An Irritating Woman

Susan Diamond learned that it doesn't pay to annoy your kids' psychiatrists, even if you're a doctor

Diamond waited nine agonizing months for Crowder to finish his report, rarely seeing her children, rarely able even to talk to them on the phone. In June, Diamond learned she won her appeal of the ruling in 2002 that resulted in her losing custody. The case was remanded for a new trial. But that didn't mean she was any closer to getting her kids back. San Soucie filed a request for a rehearing. The court proceedings could go on forever.

At last, on November 1, 2004, after talking to all the parties and reading psychiatric reports and court records, Crowder issued a stinging report, criticizing Blotcky, Keane and the passel of lawyers.

His conclusion: Diamond was not perpetrating MSBP. And what was good for the children had gotten lost in the vitriol.

A court-appointed psychiatrist believed that Dr. Susan Diamond was perpetrating a bizarre and controversial kind of deception called Munchausen Syndrome by Proxy.
Mark Graham
A court-appointed psychiatrist believed that Dr. Susan Diamond was perpetrating a bizarre and controversial kind of deception called Munchausen Syndrome by Proxy.
"House manager" Michael Lamberti contended that Diamond encouraged her son to act up. Lamberti is now in prison on an unrelated fraud charge.
"House manager" Michael Lamberti contended that Diamond encouraged her son to act up. Lamberti is now in prison on an unrelated fraud charge.

Crowder's report started with the kids. Stephen told Crowder that he would prefer to live with his mother and visit his father. "He added that his mother is a more patient parent than his father." Stephen denied that his mother pushed him to contact Mayor Miller but admitted she suggested he try again after his first attempt failed. "Dr. Diamond did advise [Stephen] he could sign an affidavit expressing his preference to live with her, but he stated he wanted to do so," Crowder wrote. "He retracted the affidavit under pressure from Mr. San Soucie and Ms. Keane."

Daniel denied that his mother encouraged him to attack his father with the knives. Crowder attributed Daniel's knife attack on his father not to Diamond but to "a command hallucination."

"Susan can be difficult," Crowder said in an interview, "but that doesn't mean she's a danger to her kids...She had the best intentions. She didn't foresee the consequences."

He suggested that "unconscious counter-transference" may have played a role in what happened to Diamond "because early on people got angry with her." (Counter-transference can happen when a therapist develops positive or negative feelings about a patient; the feelings are normal, but to act on them can, in extreme cases, be considered unethical.)

"It shows the need for diagnostic humility," Crowder said. "The risk of harm is so great with certain diagnoses," and MSBP is one of them. "It prejudices proceedings. It shifts the burden to the person to prove they are not."

For accusations with such serious consequences, Crowder said, extensive investigation should be done instead of the court relying on a court-appointed expert or even several experts.

Crowder pointed out that Daniel's illness was not fabricated. And finally, MSBP is rare, "while acting out based on personality disorder"--as he believed Diamond was doing--"is very common, especially in custody/visitation disputes."

His diagnosis: Diamond had a personality disorder, with some histrionic, narcissistic and obsessive-compulsive features. "She tends to see issues in intellectual terms to the relative exclusion of emotional considerations and has difficulty being flexible, especially concerning moral matters...The combination of these problems with her narcissistic egocentricity leads her to push her own agenda without giving adequate thought to how others will respond." San Soucie was not evaluated, however, so Crowder cautioned against drawing any conclusions about who was the better parent.

Crowder added that Diamond had significant strengths: intelligence, decisiveness, personal resolve, a willingness to sacrifice career for attention to her children and a desire for close involvement with them. "I cannot see that Dr. Diamond poses any undue risk to her children." In fact, taking her away from them could hurt the kids developmentally.

He recommended integrated psychotherapy with her and the children, a trial of unsupervised access and for everyone to stop running to the court to litigate relatively minor misbehaviors committed by Diamond.

"Finally, I am concerned that treatment for [Daniel] and relations between Dr. Blotcky, Ms. Keane, and Dr. Diamond have become so negatively polarized that allowing or denying Dr. Diamond access to them is the only intervention that can be employed to modify her virtually guarantees perpetual litigation and does not help her change what she needs to. Worst, I have the clear impression that supervised visitation has led Stephen and Daniel to distrust Dr. Blotcky, Ms. Keane, and the legal system as a whole.

"I recommend that all parties reconcile to the extent necessary to work together again...I sense a great deal of anger at her from the professionals involved in this case...Some professionals may need to be replaced if this is not possible."

Last month, Diamond was in court and pissed off again. As the lawyers negotiated in the hall with Dr. Joseph Hernandez on a plan for unsupervised visitation, she demanded a hearing on the record. After the last five years of feeling ambushed by emergency hearings, Diamond wanted everything out in the open. And she wanted Hernandez's positive report submitted into the record.

"Let's go," she said loudly. "I want it on the witness stand."

Hernandez had been appointed to meet with Diamond and her five children to develop a stair-step plan for the future. Diamond had behaved well on three unsupervised home visitations, and the kids seemed overjoyed to spend time with their mother.

"Each of them was explicit in their preference for not only a continuation of the unsupervised visits but an increase in their frequency and duration," Hernandez wrote in his report. "Dr. Diamond's actions during these visits demonstrate an understanding of the need to focus on parenting her children and moving past interpersonal conflicts."

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