The disorder can be classified as mild, moderate, or severe, with the moderate level being the most common.  The mild form is the least harmful; the severe form borders on paranoia with delusions of persecution and other irrational fears.
Gardiner lists eight primary symptoms of the PAS including 1) a campaign of denigration in which the PAS child denigrates the lost parent, 2) weak, frivolous, or absurd rationalizations for the deprecation, 3) a lack of ambivalence in which the child sees one parent as all good and the other as all bad, and 4) manifestation of the “Independent-thinker" phenomenon in which the child asserts that the decision not to see the lost parent is his/her own.  In addition, there is 5) reflexive support of the alienating parent in which the child supports almost blindly the alienating parent, 6) an absence of guilt over cruelty to and/or exploitation of the alienated parent, 7) the presence of borrowed scenarios, and 8) the eventual spread of the animosity to the extended family and friends of the lost parent. Most, if not all, of these eight symptoms are present in children who suffer with PAS at the moderate and severe levels though fewer may be seen in mild cases (Gardner, 2002b). PAS is best understood as a psychiatric disorder involving in the emotional abuse of a child or children.  It is a serious and pervasive and growing form of child abuse often not recognized by the courts, lawyers, or by many mental health professionals. The denial of PAS by the courts has encouraged the permanent estrangement of PAS children from their lost parents in the majority of cases followed up by Gardner (2001). To some degree, PAS is an artificial problem, promulgated and exacerbated by the adversarial system of child custody dispute adjudication.  Seeded by a bad Divorce Act and nurtured by a divorce industry of lawyers, judges, social workers, counselors, psychologists, psychiatrists, and guardians ad litem, it is no surprise that we have harvested a crop of PAS children who see nothing wrong with hurting and rejecting one of their parents out-of-hand, often permanently. Gardner has noted that in countries in which people cannot afford to take such disputes to court, PAS is virtually nonexistent.  Such is the case in eastern European countries but it is Gardner's observation that with economic improvement in such countries will come a significant increase in PAS as is already happening to some degree in the Czech Republic.
Because it is an artificial problem, that is to say "created" by the system rather than naturally occurring, its parameters can change over time (Cartwright, 1993). Some changes have already been observed in the significant increase of the syndrome in western society as well as in the gender shift as more and more men become alienators.  This "morphing" of the problem compels a constant redefinition which may impact ultimate solutions.

What Has Been Done

Recognition of the Parental Alienation Syndrome has come slowly. Although the problem was identified less than two decades ago, there are now 133 peer reviewed articles, and 66 legal citations from courts of law which have recognized the disorder, "including a Frye Test hearing in which the court ruled that the PAS has gained enough recognition in the scientific community to warrant recognition in courts of law." There is every reason to expect that PAS will be included in the DSM-V to be published in the year 2010. Despite this, countless lawyers and mental health professionals continue to deny that such a syndrome exists, their primary reason being that it is not found in the DSM-IV. Gardner’s analogy of a tree is most instructive:

A tree exists as a tree regardless of the reactions of those looking at it. A tree still exists even though some might give it another name.  If a dictionary selectively decides to omit the word tree from its compilation of words, that does not mean that the tree does not exist.   It only means that the people who wrote that book decided not to include that particular word.  Similarly, for someone to look at a tree and say that the tree does not exist does not cause the tree to evaporate.  It only indicates that the viewer, for whatever reason, does not wish to see what is right in front of him (her) (Gardner, 2002b).

What Remains to Be Done

Despite the work that has gone on, there remains a great deal needs to be done. It should be understood that although divorce between spouses is a sad reality in our modern society, it does not imply that children should be divorced from their parents. A much-needed reform of the Divorce Act must include the presumption of “shared parenting” rather than the current emphasis on “custody and access”.  Work must continue to sensitize the judiciary, lawyers, and mental health professionals about PAS.  Reliance on the adversarial system in the adjudication of custody disputes must be reduced by the increased use of mediation or other dispute resolution processes to enhance communication among the parties and reduce the chance that already broken families will break down further. At the research level, we need to explore the links between PAS and other social problems such as poverty, and to develop PAS prevention and treatment programs. Finally, there must be an in-depth examination of the ways in which alienated children can be reconciled with their lost parents to minimize what could be a lifelong and tragic parental loss.

Only when we have achieved these goals will it be said that we have acted “…for the sake of the children.”

---

References

Cartwright, Glenn F. (1993). Expanding the parameters of parental alienation syndrome. American Journal of Family Therapy, 21(3), 205-215.

Gardner, R. A. (1985). Recent trends in divorce and custody litigation. Academy Forum 29: 3-7.

Gardner, R. A. (2001). Should courts order PAS children to visit/reside with the alienated parent? A follow-up study. The American Journal of Forensic Psychology, 19(3), 60-106.

Gardner, R. A. (2002a). The judiciary's role in the etiology, symptom development, and treatment of the parental alienation syndrome (PAS). Unpublished manuscript.

Gardner, R. A. (2002b). The denial of the Parental Alienation Syndrome also harms women. Unpublished manuscript.

---