Jane K Toler PhD, Licensed Professional Counselor

Steve Blow is a beloved writer who retired in September 2015 after almost 30 years as columnist for the Dallas Morning News.

His columns included, among other important matters, observations and commentary about human relationships and mental health. By bringing these topics to readers’ attention, he helped open up doors for those who were scared, lonely, angry, sad, and for those who just didn’t know where to turn. Thank you, Steve Blow, for your years of observation, reporting, and caring.

In his next to last article, he wrote about the Dallas based support group Healing Estranged Relationships. Below is the article.


SteveBlow-0706
Steve Blow, Dallas Morning News, September 2, 2015

Sometimes the success of a column is bittersweet. You’re happy people responded. You’re sorry they needed to. “It was your column of April 2008,” Jane unexpectedly began, telling me how she discovered a support group for mothers suffering the particular pain of broken relations with an adult child… Read the rest of the article hereMothers separated from their adult children can find healing

Sometimes mothers and adult children become estranged. There may have been a divorce, the mother or children may have moved, their common interests may have changed with age, or there may have been an event that one or all parties could not get past.

The mother may try to maintain the relationship, but no matter what she does, it’s not good enough or it just doesn’t work.

These breaks in the mother-adult child relationship occur more often than many people realize. For some mothers, the pain is so great they choose not to talk about the estrangement. They may be embarrassed about having a ‘less than perfect’ relationship. Though the pain is kept hidden, there are feelings of anger, sadness, guilt and shame.

Healing Estranged Relationships (H.E.R.) is designed to be a personal and social resource for women who would like to:

  • Learn about types of parent-adult child relationships.
  • Recognize transitions in the parent-adult child relationship.
  • Discover new ways of relating to an adult child.
  • Develop specific approaches for mending the parent-adult child relationship.
  • Cultivate inner strengths for coping with the loss of the parent-adult child relationship.

If you have a strained or non-existent relationship with your adult child, or would simply like to learn more about parent-adult child relationships, please join us on the second Monday of each month from

6:00 PM to 7:30 PM.
Group Facilitator is Jane Toler, Ph.D.

For more details, please call Vera Shelby at 214-523-2152, send an e-mail to lnfo@HealingEstrangedRelationships.org, or visit our website at www.HealingEstrangedRelationships.org.

Stack of books on green grassBooks

Adams, J.  I’m still your mother: How to get along with your grown-up children for the rest of you life.

Adams, J.  When our grown kids disappoint us. Letting go of their problems, loving them anyway, and getting on with our lives. 

Atkins, D.  I’m OK, you’re my parents: How to overcome guilt, let go of anger, and create a relationship that works.

Baker, A. J. L.  Adult children of parental alienation syndrome: Breaking the ties that bind.

Baker, A. J. L. Surviving parental alienation: a journey of hope and healing

Bloomfield, H. H.  Making peace with your parents: The key to enriching your life and all your relationships.

Coleman, J.  When parents hurt: Compassionate strategies when you and your grown child don’t get along.

Davis, L.  I thought we’d never speak again.

Hafner, K.  Mother, daughter, me: A memoir.

Harder, A.  Letting go of our adult children: When what we do is never enough.

Herst, C.  For mothers of difficult daughters: How to enrich and repair the bond in adulthood

Isay, J.  Walking on eggshells: Navigating the delicate relationship between adult children and their parents.

Kuttner, R. & Trotter, S.  Family re-union: Reconnecting parents and children in adulthood.

Lebay, B.  Family estrangements: How they begin, how to mend them, how to cope with them.

Leiber, P., Murphy, G. S., & Schwartz, A. M.  Grown-up children, Grown-up parents: Opening the door to healthy relationships between parents and adult children.

Lieberman, S. A.  The mother-in-law’s manual.

McCoy, K. Making peace with your adult children

Merrill, D.  When your children marry: How marriage changes relationships with sons and daughters.

Merrill, D.  Mothers-in-law and daughters-in-law: Understanding the relationship and what makes them friends or foe.

Newman, S.  Nobody’s baby now: Reinventing your adult relationship with your mother and father.

Richards, N.  Heal & forgive II: The journey from abuse and estrangement to reconciliation.

Sichel, M.  Healing from family rifts: Ten steps to finding peace after being cut off from a family member. 

Smith, S. L. Making peace with your adult children.

Sucov, E. B.  Fragmented families: Patterns of estrangement and reconciliation.

Tannen, D. I only say this because I love you. Talking to your parents, partner, sibs, and kids when you’re all adults.

Tannen, D.  You’re wearing that? Understanding mothers and daughters in conversation.

Taylor, K.  Free mother to good home. A handbook & survival guide for good parents, stepparents & grandparents who find themselves underappreciated, under-loved & overwhelmed.

Zax, B. & Poulter, S. Mending the broken bough: Restoring the promise of the mother-daughter relationship.

  • Be patient. Don’t expect fast and great change.
  • Your timetable may not be your children’s. If they need more time, respect their timetables.
  • Set limits. If you have not talked with your children in awhile, try limiting the conversation to a time-length that is comfortable and manageable.
  • If past contact has been intense, arrange for less intense contact. Try meeting in public, planning an activity that will keep you from talking about sensitive topics, or dropping off a card in the mail and keeping the message light.
  • Build new traditions with your children.
  • Be aware and let go of any unrealistic expectations you may be holding concerning your children and your relationship.
  • Find the positive aspects of the relationship and nurture them.

In the Meantime

  • Take small steps to create new rituals.
  • Be with people who make you feel good.
  • Develop and strengthen other healthy relationships.
  • Take care of yourself and don’t neglect good sleep, diet, and exercise.
  • Talk. Joining a support group and talking with a therapist can be safe ways to gain insight, promote change, and begin healing.

When mothers find themselves estranged from adult children, a common reaction is to feel they are not needed by their children. Even though you may FEEL this way, it is not true – you are still needed. Although you may have a complete “cut-off” in your relationship and not have any communication with your child, you are still needed.

There are numerous books written by children who seemingly cut their parents out of their lives. Although they write that they have no contact with the parent(s), they inevitably make observations of the parent(s) and consider her/him from afar. Many children write about their thoughts of reconciliation up until a parent’s death. They consider what the parent said or did to the very end.

Although you may feel you have no influence, you have tremendous impact. Your children watch or hear about how you behave and what you say. We all draw on experience and you are your child’s experience. You are the ultimate role model.

Now, this may lead a few moms to say “Great, I messed up and that’s all my child is going to draw on.” Wrong. Give yourself a break. You did not mess up all the time. You did the best you could under the circumstances. You did the best you knew how to do at the time. Forgive yourself. Forgive your child for his/her stubbornness, short-sightedness, ability to hold a grudge, and all the rest. There is still time to be the example that you want to be for your kids because: Today is the first day of the rest of your life and your kids ARE watching and listening.

So when you feel the hurt, anger, resentment, and all the other feelings that estrangement brings out, don’t forget that you are providing a “roadmap” for your kids – they will reflect on how you handled life’s matters.

Sometimes parents and adult children become estranged. Perhaps there was a divorce, the parent or children may have moved, their common interests may have changed with age, or there may have been an event that one or all parties could not get past. The following presentation examines parent and adult child estrangement, which includes some of the reasons and issues involved as well as how healing occurs.

People Who Have Had Estranged Relationships

  • Drew Barrymore and her parents, Jaid and John Drew Barrymore
  • Meg Ryan and her mother, Susan Ryan Jordan
  • Patty Davis and her parents, Nancy and Ronald Reagan
  • Jennifer Aniston and her mother, Nancy Anniston
  • Angelina Jolie and her father, Jon Voight

Why?

  • Personality/Temperament
  • Substance abuse and mental health issues
  • Divorce
  • Move away
  • Abuse
  • Delay or resistance to navigating the normal transitions in the parent-child relationship
  • Common interests have changed with age
  • An event one or both parties cannot get past
  • Lifestyle choices
  • Sexual orientation or gender identity
  • Children or family members dating, cohabitating, marrying outside their culture. Cultural differences include:
    – Ethnic
    – Religious
    – Financial
    – Educational
  • End of life issues (e.g., wills, trusts, power of attorney)
  •  “We are a throw-away, disposable society”
  • Parental Alienation Syndrome (PAS)
  • The parent has more money.
  • “I have no money – the kids are scared they will have to take care of me, so they distance themselves”
  • The media – it exposes, and normalizes, estrangement

Normal Transitions in the Parent-Child Relationship

  • Leaving home: single young adults (accepting emotional and financial responsibility for self)
  • Joining families through marriage – the new couple (commitment to new system)
  • Families with young children (accepting new members into the system)
  • Families with adolescents (increasing flexibility of family boundaries to permit children’s independence and grandparents frailties)
  • Launching children and moving on (accepting a multitude of exits from and entries into the family system)
  • Families in later life (accepting the shifting generational roles)

Carter, B. & McGoldrick M. (1999). Overview: The expanded family life cycle: Individual, family and social perspectives. In B. Carter & M. Goldrick (Eds.), The expanded family life cycle:  Individual, family, and social perspectives (pp. 1-26). Needham Heights, MA: Allyn & Bacon.

Issues to Consider

  • Communication
  • Divorce
  • Domestic Violence
  • Emotions
  • Family Patterns/Relationships/Dynamics
  • Healing
  • Holidays
  • Mental Illness
  • Reconciliation

Communication

  • Apology
  • Communication Patterns
    – Styles
    – States
    – Types

Divorce

  • Parenting Style
  • Relationship between the parents
  • High conflict divorce proceedings
  • State of litigation
  • Parental alienation
  • Remarriage

Domestic Violence

  • Its effects on the parent-child relationship
  • The dynamics of domestic violence

Emotions

  • Anger
  • Disappointment
  • Grief and guilt
  • Shame
  • Longing and yearning
  • Emotion management
  • Coping skills

Family Patterns – Relationships – Dynamics

  • Genograms
  • Family constellation
  • Personality priorities
  • Types of parent child relationships
  • In-laws
  • Estrangement and its effect on other relationships
    – Grandparents (the interruption in the continuity of the generations)
    – Grandchildren
    – Couple
    – Siblings

Healing

  • Arlene Harder’s 5 Stages (recognition that expectations have not been met, trying to get the other person to change, taking a look at yourself, grieve what is not possible and let go, acceptance of the relationship)
  • Forgiveness
  • Acceptance
  • Gratitude
  • Patience

The Holidays

Mother’s Day, Thanksgiving, Christmas, Birthdays, Anniversaries

  • Building resources all year
  • Preparing for the occasion
  • Learning to cope and manage emotions

Mental Health Issues

  • Bipolar
  • Substance Abuse

Reconciliation

  • Preparing for reconciliation
    • Consider whether your expectations are too high
    • Be as prepared as you can for whatever your child’s reaction/response may be – positive or negative
    • Plan ahead.
      • Practice what you want to say.
      • Consider how initial contact will be made (e.g., phone call, e-mail, text, face-to-face meeting – in public or private)
  • Obstacles to reconciliation
    • Unrealistically high expectations
    • Wanting something specific (e.g., apology, explanation)
    • Allowing negative emotions to hijack the moment
  • Reconciling
    • Don’t expect fast and great change.
    • Set limits. If you haven’t talked to your child in a while, try limiting the conversation to a time length that is comfortable and manageable.
    • If past contact with your child has been intense, arrange for a less intense contact – be in public, plan an activity that will keep you from talking about sensitive topics, or drop off a card in the mail and keep the message light.
    • Don’t flood the child with the “new you.”
    • Let your child know you heard him/her. Practice reflexive listening.
    • Your timetable might not be your child’s. Respect your child’s timetable.
    • Create (new) traditions with your child.
    • Focus on the positive aspects of the relationship.

How Healing Occurs

  • Talking, sharing, listening, and being with others.
  • Realizing that one is not alone.
  • Learning new information.
  • Turning inward to self-assess – focusing on the self.
  • Working towards:
    – Forgiveness (self and others)
    – Acceptance (self and others)

Observations

  • Parents have a sense of pride in their children and love them deeply.
  • There is a great deal of pain, suffering, hurt, longing, yearning, shame, and guilt.
  • Parents do not want to “go public “ with the estrangement.

Parent-adult child estrangement has been called the “silent epidemic.” With the proliferation of information about parent-adult child estrangement in recent years, it is becoming clear that families who suffer estrangement are not alone in their quest for understanding, reconciliation and healing.

The following presentation, Elderly Mental Health, is to help caregivers understand the many changes and challenges an elderly person may be experiencing. Sometimes the changes are so subtle that caregivers do not recognize them – either in themselves or in the person for whom they are caring – until one day it seems like things are out of control, blow-up, and/or are intolerable. Caregivers can feel frustrated and exasperated that their elderly charge is depressed, irritable, confused, anxious, or engaging in bizarre behaviors. Learning about what an older person is experiencing and the possible cause(s) can help the Caregiver feel less overwhelmed and better able to empathize, sympathize, and consider alternatives that can ease and soothe symptoms of distress.

See this article for specific information about Dementia.

As People Grow Older They Accumulate More Losses

  • Retirement (loss of role identity)
  • Financial problems (fixed income)
  • Loss of loved ones
  • Physical problems
  • Relocation
  • A sense of feeling devalued in society in general

Social Isolation

Deteriorating social support system as friends/family pass, takes away the protective factors that help people get through these types of situations.

Life-Stage Development Questions

  • Has my life had meaning?
  • Have I contributed to the world?
  • Has my life been worthwhile?

Symptoms

Mental health symptoms may present quite differently in the elderly persons:

  • Sleep disturbance
  • Loss of appetite
  • Physical complaints
  • Agitation
  • Irritability

Anxiety and depression can be a consequence of underlying medical conditions (e.g., cardiac problems can lead to shortness of breath and palpitations. Hyperthyroidism can also cause agitation and anxiety).

Medical conditions can be influenced/exacerbated by anxiety and depression.

Rule Out

  • Post-operative delirium
  • Infections
  • Dehydration
  • Medications
  • Changes in the senses
    • Hearing
    • Vision
    • Taste and smell
    • Touch, vibration, pain

Commonly Diagnosed Forms of Mental Illness in the Elderly

Depression

It is not uncommon for older people to note that they may be the last of a generation, which can lead to a profound sense of loss, prompting feelings of loneliness and isolation that can be difficult for younger people to comprehend.

Anxiety

Most often takes the form of worry:

  • Family
  • Health
  • Money
  • Work
  • Miscellaneous
  • Hoarding
  • Phobias
    • Traveling
    • Being alone
    • Insects
    • Close spaces

Many times Caregivers say they feel guilty about what they thought or how they reacted to their elderly loved one. This presentation was made to help Caregivers recognize changes an older person has gone through, is currently experiencing, and faces in the future. The information includes symptoms to look for and questions to consider when talking to health professionals in order to rule out causes. By recognizing and understanding the world of the elderly person, the Caregiver can have a clearer perspective from which to think, speak, and act when interacting with them.

About the Author

As a Licensed Professional Counselor and Supervisor, Dr. Jane Toler specializes in counseling individuals, couples, and families. She has navigated the caregiver journey in her own family, with clients, and with members of the group she facilitated, Caring for the Caregiver.

Dr. Toler earned her Ph.D. in Counseling from The University of North Texas and M.S. and B.A. degrees from the University of Tennessee, Knoxville. She has been in the mental health field since 1996. She has volunteered at the Suicide and Crisis Center in Dallas and is an affiliate of the Stepfamily Association of America, now known as the National Stepfamily Resource Center.

 

The following is part of a presentation, Elderly Mental Health, designed to help caregivers understand the many changes and challenges an elderly person may be experiencing. Sometimes the changes are so subtle that caregivers do not recognize them – either in themselves or in the person for whom they are caring – until one day it seems like things are out of control, blow-up, and/or are intolerable. Caregivers can feel frustrated and exasperated that their elderly charge is depressed, irritable, confused, anxious, or engaging in bizarre behaviors. Learning about what an older person is experiencing and the possible cause(s) can help the Caregiver feel less overwhelmed and better able to empathize, sympathize, and consider alternatives that can ease and soothe symptoms of distress.

Below is information about Dementia. Click the link to the rest of the presentation, for helpful information about other mental health considerations. Elderly Mental Health.

Dementia

What is Dementia?

It is not a specific disease.

It describes a group of symptoms affecting thinking and social abilities severely enough to interfere with daily functioning.

www.mayoclinic.ort/diseases-conditions/dementia/basics/causes/con-20034399?p=1

What Causes Dementia?

Dementia involves damage of nerve cells in the brain, which may occur in several areas of the brain. Dementia may affect people differently, depending on the area of the brain affected.

What Conditions Can Cause Dementia?

  • Reactions to medications
  • Metabolic problems and endocrine abnormalities (e.g., thyroid problems, hypoglycemia, too little or too much sodium or calcium, impaired ability to absorb B12)
  • Nutritional deficiencies (e.g., thiamine/B1, B6, B12, dehydration)
  • Infections (e.g., meningitis, encephalitis, syphilis, Lyme disease, AIDS)
  • Subdural hematomas
  • Poisoning
  • Brain tumors
  • Anoxia (diminished supply of oxygen to an organ’s tissues)
  • Heart and lung problems

What Conditions Are Not Dementia?

  • Age-related cognitive decline (i.e., slower information processing, mild memory impairment)
  • Mild cognitive impairment
  • Depression
  • Delirium

What are the Risk Factors for Dementia?

  • Age – risks go up with advancing age
  • Genetics/family history
  • Smoking and alcohol use (smokers have higher risk of vascular diseases)
  • Cholesterol
  • Diabetes
  • Mild cognitive impairment
  • Down syndrome

Diagnosing Dementia

  • Dementia may be diagnosed when two or more brain functions (e.g., memory, language skills, perception, or cognitive skills including reasoning and judgment) are significantly impaired without loss of consciousness.
  • Some causes of dementia are treatable and preventable.
  • Patient History
  • Physical Exam
  • Neurological Evaluation
  • Cognitive and neuropsychological tests
  • Brain scans
  • Lab tests

Many times Caregivers say they feel guilty about what they thought or how they reacted to their elderly loved one. This presentation was made to help Caregivers recognize changes an older person has gone through, is currently experiencing, and faces in the future. The information includes symptoms to look for and questions to consider when talking to health professionals in order to rule out causes. By recognizing and understanding the world of the elderly person, the Caregiver can have a clearer perspective from which to think, speak, and act when interacting with them.

About the Author

As a Licensed Professional Counselor and Supervisor, Dr. Jane Toler specializes in counseling individuals, couples, and families. She has navigated the caregiver journey in her own family, with clients, and with members of the group she facilitated, Caring for the Caregiver.

Dr. Toler earned her Ph.D. in Counseling from The University of North Texas and M.S. and B.A. degrees from the University of Tennessee, Knoxville. She has been in the mental health field since 1996. She has volunteered at the Suicide and Crisis Center in Dallas and is an affiliate of the Stepfamily Association of America, now known as the National Stepfamily Resource Center.

 

Much has been written about living wills and medical directives, yet there is a huge gap in our knowledge about other things that involve our parents and other elderly relatives — knowledge that is important for us to have. Here are seven questions to ask them now. Read Article

About the Author

As a Licensed Professional Counselor and Supervisor, Dr. Jane Toler specializes in counseling individuals, couples, and families. She has navigated the caregiver journey in her own family, with clients, and with members of the group she facilitated, Caring for the Caregiver.

Dr. Toler earned her Ph.D. in Counseling from The University of North Texas and M.S. and B.A. degrees from the University of Tennessee, Knoxville. She has been in the mental health field since 1996. She has volunteered at the Suicide and Crisis Center in Dallas and is an affiliate of the Stepfamily Association of America, now known as the National Stepfamily Resource Center.

Elderly couple moving
The following presentation, A Checklist for Helping Parents Move, offers ideas and suggestions for helping an elderly person who is moving. This is usually about an older person who is transitioning from an independent lifestyle to one in which more care is needed. Change is difficult for most people but moving from where one has lived (in many cases, for decades) to a new residence (that may be out-of-state and where he/she knows no one) can be especially difficult for an elderly person. Waves of vulnerability, loneliness, and uncertainty may wash over them. However, the transition can be made less daunting and even one of ‘new beginnings’ if there is tender, loving support and some planning. This presentation is part of “Caring for the Caregiver,” presented by Jane K. Toler, Ph.D., Facilitator.

Questions And Considerations

  • Do you know your parents’ healthcare wishes for if/when they become incapacitated?
  • Who is your parents Power of Attorney for legal, financial, and healthcare matters?
  • Have you and your parents talked about expectations for things such as visits – e.g., how often and for how long?
  • What are the housing options for your parents?
  • If considering moving to a retirement community, tour the communities with your loved one.
  • Is care-giving needed?  If so, what type?
  • If they are living in the same town, what happens when you go out of town?
  • Will pets be involved in the move?   If so, what kind of provisions need to be made for them?

Preparing For The Move

  • Create a written list of contact names and numbers of physicians, dentists, pharmacies, legal and financial advisors, clergy and/or spiritual leaders/advisors, family, friends, and neighbors.  Add to the list as the circle grows.
  • Create  a list of all medications, vitamins, herbs, etc.  Be sure to keep it updated.
  • Interview people/companies/agencies who can help with the move (e.g., organizing, downsizing, movers, etc.).
  • Keep a list of organizations that can provide help and support (e.g., faith based, home health, hospice, meals).

The Move

  • Keep the move upbeat – it can be considered an adventure.
  • Be enthusiastic and encouraging.
  • Know your parents’ hobbies and interests.
  • Introduce them to places and people with similar hobbies and interests.
  • Check out senior centers together.
  • Find a place of worship – a place that suits your loved ones’ spiritual interests and needs.
  • If your loved one is a veteran, check-in to the local VA system and community.
  • Obtain a disability placard for your car (from Texas Department of Motor Vehicles).

Be Proactive

Create A Team

  • Create a list of everyone who is currently helping.
  • Create a list of everyone who could play a role.

Courtesy: www.aarp.org/caregiving

The List Of Team Members

This list may include:

  • Family
  • Friends
  • Neighbors
  • Faith community
  • Paid or volunteer service providers who can help with meals, household, and pet care
  • Healthcare providers including doctors, nurses, pharmacists, dentists
  • People with legal, financial, and technological expertise

Communication

Clarify roles and responsibilities

Consider:

  • Personalities
  • Skills
  • Time limits
  • Those who may be more hands-on
  • Those who need/prefer to help from a distance

Types of Team Members

  • The Big Picture Member – plans and looks at overall status.
  • Team Leader – coordinates one big chunk – e.g., finances or healthcare.
  • On-going “Interactors” – see loved ones on an on-going basis.
  • Occasional contributors – take on special projects or emergencies.
  • Task oriented achievers – do one thing at a time if you tell them what to do.
  • Back-up players – are available if your plan goes awry.

www.aarp.org/caregiving

In summary, asking, discussing, and honoring a parent’s desires and expectations about a move is most important and will reassure them that they have say and control about what is happening. Creating lists, planning, and organizing keeps the lines of communication open and fosters a sense of control. Being upbeat and showing encouragement and enthusiasm will help make the transition more of an adventure and something positive to anticipate. And, finally, get help. You can’t do it all by yourself and friends and family usually like to contribute in a way that is suitable to them and beneficial to you and your loved one.

About the Author

As a Licensed Professional Counselor and Supervisor, Dr. Jane Toler specializes in counseling individuals, couples, and families. She has navigated the caregiver journey in her own family, with clients, and with members of the group she facilitated, Caring for the Caregiver.

Dr. Toler earned her Ph.D. in Counseling from The University of North Texas and M.S. and B.A. degrees from the University of Tennessee, Knoxville. She has been in the mental health field since 1996. She has volunteered at the Suicide and Crisis Center in Dallas and is an affiliate of the Stepfamily Association of America, now known as the National Stepfamily Resource Center.