Parental estrangement in session

[Shiori]

I am always interested in the topics that break through to mainstream discussion. It seems like the current hot topic over the last few weeks has been parental estrangement.

I have seen this article referenced a few times:
Is Cutting Off Your Family Good Therapy?

There are also several YouTube videos where it's the main topic of discussion.

One theme I've pulled out from these discussions is how therapy is partly to blame for the phenomenon. There are books like Bad Therapy (which I haven't read) and Rules of Estrangement (which I have read) that point to psychotherapy as a culprit for the perceived rise in estrangement. I have had several clients on both sides of the estrangement, so it's been interesting to watch the developing conversation.

Here are a couple of other news articles discussing in. The NPR article interviews the author of Rules of Estrangement.

https://thehill.com/blogs/blog-brie...er-of-adult-children-estranged-from-a-parent/

I thought I would share since it tends to show up in our offices once it hits the news.

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[Sanman]

Having listened to the clip, I have two thoughts:

1. As we transition into a society where alternative lifestyles are more visible and acceptable generally, there are going to be those you know who are not comfortable with the with this image. I imagine that will lead to increased family discord and loss of friendships outside of specific groups. This tends to distort thinking.

2. On the topic of bad therapists, anyone who renders an opinion or diagnosis about a person without ever meeting them is not doing it right. That said, clients also tend shop for therapists who are like them. So a member of a certain group might pick a therapist also from that community. That often strengthens ideological resolve and reinforces beliefs such as family members not being allowed to render judgment on lifestyle choices, IMO at least.

 

[summerbabe]

I have worked plenty with patients who are working on establishing better boundaries with family and try to do this work from a skills-based approach (usually DBT Interpersonal Effectiveness).

I have also worked with plenty of patients who report that they are already estranged (sometimes by their choice, sometimes by others' choice) from family and that basically never enters into any future sessions.

I haven't yet to encounter anybody who was actively trying to make this specific decision and using our therapy as a tool. Or maybe they were but they weren't voicing this piece out loud.

If so, I would probably try to use a skills/data driven such as their family keep blowing past appropriate boundaries that they are trying to set up and to emphasize their autonomy within a pros/cons framework. And clarify that I don't have a horse in the race regarding their specific decision.

 

[borne_before]

• Blaming your parents for your lack of success is a great American tradition.
• Hashtag thinking is prevalent online - which trains and creates rigid dichotomies and inflexible thinking styles.
• Coddling (not allowing kids to feel emotional discomfort) breeds resentment.
• Failure to launch or basement dwelling is appropriately blamed on the parent, kids are like water, they seek the path of least resistance.
• Now we live in a world that actively reinforces people having a victimhood identity and is online.
• If your parent is a white male, this act of rebellion is a great way to score some "i'm a good one" points in the theatre of identity politics.

There was a period in my life when I took a break from my padre - and it was a good experience for me. I didn't have the mental flexibility to handle him at the time (allow him to be him), broke some less than helpful interaction patterns (high conflict), and helped me form a new perspective about him (viewing him as an and instead of a but statement, a global view of the positives/negatives) and my self concept/ emotional heritage in relation to that. Honestly, I didn't know you could just like, not talk to a parent - so it was tremendously empowering. But the break was about self development.

To be honest, a lot of the issue was me. I now appreciate the good aspects (fiercely loyal, independent, etc) of the old man and can flexibly engage with the less than good aspects of him (I kind of find them entertaining more often than not), but our way of interacting is so much more effective. I just wish he would work out slightly earlier or later because he is often on the treadmill when I driving into work.

“To grow up is to stop putting blame on parents” - Maya Angelou​

 

[Sanman]

I have worked plenty with patients who are working on establishing better boundaries with family and try to do this work from a skills-based approach (usually DBT Interpersonal Effectiveness).

I have also worked with plenty of patients who report that they are already estranged (sometimes by their choice, sometimes by others' choice) from family and that basically never enters into any future sessions.

I haven't yet to encounter anybody who was actively trying to make this specific decision and using our therapy as a tool. Or maybe they were but they weren't voicing this piece out loud.

If so, I would probably try to use a skills/data driven such as their family keep blowing past appropriate boundaries that they are trying to set up and to emphasize their autonomy within a pros/cons framework. And clarify that I don't have a horse in the race regarding their specific decision.

Healthy boundaries are a good thing. One does wonder if less skilled therapists are not doing a good job of explaining how to draw healthy boundaries vs simply limiting contact.

 

[futureapppsy2]

Healthy boundaries are a good thing. One does wonder if less skilled therapists are not ;doing a good job of explaining how to draw healthy boundaries vs simply limiting contact.

Omg, I would be overjoyed if someone made most of Reddit learn this—so many people on there think “healthy boundaries” are going no-contact with anyone who hurts your feelings or bothers you at any point, even if you’ve never actually told them that said action was something that bothered you.

 

[summerbabe]

Healthy boundaries are a good thing. One does wonder if less skilled therapists are not ;doing a good job of explaining how to draw healthy boundaries vs simply limiting contact.

I just received a VA patient referral who has hundreds of therapy notes, many of them with a provider who is retiring.

The referral source said they don’t think that patient has ever done any goal oriented therapy and was asking if I could do that lol.

So yes, I think this is very much the case.

It’s also way easier for a bad therapist to let a person vent, recommend going no contact and then have sessions where they exclusively ‘hold space’ and ‘process’ afterwards.

Hell, I can probably see about 30 or 35 of these patients a week in a cash pay private practice if I went this route.

 

[R. Matey]

I haven't yet to encounter anybody who was actively trying to make this specific decision and using our therapy as a tool. Or maybe they were but they weren't voicing this piece out loud.

If so, I would probably try to use a skills/data driven such as their family keep blowing past appropriate boundaries that they are trying to set up and to emphasize their autonomy within a pros/cons framework. And clarify that I don't have a horse in the race regarding their specific decision.

It's a fairly common presentation in the UCC, IME, as students are trying to figure out what relationship they want to have with their parents and insurance is less of a major player in that particular setting. When I have encountered it, I have dealt with it in the manner you describe.

 

[Sanman]

I just received a VA patient referral who has hundreds of therapy notes, many of them with a provider who is retiring.

The referral source said they don’t think that patient has ever done any goal oriented therapy and was asking if I could do that lol.

So yes, I think this is very much the case.

It’s also way easier for a bad therapist to let a person vent, recommend going no contact and then have sessions where they exclusively ‘hold space’ and ‘process’ afterwards.

Hell, I can probably see about 30 or 35 of these patients a week in a cash pay private practice if I went this route.

I have seen these folks. The hardest part is breaking them of the expectation that you will not provide endless non-directive therapy. After all, their last therapist did that, so why can't you? It's a challenge I am dealing with often and from patients of one therapist, in particular, that has seen these folks for years or decades.

 

[R. Matey]

I have seen these folks. The hardest part is breaking them of the expectation that you will not provide endless non-directive therapy. After all, their last therapist did that, so why can't you. It's a challenge I am dealing with this often and from patients of one therapist, in particular, that has seen these folks for years or decades.

Very true, but I've seen it the opposite as well: patients tired of endless non-directive psychotherapy (usually provided by mid-levels) are thrilled to have an actual plan and mutually agreed-upon direction for their work.

 

[jdawg2017]

I found this really interesting as someone who has been semi-estranged from my dad (my choice) and given how often this theme has come up even with my neuropsych assessment patients across my training (mostly older adults talking about relationships with their adult kids). I can certainly see how total estrangement can make sense in some cases, but I think it points to the “all or nothing” mentality that underpins a lot of society.

From my own life, being able to take a step back and look at my dad from a more mature perspective really has helped me embrace the “and” mentality that @borne_before said, as in I can see the tremendous sacrifices he made for me and also acknowledge the things he did that profoundly hurt me. I was no-contact with him for about 2 years after something especially stupid he did which really hurt me (and also really pissed off my partner), and I found that actually speaking to him in clear terms about what he did while acknowledging the good things he did for me growing up was useful in developing a healthier set of relationship boundaries which would better protect me from getting disappointed and hurt like I had been numerous times since late adolescence.

I didn’t do any of this in formal therapy but having trained some in CBT/DBT I think the skills based approach is ultimately probably the best way to help a client decide what type of relationship they want and realistically can have with an estranged family member. At least in my experience I haven’t ever found simply venting to be helpful aside from temporary catharsis… 😅

 

[Ollie123]

There is a growing literature on the health consequences of social media use, but so much of it is either extremely crass (weekly hours spent on X as a predictor of "mental health problems") or so incredibly nuanced as to be not-that-meaningful (qualitative synthesis of posts on a forum for left-handed LGTBQ refugees with diabetes living in rural communities who vape). I say this somewhat tongue-in-cheek...but not completely.

The in-between space is really where I think we're going to see effects, but its much harder work to do and therefore much less work is being done. I think this is a great example. TikTok gets more attention, but reddit in particular seems to normalize a lot of hyper-reactionary behavior that is massively toxic/insane. Minor marital spats are surefire signs of abuse to come and require immediate divorce, family members being any less than perfect should be cut off from all contact, manosphere stuff, illnesses/disability/mental health groups as people's sole source of identity, etc. I think we just don't have a great way to model the health effects yet, but I'm convinced we're going to find pretty damning evidence once we optimize the methodology.

None of this is to say there aren't great reasons to divorce partners, cut off family members, that a disability or chronic illness cannot be important aspect of identity etc. Reddit just seems particularly f'ing nuts.

 

[borne_before]

There is a growing literature on the health consequences of social media use, but so much of it is either extremely crass (weekly hours spent on X as a predictor of "mental health problems") or so incredibly nuanced as to be not-that-meaningful (qualitative synthesis of posts on a forum for left-handed LGTBQ refugees with diabetes living in rural communities who vape). I say this somewhat tongue-in-cheek...but not completely.

The in-between space is really where I think we're going to see effects, but its much harder to work to do and therefore much less work being done. I think this is a great example. TikTok gets more attention, but reddit in particular seems to normalize a lot of hyper-reactionary behavior that is massively toxic/insane. Minor marital spats are surefire signs of abuse to come and require immediate divorce, family members being any less than perfect should be cut off from all contact, manosphere stuff, illnesses/disability/mental health groups as people's sole source of identity, etc. I think we just don't have a great way to model the health effects yet, but I'm convinced we're going to find pretty damning evidence once we optimize the methodology.

None of this is to say there aren't great reasons to divorce partners, cut off family members, etc. Reddit just seems particularly f'ing nuts.

Their relationship advice is basically just "wow... divorce the mother of your four kids for not wanting to have sex three times a day" and "break up with your fiance because they want a diamond ring."

 

[Sanman]

Their relationship advice is basically just "wow... divorce the mother of your four kids for not wanting to have sex three times a day" and "break up with your fiance because they want a diamond ring."

If those are the same person, they got stuff to work out...😉

 

[Shiori]

I have worked plenty with patients who are working on establishing better boundaries with family and try to do this work from a skills-based approach (usually DBT Interpersonal Effectiveness).

I have also worked with plenty of patients who report that they are already estranged (sometimes by their choice, sometimes by others' choice) from family and that basically never enters into any future sessions.

I haven't yet to encounter anybody who was actively trying to make this specific decision and using our therapy as a tool. Or maybe they were but they weren't voicing this piece out loud.

If so, I would probably try to use a skills/data driven such as their family keep blowing past appropriate boundaries that they are trying to set up and to emphasize their autonomy within a pros/cons framework. And clarify that I don't have a horse in the race regarding their specific decision.

I am usually entering the picture following estrangement. I had one person in the middle of disconnecting themselves from their parent, but it was pretty blatant abuse and therapy was more about grieving the relationship.

I don't see as many of the kids since a lot of my population is older. I work with a lot of estranged parents who want desperately to be in their kids' lives, but won't budge on pretty basic stuff. We will explore the pros and cons of being "right" about the situation.

This is only my own anecdotal experiences, but I have seen a lot of progress in my clients who have made big errors in life and are trying to make amends. Ex: they weren't present due to career goals, had substance use issues, or there was infidelity with the other parent. Their kids aren't always receptive, but it seems easier to forgive those past mistakes if they're open to not making tons of new ones. I am seeing a lot of helicopter parents getting cut off though because they're trampling all over their kids' desires and aren't backing off. They're very...involved as grandparents. I work on helping them self-soothe when they want to critique their kids. You can be right or you can see your grandkids. Sometimes that's their reality whether it's fair or not.

As someone very close to my family, I have to watch my cultural background a bit in these situations.

 

[ThatPsyGuy]

When it comes to the matter of estrangement and cutting off family members, I like what the Psychologist said in the clip - that it's a sometimes form of avoidance.

A large portion of my current client's issues stems from the difficulty in navigating conflict and communicating, finding that it's easier to go radio silent for however long until someone breaks it. I see this as especially difficult with defying and going against what is said by parents or guardians.

It's a trap to simply say "If something's bothering you, just get rid of it." Working with clients to identify what's uncomfortable and developing skills/autonomy to work through the issue when talking to their loved ones (I love me some DEARMAN) is imperative compared to just venting about the problem and avoiding it.

Also, it's so damn boring just to hear the same venting of the same problem week after week. A friend of mine put it nicely "A lot of people want to talk about it, not work about it."

 

[futureapppsy2]

There is a growing literature on the health consequences of social media use, but so much of it is either extremely crass (weekly hours spent on X as a predictor of "mental health problems") or so incredibly nuanced as to be not-that-meaningful (qualitative synthesis of posts on a forum for left-handed LGTBQ refugees with diabetes living in rural communities who vape). I say this somewhat tongue-in-cheek...but not completely.

The in-between space is really where I think we're going to see effects, but its much harder work to do and therefore much less work is being done. I think this is a great example. TikTok gets more attention, but reddit in particular seems to normalize a lot of hyper-reactionary behavior that is massively toxic/insane. Minor marital spats are surefire signs of abuse to come and require immediate divorce, family members being any less than perfect should be cut off from all contact, manosphere stuff, illnesses/disability/mental health groups as people's sole source of identity, etc. I think we just don't have a great way to model the health effects yet, but I'm convinced we're going to find pretty damning evidence once we optimize the methodology.

None of this is to say there aren't great reasons to divorce partners, cut off family members, that a disability or chronic illness cannot be important aspect of identity etc. Reddit just seems particularly f'ing nuts.

Re: posts in subgroup forums—an interesting side effect of this has been that people outside of a community get to see dialogue that was previously really only had between closed doors, and I’ve sometimes seen this be weaponized against that group from people outside of that group—I.e., able-bodied people using visible v. invisible disability discourse to argue that one group is more “real” or “deserving” than the other, people using Ashkenormativity and diaspora discussion among Jews as fuel from antisemitism, people using colorism discourse among BIPOC to justify racism, etc—it’s interesting that these discussions often being public is shaping the ways in which communities have them.

To the broader point of the thread, I think a lot of online discourse about relationships seem to focus on absolving one party entirely of responsibility—you broke up? Well, your ex was automatically an abusive narcissist, so you did nothing wrong. Your parent didn’t always make you feel validated? They must have NPD and you should go no contact now, because they are clearly broken to the core. Now, there definitely are abusive relationships and relationships where the people are better off not being in contact, and I think people strive to see that level of black and white, victim and villain narrative in EVERY relationship where something goes wrong, because it’s much more satisfying to many people to have that lack of nuance so that you can hate one party and feel 100% justified in doing so. It’s very validating to a lot of people, similar to calling everything unpleasant you experience “trauma.”

 

[Shiori]

Oh, another dynamic I'll see is parents not supporting the adult child's partner. I see parents thinking that it's the evil spouse breaking apart the family rather than the child not tolerating what they perceive as disrespect. They'll dig themselves a deeper hole by badmouthing the partner to convince their child to leave. It blows up in their face sometimes. I have seen both sides of the aftermath.

I think these are all reconcilable issues, but only if someone can yield a little ground.

 

[futureapppsy2]

Oh, another dynamic I'll see is parents not supporting the adult child's partner. I see parents thinking that it's the evil spouse breaking apart the family rather than the child not tolerating what they perceive as disrespect. They'll dig themselves a deeper hole by badmouthing the partner to convince their child to leave. It blows up in their face sometimes. I have seen both sides of the aftermath.

I think these are all reconcilable issues, but only if someone can yield a little ground.

One of my cousins is estranged from his parents (very hardcore evangelical Christians) because they told him that he could either go back to being an evangelical Christian and make his non-religious wife become one to keep them in his life or he could continue to reject evangelical Christianity and stay married to his wife. He chose his wife (and also did not choose evangelical Christianity— or religion in general). It’s a hard line issue for both parties, even though they’ve reconciled for a bit in the past.

 

[Ollie123]

Re: posts in subgroup forums—an interesting side effect of this has been that people outside of a community get to see dialogue that was previously really only had between closed doors, and I’ve sometimes seen this be weaponized against that group from people outside of that group—I.e., able-bodied people using visible v. invisible disability discourse to argue that one group is more “real” or “deserving” than the other, people using Ashkenormativity and diaspora discussion among Jews as fuel from antisemitism, people using colorism discourse among BIPOC to justify racism, etc—it’s interesting that these discussions often being public is shaping the ways in which communities have them.

This is a great point too. Communication within those forums likely has immediate consequences for individuals as discussions take shape, but also will have much broader systemic effects.

If only our scientific culture was more about advancing the field and less about publication/funding churn, maybe we'd get some answers?🤣

 

[Shiori]

This all makes me wonder how many Unsolved Mysteries episodes were actually just about someone tired of everyone's mess and deciding to disappear without a trace to avoid another awkward Thanksgiving.

 

[futureapppsy2]

This is a great point too. Communication within those forums likely has immediate consequences for individuals as discussions take shape, but also will have much broader systemic effects.

If only our scientific culture was more about advancing the field and less about publication/funding churn, maybe we'd get some answers?🤣

I think also that people are really wary of speaking about intra-group conflicts/dynamics outside of that group, so forums are actually a good source for this type of data (as well as CBPR, but even that can be messy as you get more intra-group, IME). I think people are understandably nervous about their words being weaponized against their own group while simultaneously wanting to discuss these issues, so they go to anonymous or pseudo-anonymous spaces that seem at least somewhat closed. Of course, there’s always the possibility that these can just turn into echo-chambers, too. (And I think Reddit’s voting system encourages that, ngl).

 

[Shiori]

I am down the rabbit hole now:

Carr, K., Holman, A., Abetz, J., Kellas, J. K., & Vagnoni, E. (2015). Giving voice to the silence of family estrangement: Comparing reasons of estranged parents and adult children in a nonmatched sample. Journal of Family Communication, 15(2), 130-140.

Unfortunately, it's almost exclusively from female adult children and mothers. I still found it informative about some of the misalignments.

 

[Sanman]

Oh, another dynamic I'll see is parents not supporting the adult child's partner. I see parents thinking that it's the evil spouse breaking apart the family rather than the child not tolerating what they perceive as disrespect. They'll dig themselves a deeper hole by badmouthing the partner to convince their child to leave. It blows up in their face sometimes. I have seen both sides of the aftermath.

I think these are all reconcilable issues, but only if someone can yield a little ground.

Wait, you're telling me there are people out there that don't like their in-laws?

 

[Shiori]

Wait, you're telling me there are people out there that don't like their in-laws?

And those in-laws come in and rearrange the dishes in the cabinets and are deeply offended when that isn't appreciated. They pack their stuff, go home, and badmouth the family to anyone who'll listen. Then they proceed to be passive aggressive with their child until the spouse is forced to apologize. This occurred in my own family.

 

[Ollie123]

I think also that people are really wary of speaking about intra-group conflicts/dynamics outside of that group, so forums are actually a good source for this type of data (as well as CBPR, but even that can be messy as you get more intra-group, IME). I think people are understandably nervous about their words being weaponized against their own group while simultaneously wanting to discuss these issues, so they go to anonymous or pseudo-anonymous spaces that seem at least somewhat closed. Of course, there’s always the possibility that these can just turn into echo-chambers, too. (And I think Reddit’s voting system encourages that, ngl).

That itself is an interesting phenomenon. Even when participation is closed, nearly everything online is "open" to some degree for viewing purposes. I will agree they are "a" source of data though I'm increasingly questioning whether they are a "good" source of data😉 At least if the goal is to study a population, I think reddit is....likely not representative...in many cases. At least I hope not, or society is a lot more f'd up than I thought. And I didn't think much of it in the first place. 🤣 If the goal is to study online communication, internet forums themselves, etc....that's another matter completely. And as more and more of our life gets pushed online I think we need that.

r/therapists isn't a bad example. On average, I think prototypical therapy in the community is probably only marginally better than what one would get from a supportive friendship and actually worse in a meaningful number of cases. Yet the discourse there seems to have morphed such that it largely operates as a fringe group with a few sane people (including some posters here!) sitting on the sidelines basically gawking at the zoo animals. How many lurkers are there who could complete an anonymous REDcap survey but don't post? Beats me, but it gets at the heart of the issue...

 

[futureapppsy2]

That itself is an interesting phenomenon. Even when participation is closed, nearly everything online is "open" to some degree for viewing purposes. I will agree they are "a" source of data though I'm increasingly questioning whether they are a "good" source of data😉 At least if the goal is to study a population, I think reddit is....likely not representative...in many cases. At least I hope not, or society is a lot more f'd up than I thought. And I didn't think much of it in the first place. 🤣 If the goal is to study online communication, internet forums themselves, etc....that's another matter completely. And as more and more of our life gets pushed online I think we need that.

r/therapists isn't a bad example. On average, I think prototypical therapy in the community is probably only marginally better than what one would get from a supportive friendship and actually worse in a meaningful number of cases. Yet the discourse there seems to have morphed such that it largely operates as a fringe group with a few sane people (including some posters here!) sitting on the sidelines basically gawking at the zoo animals. How many lurkers are there who could complete an anonymous REDcap survey but don't post? Beats me, but it gets at the heart of the issue...

I think the best thing you can do is try to recruit from a variety of sources—and if you’re draw existing qual data from something like Reddit, at least recruit from a number of subreddits . What social media has really going for it is the sheer amount of data you can have—I’m on a grant where we’re training a language model using a dataset from a number of community-specific subreddits, for example, because we were able to get thousands of posts for it. Of course, keep in mind the limitations of any recruitment source, etc.

 

[smalltownpsych]

Extended family support is a protective factor from what I recollect so I work with my patients on working through conflicts and taking advantage of the support. Sometimes in abusive situations or substance abuse situations the best way to work through the conflict is disengage but short of that, I try to get them to work through it using interpersonal effectiveness skills. I do get patients that are in a victim stance and use the internet to validate unhealthy stances blaming others for their own difficulties. They tend to focus much of their energy on medications more than therapy so they tend to get off my caseload when they realize I can’t fix the other people in the world.