Bioethics, healthcare policy, and related issues.
I have commented previously on the right wing’s penchant for dressing up their particular aversions in pseudo-medical language and imputing some sort of bogus pathology to people who have simply refused to behave as they were told. I was not aware of the ways in which that temptation has invaded the so-called “men’s rights” and “fathers’ rights” movements, however.
Amanda at Pandagon has been doing a good series on “fathers’ rights” rhetoric and ideology. (Here, here.) It’s been especially weird over the Fathers’ Day weekend, with the usual from the likes of Maggie Gallagher, Rebecca Hagelin, and so forth. The issues are broad, and the rather unhinged rhetoric hyou find in many of the men’s groups is startling. Following some of Amanda’s links, though, I was particularly struck by attempts – some more than 10 years old, which shows how far out of this loop I was – to medicalize divorce and child custody. This serves to gain sympathy for men, and to paint women who anger men in divorce or child-custody cases as mentally ill, by inventing “diseases” specifically involving opposition to husbands or fathers in such a legal context.
One conservative activist has a vaguely medical-sounding essay on “Disenfranchised Father Syndrome“; another has actually published a paper in a low-circulation, but peer-reviewed, psychiatry journal on the topic of “Divorce Related Malicious Mother Syndrome“. This bolsters the previous introduction of “Parental Alienation Syndrome” by yet another ideologically-committed crusader with an MD and little empirical evidence. And there’s more.
These supposed “syndromes” are often promoted by activists with credentials in psychology or sociology – though as we’ve seen in the case of James Dobson, even extensive legitimate training in those fields is no barrier to completely batshit medical “theories”. The presentation of their “findings” often mimics legitimate medical research, and the discussion of the “syndromes'” “symptoms” and “diagnosis” adds a veneer of seeming legitimate medical terminology – for as long as the writers are able to maintain the charade. Somehow, the people who offer these new “clinical syndromes” never seem able to maintain their composure even to the end of the “clinical monographs” in which they present their “research”. The result is a bizarre melange of ranting and ideological supposition forced into the template of a serious and considered medical report. Reading with even minimal attention reveals the lack of empirical grounding for these “diagnoses”, but also the mindsets that dream them up.
“Disenfranchised Father Syndrome”, cooked up 3 or 4 years ago by Gerald L. Rowles, Ph.D., is presented in an unpublished monograph on a men’s rights Web site. Rowles – founder of his own tax-exempt “fathers’ rights” organization (“Dads Against the Divorce Industry”), and claiming a doctorate in clinical psychology – attempts to model a medical journal paper, but can’t quite pull it off. Aside from the extensive series of inspirational quotes by John Dryden at the end of the piece – something rarely found in clinical journals – the paper is a rough parody of scientific writing. It opens with an extended discussion of stress-ranking scales, noting also that divorce can be stressful for men (women are not mentioned). It includes some irrelevant discussion of child support and citations to a newspaper column by Maggie Gallagher – apparently he can’t keep from going off on whatever tangent regarding unfairness to men that suggests itself to him. He tries to return to the scientific model, however, by introducing a discussion of depression in divorced fathers – but this is hampered by the fact that he has nothing but his own anecdotal reports to offer as evidence, and by the fact that he immediately digresses again to an even longer discussion of supposed research demonstrating that divorced fathers are not all that bad and that the “deadbeat dad” phenomenon is overblown. Since those topics have nothing to do with the supposed psychological “syndrome” he is describing, again he seems to have lost the thread of his own argument. Finally, he makes a clear and unambiguous statement regarding the symptoms and diagnosis of his supposed disorder. Unfortunately, it’s this one:
[T]he stressors [men experience from a divorce] listed above begin to form symptom clusters that are most often associated with the following clinical syndromes. Because of the singular and shared association with the trauma of divorce and the loss of the Fatherhood role, as well as the frequency of occurrence, a separate diagnostic entity is warranted – the Disenfranchised Father Syndrome:
He then introduces two parallel lists of symptoms, one for Major Depression and the other for Post-Traumatic Stress Syndrome, and immediately after that goes off on another ideological rant:
How do we defend Fathers against the relentless societal juggernaut that drives them into becoming portrayed as psuedo-felons and fictitious-deadbeats? . . . Many divorced Fathers are the battle-weary casualties of a culture that no longer finds value in Fatherhood, and . . . [etc.]
That’s it. After making the claim that “a separate diagnostic entity is warranted”, he lists symptoms for two completely different diagnoses that already exist and are well known, before once more losing the thread and going off on a rant. It’s not clear what he’s saying – that “DFS” is a combination of depression and PTSD?; that it’s the result of one or both of those conditions?; that it is similar to them? – and it’s hard to make sense of it. If “DFS” has symptoms identical to those of already-recognized disease entitites, wouldn’t it just be (one of) those entities? And since neither of those is specifically related to divorce (and divorce is hardly the kind of incident that usually causes PTSD), how does anything about those diagnoses support a diagnosis restricted to disenfranchised fathers, specifically in divorce cases? He gives no explanations whatsoever. But it doesn’t matter. It can’t make sense. There are no clinical case studies attached, and, needless to say, nothing even resembling experimental data. There is no attempt to identify diagnostic criteria or validate them. This is simply not a serious attempt to characterize a new clinical diagnostic category.
No clinician would take this seriously. There is nothing here that can be used to diagnose, evaluate, or treat patients. It’s a shuck – a put-on. It’s got some vaguely medical-sounding terminology, and section headings that seem to suggest the structure of a (badly organized, and incomplete) medical journal article, but the content is mostly ranting ,and nonsensical otherwise. But it has “syndrome” in the title, and the author has a PhD, so he can now claim he has “discovered” a new disease, and put it to work in his political platform.
The so-called “Divorce Related Malicious Mother Syndrome” – its clinical plausibility suggested by the name alone – is little better. The author does ape the structure and tone of a clinical paper better than Rowles, and actually managed to get it in a minor journal, but it is equally devoid of reliable content. Ira Daniel Turkat, Ph.D., claims that “With the increasing commonality of divorce involving children, a pattern of abnormal behaviour has emerged that has received little attention” – he then goes on to define that pattern as a new clinical diagnostic category. What in fact he actually does is simply assert a list of diagnostic criteria, DSM-style, for this new “diagnosis”
A mother who unjustifiably punishes her divorcing or divorced husband by:
- Attempting to alienate their mutual child(ren) from the father
- Involving others in malicious actions against the father
- Engaging in excessive litigation
The mother specifically attempts to deny her child(ren):
- Regular uninterrupted visitation with the father
- Uninhibited telephone access to the father
- paternal participation in the child(ren)’s school life and extra-curricular activities
[The] pattern is pervasive and includes malicious acts towards the husband including:
- Lying to the children
- Lying to others
- Violations of law
The disorder is not specifically due to another mental disorder although a separate mental disorder may co-exist.
Most of the rest of the paper is taken up with what he refers to as “abundant clinical examples”. In fact, he systematically introduces a set of exactly three horror stories about scheming or duplicitous mothers at the beginning of the paper (to establish the “trend'” he refers to) and as an illustration of each of the numbered sub-categories of his diagnostic criteria. They include such things as:
One mother lied to her children that she could no longer buy food because their father had spent all of their money on women at topless bars.
A mother who had lost legal custody of her child, manipulated a secretary at the child’s school to assist in kidnapping the child.
A father called to speak to his children and was told that they were not at home when in bet [sic] he could hear their voices in the background.
In other words, Turkat almost amusingly – and completely shamelessly – illustrates the joke that “‘data’ is the plural of ‘anecdote'”. Beyond this litany of fathers’ complaints and accusations, there is no clinical data of any kind – and of course no experimental validation of these diagnostic criteria, or any other confirmation that this “syndrome” actually exists. To be fair, he acknowledges that there is a lack of research on this newly-discovered “condition”, and suggests that “Given the lack of scientific data available on the disorder, issues of classification, etiology, treatment, and prevention appear ripe for investigation.” The paper thus serves as a first definition of the “condition”, not as a true clinical validation of it. But if this is true, it cannot be used as evidence that any such syndrome actually exists, which is how it is cited by men’s rights activists. (Google the name of the “syndrome” – you’ll get an earful.) As far as I can determine, no further research on this “condition” has ever been published or attempted – yet it is widely cited by men’s groups, and the author frequently cites it in support of further, equally dubious psychological claims about divorced women.
One of the most widely-relied-upon “diagnoses” of female perfidy is the “Parental Alienation Syndrome”. Described by Richard Gardner, an MD with a reformist attitude toward parent/child psychology and a number of controversial theories, it remained a diagnosis largely promulgated only by Gardner himself, and ignored or rejected by most of the psychiatric community. Gardner slid into devoting himself essentially to defending his diagnosis, which meant (since he himself claimed the parent “alienating” the child against the other parent was the mother at least 90% of the time) going further and further to establish evidence that women were systematically brainwashing their own children. “PAS” became the tactic of choice by fathers seeking increased visitation with reluctant children, or by fathers accused of molestation or abuse – a compliant psychologist diagnosing “PAS” in the mother could argue that the accusations against the father were all made up. In this case at least, Gardner managed to publish widely on the subject and did generate a professional following to some degree – but the APA refuses to endorse the diagnosis or enter it in the DSM.
As for other “conditions”, they multiply like toadstools. Dr. Turkat, after introducing his “Malicious Mother” syndrome without offering any empirical proof that it even exists, cites both his own paper on that topic, and Gardner’s work on “PAS”, to bolster his new discovery of “Interference-Based Relocation” – the phenomenon of women moving far from their ex-husbands specifically to interfere with the men’s child-visitation rights. (I suppose we could call it “Ex-Wife Drapetomania“.) Familiarly, Turkat’s paper is published in a peer-reviewed journal; familiarly, it includes no empirical data at all; familiarly, it mimics scientific publication practice by including a list of 8 “risk factors” for “IBR” (two of them being “PAS” and “Malicious Mother Syndrome”), but those “risk factors” include no discussion of causative pathway. (Also, they are not risk factors – conditions which increase the likelihood of a certain outcome. They are, conceivably, warning signs, but that is not the same thing. Oddly, he defines “risk factor” correctly in his paper, immediately before using the term incorrectly.) Again, to be fair to Turkat, he does not claim that “IBR” is an actual psychological illness. Rather, he describes it as a “strategy” women use to deprive men of their rights – but his introduction of “risk factors” (which he illustrates almost entirely with medical examples) creates a clinical-sounding phenomenon. The risk factors themselves, in addition to the supposed psychological diagnoses mentioned above, also include such psychologically-laden factors as “a parent with significant anger” or “a parent who lies repeatedly”. The entire point to the paper is the claim that a custodial parent’s desire to move is often simply an attempt to get back at the other parent – which requires the court to diagnose her state of mind in making the move, for which Turkat’s “risk factors”, he claims, are sufficient. It’s thus a diagnostic scheme for a purely behavioral “illness”, but one which arises from women’s systematically malicious minds.
After all this, all that remains to be said is to note how pervasive the medicalization (specifically, the psychological pathologizing) of women’s behavior is, predictably, in ways systematically tending to establish them to be unfit to live their own lives and raise their own children. We have seen the medicalization of women’s autonomy in so many ways, but I am again chagrined to have overlooked for so long its role in divorce and child custody battles. The lengths the anti-woman forces go to, and the strange pseudo quality to their writing – as if children were playing at being scientists but didn’t have the vocabulary or the patience to really make it convincing – are an unwelcome, and sadly unsruprising, revelation. This is worth keeping an eye on, however.
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