Another take on 'libidos'

"The Debate over Low Libidos" (April Monitor) shows—again—how female sexuality continues to get a bad rap, even (and maybe especially) from well-meaning psychologists. As a single woman in my early 50s, done with menopause, I can tell you that sex is not what it used to be, and my friends agree. I have no problem with desire—the problem is my body is getting older and does not respond as it once did.

I don't see how Dr. Tiefer can call filling the need for women who want to have a better sexual response disease-mongering. It is simply that women have finally voiced their desire to have more fulfilling sexual relationships well past middle-age, and corporate America is responding. It's about time! I had to ask three doctors before I could get a prescription for Viagra, but I'm glad I kept persisting because it works very well for me. Now I can have the sexual experience I want.

Jan Johnston-Tyler
Mountain View, Calif.

Psychologists sidelined?

Though I very much appreciate the scope of issues that the Monitor addresses, the tone of the report on parental alienation implies that psychologists should wait on the sidelines while other professions define this issue. The article asserts that "mental health professionals" disagree about the existence of a "syndrome of parental alienation" because it has not been "defined as a psychiatric condition" in the Diagnostic and Statistical Manual. Though psychologists reference the DSM when functioning as "mental health professionals" who provide treatment and bill insurance companies, the core of our profession expands significantly beyond "mental health."

To paraphrase the preamble to our Code of Ethics, psychologists strive to improve the scientific and professional understanding of human behavior and to apply this to the betterment of individuals and society. There is no group of professionals better able to complete a thorough evaluation and analysis of parental behavior and make reasonable predictions about the effect of that behavior on their children than psychologists. No diagnosis of a "mental health condition" is required. When psychologists are sidelined as adjuncts to the domain of psychiatry by other disciplines, it is critical that we educate them about the depth and breadth of psychological science and practice. When psychologists promulgate this misconception in their own professional literature, it is a shame.

Maureen D. Rickman, PhD
Madison, Wis.

Thank you for your April 2009 article, "Toronto judge cites parental alienation in child-custody." However it seems to have been written with a bias against Parental Alienation Syndrome (PAS). The article reports what appears to be an aberrant ruling when in fact such rulings have been happening for sometime in the U.K. and U.S. The article starts by stating that PAS was "coined" by Richard Gardner, as though valid diagnoses come with their intrinsic names. The article cites that PAS is not in the DSM. This psychiatric manual is biased toward disorders that can be medicated and leaves out many disorders that involve an interaction between personality and interpersonal behavior such as PAS. The article also states that abusive fathers can use PAS as a rationalization. This is like saying that PTSD should not be considered a disorder because it is unfair to insurance companies. Mostly, however, that article fails to cite the many empirical studies that show support for PAS. In my research with my colleagues (Gordon, Stoffey and Bottinelli, 2008), based on MMPI-2s from 158 parents from court-ordered custody evaluations donated by seven forensic psychologists, we found: Both alienating fathers and alienating mothers showed signs of splitting and projective identification, while target parents were no different from the control custody parents who showed no signs of primitive defenses. APA needs to reconsider its 1996 statement on PAS to keep up with the research and stop repeating old prejudices.

Robert M. Gordon, PhD
Allentown, Pa.

Oversimplifying eating disorders

The eating disorder research and treatments highlighted in the article "New Solutions" oversimplify the nature of these complex illnesses. Any therapist who treats eating disorders can attest to the fact that most patients concurrently suffer from a wide array of problems, including depression, anxiety, substance abuse, obsessions and compulsions, mood lability, impulsivity, self-injury and Axis-II symptoms. Many have histories of trauma, particularly sexual abuse. Usually there are underlying difficulties in self-regulation, toleration of affect and interpersonal relations. Preoccupation with weight and food in a thin-obsessed culture is just the tip of the iceberg. For treatment to be effective and long-lasting, it needs to address the patient as a multidimensional whole.

Danielle Novack, PhD
New York City

Please send letters to Sara Martin, Monitor editor, at the APA address. Letters should be no more than 250 words and may be edited for clarity or space.