by John M. Grohol, PsyD
September 22, 2012

from PsychCentral Website



In a stunning display of ignorance, researchers attempt to create a mental diagnosis that can be applied to entire families at once.

"Parental Alienation Disorder" was denied acceptance into the psychiatric bible, the DSM-5 in spite of "intense lobbying" by supporters. This unofficial yet bold new disorder occurs to more than one person at a time.

I guess if you are trying to label as many people mentally ill as possible, you may as well begin slapping diagnoses on groups.

'Parental Alienation Disorder' supposedly happens when parents engage in the common but unfortunate attempt to alienate children from each other.


For example, a mother may complain to her son that his father is a flake or a loser or a liar. The father may do the same in return as both parents attempt to win the approval of the child.

This dynamic is not unusual in families. If something similar is going on in your family, you should take measures to correct it.

This is a communication issue, however, not a mental illness. This pattern that occurs within a family system involves resentment, immaturity, shortsightedness and even ignorance. It is an unfortunate practice, though, not a single mental illness for a group of people.

However, if you want an expressway to "medicalize" several people at once, 'Parental Alienation Disorder' may be the ticket.

In fact, some individuals could conceivably receive a diagnosis without even stepping foot into a mental health worker's office!


Sound appealing? If so, support the American Psychiatric Association and pharmaceutical companies in their takeover of mental health.

The trend in the industry, worldwide, is to expand the market for pharmaceuticals. By increasing the number and breadth possible medical diagnoses, more and more people have become mentally ill.


More mentally ill people means more business for Big Pharma and psychiatrists.

'Parental Alienation Disorder' - the attempt to expand beyond the typical single person diagnosis - was a step too far for the DSM-5. The board must have known how much heat they would take if they allowed it.


We should be alarmed, however, that it was even considered.



The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the yardstick that mental disorders are measured against. But every disorder in this reference guide is meant for individuals, because that’s how doctors diagnose diseases and disorders.

So it would be ground-breaking if the working groups that are focused on revising the DSM suddenly decided that a disorder could be diagnosed not just in an individual, but in a set of people - such as two people in a particularly unhealthy romantic relationship (Co-dependency Disorder?) or family (Scapegoating Disorder?).

This is exactly what some folks wanted to do to make their paydays easier in divorce court.

  • The proposed disorder? Parental alienation disorder.

  • Its “symptoms?” When a child’s relationship with one parent is poisoned by the estranged parent.

Thankfully, it appears the working group charged with reviewing the research in this area and making a decision for the new draft of the DSM has erred on the side of keeping to the standard - that we shouldn’t be diagnosing disorders that aren’t contained within an individual.

"The bottom line - it is not a disorder within one individual,’’ said Dr. Darrel Regier, vice chair of the task force drafting the manual. ‘‘It’s a relationship problem - parent-child or parent-parent. Relationship problems per se are not mental disorders."

Regier and his APA colleagues have come under intense pressure from individuals and groups who believe parental alienation is a serious mental condition that should be formally recognized in the DSM-5.


They say this step would lead to fairer outcomes in family courts and enable more children of divorce to get treatment so they could reconcile with an estranged parent.

Among those on the other side of the debate, which has flared since the 1980s, are feminists and advocates for battered women who consider ‘‘parental alienation syndrome’’ to be an unproven and potentially dangerous concept useful to men trying to deflect attention from their abusive behavior.

The problem is that there’s very little scientific evidence to support this disorder; this comes as no surprise when you read the proposed definition:

Dr. William Bernet, a professor emeritus of psychiatry at the Vanderbilt University School of Medicine, is editor of a 2010 book making the case that parental alienation should be recognized in the DSM-5. [...]

Bernet’s proposal to the DSM-5 task force defines parental alienation disorder 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."




  • What the heck is “legitimate justification?”

  • And who determines what’s “legitimate” and what’s not?

  • Isn’t it a child’s right to align themselves with whomever they’d like, whenever they’d like, with or without justification?

  • Since when would that be considered a disordered behavior ; doesn’t this occur every day in perfectly healthy marriages?

Talk about a slippery slope that seems designed to ensure it could be used in whatever way needed in a messy divorce.

After reviewing the evidence, I don’t believe we’re anywhere close to saying that this sort of triangulated relationship is a “disorder.” Certainly it’s unhealthy behavior, and certainly it can be treated if all parties are interested.

Parental alienation disorder is not a recognized mental disorder, and it’s unlikely to appear in any form in the new DSM-5 coming out next year - and that’s as it should be.