Tuesday, October 20, 2009

When parents are too toxic to tolerate

When Parents Are Too Toxic to Tolerate

Published: October 19, 2009

You can divorce an abusive spouse. You can call it quits if your lover mistreats you. But what can you do if the source of your misery is your own parent?

Granted, no parent is perfect. And whining about parental failure, real or not, is practically an American pastime that keeps the therapeutic community dutifully employed.

But just as there are ordinary good-enough parents who mysteriously produce a difficult child, there are some decent people who have the misfortune of having a truly toxic parent.

A patient of mine, a lovely woman in her 60s whom I treated for depression, recently asked my advice about how to deal with her aging mother.

“She’s always been extremely abusive of me and my siblings,” she said, as I recall. “Once, on my birthday, she left me a message wishing that I get a disease. Can you believe it?”

Over the years, she had tried to have a relationship with her mother, but the encounters were always painful and upsetting; her mother remained harshly critical and demeaning.

Whether her mother was mentally ill, just plain mean or both was unclear, but there was no question that my patient had decided long ago that the only way to deal with her mother was to avoid her at all costs.

Now that her mother was approaching death, she was torn about yet another effort at reconciliation. “I feel I should try,” my patient told me, “but I know she’ll be awful to me.”

Should she visit and perhaps forgive her mother, or protect herself and live with a sense of guilt, however unjustified? Tough call, and clearly not mine to make.

But it did make me wonder about how therapists deal with adult patients who have toxic parents.

The topic gets little, if any, attention in standard textbooks or in the psychiatric literature, perhaps reflecting the common and mistaken notion that adults, unlike children and the elderly, are not vulnerable to such emotional abuse.

All too often, I think, therapists have a bias to salvage relationships, even those that might be harmful to a patient. Instead, it is crucial to be open-minded and to consider whether maintaining the relationship is really healthy and desirable.

Likewise, the assumption that parents are predisposed to love their children unconditionally and protect them from harm is not universally true. I remember one patient, a man in his mid-20s, who came to me for depression and rock-bottom self-esteem.

It didn’t take long to find out why. He had recently come out as gay to his devoutly religious parents, who responded by disowning him. It gets worse: at a subsequent family dinner, his father took him aside and told him it would have been better if he, rather than his younger brother, had died in a car accident several years earlier.

Though terribly hurt and angry, this young man still hoped he could get his parents to accept his sexuality and asked me to meet with the three of them.

The session did not go well. The parents insisted that his “lifestyle” was a grave sin, incompatible with their deeply held religious beliefs. When I tried to explain that the scientific consensus was that he had no more choice about his sexual orientation than the color of his eyes, they were unmoved. They simply could not accept him as he was.

I was stunned by their implacable hostility and convinced that they were a psychological menace to my patient. As such, I had to do something I have never contemplated before in treatment.

At the next session I suggested that for his psychological well-being he might consider, at least for now, forgoing a relationship with his parents.

I felt this was a drastic measure, akin to amputating a gangrenous limb to save a patient’s life. My patient could not escape all the negative feelings and thoughts about himself that he had internalized from his parents. But at least I could protect him from even more psychological harm.

Easier said than done. He accepted my suggestion with sad resignation, though he did make a few efforts to contact them over the next year. They never responded.

Of course, relationships are rarely all good or bad; even the most abusive parents can sometimes be loving, which is why severing a bond should be a tough, and rare, decision.

Dr. Judith Lewis Herman, a trauma expert who is a clinical professor of psychiatry at Harvard Medical School, said she tried to empower patients to take action to protect themselves without giving direct advice.

“Sometimes we consider a paradoxical intervention and say to a patient, ‘I really admire your loyalty to your parents — even at the expense of failing to protect yourself in any way from harm,’ ” Dr. Herman told me in an interview.

The hope is that patients come to see the psychological cost of a harmful relationship and act to change it.

Eventually, my patient made a full recovery from his depression and started dating, though his parents’ absence in his life was never far from his thoughts.

No wonder. Research on early attachment, both in humans and in nonhuman primates, shows that we are hard-wired for bonding — even to those who aren’t very nice to us.

We also know that although prolonged childhood trauma can be toxic to the brain, adults retain the ability later in life to rewire their brains by new experience, including therapy and psychotropic medication.

For example, prolonged stress can kill cells in the hippocampus, a brain area critical for memory. The good news is that adults are able to grow new neurons in this area in the course of normal development. Also, antidepressants encourage the development of new cells in the hippocampus.

It is no stretch, then, to say that having a toxic parent may be harmful to a child’s brain, let alone his feelings. But that damage need not be written in stone.

Of course, we cannot undo history with therapy. But we can help mend brains and minds by removing or reducing stress.

Sometimes, as drastic as it sounds, that means letting go of a toxic parent.

Dr. Richard A. Friedman is a professor of psychiatry at Weill Cornell Medical College

When people find out I no longer talk to my mother they make faces like it’s a really sad thing, and some of my friends occasionally ask if I have ‘made up’ with her yet. But I have no plans to resume contact with her. I don’t think I would have been able to cut her off if she hadn’t cut me off first. But our relationship was never great, ever since I told my parents at age 17 that I was no longer religious- and every time I talked to her I felt like she was trying to shame me. By cutting me off first I feel as if she actually did me a favor.

After this experience I feel a certain kinship to gay people…having been disowned and kicked out of my family for “coming out” as an atheist and having a partner who is also an atheist. At least now I know how to NOT treat my own children.


  1. >After this experience I feel a certain kinship to gay people

    I recently met a gay ex-orthodox person. he is openly gay, but he's still in the closet regarding not keeping shabbos. It could be that not being shomer shabbos is worse in the minds of orthodox jewish parents than being gay

  2. I was just reading this now. The comments on the Well blog piece that accompanies this are fascinating.

  3. Hey AE,

    This is a very strong piece; almost as strong as the article on how unconditional love is essential for children.

    Keep up the good work,

  4. Two facts of life I know for sure as a psychologist and my experience as a human being:
    1. Not all parents love their children
    2. Not all children, or adult children, are better off with their biological parents in their lives.

    Things in life are not always as they "should" be.

  5. spinoza- my parents once told me that in their minds marrying a non jew was an equivalent of being a murderer and the only thing worse I could do would be to be a lesbian!

    i wrote about it here: http://abandoningeden.blogspot.com/2007/08/hiatus-revoked-2007.html

  6. Thanks for sharing that article. I hear you, re: the closeted feeling. An orthodox uncle of mine friended, then unfriended me on fb. Not sure if he ditched his account totally, or what. The aunt who's married to him is still an fb friend of mine. She was a convert before she met him. I didn't make any formal announcement, but I don't abstain from posting on shabbat/holidays. I figure they're grown-ups. If they can't handle the truth, they can un-friend me. Part of me wonders what his deal is (he just got in from Israel today; may see him, at some point soon).

  7. AE:

    Interesting article and unfortunately, I can relate to this too.

    However, as much as you might abhor your parents for their decision not to accept you as an atheist and your marriage, that does not qualify them as toxic parents.

    Orthodox Judaism is to blame. Their attitude is a product of the religion. And with all honesty, due to my upbringing as well, I might not have acted differently, and I pray not to be tested as such.

    People make choices. You made yours and they made theirs.

    I'm not saying you should renew contact with them. But, in time, perhaps you will view them with piety rather than with anger.

    Finally, please do not take this comment as an attack on you.

  8. >It could be that not being shomer shabbos is worse in the minds of orthodox jewish parents than being gay

    I used to let my parents assume I was gay, so we wouldn't have to talk about my dating non-Jews of the opposite sex. I think it might have been much easier if I had been gayer. When one of my siblings came out to them years later, it wasn't so bad. They rethought things for the sake of that child.

  9. Among Orthodox Jewish parents generally, I don't think there's much difference between coming out as an atheist and coming out as gay. Both are a rejection of the faith.

    I've been a secret skeptic for a few years now, hoping not to hurt my parents (and my husband's). A couple of my siblings haven't been so thoughtful and my parents have coped. But I'm still torturing myself a bit, desperate not to disappoint them (for now, anyway - and the other side of the family might not be so good about it, which is our bigger concern). Ultimately yes, I think some people may well be better off without their parents in their lives.

  10. This is not a case of a parent that does not love a child. It is a tragic case of a parent who's life outlook is poisoned by their beliefs.

    Parents in this case, and in the case of gay children, do not reject the child out of hatred. It is usually a conscience decision to reject the child based on their perception of their moral responsibility, which is supported by their community.

    In any case, I do think that it is sad that you can't have a relationship with your mother. It may very well be the only option available right now (or ever), and I strongly believe that you lose more by having a make believe relationship than by having none (e.g. pretending to be hetero in front of your parents). Still, there is collateral damage. You can certainly compensate, but losing the love and respect of a parent is an emotional challenge.

    I think that parents who reject their children in these cases are emotionally abusing them and I believe that the best course is for children to use the same tools as other abusive parents. Primarily, to set boundaries under which they will see that parent. The speech goes something like this, "I will try to keep seeing you, but if you can't control yourself from denigrating my beliefs and choices, then that visit or phone call will be over. I would not expect you (or anyone else) to tolerate my denigrating you or your beliefs, and I won't tolerate it from you, even though I love you." The key is to try to stay with this message consistently.


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