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The Parentified Child

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Chris TerryNelson

on 13 July 2016

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Transcript of The Parentified Child

Chapter 1: "How We Became Psychotherapists"
What is Parentification?
- Parentification "is the familial interaction pattern in which children and adolescents are assigned roles and responsibilities normally the province of adults in a given culture, but which parents in a particular family have abdicated." (Mika, et al, 1987).
- These may include caring for siblings, assuming various roles via the parents (e.g. consoler, confidant, peacemaker, adviser) or assuming household responsibilities (e.g., cooking, cleaning, paying bills).
Parameters of Parentification
- Parentification, while not pathological per se, may become pathological when:
1) the child is overburdened with responsibilities beyond his or her developmental level,
2) the child's needs are neglected, and
3) the parent assumes the child's role in the family

- There are several problems associated with parentification:
1) believing that one is loved for what one does for others rather than for who one is;
2) difficulty setting limits upon others' requests; and
3) problems getting one's own needs met directly. (Jurkovich, 1997).
Boszormenyi-Nagy on Parentification

- In
family relationships:
1) Parents are sensitive to asymmetry with children
2) Reciprocity is not expected

- In
family relationships:
1) Deprivation and abuses in the parents' past leave them destructively
2) In pathological forms, children are often the victims of this entitlement.
- Is the child being exploited as a direct caretaker in the family system? Or indirect (e.g. distracting marital conflict through misbehavior)?

Type of Role Assignments:
- Instrumental vs. Expressive/Emotional
- Instrumental: requires children to assume responsibility for concrete functional tasks and support
- Expressive: requires children to serve as confidants, companions, matelike figures, family mediators, comforters.

Extent of Responsibility:
- Degree/Duration of Caretaking
- Excessive caretaking extends beyond situational crisis
- But: too little parental expectation of responsibility is unhealthy
Object of Caretaking:
- Does the child overfunction in relation to the mother, father, one or more siblings, several family members, the marital subsystem, or the whole family?

Age Appropriateness:
- The earlier and the more age inappropriate the caretaking charge (e.g., assigning unsupervised sibling caretaking responsibilities to a 6-year old), the more destructive.

- Disruption of developmental tasks (formation of secure attachment, exploration of environment) due to excessive caretaking demands is also destructive.

- Children are induced to accept assignments that exploit and fashion their natural loyalty and concern into an obligation to serve parental and familial interests.

- At its worst, this exploitation leads children to distrust their interpersonal world as one which will only exploit them and never give them what they need.
The Parentified Child
The Parentified Therapist

Chris TerryNelson

“These people have all developed the art of not experiencing feelings, for a child can experience her feelings only when there is somebody there who accepts her fully, understands her, and supports her. If that person is missing, if the child must risk losing the mother’s love or the love of her substitute in order to feel, then she will repress her emotions. She cannot even experience them secretly, “just for herself”; she will fail to experience them at all. But they will nevertheless stay in her body, in her cells, stored up as information that can be triggered by a later event.”

- How much did/does the child internalize their parentified role as part of their identity and interpersonal style?

Family Boundaries:
- Were caretaking responsibilities supervised or shared? Were children triangulated (Bowen) or enmeshed (Minuchin) with undifferentiated figures as a result of this role?

Social Legitimacy:
- In many sociocultural contexts, parentified role patterns (such as sibling caretaking) is adaptive and legitimate within the context, mitigating its destructive potential.


Boszormenyi-Nagy, I. & Krasner, B. R. (1986). Between give and take: a clinical guide to
contextual therapy. New York: Brunner/Mazel.

Jurkovic, Gregory J. (1997). Lost Childhoods: The Plight of the Parentified Child. London:

Mika, P., Bergner, R., & Baum, M. (1987). The development of a scale for the assessment of
parentification. Family Therapy, 14(3), 229-235.

Miller, Alice (1997). The Drama of the Gifted Child. New York: Basic Books.

Waldrip, C. C. (1993, Winter). The therapist as a recovering codependent.
Association for Marriage and Family Therapy Newsletter.

Causes of Parentification

(abuse, exploitation, boundary disturbance)
(disrupted, insecure, anxious, avoidant)
(primary narcissistic needs were frustrated, no core sense of self, emotionally fused with or reactively cut off from family of origin, cannot think, feel or act for themselves).
Cognitive Schema
: internal working models of the child's role (overgiving) and the other's role (exploitative) are disturbed and egoistic. Examples:
Therapist: "
What do you feel is the most important goal of raising a child?
Client: "
I think to grow up into the image of what you wanted to be, or what you wanted them to be, what you wanted to be yourself
." (Newberger, 1977)
Father to Daughter: "
I brought you into the world, and I can take you out
." (Jurkovich, 1997).
Shy and slow to warm up, although interpersonally sensitive, seek gratification within immediate home environments.

Capacity to Care:
Infants as young as 7 months can become prematurely attuned to unconscious needs/affects of parents, increasing risk of parentification (sacrificing spontaneity and self-development)

Will often develop and maintain affectional bonds with abusive figures through caretaking.

Family Factors:
Substance dependence
- Adult children of alcoholics report greater degree of destructive parentification (Goglia, 1992).

Birth Order and Family Size:
- Oldest children tend to take on most responsibility

Single Parenting:
- Children of single parents not only instrumental but expressive (confidants, companions, supervisors).

Marital Dysfunction:
- Parentified adults often want to be parented by their mates. When this fails, they turn to children. Children as young as 2 years old console unhappy marital partners, acting as peacemakers (even preventing domestic violence).
Role Induction:

Parental Underfunctioning:
Overpermissiveness, physical abandonment of the family, abdication of parental responsibility, co-parenting difficulties, incompetence or preoccupation with unmet needs and fears.

Displays of parental neediness, helplessness, dependency

Threats, persuasion and moral exhortations to behave in a caretaking way.

Allowing over-involvement with siblings

Lack of challenge/abandonment by non-parentifying parent
Peers and School:
Children assume the role they play at home with their teachers and peers.

Tend to overfunction, assume most responsibility for initiating and maintaining contact

Avoid hurting peers' feelings at their own expense of their own.

Frequently sought after for advice and support.

Excessive orientation to adults exposes lack of development of age-related social skills, leading to social isolation (which enhances reliance on caretaking at home)

Pseudomaturity endears them to teachers.

A supportive school can be a relief for parentified children.
Parameters of Parentification
Parameters of Parentification
Causes of Parentification
Causes of Parentification
Causes of Parentification
Consequences of Parentification
When responsibilities are appropriate and fair, then parentification can facilitate healthy development of:
- Learn important social skills: responsibility, independence, empathy, nurturance, and fair give-and-take in relationships.
- Even true of exploitative parentification.

However, pathologically parentified children are at risk for experiencing the following difficulties:
- Loss of childhood, parents, & trust
- Anger and resentment
- Stress
- Guilt and Shame
- Physical and sexual abuse
- Peer problems/School
- School difficulties
- Disrupted identity development
- Conflicts about leaving home
- Occupational concerns
- Personality dysfunction
Loss of Childhood, Parents and Trust
- Bitterness, disappointment and depression related to childhood deprivation/neglect may not surface until later in life.
I'm like an orphan, but I don't have the upside of being an orphan; I'm still responsible for my family
" (Jurkovic, 1997).
- Increased suicidality is common when caretaking efforts are ineffectual, unappreciated or criticized, while their psychic pain goes unnoticed.
- Distrust of others, difficulty being dependent, and even a mistrust of their own perceptions and experience of inner life.

Anger and Resentment
- Parentified children are angry, but can't show it.
If I told [Mom] my real feelings, she'd fall apart. Then what would I have?
- Insecure feelings, anxiety, low energy, psychosomatic disturbances.
- "In many cases, parentified children meet diagnostic criteria for generalized anxiety disorder" (Jurkovic, 1997, p. 54).

Guilt and Shame
- Find it difficult to be happy and enjoy success when their family members are not doing well emotionally, physically, financially, or otherwise.
- Reminded of their failure to fulfill their roles, leading to feelings of worthlessness

Peer Problems
- "He's fine with adults, but not so much with kids...."
- Seen as too serious and grown up, don't fit in.
- Used for advice and support, without reciprocation
School Difficulties
- Often excel in academic activities
- May be the result of the achievement needs of the parents
- School performance may suffer due to preoccupation and exhaustion from responsibilities at home

Disruption in Identity Development
- The parentified identity is other-directed, reactive, and undifferentiated.
- Can be a source of control when family is out of control
- Create order in their psychic worlds through caretaking (even just ruminating)
- Rescuing others meets a profound existential need.
- Asking "Who am I?" often provokes anxiety and guilt.

Conflicts About Leaving Home
- Failure to form an independent sense of self makes launching difficult.
- Guilt about abandoning needy parents
- Frequently made to feel dependent on parents through symptoms (conspiring with parents to sabotage separation)

Occupational Concerns
- At risk for job dissatisfaction when their work does not meet their needs for dependency and nurturance.
- Occupations are often extensions of the familial roles, to ensure they are "needed."

Personality Dysfunction
- Parentification can severely injure core personality processes (attachment, narcissism, separation-individuation).
- At risk of forming unhealthy traits and personality disorders, lacking object constancy, self-soothing skills, and the capacity to be alone.
- Narcissistic disturbance can occur in cycles of grandiosity (the parentified role) and depression (the failure to fulfill the role), which include dynamics like loss of self, perfectionism, need to be special, fear of loss of love, strong conformist, and denial of true feelings.
Personality Dysfunction Cont'd

- Parentified personality attributes are similar to codependency.

- Parentified children later in life associate giving with duty to avoid a loss of love, rather than with spontaneous pleasure.

- Giving is not related to intimacy, but to

- Often feel unworthy of being cared for and do not know how to ask for what it is that they need, and may even sabotage themselves from receiving care.
Treatment and Prevention
Stage 1: Identify
- Look for the stealthy behavioral signs of overcompliance in children
(typically the non-compliant/delinquent members addressed first)

Stage 2: Describe
- How are caretaking behaviors expressed?
- What type of caretaking is it (instrumental/expressive)?
- How extensive is the caretaking (situational/chronic)?
- Who is the primary object of the child's caretaking?

Stage 3: Contextualize
- Genogram/Developmental History/Interviews with Parents, Child and Sibs
- Is this caretaking age-appropriate? Are developmental milestones and social skills being missed?
- How much does the child depend on this role for self-esteem?
- Is the caretaking role/parental need made explicit or implicit?
- Where is the nonparentifying parent?
- How is this role impacting the child at school with peers?
- Does this role fit within a cultural framework that mitigates damage (sibling caretaking)?
- What consequences has it had on the family system?
(Jurkovic, 1997)

Joining: can be difficult!
- Therapist can be intruder to the parentified child who challenges loyalty!
- Therapist is the caretaker! There can only be one! (not about power, but about security/attachment through role).
- Process fears about therapy, especially fear of being displaced.
- Invite parentified child to monitor a parent's mood
- Don't forget to join with parents (who may also be parentified, as this helps the child not to feel disloyal in therapy.

Address the Parentification Process
- Needs to wait, don't try to rescue the child.
- Allow the child room to express feelings of anger/resentment towards parents/situation.
- Educate parents on why child is trying to care for them (non-blaming stance)
- Address the relational imbalance through facilitating parents' active listening.
Treatment and Prevention
Treatment and Prevention
Restore Parental Accountability
- Some clients may need direct guidance on the asymmetrical nature of the parent-child relationship.
- Help parents understand their child's inner experience when they are in their parentified role.
- Help parents acknowledge their children's contributions to the family.
- Be careful not to play the role of parentified child with parents (disregarding children by being overly attentive to the parents subtly recreates the destruction of parentification)
- Encourage parents to reconnect with family of origin, establish friendships, find gainful employment, and join self-help groups for support.
- Help parentifying parents work through destructive entitlement in their family of origin.

Help Family Members Grieve Their Losses
- Parentification is usually a way that parents avoid (an yet reenact!) the pain of their own childhoods and marriage(s).
- Allow for parents and children to grieve lost aspects of childhood
("I had to grow up to quickly. I always wanted to play sports, but no one could take me to the games.")
Fostering New Relational Possibilities

- Parents must not only assume greater responsibilities, but should engage in child-centered activities and play - both at home and in therapy sessions.
- Some parentified children will need help adjusting to the parents' emerging caregiving, and this will require time. Help parents not to be discouraged too quickly.
- Parents can focus attention meeting parentified child's developmental milestones and fostering social time with other kids.
The Parentified Therapist
Possible issues include:
Boundary Distortions
- Being "more than a therapist" to clients
- Losing asymmetry
- Go beyond the call of duty
- May work longer/harder than the client
- Assume excessive responsibility
- Vulnerable to coalitions/favoring individual in families
- Unpredictably withdraw or strike out when resentful of overfunctioning.
- Poor/erratic management of session time and phone/email contact

Compulsive Giving
- "To exist is to save others!"
- It's more than a job, it defines their identity.
Narcissistic Disturbances
- Enormous pressure to be admired by clients and to perform exceptionally well.
- Unable to regulate their own self-esteem, they are dependent on feedback from others.
- Just being adequate or any mention of failure will often lead to feelings of incompetence and insignificance. Some may even become sick.
- If a client says "you haven't done enough," the parentified therapist says "I'm not good enough."
- Imposter syndrome, based on the repetition of the failure of previous caretaking efforts with family of origin.
- Overestimate their abilities when they're praised

Ethical Violations
- Boundary problems and overgiving lead to violations, despite the parentified therapist's loyal demeanor.
- Typically overambitious and attempting to control change in the family rather than entrusting them to figure it out on their own.
- Failure to deal with parentification places them at risk of unconsciously exploiting clients to address their own wounds.
Divided Loyalties

- Difficulty navigating work and family life
- Spouses and children often feel they are in competition with clients for time, energy and commitment, while clients are the victims of their strained role.


- Like anyone else, therapists can become mentally and physically impaired.
- Signs of burnout include: "constant complaints about work, sense of 'imminent doom,' feelings of tedium, increased negative countertransference reactions, extreme irritability and withdrawal at home, frequent illnesses of unknown origin, a desire to 'run away,' and periodic suicidal ideation" (Kaslow and Schulman, 1987, p. 94).
Strengths of the Parentified Therapist
Dedicated Empathic Caring
- Clients feel understood and cared for
- Parentified therapists overintellectualize and detach in relationship to their clients to avoid repeating the feeling of loss of control experienced with needy parents, and so they truncate their empathy to protect themselves.

- Appear less inhibited and are freer to be themselves because they have been doing this for a long time.
- This allows the client to be more of him or herself.
- "A critical measure of the success of the relatioship between therapist and client is not their mutual feelings of affection, attraction, and connection but rather their ultimate 'regard for the well being and success of the other" (Boszormenyi-Nagy & Krasner, 1986, p. 409).

- Well-trained in interpersonal problem solving and crisis intervention.
- Less dependent on techniques learned in their professional schooling than other therapists.

Clinical Range
- High capacity and willingness to handle severe psychopathology and family dysfunction (early attachment issue, custody disputes, family violence, sexual trauma), and able to attune to the pain of their clients.
Self-Care for the Parentified Therapist
Enhance family-of-origin relationships
- Insight is not enough, relationships have to change
- Learn to differentiate from the care-taking role

Keep the home fires burning
- Attend to your current family

Remember "It's Just A Job"
"Moving ... into a healthier, free place means ... that I don't have to cure people; I can give them permission to get better or not, and at whatever speed they choose. It means I don't work harder than my clients do in the therapy session. It means that I work at setting appropriate limits with my clients and standing firm. It means I'm trying to break the habit of single-handedly taking on any client situation that presents itself, no matter how difficult it is . . . I've begun in recent years to taste the fruits of authentic commitment and compassion for my clients, and to see that they come not from compulsion, but from freedom." (Waldrip, 1993, p. 7).

Handling Taxing Clients
- Parentified therapists who work with difficult clients shouldn't be afraid to ask for help by 1) working with a cotherapist, 2) seeking consultation or supervision, and 3) when intractable, transferring the client to another therapist.

Fostering Personal Relationships
- By disengaging from the caretaking role, parentified therapists can discover the joy of receiving love and sustenance.
- Friends can help us be accountable to just "being human."

- There is no better training for a therapist than being a client. Working to establish self-differentiation, fairness, caring, and integrity with significant others will pay dividends.
“Where there had been only fearful emptiness or equally frightening grandiose fan­tasies, an unexpected wealth of vitality is now discovered. This is not a homecoming, since this home has never before existed. It is the creation of home.”

- Alice Miller, The Drama of the Gifted Child
Jurkovic, 1997
Jurkovic, 1997
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Jurkovic, 1997
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Faculty Sponsor: Dr. Sara Hopkins
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