Richard A. Gardner is a child psychiatrist - one of the most popular child psychiatrists in the country. He has written scores of books, lectured internationally, served as an expert witness in numerous child custody disputes, and is regularly quoted in the press. Soon, his authority will be formally acknowledged in what he has called "a companion volume to the DSM-IV."
In case you didn't know, the DSM-IV is the current edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. This manual, which represents state-of-the-art mental health science, is a comprehensive, exhaustively researched volume that describes and categorizes virtually all known mental disorders. Some practitioners refer to it as "the bible" because it reflects the accumulated knowledge of an entire discipline. Not surprisingly, then, you'll find it in the office of nearly every psychiatrist, psychologist, psychotherapist, counselor, and social worker in the country.
Dr. Gardner's invited contributions to the upcoming Treatment Statistical Manual of Behavioral and Mental Disorders, or TSM-I (New York: Jossey Bass) announce professional recognition for work that some feel is long overdue. It is a vindication of his theories and a counterblow to criticism that his assessment tools have not been generally accepted by the scientific community.
I was amazed that the mental health world had failed to notice the long list of "peer-reviewed" sources where his protocols and theories had been published. It was an obvious point of myopia and so aroused my curiosity that I decided to examine Dr. Gardner's publication credits myself. Perhaps I could exercise a little more scrutiny than apparently had been applied by the psychiatric establishment. I took a deep breath, girded myself for the grueling task, and dove head first into his vast record of scholarship.
First of all, his list of credits is long! That's impressive right off the bat! I marveled at all those lines of complicated words and phrases. After a while, my bedazzlement subsided and I was able to neatly organize the list of credits into three categories.
The first and largest category of items consists of Dr. Gardner's books, all of which are published by the same company - "Creative Therapeutics." Judging by the company's name, I thought they must be a specialty house, so I looked them up in Books in Print. Indeed they are a specialty house! All of their titles - about 30 of them - are authored by Dr. Gardner. And less than a handful of other titles by Dr. Gardner have been published elsewhere. Hmmm. With 30 of his books in print, Creative Therapeutics must be making a healthy profit! I mean, how else could they stay in business? Or are they a business? Database America can produce no sales tax records, DBA (doing business as) records, or corporate records for this firm. However, the company does have a business address. It just happens to be the same address as the one listed for Richard A. Gardner in the phone directory. Now what am I to make of this?
If I was a skeptical inquirer - and I'm not saying that I am - it would look to me as though Creative Therapeutics is Dr. Gardner's vanity press. If that is the case and this entity exists solely to promote Dr. Gardner and his theories, who performs the function of peer review there? Sadly, I don't think I'll ever have an answer to that question, so I guess I'll keep on wondering.
The second category of Dr. Gardner's peer reviewed work consists of articles published in a little-known journal called Issues in Child Abuse Accusations. I call it "little known" because it hasn't appeared in any of my many sessions on MEDLINE, the world's most heavily searched biomedical database. Issues in Child Abuse Accusations is published by the Institute for Psychological Therapies, which is run by Dr. Ralph Underwager. Dr. Underwager gained considerable notoriety some years ago when statements he made in an interview for the Dutch journal Paidika-The Journal of Paedophilia were publicized:
Paedophiles need to become more positive and make the claim that paedophilia is an acceptable expression of God's will for love and unity among human beings.
Reading through one of Dr. Gardner's articles ("A Theory About the Variety of Human Sexual Behavior"), it's not hard to understand why his work finds favor with Dr. Underwager:
. . . Basically, the definition of a pedophile for a psychiatrist is what the nomenclature committee of the American Psychiatric Association considers to be a pedophile for that particular edition of the DSM . . . Pertinent to my theory here is that pedophilia also serves procreative purposes. . .
. . . Many societies, however, have been unjustifiably punitive to those who exhibit these paraphilic variations and have not given proper respect to the genetic factors that may very well be operative. Such considerations might result in greater tolerance for those who exhibit these atypical sexual proclivities. My hope is that this theory will play a role (admittedly small) in bringing about greater sympathy and respect for individuals who exhibit these variations of sexual behavior. . .
To be sure, Dr. Underwager brings his professional expertise to the role of journal editor. In years past, his considerable knowledge base was sought out over and over by attorneys defending clients in child abuse cases. Repeatedly, though, courts denied Dr. Underwager's "expert" testimony in whole or in part because he was found to be unqualified. A Canadian court once described the evidence he gave as being "replete with misinterpretation, misquoting, and reliance upon information that is not empirical data."
I contacted Dr. Underwager recently to ask him who serves on his peer review board. He said his review board was an anonymous group but he assured me that the board members were all "experts" in their respective fields. I guess we'll just have to trust Dr. Underwager and take his word on that.
The third category of Dr. Gardner's peer reviewed work consists of papers published in legal journals - Journal of Divorce and Remarriage, New Jersey Family Lawyer, and similar publications. At these journals, submitted articles are reviewed by plenty of really smart lawyers who understand psychology stuff, so I'm pretty sure they were able to separate the wheat from the chaff before publishing Dr. Gardner's sex abuse protocols ("Differentiating Between True and False Sex-Abuse Accusations in Child Custody Disputes"). With the seal of good housekeeping from places like the Journal of the American Academy of Matrimonial Lawyers, who needs the American Psychiatric Association!
I spoke to Dr. Gardner the other day but didn't get a chance to ask him why I can't find the kind of rigorous validation studies for his sex abuse protocols that are done for other assessment tools used in courts and clinics. Hmmm. Maybe I just haven't looked for them in the right place yet. I've only searched the scientific literature, and there are lots more places they could be hiding. I'd better work fast, though, because the Joint Commission for TSM-BMD is scheduled to endorse Dr. Gardner's brilliant theories with the first printing of their "TSM-Taxonomy" - a preliminary work to their upcoming "TSM-I" (not to be confused with the DSM-IV, but, hell, what idiot judge, lawyer, or jury member will be able to tell the difference!). Finally!! A peer group to call home!!
And who exactly is the Joint Commission for TSM-BMD? According to Laurie McQueen, DSM Project Manager for the American Psychiatric Association, the Commission has nothing whatever to do with the APA. Furthermore - and contrary to what Dr. Gardner claims - the TSM-I is not a companion to the DSM-IV.
I did get the inside poop from Alan Rinzler at Jossey Bass, though. He informed me that the Commission is an "independent group" of about 150 MDs and PhDs who have been working together for about four years. Their identities are to remain anonymous at this time, but he was proud to tell me that Dr. Gardner is a commission member.
There is a take-home message in this story: If you want something done right, DO IT YOURSELF!! Damn the torpedoes, to hell with the APA, and strike out on your own! All you need is a little innovative spirit and chutzpah of the kind shown by the National Association for Consumer Protection in Mental Health Practices - another largely anonymous group mysteriously connected to the False Memory Syndrome Foundation (FMSF) that also has been trying for the last four years to give clinical psychology a cosmetic beauty make-over.
Should I be surprised that Dr. Gardner is a long-time darling of the FMSF? Not really. Great minds stink alike.
Judith M. Simon is a writer and editor of academic health science literature.
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