Case Study

Get Out of My Life!

Working with Cut-off Family Members in the Consulting Room

Magazine Issue
November/December 2014
Get Out of My Life!

When someone has been cut off by a family member, he or she often feels immense hurt, incomprehension, rage, rejection, and a sense of injustice. Of course, this can be true for the initiator of a cutoff as well. Even when someone initiates a cutoff for legitimate reasons (abuse or betrayal, for example), the initiator is still likely to experience regret, sadness, and longing for what might have been. Indeed, the profoundly damaging power of a protracted cutoff can last a lifetime—for initiators and those on the receiving end of cutoffs.

Helping families heal cutoffs is painstakingly delicate work, with a high risk for stumbling over buried land mines. Therefore, I always start by asking the client whether physical violence of any sort has occurred. If so, I calculate, based on when and how it happened, the seriousness of it and the likelihood that violence will erupt again as a result of attempting reconnection. If the risk of repeat violence seems too great, I may see a client individually but postpone or discourage any attempt at reconciliation.

Some cases can’t or shouldn’t be reconciled, but if resolution is the goal, I suggest a meeting with each family member separately as a prelude to scheduling joint sessions. If anyone outright refuses the individual session, I work with the initiating party to bring that person in through methods that may even involve a neutral third party.

In each individual session, I keep expectations low by explaining that the purpose of a family meeting isn’t necessarily to restore the relationship, but merely to explore the possibility of it. The goal is for each person to feel understood, try to understand how the others feel, and clear up misunderstandings. Only then can everyone decide whether to rebuild the relationship. I usually ask for a commitment from each person for a minimum number of sessions (three to six after the individual ones). I also ask each person to agree in advance to leave the room for a few minutes if the discussion gets too heated. Last, I explore each member’s willingness to accept my lead in order to keep emotions from getting out of hand.

Initial Contact

The urgency in Anita’s voice was apparent when she first called me. “My daughter, Tanya,” she began, “ended her relationship with me and her stepfather, Bradley, five months ago without any warning. I’ve asked her why, and all she says is ‘Don’t you get it, Mom? I want you out of my life, period!’” This also meant that Anita and Bradley were no longer able to see Cal, their 3-year-old grandson. “I thought she might change her mind,” Anita explained, “but she won’t answer the phone or return our calls.”

Anita wasn’t sleeping and wanted a family meeting immediately, but before trying to bring everyone together, I suggested that I see her first. In our meeting, she explained that she and Bradley were largely supporting Tanya and Cal financially, and up until the cutoff point had babysat for Cal twice a week. Since they seemed to be engaged, supportive parents and grandparents, the obvious missing piece of the puzzle was why Tanya had cut them off. Were there dark and volatile issues behind the cutoff? Having seen cases like this before, I wondered if stepfather incest was a possibility, but when I take on any new case, I’m always careful to hold these kinds of immediate reactions at arm’s length and resist any tendency to side with someone or overlook seeing the good in someone else. I easily related to Tanya, since during my 20s I stopped speaking to my mother for a few months. At the same time, as a mother who sometimes wishes my own adult children were more communicative, I related to Anita’s anguish. Having absorbed some cultural stereotypes portraying stepfathers of young girls as suspicious characters, I was unsure about Bradley—but I also had the upstanding models of my own stepfather and my husband, who’s a loving, responsible stepfather to my children.

Anita told me she and Tanya’s father had divorced when their daughter was a year old. He’d moved away, and neither parent had made any effort to keep in touch, nor had Tanya ever inquired about him. Four years after the divorce, Anita had met Bradley, 10 years her junior, when she was 35 and Tanya 5. Before Bradley had entered their lives, mother and daughter were “inseparable,” a fact that Anita was so insistent about that I wondered if they’d been too close. Anita had had a tenuous relationship with her own mother, who’d died just before Tanya was born. “I could never get my mother’s attention,” she said. “So I was determined to be there for Tanya.” Although Anita was having a successful career as a lawyer and what seemed like a solid relationship with Bradley, she mostly looked to Tanya to fill her emotional needs.

Because Anita predicted that Tanya would resist engaging in therapy, I asked Anita’s permission, if the need arose, to ally myself with Tanya—to take her side in upcoming family sessions. Yes, in training we’re cautioned not to take sides with one family member, but there are exceptions. In this case, asking for Anita’s consent was actually a way of bonding with her, implicitly acknowledging her ultimate authority in the family. It was nevertheless a risky move. What if Anita had said no? In that case, I’d have empathized with her hesitation while explaining that I doubted I could facilitate reconciliation as readily without the leeway to ally with Tanya, if only temporarily. But here, Anita responded immediately with “I’ll do anything to reunite with my daughter!”

So I helped Anita write a letter to Tanya about her wish to explore reconnection. After some work to temper Anita’s brusque, no-nonsense style, it read, “I know you’re angry at me or us. I don’t understand why, but I’ll try, and do whatever it takes. We’ve found a qualified therapist, and I’m only asking you to take her call, maybe meet with her, and then with me and Bradley in her office. She’s agreed to call you to discuss whether this is something you’re willing to do. I love you, Mom.”

Tanya responded to her mother’s letter with a terse “I’ll talk to her; no promises.” I decided to see Tanya before Bradley to prevent any feeling in Tanya that I was colluding with her parents against her. In my phone call, I directly communicated my strong support to Tanya, telling her how brave I thought she was even to consider family therapy, and that I understood that adult children usually have good reason to stop speaking to their parents. “I’d really like to have your perspective on this situation and help you explore the possibility of reconciliation.” Tanya came in two days later, with Cal napping in a stroller.

“Mom was pretty good to me,” Tanya relayed, “but I always felt I had to be perfect and live my life to please her. She was, and is, incredibly bossy. She resented my involvement in the music school, even though she knew how much I loved the cello. My parents have helped me financially and by babysitting, but I never heard the end of everything they did for me. They have no faith in my talent or my ability to make decisions.”

Tanya paused then continued, “I can’t believe my mother doesn’t know why I’m so angry. I tried over and over to show her that I’ve worked out my problems. I experimented with drugs in my early 20s, but never to the point where I couldn’t function. For five years now, I’ve been clean, and that period of my life is over, but she won’t stop criticizing me about how I’m raising Cal. I’ve tried to get her to lighten up, but she still thinks I’m a child. I had no choice but to cut her off. Bradley too, because he either stays out of it, or backs my mother.”

Toward the end of the session, I suggested to Tanya that she might consider reconciliation if only for Cal’s sake, who’d otherwise never know his grandparents. And, I added, that since cutoffs tend to repeat in succeeding generations, Cal might cut her off if he grew up thinking that this was the way to resolve family conflict. This persuaded Tanya, who not only wanted to protect her relationship with Cal, but also recognized the importance of Cal’s connection to his grandparents. As an aside, she wistfully confided that she sometimes actually missed her parents.

I met with Bradley last. He struck me as open, comfortable in his own skin, with nothing to hide. A labor mediator with impressive communication skills, he wished he could’ve been more helpful in mending the family schism. But after Tanya had rejected his attempts several times, he bowed out. No longer concerned that he might be the cause of the cutoff, I encouraged him to consider being more active in the upcoming family session.

The Family Meets

I began the family session by reiterating the main points covered in the individual sessions, and the fact that all three had agreed to the ground rules. I reminded them that this meeting was exploratory and that no decision about reconciliation had to be made on the spot. I did report that in the individual sessions they all wanted to “unpack” the reasons for the cutoff, rather than bypass them, and to repair the relationship if possible.

I then suggested that we start with a memory of better times. They jointly summoned up a camping trip they’d taken when Tanya had been 7. I emphasized that we’d return to the meaning of that memory after we’d discussed the cutoff. At this point, Anita asked Tanya to explain once more the reason behind her cutoff and what she and Bradley could do to rectify the problem.

Tanya rolled her eyes and said with deep exasperation, “I’ve told you before. I can’t take your overinvolvement and constant criticism about my work, how I’m raising Cal, my choice in men. You’re always watching me, giving me verbal and nonverbal messages that I’m not measuring up. Whenever you babysit for Cal, I get a lecture about how you got him to eat something new instead of the ‘junk’ I give him. I could go on, but I feel like you’ve just decided I’m a bad mother.”

At this point, Anita jumped in to defend herself by saying, “Talk about criticism! Who’s criticizing who now?”

Things were off to a bad start. I reframed Tanya’s monologue as necessary to vent her pain and put the issues on the table—that while there’d be time to help Tanya appreciate Anita and Bradley’s good intentions, Anita first needed to settle down and keep listening. Then Bradley expressed his dismay that Tanya felt so criticized and unappreciated.

“I should have picked up on this earlier,” Bradley said. “I see how you misinterpret our concern about Cal, not to mention our worrying out loud about your finances and how you’re going to earn a living, as lack of faith in you. I’m really sorry.”

Anita, who seemed to have quieted down, suddenly erupted, “Bradley, how can you defend Tanya like that? Have you forgotten how much she hurt me? Shouldn’t she be the one to apologize?” Poor Bradley, who’d tried so hard to keep a low profile, was now fully embroiled in the drama. While encouraging him to stand his ground, I drew my chair closer to Anita and put my hand on her arm. “Anita,” I said gently, “If you want to repair your relationship, it’s critical for you as the parent to hear Tanya. Your turn to be understood will come next.”

In reminding Anita that she needed to be more mature, I was obviously siding with Tanya and Bradley, but also supporting Anita’s main objective—reconciliation. “If you can handle being confronted,” I told her. “The repair process can begin.”

Bradley expressed hope that he and Anita could relax their vigilance and begin to let Tanya be. “We both need to offer more praise, less criticism, trust her more. We have no choice.”

I followed with more support for Anita: “Holding Tanya extra close and worrying about her made sense when you were alone with her as a baby,” I said. “It even made sense into her early 20s, when drugs were an issue, but probably not now. You’ve done a great job, Anita. You’ve got a wonderful daughter, and I think you can relax.”

Surprisingly, Anita, who’d been keeping a poker face, began to well up. “How can I relax when I have no idea how Tanya will support herself when we retire?” she asked. “She’s told me nothing about her life for years now.”

Tanya replied, “Don’t worry. I know I can’t keep relying on your support, and I won’t be doing it much longer.”

At this juncture, I picked up on Tanya’s use of the word worry as a reframe. “I think you have it right now, Tanya,” I said. “If you can interpret what sounds like criticism as your mother’s anxiety about the future, I think you can help her reactions soften.”

Here, Tanya turned to Anita and tried to mollify her, albeit in typical hyperbolic, postadolescent style. “For God’s sake, Mom, can’t you ever relax for a second! I’m going to have a surprise for you very soon.”

As we concluded this meeting, Tanya agreed to come back with her parents for a few more sessions. By session five, Tanya proudly announced her new job, a seat with a major orchestra, significantly reducing the family’s financial bind. Anita breathed a sigh of relief, and Tanya explained that although she’d been serious about her career all along, she was embarrassed at still having to rely on her parents financially. Now that they’d be free of the obligation, Tanya hoped out loud that her parents would “finally” support her career choice.

In session six, with the mood a bit lighter, Bradley asked Tanya to try to empathize with her mother, who was still distraught about the cutoff.

“I’m glad Tanya’s doing well now,” Anita said. “I know I’m demanding at times, so I’ll work on it, but I need some assurance that Tanya will let me back in her life. We used to have such good times together.”

That was my cue to move to the next stage—figuring out how to reconstruct their relationship—so I suggested returning to the camping-trip memory. “What was so special about that trip?” I asked.

Tanya explained that out in nature, they’d enjoyed the quiet together, sharing sights, sounds, and nature photography in a nonverbal way. “I always preferred doing things with, rather than talking with, my mother. After all,” Tanya continued, “how can a child keep up with a trial lawyer?”

Now it was Anita who was shocked. “I had no idea you felt that way,” she said slowly, her face softening as she glanced over at Tanya.

The better-times memory is a powerful way of finding or retrieving a new or different way for family members to communicate. Here, it led directly to the idea of relying less on verbal channels that had become too fraught for comfort. Anita suggested she and Tanya register for a one-week summer photography course in Maine. Tanya replied that she’d love to, but couldn’t leave Cal. Bradley immediately volunteered to come along and watch Cal. As they left the session and walked down the hall, I saw Tanya give her mother a big hug.

The family came in once more at the end of summer to report being “back on track.” Anita mentioned trying hard to listen more and criticize less. Tanya agreed that her mother was “improving slowly.” The parents were back babysitting and, along with Tanya, were optimistic that they could work out ongoing problems on their own.

At the heart of this case was a mother–daughter enmeshment and a daughter’s use of a cutoff to break out of what she felt was her mother’s stranglehold on her life. Ultimately, Tanya admitted that she’d been ambivalent about having gone so far as to break off all contact. That’s how it is with most cutoffs: part of the person who cuts off usually wants to reunite. As therapists, it’s our job to help people find a way back. Of course, it’s often scary work, dealing with the unknown, groping in the dark, fearing that anything could happen if we bring cutoff parties together. But if we shy away from it, we may miss opportunities to address the devastating emotional effects of cutoffs on our clients, as well as the spillover into their other relationships. We may also miss the opportunity to witness deeply moving moments of healing and reconnection.

Case Commentary

By Jay Efran and Jonah Cohen

Cutoffs are treacherous, both on the highways and in families. The term was first used in a family therapy context by Murray Bowen in 1974. In his paper “Toward the Differentiation of Self in One’s Family of Origin,” he wrote that any attempt to reduce a cutoff is bound to “soften the intensity of the family problem, reduce the symptoms, and make any kind of therapy far more productive.” Thus, we certainly concur with Elena Lesser Bruun’s assessment that cutoffs are invariably associated with a catalog of family woes and deserve more therapeutic attention than they currently receive. Further, we appreciate Bruun’s disciplined, diplomatic, and creative approach to orchestrating face-to-face reunions between family members. In this particular case, we applaud her helping Anita to craft an emotionally tempered letter to her daughter. Without that assistance, the joint sessions may never have happened. We also acknowledge the wisdom of her insisting that everyone sign on to a specific therapeutic contract that helps ensure civil communication. Clearly, Bruun has been around the block a few times in this domain and is well aware of the many pitfalls of refereeing emotionally charged family meetings. We consider it helpful that she reserved judgment about who, if anyone, was the villain of the piece.

That said, we’d argue that this case lends itself to two different kinds of emphasis. Bruun mentioned both, but seemed to focus primarily on one. She chose the role of mediator or negotiator, with the major effort being to be get the parties into the same room, or at least to enable them to start talking to each other. Obviously, this is a role in which Bruun feels comfortable and is highly skilled. The second approach makes reuniting family members a secondary goal, subsidiary to a more extensive exploration of the factors—intrapsychic and interpersonal—that necessitated the cutoff in the first place. Of course, this second approach doesn’t preclude having family members reconnect at some point along the way. Murray Bowen went down yet a third pathway. He’d typically coach individuals about how to handle cutoffs in their own family, but was unwilling to referee sessions directly with the cut-off individual.

The potential problem with emphasizing the role of mediator is that, unless the roots of a cutoff are explored and rectified, any gains achieved are likely to be short-lived. Although we don’t have long-term follow-up information in this case, we’re concerned that several core issues weren’t given sufficient attention.

The initial urgency to reestablish mother–daughter contact was motivated primarily by Anita’s fear—panic, really—that she’d lost her relationship with her daughter. In such circumstances, we usually remind parents that they can never lose their relationship with a child, even if he or she is refusing to engage in reciprocal interaction or is deceased. A parent–child relationship certainly undergoes many transformations over a lifetime, but it never ceases to exist.

Because of her initial dread and domineering personality, much of the therapy seems to play out on the turf that Anita establishes. Beginning with that initial contact, she really does appear to be running the show. She scolds her husband, Bradley, for his reasonable move to empathize with Tanya’s position, and—in a textbook example of what transactional analysts used to call a super-now—criticizes being criticized in the midst of a discussion of her being excessively critical! Although she purports to be willing “to do anything” to reconnect with her daughter, she never gives much ground or accepts much responsibility for her role in creating the current set of circumstances. Even in the last session, she agrees to “work on” being less bossy only if she has assurances that Tanya will let her back into her life. In our experience, that kind of tepid and conditional commitment isn’t a good prognosticator of sustained progress. Although Bruun is aware that there are issues of enmeshment and that Anita is far too invested in keeping tabs on her daughter, what’s missing for us is the sense that this was a strong treatment focus. We’d have liked to see more individual work with Anita, either before or after the group sessions. At the very least, it would’ve been helpful to underscore how Anita’s intense desire to avoid making the same mistakes as her mother were now hurting, rather than helping, her relationship to Tanya.

At the point at which it occurs, the feel-good exercise of having the family recall a pleasant memory is as much a distraction as a solution. Unfortunately, unless there’s a significant shift in Anita’s drive to overparent, the in-session induction of good feelings can have only minimal effects.

It’s worth noting that fortuitous factors contributed to the ease with which this family agreed to a reconciliation. Tanya had already begun experiencing regrets about having instigated the cutoff. Thus, the letter from her mother and the phone conversation with the therapist provided an ideal occasion for her to change her position without losing face—always an important factor in overcoming resistance to resolving cutoffs. At around the same time, Tanya’s career prospects had brightened, lowering the emotional temperature in the room. Tanya’s demonstration that she was indeed measuring up to the standards of society presumably reduced both Anita’s implicit concerns about being a bad parent and Tanya’s level of guilt and defensiveness.

Note, however, that these factors do little to address the mother–daughter enmeshment that Bruun recognizes as central. Ironically, both Tanya and Anita readily embrace the solution of placing limits on their verbal interaction. As Tanya puts it, “I always preferred doing things with, rather than talking with, my mother.” In other words, “Let’s both just keep our mouths shut.” Although this code of silence may make some of their interactions more palatable, it inevitably sidesteps, rather than resolves, their conflicts. Thus, instead of being an assurance that the family is finally on track, it’s an expression of the continuing fragility of their relationship. To put the matter succinctly, durable reconnection requires adequate resolution.

Author Response

I agree with Efran and Cohen that it’s important for the durability of reconnection to have cut-off family members work through underlying issues. But from a practical and strategic standpoint, I don’t always push for it—and didn’t in this case. First, although Tanya may have been incompletely launched psychologically, she was nevertheless an adult with a child; and adult children aren’t generally inclined to engage in a lengthy therapeutic retrospective with their parents. Further, Tanya lived an hour from me, had a demanding work life, insufficient funds for babysitters other than her parents, and so on. It was difficult enough to get her to come once.

More importantly, I determined after a brief probe in our initial individual session, that there was no way Anita could be convinced of the value of reflecting on her own behavior prior to reengagement with her daughter. Had I pushed it then, Anita would have bolted and nothing would have been accomplished. In fact, I frequently and specifically recommend bypassing discussion of the cutoff until some relationship repair has occurred. At the same time, I caution families that there may be deeper, even more challenging work to do after reconnection, and that a reconnection without it might not hold.

I also want to question the notion that parents never really lose their relationship with children who cut them off. While it’s true that the biological relationship is permanent and endures in one’s mind, it’s the ongoing contact, connection, and closeness that matters.

In the end, I wanted to present this case specifically because it involved sitting with cut-off family members in my office. Most of us already know how to help clients work through the intrapsychic antecedents to cutoffs in their lives. What we need to do now is stop avoiding intense intrafamilial conflict, and do a better job of working directly with cutoff parties in the room. We also need to become better at assessing and working through our own anxieties about such work, develop effective strategies in our own practices, and pass them on to the next generation of clinicians.


Illustration © Sally Wern Comport

Elena Lesser Bruun

Elena Lesser Bruun, EdD, LMFT, is currently in private practice in New York City. She is coauthor of two books, Marrying Well and Not on Speaking Terms.

Jay Efran

Jay Efran, PhD, professor emeritus of psychology at Temple University.  He received the Pennsylvania Psychological Association’s 2009 award for Distinguished Contributions to the Science and Profession of Psychology and is co-author of Language, Structure and Change and The Tao of Sobriety.