of the alienated parent.

Critics argue that PAS is not a syndrome. It certainly satisfies the medical definition: a cluster of symptoms, occurring together, that characterize a specific disease. Newly described disorders are generally referred to as "syndromes," and when research provides verification of a bona fide disease, the term "syndrome" may be dropped, for example, Tourette syndrome became Tourette disorder.

Critics claim that I routinely recommend custody to the targeted parent. This is not so. I generally recommend that the alienator maintain custody in mild and moderate cases. In severe cases, I recommend custodial transfer.

Critics claim that my work in PAS has resulted in courts’ assigning primary custody to bona fide abusers. In such cases, proper differentiation has not been made between bona fide abuse and PAS.

Some abusers claim that the children’s animosity was not caused by their abuses, but the spouse’s PAS programming. The critics imply that I am somehow responsible for this misuse of my contribution. In my 1998 book on PAS, a chapter is devoted to this differentiation.

The critics imply that I don’t properly recognize bona fide sexual abuse. This is not so. Because some (about 10 percent in my experience) PAS cases involve a false sexual abuse accusation does not mean that all sexual abuse accusations that emerge in child-custody disputes are false, nor does it mean that I am denying the ubiquity of bona fide sexual abuse.

Dr. David Shaffer states that PAS has not been proposed to any DSM committee. There were not enough articles in the literature to justify a submission to DSM-III-R or DSM-IV. With now approximately 100 articles in peer-reviewed journals, submission will be considered when committees are formed for the next edition of DSM. Dr. Shaffer states that PAS is "a psychological process that occurs within families, rather than a diagnostic profile that falls within the province of the DSM." Many DSM disorders are the result of psychological processes that occur within families, for example, separation anxiety disorder, conduct disorder, and adjustment disorders.

Richard A. Gardner, M.D.

Cresskill, N.J.