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Sunday, January 30, 2011

Healing Mother-Daughter Relationships

In my prior two blog posts, I provided some background information about life stages in mother-daughter relationships and I also discussed how early infant bonding and attachment affect mother-daughter relationships: Life Stages in Mother-Daughter Relationships and Mother-Daughter Relationships: Early Bonding

Healing Mother-Daughter Relationships

In this blog post, I will discuss how mother-daughter relationships can be healed using a composite vignette, which does not represent any one particular case with no identifying information.

Clinical Vignette
The following vignette is based on a composite of many different cases with all identifying information removed to protect confidentiality:

Ellen was a married woman in her early 50s when she first came to see me. She came because she and her adult daughter, Sandy, had difficulties in their mother-daughter relationship since Sandy was an infant. Ellen felt very sad and frustrated that she and Sandy never had a good relationship, and she felt that they were both stuck in a dysfunctional pattern or relating that neither of them knew how to change. Sandy was her only child, and Ellen wanted very much to heal their relationship.

Ellen had given birth to Sandy when Ellen was 18. She hid the pregnancy from her family through most of her pregnancy because she was ashamed and afraid to tell her parents. By her eighth month, she could no longer hide the pregnancy, despite wearing baggy clothes, and she had to tell her parents that she was pregnant. 

Both of her parents were very upset, and they wanted to confront the boy's parents, but Ellen refused to tell them who the father was. She told me that the father was a young man in his early 20s who was visiting NYC, on leave from the Army, and he left for his home town and never knew about her pregnancy.

Ellen's parents decided that they would raise the baby and, Ellen, who dropped out of school in her eighth month, could focus on getting her GED and going to college. She described this time in her life as being very tumultuous. She was aware that her parents were very disappointed in her and they felt that she had "ruined" her life with this pregnancy.

Since all of her parents' relatives lived on the West Coast, Ellen's parents told them that the baby was Ellen's mother's and that she had kept the pregnancy secret because she wasn't sure she would be able to carry the baby to term due to her age. This was the first secret related to Sandy's birth.

When Sandy was born, Ellen's mother took over. Her mother would hardly allow Ellen to hold the baby and she didn't allow her to breast feed the baby. Ellen said that when Sandy was born, she looked upon her more as a doll than as a live baby. Ellen said she felt a deep shame about having a baby out of wedlock, and it was easier for her to go along with her parents' lies than to deal with the truth.

Before she went away to college, Ellen said she remembered many nights when Sandy cried for hours by herself by herself in her crib. Ellen's mother didn't believe in picking up Sandy when Sandy was in distress because she thought that this would spoil her. Her mother also wouldn't allow Ellen to go to her. So, most nights, Sandy cried until she was exhausted without anyone to comfort her. Ellen said this was excruciating for her, and she was glad to go away to college so she didn't have to hear Sandy cry any more.

While she was in college, Ellen visited home occasionally on weekends. She remembers thinking that Sandy was a sullen, irritable, anxious child. Sandy's basic needs (in terms of being feed, bathed and clothed) were taken of, according to Ellen, but Ellen's parents didn't spend much time talking to Sandy or playing with her. 

 She was left in the crib most of the day by herself. Ellen said that her parents were never overly affectionate people, but their behavior was in stark contrast to how they behaved with her when she was younger. She felt that they were not emotionally prepared to take care of Sandy, and they resented it.

According to Ellen, Sandy grew up thinking that Ellen was her older sister. By the time Sandy was old enough to walk and talk, Ellen said she had also convinced herself of this deception too because it was easier for her to live with. She described the difficulties that Sandy had in school. Although she was bright, Sandy had difficulty making friends with other children and she didn't relate well to her teachers.

After Sandy was evaluated and it was determined that she didn't need a medical intervention, the school recommended counseling. Ellen's parents were opposed to counseling, especially after they heard that the whole family had to be involved in the counseling sessions, so they refused at first. 

 But the school administration continued to pressure them and warned that they would contact the Bureau of Child Welfare if they didn't comply with their recommendations, and Sandy might be taken away from them. The principal felt that Sandy was having basic problems relating interpersonally, and if she didn't get help, this could be a lifelong problem for her. So, Ellen's parents relented very reluctantly.

During family counseling, Ellen's parents finally revealed their secret--that Ellen was really Sandy's mother. Ellen said that her mother broke down one day and told the family therapist the truth. 

 The family therapist helped the family to get through this very difficult time. She told Ellen and her parents that Sandy needed to be told. Ellen and her parents struggled with this for a few months but, with the family therapist's help, they prepared themselves to talk to Sandy in session to tell her, in a way that a child might understand, that Ellen was her real mother.

Ellen told me that she felt retraumatized when she and her parents had to reveal the truth to Sandy. Until then, she had gone into a sort of state of denial about being Sandy's mother, and she felt like she was being confronted with it all over again.

According to Ellen, after she was told, Sandy became very angry and she began acting out in school and at home. She stopped talking to Ellen and she vacillated between clinging to Ellen's mother and pushing her away. 
She behaved in much the same way with Ellen's father. 

During those sessions when Sandy was told the truth about Ellen being her real mother, she was also told that her father lived far away and no one had contact with him. 

Over and over again, the family tried to reassure her that she was much loved by them (even if Ellen's parents had difficulty showing it), but Sandy's school work suffered. Her therapy sessions were increased to three times a week so the family therapist was able to help her get through this crisis.

Soon after that, Ellen moved out of the household to get her own apartment with roommates, and she only went home occasionally to visit her family. She said she made efforts over the years to reconcile with Sandy, but Sandy was very resistant to this. Sandy completed high school and she went on to college. 

She made a few close friends, but she had a lot of problems in her relationships with young men. She tended to choose men who were emotionally unavailable and she was constantly trying to win their affection. According to Ellen, these relationships usually ended in the young men abandoning Sandy.

By now, Sandy was in her mid-30s. As a college graduate, she was underemployed as an office clerk, and she had a succession of roommates over the years. She had not been in a relationship for several years. 

Ellen called Sandy about once every couple of weeks to find out how she was doing, but she said, most of the time, she got Sandy's answering machine and Sandy rarely returned her calls. Whatever she knew about Sandy, she knew from a cousin who moved to NY and who befriended Sandy.

In the early stage of our work together, I helped Ellen to understand what might have gone wrong with Sandy in the early attachment phase when she was an infant. In order for babies to learn how to bond and develop a secure attachment to their primary caregiver (in this case, Ellen's mother), they need to have consist nurturing and care.

Based on Ellen's description of her mother's interactions with Sandy as an infant, it appeared that Sandy's basic needs were taken care of, but there wasn't a lot of nurturing or affection. As a result, Sandy grew up to feel insecure and had difficulties forming relationships. 

I assured Ellen that this didn't mean that Sandy was doomed to continue in this way, but she had to be willing to get psychological help. 

 I told her that the family therapy was probably helpful to her when Sandy was younger, but it seemed, based on Ellen's account, that Sandy probably had a lot of unspoken anger, hurt and resentment towards her. If they were going to heal their relationship, Ellen would have to learn to forgive herself and make amends with Sandy. Sandy would also have to be willing to reconcile.

Our early work together involved helping Ellen to develop emotional resources for herself. Her husband was her main source of external support. She also had supportive, close friends. 

During this period of our work, Ellen grieved for the loss that she felt for not being closer to Sandy when she was a baby. 

She felt that she really missed out on having these early years with her daughter. Ellen also learned to be compassionate with the teenage part of herself who was obviously not equipped on any level to take care of an infant and who had no choice but to go along with her parents' wishes with regard to Sandy.

When she felt ready, she tried to contact Sandy by phone to ask to see her and talk to her, but
Sandy remained unresponsive to her. So, Ellen wrote Sandy a letter in which she expressed her deep sorrow and regret for what happened between them. She asked Sandy to forgive her and told her that she hoped they could develop a better relationship.

Much to Ellen's surprise, Sandy agreed to come in for a therapy session to meet with Ellen and me. It was a very emotional session with lots of anger and tears on Sandy's part and much anguish and pain for Ellen. Sandy agreed to come back for another session a week later. 

Since Ellen had no expectations of how the session would go, she was able to come into her next session with me and talk about how she felt. Even though it was very painful to hear Sandy's anger and pain, Ellen felt that, at least, they were talking in an honest way and the lines of communication were finally open. But she also knew that she could not force Sandy to have a mother-daughter relationship if she was not open to it. At that point, Sandy seemed highly ambivalent.

Ellen and Sandy met with me for several months. It was very rocky at first, but I saw some hope in that they both wanted to continue the process. During our sessions, Sandy developed a psychological curiosity about her own emotional process, and she also began her own individual sessions with a psychotherapist.

Gradually, Ellen and Sandy began to make some progress. 

Just like most psychological changes, it was not a steady line of progress. It was more like two steps forward and one step backwards, but it was progress nonetheless. They began going for coffee after their sessions and, after a while, they were having dinner together. 

Although Sandy was guarded and very cautious at first about opening up, she also seemed, underneath it all, to have a real need for the compassionate, nurturing mother that she never had. By now, Ellen's parents were in their mid-70s and they never really bonded with Sandy.

With Sandy's consent, I also maintained contact with her individual therapist. Her therapist reported that Sandy had formed a rapport with her, and she was making slow, steady progress in treatment. She was beginning to let go of some of her fears about starting to go out with men again, and she eventually met a man that she really liked and who was very interested in her, and emotionally available.

When there is this type of emotional rupture in the mother-daughter relationship, the work tends to be slow. Healing doesn't happen over night, if it happens at all. Trust must be regained over time for both the mother and the daughter.

For mothers and daughters to make amends in these types of situations, there usually needs to be an overarching motivation to transcend their differences. A therapist never knows in advance how this will go in the treatment. 

Healing Mother-Daughter Relationships

Fortunately, for Ellen and Sandy, they were eventually able to develop a belated mother-daughter relationship that they could both feel comfortable with over time. There was nothing magical about it--it involved a lot of sustained, hard work on both of their parts and a willingness to be emotionally vulnerable.

Sandy also tracked down her father who, at that point, was divorced with adult children. After the initial shock of hearing that he had a daughter that he never knew about, he wanted to meet her. Over time, Sandy began taking steps to develop a belated relationship with her biological father.

I hear from both mothers and daughters in this type and other types of relationships. Sometimes, they decide to come in after many years of estrangement. 

Often, mothers and daughters, who might have been reluctant to heal their relationship earlier on, will have a change of heart as the mother ages. Often, they see it as their last chance to reconcile before the mother becomes too frail or before she dies. Other times, as daughters become mothers themselves, they develop more compassion and empathy for what their own mothers might have gone through with them.

There are times when mothers or daughters cannot heal their relationship for a variety of reasons. Sometimes, one or the other of them is not willing or able. Other times, one of them is no longer alive and so the person remaining has to heal her own internal mother-daughter relationship on their own in therapy.

At times, whatever occurred in the mother-daughter relationship might have been so abusive that the relationship is just still too toxic to heal, especially if the mother is unable to own up to the abuse (if she was the abuser) or unable to accept that abuse occurred (if the abuser was someone else). 

Often, these are instances where there was physical and/or sexual abuse that remains unacknowledged and unresolved. At those times, you might need help to overcome the trauma of what occurred without involving the other person.

Getting Help in Therapy
As I've mentioned in prior blog posts, the mother-daughter relationship is the most intense family of origin relationship. This can make it the most rewarding as well as the most painful relationship.

If you and your mother or daughter are having problems healing your relationship on your own, you might consider getting professional help to assist you with this process, whether you decide to do this on your own or with your mother or daughter.

About Me
I am a licensed New York City psychotherapist, hypnotherapist, Somatic Experiencing therapist and EMDR therapist (see my article: What is a Trauma Therapist?).

I work with individual adults and couples.

I have helped many clients to work through mother-daughter issues as well as other family of origin problems so that they can lead meaningful and fulfilling lives.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

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