Parental Alienaon (Syndrome)-A serious form of psychological child abuse
other parent, boycott of visitation, rupture of contacts, planned misinformation, suggestive inuence, and confusing double- bind messages. Sometimes direct psychological threats (such as withdrawal of love, suicide threats) or physical threats (hitting, locking in) are used against children [67,68]. Two documentaries by G. Gebhard (see the References), “Victims of Another War-The Aftermath of Parental Alienation”  and “Sarah Cecilie” , show the problem from the point of view of formerly alienated children. (I recommend to look at these two lms.)This enhances the loyalty conict in the child, which exists in any case in a divorce situation. Fear, dependence on, submission of the child, making him/her pliable, and his/her identication with the alienating party play an important role [90-93]. Related psychodynamics can be found in the Stockholm syndrome, in cases of hostage taking.In a separate chapter of his book, Lowenstein  explains the Stockholm syndrome in the context of the well-known “Natascha Kampusch abduction case” in Austria, showing how it relates to the parental alienation (syndrome). In sect systems, too, [95,96] similar mechanisms come into play. Some cases of the severe form of PA(S) show similarities in their dynamics with the Munchausen by proxy syndrome, a disorder that involves parents articially inducing or exaggerating symptoms of illness in their children [97,98]. The aected children depend upon outside help.
Psychiatric and psychosomac eects of PA(S) inducon on aected adult children of divorce
A number of international authors consider PA(S) induction as a form of psychological child abuse like Gardner [78-80], Kelly & Johnston , Deegener & Körner , Hirigoyen , this places PA(S) in the eld of psychotraumatology.In legal terms, it can be classied as a psychological hazard to the welfare of a child resulting from an abuse of parental care that exploits the dependency relationship of the child [100-103]. Some critics of the PA(S) concept trivialise this or deny it, reducing the problem to the “parental conict” or the child’s “conicting loyalties” during separation or divorce.Children and young people experiencing their parents repeated severe marriage crises, aggressive conicts and traumatic separation and divorce, may suer from personal development disorders as a result of these chronic, diuse stresses . In 70-90 % of borderline personality disorders found in adults, childhood trauma could be shown retrospectively .In PA(S) cases of the severe form, there is often a long-term, or even permanent, rupture of the relationship and contact between the child and the parent, sometimes also between siblings, with the related pathological consequences [106,107].The psychological trauma suered by the PA(S) child, the left behind parent and other close relatives (such as the grandparents) is rarely given adequate consideration [108,109]. People who have been traumatised in this way will later often suer considerable psychological, psychosomatic or psychiatric problems and seek treatment at psychiatric and/or psychotherapeutic practices and clinics [110-112].and handing over of the child: the child will stubbornly refuse contact, but re-spond once contact is made and when the alienating parent is absent.In severe cases of PA(S) Warshak , the child will radically and without objective reasons refuse contact with one parent (father or mother) with whom s/he previously had a loving attachment, because s/he has internalised a false negative image of the parent. The attitude of rejection and level of negativity vary considerably between the mild and moderate forms. The child manifests an extremely polarised view of his/her parents (black and white). In such a case, the family court in collaboration with a specially trained expert psychologist or therapist will be the nal authority who can either interrupt the alienation process (for instance, with sanctions or a believable announcement or possibly implementation of custody transfer) or ensure its permanence (through passive waiting: “If the child does not want to, there is nothing we can do.”) [21,38,74].The presence and degree of PA(S) are diagnosed on the basis of the behaviour observed in a child, not on the basis of the degree of manipulation to which the child is exposed. A careful evaluation Bricklin & Elliott , Sauber & Worenklein , of the entire family system and identication of the manipulating person(s) is indispensable. Also, the role of the so-called alienated parent and his or her possible contribution to the process of alienation need to be evaluated, in order to avoid a misdiagnosis.PA(S) is not the same as obstructing access for the non-custodial parent, or any kind of refusal of con-tact or alienation, as many believe (Summary of the debate by Gödde , it is, in fact, a psychiatrically relevant disorder in children that results from traumatisation [20,21,74,78-80]. It concerns the child’s cognitive and emotional levels and his/her behaviour. In contrast to other for instance, psycho-dynamic – interpretations of contact refusal by children Figdor , PA(S) always involves a severe obstruction of contact and/or manipulation and indoctrination of the child by others.Active manipulation is carried out consciously or not by the primary caregiver and/or other important attachment gures for the child. These manipulative persons are usually found to have specic psychological problems, such as severe narcissistic and/or borderline personality disorders Kopetski, [36,37], Siegel & Langford , Hirigoyen , traumatic childhood experiences Blank , Bernet et al. , paranoid coping with the divorce conict, or psychosis [78,79,85].The attitude and behaviour of professionals accompanying the divorce process also play an important role in the course of the alienation process [64,86,87].
Important alienaon techniques in PA(S)
In a study of 97 adults who described themselves as victims of parental alienation Baker & Darnall  (2006) identied 66 dierent alienation strategies, 11 of which were mentioned by at least 20 % of the study subjects. Signicant alienation techniques in the induction of PA(S) are, among others, denigration, reality-distorting negative presentation of the