Psychiatry Consultations and Counselling Services  in  Goa, India 

 Controlling Parents

by Ashutosh Prabhu Dessai, M.D.

Contrary to the popular experience and perception of the mother being a benevolent force akin to God, sometimes shocking presentations of young girls (or boys) and even middle aged women, facing difficulties with their mothers (or fathers) , are seen.

The latter have controlling and interfering tendencies with or without  a combination of one or more other traits such as

·  Anxiety

·  Domination

·  Dependency

·  Rigidity 

 

This makes life miserable for the daughters both before and even after marriage with potential to disrupt their lives.

The erosion of independence , self esteem, self love and consequently being riddled with self doubt, guilt , anxiety , feelings of incapability,  of being watched , of just not being able to do anything right etc, occur as a result of prolonged exposure to above traits over years. 

Such emotional and psychological inadequacies are induced through various mechanisms such as

• Devaluation

• Deception

• Sabotage of independence by taking over simple tasks like shopping, selection or  arrangement of their personal items, and even making career choices. Many controlling parents continue to provide directions to their adult children for the minutiae of life which even a five-year old does not need to be told. For example, they continuously instruct victims through the day to wash their hands before meals, watch where they are walking, be careful while crossing the road, remind them to take baths, take their umbrellas if it is raining, and check if they are carrying their mobiles and other items if they are going out of the house. 

• Generation of guilt through first providing praise and bombardment with gifts and then resorting to tantrums, threats, and developing somatic complaints such as headache or giddiness when their wishes are not complied with.

• Other guilt tactics include hinting about other old parents in their social circles who are ill treated or thrown out by their children or referring to popular movies or books on the same theme.
  

•  Excessive vigilance

• Alienation from friends and social circles by suggesting  negative ideation about friends

• Financial control inducing financial dependency

• Placing their entire well-being on the victim indicating that they cannot survive without the victim

• Efforts to manage the married life of the victim by either controlling the spouse by proxy or developing good relationships with people in the social circles of the victim to maintain control. In the event of a conflict or an act of defiance by the victim for independence, the parent draws on the social circle to influence the victim in her favor . 
• 
  
• Terminating child's therapy by attacking therapist's credibility or competence using deception to misguide eg . by giving wrong example of indication of a prescribed medication saying it is not indicated or that the medication is outdated for the wrong indication eg blood pressure when it was actually given for stress .

• Outright verbal abuse

In essence, controlling parents use various tactics and keep changing them as and when required to keep the victim off balance. The constant mental engagement that is caused by the barrage of these tactics, as well as through repeatedly asking trivial questions, prevent the victims to step back and be objective.

The parent takes up so much of their mind space that the victim cannot concentrate effectively in their academic, domestic, marital and work environments.

Such systemic issues arising from difficult and toxic traits in the parent need intense intervention to rebuild the lives of the victims converting it into an onerous task to undergo individual  therapy, many times, when the client herself doesnot have a primary psychiatric disorder.

Family therapy is also necessary  and may be better suited to deal with such maladaptive interactons  but more often than not , is not agreed to by the parent in question rigidly and vehemantly denying any disturbance, making the issue difficult to deal with.

The fathers/husbands sometimes are also renedered ineffective by these mothers/wives making their role insignificant to take corrective measures for the  client girl/child.

On occassions the client presents with various Trauma spectrum disorders experiencing anxiety, depression , dissociation with development of somatic complaints,   and even psychoses. The degree of disorganisation  faced , varies from person to person and depends to a large extent on the degree to which  healthy personality formation occurred in the child before she became the focus of such mechanisms by a realignment of protective systemic familial factors such as movement of the other parent (father) away from family , as well as genetic factors.

The interventions, intensity and duration of therapy is therefore different for different clients,  so is their progress and recovery.

Dr. Ashutosh Prabhu Dessai is a professor of psychiatry in Goa and former consultant psychiatrist Northland Health New Zealand

When Parents Are Too Toxic to Tolerate

by Richard A. Friedman, M.D.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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