Crítica al S.A.P. desde un punto de vista médico

Transcripción

Crítica al S.A.P. desde
un punto de vista
médico-psiquiátrico
Antonio Escudero (psiquiatra)
Lola Aguilar (pediatra)
Julia de la Cruz (médica)
SANTA CRUZ DE TENERIFE, DICIEMBRE 2009
La definición del SAP (1985...)
• “El síndrome de alienación parental (SAP) es un trastorno
infantil que surge casi exclusivamente en el contexto de
disputas por la custodia de los niños. Su manifestación
primaria es la campaña de denigración del niño contra un
padre, una campaña que no tiene justificación. Ello
resulta de la combinación de una programación (lavado
de cerebro) de adoctrinamiento parental y de las propias
contribuciones del niño para el vilipendio del padre
objetivo. Cuando un «maltrato/abuso sexual» está
presente, la animosidad puede estar justificada y así la
explicación del síndrome de alienación parental para
la hostilidad del niño no es aplicable ”
La MUESTRA EXPERIMENTAL de Gardner
“Los pacientes seleccionados para este estudio
fueron casos en los cuales estuve
personalmente implicado. No había ningún
caso en este estudio en el cual yo no hubiera
tenido alguna participación directa. En
muchos casos yo tuve la oportunidad de
conducir las evaluaciones completas de ambos
padres y los niños, tanto individualmente como
en varias combinaciones. (...)
Síntomas que definen el sap según
Garner
1. Una campaña de denigración.
2.
Racionalizaciones débiles, absurdas, o frívolas para la desaprobación.
3.
Ausencia de ambivalencia.
4.
El fenómeno del “pensador-independiente”.
5.
Apoyo reflexivo al padre alienante en el conflicto parental.
6.
Ausencia de culpa sobre la crueldad y/o explotación hacia el padre alienado.
7.
La presencia de escenarios prestados.
8.
Extensión de la animosidad hacia los amigos y/o familia extendida del padre
alienado.
EL RECONOCIMIENTO DEL SAP
No ha sido reconocido por la Asociación Médica
Americana o la Asociación Psicológica Americana.
Se ha rechazado su incorporación en los sistemas de
clasificación de enfermedades de:
La Clasificación Internacional de
Enfermedades (CIE-10) de la OMS.
Los Manuales Diagnósticos y Estadísticos de
los Trastornos Mentales de la Asociación
Psiquiátrica Americana (DSM-III, DSM-IIIR, DSM-IV, DSM-IV-TR)
“Un marco contradictorio: al servicio de dos amos”
• “Una investigación que no se lleva a acabo de
acuerdo con los cánones de la ciencia no es ética.
Los proyectos de investigación deben ser
aprobados por un comité ético debidamente
constituido. Los psiquiatras deben cumplir las
normas nacionales e internacionales para llevar a
cabo investigaciones (...)”. Asociación Mundial de
Psiquiatría. Declaración de Madrid. Asamblea General de
la AMP, Madrid, 25 de agosto de 1996.
EL RECONOCIMIENTO DEL SAP
El National Council of Juvenile and Family
Court Judges determinó en 2004 que “la
teoría de Richard Gardner que postula la
existencia del ‘síndrome de alienación
parental’ o ‘SAP’ ha sido desacreditada por
la comunidad científica. Testimonios de
que una de las partes en un caso de
custodia sufren del síndrome deberían por
tanto ser considerados inadmisibles (...) ”.
¿Qué es el Síndrome de Alienación Parental o SAP?
•
La analogía con el «Síndrome de Down»: La denominación de
«síndrome médico» del SAP
•
Un ejemplo podría ser el Síndrome de Down, el cual incluye una multitud síntomas
aparentemente dispares que no parecen tener una vinculación común [...]. Los pacientes
del Síndrome de Down parecen a menudo muy semejantes y la mayoría exhiben
típicamente todos estos síntomas. La etiología común de estos síntomas dispares se
relaciona con una anormalidad cromosómica específica. Es este factor genético el
responsable de agrupar juntos estos síntomas aparentemente dispares. Hay entonces una
causa primaria, causa básica del Síndrome de Down: una anormalidad genética.” [1]
[1] GARDNER, R.,A., «Parental Alienation Syndrome vs. Parental Alienation:
which diagnosis should evaluators use in child-custody disputes?», The American
Journal of Family Therapy, 2002, 30, 2, pp. 93-115.
Sobre su apariencia
• Los síntomas (que constituyen el
síndrome) tendrían como propiedades
fundamentales, ser “injustificados” y ser
específicos de una programación por
parte de un progenitor. Por deducción
este progenitor no puede ser el
“vilipendiado”.
Diagnóstico diferencial
LEVE/ MODERADO/ SEVERO, según:
-presencia severa de psicopatología previa a la separación
-frecuencia de pensamientos de programación
-frecuencia de verbalizaciones de programación
-frecuencia de maniobras de exclusión (obstrucción visitas o tf…)
-frecuencia de denuncias a policía o servicios sociales
-litigaciones
-episodios de “histeria”(explosiones emocionales)
-violaciones de órdenes de la Corte
-éxito en manipulación del sistema legal para aumentar programación
Sobre su fin
“(...) antes de que el tratamiento principal pueda
comenzar los niños deben ser retirados de la casa
de la madre y situados en la casa del padre, el
padre supuestamente odiado. Esto puede no ser
logrado fácilmente, y el tribunal podría tener que
amenazar con sanciones (como las multas o la
pérdida permanente de la custodia) y aún la cárcel
si la madre no accede. Después de este traslado
debe haber un período de descompresión y
‘debriefing’ en el cual la madre no tiene ningún
contacto con los niños.”
GARDNER, R.,A., «Legal and psychotherapeutic approaches to the
three types of parental alienation syndrome families. When psychiatry
and the law join forces», Court Review, 1991, 28, 1, p 14-21.
Sobre su apariencia
• Dado que dicha programación requiere un
contacto constante entre un progenitor y el
menor, se deduce que el progenitor que
tiene la custodia es el causante primario
del síndrome. Esto es independiente de
que el progenitor sea padre o madre, si
bien Gardner establece que la mujer, por
sus características vinculares, tiene más
posibilidades de generar el síndrome.
Sobre su apariencia
• Dado que el tiempo de contacto entre
el progenitor diagnosticado y el hijo
es un elemento fundamental para la
programación, se propone el cambio
inmediato de custodia o en su
defecto la amenaza disuasoria de
llevar a cabo dicha medida.
Sobre su apariencia
• Si, habiéndose producido el cambio
de custodia, persiste aún el rechazo
del niño al progenitor ahora custodio
se deduce por ello la existencia de un
refuerzo de la programación durante
las visitas acordadas debiéndose
reducirse estas visitas o suspenderse.
¿Qué es el Síndrome de Alienación Parental o SAP?
• «Los terapeutas que trabajan con los
niños del SAP deben sentirse cómodos
con métodos alternativos de terapia, la
terapia que implica un enfoque
autoritario del tratamiento. (...)
GARDNER, R. A., «Should Courts Order PAS Children to Visit/Reside with the Alienated
Parent? A Follow-up Study», The American Journal of Forensic Psychology, 2001, 19, 3, pp.
61-106.
¿Qué
es esto,
según lo
se dice...?
¿Cómo
explicar
elcual
SAP?
• (...) Deben ser capaces de decir a un
padre alienador: “Si los niños no son
dejados en la casa de su ex-espos@ a
las 5:00 de la tarde este viernes, yo
informaré al juzgado y recomendaré las
sanciones ya descritas en la orden
judicial”. (...)
61-106.
¿Qué es esto, según lo cual se dice...?
• (...) Ellos deben sentirse cómodos
trabajando sin la confidencialidad
tradicional tan necesaria al tratamiento
estándar. (...)
61-106.
• (...) Ellos deben sentirse cómodos
amenazando a los padres alienadores
así como a los niños de que habrá
consecuencias si ellos violan el
programa de visitas ordenado por el
juzgado. (...)
61-106.
• (...) Tales terapeutas deben sentirse
cómodos con enfoques de
confrontación, el propósito de los
cuales es desprogramar a niños con
SAP. (...)
61-106.
• (...) Ellos deben reconocer que hacer lo
que los niños manifiestan puede no ser
sus mejores intereses. Lo que es el
mejor interés en los casos de SAP es
que los niños sean forzados a visitar al
padre alienado. (...)
61-106.
• (...) Los terapeutas que no se sientan
cómodos con lo que yo llamo "terapia
de la amenaza" no debe trabajar con
las familias de SAP.»
61-106.
Sobre las consecuencias
• La espontaneidad del vínculo quebrada
• La confianza en los adultos quebrada
• Se ha dotado de una formidable
herramienta de disuasión de abandono o
maltratadores
• Paradójicamente, ya “todo” es falso
GRACIAS.
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Crítica al S.A.P. desde un punto de vista médico

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