I am grateful for the opportunity to contribute to this compilation of insightful articles and, in particular, for the opportunity to respond to the critical commentary on rhetoric and alienation by Milchman et al. (2020). I write as much to complement those authors on their incisive perspective, as to suggest that we may all be asking the wrong questions. Milchman et al., renew the call for objective, scientifically sound research informing the constructs and methods that underlie child custody evaluations (“CCEs”). They correctly disparage rhetoric in favor of empiricism. They demand that balance replace advocacy, and they caution professionals and courts not to be misled by emotionally compelling, but logically flawed and statistically weak arguments. These observations are as important today as they were when they were first formulated by Aristotle (Cooper, 1993) and codified under Frye (1923), Daubert (1993) and Mohan (1994). Milchman et al., are furthermore correct to remind us of one of the central tenets of cognitive behavioral therapy and cognitive science more generally, that is, that words reify experience (Boroditsky, 2011). Thus, the labels that we use carry meanings that often communicate more than what may be intended. This is why many jurisdictions have replaced emotionally-loaded language, such as “custody” and “visitation,” with more descriptive and objective concepts, such as “decisionmaking responsibility” and “parenting time.” Indeed, my other article in this volume (Garber, 2020) advocates for just such an objective, balanced, and behavior-based approach to resist-refuse dynamics. For all of the wisdom in these words, I fear that we are, nonetheless, asking the wrong questions. Careful attention to our choice of words, to the capitalization of labels, to the empirical credentials and consensual acceptance of those labels is necessary, but not sufficient. I fear that we are trying to tape and glue together a workable structure on an essentially flawed foundation. That foundation is the medical model of individual illness, diagnosis, and intervention that psychology inherited from its physician parents, disseminated more or less effectively among its allied mental health siblings, and has since brought to bear on our efforts to assess and intervene with high conflict, courtinvolved families. It is the medical model that prompts us to even consider whether “alienation” should be codified as a “syndrome,” a “disorder,” or a lower-case description of behaviors. It is the medical model that prompts us to try to impute family law meaning to clinically designed methods. It is the medical model that prompts so many custody evaluators, attorneys, and courts to incorrectly believe that an assessment of mother, father, and child is the same as an assessment of the system that they make together. Thirty-plus years in the trenches have slowly and painfully worn away my training as a clinician and diagnostician. Trial by fire has allowed me to finally understand that family law questions are about relationships, not individuals. The work that we do is about dynamics, not diagnoses. There is no Diagnostic and Statistical Manual (“DSM”) of relationships. The DSM and the ICD are catalogs of individual pathologies. Applying those nosologies to family law matters is a bit like trying to measure time with a tape measure. This is at the core of my argument against the use of standardized adult psychometric instruments in the context of CCEs (Garber & Simon, 2018; cf.,

中文翻译：

---

动态，而不是诊断

我很感激有机会为这篇富有洞察力的文章的汇编做出贡献，特别是有机会回应 Milchman 等人对修辞和疏远的批判性评论。(2020)。我写了尽可能多的文章来补充那些作者敏锐的观点，以表明我们可能都在问错误的问题。Milchman 等人再次呼吁进行客观、科学合理的研究，为儿童监护权评估 (“CCE”) 的基础结构和方法提供信息。他们正确地贬低修辞而赞成经验主义。他们要求这种平衡取代倡导，并告诫专业人士和法院不要被情感上令人信服但逻辑上有缺陷和统计上薄弱的论点所误导。这些观察结果在今天与亚里士多德 (Cooper, 1993) 首次提出并在 Frye (1923)、Daubert (1993) 和 Mohan (1994) 下编纂时一样重要。Milchman 等人更正确地提醒我们认知行为疗法和认知科学的核心原则之一，即语言具体化经验（Boroditsky，2011）。因此，我们使用的标签所含的含义往往比预期的要多。这就是为什么许多司法管辖区用更具描述性和客观性的概念，例如“决策责任”和“养育时间”取代了“监护”和“探视”等充满情感的语言。事实上，我在本卷中的另一篇文章 (Garber, 2020) 提倡这样一种客观、平衡、和基于行为的方法来抵制拒绝动态。对于这些话中的所有智慧，我担心我们仍然在问错误的问题。仔细注意我们对词语的选择、标签的大小写、经验证明和对这些标签的一致接受是必要的，但还不够。我担心我们正试图在一个本质上有缺陷的基础上将一个可行的结构粘在一起。该基础是个体疾病、诊断和干预的医学模式，心理学从其医生父母那里继承而来，或多或少有效地在其相关的心理健康兄弟姐妹中传播，并从那时起影响了我们在高度冲突的情况下评估和干预的努力，法院涉案家庭。正是医学模型促使我们甚至考虑是否应该将“异化”编入“综合症”、“障碍”或对行为的小写描述。正是医学模型促使我们尝试将家庭法的意义归于临床设计的方法。正是医学模型促使如此多的监护权评估员、律师和法院错误地认为对母亲、父亲和孩子的评估与对他们共同做出的系统的评估相同。三十多年的战壕里慢慢地、痛苦地磨练了我作为临床医生和诊断医生的训练。火刑让我终于明白，家庭法问题是关于关系的，而不是关于个人的。我们所做的工作是关于动力学，而不是诊断。没有关系的诊断和统计手册（“DSM”）。DSM 和 ICD 是个体病理的目录。将这些疾病分类法应用于家庭法问题有点像试图用卷尺测量时间。这是我反对在 CCE 背景下使用标准化成人心理测量工具的论点的核心（Garber & Simon, 2018; cf.,