By Jamie Talan, Newsday.com, July 1, 2003
In life, Richard A. Gardner was known for single-handedly devising a psychiatric syndrome that became widely used in courtrooms by parents battling over child custody.
Gardner died in May, and only time can determine his legacy -- whether the label he created, parental alienation syndrome, can withstand critics now that he can no longer defend it.
Most mental health professionals have an opinion about Gardner's creation -- and it's not generally flattering.
"This is junk science," said Dr. Paul Fink, a professor of psychiatry at Temple University School of Medicine and a past president of the American Psychiatric Association in Arlington, Va. "He invented a concept and talked as if it were proven science. It's not."
Gardner developed the syndrome, known as PAS, almost 20 years ago, contending that a child has been alienated from one parent -- usually the father -- when the other parent makes charges of sexual, physical or emotional abuse. PAS appears to be used only in custody battles during divorces.
Gardner's online biography says he testified in about 400 cases in 25 states. Psychologists and psychiatrists who trained under him or embraced his theory also have offered testimony in such cases.
ost often, it is a father who hired Gardner or another psychiatrist in response to the mother's allegations that their child or children had been abused, Fink said. The psychiatrist then would label the mother a "parental alienator" and urge the court to prevent her from being with the children -- the ones diagnosed with PAS.
But most mental health professionals say the label doesn't meet the definition of a psychiatric illness.
It's not found in psychiatric textbooks on diagnoses. In the late 1980s, when psychiatrists were revising the profession's Diagnostic and Statistical Manual, Dr. Robert Spitzer, who was leading the effort and is a professor of psychiatry at Columbia University College of Physicians and Surgeons in Manhattan, said Gardner, also affiliated with Columbia, asked whether PAS could be included.
"It would never be taken seriously in DSM," Spitzer said in an interview. "It isn't a mental disorder."
Dr. David Shaffer, chief of child and adolescent psychiatry at Columbia, said that the controversy triggered several in-house reviews of Gardner's ideas. (Gardner had a nonpaid clinical appointment on Columbia's voluntary faculty.)
Reviews found he "didn't do formal research."
Nevertheless, he defended Gardner's right to create a syndrome.
"Most of medicine is not based on formal research but clinical observation," he said. He saw Gardner as a "contrarian ... he liked getting a rise out of people."
Fink said the practical effect of introducing Gardner's theory in custody cases is that the issues of abuse are pushed aside.
Harvard's Dr. Eli Newberger, an assistant professor of pediatrics and an expert on child abuse, said he's been called on by state child protection agencies to evaluate ambiguous disclosures of abuse in divorce cases and believes that PAS deflects any real investigation into such allegations.
At the center of the storm, Newberger said, is Gardner and his theory.
"This is an atrocious theory with no science to back it up," he said. "This so-called diagnosis has been used to steer clear of the children's needs."
"There are lots of people who alienate their partners during a divorce," Fink said. "But it is not a syndrome, a disease or a disorder."
Joyanna Silberg, a Baltimore psychologist and strong opponent of the theory, said that Gardner used a questionnaire to determine whether a parent fit the profile of a sex offender -- then used the results to show that allegations of child abuse are lies.
But the questionnaire is "far from valid," said Massachusetts child sex abuse expert Robert Prentky of the nonprofit Justice Resource Institute in Bridgewater, Mass. Scales that Prentky has developed to diagnose sex offenders have been tested and accepted by the profession. "There is no science to back up Gardner's tests," he said.
Gardner, who was 72 at his death, trained in the heyday of psychoanalysis in New York, the late 1950s and early '60s. He then served a two-year stint in the Army as director of child psychiatry for a U.S. Army Hospital in Germany, and subsequently settled in Cresskill, N.J., where he began testifying in child custody cases, according to an entry on his Web site: "Qualifications for providing court testimony."
That he wrote a popular children's book on divorce in 1969, followed by a book for parents, helped bolster his role in custody cases.
According to Donna LaTourett, Gardner's editor at his own publishing company, Creative Therapeutics, by the 1980s he noticed that more children were having "strong objections over one parent for no good reasons." He coined the term PAS in 1985 and listed eight primary signs and symptoms.
In 1992, he self-published a book about the syndrome. Fathers' groups heralded his work. Women's organizations bashed it. After a period of observation, professional mental health organizations tried to discredit it.
Gardner had a growing group of followers and clients, mostly men. He promoted his theory around the world and built a practice as a court-appointed psychiatric evaluator and paid expert witness. Detractors say he also used his affiliation with Columbia to bolster his status.
There are no statistics on how many children have been characterized as having PAS.
"I do believe that there is a phenomenon of children who turn against the parent for no good reason," said Richard Warshak, a clinical professor of psychology at the University of Texas Southwestern Medical Center. "Children are influenced by their parents."
He is a proponent of Gardner's theory and says that his death won't stop the controversial diagnosis. He agreed that use of "syndrome" may "strengthen confidence in the expert's testimony and the validity of it" and said mental health professionals are trying to shorten the term to "parental alienation."
"Yes, he said things that were very provocative," said Warshak, author of "Divorce Poison: Protecting the Parent-Child Bond from a Vindictive Ex" (Regan Books). "Some of the stuff is outrageous, speculative and outright contrary to the evidence."
But the court's acceptance of the diagnosis without the psychiatric profession's endorsement is "dangerous," Newberger stressed.
During a hearing in Nassau County in 2000, Gardner was called to testify about PAS. According to the transcript of the hearing -- called to evaluate scientific evidence supporting the theory -- Gardner offered this definition of PAS: "The programming of the child by one parent into a campaign of denigration directed against the other."
"Courts cannot wait the 25 years or more that it would take to conduct such studies [to validate a syndrome]," Gardner told the court. "... Neither can people who have been accused of sex abuse wait for these results."
The court ruled that there was not convincing scientific evidence that PAS was a psychiatric syndrome.
But it has endured -- perhaps, said Silberg, the psychologist in Baltimore, because it is rare in family courts for lawyers or judges "to question the expert testimony of a psychiatrist with a long list of seemingly impressive credentials and dozens of professional-looking books and journal articles."
PAS "is a defense lawyer's dream," said Richard Ducote, a New Orleans, La., lawyer who has spent a decade fighting Gardner and his supporters in court.
Last year, Norma Perez of Elgin, Ill., was suing for divorce and testified that she worried that her husband's history of alcoholism might endanger the welfare of her daughter during visits. Her husband's attorneys began to talk about parental alienation syndrome and hired Gardner, who eventually testified that the mother was a parental alienator.
"He never interviewed me or my daughter," said Perez, 44, who lost custody of her daughter and was not permitted to see her for eight weeks after the judge's ruling. She now gets to see her daughter every other weekend. Her lawyers have appealed the decision.
But fathers' rights activists see Gardner's theory as a boon.
"Richard Gardner gave science to the anecdotes of alienation," said Warren Farrell, author of "Father and Child Reunion" and a board member of the National Congress for Fathers and Children. He says that PAS "is an attempt to distinguish between false accusations and real abuse."
Farrell added that parental alienation itself is "probably the most insidious form of child abuse" and charged that many women allege abuse during a custody battle to curtail visitation with the father.
But others say that in many of these cases there are confirmed reports to back up the allegations of abuse. However, so many women have lost custody battles when PAS is used that lawyers are beginning to advise them not to make allegations of abuse, Silberg said.
Gardner's son, Andrew, said that his father's death came when he was at the height of his career, when he "had to turn down case after case."
His father had undergone three foot surgeries, the last of which triggered a disorder called reflex sympathetic dystrophy, which caused sharp pain in his legs. He was taking pain medications, Andrew Gardner said.
On the last weekend in May, his pain out of control, Gardner took an overdose to end his life. He sent an e-mail to his office about the suicide.
But he awoke from the drug stupor and killed himself with a knife, said his son, who added that the suicide had no connection to his father's work.
But that work -- and that syndrome -- has left hundreds of women questioning its value.
"We are exhausted," said Lauren Smith, a 52-year-old who lost custody of her daughter in 1993. She told the court that her husband, Marshall Krause, a criminal attorney in Marin County in California, had a violent temper. He used PAS to gain custody of their daughter, Alanna, and Smith was denied visitation. In 1995, according to court records, a teacher reported to police that Krause physically abused Alanna at school. A court reversed custody upon evidence that Alanna's father had been physically violent.
Alanna, now a student at Northwestern University, has filed a multimillion-dollar lawsuit alleging that she suffered years of abuse at the hands of her father.
Idelle Clarke knows firsthand how damaging an untested theory can be. "Our children are his legacy," said Clarke, a Californian whose ex-husband was twice identified and charged as a child abuser by Children and Family Services. But Clarke was characterized as an alienator and lost custody to the father.
"What's a child to think?" she asked. "I will not give up."
The PAS label "has lived a lot longer than the data that supports it," added Alan Scheflin, a professor at Santa Clara University Law School. "I expect people to come up with crack-pot theories. "But then I expect scientists to do their jobs."