Catherine Cheyette dissertation by ICSW

Institute for Clinical Social Work

Estranging from a Parent and the Implications for Clinical Work

A Dissertation Submitted to the Faculty of the Institute for Clinical Social Work in Partial Fulfillment for the Degree of Doctor of Philosophy

Catherine Cheyette

Chicago, Illinois October, 2020

Abstract

This qualitative study uses an interpretive phenomenological analysis (IPA) to explore the lived-experience of the decision to estrange from a parent in adulthood and the experience in therapy addressing issues related to the estrangement. The criteria for the study was that participants be estranged for at least three years and had been in therapy where they worked on issues which emerged as a result of the estrangement. Several themes were identified for each area of inquiry. Many of the themes for the lived experience supported some of the existing literature on estrangement by Agllias and Blake, that it came after much effort to repair problems in the relationship, that it felt like the only option to have a better life, that there are challenges to maintaining the estrangement and that while there are no regrets about the decision, there is still a longing for a family. This study adds to the existing literature in identifying some of the specific positive changes. The themes for the experience in therapy identified the positive impact of therapists who were seen as supportive and non-judgmental. The significance of an open-ended, psychodynamic approach as the optimal treatment for those living in the aftermath of estrangement from a parent was identified in this study.

For Oren, Sam and Anna

Acknowledgements

I owe the fruition of this dissertation to the support of many people and to the two schools which provided the structure and academic guidance to see me through to the end. The Sanville Institute gave me a solid foundation where I developed professionally through a strong academic curriculum and from dedicated staff. I also want to express my gratitude to the Institute for Clinical Social Work in accepting me as a transfer student when the Sanville Institute closed, making it possible for me to continue and complete this work. The two people I feel most indebted to are Dr. Silvio Machado and Dr. Whitney van Nouhuys. In agreeing to remain on my committee when I transitioned to ICSW they provided invaluable guidance and continuity to a process that was well underway. I also want to thank Dr. John Ridings for all the extra support and instruction he gave me to meet the new requirements and protocols when I began at ICSW. I most particularly want to thank the participants for their willingness to share so much detail about such a complex and difficult reality of their lives. In doing so, they enabled a better understanding of the experience of estrangement which clinicians can access to support them in their work. CC

Table of Contents

Page Abstract…………………………………………………………………………..ii Acknowledgements…...…………………………………………………………iv List of Tables……………………………………………………………...……..ix Chapter I. Introduction…………………………………………………………...1 General Statement of Purpose Significance of Study for Clinical Social Work Statement of the Problem and Specific Objectives to Be Achieved Research Questions Statement of Assumptions Approach to Scientific Philosophy Foregrounding Outline of Dissertation II. Literature Review…………………………………………………..15 Introduction Review of Sociological Literature Review of Communications Literature Review of Clinical Literature Conclusion 5

Table of Contents—Continued

Chapter

Page III. Methods…………………………………………………………..55 Introduction Rationale for Qualitative Research Design Rationale for Interpretive Phenomenological Analysis Research Sample Research Process Data Collection Recruitment Data Analysis and Presentation of Findings Issues of Trustworthiness Limitations and Delimitations Conclusion

Table of Contents--Continued

Chapter

Page

IV. Results……………………………….........................………………………73 Description of Research Process Introduction to Sample Description of Participants and Backstory of Their Estrangement Superordinate Themes Experience Addressing Estrangement in Therapy Summary V. Discussion……………………………………...............…………………....116 Summary of Results Interpretation of Results An Act of Self Preservation Challenges to Estrangement Come from Multiple Sources Relevance of Findings to Literature Limitations of Study and Recommendations for Further Study Conclusion

Table of Contents--Continued

Appendices

Page

A. Informed Consent………………………………………......…………147 B. Interview Guide………………………………………………..……...152 C. Screening Form………………………………………......……………155 D. Recruitment Posting…………………………….....………………….158 E. Recruitment Flyer……………………………………………..………160 References……………………………………………………….…………162

List of Tables

Table

Page 4.1. Participant Demographics…………………………………………………...75 4.2. Participant Therapy Experience…………………………...……………….106

Chapter I

Introduction General Statement of Purpose The purpose of this phenomenological study was to explore the lived experience of adults who have made the decision to dissolve a relationship with a parent and their experience addressing issues related to estrangement in therapy. The focus was on understanding the impact this decision had on their lives as broadly as possible, including emotional, psychological, interpersonal, and interfamilial/generational aspects of their lives and how therapy was effective in helping clients work through issues that arose from having made this decision. Estrangement is being defined as the condition of being physically and/or emotionally distanced from another person, either by choice or at the request of the other.

Significance of the Study for Clinical Social Work While many who reach the conclusion that they need to sever ties to a parent are unconflicted about their decision, it is often not simple living in the aftermath of the decision. Because this subset of people is a minority and estrangement is not held in the culture as normative, there is often little support or understanding for those who feel it is the best alternative for their well-being. As therapists there also are no guidelines or theoretical models of how to work with those who have made and are living with this

choice. However, clients do come to treatment seeking help addressing these issues. It is important as clinicians to have a grasp of the challenges they face. Given this, the focus of my research was to explore the lived experience of those who have made the decision to cut off ties with a parent. To gain more insight into the therapy experience, this study also explored the experience in therapy in addressing the estrangement. Exploring the experiences and learning about the challenges particular to this group can provide valuable information for clinicians working with clients who are estranged from a parent. Within a western cultural perspective, healthy, normative development from infancy to adulthood is characterized by a move from dependency on our adult caretakers toward independence and self-sufficiency (Ainsworth, 1978; Bowlby, 1969, 1988; Mahler, 1963, 1968, 1972: Main, 1985). As one matures their needs are met more and more from the outside world and less from one’s family of origin. Yet, most young adults continue to stay connected to their parents and siblings even after they have established their separate lives with new significant others, independent interests, careers and perhaps children of their own. While the relationship to the family of origin shifts, for most it remains significant and meaningful and continues to evolve until death. Families vary in terms of attachment style, interpersonal dynamics between family members, external stressors they face, and quantity and quality of communication and connection. Through time and with changes in the individuals (e.g., maturity, physical or cognitive decline, shifting circumstances), the nature of these relationships can change. The continuity of these relationships is most often a given and serves as an anchor to one’s past. The relationship to one’s parents, typically the first and most formative one, shapes identity, core values and attachment patterns. And the ongoing

engagement with them provides an opportunity to know oneself better and develop new and more differentiated perspectives on them and one’s relationship to them. Psychodynamically-oriented therapists listen to clients’ narratives about their personal and developmental histories and help them see how relationships to primary caregivers shape them. In some cases, the therapy process helps clients grapple with some current or unresolved issues with a parent. It may open up an opportunity for them to go back to the parent and repair or to see the parent through a different lens, allowing for a new understanding of them and their relationship to one another. However, sometimes the therapist is confronted with a client who reports that they have cut off communication with a parent, having already determined that the relationship is beyond repair. The clinical issues and challenges posed by the adult client who has cut ties with a primary caregiver are distinct. By focusing on the nature of these issues, clinicians can become better informed when working with this population. There are seemingly two contradictory theoretical positions about the meaning and effect of relinquishing a relationship with a parent. One posits that it is an immature, reactive act that is only a temporary solution to a relational problem and that without healing the relationship one is bound to suffer and play out the dynamic in other relationships. The other suggests that sometimes ending a relationship with someone who feels toxic is a healthy, self-affirming act which makes room for growth that otherwise would not have happened. Given that there is no clinical consensus as to the psychological implications of estrangement from a family member, it was seen to be a worthwhile endeavor and addition to the existing literature on the topic, to dig deeper into the lived experience of those who dissolved a relationship with a parent without ever

returning to it. Looking specifically at the emotional, psychological and relational challenges of this group would provide clinically relevant information for clinicians working with this population. As there is no research that directly looks at the experience of therapy for those who have entered therapy to address issues related to having chosen to estrange from a parent, exploring this would potentially add new and valuable clinical data. This could be important in guiding clinicians on useful interventions when working with clients that present with concerns related to their decision to estrange from a parent.

Statement of the Problem and Specific Objectives to be Achieved There is much literature and recent research exploring this phenomenon, referred to in the literature as “estrangement.” Murray Bowen (1978), a pioneering family systems theorist writing in the 1970s and 1980s, used the phrase “emotional cutoff” to describe this type of distancing by a child toward a parent. His theory explains this as a strategy employed when there is a lack of differentiation between parent and child. To manage the anxiety of losing oneself in a fused or merged relationship to the parent, the child emotionally or physically disengages. However, in contrast to a healthy, mature trajectory toward individuation, which occurs when there is a clear sense of one’s separate identity, estrangement is instead a “pseudosolution” according to Peter Titelman (2003, p. 9), a Bowenian family therapist, in that it is a reaction to the “unresolved emotional attachment” (p. 9) to a parent. It is a common phenomenon in adolescence where the adolescent is indeed dealing with the developmental challenge of moving away from dependence on parents and forging his or her independence. According to Bowen

(1978), while cutting off can be a useful way to ward off anxiety in the short run, it is not a solution to managing the unresolved attachment issues that trigger the anxiety. These still need to be addressed to be able to remain close yet differentiated from one’s parents. There are many (e.g. Gilligan, 2013; LeBey, 2001; Sichel, 2004) who recommend and prescribe therapeutic intervention to address estrangement and promote reconciliation. Their perspective is that healing these ruptures is possible and preferable than not doing so. Bowen (1978) and other family therapists (e.g., Titleman, 2003; Kerr, 1988) go further to state that if these ruptures are not healed, they will be enacted in other relationships through the next generation. Yet, current research on estrangement suggests that most often it occurs after a “long and complex process” (Agllias, 2016, p. 94) where there have been multiple efforts to continue the relationship and repair ruptures. Participants from two studies (Agllias, 2015; Scharp, 2014) reported that their parents had been emotionally, physically and psychologically abusive and they identified the abuse as the reason for estrangement. In circumstances such as these, where either the damage to the relationship is too great or efforts at repair have failed, ending the relationship appears to become the healthiest option (Novak, 2014; Sharp, 2014). There are a number of recent studies exploring various facets of estrangement or cutoff from a family member. Agllias (2009, 2015, 2016) has looked extensively at the phenomenon. Her studies have explored the reasons adult children give for ending contact with a parent, the reasons parents give for why their children are no longer speaking to them, the intergenerational impact on elderly parents at the end of their lives whose adult children had cut them off. Carr et al. (2015) contrasted in a non-matched

sample the reasons given by adult children and their parents for their estrangement. Scharp et al. (2015) focused on the back stories that adult children give as a way to situate their estrangement in a context and give meaning to why they made the decision to dissolve a relationship to a parent. This body of research has shed light on the, until recently, under-studied, but prevalent topic of parent-child estrangement. Mainly, it looks at cases where the adult child is the one who initiates the break in the relationship. For the most part it describes the reasons the decision was made and how it was sustained. In terms of the effect on the individuals, there is only one research qualitative study by Agllias (2017) that focuses on the experience of adult children who have chosen to end contact with a parent. The one other study of the lived-experience of estrangement is a survey study by Blake (2015). While there are other studies that reference aspects of the experience for an adult child having cut off a parent (Carr, 2015; McCall, 1982; Sharp, 2014) only Agllias’ qualitative study looks at the emotional and psychological issues that are common to this group and the effect of the decision on the trajectory of individuals’ lives. A dissertation by Ring (1998) which looked at the experience of cut off and reconciliation focused only on those who had cut off connection for a short period of time. The emphasis of the study was on the reconnection which was seen to be a positive and growth promoting outcome. The literature that addresses therapy with this population is largely focused on reconciliation between estranged family members (McGoldrick & Carter, 2001; Dattilio & Nichols, 2011). Agllias (2017) made recommendations for therapists in light of her findings that identified the core issues for those living with estrangement—stigma, grief and trauma. She advised therapists to normalize the estrangement experience to reduce

the sense of isolation and shame. She recommends cognitive behavioral therapy and motivational interviewing interventions as most effective in addressing the particular issues of negative thinking common to those who are estranged from a family member. She cautions that therapy is not necessarily indicated immediately after an estrangement as estrangement related grief is normal and may not require intervention. Aside from these interventions and recommendations there are no studies that address the therapy experience for those who have made the decision to estrange from a parent. This study sought to add to the existing literature on estrangement by gaining an understanding of what has and has not been helpful for those individuals who went to therapy to address issues related to their decision to estrange from a parent. By gathering first hand experiences from those who had used therapy to work through aspects of having made this decision and reflect on what was and was not helpful in these experiences this study was able to further the clinical research on the issues that confront those who chose to estrange from a parent.

Research Questions Much of the research on family estrangement focuses on the reasons people choose to end a relationship with a family member. There is theory coming mostly from family systems literature that shapes thinking about dynamics of cutting off a family member and there are many self-help books that identify the struggles of those estranged from a family member and offer useful strategies for coping with rifts and/or working toward reconciliation. However, there is not a large body of knowledge for clinicians to turn to when working with clients who have severed ties with a parent to help them cope

with the complex mix of emotions and complicated relational terrain to navigate after making and living with the decision. While there are studies aimed at understanding the choice to estrange from a parent and the lived-experience of this choice (Agllias, 2016, 2017; Scharp, 2015, 2018; Gilligan, 2015) there is not very much research on how to work with clients who struggle with issues related to having estranged from a parent. To that end, this research addresses the following research questions: 1. What is the adult child’s lived experience of having intentionally ended a relationship with a parent where the adult child is resolute in this decision? 2. What are the emotional and psychological and relational ramifications for people who have severed ties to a parent as a direct correlate to this decision? 3. What has been the experience of therapy for these individuals in addressing the estrangement? Theoretical and operational definitions of major concepts 1. Estrangee: A person who has been physically or emotionally estranged, disowned, or cut off by a family member or members. An estragee does not choose the relationship dissolution. 2. Estranger: A person who chooses to dissolve a family relationship, or emotionally distance themselves from a family member or members. They may declare this position to the other party, stop contact without an announcement or use emotional withdrawal to maintain distance.

3. Cutoff: A Bowen Family Systems Theory term used to describe the reduction or cessation of contact with a family member due to unresolved emotional issues. It is most likely to occur when the parties have a fused (or less differentiated) relationship, resulting in higher levels of emotional reactivity in anxietyprovoking situations.

(Definitions from Family Estrangement: A Matter of Perspective, K. Agllias, 2017)

Statement of assumptions This study looked at the experience of living with estrangement and also the experience of addressing issues related to estrangement in therapy. The assumptions I made relate to each of these foci and are the following: 1. In regard to the estrangement itself, I had assumptions both about how one decides to estrange from a parent as well as about the issues that arise after one has estranged themselves from a parent. The assumption I made about why people estrange from a parent is that it is borne from a long-standing, conflictual relationship. Efforts that were made to repair or reconcile these issues failed and the estranger, in weighing the pros and cons, determined that it was in their best interest to end a destructive relationship rather than subject themselves to a relationship that was beyond repair. 2. The assumption I made about living in the aftermath of the decision was that while it is difficult to make the decision, it is in fact experienced as better for the

estranger. However, this does not mean that it is simple, and there are many complicated and difficult emotions to address and learn to live with. Because the relationship with a parent is primary, unique and filled with meaning, dissolving a relationship with a parent has complex and long-standing ramifications. 3. The assumptions about the estranger’s experience in therapy were that it would be mixed. I suspected, depending on the orientation of the therapist, that the interventions would vary from therapist to therapist. I thought that some therapists might view the estrangement as an acting out and an immature response to conflict and may have worked toward helping the estranger reconcile with the parent. Other therapists may have wanted to work with the estrangee to feel more confident in his/her decision and provide support through acknowledging the difficulty of such a decision, yet believing that it was the healthiest choice their client could have made.

Approach to Scientific Philosophy This research is an exploration of the subjective experience of participants who have chosen to estrange themselves from a parent. This idiographic research, which focuses on understanding the complexity of an individual’s experience, is best gathered in a way that allows the participants to convey its richness and to fully express the many dimensions of the experience without it being curtailed prematurely—using open-ended questions and allowing ample time for participants to respond. For this reason, the method of this study was a qualitative design in which data is gathered through descriptive, verbal reporting of the phenomenon under investigation by the participant

and the findings are likewise presented through verbal description of the prominent themes in the data. Specifically, this study followed the constructivist-interpretive paradigm using a hermeneutic approach. The goal of the interpretive paradigm is: to seek to interpret the world, particularly the social world…[where] knowledge…comprises constructions arising from the minds and bodies of knowing, conscious beings…generated through a search for meaning, beliefs and values, and through looking at wholes in relationships with other wholes (Higgs, 2001, p. 49). Because the study of the lived experience of estrangement is, by definition, the subjective experience as reported by those who have experienced it, the constructivist-interpretive approach is well suited to find the answers through gathering deep and rich descriptive information from the participants about their experience of life after choosing to estrange themselves from a parent. Hermeneutics is the theory and practice of interpretation. It assumes that meaning is not readily available and must be “brought to the surface through deep reflection” (Ponterotto, 2005, p. 129). This is achieved through a dialogue between the participant and the researcher who “jointly create (co-construct) findings from their interactive dialogue and interpretation” (p. 129). Interpretive-phenomenological analysis (IPA) was chosen as a suitable method for this study both in gathering and analyzing the data; it prioritizes the communication of the participant and encourages free, open-ended discourse between the participant and the researcher with the goal of attaining as rich and thick description as possible. It also recognizes the researcher and her subjectivity as an integral part of the analysis of the data. Smith and Osborne (2008) refer to IPA as a

“double hermeneutic” (p. 53) process in that the participant is at first trying to articulate and make sense of the phenomenon being studied and then the researcher takes this data and makes meaning out of it through her own subjective lens. Reality, from the constructivist-interpretive perspective, is relative, as opposed to the positivistic view which holds it to be fixed and preordained. The constructivistinterpretive approach sees reality as constructed through each individual’s experience and shaped by context and social environment. This research into the lived experience of choosing to estrange from a parent holds this view. It assumes that each participant will have their own, unique response to the experience which will have multiple determinants. Thus, it is the depth and details that matter when gathering data. To that end, this study is designed to glean as much nuance and complexity as possible through multiple interviews with each participant. The constructivist-interpretive approach also recognizes that the interaction between the participant and researcher is a factor in determining the meaning made of the experience. In order to be as transparent as possible about the potential biases in the research, I have noted my assumptions (see above) going into the interview process and kept an audit trail of my work as I analyzed the data, so that there was documentation of my own thought process as I analyzed the data.

Foregrounding As a psychodynamically-oriented psychotherapist I am always looking at the family history and dynamics which shape my client’s life. I use this understanding as a guide to help clients understand themselves and work through issues which create

intrapsychic and interpersonal conflicts. Ideally, this work leads to better relations to self and others and includes a more nuanced understanding of other significant people in one’s life, a working through of difficulties in these relationships, acceptance of limitations of others and a more positive connection to them. Conflict with parents is not uncommon of course, and throughout my work with my clients, the nature and substance of their relationship to their parents and the areas of conflict become topics of focus. In most instances, while there is conflict and even destructive patterns, the decision to estrange from a parent is rare. So, in instances where clients declare that they have decided to estrange from a parent, I have found myself wondering about the clinical implications of this choice. When working with clients who have made this decision to estrange themselves from a parent, I find myself mired in my own countertransference reactions and unclear as to what will be the best approach in working through issues related to such a final decision toward one’s parent. I am at first curious to understand the circumstances that led someone to make what seems to be a very radical decision and then wondering if helping them let go of youthful expectations and disappointments toward a more nuanced and compassionate stance toward the parent in question would be the clinically sound approach. However, I can equally hear my client’s narrative and believe that in some instances and with some people there is no prospect of reconciliation or healing and that the best thing I can do for the client is to honor their decision and to support them as they work through the complex emotional and psychological terrain of estrangement from a parent.

It is this quandary which led me to want to explore in more depth the experience and emotional and psychological meaning for an adult child to make the decision to estrange from a parent and the ramifications of living with this experience. I wanted to also find out from those who have made the decision and had sought help from therapists what they wanted from therapy, what was or was not helpful in therapy and what they came to believe about the estrangement and its impact on their lives after focusing on it in therapy. My hope is that this research will provide clinicians with some useful information which can be applied clinically when working with clients who have estranged from a parent.

Outline of the Dissertation This qualitative study takes the form of a first chapter introducing overall concepts, followed by chapters covering a review of the literature, methodology, findings, and a final chapter covering discussion and conclusion. This will be evident by tables, charts and narratives from volunteer participants. It summarizes the main points found in the research and provides a deeper understanding of the experience of the lived experience of adults who have chosen to estrange themselves from a parent. It also explored the experience for this population in working on issues related to the estrangement in therapy.

Chapter II

Literature Review Understanding the structure of the family and the ways that individuals within it navigate relationships with one another has been of interest to multiple researchers within a number of disciplines in the social sciences (Bengston et al., 1976; Bengston & Roberts, 1991; Bowen, 1944; Bowlby, 1944; Carr, 2015; Fingerman et al., 2012; Luchar & Hoff, 2013; Scharp, 2014, 2016a, 2016b, 2016c, 2016d: Scharp & Hall, 2017; Scharp & McClure, 2017; Scharp & Thomas, 2016; Silverstein & Bengston, 1997). The focus of interest varies depending on the field of study, but each sheds light on important aspects of family life. The field of sociology, for example, looks at the broader social and cultural contexts in which families exist and the rules or norms that guide intergenerational relationships. By contrast, clinical research within the fields of psychology, social work, and marriage and family therapy looks more closely at the interpersonal and relational dynamics between family members to understand the attributes that determine the quality of these relationships and to infer how they impact the psychological health of the individual. Each of these disciplines has developed theories to explain cohesion or its lack within families. How conflict is managed within a family is complex, as are the strategies employed to maintain relationships with people with whom one is bound, not by choice, but by birth. Of interest to several researchers

(Hall, 2016; Hess, 1996; Scharp 2015, 1017) in the field communications is how closeness and distance between parents and children is defined, understood and maintained. These studies show that the decision to sever all contact with a family member with whom one is in conflict is rare, and instead the more typical solution is to develop strategies that establish a degree of distance while also maintaining the connection to the individual family member. Each individual achieves the optimal balance between intimacy and distance within a particular relational dyad depending on a broad range of factors. This spectrum of distancing is reflected in the literature. Estrangement from a family member is at the extreme end of this continuum. However, looking at the broad research into the elements of family life, intergenerational relationships and interpersonal relationships from a number of perspectives provides a context for when this extreme is chosen. The literature reviewed here is organized by discipline. Beginning with the broad lens of sociology, moving to the literature from the field of communication, which focuses on the strategies employed to manage interpersonal relationships, and finally to the clinical literature, which explicates the interpersonal and intrapersonal aspects of moving toward making a choice to distance and/or ultimately estrange oneself from a family member. Included in this section is an overview of literature on the use of therapy in addressing issues related to estrangement.

Review of the Sociological Literature The field of sociology looks at the family as a structure that exists in dynamic interplay with other elements and structures within the culture in which it is embedded.

The focus on intergenerational family and kin relations began in sociology in the 1980s as traditional family roles and norms were shifting rapidly (Fingerman et al., 2012; Lucher & Hoff, 2013 Silverstein & Bengston, 1997). Many in the field argued that there was a breakdown in the American and Western European family due to the high divorce rate, geographic dislocation and the shift in the norms around care for the elderly. Some in the field attributed the trend of elderly parents living independently outside the family unit instead of moving in with their adult children, as they once had, to a weakening kinship bond between adult children and their aging parents (Silverstein & Bengston, 1997) and said that this reflected “family decline.” Yet, some research (Riley & Riley, 1993; Silverstein, Parrot & Bengtson, 1995; Whitbeck, Hoyt & Huck, 1994) revealed that, in fact, despite these changes there was still much that held the family together. This literature describes the qualities that sustain intergenerational cohesion by examining the social-psychological, structural, and transactional aspects of the adult child-parent relationship. These studies have identified qualities which enhance or diminish what is referred to as “intergenerational solidarity” (Bengston, 1976).

Solidarity theory. Contemporary sociological theories and research into intergenerational relations have evolved since the 1970s when sociologists first focused on this particular interpersonal dimension of the family. Building on the earlier work of French sociologist, Emile Durkheim (1951) who found a correlation between frequency of association and kinship bonds, the model of intergenerational solidarity put forward by Bengston et al. (1976) identified three qualities that defined familial solidarity. These were association,

or frequency of interaction; affection or positive sentiment; and consensus, or the extent of agreement or similarity of beliefs. Subsequent studies (Bengston & Roberts, 1991; Bengston et al., 2002) identified the various dimensions in which solidarity can be measured. These include “affectional solidarity (intimacy vs. distance), functional solidarity (autonomy vs. dependence), consensual solidarity (agreement vs. dissent), associational solidarity (integration vs. isolation), structural solidarity (opportunities vs. barriers) and normative solidarity (familialism vs. individualism)” (Merz et al., 2007, p. 177). This research suggests there are a number of ways that adult children and parents can be bonded and there is a continuum in each dimension. In a significant conceptual shift that challenged the hypothesis of “family decline” (Popenoe, 1988), and looked more closely at the shifting nature of the intergenerational bonds, it was noted that in spite of the transience in contemporary life and the geographic independence between family members, the high divorce rate and “increasing heterogeneity in intergenerational family structures” (Silverstein & Bengston, 1997, p. 431), there still exists a “latent kin matrix” (Riley, 1983). This concept describes the phenomenon in which families remain linked in spite of physical dislocation and long periods of non-communication, but when the need arises, they come together to support one another. Thus, the research into family solidarity evolved to incorporate a more refined understanding of the impact of the changing structure of the family on the bonds between its members.

Negative emotions, conflict & ambivalence. Later sociological studies of intergenerational cohesion moved to broaden the solidarity concept in trying to understand the role of conflict and negative emotions. While conflict had been assumed to be the opposite of solidarity, many researchers (Gaaleen & Dystra, 2006; Fingerman et al., 2004; Lucher & Hoff, 2013; Szydilk, 2008) in fact saw conflict as an integral part of intergenerational relations and found that there is a more complex matrix to define the relationship between conflict and family cohesion. Szydilk (2008) conducted a study to determine the relationship between conflict and solidarity between adult children and their parents in which he delineated four conditional factors for solidarity. These are opportunity structures (e.g., geographic proximity), need structures (e.g., financial), familial structures (e.g., family socialization and history) and cultural-contextual structures (e.g., social, economic). From his study, Szydlik identified three types of intergenerational relations—solidarity, conflict and autonomy. He makes a distinction between consensual solidarity and conflictual solidarity, but emphasizes that conflict alone does not diminish the solidarity that exists within an intergenerational dyad. However, too much conflict has the potential to reduce the connection between generations leading to “autonomy” which he believes is the opposite of solidarity where the ties that held the connection become severed. A 2006 study by Galeen and Dystra used a latent class analysis to look at the variety of dimensions of solidarity to determine which variables in parent-child relationships were indicators of the strength of the bond. From this research they delineated five types of parent-child relationships–harmonious, ambivalent, obligatory, affective and discordant. These types were found to be differentiated by social-structural

characteristics such as gender, family size, geographic distance and parental marital history, indicating that these types are not fixed and are shaped by the socio-cultural factors. The authors concluded that: parent-child relationships cannot be placed on a continuum where solidarity implies absence of conflict and vice versa…[t]he distinguished solidarity behaviors are not always exhibited simultaneously, just as the likelihood of having conflicts in one area does not imply having them in another area. (Galeen & Dystra, p. 956) While the authors did rank the quality of the relationships on a scale (harmonious as highest and discordant as lowest), they were also able to show the complex and multiple ways in which solidarity manifested itself (e.g., emotional closeness, practical help etc.) and that conflict can occur on one dimension and not another, resulting in a more nuanced relationship between solidarity and conflict. In the 1990s there were two emerging lines of argument put forward to describe intergenerational relations. The first, reviewed above, stressed the importance of solidarity, the second, emerging out of the field of gerontology and working to understand elder abuse, emphasized the inherent conflict within families (Luscher & Pillemer, 1998). In order to bring these two lines of inquiry into a broader and overarching conceptual framework, Lucher and Pillemer proposed the term intergenerational ambivalence. This term encompasses both the positive and negative aspects of intergenerational relationships. The authors also distinguish “two dimensions of ambivalence: (a) contradictions at the level of social structure, evidenced in institutional resources such as status, roles or norms and (b) contradictions at the subjective level, in terms of cognitions, emotions and motivations” (p. 416). These two dimensions refer to the

conflicts which can exist between a parent and adult child because of role expectations on a more macro-, socio-cultural level and on the micro-, interpersonal level. Further literature on the topic describes this distinction as “sociological ambivalence” or “psychological ambivalence” (Fingerman et al., 2012). The meaning of sociological ambivalence has been hotly debated in the field of sociology. The predominant definition from the existing literature, mirroring the description above, is that sociological ambivalence “involves incompatible normative expectations (e.g., with regard to status, roles or norms) that present structural challenges in social relationships” (Fingerman et al., 2008). This definition sees ambivalence being played out on an interpersonal level and within the bounds of the family; ambivalence occurs when expectations in one family role are at cross-purposes with another. For example, when an adult child is both needing to care for a parent and also struggling for autonomy and independence. Another view put forward by Connidis and McMullin (2002) moves the definition into a more socio-political realm. It attributes the ambivalence experienced by any one person within a family to the constraints placed on them by the larger socio-cultural norms. As “individuals seek to exercise agency in the negotiation of relationships … they experience ambivalence when social structural arrangements constrain their attempts to do so” (p. 559). Connidis and McMullin draw on critical theory to make their argument about ambivalence stemming from oppressive features within a particular set of societal norms. Critical theory is a philosophical approach to culture that “sees an essential conflict or tension placed on individuals by social structure and the desire of individuals to act with agency” (p. 559). It also asserts that certain groups of people in a society have

privilege over others based on class, gender, age and race. An example Connidis and McMillan give is the societal expectation of women to serve as caretakers. Due to the social pressure that women experience to assume a caretaking role they are more often pulled to take it on. In trying to juggle both caretaking and the demands of work, they are prone to experience ambivalence when the pressure to provide care comes up against their desire for personal agency. Much of the literature has emphasized the distinction between the psychological and sociological notions of ambivalence, yet, in the descriptions and definitions of sociological ambivalence there is a blending of the interpersonal and structural. The distinction seems to be blurry. And this actually appears to be a more accurate depiction of the complex interplay of societal and interpersonal roles, norms and conflicting expectations that make up the experience of ambivalence. Lucher and Hoff (2013) argue that perhaps “the real power of the concept lies in its potential to connect both dimensions” (p. 42). The literature from the field of sociology on the family is useful to keep in mind when looking at the decision by one individual to cut him/herself off from a family member. Because this decision does not occur in a vacuum, but within a larger sociocultural context, it has ramifications beyond just the immediate family due to the norms and roles which society imposes on each individual. Stepping out of one’s expected role not only affects the relationship with the estranged family member, but challenging norms will inevitably have repercussions in other areas of one’s life and in other relationships. It is also a reminder that estrangement means different things in different cultures. The focus here is on its meaning in a Western, and more specifically North

American, cultural context. In keeping in awareness that we are looking at a particular society and era, it helps to establish and think about what really defines estrangement. Contemporary family life being much more dispersed and transient forces the questions that sociologists study about what binds families together when the members are not living in close proximity. Contextualizing the very relational and interpersonal phenomenon of an adult child’s estrangement from a parent within the societal constructs around role expectations and norms adds an essential element to the study of the experience. It can be an added barrier to personal agency and can also affect the outcome of the decision. Therefore, it can play an essential part in the overall experience of the choice to estrange oneself from a parent.

Review of the Communications Literature According to Galvin and Braithwaite (2014), communications researchers, the study of family communication emerged as an academic field within the field of communications in the 1970s. They attribute this to three major factors: “(a) expanding research on interpersonal communication, (b) advances in the field of family therapy and the self-improvement movement, and (c) increased scholarly attention to functional family interaction” (p. 98). The focus of interpersonal communication began with the study of dating and friendship dyads, but expanded and shifted to looking at the marital dyad and then to the family system. The research into family communication patterns has led to multiple theories about the ways in which individuals within families use language to maintain their

relationships and manage closeness and distance to other family members. As with the field of sociology, the field of communications has emphasized and privileged interpersonal closeness over distance (Bersheid, Snyder, & Omoto, 1989). Jon Hess (1996) was the first communications researcher to emphasize the importance of distancing strategies in maintaining relationships. His work focused on what he described as the “non-voluntary” nature of family relationships and how, in order to tolerate people one is stuck with, but does not like or are destructive to one’s personhood, it is vital to develop strategies to both stay in relation to that person while also establishing protective barriers to keep them at a safe distance. His research into distancing behavior challenged the scholarly and popular literature that tended to equate “closeness” with “goodness” in relationships and distance with “badness” and instead concluded that “both qualities are essential components in the dialectic tensions that govern relationships” (p. 480). More current research into distancing strategies comes from a group of academics that collaborate and are involved in the Family Communications Lab, which is a social science lab based at Utah State University and Michigan State University (Hall, 2016; Scharp, 2014, 2016a, 2016b, 2016c, 2016d; Scharp & Hall, 2017; Scharp & McLaren, 2017; Scharp & Thomas, 2016). Reiterating Hess’s (1996) point that closeness is not always the optimal state given that many parents and children report familial neglect and abuse and, for these reasons report needing to maintain a distance from a family member, Scharp (2015, 2017) focused specifically on the distancing strategies used by adult children to maintain their estrangement from a parent with whom they had a negative relationship. She found that adult children reportedly spent a considerable amount of time engaging in communicative distancing practices in order to maintain their distance. She

also found that they often did not reveal their estranged status to people in their social network due to the stigma associated with estrangement. In a 2017 article which examines three distancing processes—family marginalization, parental alienation and estrangement—Scharp and Hall question whether the paradigm of the family as “involuntary” should be challenged given how stigmatizing it is for those who are marginalized, alienated or estranged. They suggest that shifting the discourse around these “taken for granted assumptions” could “give voice to alternative discourses that entertain, counter, and negate the hegemonic ideologies surrounding family” (p. 38). The implication here is that by being more open about the actual realities that exist within families and between family members the true complexity and variation becomes apparent. This, in turn, loosens the fixed and false broadly held idea that individuals are always better off united with family and makes room for those that are estranged, marginalized or alienated from family to more freely share these realities with others. An earlier study by Scharp et al. (2015) focused on the importance of having a “backstory” for an adult child in maintaining distance from a parent given the familial and cultural pressures to reconcile. This study grounds its findings in a narrative interpretative perspective which argues that we make sense of the world and our interpersonal relationships through stories and, in fact, the “stories construct the reality within relationships” (p. 333). The researchers found that in order to maintain distance from a family member, it was essential for the individuals they interviewed to have a coherent narrative to explain earlier events that led up to the decision to disengage from a parent.

This research study found two distinct types of estrangement backstories: continuous estrangement and chaotic (dis)association. Primarily these backstories told of parental maltreatment or indifference. The participants pointed to either an external event or an internal realization which was the catalyst or “last straw” that led to a final and continuous estrangement (Scharp et al., 2015, p. 343). However, the study revealed the difficulty in sustaining distance and that it required an ongoing effort on the part of the participants to communicate to themselves and to others the story which helped to justify this decision to be able to maintain the estrangement. The second type of estrangement, chaotic (dis)association, refers to instances in which a participant was unable to withstand the pressure to reconnect to the parent. This would lead them to lessen the distance to the parent only to again be reminded of the past maltreatment and distance once again, developing what the authors deemed an “on-again/off-again” (p. 343) pattern. The study found, in these instances, that the reasons the participants gave for wanting to distance changed as participants distanced a second or third time. Some participants were eventually able to maintain distance after a new internal realization or external event which established a new narrative construction of the backstory. A related study by Carr et al. (2015) compared the reasons given for estrangement by a non-matched sample of adult children and parents. Using attribution theory (Heider, 1958), which looks at whether individuals ascribe the reason for a particular behavior to internal or external factors, the researchers found that their study participants’ reasons fell into three primary categories. These were intrafamily, interfamily and interpersonal. Estrangement that occurs due to intrafamily reasons is seen as originating from negative behavior that occurred between estranged family members. Interfamily estrangement is

seen as emanating from external situations outside of the family relationship. Intrapersonal assigns responsibility for estrangement to a personality characteristic of oneself or a family member. This study found distinct differences in how each of these participant groups described the reasons for estrangement with either an adult child or a parent. By and large, the adult children attributed their estrangement from a parent to their parent’s toxic or unsupportive behavior, thus as a result of the personal characteristics of the parent. By contrast, parents more often blamed external factors (e.g., geographic distance, objectionable relationships with individuals outside the family). Yet, for both groups, more often, the onus of blame for the dissolution of the relationship was put on the parent’s behavior rather than the adult child. The authors surmise that this may be due to the social expectation that parents are seen to be responsible for maintaining the parentchild relationship. The above studies from the communications field provide insight into how and why individuals distance themselves from a family member. The communication literature highlights the power of internal narrative in shaping the perceptions of others and relationships and the decisions about future interaction. It also points to how the dominant narratives about family, at least up until the early 1990s and Hess’s (2000) research into distancing privileged closeness within families and between family members. Distancing from a family member requires active rejection of this narrative, the creation of a non-conforming narrative of one’s own and the need to communicate this when there is pressure to reconcile. This echoes some of the conclusions that come out of the sociological literature—that creating distance is a complex process that does not

occur in isolation, but happens in a cultural context where it is often stigmatized because it is a norm violation. The following section which focuses on the clinical dimension of estrangement moves from the broader cultural and interactional aspects of estrangement into a discussion of the literature on the internal, psycho-affective experience of individuals who have chosen to estrange themselves from a family member.

Review of the Clinical Literature While there is overlap with some of the sociological and communications literature that explores the circumstances and processes involved in why and how individuals detach themselves from family members, the emphasis in the clinical realm is on the affective, psychological and relational aspects of the estrangement process and experience. This section will review the literature that addresses the psychological and emotional consequences of ending a relationship with a family member, of living with this decision, and the resources that exist for those who grapple with the often difficult, painful and complex realities of living with estrangement from a family member, both from the perspectives of the estranger and the estrangee.

Causes of estrangement. Many studies have found that intergenerational estrangement does not happen suddenly, but is the final step after many attempts to find other strategies to manage difficult and stressful interpersonal realities within the family context and with a particular individual within it (Agllias, 2008, 2011, 2014; Robinson, 2011; Scharp, 2014, 2016). Agllias (2017) describes estrangement as “a complex socio-politically and

historically situated phenomenon that is regularly entwined with intergenerational stressors, such as a traumatic event, divorce, poverty, mental illness, drug and alcohol abuse and domestic violence” (p. 14). Results from a study conducted by Ipsos MORI (2015) for Stand Alone, a United Kingdom charity serving those who self-identify as estranged from their family, found that 8% of that country’s population reported being estranged from a family member. The common factors that participants attributed to their estrangement were emotional abuse, clashes of personality and values, and mismatched expectations about family roles and relationships. Many of the early precipitants of estrangement stem from dysfunction and instability in the family of origin. Abuse, neglect, marital discord and divorce, a parent suffering from mental illness or substance abuse all negatively affect the bonds between the child and caretaker and can lead a child to choose to distance him/herself from a parent (Agllias, 2015, 2015b; Aquilino, 1994; Scharp et al., 2014). The literature and research on the infant’s attachment to a caregiver offers insight into how parent-infant bonds are formed and how these formative relationships shape one’s attachment style and the quality of future relationships.

Psychodynamic considerations. In an article by Horwitz (2003) on the intrapsychic and developmental processes and structures involved in the capacity to forgive, he points to four theoretical perspectives to think about how one comes to develop this capacity. The intrapsychic process of forgiveness is a useful and related one to apply to the estrangement phenomenon. The choice to either remain connected to an offending parent or to estrange

from them can be reflected upon in this light as having achieved certain developmental capacities. Through the lens of object relations theories, attachment theory, the concept of mentalization and views about mourning, he considers what is involved in being able to feel forgiveness. When one has estranged from a parent they have reached a point where they believe that the differences with the estranged person are not reconcilable. The possibility to forgive and repair has been foreclosed. While the choice to estrange is complex and has multiple determinants, the psychodynamic underpinning can be considered along the same lines as this article on forgiveness. While mourning is not particularly relevant, as the estranged person is living, it may be significant in thinking about what happens to the estranger, intrapsychically, when the estrangee dies. Thinking about estrangement from an object relations perspective, from attachment theory and through Fonagy’s concept of mentalization should deepen the understanding of the psychodynamic issues involved in making a decision to end a relationship with a parent.

Object relations. While the decision to estrange from a parent may represent the most healthy, selfpreserving response to a dysfunctional relationship, it is worth considering the possibility that it also curtails development and perhaps reflects a failure to achieve an intrapsychic shift from the paranoid-schizoid position to the depressive position. Melanie Klein’s theory of the psychological development of the infant describes a move from a primitive state of development where “the self exists predominantly as object” (Ogden, 2004 p. 42)

and through development arrives at the more psychologically sophisticated and mature depressive position which is achieved through a number of developmental milestones. The psychological reality of the infant in the paranoid-schizoid position (age 0 to 3 months) is characterized by managing anxieties experienced by the infant as threats of aggression that risk annihilation, that need to be metabolized through defensive operations. The key defense employed during this phase is to split off the threatening “bad” or endangering experience and project it onto an object (e.g. caregiver) outside the self. The paranoid-schizoid position though is devoid of any self or objects representations. Ogden refers to it as a paradox in that it is a “psychology with no subject” (2004, p. 45). It is only through the mediation of the infant’s projections that the beginning of an interpersonal psychological configuration emerges. Bion (1962a, 1962b) feels that it is through projective identification, in which the mother, through containing the infant’s raw feelings, transforms them into meaningful experience. It is through this interpersonal process that the infant is able to move into the depressive position which recognizes the other as having a subjectivity of their own independent of the infant’s internal and projected reality. Winnicott’s theory of the development of awareness of external objects and of the other’s subjectivity grew out of Klein’s conceptualization of the steps toward the achievement of the depressive position. Winnicott emphasized the role of the mother in the child developing the capacity to relate meaningfully and to be able to empathize with others. He stated (Winnicott, 1968) that it is the mother’s survival of the infant’s destruction that allows the infant to discover her as an external other. It is both her

survival and lack of retaliation and her continuing to be loving and attentive, which Winnicott refers to as the “environmental mother,” that leads to the child’s capacity for concern for her. In Horowitz’s article on forgiveness he speculates that adults who cannot forgive have failed to accomplish these developmental tasks described by object relations theorists. Given that the literature on those that estrange from a parent shows that many report having grown up in households with abuse, neglect and with parents with mental illness, it is easy to imagine that these early developmental milestones were not achieved. Consequently, those who estrange, much like those who cannot forgive, are potentially arrested in their interpersonal development, unable to maintain connection to the damaged and damaging caregiver. Whether estrangement from a parent is indicative of problematic internal and external object representations is a question worth consideration.

Attachment theory. John Bowlby, a major contributor to the understanding of the critical role that the caregiver plays in the psychological well-being of the infant, was a child psychiatrist working in a child guidance center in the late 1930s. In working with delinquent boys separated from their mother or primary caregiver he observed and documented the impact that protracted separations from a mother or primary caregiver had on these children. He witnessed the developmental and emotional damage that these disruptions had and became convinced that they were responsible for later pathology (Bowlby, 1944). Attachment theory, which originated with Bowlby and evolved and expanded with future researchers, has much to offer in understanding the possible precursors that

would lead a child to distance from and to even estrange from a parent. Studies of animal attachment by Konrad Lorenz (1935) and Harry Harlow (1958) strongly suggested that there is a biological basis to infant attachment to a caretaker. These studies revealed that infants seem biologically programmed to keep their caretakers in close proximity as a means of survival. Bowlby referred to these studies as he began his own exploration of human attachment. He extrapolated this to human infants and theorized that humans had behavioral systems, of which the attachment system was one. He theorized that when the attachment figure is unavailable in some way, infants find other strategies to comfort themselves such as hyper-activation and protest or deactivation and compulsive selfreliance. (Shaver et al., 2009). A student of Bowlby, Mary Ainsworth, and her colleagues in the 1970s furthered this work by conducting The Strange Situation experiment, which looked at infants’ behavior toward their mother when the pair was separated and reunited. Ainsworth and her team identified three patterns. They observed the different qualities of infants in the reunion, which they labeled either secure or insecure. Within the insecurely attached group they identified two distinct patterns—anxious resistant and avoidant. The children with avoidant attachment showed no reaction when separated from their mother, did not seem distressed by strangers, and seemed indifferent to their mothers when they returned (Ainsworth & Bell, 1970). Bowlby (1973) theorized that from infancy we develop expectations based on prior experiences with our primary caregivers. For infants who have an avoidant attachment he suggested that their expectations were shaped by parental behavior that was rejecting or emotionally unavailable or unstable. These infants adapted by shutting down and inhibiting their expressions of need for the attachment figure.

Children that develop an avoidant attachment are more likely than others to estrange from parents in adulthood (Agllias, 2017; Shaver et al., 2009). Research by Agllias (2014, 2015b) and Scharp et al. (2014) found that many adult children attributed their estrangement from parents to poor parenting practices, long-term disconnection and physical and emotional abandonment. A study by Wei and associates (2005) focused on the coping strategies used by those whose attachment style was either anxious or avoidant. The findings indicated that those with an avoidant attachment style were more likely to mediate their negative mood or interpersonal problems by cutting off and distancing from others as a way to self-regulate.

Mentalization. The capacity to reflect on one’s own behavior and that of others and be able to use it to assess underlying mental states is a universal human capacity that is developed at an early age and fostered through our attachment figures. Fonagy and Target write that mentalization or “theory of mind is part of an intersubjective process between the infant and caregiver” (1997, p. 690). The interaction between them leads the child to see that his feelings determine his actions and the reactions others have to him and that his experience is generalizable to other people. It is through mirroring and secure play with a parent that children develop this capacity and the ability to distinguish between pretend play and reality. Fonagy and Target (1997) write that it is a “secure attachment… [that] provides the basis for acquiring an understanding of mind” (p. 691). Insecurely attached children and resistant/preoccupied adults are limited in their ability to reflect on their own

behavior and that of others and thus are less likely to be able to empathize with others. Horowitz concludes that those that cannot mentalize are less able to forgive because of this. Given that the research on estrangement and attachment shows that adults who estranged from a parent had been insecurely attached it could be speculated that their capacity for empathy and forgiveness and reconciliation would be limited.

Stressors Some of the causes of estrangement are the result of stressors or challenges to norms, values and roles that exist within the family system. Family stress theory suggests that when the resources within the family are unable to buffer the stresses that are both a part of the normal life cycle or that are non-normative stressors, families are more susceptible to conflict and cut off (Galvin et al., 2008). Some of the reasons given for estrangement are related to choices made that are seen to betray the family in some way (LeBey, 2001; Sichel, 2004). This includes political, moral or religious beliefs, choice of marital partner and sexual orientation. Gilligan et al. (2015) found that similarity of values between mother and adult children is a high predictor of closeness. In contrast, when adult children hold values that are dissimilar to their mother’s there is a greater risk of estrangement. That there are negative repercussions to the bond between parent and child after divorce is well documented (Amato & Sobolewski, 2001; Aquilino, 1994; Cooney & Kurz, 1994; Zill et al., 1993), as is the likelihood that divorced parents are more likely to be emotionally distanced and estranged from a child than those who remain in an intact marriage (Shapiro, 2003). Marital conflict has been shown to disrupt children’s

autonomic nervous system, which may lead to later life health problems (El-Shiekh & Erath, 2011). Children of divorce have been found to be more likely to suffer from depression (Cooney & Kurz, 1996) and have less stable intimate relationships in adulthood (Amato & Booth, 1997) than those in non-divorced families. There is also research that shows that the relationship between the child and non-custodial father (notably, not so with the non-custodial biological mother) frequently deteriorates after the parent and child no longer live under the same roof (Aquilino, 1994). Often children see the non-custodial parents as having abandoned the family and keep them at a distance to avoid further hurt and rejection (Kurdek & Berg, 1987). In high conflict divorces children are often susceptible to a parent who may attempt to negatively shape their child’s view of the other parent. In these instances children often feel compelled to take sides with one parent over the other. In situations in which there is no clear cause to keep a parent away from the child (i.e., a danger) this becomes a form of child maltreatment. Parental alienation is the term used to describe the intentional manipulation by one parent to turn the child against the other parent (Baker, 2007; Warshak, 2015). This form of brainwashing can lead to estrangement between the child and parent who has been cast in this light by the alienating parent (Baker, 2007; Clewar & Rivlin, 1991; Gardiner, 1998).

Bowen’s Theory of Emotional Cutoff Murray Bowen, a family systems theorist, used the term emotional cutoff to describe the psychological process of one family member distancing from another. His theory describes emotional cutoff as the physical or emotional distancing that is enacted

as a way to manage feelings around unresolved emotional attachment to a parent (Titleman, 2003). Bowen theorized that it is both a natural process of separation from a parent, and also an immature reaction that serves to ward off the anxiety of fusion and lack of differentiation from a parent (Kerr & Bowen, 1988). In Bowen’s model differentiation of self is a key concept that refers to the way an individual manages to be in relation to others while also remaining individuated (Bowen, 1982). The highly differentiated person is able to self-regulate strong emotions and anxiety and is more likely to negotiate relationships successfully without needing to distance or cut off from others when there is conflict or tension. Those who are less differentiated are more likely to react to anxiety by estranging themselves from the source of conflict. In his overview of Bowen’s theory of cutoff, Titleman (2003) underscores that “it is an emotional process rooted in the family as a multigenerational unit” (p. 23), and that the parent-child triangle is where it plays out. The emotional maturity and level of differentiation the parents have will determine how well the child can navigate the transition to adulthood. If the parents are in conflict with one another or if the parentchild triangle leaves blurred boundaries and role confusion, then the child’s path to individuation will be fraught with anxiety and is more likely to lead to emotional cutoff (Titleman, 2003).

Adult Child and Parent Narratives of Estrangement There are several studies that explore the reasons given for estrangement and that reveal a different emphasis given by adult children and parents. The article referred to in

the above section on communications literature by Carr and her colleagues (2015) is one such example. This study found that the attributions given by adult children were more likely to be due to the character or toxic behavior of the parent or intrapersonal issues while parents were more likely to see the estrangement as a result of family stressors— intra or inter-family related. Agllias (2015, 2016) conducted similar research looking at the reasons given by adult children for estranging from a parent and the beliefs and understandings parents had about why their children chose to estrange from them. The 2016 study of adult children found many mentioned a long-term disconnection from childhood as a context for the estrangement, either an absent parent or one that was emotionally unavailable. Poor parenting, abuse and betrayal were the three most common reasons given for why they estranged from a parent. When participants spoke of poor parenting, they often referred to authoritarian parenting styles where the parent was demanding and highly critical and where they were subjected to “shaming, scapegoating and favouratism” (p. 98). Verbal, physical or sexual abuses toward the participants or another person were all mentioned as reasons for estranging. And betrayal took the form of family secrets or lies that were revealed and caused pain or embarrassment to the participant, or a parent sabotaging or undermining the participant’s relationships with other people (p. 99). In contrast, in the 2015 study looking at parents’ understanding as to why their children cut off contact, Agllias grouped their responses into three categories—choice, disparate behaviors and values, and punishment. These parents felt their adult children made a choice often between them and another person—the other parent, a spouse or partner. Disparate values and behaviors included attitudes toward “telling the truth,

parenting, money, politics and cleanliness” (p. 121). Agllias noted that these differences were often seen as an affront to the parent and had created a strain in their relationship prior to the estrangement. Where parents felt that their child had estranged from them as a punishment, they saw their child as snubbing them for not fulfilling an expectation, often financial, but also for leaving the family after divorce or not being there as the child grew up. Many of the participants cited stressors that negatively impacted their ability to optimally parent their child, including, “separation and divorce; conflict and domestic violence; a child with a disability or serious illness; miscarriage or stillbirth; forced relocation; poverty; and parental incarceration” (p. 124). They felt that such stressors were responsible for eroding their relationship and were a precursor to the estrangement. Jerrome (1994) draws on material from interviews with elder adults in which she explores the theme of aging and family life. Looking at two of these case studies in-depth to explore how parents and children “lose touch” or become emotionally distant or estranged, she was able to identify several factors ranging from the interpersonal to cultural. The narratives of these elderly parents spoke of the shifting cultural trend toward valuing independence above all else and seeing this as “responsible for the failure of communication between parent and children and a sense of being trapped” (Jerrome, 1994, p. 248). Jerrome theorizes that both parents and children must suppress relational needs and hurt feelings in order to prioritize independence. She goes on to say that the related values of “individualism, autonomy, self-interest—contribute to the reluctance of family members to challenge one another when their personal interests are affected” (p. 249). This also means that it is hard for an elderly parent to ask for help when needed.

Prioritizing independence dovetails with another characteristic of these estranged or emotionally distant dyads: the value of “busyness” and “achievement.” These attributes are aspects of what Jerrome (1994) refers to as “the dominant success ethos of society” (p. 250) Parents take pride in their children when they are hardworking and successful. However, the flip side to this is that it can also mean that children prioritize success in work over connection to family, which can cause the parent to feel neglected. Family structure and gender roles are also relevant to estrangement. Jerrome (1994) draws from earlier studies (Jerrome, 1993; Troll, 1986) showing that men generally leave the family to bond with their wives and choose their wives over their parents if conflict arises. She also references literature that speaks of the “feminine tilt in family life” (p. 251). This suggests that the in-laws on the husband’s side of the family are often alienated from home of the daughter-in-law in which her family values, traditions and norms dominate the culture of the new home. Thus, the role for parents in their son’s new home can become ambiguous or uncertain and potentially inhibits their relationship with the members of that nuclear family. Considering the intrapsychic dimension of the phenomenon of estrangement provides a theoretical perch for clinicians as they assess and work with clients on issues related directly to their estrangement from their parent and more generally around interpersonal and relational difficulties with which they may struggling. Applying Horowitz’ (2003) formulation of the psychodynamic processes involved in forgiveness to those of estrangement is helpful in thinking about developmental milestones that may not have been achieved and the causal relationship between this and the decision to estrange from a parent. Certainly, this is also part of Bowen’s (1982) theory of emotional cut-off.

The literature on the variations in the narratives from the adult child and the parent from Agllias (2015, 2016), Carr (2015) and Jerrome (1994) highlight the intersection between the interpersonal and intrapsychic processes involved in making a decision to estrange. It also underscores how the larger cultural and social context impacts the narratives which individuals tell and believe about the relationships they have with a particular family member. While the reasons for estrangement are documented and while there are differing perspectives on why a parent and child estrange depending on who is describing it, the experience of what this means for the estranged family member remains less clear. The following section explores the scant existing literature on the topic.

Research on the Experience of Estrangement Several dissertations look at aspects of the adult’s lived experience of estrangement from a parent, but there are only two comprehensive, peer-reviewed studies; one a survey study by Blake (2015) and the other a phenomenological study by Agllias (2016) Agllias’s research used an exploratory qualitative design to conduct indepth interviews with 25 participants who had 39 estrangements in total with one or both parents. Twenty-three of these were initiated by the participant; eight were initiated by a parent. There were 35 physical estrangements and four emotional estrangements. The physical estrangements ranged from one month to 39 years, with the average being nine years. From these interviews Agllias (2016) identified five core themes. The first theme was that estrangement came as a relief and led to healing and growth. While the decision

to estrange from a parent was not easy, participants felt that it was their only option “to becoming a healthy and contributing member of society” (p. 10). Rather than try to repair a relationship that was “considered destructive and unmovable,” they made the difficult decision to estrange from that relationship for the benefit of their own personal growth. The second theme was that in spite of wanting to estrange from a parent the participants still experienced their absence as a significant loss. They also experienced anger toward their parent for what had happened to lead to this decision, a decision that comes with its own set of difficulties and stigma. They reported periods of feeling doubt and guilt about the decision, triggered at times by events such as holidays. A third finding was that for many participants the difficulty was not so much the loss of their family, but of the sense of belonging to a family. They missed the “emotional, educational, financial and physical support that family can afford” (p. 12). They missed having “someone who knows you” (p. 12) and felt the loss of historical information that comes down through family and family contact. Many described becoming very independent, but missing having family support, both practical and to help process problems as they arise. Another finding from the study (Agllias, 2016) was that being estranged from a parent led to multiple relational difficulties and affected one’s sense of trust in others. Many of the participants were guarded about their estrangement and were very selective with whom they shared it. Participants reported being very distrustful and avoidant of intimate relationships, but also of longing for closeness that they did not have. Some reported that they remained in unhealthy relationships because of their fear of being alone. Because of their prior abuse many participants were desensitized to mistreatment and tolerated abusive partners.

A final theme from this study was about protecting the gains made as result of the estrangement. Agllias (2016) found that for many of the participants “maintaining the estrangement required considerable emotional and physical energy and often resulted in additional losses” (p. 15). They felt protective of their lives post-estrangement and developed strategies to maintain the distance they had created with their estranged parent. They felt pressure to reconnect from the estrangee and from other family members and often had to estrange themselves from these other family members in order to maintain the primary estrangement. They reported that their resolve became challenged at times when their parent was ill or dying and felt that visiting the unwell parent would be “a step backward from personal growth” (p. 16). Where Agllias’ research used open-ended, in-depth interviews with a sample of 25 participants to derive the common themes of the estrangement experience, Blake’s (2015) survey study had 807 participants and was conducted online. While the different research format led to some different results, there was also some overlap in the data between the two studies, namely as it pertained to trust of others, feeling that estrangement from family carries stigma and the difficulty managing times of the year when families traditionally come together. This research was a collaboration between the Center for Family Research at the University of Cambridge and Stand Alone, the British charity referenced at the beginning of this section. The participants were asked a series of questions to try to understand how they experienced family relationship breakdown. Below is a summary of the areas covered and the participant’s responses. One of the questions asked the participants with whom did they share the details of their estrangement and what their experience of sharing was like. Most of the

respondents had shared their estrangement with close friends; few had shared with acquaintances or colleagues. Of those who were married or in a civil partnership, 96% had told their partner the full story. They also felt that talking to a close friend was “very” or “somewhat” helpful and talking to an acquaintance or colleague was “somewhat” helpful. The participants said that they had received both emotional and practical support, and felt that just being listened to and believed made a positive difference. They also were asked what was unhelpful to which they listed feeling blamed and judged, getting a dismissive or disbelieving response when sharing the estrangement and having others avoid the issue altogether out of discomfort. Most of the participants felt there was stigma associated with estrangement. The participants felt that others assumed they were at fault for the estrangement and were judgmental. The participants experienced others’ rigid belief around family and sticking together no matter as another reason they were judged; they felt criticized for having abandoned their family. They thought others lacked understanding because they lacked the experience of growing up in a less than loving home, and that was another factor the participants listed for the stigma surrounding estrangement. They also mentioned that because estrangement is not talked about and remains taboo, that it instills fear and confusion in those who have no understanding of it. Other factors mentioned were religious or cultural values that harshly condemn moving out of the family and contradictory expectations around holidays from family and friends. Many of the participants reported that certain events and times were harder than others. The holiday season was at the top of the list for 90% of these participants, followed by birthdays, being around other families, a death of a family member, Mother’s

and Father’s Day, December in general, seeing photos on Facebook or social media, weddings of family members, births in the family, breakups and difficult relationships, financial stress, and anniversaries of relationships. Participants said they turned to counselors and therapists, physicians, religious leaders, social workers and the police for support. Participants ranked counselors, therapists and physicians as most helpful in that they felt seen and taken seriously by them. When the participants had a negative experience when turning to a professional for support, they mentioned having their problem minimized or seen as a medical issue for which they were prescribed medication rather than understanding it as the complex psychological and emotional issue that it is. Encouragements by the professional to forgive the family member from whom they were estranged and/or reunite with this family member were other unhelpful responses from professional or religious authorities. A handful of dissertations have been written that touch on various aspects of the lived-experience of individuals estranged from a family member. A dissertation by Reifman (1986) found a positive correlation between cut off with family of origin and decreased marital intimacy. Another dissertation by Macklebury (1988) focused on the effects of depression and cut off from family of origin in a quantitative study using an intimacy measurement instrument, the Waring Intimacy Questionnaire, and the Beck Depression Inventory. The findings from this study refuted Reifman’s (1986) findings and found no correlation between cut off and marital intimacy, but did find a correlation between depression and decreased marital intimacy. Another dissertation by Ring (1998) used a qualitative approach to look at the experience of emotional cut off and reconnection between parents and adult children. The

15 subjects were both parents and adult children. This study found that the majority of the participants described the experience of being cut off as negative, describing the period as one filled with hurt, anger and pain. Conversely, many of the participants described reconnection as positive, occurring after they had achieved some personal growth which was expressed through the ability to separate, yet stay connected without a feeling of obligation, an ability to hear others’ views without becoming emotionally reactive and expressing their own with less reactivity, and recognizing the other person as an adult. Finally, a dissertation by Robinson (2011) used a qualitative approach to study the experience of 15 participants who were estranged from a parent, sibling or child for at least one year during adulthood. Some were still estranged and others had reconciled. The findings parallel Scharp’s (2015) findings in that they suggest that estrangement is experienced “as a complex process or personal transition and continual adjusting, which involves the negotiation of emotional and ideological distance from family relationships” (Robinson, 2011, p. 63). These studies bring to light some of the issues common to people who have estranged from a family member. Most notable are the feelings of being judged or misunderstood by others and that there is a stigma attached to having estranged from a family member. Another common theme is the difficulty managing certain times of the year when families typically come together. Each of these studies asks slightly different questions, but all draw out important aspects of the lived experience after having ended contact with a family member.

Estrangement and Ambiguous Loss The term ambiguous loss refers to losses that, unlike in the death of a loved one, occur without closure (Boss, 2006). There are many circumstances that might lead to someone experiencing ambiguous loss. Boss (2006), who researches and writes extensively on the subject, describes two types of losses that characterize ambiguous loss: physical absence with psychological presence and physical presence with psychological absence. She states that both types “have the potential to disturb and traumatize relational boundaries and systemic processes” (p. 7). Examples of the first type are missing persons or missing bodies due to war or terrorism or natural disasters such as earthquakes or tsunamis. In the second type a person is psychologically absent in that they are emotionally or cognitively missing, such as with dementia, brain injury, depression, addiction or other chronic mental or physical illnesses. Boss emphasizes that ambiguous loss is “a relational disorder, and not an individual pathology” (p. xviii) and, because of this, requires family and community-based interventions rather than individual therapy to support those experiencing it. Agllias (2015) notes that the loss experienced by parents whose children have estranged from them is a form of ambiguous loss. It is a situation where a family member is physically distant, but “a complex interplay of psychological and social factors keeps the estranged member psychologically present” (p. 109). It is a loss where one is unable to grieve and thus unable to move past and heal as one can with a family member who is physically dying.

Resources for Those Who Are Estranged from a Family Member There are a number of self-help books written by clinicians and non-clinicians aimed at helping those who are living with estrangement from a family member. Coleman (2008), a psychologist who specializes in working with families, wrote a book that offers advice specifically for parents who have been cut out of their child’s life. He focuses on helping parents reduce the guilt and shame that are very common reactions to having been estranged from a child. By describing the factors that shape family life and interfamilial dynamics ranging from parenting, effects of divorce and conflict on children, to differences in temperament between parent and child, Coleman helps educate families about what are possible contributors to estrangement and suggests ways to accept oneself and the estranged child. He also offers advice on ways to work toward mending the rift with the estranged child. LeBey (2001), a lawyer and former judge who became interested in the topic of family estrangement after her own experience of being estranged by her son, recounts the stories of several different people that experienced estrangements from a family member. Applying material from a broad range of literature—clinical, sociological and narratives from others’ experiences with estrangement and her own—to the vignettes outlined in her book, she theorizes how estrangement comes to be. She discusses how estrangement might occur from a sense of betrayal or disloyalty to family and also about how life transitions can disrupt the stasis in the family making it less cohesive and more vulnerable to estrangement. In addition, her book offers suggestions for repairing the relationship with the estranged family member.

A book by Sichel (2004), a clinical social worker, also focuses on the estranged person and offers guidelines for coping with the loss of a family member and advice for how to move forward. Inspired by his own experience of having his parents cut him out of their lives and from his patients’ accounts of their own experiences of being cut off from a family member, Sichel outlines the lessons he learned from these experiences to produce this self-help book. Describing estrangement as a traumatic event, he begins by laying out the symptoms of trauma and instructing the reader to seek support from family and friends. The next chapters move from understanding family roles and family myths to letting go of resentment, discussion of measures to be taken in order to reconcile, developing qualities such as gratitude and emotional generosity and empathy that he states are often not highly developed in those that were raised in dysfunctional families. Cultivating these attributes, he believes, will lead to personal growth and healing and to better interpersonal/interfamilial relationships. The last chapter of his book explores how to apply the earlier lessons to everyday interactions with others and use them to make choices in relationships which enhance connection and lead to positive outcomes.

Online Blogs and Support Groups A search online for “support for family estrangement” produces many links to online advice, Meetups for individuals estranged from a family member, estrangement blogs and therapists who work with estrangement. Looking further on these sites reveals estrangement groups that address the many configurations of the estrangement experience. There are groups for adults who have been estranged and those who have

been the initiator of the estrangement; there is support for those who are estranged from a parent, a sibling, a child and a grandchild. There are numerous articles offering advice and education for those who are dealing with an estrangement. Stand Alone has a website for those seeking support through estrangement. Coleman hosts an online forum on a variety of topics and for both those who have estranged from a family member as well as for parents who are dealing with a child estranging from them. There is a Facebook page for “rejected parents” as well as an online site called Meetup which provides a space for those to chat with others about the estrangement experience and get support from those who are also estranged from a family member. These are just some examples of what is offered online to support those who are estranged from a family member. That estrangement has such a prolific online presence speaks to how common the experience is as well as how difficult it is to cope with. It is apparent that many people feel very alone with the experience and are looking to find some support and understanding from others that are also living with no longer being in touch with a family member, whether by their own choice or that of the family member.

Literature on Working with Estrangement in Psychotherapy There is a dearth of research available on adult children’s experience of addressing their estrangement from a parent in therapy. While the Stand Alone (2014) survey and Agllias’ (2017) research did ask their participants broadly about what had been helpful in addressing the issues that arose living with estrangement from a parent, the focus was not on understanding the therapeutic work and its effect.

Most of the literature that exists relating to treatment for estrangement focuses on reconciliation. The bulk of this comes out of the family systems tradition and views cut off or estrangement as a problem in the family system that needs to be repaired. A paper by McGoldrick and Carter (2001) describes how to use “coaching” with an individual as a way to intervene in the family system with the goal of helping “clients define themselves proactively in relationship to others in their families without emotionally cutting off or giving in” (p. 281). Dattilio and Nichols (2011) outline an approach to reuniting estranged family members by combining cognitive-behavioral techniques with an integrated family systems strategy. They theorize that most cases of cut off are a result of hurt feelings and describe interventions which provide family members with skills needed to diffuse the intensity of these feelings and reconcile. Agllias (2017) is the one academic researcher who discusses approaches to clinical intervention for therapists working with individuals who are living with estrangement. Her opinion is that “estrangement related grief does not necessarily require intervention” (p. 158) and it is only when it does not abate that professional help might be indicated. She cites her earlier research that found that therapy was not found to be helpful when individuals sought it out as a “quick fix” immediately after the estrangement occurred. Agllias suggests that when clients are seeking treatment when they are in acute pain, in order for therapists to establish a trusting therapeutic alliance they should: 

attend to issues of grief and loss…normalize the estrangement experience, proactively



seek and clarify the client’s purpose early in the session, clarify the limits and boundaries



of intervention, explain the notion of ambiguous loss, and realistically explain the possible benefits that might accrue from a future exploration of estrangement and its effects (if this is something the client wants to pursue sometime down the track. (p. 159).

Agllias’ (2011, 2014) research also found that her participants who began therapy long after the initial estrangement had more positive outcomes. These individuals tended to want to work on some residual emotional reactions that had surfaced. The responses that Agllias got from them revealed that the most effective practitioners normalized the estrangement experience and reflected back to the client that loss of family due to estrangement is complex and difficult given its “marginalised or stigmatised status (sic)” (Agllias, 2017, p. 159). They also acknowledged the client’s strengths, resources and progress. Given that symptoms of trauma, grief and loss are common in those who are estranged from a family member, Agllias (2017) recommends treatments that focus on “continuing bonds…where the acceptance of the estrangement is supported by the creation of a new relationship with the other rather than full detachment” (p. 162). She cites cognitive behavioral therapy, motivational interviewing and acceptance and commitment therapy as approaches that can be particularly helpful in reducing stress and anxiety and unhelpful thought patterns that are all aspects of the estrangement experience.

Conclusion The literature from the field of sociology on the structure of the family and the way conflict and negative emotion is managed intergenerationally as well as the research from the field of communications on distancing strategies provide a good overview of the alternative options employed to cope with problematic intergenerational relations other than estrangement. The clinical literature more directly describes the interpersonal dynamics that lead someone to finally decide to cut off contact with a family member. Much of the clinical literature on estrangement is focused on the reasons for estrangement, reconciliation, or support and/or guidance in coping with having been estranged from a family member. Very little has been written about the experience of the adult child who has decided to end connection and communication with a parent, apart from Agllias’ (2017) study of the lived experience of those estranged from a family member. Her work begins to look with more complexity at the ongoing experience of those who were cut off from a family member, either through their own choice or the choice of the family member. There are also some important inferences regarding conclusions that can be drawn about how therapy can be helpful for those who are grappling with their decision to estrange from a parent. However, this issue has not been given explicit consideration in the existing literature. This study furthers the research on this topic with a focus on the lived experience of estrangement from the perspective of the adult child who initiated the estrangement, with special attention to the experience of therapy in working with issues that arise because of the estrangement. Since the research shows that there are different perspectives held by adult children and parents as to the reasons for estrangement, it

seemed that there would also be a distinction between the lived experience of the estranger and the estrangee. Through researching the lived experience of the adult child who has cut out a parent from their lives and their experience addressing this issue in therapy, this study provides further understanding of their experience with hopes of it being helpful to clinicians working with clients who have made this decision.

Chapter III

Methods Introduction The purpose of this phenomenological study was two-fold: to understand the lived experience of adult children who have chosen to estrange themselves from a parent, and, to use the results to help clinicians understand the common issues facing this population. The focus was on understanding the impact this decision had on their lives on multiple dimensions—emotional, psychological, interpersonal and interfamilial/intergenerational. The other goal of this study was to understand the way therapy has been experienced by this population in addressing the issue of estrangement. To achieve these ends, the research questions that were posed in this study were: 1. What is the adult child’s lived experience of having intentionally ended a relationship with a parent where the adult child is resolute in this decision? 2. What are the emotional and psychological and relational ramifications for people who have severed ties to a parent as a direct correlate of this decision? 3. What has been the experience of therapy for these individuals in addressing the estrangement. The following section will describe the research design and specific approach to gathering data from the participants and how the data was analyzed.

Rationale for Qualitative Research Design This study uses a qualitative approach. This approach is well-suited to a study that describes the meaning people make of their social world. In contrast to quantitative research, which measures discrete occurrences of predetermined categories, qualitative interview research is an open and flexible approach that collects data from naturalistic, verbal reports with the goal of describing, exploring, and interpreting personal and social experiences. The way this is often accomplished is through in-depth recorded interviews which allow the researcher to enter the subjective world of the participants to learn how they describe and make meaning out of the area of inquiry.

Rationale for Interpretive Phenomenological Analysis The qualitative method which was used to conduct this research was interpretive phenomenological analysis (IPA). This method is grounded in phenomenology based on phenomenological philosophy developed by Edmund Husserl at the beginning of the twentieth century. According to Giorgi and Giorgi (2008), the motivation for developing a phenomenological approach to analyzing data was to create a scientific method to understanding consciousness. The timing of Husserl’s interest in consciousness coincided with the emergence of the field of psychology which also was focused on the study of consciousness, so there was overlap between the two and application of the concept in psychological studies. In essence, phenomenological psychological research is the study of subjective experience. Smith and Osborn (chapter in Smith, 2008) describe IPA as a method which uses the phenomenological approach to get at the lived experience of the participants, but also

“emphasizes that the research exercise is a dynamic process with an active role for the researcher in that process” (p. 53). In further explanation of what this means they write: Access depends on, and is complicated by, the researcher’s own conceptions; indeed, these are required in order to make sense of that other personal world through the process of interpretive activity. Thus, a two-stage interpretation process, or a double hermeneutic, is involved. The participants are trying to make sense of their world; the researcher is trying to make sense of the participants trying to make sense of their world. (p. 53) This approach both gathers deep, descriptive data from the participants and also holds the subjectivity of the researcher as a meaning-maker in her own right. The emphasis is on culling the essence of how individuals experience their world and then on decoding that meaning. This study addresses three primary research questions: (a) what is the lived experience of estrangement from a parent for an adult child? (b) What are the emotional and psychological and relational ramifications for people who have severed ties to a parent as a direct correlate to this decision? and (c) what has the experience of therapy meant for this population in dealing with estrangement? Because all of these questions rely on the meaning made from an experience, an interpretive phenomenological approach is well-suited to gather data pertinent to these questions. It allows for a narrative to unfold and room for the researcher to probe further to flesh out a more thorough and nuanced understanding of the participants’ communication.

Research Sample Interpretive phenomenological studies are in depth analyses of the data gathered from individual cases. For this reason, the sample size is small. While there is no rule as to the number of participants to include in an IPA study, there are several factors to consider in determining the optimal number. Pietkiewicz and Smith (2012) outline some of these: “1. the depth of analysis of a single case study, 2. the richness of the individual cases, 3. how the researcher wants to compare or contrast single cases, and 4. the pragmatic restrictions one is working under” (p. 4). Smith (2008) reports that in the recent past five or six subjects has been the recommended number of participants. He refers to a paper by Turpin et al. (1997) who report that doctoral programs in Britain recommend six to eight as an appropriate number of participants for an IPA study. However, Smith himself recommends beginning students start with a sample size of three which “allows sufficient in-depth engagement with each individual case but also allows a detailed examination of similarity and difference, convergence and divergence” (p. 57). Because the sample size in an IPA study is small, it is recommended that researchers find a fairly homogenous sample. This is in order to have a “more closely defined group for whom the research question will be significant” (Smith, 2008, p. 56). What criteria determine the homogeneity of a sample is dependent on the nature of what is being studied. Taking all this into account for this study of the lived experience of adults who are estranged from a parent, I specified the inclusion criteria which was used in selecting participants and in thinking about the sample size. Since it is important that the participants lived enough time after the decision to end their relationship to a parent to be

able to gather a rich account of the factors which arise, and which may only be apparent after some time, the participants all had to be estranged for at least three years and be between the ages of 24 and 64 which falls within the correlates to the establishment (2444) and maintenance (45-64) stages of development in life rainbow model and also ensures that the participants are fully into the establishment phase making the participant group more homogeneous along the axis of life phase. In this model these stages of development one’s self-concept has stabilized and matured. The point of estrangement dad to have to have occurred in late adolescence or later to exclude individuals who may not have been wholly responsible for the estrangements given that they would have been minors at the time and their volition would have been limited. In order to draw on material that examines the clinically significant issues of living with a decision to estrange from a parent, care needed to be taken to select participants who had not been so cruelly abused by a parent that the trauma was the central factor shaping the relationship to the parent. This was one of the primary exclusionary criteria. While there is value in looking at the meaning estrangement has for this group of abuse survivors as well, it has the potential to skew the emphasis away from the more nuanced and subtle aspects of cut off from a parent that is the focus of the study. In order to get a deeper understanding of the clinical issues that confront this population and to understand the way therapy has or has not been helpful and why, the participants had to have been in therapy in which they addressed the estrangement as a criterion for inclusion in the study. With the above parameters to determine the participant selection as a control for the homogeneity of the sample, I kept the participant sample size between three and five. Each participant was interviewed three times which allowed for more thick, descriptive

data. The sample size and multiple interviews enabled me to find significant similarities and differences between participants and to be able to identify common themes.

Research process Steps used to carry out this research were: 1. Once the study was approved, I performed a pilot interview who fit the criteria for the subjects for my study. That is to say that she was between 30 and 60 years old, had chosen to estrange from a parent and had been estranged from the parent for at least 3 years with no history of sexual or severe physical abuse. 2. Next, I used purposive sampling by initiating inquiries to professional membership organizations, colleagues, personal contacts and on-line support groups for those who are estranged from a family member. I sent a letter or email outlining the nature of the study and the participant criteria that I was looking for. 3. For prospective participants who contacted me, I sent a letter via email with the description of the research project and the methodology, a letter outlining the criteria for inclusion (see Appendix C), and the consent form (see Appendix A). 4. Once I recruited all the participants for the study, I contacted them by phone to review the informed consent. This is so they could be given an opportunity to express their understanding of the consent. Once the participants demonstrated understanding of the purpose of the study and what was going to be asked of them in the interview, I sent them a copy of the interview questions to get them further oriented as to what to expect in the interview and so they could reflect on the questions beforehand. We set up a meeting time and determined whether we will

meet in person at my office or via Skype or Zoom. At that time, I asked the participants to select a pseudonym that was used in all forms of data collection including interview. 5. Using a semi-structured interview guide I used an audio recording to interview each participant. 6. The interview audio recordings were then sent to a professional transcriptionist for transcription. Once the professional transcriptionist had returned the transcriptions, I vetted them for accuracy. 7. Using the guidelines for analyzing data for an Interpretive Phenomenological study laid out by Smith (2008), I became very familiar with the interviews by reading and re-reading each transcript. I broke down each section of the interview by paraphrasing or summarizing the content, using the left-hand margin to annotate what the participant said. 8. Once this was completed, I returned to the beginning of the transcript and began to identify themes. I noted these emerging themes in the right-hand margin. 9. I then looked to see if I could identify connections between themes as I listed them chronologically. 10. I then moved to a more analytical ordering whereby I tried to make my own connections between these emerging themes. Smith (2008) explains that in doing this kind of analysis “some themes cluster together and some may emerge as superordinate concepts” (p. 70). I made a list of these themes and checked back with the transcript to make sure that my list of clustered themes was reflected in the actual words of the participants.

on the topic. Identifiers--page number and phrase from transcript-- were noted that reflected where on the transcript the example of the theme occurs. 12. After completing this process for all the participants’ transcripts, I then created a final table of superordinate themes that occurred across participants. I again used identifiers to reflect where the instance occurred for each participant. By doing this I was able to compare and contrast the data across participants and find where meanings converged and diverged in order to be able to note the broad themes as well as the more idiosyncratic themes.

Data collection Data for this study was be collected through semi-structured interviews which will be audio recorded. This form of interviewing allows for some flexibility in that while there is an interview schedule in advance—meaning that there is thought put into the shape of the interview and potential difficulties that might arise through the interview process—it leaves room for the “the researcher and participant to engage in a dialogue whereby initial questions are modified in the light of the participant’s responses and the investigator is able to probe interesting and important areas which arise” (Smith, 2008, p. 57). Kvale and Brinkman (2009) advise that “A good interview question should contribute thematically to knowledge production and dynamically to promoting a good interview interaction” (p. 131). They recommend developing two interview guides when preparing the interview “one with the project’s thematic research questions and the other with interview questions to be posed, which takes both the thematic and dynamic

dimensions into account” (p. 132). The research design for this study followed this recommendation in preparation for the final interview guide. I interviewed each participant three times. Each interview was approximately one hour. I recorded the interviews and transcribed the recordings. I used an interview guide with questions that probe the topic of the study (see Appendix A). The interview guide covered both the broad questions to be addressed as well as the sub-questions that were of interest. It served as a guide and the questions were for me to refer to as the interview unfolded with the goal of prompting the participants to discuss central research questions. While the back-story of the decision to estrange from a parent was not the focus of the research, it was critical information for the analysis of the data. Thus, each interview began by asking participants to describe the factors that led them to the decision to estrange themselves from their parents. Having gathered this background data, I then began to explore the research questions. The first area of inquiry is apparent in two questions: (a) What is the adult child’s lived experience of having intentionally ended a relationship with a parent where the adult child is resolute in this decision? (b) What are the emotional and psychological ramifications for people who have severed ties to a parent as a direct correlate of this decision? and (c) what has the experience of therapy meant for this population in dealing with estrangement? In order to address the first of these questions I explored how the participants described and marked meaning out of this experience. Follow up questions were prompts around different areas of life that may be affected—relationships with other members of the family of origin, current relationships with friends and significant others, practical concerns related to money, housing, health and support.

In order to address the second question on the emotional and psychological ramification of the decision to sever ties to a parent, the interview focused on the exploration of the intrapsychic and interpersonal issues that can be seen as a by-product of the estrangement experience. The prompts were toward getting the participant to talk more about internal narratives about themselves and others. The third area of inquiry has to do with the therapy experience. In order to gather this information, participants were asked about the circumstances that made them choose to enter therapy. They were sked about the duration of the therapy, the orientation of the therapist, the length of time in therapy. They were then asked to describe their experience of talking about the estrangement in therapy and if needed, follow up prompts explored their experience further. They were asked what was and was not helpful and what thoughts they have about what they feel therapists working with this population should be aware of. Before beginning each interview, I reviewed the purpose of the study and issues of confidentiality and had the participants sign the informed consent which they received prior to the interview.

Recruitment This study aimed to get at the lived experience of a very specific phenomenon. Recruitment was done using purposive sampling, aiming to find participants who met the criteria of this more closely defined group. Thus, the recruitment materials specified the criteria for participation in the study. These being that they were an adult child that has been estranged from a parent for at least 3 years, at least 24 years of age, and that they

had not experienced physical or sexual abuse by this parent and that they had addressed this issue in therapy. I recruited participants through recommendations from colleagues or personal connections and from professional membership organizations in the San Francisco Bay area. I sent a letter (see Appendix D) describing the study and the details of what I was searching for in the way of participants. I gave this letter to colleagues and other contacts that potentially would have connections to the target population. I also posted an advertisement (see Appendix E) in the Berkeley Psychotherapy Institute’s newsletter and in online support groups for individuals who are estranged from a family member. This posting requested that anyone who felt they meet the criteria for inclusion in the study to contact me by phone or email. I then sent a letter to those who contacted me with a description of the research project and methodology, the consent form (see Appendix A) and a brief screening letter (Appendix C). I telephoned the participants I selected for inclusion and set up a time and place for the interview. Once I recruited all the participants for the study. I sent them a copy of the interview questions to get them oriented to what to expect in the interview and so they could reflect on the questions beforehand. Interviews were conducted in my private psychotherapy office or in the participant’s home.

Data analysis and presentation of findings.

In analyzing the data, I followed the IPA guidelines laid out by Smith (2008) in which the emphasis is on understanding the meaning and “the aim is to try to understand the content and complexity of those meanings rather than measure their frequency” (p. 66). This process involved first transcribing the recorded interview, then reading and rereading it in order to become very familiar with it. The next step involved a preliminary interpretation, breaking down each section of the interview by paraphrasing or summarizing the content, using the left-hand margin to annotate what the participant said. Once this stage was completed, I returned to the beginning of the transcript and started to identify themes which became apparent to me as I read, summarized and condensed the content of the transcript. I noted these emerging themes in the right-hand margin. Moving from this into finding connections between the themes, I listed all the themes chronologically as they came up in the interview. Then I moved to a more analytical ordering whereby I tried to make my own connections between these emerging themes. Smith (2008) explains that in doing this kind of analysis “some themes cluster together and some may emerge as superordinate concepts” (p. 70). The next step was to make a list of the themes that appear to cluster together. As I did this, I continued to check back with the transcript to verify that my list of clustering themes actually reflected the words of the participant. Following this, the next step was to make a table of the themes. Using Smith’s (2008) protocol, I gave the clusters a name that represents a “superordinate theme” that reflected the participant’s most central ideas/feelings on the topic. Identifiers were noted which reflected where on the transcript the example of the theme occurs. Smith

recommends using both the page number as well as a phrase from the transcript as identifiers. I did this in my study. After completing this process for the transcripts of all the participants I then created a final table of superordinate themes that occur across the participant group. I again used identifiers to reflect where the instance occurred for each participant. By so doing I was able to contrast and compare the data across participants and find where meanings converge and diverge to be able to note the broad themes as well as more idiosyncratic themes. I have presented the data in two chapters. The first, the results chapter, is a summary of the data and the findings. I outlined the themes and used examples from the participants’ responses to show how I arrived at them. The second chapter is the discussion and analysis of the findings and how they relate to the extant literature, and how the findings might inform clinical work

Ethical considerations. In order to maintain confidentiality, all the participants’ names were changed, along with any identifying information. To ensure that the participants were protected should they become emotionally dysregulated through the interview process, I had to plan certain safeguards as stated in the consent form (see Appendix C). Before conducting the interview, I stated that if at any time they feel the interview is too distressing to continue, they should let me know and we would end it. I also told them that if there were any questions that they do not want to answer they just need to say. If they became unsettled through the interview, I planned to stop the interview, offer

support, and check to see whether or not they want to continue the interview. I had a list of three therapist referrals to offer them if necessary. This turned out not to be needed in any of the interviews.

Issues of Trustworthiness The criteria used to measure the meaningfulness and significance of a qualitative study are similar to, yet, necessarily, different from those used in a quantitative design study. Where quantitative studies measure discrete phenomena and seek assurance of the validity and reliability as the measures of the solidness of any particular study, qualitative studies, that are measuring data which is primarily gathered through interviews with human subjects, is held to a different set of criteria for assessing the trustworthiness of a particular research design. Trustworthiness as a term for describing the significance of a qualitative study was introduced by Guba (1982), Guba and Lincoln (1982) and Lincoln and Guba (1985). Establishing trustworthiness as the standard for qualitative design, Guba (1981) posits four criteria that are necessary in ensuring that a study meets this standard--credibility, dependability, confirmability and transferability.

Credibility. For a study to be credible it needs to show that it is measuring what is intended, that the findings are accurate and the methods used are going to elicit the information that will answer the question(s) being asked. Marshall & Rossman (2016) contend that credibility of a study means that it needs to be accurate and credible from the standpoint of the researcher, participants, and the reader.

According to Bloomberg & Volpe (2019) credibility “involves consideration of the interrelationship between the research design components--the studies purpose, theoretical or conceptual framework, research questions and methods” (p. 223). To that end, in this study I achieved this by triangulating the recruitment sources, ensuring a thick description by asking open-ended questions and allowing participants to elaborate on their responses and asking follow up clarifying questions. When coding data I shared the data with my dissertation committee and got their feedback as to my interpretation and conceptualization of meaning.

Dependability. The correlate of dependability in quantitative research is reliability which is the measure of a studies consistency and whether it can be repeated with the same outcome. It has been noted (Fidel, 1993; Marshall and Rossman, 1999) that due to both the small sample size and the changing nature of the phenomenon being studied this term is problematic in qualitative studies. Dependability then becomes a better descriptor for qualitative studies. For a study to be dependable it needs to be outlined and administered clearly and systematically and the findings need to reflect the data that is collected. In order to achieve dependability in my study, I provided an audit trail--copies of my research questionnaire, documents of all my data and documentations of how the data was analyzed.

Confirmability. Confirmability is the correlate of objectivity in quantitative research. It is concerned with ensuring the findings are really reflective of the data and guard against the researcher’s biases. In order to assure the confirmability of this study I noted my assumptions as I entered this research process (see Introduction). I provided an audit trail so that my choices in research questions and data analysis were part of the record. I documented any reflections I had throughout the research process in order to show how my thinking was being shaped by the research.

Transferability. Transferability refers to the qualities within a study which make it possible for others to apply what was studied and the conclusions drawn to another similar context. While qualitative studies are not generalizable to a broader population as many quantitative studies can be, they can provide data that can be useful in another setting. The study, to be transferable in this way, should “develop descriptive context-relevant findings that can be applicable to broader contexts while still maintaining their contentspecific richness” (Bloomberg & Volpe, 2019, p. 205). Toward this end, the proposed study was to provide a thick description, i.e. as much detailed information about the contexts of how the subjects were recruited, their demographics, sample size, the interview settings and transcripts, the investigator’s impressions and careful and thorough explanation as to how data was interpreted.

Limitations and delimitations. I drew on a small sample of individuals who live in the Bay Area of northern California. This means that it excluded people from other areas of the county, but also, from the larger world. Estrangement for someone brought up in a Western culture will undoubtedly mean something different from someone brought up in a society in which the family structure and norms are vastly different. And even within this population, I would not be able to control for the familial culture in which the participants were raised. The meaning of estrangement from a parent may be very different between participants whose families hold other cultural expectations. Because the sample size is small, it means the study was exploratory and not generalizable. The study also asks participants to rely on memory which can sometimes be revised or inaccurate. Other factors that I have not controlled for in the study have to do with age, race, gender, sexual orientation and socioeconomic status.

Conclusion This study uses a qualitative design to explore the lived-experience of adults who have estranged themselves from a parent and their experience in therapy addressing issues pertaining to the estrangement. Qualitative studies are useful when looking at rich, descriptive data gathered through participants’ subjective account of their experience. The qualitative design for this study is Interpretive Phenomenological Analysis which is an approach which is optimal for a study of lived-experience. This approach applies a twostage interpretive process in that it gathers the participants’ description and the meaning

they make of their experience and then recognizes the researcher as an active participant in the meaning made of this data. Participants were recruited through colleagues, personal connections, ads in professional organizations and online support groups for those estranged from a family member. Once I had five participants, I began to screen them for appropriateness for the study. I took the appropriate measures to ensure their confidentiality was protected and to set up safeguards to protect their safety and sense of agency throughout the process-reviewing the informed consent with them, making sure they understood that they could end the interview at any time and making sure to have referrals to therapists available if necessary. I took the necessary steps to establish the trustworthiness of the study. I considered the qualities of credibility (is the research design studying what it is intended to study), dependability (is the design replicable), confirmability (are there safeguards against researcher bias) and transferability (can the results be applied to other similar situations). I outlined how each of these issues were addressed and noted that there are some limits to the generalizability of the study given its small sample size and the local pool that the participants were drawn from which means that broader socio-cultural distinctions won’t be accounted for. After all these steps were taken, I began conducting the interviews. Once they were completed, they were sent to a transcription service and transcribed. I used these transcribed interviews to then analyze the data and look for themes in greater and greater levels of abstraction as outlined above. I did this for each participant’s data and then went back and compared data between participants looking for overlapping themes.

Chapter IV

Results Description of Research Process I first conducted a pilot test with a volunteer who fit the criteria for inclusion, recruited through a personal connection to the investigator. This was a useful exercise in preparing me to conduct the interviews with the participants. This interview helped me identify how to keep the interviewee on track and when redirection or prompting for more information was needed. It also allowed me to work with the recording devices and figure out how to make sure they were recording properly. Writing up a summary of the interview and going through the steps of the analysis was useful. It helped me better gauge what to expect in both the substance of what might be talked about and the potential emotional reactions to questions, making me better equipped to navigate the interviews. After the pilot test, five individuals were recruited. Three of them responded to a posting on the social networking site Next-Door and each of the other two were forwarded the recruitment post from their therapists who had seen it on a list-serve for therapists. Four of these individuals met all the criteria for inclusion in the study. During the interview process with the fifth recruit it was revealed that she had, in fact, not been estranged long enough (one and a half years instead of three) to meet the requirements for

inclusion. While this recruit completed the interviews, she could not be included in the formal study. The four remaining recruits completed the requirements for participation in the study. They were all women between 40 and 60 years old. Each was interviewed three times for a total of 12 interviews. The first interview gathered the backstory to the estrangement, the second interview addressed the two research questions aimed at exploring the lived-experience of estrangement and the third interview addressed the participants’ experience working on issues around the estrangement in therapy. All interviews were recorded and sent to a transcription service (Rev.com) to be transcribed. I listened to each interview, read through the transcripts, coded them, at first summarizing the data, and then moving to identifying higher order concepts that emerged from the initial coding. These emergent themes were identified for each participant and written up so that they could be compared and connections between each participant’s case and superordinate themes for each research question could then be identified. Through this section I have identified where a particular quote is located with its timestamp. Noting both which of the three interviews it came from and the line number from that transcript.

Introduction to Sample The inclusion criteria for participating in the study was that participants be between 24 and 64 years old, that they be estranged from a parent for at least three years, the estrangement began in late adolescence and that they did not experience severe physical or sexual abuse from the estranged parent. Participants also needed to have been

in therapy where they addressed issues related to the estrangement. All the participants met the criteria for inclusion. All participants were female between the ages of 40 and 60; identified as white and one was mixed Chinese and white. All live in the San Francisco Bay Area. Table 4.1: Participant Demographic Data Pseudonym

Current Age

Years Estranged

Race

Partner Status

Has Children

Ilana

White

married

Elinore

White

married

yes

Elsa

divorced

Barbara

Mixed Chinese and White White

married

yes

Summary Data

Avg: 46.5 Min: 40 Max: 53

Avg: 14 Min: 4 Max: 23

Mode: White (n=3)

Mode: Married (n=3)

Mode: Yes (n=2) No (n=2)

Description of Participants and Backstory of Their Estrangement Ilana. Ilana is a 51-year-old married, Caucasian-American, Jewish woman. She has no children. She estranged from both parents in her early thirties and has remained estranged with some minimal, periodic contact with them over the last 18 years. She describes both her parents as narcissistic and highly critical throughout her life. Her father was very demeaning, which took a toll on Ilana’s self-esteem. She described feeling as if there was “an unwritten contract that I needed to hate myself. I feel that they passed on this message over and over that I was worthless and I was supposed to take this and accept it and stay a lesser person” (1:252-254). Her mother was “extremely

inconsistent” (171), and seemed, to Ilana, to be threatened by Ilana’s growing independence: “Because, I think she felt rejected, because she’s so narcissistic that if I showed that I had an independent life, it was against her or something” (1:165-166). Growing up she had no awareness of how the difficulties she was having stemmed from the dysfunction in her parent’s treatment of her. She remembers feeling ganged up on by her parents and sister: “all three of them took out their crap on me, over and over and over” (1:209-210). Her mother “didn’t miss an opportunity to put me down. It was just this constant thing, where I didn’t even hear it, people would notice it” (1:325-327). She felt unlovable and needy and described being co-opted as her father’s confidant: “So I was his sailing buddy, his golf buddy, his tennis buddy, and we would go for walks. He would complain to me about his marriage and tell me what he was thinking, he had fantasies of leaving my mother, and he was a doctor at the hospital, he’s rich, he could have any woman he wanted” (1:216-220). Being used in this way has had ramifications for Ilana in her adult relationships: “He was telling me this like I was his golf buddy, an adult male, not his daughter. It was too much for me to take, so I’ve had this terrible pattern; I’m struggling with it still, of being drawn to wounded men” (1:221-224). At 18, when she entered her first therapy, she began to understand how her depression, feelings of low self-worth and difficulties interpersonal relationships could be attributed to her parent’s mistreatment: “I was unaware up until age 18 that there was anything really wrong with my family system, dynamics, anything. I thought anything, everything was wrong with me” (1:12-14). At 21, when she met her husband, an Asian man who also was estranged from his parents. Illana’s relationship with her parents deteriorated. They were critical of her choice of partner and were very vocal about it. Ilana

and her husband moved across the country, yet Ilana continued to be in contact with her parents. She continued to work in therapy to process her feelings about her parents and try to find ways to work on improving her relationship with each of them. She was becoming more and more aware of how toxic her parents were to her and “the machinery behind all of their actions” (1:85). There was a growing awareness that it was not going to change: But what I understand, thanks to a therapist, or many therapists, is, no, they will constantly have this need to grind me to the ground, to make sure I feel as crappy about myself as possible, because of whatever’s going on with them. So this won’t stop (1:95-98). It was after a visit from her parents at age 33 where her father again berated her and her mother sat idly by, that Ilana came to the decision to remove them from her life. She had the thought, I can’t feel good about myself until these two people die” (1:255), followed by the thought “I’d really actually like to feel good about myself and enjoy my life before they die” (1:256-257). This is when she initially stated that she no longer wanted to be in contact with her father. She remained in communication with her mother for a few years longer, but ultimately decided to end that relationship as well. Upon the decision to estrange, Ilana felt a freedom to create herself anew: Okay, I can make this life be anything I want now…I get to decide. I get to be the author of my life. I don’t have to be on the receiving end of all of this abuse. I don’t have to make myself small, just so someone else doesn’t feel threatened. I can be as big as I want to be physically or mentally (1:410-415).

She has maintained the estrangement for 18 years with no contact with her father and only a birthday card exchange with her mother each year.

Elinore. Elinore is a married, white woman in her early 40s. She has two children. She has been estranged from her mother for four years. She has had no contact with her during this time. She lived in Asia with her family for several years when at age 37 she described having a mental breakdown which eventually was diagnosed as Bipolar Disorder and was experiencing a manic episode with psychotic features. While she struggled with depression in the past, this was the first time she had a manic episode. During the period when she was symptomatic, but not yet clear what attributed to her symptoms, her husband contacted her parents in the United States to let them know of his concern. Elinore’s mother flew to Asia with the intention of helping, but, as Elinore states, “rather than helping, she made everything worse because she couldn’t deal with me being so sick and didn’t know what to do'' (1:21-23). When Elinore’s mental health continued to deteriorate, she was hospitalized twice; her mother’s behavior became increasingly problematic and destructive to Elinore. She would become highly critical and disapproving of Elinore, showed no ability to appreciate the fragile state Elinore was in. On one occasion, when Elinore’s husband asked her mother to stop mistreating Elinore, she lost her temper, began yelling and locked herself in a bedroom with Elinore’s threeyear-old daughter, causing great distress to the daughter as well as Elinore and her husband.

Elinore’s husband, witnessing the negative impact on Elinore, vocalized his concern to Elinore and suggested that she consider ending contact with her mother. “In the end, my husband decided that I was worse when I was around her. She was triggering me to behave badly, and it would be better if I didn’t see her” (1:28-29). Up until this time, Elinore maintained contact with her mother and even felt close to her. She described her mother as having always been “a controlling person” (1:38) though, and Elinore always felt she had to acquiesce to her mother. Elinore’s inability to stand up to her mother had ramifications on her relationship with her husband and children began to cause friction in her marriage and was disruptive to her family life. “Whenever we saw her I would try and do whatever she wanted and kind of ignore the needs of the rest of the family. Like, if I would make plans with my husband to do something and then she didn’t want to do those plans, then I would just act like I never made plans with him and just dismiss them” (1:39-42). Growing up, Elinore was diagnosed with Oppositional Defiant Disorder and was in therapy for a period of time to address her behavioral problems. She attributes these issues to her difficulty managing her mother’s narcissistic and controlling nature. “She was always kind of controlling and needed to be in charge, and I didn’t know how to deal with that or defy her” (1:49-50). She continued to struggle with how to establish her autonomy in the face of her mother’s dominance and needed to physically distance herself to do it: “because I didn’t know how to separate myself from her except by moving out of the country” (1:64-65). Elinore and her family returned to the United States shortly after the psychotic episode and hospitalization. She continued contact with her mother. However, her mother

was very hostile toward Elinore’s husband and continued to create distress for Elinore. Elinore began to realize that her husband was right, that contact with her mother was unhealthy for her. It was then that she felt that she had to estrange from her mother for her own mental health and the well-being of her immediate family. While Elinore feels that estranging from her mother was necessary and has led to a more stable and calm existence, she misses her mother and struggles with the decision. She entered therapy to work on issues related to her mother and her ambivalent feelings about her decision to become estranged from her. Unfortunately, the therapist ended his practice a year after they began working together. She has just begun working with another therapist as she still feels unresolved about the estrangement.

Elsa. Elsa is a 53-year-old divorced, mixed race (Chinese father, Caucasian mother) woman. She has no children and lives alone. She became estranged from her mother when she was 42 years old and has had no contact with her since then. Elsa’s parents were married for 10 years prior to her birth. They were having difficulties in their marriage and Elsa believes that she was conceived as a way to salvage the marriage. Her father was an alcoholic who became violent when drinking. Elsa witnessed a lot of conflict and abuse between her parents before they eventually divorced when she was four or five. Growing up she had an idealized image of her mother. “It was easy for me to see her as the good parent because my father was the alcoholic, the violent narcissist” (1:1415). She saw her mother as the victim and felt aligned with her against her father. This was

in spite of the many instances of neglect by her mother who, despite the father’s unfitness to parent Elsa because of his alcoholism and abusiveness, allowed him to have primary custody of Elsa. Her mother treated her more as a confidant than a child which, at the time, made Elsa feel important. She would treat me as an adult and cry to me about the unfairness she would encounter in her jobs and dating life and things like that. So I felt very proud to be my mother’s confidant and to be so “mature” and be able to think that I was on the good parent’s side rather than the bad parent’s side (1:52-56). As Elsa grew up she began to experience her mother as self-absorbed and unable to think of Elsa’s needs. At age 10, she abruptly took an extended trip abroad which caused Elsa to “have a nervous breakdown” (1:56). This incident led Elsa to her first therapist. Her mother’s unpredictability and instability was a constant stressor in Elsa’s life. Her mother suffered from depression and would lock herself away, leaving Elsa to fend for herself. According to Elsa’s therapist she manifested many of the qualities associated with Borderline Personality Disorder. Manifest as instability in relations to others, little ability to empathize or be self-reflective. She would be judgmental and critical of Elsa and dismissive of her feelings. Elsa internalized much of her mother’s criticism and tried to accommodate her as much as possible. She felt as though she was responsible for taking care of her and her father. At age 14 Elsa was diagnosed with leukemia. This was a pivotal event that shifted the dynamics with her parents and, since her mother had remarried, her stepfather as well. She was no longer able to take care of her parents and was in a position where she had to accept help for herself. “Both my parents were incredible narcissists, and for the first time

they had to deal with me no longer being able to serve their narcissistic needs” (1:129131). Her mother was unable to be available for Elsa in the ways she needed. “She also didn’t know how to adapt to my being the focus of attention and care” (1:152). Her mother would rarely visit her in the hospital where she was getting treatment. She became angry when Elsa’s poor health caused her to have to forego activities and she began using Elsa’s illness “as a way to gain attention for herself, or sympathy or pity for herself” (1:187). She would get jealous of the relationships Elsa was forming with therapists and doctors and would try to sabotage them by talking badly about them to Elsa. Elsa attended family therapy with both her mother and father on several occasions. She felt as though in each therapy session, her mother would demonstrate her inability to own her part in the difficulties they were having and would cast Elsa as the problem. So she’s used psychology as a way to label me as crazy unless family therapy, which we’ve done to a large degree, seems to turn against her…now I think she doesn’t trust therapy, unless she can use it as a way to justify her position against other people (1:494-498). Elsa left for college. Because she felt close to her stepfather “he was the one sane adult I had in my life. He was the best parent I had growing up” (1:121-122), she remained in contact with him and her mother. Her father died during her sophomore year. She was diagnosed with a brain tumor during this time and had a similar experience with her mother as when she had leukemia. Her mother had little contact and provided no support.

It was her stepfather who called her every day when she was hospitalized and undergoing a bone-marrow transplant. She said, “The only thing that was keeping us together was him [stepfather]. After he died it was easy to cut her off completely” (1:407-409). She had been working on trying to manage her relationship with her mother in therapy for many years and, when the therapist suggested her mother had Borderline Personality Disorder and she read about it, it resonated with her experience and helped her to understand her mother and the reasons for her behavior. She came to realize that her mother was not going to change. Elsa ended up having a second brain tumor. She asked her mother to help her financially and her mother told her she would help only if Elsa moved in with her. While Elsa’s financial situation was very precarious because of her medical expenses, she could use the financial support her mother could have offered Elsa realized that in order to take care of herself emotionally and physically, she had to become estranged from her mother and the demands she made on her. Elsa was in therapy at the time she made the decision to estrange. It was out of this work that she was able to gain clarity about the necessity of removing her mother from her life as a measure to take care of herself.

Barbara. Barbara is a 42-year-old married, Caucasian woman with two children. She became estranged from her mother and stepfather at 16 and then from her father at age 18. She has had virtually no contact with them since choosing to estrange.

Barbara’s parents divorced when she was three and a half. She lived primarily with her mother after the divorce her older brother went to live with her father. Her mother remarried within a year or two of the divorce. Very soon after her stepfather entered Barbara’s life, he began sexually molesting her. This went on throughout her childhood. And while her mother and father both knew this was happening, they did nothing to stop it. Barbara began sinking deeper and deeper into depression as the abuse continued and none of the adults in her life sought to get her help. In her sophomore year of high school, at 16 years old, her brother became concerned about her mental health and convinced their father that Barbara needed to get out of her mother and stepfather's house and to let her move in with them. Barbara reached a point where she knew she could not survive mentally or emotionally if she stayed in their house. She decided very abruptly to leave and end contact with her mother and stepfather. Her father, unable to stand up for her, made Barbara go back to and explain why she was moving out. I had to walk back over to my mother and stepfather and stand in front of them. My father stood behind them and then I had to say that I didn’t want to live with them anymore and why and go. That was my dad and he was never going to confront anybody…I was already disassociating at that point anyway because I didn’t want to go over there. I was terrified (1:253-260). While Barbara’s relationship with her father was difficult, moving in with him was her only option. She lived with him for two and a half years. At the urging of her father’s girlfriend, she began therapy during this time. In the beginning she worked on

issues related to the sexual abuse and her relationship with the mother. Barbara’s mother wanted her to resume her relationship with her. Barbara told her that she would only see her without her stepfather. Her mother was unwilling to accommodate this. It was clear to Barbara at that point that she needed to become estranged from her mother altogether. “And she was like, you’re making me choose between my husband and my daughter and I was like, well you already did, so I don’t know what to tell you. And then, that was kind of it” (1:534-538). Barbara felt her father was unable to be available to her and her brother through the challenges in their lives. “My dad loved me as a concept…he loves you as long as you’re not yelling or chaotic or have any anger or are a girl or are calling him out on something…It’s super conditional” (1:329—333). Things began to get harder with her father. The girlfriend, mentioned above, who was now his wife, became very hostile toward Barbara. Barbara recounts a pivotal incident that began her distancing from her father and, ultimately, to estrangement. After an argument between Barbara and her stepmother, her stepmother locked her out of the house. The fact that her father allowed this to happen hurt Barbara deeply. Barbara ended up bouncing around from one friend’s home to the next. She held various jobs at fast food restaurants to support herself. Her father supplemented this, but it was never enough and Barbara’s life became very chaotic and insecure—trying to complete high school and make ends meet. “A big part was just surviving and then the pain; I mean there was a lot of pain” (1-415-416). Barbara felt bitter and angry that she had to endure so much hardship. She had no driver’s license so getting from place to place was difficult. Her father would not sign off

on her being financially independent, so she was unable to get financial aid to go to community college. It wasn’t until her mid-twenties that she would be in a stable enough position to go to college. She often did not have enough money to eat and had her electricity cut for not having enough money to pay the bill. The indifference her father and stepmother had toward Barbara’s struggles was unbearably hurtful. She finally reached a point where she knew she needed to cut them out of her life for her own well-being, just as she had done with her mother. It was frightening to think of cutting out her one remaining parent: “I knew I wouldn’t have anybody if I left my dad. That’s the last parent I had” (1:417-418). She had a moment of clarity about who her father was and that he would never be able to be there for her. And I wasn’t getting the connection from my dad that I wanted and that wasn’t my choice. But then I also realized I can’t do this anymore. And it was like literally that moment, I just felt like all this bitterness just leave. It was very resolved (1:443-445). Shortly after this epiphany she received a letter from her father that reaffirmed her decision to estrange. But it was a whole thing about how, you know, he didn’t want to hear about the hard things in my life. He just had to hear about my triumphs and all the good things…. also, he couldn’t really be a parent now because he had to be a husband and he couldn’t have time to be a parent (1:461-467). She wrote her father back saying she would not agree to these conditions: “If you don’t want to hear from all of me, you don’t hear from any of me. And that was it” (1:479480).

Throughout this period, she was in therapy which she credits for helping her weather all the pain and stress. Having her therapist (with whom she has remained in therapy to the present) as a model of consistency and caring with clear boundaries was very healing. Barbara felt bolstered by her therapist and the work she was doing with her to take the steps to do what was necessary to take care of herself. In this case, it was becoming clear that her father was an unhealthy presence in her life that she needed to distance herself from. “Being done with him…was about removing…. this toxicity” (1:524-525).

Superordinate Themes As this research aimed to find answers to two distinct questions related to estrangement, the data was analyzed for each question discreetly. The first analysis covered the first two research questions related to the broader topic of the lived experience of estrangement: 1.

What is the adult child’s lived experience of having intentionally ended a relationship with a parent where the adult child is resolute in this decision?

What are the emotional and physical and relational ramifications for people who have severed ties to a parent as a direct correlate of this decision?

The second analysis covered the third question related to experience in therapy: 3.

What has been the experience of therapy for these individuals in addressing estrangement?

Living with estrangement. The following addresses the findings related to these research questions: 1.

What is the adult child’s lived experience of having intentionally ended a relationship with a parent where the adult child is resolute in this decision?

What are the emotional and physical and relational ramifications for people who have severed ties to a parent as a direct correlate of this decision?

There were six themes identified as the lived experience of intentionally become estranged from a parent. In brief, they can be categorized as: a) the only option, b) positive changes as a result of estrangement, c) challenges to maintaining the estrangement, d) it gets easier over time, e) on-going reminders in daily life can trigger painful emotions, f) longing for a family. Below is a discussion of each of these themes and some examples from the data.

The only option. Each participant said that they felt they had to estrange; there was no other choice. While they all made efforts to stay in and work on improving the relationship with their parents, they each eventually realized it was futile. Given the inability of their parents to change and the entrenched and pervasive dysfunction in their parent’s behavior, they each came to feel that remaining in the relationship with them was damaging to their own mental health and, by estranging from them, they were removing a toxic person from their life. Barbara said, “I knew it was toxic…I was breaking down every day. I was going into hysterics…I don’t know that I could hold off anymore. And it was just so much pain”

(2:155-162). She described the decision to estrange as “having cut off a poisonous tree” (2:372). Ilana, who stayed in the relationship with her parents into her thirties in spite of feeling hurt and belittled by them throughout her life, came to a point that she knew she would never feel good about herself if she kept contact with her parents. She described recognizing the recurring pattern when she would visit them, feeling mistreated and hurt, “I would feel like I’d recover, then expose myself to this poison again and again and again, I thought, I can’t keep doing this. I don’t want to live like this. I’m not living” (2:384-386). She felt that continuing to see them, was giving implicit consent for them to treat me the way they treated me and for them to be able to say whatever they wanted to say…The estrangement was one way in which I was saying, I’m not having it anymore. You don’t have the right and I don’t consent (2:530-535). For both Elinore and Elsa, their need to estrange was tied to their need to prioritize their health. Elinore, who had a manic episode and several hospitalizations, became increasingly distressed at her mother’s reaction to her illness and her inability to be able to be a support to her. She felt that allowing her mother to remain in her life was a threat to her emotional stability and mental health. Of this she said, “I felt like I was backed into a corner, like I didn’t have an option” (2:26-27). Elsa has lived with serious medical conditions since she was 14 years old when she was first diagnosed with leukemia. She had a relapse two and a half years later. Managing her health along with her mother’s narcissistic neediness was an on-going struggle, one that she was constantly trying to manage. It was not until she was diagnosed

with the first of two brain tumors in her late 30s that she became clear that she could not take care of her health with her mother in her life: “I feel that it wasn’t so much a clear decision as that I had to do it. I had to do it. And I wasn’t imagining that my life would be so much better, it was just for stress relief. And I was also in a very difficult part of my life. It was around the time I was diagnosed with my first brain tumor and I knew that for my own safety and for my own health literally, this was something I had to do” (2:27-29).

Positive changes as a result of estrangement. While choosing to estrange oneself from a parent is difficult, and living with the estrangement complex, all of the participants reported that they felt that it was the right decision and, overall, it made a positive difference in their lives. They felt their lives became calmer and their self-esteem improved. They felt freedom to define themselves and to be the author of their own lives now free of the negative impact their parents had on them. Here are some of the ways Barbara described feeling after making the decision to become estranged from her parents: “I mean honestly, my life is really good, and it’s really stable” (2:11); “You can’t envision the good parts, the comforts. Like you can’t envision that and life is so much calmer, like that’s not something I’d ever experienced”(2:334336); “No regrets at all, ever, ever, ever”(2:697); “Everything else in my life is calm, and just not being yanked around in 10,000 directions”(2:807-808); “But just feeling so free of all that. It’s really awesome…everything is better” (2:812-813); “I was able to get a job, I

started a lasting relationship. I was able to handle my depression without medication and just build regularity, have a place to live” (2:347-349). For Elinore, the calm that she experienced after making the decision to become estranged from her mother was a great relief. Here are a few of the ways she described it: “In a way it’s been good because it’s been calmer. It was causing a lot of drama to interact with her, and the fights with my husband about how I behaved around her. And so since I haven’t seen her, there haven’t been any fights and it has been less drama” (2:6-9). And, “Just having the calmer family life is nice” (2:150). Elinore also felt that the estrangement helped her grow and to individuate. In the past, she felt reliant on her mother’s affirmation to feel good about herself. After not interacting with her for a number of years she realized that she was able to appreciate her value and trust herself more without her mother’s input. She stated, “I felt like I really needed her, needed her approval, and I don’t have that and still I’m okay” (2:141-142). For Ilana, estranging from her parents allowed her to feel a surge of self-esteem and growth, both personally and professionally. She felt an enormous sense of freedom to create her life anew, a sense that anything is possible. Here are some of the ways she talked about it “100% sure it’s the right decision. It also doesn’t mean there isn’t a lot of pain” (2:419-420); “There’ve been so many more pluses than minuses. A big sense of freedom, an enormous sense of freedom to be in control of my own life, to be the author of my own life, to feel important in a way I never could feel with them because they just needed me to be really small and not take up space”(2:12-16);“So my career took off immediately and that was sort of noticeable to other people, feeling like I’m not qualified to write this. I was just stuck before” (2:21-23); “All the freedom I have felt and the

growth…that sense of hope. Everything. That my whole view of life changed what was possible. And that I could enjoy my life. I didn’t know I could” (539-542). Ilana even sees herself as an advocate for estrangement. She has written about it and feels strongly that one should not stay in relationships with people who are unhealthy for you even when those people are parents. She recognizes that there is stigma in the decision to cut a parent out of one’s life and that make her all the more determined to have it be accepted as a positive option: Okay, there’s my point of view….pro-estrangement…I want to put my energy both with the essay and with this [participating in study] behind that and be a voice for that because it’s been, on the whole, completely beneficial and I feel sad that so many people are stuck, really stuck in these terrible relationships and think they don’t have a choice about getting out of it(2:60-698). Elsa also experienced a great sense of relief at not having to cater to her mother’s needs. Being able to have the energy to take care of herself and live an independent life has been an enormous positive shift for her. Here are some quotes from her reflecting these feelings: “I can’t imagine not doing it. I would have no time and energy for anything else in my life because my mother is like this black hole that sucks. I could never have an independent life if I hadn’t done the estrangement because her needs are so overwhelming that I could never be an independent being if I hadn’t estranged myself” (2:27-29). “I have freedom and I can invest in my own life and discover life for myself and not have to feel so much guilt and responsibility” (2:198-199). “It’s also a relief not to have to take care of her” (2:205-206).

There are challenges to maintaining estrangement. Each participant expressed how hard it had been to maintain the estrangement. Sometimes the challenges were internal. Guilt, remembering positive aspects of the parent and needing to hold onto the anger and remember the reasons for the estrangement all led to feelings of confusion and doubt about their decision to estrange. Elinore struggled the most with her own ambivalence about estrangement from her mother. She said, “The hardest part has just been that I have mixed feelings. So I do it and then I regret it or feel bad about what I’ve done. And so that’s hard to have mixed feelings” (2:136-138). Ilana’s internal struggles had to do with not wanting to have to demonize her parents in order to maintain the estrangement. She initially felt that in order to justify estranging from them she needed to paint them as all bad, yet, over time, was able to come to a more integrated attitude toward them, recognizing that they have both good and bad qualities, and at the same time, feel confident that, in spite of this, her decision to estrange from them was the healthiest thing she could do. She described her process this way: I can’t function anymore and I felt like I was just getting much more of the bad than the good and I’ve got to put an end to it. So, I thought, I’m going to need to simplify my image of them. I'm going to need to forget all the good stuff (2:558560). And Elsa said, It took me a long time not to hate myself for doing it and not feeling guilty and not feeling selfish and not feeling like I was a bad person for doing it. It took a couple of years to get over that (2:329-332).

Much of the difficulty maintaining the estrangement was external. It often came from the estranged parent’s efforts to reconnect, especially in the beginning. Elsa’s mother would send letters and show up at her house unannounced. Barbara, who went to great lengths to keep her contact information private, was contacted by her father who had gotten her brother to share her number with her mother. She shared that, “my concern has always been around them finding me or showing up or insisting on conversations or phone calls...I made a fair amount of effort to not have that happen” (2:727-731). After her father contacted her, she confronted her brother and told him that she would not share her contact information with him if he could not respect her need for privacy. She also recounted that on several occasions family members would contrive a meeting between her and her father or mother out of some fantasized narrative in which the only positive outcome is a reunion. Barbara expressed frustration that this trite and simplistic view is fueled by media versions of family life. She said, I think the narratives that are out there are bad. It was the 80s and 80s television, right? So, it’s these, you’re broken until you reconnect on their deathbed...It’s half the reason people will try to engineer a stupid meeting with someone you’ve cut off (2:945-949). Other participants were similarly pressured by immediate and extended family to reconcile and end the estrangement. The societal and cultural bias toward maintaining connection with parents, even when the relationship is dysfunctional and destructive to one’s sense of well-being, caused them to feel judged, misunderstood and stigmatized for wanting to end contact with the parent. Elsa described how hard it was to come up against

other’s pre-judgements about her decision and its reflection on her own judgement, maturity and mental health: At first I had a lot of social pressure because everyone thinks it’s abnormal or there’s something wrong if you are separated from your family and it’s a phase; that you need to get over it. And that it’s a sign of mental health to actually resolve and forgive. And life is finite; you should get back together while you can. And there is a lot of pressure to reconcile and to feel that I was too angry or I was harming myself (2:22-24). Ilana felt that her extended family saw her mother as fragile and felt that her decision to estrange was a selfish and unkind act: So everyone still thinks of her [mother] as the child that she was because she's still like that mentally. So for me to be rejecting of her, to be causing her pain is what’s made me a villain in the extended family (2:587-590). In the beginning of the estrangement, coming up against these reactions was very hard for her: “I was really sensitive and I could be swayed, my own view of myself was very easily influenced by other people’s view of my situation” (2:45-46). As time passed, “that stabilized and became a non-issue [but] for many years it was like a coming out process. Anytime I had to tell someone about this charged thing, I risked being judged and certainly risked being misunderstood” (46-50). Decisions about how to manage relationships with other family members while trying to maintain the distance from the estranged parent(s) are challenging. This is particularly hard when there are events such as weddings and funerals and social gatherings where the estranged parent is in attendance. It became necessary to be proactive about anticipating situations that may be difficult to navigate and developing strategies for

protecting oneself from being in uncomfortable or stressful situations or just decide to avoid the event altogether. Barbara described that for her there was “a lot of walking away from things and people” (2:229-230). When her paternal grandfather died, she went to the funeral. Her father and step-mother took that as an opportunity to try to sway her to resume their relationship. “I think they thought that this was the moment I would come back into the fold or whatever it was” (285-286). She said she learned from this experience that she needed to avoid these kinds of situations where she would be confronted and pressured to end the estrangement. She stated: I went, and I would not do it again. But I’m glad I did do it because it was a lesson….and I think that in the future if….well I know I didn’t because when my grandmother died, I didn’t...I walked away from all of it (2:303-306). Elinore also described how difficult it was to sustain her relationships to her father and sister, who have made it clear that they are troubled by her decision to become estranged from her mother: It’s made it more awkward with my father because I see him and I don’t see my mother, and he would like me to see my mother. And also more awkward with my sister because she sees my mother and would like me to see her (2:33-35). She went on to say, It’s very inconvenient not to see my mother because she’s kind of the linchpin around which the family revolves. And it’s difficult to see other people in the family without seeing her (2:186-188). Elsa and Barbara both mentioned the financial insecurity they experienced after estranging from their parents as a consideration in their being able to estrange or maintain

the estrangement from them. For Elsa, who, because of her health problems, had periods of unemployment and insurmountable medical expenses, worried about what it would mean for her to no longer have her mother as a safety net: “So, the thought of knowing that estrangement would mean I would be completely disinherited; I wasn’t going to get money at all; I have to admit that that was a bit of a block to making the ultimate decision” (2:305-308). Similarly, Barbara, whose estrangement happened in her early teens, struggled with being able to support herself and make ends meet for many years and had to postpone many of her plans for college and starting a family.

Living with estrangement gets easier over time. The more time that passes, the easier it is to live with being estranged. For the three participants estranged for over ten years--Ilana (estranged 18 years), Elsa (estranged 11 years), and Barbara (estranged 24 years), their lives had fully adjusted to life without the estranged parent(s). They established norms to sustain and live with the estrangement and strategies for dealing with or mitigating challenging scenarios should they arise. After numerous years of estrangement, more people who are central to their lives know and have accepted that they are estranged, making it easier to live with. Also, with the passage of time other things start to take precedence and life gets filled with other meaningful relationships and activities. Barbara recounted an instance several years ago that made her aware that the estrangement was no longer at the forefront of her mind and had not been for some time. She said,

The greatest moment was when somebody asked me if I knew where either of my parents live. I said “no.” Because I didn’t. I had no idea even what state at that point...Because it was so past, so it was great...All of this past brain space that’s already been taken up (2:852-863). Ilana voiced a similar sentiment when she said, “That [the estrangement] was huge and it lasted for years and I thought it would never stop being an issue, but then other charged big issues came into my life and replaced them” (2: 52-53). She also no longer feels triggered by the annual birthday exchanges she has with her mother: “There’s the birthday stuff...that used to be really upsetting and now it’s just a sort of blip. She’s so predictable. There was another cold birthday email. Okay, that’s done. It doesn’t hit me anymore at all” (2:545-548). Ilana’s ability to feel less emotionally charged by these annual email exchanges with her mother can, in part, be attributed to her greater capacity to be grounded in her own perspective of who she is. Also, she is able to understand her parents’ mistreatment of her as a manifestation of their own mental health issues. Thus she freed herself from selfblaming as she had prior to the estrangement and prior to work she had done in therapy to address the emotional and psychological impact growing up with parents who belittle her. Becoming stronger and free of internalizations of a parent's negative portrayal of who they are is a significant shift and an important contributing factor in how these participants are able to live more easily with the decision. Holding onto anger, as Ilana and Elsa described, was a way to maintain the estrangement in the beginning, but an obstacle, later on, when needing to find some way to move past the anger and resentments toward acceptance and understanding.

From their work in therapy, participants began to appreciate that their parents' behavior reflected the fact that they suffered from clinical disturbances and this helped the participants feel more compassion for them, less self-blame and also less alone. Elsa said that when she read about Borderline Personality disorder it described her mother perfectly. She said: I’d never seen that before, I always felt very alone because no one else had described anything like that. And just having this sense that there’s more than one and it’s not my imagination. It’s not this unheard-of phenomenon. It made me feel less lonely. It made me trust my own feelings and interpretation (2:169-176). She said that things have improved because of this awareness: “I’ve gotten a lot better. And I can recognize the internalization of that. I used to completely block myself….I felt stifled by her” (2: 124-129). By contrast, Elinore, who had only been estranged from her mother for four years and who’s therapy ended prematurely after one year, is still struggling with feelings of guilt and hopes to be able to reconnect with her mother in the future. While many aspects of her life have improved, namely that there is much less distress and a calmer and happier life at home with her husband and children, she has not reached the same level of acceptance around her decision. She stated, I think about her all the time because she’s my mother and I’m a mother, and I think about how my childhood was and what she did and all the nice things she did for me...and I wonder how she’s doing and what she’s up to (2:154-157).

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Ongoing reminders in daily life can trigger painful emotions. In spite of things improving overall with time and distance from the estranged parents, there are times when a situation or thought will trigger painful memories of the parent or sadness about the estrangement. While they all express that they had to estrange from their parent(s) for their own wellbeing, nonetheless, the fact that this is the case, is a difficult reality to face and live with. Several of the participants said they often wondered about how they will feel when their estranged parent dies and how they will handle it. Ilana said, “I suppose I’ve wondered about funerals a lot and usually people don’t die together, so one of them would be dead and one would be alive and what do I do?” (2:634-637). Elsa, who is an only child, worries that she would feel guilt if she did not respond when her mother died: But I don’t know if I’d have a funeral because I have no idea. I don’t know anything about her life. But there is a lot of social guilt about what you do with the dead...but then why do I care? I don’t know anyone. I don’t know. But I would feel guilty or like a bad person because I’m not showing the right respect (2:362-367). While life goes on for each of the participants and the memories of the parent and the realities that necessitated the estrangement no longer occupy so much emotional and psychological space, the pain around the relationship with the parent and regret that things ended up as they did still surface from time to time. Ilana said of the estrangement, “I’m 100% sure it was the right decision. It also doesn’t mean there isn’t a lot of pain” (2:419420). Elsa described her ongoing feelings about the estrangement this way:

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Yeah, I still have feelings and they are not the same feelings. I don’t have anger. I have regret...I still wish things were different. But I actually don’t think about it very much because I have to think about other stuff (2:504-508). Ilana said that after a recent meeting with a cousin she had not seen in years, a lot of feelings about her father came flooding back: When I saw my cousin...all that stuff came up for me. All the unresolved stuff about wanting to be seen for who I am by my family and not being, how it’s impossible and how I’m just stuck in this loop of craving and frustration and knowing that it’s really about my father in particular and just realizing how much unresolved stuff I’m still carrying and usually, conveniently, I am not aware of that (2:562-658). Barbara and Elinore, both parents themselves, talked a lot about ways in which the estrangement impacted aspects of life with their children. Barbara’s eight-year-old daughter has recently been asking a lot of questions about Barbara’s parents and her estrangement from them. Barbara is careful about how she navigates answering these questions: I’ve been trying to carefully not talk to her about it because I don’t like to use things like “they were sick” ... I have explained that they weren’t good parents and not just in an unhappy way, but in a not very safe way (2:414-420). She also talked about how the estrangement comes up over and over as she meets new parents who ask about her family, holidays when others are spending them with parents and grandparents and the school projects that have prompts that have to do with

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writing about extended family. Recently it came up when having to help her daughter with a school family tree project: We just did our third family tree because there’s a school project that never dies, and no matter how inclusive you try to make it, there’s just no understanding that it’s fundamentally crappy. All these crappy, stupid little things that will just cut you apart if you let them in daily life (2:399-407). Elinore, who is in regular contact with her father who lives with her mother, finds it hard that her children only have a relationship with him. She feels sad that her children are missing out on a relationship with her mother because of her own need to be estranged from her. She said, “I miss her being around the kids and playing with them because she’s really good at that. And I feel sad that she [her daughter] can’t be around her and have a relationship with her” (2:118-120).

Longing for family. The cost of estranging from a parent is giving up being part of the family in which you grew up, sharing holidays and traditions, having people to lean on in times of crisis and financial hardship. Again, the participants who had been estranged for over 10 years were clear that there was no thought of reconnection with their parents, but there was a longing for the sense of belonging that comes with being a part of a family. Barbara expressed how hard it is to live with the conflicting truths of needing family and it not being safe to have contact with the parents who raised you:

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I mean it’s all hard, none of it is easy. It sucks. You love your parents. You grow up loving your parents. So, yeah, it’s shitty, that’s the part that hurts...there is such a big abstract hurt that your family was not what is supposed to be (2:755-759). Ilana spoke of the longing to be loved and to be valued by family, but knowing she could never get this from her parents: “I want a family; I want parents who love me. I don’t want those two and going back to them will give me nothing that I am craving. It will only bring pain again” (2:311-313). Later in the interview she said, “But I guess I’m still looking for some family member to accept me and value me and admire me or something” (2:932-933) Elsa, who was an only child and has few relatives with whom she has no contact shared how hard it is not to have any family at all: “I don’t have any family and so I am completely responsible for every part of my life, which can sometimes feel overwhelming” (2:203-204) Elinore, the one participant who expressed more ambivalence around her decision to estrange, talked about missing her mother and her hope that one day she would no longer be estranged from her. She said: I do [want to end the estrangement]. I don’t see how this would happen though because my husband is very against it, so I don’t know when that would happen or how it would happen, But I do imagine being reconnected and seeing each other again and being close like we used to be close (2:161-163). The participants acknowledged that they were dealt a bad hand and did not get the parenting they needed. Some said they felt there was no way to create a feeling of closeness and belonging with others that could substitute and fill the void like Barbara

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who said, “I’m never going to have a replacement family...I had a family. It was a shitty one” (2:608-612). And, “Your friends are not your family. You can have friends who are like family and that are super close to you, but it’s always going to be a little bit different. It just is. That’s nature and that’s the cost of it” (2:604-606). In spite of saying this, she, Ilana and Elsa, all talked about how they did find ways to fill their lives with people who felt like family. Elsa said that she identified with many people in the gay community who are estranged from family who have not accepted their sexuality and manage to create a tight knit community with friends: I have a lot of friends who are gay...and a lot of them had to estrange from their family because of their sexuality. So there’s one thing I’ve learned from this is your family are the people you choose. And I’ve sort of adopted that philosophy (2:219-223). Barbara similarly has created a network of friends that she feels very bonded to. She described feeling comfort and pride in being the host of a Christmas party that has spanned 20 years. Of it she says It’s a family tradition and that is important because of that. Like, that’s why it’s important to me, probably more than my husband, that I do that. We have friends that come to almost all 20. That’s cute. It’s like a badge of honor (2:567-570). Ilana talked about the pain of not having parents and her need to bring people into her life that act as parent substitutes. She sees this as a form of healing: The way I’ve healed most I think, other than therapy, other than growing as a writer, is I have somewhat unconsciously and somewhat consciously found mother substitutes, father substitutes, people like a generation older than I, who

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really see and value me. I just soak in every bit of love that I can get from them and that has done a lot for me (2:866-871).

Experience Addressing Estrangement in Psychotherapy The following addresses the findings which answers the third research question: “What has been the experience of therapy for these individuals in addressing estrangement?” The participants’ experience and duration in therapy varied. Some had been in multiple therapies over many years and others just one. Some started therapy in childhood and had been in family therapy with their parents as children and in their teens. Some attended therapy with multiple therapists simultaneously with different therapeutic approaches to address different issues with which they were struggling. Three of the four participants were in therapy for many years prior to deciding to estrange from their parents. Only one participant had not been in therapy prior to estrangement from her parent and started treatment in order to cope with feelings which were emerging as a result of the estrangement. This study focuses on the work with the therapist that was being seen either while the participants decided to estrange or the primary therapist with whom they worked on issues related to the estrangement. The chart below identifies some relevant details of these participants' experience in therapy as it relates to issues surrounding the estrangement from their parent(s). The average age of participants at the time of this study was 46.5, while their average age at estrangement was 32.5. Three of the four subjects had been in individual therapy for 20+ years, while one subject (Elinore) had only been in therapy for 1 year.

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Table 4.2: Participant Therapy Experience Current Age

Age at Estrangement

Barbara

yes

Psychodynamic/ Family Systems

Elsa

20+

yes

Psychodynamic

Ilana

20+

yes

Psychodynamic

Elinore

Open/ Exploratory

Avg = 32.5

Mode: Yes = 3

Summary Avg = Results 46.5

Total Years of Individual Therapy

Therapy Prior to Estrangement Focused on Parental Relationship

Participant Description of Therapist’s Approach

There were five themes identified in the participants' experiences working on issues related to estrangement from a parent in therapy. These were: 1) affirmation of participant’s experience of parent’s destructiveness, 2) helpfulness of the psychodynamic approach, 3) experiencing the therapist as an ally, 4) the relationship with the therapist was a corrective emotional experience, and 5) the therapist must be able to hold complex and contradictory feelings. Following is an elaboration of these themes and descriptions gathered from the interviews with the participants in answer to the research question: What has been the experience of therapy for these individuals in addressing estrangement? 106

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Affirmation. In many of the interviews the participants talked about how they had little confidence in their own perceptions of what they experienced with their parent(s). They doubted themselves and whether they could trust that the hurt and anger they experienced as a result of their parents’ often dysfunctional or emotionally abusive behavior was justified. Having grown up in an environment where their feelings were rarely validated and were cast as the problem, having them affirmed and taken seriously in therapy is, in itself, cathartic. When another person bears witness to the destructiveness of a parent and the damage it has caused was identified as a first step in healing, as it helped each participant begin to trust her own experience, and use it as a guide in interactions with others. Ilana described her experience as “this deep well of unhappiness [that] just needed to be expressed and addressed and noticed over and over and over...until it just all came out, what I really needed, the childhood wounds” (3:73-75). Elsa shared how much her therapist’s support and validation helped free her from feeling guilty and to blame for the difficulties in relationship with her mother: “I needed it for reassurance and also because my mother was so good at putting the blame on me and saying that I’m the one who’s crazy. So, I needed the reassurance that I’m not the one who’s crazy” (3:120-122). Both Elinore and Barbara talked about how just having their therapists listen with acceptance and without judgement had an impact and helped them hold the complex and painful feelings about their parents and the circumstances that led to the decision to estrange from them. Elinore said that her therapist “mostly just listened and just validated my feelings and didn’t really give me advice about what to do” (3:76-77). She described it as being a “safe

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space” (3:115) to talk about her feelings and experiences with her mother. Barbara expressed how appreciative she is of her therapist this way: “So, yeah, I’ll tear up still because these experiences aren’t validated very much. So to have someone who’s so unquestioning...she never once questioned” (3:239-241).

Psychodynamic framework. The three participants who were in therapy for an extended period (i.e., 20 years or more) felt that the psychodynamic stance of the therapist was an essential aspect of the therapy and the positive changes they made. It helped in multiple ways. It kept them focused on exploring their own experience. It provided a psychological education which helped elucidate the pathology of the parent and the dynamics in the relationship with the parent and provided language to be able to talk about it. And, by understanding the patterns in these relationships, they could identify when they were replaying them in current relationships and feel empowered to use this understanding to avoid getting locked into a habitual and dysfunctional way of managing issues that arose. In developing this self-awareness, and a deep understanding of the emotional and psychological toll of their childhood, helped them to begin to heal from it and to avoid repeating destructive patterns in their current lives. The value of the open-ended, exploratory approach was felt and articulated by these participants. Barbara talked about her appreciation of her therapist for never closing down a discussion by making suggestions or coming up with answers to her struggles: “So it’s very psychodynamic. It’s much more about just asking me questions and me putting it out there. Again, if anything, I think that’s something that’s huge is that she’s rarely ever given me a straight up “you should consider x” (3:179-183).

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Both Barbara and Elsa contrasted their therapist’s psychodynamic approach to CBT or other behavioral approaches. Both felt that, while behavioral approaches have benefits for particular discrete issues, the psychodynamic approach was optimal for an issue with such complexity as estranging from a parent. As Elsa stated, “...with problems this complicated, which is different for every person, it helped to treat it as a specific case without set-in-stone guidelines” (3:444-451) as she understood a CBT approach to be. Barbara, who had been in a CBT therapy to help manage specific symptoms, spoke about her experience with each and why the psychodynamic approach was preferable for dealing with the estrangement this way: Psychodynamic approach for me is huge in general...Cognitive based solutions are great for symptom management, in my opinion, like I use them all the time for depression, for all kinds of things to stop thought-spiraling. But to get into the actual emotions of what it means to give up the symbol of your parenthood...Going through those emotional connections and not have it be about stopping unpleasant thoughts or deflecting or removing...But, no, it’s about going through how are you feeling about this and having someone hear it and be like, yeah, you’re right, like, I can see that sucks. That’s huge (3:274-286). Ilana felt that entering therapy with a psychodynamically-oriented therapist opened her to a new way of seeing. She said, “It gave me a totally different framework for understanding everything, as if I had been viewing reality through one lens and this was a completely different one, so that before, I thought everything was my fault; I was deeply defective” (3:108-111). She feels that this perspective was invaluable to helping her mental health and without it she fears she may have “committed suicide” (3:523). She went on to say,

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“I think, because it gave me the only way to understand myself, my parents, family systems and how other people are acting, other people’s responses, the way they get triggered by my news. If I hadn’t been in therapy, I wouldn’t get it” (3:524-526) Through work with their therapists, they gained an understanding of some of the clinical terminology and learned about specific diagnostic disorders. They saw, reflected in the description and criteria for some of the personality disorders, many of the traits of their estranged parents. When Elsa’s therapist shared a book on the borderline mother, it had the effect of making her feel less alone and, also, validated her experience living with her mother. Ilana said “I’d say narcissism is one of the most important words in terms of what I learned from therapy about my family, and attachment is another” (3:501-502). In contrast, Elinore, whose therapy was prematurely ended after one year, continues to struggle with the estrangement. She feels highly ambivalent and unsure as to whether she will maintain the estrangement. She expressed that the open-ended, non-directive approach frustrated her and wanted advice from her therapist, as she felt it might help her feel clearer. She said, “It was difficult because I felt confused, and I was saying I feel confused and he wasn’t answering that. He was kind of like, okay, you feel confused. Alright. And I wanted someone to be like...guide me a little” (3:145-148).

Therapist as ally. All the participants talked about ways in which their therapist supported them. They experienced them as being on their side, non-judgmental, and with no agenda other than the

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participant’s wellbeing. Several mentioned how powerful this was for them as it stood in such stark contrast to the parent. The therapist’s focus was on keeping them grounded in and prioritizing their own experience. Reconciliation or repair of the relationship with the parent was never emphasized as the goal, only what best served the participant at any given moment. Barbara said, “No, her stand was me. I mean, it’s not neutral. It’s that she’s always in my corner, and it’s my choice of what my corner is'' (3:221-222). She also said how much it meant to her therapist was always “at the mat” for her (3:501) and never once questioned her. Similarly, Elsa said, “She made it clear from the beginning, when this issue about seeing my mother came up, that she was not neutral, that she was my advocate” (3:454-455). Ilana said, “...she certainly never pushed me in any direction.... certainly validated it, never judged me for a second''(3:287-289) and, when she decided to estrange from her parents, “she supported it 100%” (3:342). While Elinore didn’t feel the same strong support from her therapist as the other three participants, she did feel her therapist as having no agenda and interested in helping her explore her experience. She said, “Mostly he just listened and validated my feelings and didn’t really give me advice about what to do'' (3:76-77).

Relationship with therapist corrective emotional experience. All the participants came from families in which their parents behaved in hurtful and inappropriate ways that caused the participants to decide that, for their own wellbeing, they needed to remove them from their lives. For each of them, the experience with the therapist, who affirmed and validated their feelings, who they experienced as an ally, was, in itself, healing. Their therapists served as role models of a healthy adult who welcomes all the

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participants feelings and can withstand and even encourage the expression of anger or negative emotion with equanimity and without retaliation. Through experiences in which the therapist consistently behaved in appropriate, boundaried and reliably empathic ways, the participants were able to develop their own capacity for these qualities, applying them in their own lives. In doing so they were able to nurture healthy relationships and expectations of themselves and others. The participant for whom this was most profound was Barbara who, having estranged from both parents by the time she was 19 years old, shared how much she grew as a result of her therapist serving as a role model. She described how she had to face so many hurdles and grow up through the early years in therapy and how her relationship with her therapist served as a practice ground for managing and working through feelings that she could then transfer to other situations and interactions in her life. Here are some examples from her transcript that relate to how her interaction with her therapist impacted her and served as a corrective emotional experience: “And having it be a place where I could have emotions and again, even emotions or conflict with her, but that weren’t relationship altering...That really made a big difference” (3:94-97); “ I’m also expected to be an adult and expected to have responsibilities to her. Like, I need to pay. I need to be on time. Having that place to practice that and consistency and acceptance which was not anywhere else in my life at that time...like an unconditional acceptance” (2:301-303); “And I remember I had like a particularly bad session, frankly, and so I was able to go back like the next week and be like, you know what, that sucked and she was able to hear that and go through it” (3:77-79).

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Therapist Must Be Able to Hold Complex and Contradictory Feelings Because those who estrange from a parent experience a broad range of emotion, any therapist working with those who have estranged needs to be comfortable and adept in holding and inviting these difficult and sometimes contradictory feelings. That there exists both sadness about no longer having a relationship with the parent and the certainty that estrangement is the only healthy option is one example of the seemingly contradictory feelings that can exist for those who have estranged from a parent. Participants expressed appreciation that their therapists could understand and accept this. Elinore, when asked what she felt therapists who worked with people who estrange from a parent should understand, said, “I think they should understand that it’s very difficult and that you have a lot of mixed emotions about it and I think it would be good if they helped you work through your mixed emotions” (3:161-163). Barbara talked about how helpful her therapist had been in guiding her through her layered feelings of grief. She said: ...and being able to process just all of it, like the thoughts of leaving everything I knew behind, not having any family left, and the grieving process. Being able to tease out so much of what was grieving for my actual dad, which was certainly a big part, and then grieving for the parenthood that I did not get from any parent...like a concept of a good family you didn’t get (3:151-155). All the participants talked about how much shame they experienced being estranged from a parent and how healing it was for them to be able to share this with their therapist. Barbara said, “...at least for me, the very nature of being estranged from a parent...you are already sensitive to feeling defective, broken” (3:538-539). Her therapist’s appreciation

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of this and her skilled interventions in addressing it with her eased Barbara’s pain. She said, “The way my therapist approached everything was super great because...I never once felt in there that I was defective somehow. If anything, it was the reassurance” (3:551-553). And Ilana emphasized that therapists “need to understand how much shame there is. Nobody comes to this decision to push their parents away unless they’ve been abused emotionally, physically, sexually” (3:471-473).

Summary In summary, this study used the data from interviews with four participants who each sat for three-hour long interviews to learn about their lived experience of estranging from a parent and their experience in therapy addressing the estrangement. The first interview gathered the backstory to their estrangement, the second interview focused on their experience in living with the estrangement and the third interview on their experience working on the issues related to the estrangement in therapy. The findings were categorized into those pertaining to the lived experience or estrangement and those pertaining to the experience in therapy. There were six superordinate themes for lived experience of estrangement. They were: a) the only option, b) positive changes as a result of estrangement, c) challenges to maintaining the estrangement, d) it gets easier over time, e) on-going reminders in daily life can trigger painful emotions and f) longing for a family. There were five superordinate themes identified in the participants’ experiences of working in therapy on issues related to the estrangement. They were: a) affirmation of participant’s experience of parent’s destructiveness, b) helpfulness of the psychodynamic

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approach, c) experiencing the therapist as an ally, d) the relationship with the therapist was a corrective emotional experience and, e) the therapist must be able to hold complex and contradictory feelings.

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Discussion The purpose of this study is to answer two related questions about estrangement which was initiated by an adult child from a parent from the perspective of the adult child (the estranger). The first question sought to understand the lived experience for those who have chosen to estrange themselves from a parent. The second question sought to learn how therapy was used and experienced to talk about issues that emerged related to the estrangement. The motivation to explore these issues grew out of my experience as a psychotherapist working with clients who had chosen to estrange. While resolute in their decision to estrange, these individuals have many complex and unresolved feelings around their decision. In researching the topic, I found a dearth of clinical literature on

the psychological aspects of estrangement and psychotherapy with those who were estranged. There were only two studies (Agllias, 2016; Blake, 2016) that specifically focused on the lived experience of adult children who had estranged from a parent. This led me to explore these questions further. These queries were framed within three research questions. The first two relate to the lived experience of estrangement; the third to the experience of therapy. The questions are: 1. What is the adult child’s lived experience of having intentionally ended a relationship with a parent where the adult child is resolute in this decision? 2. What are the emotional, psychological, and relational ramifications for people who have severed ties to a parent as a direct association to this decision? 3. What has been the experience of therapy for these individuals in addressing the estrangement? The following sections will summarize the findings, interpret their meaning and look at how this research relates to and enhances the existing literature on estrangement. The final sections will discuss the limitations of the study and suggestions for further research.

Summary of Results In analyzing the data, I organized the findings under two categories. The first was to answer the question of the lived experience of estrangement and the second was to answer the question about the experience of working in therapy on issues related to the estrangement. Six themes were identified for the lived experience of estrangement and

five for the experience of work in therapy on issues around the estrangement from a parent.

The lived experience of having estranged from a parent. While each participant had their own unique experience of life after deciding to estrange from a parent, there were several areas in which there were commonalities in their lived experience. Each conveyed that they felt it was the only option. They all shared that there were positive changes which came from choosing to estrange from their parents, that there were many challenges to maintaining the estrangement, but that it, and living with estrangement generally, gets easier over time. While life improves overall as a result of the estrangement, there are always on-going reminders of painful aspects of the decision and, while not wanting to reconnect with the estranged parent, there is sadness around not belonging to a family and a longing to be a part of one.

The experience of addressing estrangement in psychotherapy. Of the four participants in the study, three had been in long-term therapy for many years both before and after the estrangement. Contrasting their experience to the participant who had been in a much shorter therapy, which was initiated only after the estrangement and which had ended prematurely after a year, was very instructional. It helped to identify and distinguish the meaning of different aspects of the therapy experience and the significance of having therapy prior to initiating the estrangement. I will elaborate more on this in the following section.

Having made the decision to estrange was not easy for any of the participants. As stated above, it was a last resort to escape from the destructiveness of the relationship with the parent. The damage to their sense of self led them to discount their own feelings and not trust that they had reason to want to distance themselves from their parents. For this reason, all the participants felt profound gratitude for their therapist affirming that the pain they experienced in relation to their parents reflected an actual problem and was unhealthy. The value of long-term psychodynamic psychotherapy was highlighted by those who had been in this kind of therapy. In its focus on self-awareness and process, it helped them heal from and gain insight into the dynamics in the relationship to the parent. They credited it with being able to live with the contradictory and often painful experiences related to their relationship to their parents and in living with estrangement from them. All the participants felt supported by their therapists and saw them as an ally. And relatedly, they talked about their relationship with their therapist as healthy and a contrast to their relationship with their parents. For those in long-term therapy, the relationship with the therapist became a corrective emotional experience. Along these lines, the participants held the therapist’s ability to hold the complexity and contradictory feelings that are inevitably a part of the experience of living with estrangement as essential in helping them manage them as well.

Interpretation of Results The data from this study showed that living with estrangement from a parent is a process which has some universal characteristics for the sample participants. Namely that

1) choosing to estrange from a parent was an act of self-preservation) there are always challenges to the decision and they come from multiple sources, and 3) life postestrangement is rife with complex and mixed feelings that take time to adjust to and learn how to manage. From the distinctions between participants, specifically regarding their experiences in therapy, I was able to infer that long-term psychodynamically-oriented psychotherapy prior to estrangement led to a better adjustment post-estrangement. These broad interpretive categories will be elaborated on in this section.

An act of self-preservation. Parental dysfunction. Each of the participants described their parents as having serious and longstanding patterns of behavior that were damaging to them. In spite of many attempts to challenge their parents and work on issues in their relationship, the destructive behaviors continued. Starting in their childhoods, the participants endured treatment from their parents that was hurtful in a variety of ways--critical, demeaning, indifferent, negligent and/or controlling. Growing up with parents who treated them such affected their sense of self-worth and left them suffering emotionally often with severe and debilitating depression. As children they internalized the messages that were transmitted through their parent’s behavior toward them and easily blamed themselves for the problems in relation to them. As they grew and began to question the family dynamics they were able to

question the norms of their family. Those in therapy were able to gain psychological insight and language that led them to conclude that their parents suffered from psychopathology, such as Narcissistic and Borderline Personality Disorders, which led to an insecure attachment between the participants and their parents.

Situational necessity. While many who grow up in unhealthy or dysfunctional families remain connected to their parents, this study required the participants to have estranged from a parent. For them, the decision came as an act of self-care. They acted to get out of a situation that was destructive. They became more certain that staying in the relationship with the parent who was causing them distress would mean they would have to compromise their own well-being. They chose their emotional, mental and physical health in deciding to remove their parents from their lives. “Toxic” was how many of the participants described their parents and the effect they were having on them. Barbara said she was “breaking down every day” and that she was in so much pain that the decision to estrange was “like cutting off a poisonous tree.” Ilana also described feeling so beaten down each time she reconnected with her parents that she felt the only way she could have hope of a life without pain was to end her relationship with them. Two of the participants had serious health issues which they needed to prioritize. The decision to estrange from their parents came as a way to remove a stressor that could compromise their health. These two participants described the moment they made the decision very similarly. Elinore said, “I felt like I was backed into a corner, like I didn’t

have an option.” And Elsa said, “I feel that it wasn’t so much a clear decision as that I had to do it.”

A difficult and painful decision. How some people are able to take such a leap to choose to completely end a relationship with a parent who causes pain is an interesting question. It points to some internal self-protection instinct that trumps adherence to all other expectations and deviates from family and cultural norms. For each participant, the decision was hard and for most it was a last resort after many attempts to repair the relationship to the parent or to work through and come to some acceptance of the status quo. Giving up on a relationship with a parent was hard, in different ways, for each of the participants. Barbara, who had already estranged from her mother, felt that in estranging from her father she would lose all connection with her parents which made it feel riskier and caused her to delay the decision even when she felt it was the right thing to do. Elsa, whose mother leaned heavily on her, felt a lot of guilt in making the decision to cut her mother out of her life, knowing how difficult it would be for her and how much resistance she would put up. It was not until she was 42 years old, and on the heels of a serious medical diagnosis, that she was able to follow through with ending contact with her. Ilana, who also remained in the relationship with her parents well past the time she recognized how destructive they were to her, ended contact with them at 33.

Personal growth and healing following estrangement.

Despite how difficult their lives had become and how prolonged the eventual estrangement took, each of the participants reported how healing it was to remove their parents from their lives. The positive changes they experienced came in many forms. They all reported experiencing more stability and feeling life was much calmer. Elinore said that “just having a calmer family life is nice.” Ilana talked about how her self-esteem improved dramatically and how this led to positive changes in her career-- “my career took off immediately” and in a sense of hope and freedom to create her life anew-- “that whole view of life changed what was possible.” Because of the positive and transformative experience after estrangement from her parents she sees herself as a proponent of estranging from parents and feels strongly that people not remain in relationships that are unhealthy. Barbara also reported that as her mental health and self-esteem improved the quality of her life improved. She feels that her ability to hold a job and have a lasting relationship with a partner and a happy family life could not have been possible without estranging from her parents. Elsa referred to having energy to take care of herself and her health condition, knowing that if she had not estranged from her mother she would “never have an independent life.” For her it is a relief to not have the responsibility of caring for her mother on top of her own serious health issues.

Challenges to decision come from multiple sources. Family pressure. Once the decision has been made to end the relationship to the parent the challenge becomes maintaining it. Efforts by the parent to reconnect are common and

very difficult to withstand. Each participant that experienced this came up with different strategies to keep from backing down from their decision in the face of the resistance from their parents and the feelings of guilt and self-doubt around their decision to estrange that emerged in reaction to it. Holding onto the memory of the anger and hurt that initiated the estrangement became a way to counter these feelings and remain resolute. Finding ways to keep one’s contact information private to keep the parent from locating them and showing up unannounced or contacting them became necessary for several of the participants. It is not only the parents who resist the estrangement. Challenges also come from the immediate and extended family. Some family members express sadness that the family unit has been disrupted by the estrangement, making it awkward and uncomfortable for them. They wish for things to return to how they had been and resent the estranger for disrupting the status quo. Frequently, the extended family are critical and judgmental toward the participants for estranging from their parents. In the case of Ilana, for example, she describes her relatives casting aspersions on her for what they saw as a selfish and unkind act. Ilana felt they could not see the damage that her mother had caused her, viewing her mother as a fragile person, needing to be treated with kid gloves. In this way, estranging is a very lonely endeavor. Often those who decide to estrange feel others do not see the dysfunction in the family and the negative impact it has had on the participant. Estranging from a parent exposes this. It forces others to see and confront a reality that they may not be willing or ready to face. And so, instead of integrating this into their understanding, they alienate the person who shows them an

uncomfortable truth. Certainly, this is what happened in Ilana’s family. She felt the fallout from her decision meant that her extended family disowned her. Other complications arise for the estranger when there are family functions where the parent is likely to be present. Navigating these situations is tricky and maintaining distance from the parent is challenging. It puts the estranger in a bind, wanting to attend an event - a wedding or funeral most commonly - but not wanting to risk crossing paths with the estranged parent. The tension around this has sometimes felt too hard to manage and has left the estranger deciding to forgo many family events to avoid the stress of it.

Lack of cultural acceptance and stigma surrounding estrangement. A significant factor making the transition to living with estrangement from a parent so challenging is the way it is held in the culture. Each participant talked about how the stigma associated with estranging from a parent impacted them. Much of the pressure they described came as a judgment and adherence to a view that estranging from a parent is taboo. Elsa said that she experienced a lot of social pressure, when she first estranged from her mother, from others who felt that it was “abnormal or there’s something wrong if you are separated from your family.” Elinore was guarded in sharing with others that she was estranged from her mother, saying that she felt “embarrassed” to let people know and that she felt some shame around the decision. Each person who made the decision to estrange reported that they had no reservations about doing so, that they felt clear it was the right decision and they all reported an improvement in quality of their lives once they no longer communicated with their parents. Of note then, is the collective cultural attitude toward estrangement that

pathologizes or delegitimizes those that opt to end a relationship with a parent as immature. There is a narrative of estrangement as either being “a phase” and “something you will grow out of'' as Elsa experienced, a temporary act of defiance where reconciliation is the inevitable and healthy resolution. Barbara referred to this as a simplistic fantasy borne and hyped in the story arc of television dramas. Cohesiveness and sticking with family no matter what is a cultural trope that does not allow for the multiple realities reflected in relations between individuals within families. This rigid view of family makes estrangement almost a defiant act, held in a cultural context. All the participants that estranged from their parents to have a better and healthier life and to remove someone whom they describe as toxic from their lives and did it with the backdrop of societal disapproval. This left them feeling deviant which added to how difficult it was to finally do and maintain. Ilana, who felt strongly that this was unacceptable and has written much about her journey with estrangement, sees herself as an advocate for people to estrange. She said she is “pro-estrangement” and feels for “people who are really stuck in these terrible relationships and think they don’t have a choice about getting out of it.”

Managing complex feelings and ongoing reminders of estrangement status is an inevitable reality of life after estrangement. Complicated grief. The attachment formed between a parent and child is unique. No matter the quality of parenting, the caretaking role of the parent combined with the total dependency of the child on the parent and the formative nature of the relationship make the bond

between a parent and child unparalleled. Certainly, tensions and differences exist to a greater or lesser degree between a parent and child within every family unit, yet the bond that is established in the early years of a child’s life with a parent almost always spans a lifetime where transgressions are forgiven or ignored, and maintaining connection is never questioned. The dependency on and comfort found in belonging to a family is a universal reality of being human. This is not any less true for those who make the difficult decision to end a relationship with a parent. The concept of ambiguous loss put forth by Boss (2006) captures the psychological and emotional realities of those who have estranged from a parent. It describes a loss of a significant person which, unlike a typical loss of a loved one through death, is a complicated loss in which the person is physically no longer present, but is still psychologically present. The fact that choosing to remove a parent from one’s life is necessary for one’s well-being does not mean that it doesn’t come without grief and mourning. This is the complicated reality for those who have estranged from their parents. As Barbara put it, “...it’s hard, none of it is easy...You grow up loving your parents.... there is such a big abstract hurt that your family was not what it is supposed to be.” The longing to belong and be a part of a loving family is a conundrum for those who decide to estrange from a parent. This is highlighted in a quote from Ilana: “I want a family; I want parents who love me. I don’t want those two and going back to them will give me nothing I am craving...But I guess I’m still looking for some family member to accept me and value me and admire me or something.” Maintaining connection to other family members,

creating new close-knit social circles and even surrogate parents were some of the strategies employed to manage the loss and fill the void she describes.

Navigating situations in which the estrangement becomes exposed. Reminders of their parents and/or the estrangement from them come up in a variety of ways over time. Sometimes it is something such as a medical form which asks about family history, other times it is managing a social gathering where someone asks about your family. Finding ways to weather the feelings which arise and ways to talk about it with others is part of the process of learning to live with estrangement. Feeling outed, fearing judgment, anger at the assumptions that people make that force having to share a painful and private aspect of one’s life, is unavoidable when being estranged from a parent makes you an outlier in society. Having to field people's curiosity or faulty beliefs or assumptions about what it means to be estranged can be upsetting and can trigger a spiral into negative self-talk. Developing an ability to predict or anticipate these situations helps to manage them better. Learning to shift the conversation, or have some planned response to give to those who ask too many questions are useful coping strategies. Being protective about who to let into one’s life and cutting out people who pass judgements on the choice to estrange were things the participants described doing and lessons they learned over time to adapt to life post-estrangement. While the triggers decrease over time and the ability to anticipate and deal effectively with situations which could become painful and unpleasant increases, there are times when they will be caught off guard and a situation will thrust them into emotional turmoil. Ilana described seeing a cousin for the first time since the

estrangement and the way it brought her back into a regressed and unhappy place. She said she returned to a “loop of craving and frustration...and just realizing how much unresolved stuff I’m still carrying…” This incident happened many years after the estrangement, but serves to highlight how living with estrangement, while easier over time and, over all a positive choice, is always a work in progress with ongoing challenges. Becoming a parent oneself brings up a number of challenges for those who have estranged. There are school projects that ask questions about extended family and grandparents which need to be fielded. How to talk to one’s children about what happened to them, why they chose to estrange from their grandparents are very delicate subjects that are emotionally challenging and need to be handled carefully by taking into account the child’s developmental maturity in deciding how to talk about it. Again, this is another example of how there are continual reminders and challenges that come up in the lives of those who estrange from a parent.

Long-term psychodynamic psychotherapy associated with positive adjustment to living with estrangement. Damage to sense of self exists alongside issues of living with estrangement. The choice to estrange from a parent grows out of long-standing problems in the relationship between parent and child. The emotional toll from the years of hurtful and problematic exchanges with them does not disappear once the parent is no longer in the picture. While living with estrangement comes with its own trajectory--challenges as well as positive changes--it is important to distinguish the issues related to adjusting to life

after estrangement from the psychological and emotional ramifications from the relationship with the parent itself. A significant part of the healing work that took place in therapy for these participants addressed issues related to distorted and negative self-images etched into their psyche over the years of being debased, devalued and blamed for the difficulties in their relationship with their parents which they had internalized. Even in their determination to free themselves from suffering any longer at the hands of their parents and fleeing from a destructive relationship, they needed affirmation that their decision was justified. They needed much assurance and validation from their therapists before they were able to begin to trust themselves. Elsa described it this way: “My mother was so good at putting the blame on me and saying that I’m the one who’s crazy. So, I needed the reassurance that I’m not the one who’s crazy.” Much of the work in therapy was also around processing the hurt, sadness and anger at parents who were not able to be the supportive, loving people they needed. Beginning to see that they were not responsible for the problems in relation to their parents opened the door for the participants to move into grief over this realization. Having the therapist as a sounding board and someone who did not question their feelings and experiences was cathartic and helped them move more toward trusting themselves.

Psychodynamic psychotherapy prior to estrangement enabled a more successful adjustment to estrangement with less ambivalence. Of the four participants in the study, three had been in long-term psychodynamic psychotherapy both before and after the estrangement from the parent. The work they did

prior to the estrangement laid the groundwork for their transition to life postestrangement and gave them time to work through some of the issues they struggled with in their relationship with their parents. This early work involved efforts to manage and improve the relationship with the parent which allowed them to feel clear about their decision to estrange when they finally did so. It also gave them time to develop a relationship of support with their therapists and to have an ally in their process who could witness and understand their experiences with their parents. Many of the characteristics of a psychodynamic approach to treatment were identified as having been helpful in their work with their therapists. The focus on affect and paying close attention to their own experience was empowering, allowing them to develop language to convey their feelings. This was especially important when managing the complex mix of emotions that arise after estranging from a parent. The paradigm shift that came from understanding the relational dynamics within their families that they developed through their work in therapy had a profound positive impact and helped them temper their harsh self-judgements as well as to free them from getting stuck in destructive relational patterns with other significant people in their lives. Ilana described this shift as giving her “a totally different framework for understanding everything, as if I had been viewing reality through one lens and this was a completely different one, so that before, I thought everything was my fault; I was deeply defective.” Through her work in therapy she was able to begin to make room for and to value and trust that her experience mattered. In turn, she was able to use this self-awareness to shape her interactions with others.

The therapist's open-ended and non-judgmental stance, capacity to hold complexity, ambiguity and shifting emotional states enabled the participants to do the same. Those that were able to do this work prior to estrangement from their parents were clear and unwavering in their decision. While the challenges of living with their decision were often difficult and painful, they were able to weather them and learn to manage them better over time. For the one participant who had not been in therapy prior to her estrangement, there was much more uncertainty and ambivalence about her decision. This seems to highlight that having an opportunity to work through some of the issues in the relationship with the parent is an important first step before estranging from them. It is a weighty decision which one needs to be prepared for, both in arriving at and in living with. Psychodynamic psychotherapy provides an opportunity to develop selfawareness and clarity about the dynamics that are operating in relationship to one's parents and to assess whether there is a possibility to repair and heal within the relationship. Arriving at the conclusion that it is not possible through this soul-searching work leaves the estranger more confident in their decision, less conflicted and freer to embody their life post estrangement.

Significance of relationship with therapist as corrective emotional experience. For those who have grown up in a family where needs are not met, where there is neglect, abuse or other forms of dysfunction, psychotherapy not only affords an opportunity to work through the presenting issues through insight and self-awareness, but equally reparative is the actual relationship with the therapist which serves as a model of a different and healthy way to be in an intimate relationship with another person.

It is most certainly the case with the people in this study who felt that there was no alternative but to estrange from their parents. If there were a possibility of improving their relationship with their parents and repairing the damage done within the context of the relationship they would have. The data show that in each of the cases the parents were unable or unwilling to be responsive in a way that would have brought about a necessary and reparative shift. The participants learned how to survive within a family system that distorted and denied their feelings and came to expect this and adapted accordingly. The toll this took on their sense of selves and what they could expect of others became an obstacle in their move into a happier and healthier life. Getting out of the destructive relationship with the parent was a relief and a necessary first step in taking care of themselves, but the repair that came through the relationship with the therapist was essential in tempering the harsh and self-critical voice and in beginning to trust that others can welcome and manage the full range of their feelings. Those who were in a long-term relationship with their therapists valued the experience of being affirmed and validated. They described the growing trust that developed from the consistency and empathy of their therapists who they came to really feel that cared about them and wanted to see them heal and grow. Working through ruptures that occurred in the relationship to the therapists were profoundly cathartic. The therapist's ability to hold the tension and tolerate and even invite their anger, hurt and disappointment in them stood in stark contrast to their interactions with their parents who often deflected, attacked or denied when confronted with these same feelings. These experiences with their therapists opened the door to the possibility of and hope for better relationships with other significant people in their lives. Having

developed trust through this long-standing relationship in which sharing and exposing intimate details were welcomed and taken seriously led to an internalized sense of selfworth. The experience of therapy as a safe space to talk about disappointments with the therapist without retaliation and in which these exchanges were worked through, and, instead of damaging the relationship, made it stronger, were healing and reparative. The corrective emotional experience in this relationship with the therapist was transformative. The shift in self-esteem and the developing capacity to communicate complex feelings in therapy opened up possibilities in how to be and relate to others outside the therapy relationship. The confidence they began to feel helped them address issues in relations with spouses, colleagues and other significant people in their lives. This meant that they were forging different and more positive life trajectory, not destined to repeat unhealthy patterns in their family of origin.

Relevance of Findings to Literature Sociological literature. Much of the literature from the field of Sociology focusing on family addresses issues related to its structure and cohesion. This, in itself, speaks to the presumption of the intact family. Solidarity theory (Bengston et al. 1976) and even the later research on negative emotion (Galeen & Dystra, 2006), and ambivalence (Fingerman et al., 2008; Lucher & Pillemer, 1998) all focus on variations in family cohesion and how conflict is normative and differentiates the various dimensions which family members can experience solidarity with one another and how conflict within families does not imply lack of solidarity.

The fear of “family decline” in the 80s (Poponoe, 1988) addressed the issue of geographic dislocation and what it said about the cohesiveness of families. There was assurance from the research that the family remained a cohesive unit in spite of the lack of close physical proximity. Riley (1983) noted that while there can be periods of noncommunication between family members who are physically distant, when the need arises they do support one another. He referred to this phenomenon as the “latent kin matrix.” The decision to end a relationship with a parent when there is no acceptable model of estrangement reflected or condoned in the culture is extremely difficult. While there is no stigma around detaching or distancing from a parent, to actively and completely cut off a parent is an extreme not modeled or normalized within the culture. In society it is close to being taboo. The self-doubt expressed by the participants in this study; the effort they all made to find ways to work out problems in the relationship with their parents beyond the point where it was in their best interest to do so is, in part, due to the stigma around ending the relationship. Each of the participants in this study talked about how they came up against this within themselves and in reactions from others.

Communications literature. As with the field of sociology, the communications research began with a focus on understanding communications patterns between individuals within families that promote cohesion. It was not until Hess in 1996 began challenging the notion that closeness was always optimal. He noted that especially in dyads, where one person was destructive to the other, that was not the case. He emphasized that in these instances

developing distancing strategies is essential to staying in a relationship with someone who is not safe or healthy to be around. Sharp (2015, 2017), too, emphasized that closeness should not always be seen as better than distance given that many people are born into families where there is abuse and neglect. She, along with her colleague Hall (2017), discussed the bind people are put in when they want to distance themselves from a family member as a result of the “taken for granted assumption” that family ties are sacrosanct and should never be broken. The stigma around distancing or estranging is the price paid by many who choose to do so. Sharp (2015, 1017) in her research on distancing strategies employed by adult children who estranged from a parent found that they had to work to maintain the estrangement and enforce the established boundaries. She also found that the stigma around estrangement led them to keep their estrangement status from people in their social network. The findings and conclusions drawn by both Hess (1996) and Sharp (2015, 2017) are echoed in the findings in this study. Prior to estranging from their parents, the participants made efforts to maintain the connection to their parents while also building barriers to protect themselves from the hurt and distress they experienced when in contact with them. They moved away physically, they attempted to set boundaries and significantly decreased the time they spent with them. They worked with therapists to explore the difficulties in their relationships with their parents with the hope of improving them. When these efforts proved not to be enough and they finally decided to estrange from their parents, they expended a lot of energy, especially in the beginning, maintaining

the estrangement. Scharp (2015) wrote about the significance of having a “backstory,” or a coherent narrative around the lead up to the estrangement in order to maintain it. In her study she noted that these stories told of parental mistreatment and an eventual external or internal event which they referred to as “the last straw.” The narrative arc of each of the participants in this study was similar. They all told of parental dysfunction, neglect or mistreatment that went on for some time. They each described reaching a moment of clarity that in order to take care of their own wellbeing they needed to end the relationship. The challenges to maintaining the estrangement came from many places—family pressure to reconnect, internal ambivalence or self-doubt and from the parent trying to reconnect. While having a backstory served as a buffer and support for their resolve in remaining estranged, there were also new experiences which had a significant impact and helped reshape the on-going narrative which also made it easier to maintain the estrangement. The work done in therapy combined with the passage of time and maturity all factored into the development of new ways to understand and talk about the estrangement. The greater self-awareness and self-esteem allowed for more equanimity around their estrangement making them less vulnerable to others. Their developing narrative became richer; more nuanced; more compassionate toward themselves and their parents, making room for forgiveness and more self-acceptance. At the same time, the more experience in living with estrangement made it possible to anticipate situations and, rather than be reactive and defensive, be proactive in shaping how to manage the narrative around their estrangement with others.

Clinical literature. Estrangement doesn’t happen suddenly. The findings in the literature (Agllias, 2008, 2011, 2014; Robinson, 2011; Sharp, 2014, 2016) that intergenerational estrangement does not happen suddenly, but is the final step after many attempts to address issues between the estranger and estrangee is borne out in this study. For each of the participants, ending their relationship to their parents was not considered until they had exhausted all other options. When considering the long-standing familial dysfunction, the efforts these participants made to find solutions to difficulties in relation to their parents before finally deciding that they needed to estrange from their parent, makes it clear that the decision was not spontaneous or premature, as suggested by Bowen (1982) in his theory around emotional cutoff. Bowen’s theory states that emotional or physical cutoff is an immature reaction around unresolved attachment to a parent and the anxiety around fusion and lack of differentiation from them. Bowen’s theory reflects a type of cutoff that occurs as part of a normal developmental stage in separation and individuation. It is the type of cutoff that occurs in adolescence when working through the internal struggles of growing up and defining oneself and is outgrown once this is achieved. In other words, it is entirely an internal process that is devoid of other external or environmental factors. In the case of the participants in this study, the dysfunction of the familial environment was a central factor in the decision to estrange. The fact that the efforts the participants made to repair damage in their relationship with their parents failed because

their parents were not able to be responsive to their needs or requests made estrangement the only viable and healthy alternative. Far from a premature or immature action, it was a mature and thoughtful action that grew from a long and painful process.

Parental emotional abuse primary reason for estrangement. One of the criteria for participation in this study was that participants had not been subject to severe abuse by the estranged parent. This was in order to uncover the more nuanced factors in making the decision to end a relationship with a parent. Nonetheless, the participants, while not experiencing severe physical or sexual abuse by the parent they estranged from, described emotional and psychological mistreatment by them and stated that this was ultimately why they made the decision to estrange. While prior research (Gilligan et al., 2015; LeBey, 2001; Sichel, 2004) attributes some causes of estrangement to situational or other external factors, clashes in values or feelings of betrayal, as the reason some chose to estrange, most (Agllias, 2015, 2015b; Aquilino, 1994; Scharp et al., 2014; IpsoMORI, 2015) reflects that the experience of the parent as toxic by the adult child as the reason identified for choosing to estrange. Carr’s (2015) research found that the attribution for estrangement is different between the adult child who estranges and the parent from whom they estrange. The adult child typically describes the parent’s behavior and personality as responsible for their decision, while parents identified external factors such as geographic distance, conflict regarding choices in significant others as the reason for the estrangement. No doubt these external factors do account for some instances of family estrangement. It is also possible that the parents of the participants in this study, if they

were interviewed, might attribute the estrangement to other factors. Yet, the participant’s subjective experience was that they ended a relationship with a parent who had been unhealthy for them. Therefore, that is what is significant in terms of understanding the lived experience of this subset of the population.

Psychodynamic Implications. To understand the psychodynamic implications of estrangement, it is essential then to focus on the lead up to the decision and the intra- and inter-personal factors that shaped estrangement decisions. As described by the participants, their parents were selfinvolved, had difficulty empathizing, were highly critical and judgmental and had little self-awareness and humility. In other words, they lacked the qualities necessary in functioning as Winnicott’s (1968) “good enough mother” in providing continuous loving attention and the capacity to withstand the demands of the child without retaliation. From the description of their experiences with their parents it is not hard to imagine that their parents were unable to provide an environment where they could move through Klein’s primitive and chaotic paranoid-schizoid position of early infancy to the depressive position and develop healthy self and object representations. The participants all described having suffered with distorted and negative self-images. They also talked about their difficulty forming intimate relations with others and how they projected aspects of their parents onto others, making it hard to trust and feel safe to let others in. The participants attachment to their parents was not secure. The coping strategies they used to adapt to living with them prior to the estrangement reflected the avoidant attachment style of the children in Mary Ainsworth’s Strange Situation study (1970).

They moved away, became highly self-sufficient and detached emotionally from them. Estrangement came as the culmination of a long-standing practice of distancing from their parents.

Reflecting on how findings compare with other studies on the lived-experience of estrangement. It is noteworthy that there is much overlap in the results regarding the livedexperience of estrangement between this study and those of the two other studies that exist on the lived experience of estrangement by Agllias (2016) and Blake (2015). As in this study, Agllias found that for the participants in her study, the decision to estrange felt like their only option in order “to become a healthy and contributing member of society” (p. 10). The estrangement came after many unsuccessful attempts to resolve issues in their relationship with their family members. A common theme which exists across all the three studies is the experience of the difficulty in maintaining the estrangement due to pressure from family and the stigma associated with it. Each study reported that managing the reactions of others required much effort and that the participants learned to implement strategies to manage the judgment or rigidly held beliefs of others in order to safeguard their estrangement. Blake’s study, for example, found that the participants were very selective with whom they shared their estrangement from their parents. Agllias’ study also found that the stigma around estrangement caused the participants to be guarded, but also led to feelings of self-doubt around their decision. In the present study too, there were both external and internal challenges that the participants faced in maintaining the estrangement.

A final area of overlap between these three studies has to do with missing having a family. In each study the participants make clear that they do not miss the family or parent from whom they have estranged, but more broadly, they miss belonging to a family. Participants in both Blake’s (2015) and Agllias’ (2016) studies mentioned that these feelings were triggered around holidays or other special events. Agllias described the feeling the participants in her study had of missing “someone who knows you” (p. 12) and the “emotional, educational, financial and physical support that a family can afford '' (p. 12). In addition to these feelings around missing family, this study found that feelings of sadness and resentment at having to make the choice to give up belonging to a family in order to take care of themselves was also a piece of the experience of living with estrangement. While Agllias’ (2016) study identifies that estrangement had benefits and led to personal growth, it does not identify the gains specifically as this study does. The participants in this study talk about feeling their life becoming much more manageable and calmer after estranging from their parents. They talk about specific areas in which they had grown as a result of estranging from a toxic parent. Their confidence grew; they were able to manage work and relationships more successfully; and they reported having more energy to attend to other things in their lives and a sense of freedom which went with it. The area where this study charts some new ground is in its attention and exploration of the experience of therapy for those who estranged from a parent. Much of the existing literature on work in therapy with those who have estranged focuses on reconciliation (McGoldrick & Carter, 2001; Dattilio & Nichols, 2011) or on parents who

estrange their children (Agllias, 2013). Agllias (2017) does outline her recommendations for therapists working with clients who have estranged from a family member based on what her research which identified trauma, grief and loss as common aspects of the experience of those who have estranged from a family member. Her recommendations of cognitive behavioral therapy, motivational interviewing and acceptance and commitment therapy address symptom reduction for stress, anxiety and negative thought patterns. The findings in this study show that psychodynamic psychotherapy both prior to and following estrangement from a parent, contributes significantly to the positive adjustment to life post-estrangement. Long-standing relational trauma in living with the destructive influence of a troubled and/or emotionally abusive parent is a central causal factor that led to estrangement. Thus, it makes sense that a long-term relational approach to treatment is associated with positive outcomes for those working through estrangement-related issues. The complications in living with estrangement cannot be parceled out of this reality and so require a depth-oriented approach to treatment. That is not to say there is no value in other approaches which help with symptom management, but they can’t address the relational-trauma which those who decide that they must estrange from a parent for their own well-being are living with.

Limitations of Study and Recommendations for Further Study The study is limited in its sample size, demographics, and geographic constraints. A sample of four people is not enough to make any conclusions generalizable to the larger population. It is an exploratory study focused on the lived-experience of a few people who have in common that they have been estranged from a parent for more than

three years, they chose to estrange from their parent and have been in a therapy where they addressed the estrangement. There is little diversity among the participants. They are all heterosexual women, three are white and one is mixed race. They all live in the California Bay Area. Further study could include more diversity in all these areas. Comparisons of the meaning of estrangement cross-culturally would be very interesting and could add to the findings of this and other existing research on estrangement. An aspect of this study which, while a requirement for participation this study, also limits it is that all the participants had been in therapy. Three of the four participants had extensive therapy and were very psychologically-minded. The one participant who had not undergone long-term therapy was much less resolved in her decision to estrange and less positive about the benefits of estrangement. This suggests, and was a central finding of this study, that long-term therapy is associated with a more positive adjustment to living with estrangement. Since this was the case, further study could look at the lived experience of estrangement for those who never attended therapy to see how their adjustment to living with estrangement compared and how they would talk about it without the psychological language with which the participants in this study were familiar and which shaped the way they talked about their experience. Another line of inquiry that would be interesting is to look at two groups who both described growing up in a toxic family environment and compare those who decided to remain connected to their parents to those that made the decision to estrange. It would be informative to see how each group talked about their family, how staying connected versus ending contact with a parent whom they felt was destructive shaped their sense of themselves and the trajectory of their lives.

Conclusion This was an exploratory study of the lived-experience of having estranged from a parent and the experience of working on issues related to the estrangement in therapy. The findings from the data on the experience of living with estrangement revealed common themes across the participants and reaffirmed some of the findings from earlier research. The findings from the data on the experience in therapy addressing issues around estrangement shed light on the significant role therapy played for the participants in working through issues related to their parents and their estrangement from them. The findings from this study overlapped with those from Agllias’ 2016 study that also explored the lived-experience of estrangement. Participants in both studies talked about how making the decision to estrange was not easy and came after many efforts to repair or find ways to maintain the relationship via distancing strategies. The wish for a better relationship in combination with the stigma that comes with estrangement kept the participants in a relationship with their parents long beyond the point where it became clear that things would not change and that remaining in the relationship was unhealthy. Both studies also found that, while there are many challenges in learning to live with estrangement, the participants all feel positively about having made the decision. Freeing themselves from a “toxic” relationship was key in opening the door to a happier and healthier life. The trajectory in learning to live with estrangement was similar between participants within this study and those in Agllias’ study. They all describe a “last straw” moment that allowed them to cut off contact with their parents. They all face similar challenges in maintaining the estrangement both from internal struggles--guilt and

self-doubt, and external pressures, from family and others who judged their decision, to end the estrangement. They all live with a complex mix of feelings which comes from having to cut a primary attachment figure out of your life in order to protect and preserve oneself. Arriving at a place of self-acceptance and equanimity around their decision takes time and requires a lot of emotional work. The most significant finding from this research is around understanding the importance of therapy for those who have estranged from a parent. All those who have chosen to estrange only do so because things have become so dire or have been for much of their lives--either their parent is abusive or so troubled that the relationship to them is dysfunctional. All those who have estranged have suffered as a result of the relationship with their parents which has impaired their sense of self and self-worth. The participants in this study who had been in long-term, psychodynamic therapy credited it to helping them both heal the wounds from the relationship with their parents as well as in helping them weather the challenges to life post-estrangement. Far from being a reflection of some deficiency, the option to estrange from a parent who is a source of pain is a testament to their resilience and determination to have a better life. This study has convinced me that estranging from a parent is a healthy and necessary response in many circumstances and that efforts need to be made to remove the stigma of it. I hope this research is a step in that direction and will be helpful to other therapists working with clients who have estranged or may be considering estranging from a parent.

Appendix A Informed Consent Form

Institute for Clinical Social Work Research Information and Consent for Participation is Social Behavioral Research The Lived-Experience of Estrangement from a Parent: An Exploration to Help Therapists in Their Clinical Work with Adults Who Have Chosen to Estrange Themselves from a Parent

I,_____________________________________, acting for myself, agree to take part in the research entitled The Lived-Experience of Estrangement from a Parent: An Exploration to Help Therapists in Their Clinical Work with Adults Who Have Chosen to Estrange Themselves from a Parent This work will be carried out by Catherine Cheyette, LCSW under the supervision of Silvio Machado, Ph.D. This work is being conducted under the auspices of the Institute for Clinical Social Work; Robert Morris Center, 401 South State Street; Suite 822, Chicago, IL 60605; (312)9354232. Purpose The purpose of this study is to gain an understanding of the lived-experience of adult children who have chosen to estrange themselves from a parent and have sought psychotherapy to address some aspect of the estrangement. This study seeks both to understand the lived-experience of those who have made the decision to estrange from a parent and to learn about the experience of psychotherapy in working on issues related to the estrangement.

Procedures used in the study and duration The study will require each participant to be available for two to three semi-structured interviews lasting approximately one hour each. The interviews will be conducted either in person at the investigator’s office or in an agreed upon location between the researcher and participant or via visual social media. The interviewer will ask broad questions on the topics of interest and leave room for the interviewee to answer in as much or little detail as desired. The interviewer may ask for elaboration or ask some follow up question. Once a particular focus of questioning is completed, the interviewer may begin with another area of exploration. The interview will proceed in this fashion until the interview is complete. Each participant will be compensated $20 per interview. Benefits While there are no benefits to participating in this study, the aim of this research is to gather information that will be useful for clinicians when working with clients who have estranged from a parent. So, the knowledge obtained through sharing your experience is of potential benefit to others who have similarly estranged from a parent. Costs There are no direct costs for participating in this study other than the cost of travel to and from the interview. Possible Risks and/or Side Effects As you will be sharing information that is personal and potentially emotionally charged, you may experience distress either before, during or after the interview. If at any time during the interview you do begin to feel distressed, you can ask the interviewer to pause

or end the interview. You can expect the interviewer to offer support and to offer a referral to a local therapist if you require further support. Your participation in this study is completely voluntary and you may withdraw at any time. You can decline to go through with the interview process and can stop an interview at any time. You have the right to request that the data you provide be withdrawn from the study at any time before completion. Privacy and Confidentiality While the results of this research may be published or presented publicly, you can expect your identity to be protected and kept confidential. You will be asked to give the investigator a pseudonym that will be used instead of your true name throughout the research to protect your anonymity. During the analysis of the data, the investigator will use alpha-numeric coding to identify each participant and protect confidentiality through this phase of the study. By signing this consent form, I agree to take part in this study. I have not given up any of my rights or released this institution from responsibility for carelessness. I may cancel my consent and refuse to continue in this study at any time without penalty or loss of benefits. My relationship with the staff of ICSW will not be affected in any way, now or in the future, if I refuse to take part, or if I begin the study and then withdraw. If I have any questions about the research methods, I can contact Catherine Cheyette, LCSW (principal researcher) at (510) 910-6007/ccheyette@gmail.com or Silvio Machado, Ph.D. (Dissertation Chair) at 707-849-3315/silmachadophd@gmail.com.

If I have any questions about my rights as a research subject, I may contact Dr. John Ridings, Chair of Institutional Review Board; ICSW; Robert Morris Center, 401 South State Street; Suite 822, Chicago, IL 60605; irbchair@icsw.edu. I have read this consent form and I agree to take part in this study as it is explained in this consent form.

_______________________________ Signature of Participant

_____________ Date

I certify that I have explained the research to ________________________________ and believe that they understand and that they have agreed to participate freely. I agree to answer any additional questions when they arise during the research or afterward.

_______________________________ Signature of Participant

_____________ Date

Appendix B Interview Guide

Interview Guide Research questions addressed in interview questions below: What is the adult child’s lived experience of having intentionally ended a relationship with a parent where the adult child is resolute in this decision? What are the emotional and psychological ramifications for people who have severed ties to a parent as a direct correlate to this decision? Interview Questions: Please tell me the circumstances which led you to estrange yourself from your parent. 1. Tell me about how your life has been since your estrangement from your parent. 2. What did you imagine it would be like to cut out your parent from your life? How has the actual experience been compared to this? 3. Do you feel being estranged from a parent has affected your relationships with other people in your life? If so, how? 4. Do you feel there are other areas of your life that have been impacted by your decision to estrange yourself from your parent? (relationships with significant other, children or friendships; work, community or religious affiliations) If so what and how? 5. How do you feel about having made this decision? 6. What has been the hardest part of this decision? 7. What would you say was the best part of making this decision? 8. Do you ever think about your parent? a. If so, when and what do you think about? b. Do you ever imagine reconnecting with them? 9. Do you share your estrangement from your parent with others? If so, what has it been like to do so? If not, why not? 10. What motivated you to participate in this study? Research question addressed in interview question below: What has been the experience of therapy in addressing the estrangement? Interview questions:

1. When and for how long were you in therapy when you worked on issues related to the estrangement from your parent? 2. What was the reason you began therapy? 3. What issues related to the estrangement did you work on in therapy? 4. How do you feel the work related to the estrangement went? Did you see the progress you wanted? What, if anything, changed as a result of therapy? 5. What was the therapist’s approach in working on this issue/these issues with you? 6. How do you feel about how your therapist worked with you on these issues? What did you find helpful or unhelpful? 7. What do you think therapists who work with people who are estranged from a parent should understand about the experience?

Appendix C Screening Form

Dear Participant #, Thank you for offering to be a participant in my dissertation research study The Lived Experience of Adult Children who have Estranged from a Parent and The Experience of Addressing the Estrangement in Therapy. The purpose of this study is to describe the experiences of those who have chosen to estrange themselves from a parent and the experiences this population has had in therapy in which the estrangement was addressed. The criteria for inclusion in this study are that you are between 30 and 60 years old, made the decision to estrange from at least one parent and have maintained the estrangement for at least 3 years. You must not have experienced severe physical or sexual abuse by this parent. You have been in therapy in which issues related to the estrangement were addressed. The study will be either two or three recorded, open-ended, semi-structured interviews lasting approximately one hour each. They will be conducted either at my office at 1676 Solano Ave., Berkeley, CA 94707, a location that both you and I agree is suitable or via video chat. In a semi-structured interview, the interviewer will ask broad questions on the topics of interest and leave room for the interviewee to answer in as much or little detail as desired. The interviewer may ask for elaboration or ask some follow up question. Once a particular focus of questioning is completed, the interviewer may begin with another area of exploration. The interview will proceed in this fashion until the interview is complete. While the focus of the study is on the experience of living with estrangement, understanding what led you to the decision to estrange from your parent is important

information which you will be asked to describe in the beginning of our first interview meeting. If you meet the above criteria for inclusion in the study, understand the intent and what is being asked of you and what to expect in the interview then we can schedule a time and place to meet. I will be in touch with you to arrange this first meeting. During the meeting we will go over the consent form and we will both sign it if you still feel confident that you are interested in being a participant. If you have further questions before you proceed with the study contact me at (510) 910-6007. Thank you so much for considering being a participant in this research project. Regards,

Catherine Cheyette, L.C.S.W.

Appendix D Recruiting Participants for a Doctoral Research Study

Catherine Cheyette, LCSW, a doctoral student at the Chicago Institute for Clinical Social Work, is conducting a research study on the lived-experience of adult children who have chosen to estrange themselves from a parent and who have sought psychotherapy to address aspects of the decision. This study seeks both to understand the lived-experience of the participants after making this decision and their experience in therapy to address the estrangement or estrangement-related issues. The participants will be asked to take part two to three-hour long face to face semi-structured interview either in person or via social media (Zoom or Skype). Each participant will receive $20 per interview. The preconditions for inclusion in the study are the following: 1.

Be between 30 and 60 years of age.

Initiated an estrangement from a parent.

Have been estranged for at least 3 years.

No history of incest or severe physical abuse by the estranged parent.

History of or current participation in psychotherapy in which issues related to

the estrangement were addressed. Those who meet the above criteria and are interested in participating should contact the researcher either by email or phone. Email: ccheyette@gmail.com Phone: (510) 910-6007 Please pass this onto anyone you feel may be interested or know of someone who may be interested in participating in this study. Thank you.

Appendix E Looking for Participants for a Research Study on Family Estrangement

Doctoral student from the Chicago Institute of Clinical Social Work is looking for participants for a dissertation research study on the lived-experience of adult children who have chosen to estrange themselves from a parent. The purpose of this study is twofold. It aims to understand the experience of those who have chosen to estrange themselves from a parent. It also aims to gain an understanding of the experience that this population has had in therapy in addressing the estrangement from a parent. The investigator is seeking participants who have been estranged from at least one parent for at least 3 years. The estrangement needs to have begun in late adolescence or later. The participants need to be between 25 and 64 years old. The participants must not have experienced severe physical abuse by a parent or been victims of incest. They also will have been in therapy and addressed the estrangement. There will be between 2 and 3 interviews of each participant lasting approximately one hour each. The interviews will be conducted either in person or over visual social media (Skype or Zoom). Each participant will receive $20 per interview. If you know of anyone who meets the criteria and may be interested in participating in the study please refer them to the researcher, Catherine Cheyette to let her know of their interest. They can reach her by phone (510)910-6007 or e-mail ccheyette@gmail.com.

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