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Book Review-Parental Alienation: An Evidence-Based Approach

Kids should be first.  When parents get a divorce or separate, the primary concern should be that of the wellbeing of the children.  However, too frequently, parents are more interested in “winning” the popularity contest and ensuring that their ex doesn’t have a better relationship with the kids than they do, so much so that they’re willing to sabotage the relationship.  Parental Alienation: An Evidence-Based Approach reviews the psychological and legal research on the topic and creates a framework for evaluating the presence of parental alienation as well as informing responses.


Parents don’t typically set out to alienate their children from the other parent.  There’s a conversion of their hurt and disappointment with the other parent that led them to overt and covert behaviors that create alienation.  In my post, The Progression of Parental Alienation, I explained how parents can alienate children through a normal progression and in ways that may not be completely transparent.

Put Out the Fire


One of the criticisms leveled against parental alienation’s legitimacy is that the APA refused to include it explicitly in DSM-V.  The DSM-V is the diagnostic manual used to code patient concerns for billing.  There are two issues with this.  First, is that DSM does not primarily include relational diagnoses.  It’s focused almost exclusively on individual diagnoses.  The few relational diagnoses that exist are correlated to individual diagnoses.

Second, “parental alienation” as a name isn’t called out, but there are the codes V995.51 for “Child Psychological Abuse” and V61.29 for “Child Affected by Parental Relationship Distress.”  Both of these are applicable.  Given that we know children are better off with relationships with both parents, depriving the child of the relationship of the other parent is abuse.

In short, a surface look at the DSM-V would lead someone to believe that parental alienation should be called out but isn’t – but a deeper look reveals why it doesn’t meet the criteria for inclusion.

Frequently, the ICD codes published by the World Health Organization correspond to the DSM for behavioral health issues.  ICD codes are for all medical issues, including both physical and mental health issues.  However, there are some differences.  ICD includes a code for burnout where DSM-V does not.  ICD calls it an “occupational issue” to avoid it being something related to a person that should be included in DSM-V.

An argument could be made that ICD should include a separate code for parental alienation.  There is a precedent for including codes not listed in the DSM-V.  So why not in this case?  While there’s no clear answer, having appropriate codes that can be used, the lack of explicit call out in DSM-V (despite a petition), and the relational nature of parental alienation may all play into it.  Given that there is a code QE52.0, “Caregiver Relationship Problem,” which covers many of the associated problems with parental alienation, it may also be that the World Health Organization believes they have it appropriately covered.

Would it be ideal for parental alienation to have codes in both DSM-VI and ICD 12?  Yes.  However, the lack of inclusion hasn’t stopped parental alienation from being used and accepted in progressively more court cases over the past several decades.  It seems that the courts are accepting the premise without an explicit mention – because there’s sufficient research to demonstrate validity.

Digging Deeper

McCartan makes the point in Parental Alienation that it seemed impossible to write about the topic without checking every detail.  Numerous accounts were distorted to fit the narrative that authors wanted to portray – that there’s no such thing.  Her comment and the discrepancies that she discovered had a striking resemblance to the denial that occurred when Sigmund Freud first identified childhood sexual abuse and then recanted to save his career.  (See The Assault on Truth.)

Even in the previous section while discussing DSM-VI and ICD-12, it’s easy to search for “parental alienation” and not find it, then decide it’s not addressed.  It’s only by looking deeper into what is available can you recognize that searching for “silver maple” won’t tell you if a book contains knowledge about trees.  (See Pervasive Information Architecture for more about specificity of terms and why experts use more specific terms.)


One of the factors that pushes towards parental alienation is when one of the parents becomes enmeshed with the child.  This enmeshment creates a challenge in the beliefs about the other parent.  If the parent in the enmeshment doesn’t like the other parent, then the child shouldn’t either.  This can cause the enmeshed parent to try to shape the child’s perception to match their own.

Enmeshment isn’t healthy, particularly in a parent-child relationship because of the long-term relational damage it can do to the child and the way that they express their relationships.  (See The Gift of Failure for more on enmeshment.)

Parents Are Parents Not Friends

“Fish are friends, not food” is the famous refrain from the shark, Bruce, in Finding Nemo.  There’s not a similar refrain about parents being parents, not friends – but there should be.  In today’s world, we find that parents crave friendship and often place their children into the role of a friend.  This necessarily breaks the power dynamics of a parent-child relationship and deprives the child of the discipline and correction they need to grow.

Parents have a responsibility to shape and correct their children towards societal norms.  That is an entirely different relationship than two friends who should support and accept each other rather than shape them.


Worse are the cases where the parent isn’t capable of being a parent and requires that the child be the parent in the relationship.  While this is obviously not literally true, the roles and responsibilities are reversed to a substantial degree.  The child may be responsible for remembering important things, like paying the bills, or doing the tasks that are normally the responsibility of the parent, like cooking dinner.  In these cases, children are adapting to unstable environments and using their personal agency – no matter how small – to increase the degree of predictability in their environment.

Adult Information

Sometimes, alienation comes in the form of information that is shared – that shouldn’t be.  It can be information about court cases or other issues that aren’t something the child should need to be concerned about.  Often, the intent of sharing this information is to manipulate the perceptions of the child.  “Your father is taking me back to court” seems innocuous enough, but it leaves the perception that the father is “attacking” the mother.  What’s worse is when the reality is that the father is not the petitioner – both parents are just responding to another round of court appearances.

False Memories

An evaluator enters into the home and begins the work of assessing the situation.  Before long, the child asks if they can go ask the parent what they were supposed to say.  It’s a clear indication that the child has been coached into what they should say to make the parent appear in the way that they desire the evaluator to see them.

Other times, the clues are more subtle.  The child claims to remember events that happened to them before memories are reliable.  (Generally, memories before about age 2 aren’t reliable because of the neural pruning that happens around this time.)  Perhaps the child describes the situation using adult language – language they shouldn’t know.  Other times, they may describe the situation from a perspective that they couldn’t have possibly had.

It’s a tricky thing to determine the truth of the situation.  Research indicates that adults are only capable of identifying children lying 54% of the time – with professionals only doing slightly better.  On the one hand, we don’t want to discount a child who is telling the truth, and on the other hand, we don’t want to propagate false accusations against innocent parents.

The Blurring of Facts and Feelings

There’s plenty of research and work to support the understanding that our memories aren’t infallible.  However, we continue to believe that what we remember is the “truth.”  Without an irrefutable record of the event – like video recordings from multiple angles – we’re forced to accept what we remember as truth.  (For more on the fallibility of memory, see Mistakes Were Made (But Not by Me).)

The distortion of memory is particularly prevalent when strong emotions are in place.  People believe what they believe because it justifies their beliefs or behaviors.  There have been cases in my life where it was necessary to share video evidence to shift people’s beliefs.  They believed one thing because it made them look good, yet the reality of the situation was quite different.

Perceived Abandonment

One of the outcomes of distorted memories is that the child can believe the other parent abandoned them.  This may be amplified by the alienating parent failing to deliver presents or messages to the child or fabricating appointments – but never telling the targeted parent.  The strategy of controlling communications can be quite effective at manipulating the perception of the impressionable child.

Luckily, with the advent of child phones and court requirements to allow contact, some of the strategies are less effective – however, they’re not completely out of the question, even in today’s world.

Ten Fallacies

The book lays out ten fallacies about parental alienation:

  • A child will not unreasonably reject a parent with whom they spend most of their time.
  • A child will not unreasonably reject their mother.
  • Parents contribute equally to alienation.
  • Alienation is a temporary response to parental separation.
  • Parental rejection can be a healthy coping strategy after separation.
  • A young child living with an alienating parent does not require intervention.
  • Alienated adolescents should be permitted to make decisions about their contact.
  • An alienated child who is functioning well in other areas of life does not require intervention.
  • Therapeutic intervention will be successful even if the child lives with their alienating parent.
  • Separating the child from the alienating parent is traumatic.


The question is, once alienation has been identified, what is to be done?  The answer depends on the situation, the willingness, and the patience.  The unfortunate truth is that by the time that alienation is discovered, it may be too far gone.  It may not be possible to repair the relationship in the short term.  Perhaps the issue will resolve itself over time – but it may not.

In an ideal world, the alienating parent would acknowledge their behavior and work towards reunification.  Unfortunately, even after court orders, many alienating parents continue their bad behaviors – perhaps unconsciously.

With the right cooperation between all of the parties, reunification is possible – and it is in the best interests of the child.  Tragically, too few situations end this way.

Truth or Lies

With parental alienation, it’s hard to tell what is and isn’t alienation.  It’s hard to separate the fact from the fiction.  Even well-meaning people are unaware of how their children are impacted by their responses.  I hope that neither you nor any of the people you know have to experience Parental Alienation.

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