Adult Children of Difficult Families: Therapy on Long Island
by Dr. Marc J. Shulman | Long Island Psychology | Family Relationships, Nassau County | Page last updated: September 2026Across Nassau County, adults who grew up managing a parent’s moods or competing for a sibling’s fair share often carry that exhausting vigilance quietly into their forties and fifties, long after the household that created it is gone.
Some families are easy. The people in them mostly get along, and nobody has to manage the relationship for it to keep running. That may not be the family you grew up in. If a parent or a sibling (or both) turned the whole thing into work, you already know what the other kind costs: the bracing before a phone call, the seating chart you quietly plan around one person every holiday, the sense that you are still, decades on, handling something you never agreed to handle. This page is about that territory. What makes a parent or sibling relationship genuinely hard to be the adult inside of, and what to actually do about it.
Part of what makes it hard is a belief most people never get to examine directly: that a family relationship carries an obligation simply because of how you happen to be related, regardless of what the other person did with the relationship. In an ordinary family, the belief holds up fine. It gets heavier, and considerably more tangled, when the parent in question is genuinely difficult; volatile, self-absorbed, checked out, or living with a mental health issue that shaped the household around it. The sense of owing starts to float free of anything that was ever actually earned. On the sibling side the same logic shows up in a different shape, as an assumption that closeness should simply exist because two people grew up under one roof, whether or not the relationship ever became one worth having.
If that sounds familiar, with a parent or a sibling or both, you’re in the right place. Not every difficult family history involves what would formally be called childhood trauma, and this work doesn’t require that label to be useful. Nobody here is asking you to decide your parent or sibling is a bad person. What this work gives you is a framework for a kind of relationship most people never got one for, along with a practical sense of what to do with it now that you’re the adult standing in it.
Reach out to Long Island Psychology to talk with a therapist who treats this pattern regularly. No pressure, just a conversation about whether it’s a fit.
How the Parent Relationship Is Supposed to Change, and What Happens When It Doesn’t
As you move into adulthood, the relationship with a parent is supposed to shift. You depend on them less. Your read on who they actually are gets more sophisticated, with real strengths and real limits held in view at once, instead of the child’s version where a parent is either entirely safe or entirely frightening. Often the caretaking eventually starts running the other way. At its best that transition keeps all the warmth and simply updates the terms: two adults, rather than a parent and a child. When a parent is significantly difficult, or carrying a mental health issue that shaped the household, the evolution tends to stall. A parent who never built a secure, respectful relationship with a child rarely gets one handed to them later just because the child grew up.
That stall isn’t a character flaw in the adult child, and calling it ingratitude misses what actually happened. Closeness grows where a child felt safe and taken seriously; where that was thin, there’s simply less of it later. Plenty of parents in exactly this spot are caught off guard anyway. They feel wounded, sometimes resentful, about a closeness nobody ever put in the work to build. That gap, between what a difficult parent expects and what the relationship actually produced, is where most of the guilt and confusion in this territory lives.
Why This Isn’t Just “Family Estrangement” Content
A lot of what gets written about difficult parents and difficult siblings online assumes the endpoint is cutting the relationship off. Sometimes that is the right call, and we’ll talk honestly about when. But most of the adults we see in this part of the practice have never gone anywhere near estrangement. They’re still at the Thanksgiving table. They still pick up the phone; they still answer the family group text. The wound isn’t distance. It’s what staying close keeps costing them: guilt after every visit, dread before every holiday, the strange experience of being forty-eight years old and still tending to a parent’s moods (or smoothing over a sibling’s) the way they learned to at ten.
Anyone caught in this is balancing two things that don’t always point the same direction. On one side sits whatever real obligation, love, or connection they feel toward the parent or sibling. On the other sits their own need to not feel violated, managed, or diminished inside the relationship. Left alone, that balancing act often hardens into a people-pleasing pattern that follows a person well outside the family, which is why it shows up so often in our self-esteem therapy work too. The healthiest version of this work has nothing to do with rendering a verdict and walking away. It’s about building a relationship, close or distant, that doesn’t require you to disappear inside it.
What This Looks Like: Two Different Relationships, One Underlying Pattern
This territory shows up in two connected but distinct relationships, and we treat them as related pieces of work rather than one.
The Parent Relationship
Here the focus is the parent: someone who may be narcissistic, emotionally immature, volatile, addicted, or simply never able to build the secure relationship a child needed. The work involves understanding where the pattern started, deciding what kind of relationship (if any) is sustainable now, and learning to set boundaries without collapsing into either full compliance or full estrangement. Read more on our Growing Up With a Narcissistic or Emotionally Immature Parent page, or our page on Family Estrangement & Setting Boundaries With Parents.
The Sibling Relationship
Adult siblings becoming friends is a genuinely good outcome when it happens, a closeness built on shared history no other relationship has access to. It is an outcome, though, not something the relationship arrives with automatically because two people happen to share parents; assuming otherwise is exactly what sets a person up to feel disappointed by their own brother or sister. In a lot of the families we see, the childhood underneath the relationship wasn’t especially even-handed to begin with. One child got cast, usually without either child choosing it, as the capable one or the favorite. The other got cast as the problem, or the afterthought. Those roles rarely stay contained to childhood. They resurface at holidays, in the family group chat, and in who gets asked for help versus who gets asked to explain themselves, long after both siblings have households of their own.
That history is a big part of why closeness with a sibling doesn’t simply show up on schedule once everyone is grown. People spend years quietly frustrated, trying to manufacture a bond that was never there. One question tends to cut through it: would you choose this person as a friend if they weren’t your sibling? A genuine yes means you have something worth investing in. A genuine no isn’t a verdict on either of you; it just changes what a satisfying, appropriately scoped sibling relationship can look like from here. Read more on our Adult Sibling Relationships: The Golden Child & Scapegoat Dynamic page.
Raising the Next Generation Differently
For many of the adults we see in this work, the urgent version of this has nothing to do with the past. It’s about not repeating it. Parenting now, while consciously trying not to pass down what was done to you, is its own specific and often exhausting kind of anxiety. Read more on Breaking the Cycle: Parenting Differently Than You Were Parented.
Signs This Territory Applies to You
- You feel a low-grade dread before a visit or a phone call with a parent or sibling, even when nothing in particular is wrong that day.
- You still manage a parent’s mood, logistics, or emotional state the way you did as a child, decades after you stopped needing to.
- Guilt arrives the moment you consider saying no to a parent, or setting a real limit with a sibling, even over something entirely reasonable.
- You give far more to the relationship than you get back, and the resentment that’s built up has nowhere useful to go.
- You’ve tried more than once to force a real friendship with a sibling, and ended up disappointed each time.
- You can list a parent’s or a sibling’s real flaws clearly; you still feel like the bad one whenever there’s conflict.
- You’re raising your own kids and catch yourself mid-moment, terrified you’re about to repeat something from your own childhood.
Where This Actually Comes From
A difficult parent-child relationship rarely traces back to one dramatic event. Far more often it traces to a parent who was emotionally immature: quick to anger or to withdrawal, low on empathy, unable to stay steady when a child was upset. The child learns early not to bring problems to that parent at all. However much love was there, the pattern tends to produce an adult who is still, years later, trying to get an emotional need met by someone who was never able to meet it.
Difficult sibling relationships usually trace to something quieter. Attention, approval, or protection was scarce enough in the household that children ended up competing for it, consciously or otherwise. One sibling absorbs the role of the reliable one, the easy one, the one who can do no wrong; the other absorbs the role of the difficult one, blamed first and believed last. Neither role gets chosen. Neither is really about who either sibling is. Both calcify with repetition, and plenty of people carry an assigned role into adult family gatherings without ever having agreed to keep playing it.
Sometimes, on the parent side, the child fills the gap a parent left: managing moods, raising younger siblings, holding the family’s stress so that somebody else didn’t have to. That pattern, often called parentification, tends to produce a capable, responsible adult who has real trouble letting anyone take care of them in return. Other times it runs the opposite way. A parent has no real boundary around the child’s inner life, and the child’s feelings and choices get treated as extensions of the parent’s own. Clinicians call that enmeshment; it tends to produce an adult who feels intense, disproportionate guilt the moment they try to become a separate person.
None of this is only theory. How willing adult children are to provide warmth and care to an aging parent tracks the actual quality of the earlier relationship, not the biological fact of being someone’s child. Plenty of families sense this without ever putting words to it. The son or daughter who shows up easily for one parent and reluctantly for another usually isn’t reacting to biology; they’re reacting to what the relationship actually was.
What This Looks Like in a Session
A composite of what comes up often, with a parent: someone describes a twenty-minute Sunday call that covered the weather, a cousin’s new job, and whether the car needed inspection. Nothing in it would strike an outsider as a problem. And yet they hang up drained, vaguely guilty, and roughly ten years old. When we slow the call down together, the exhaustion turns out to have nothing to do with what was said. It’s the volume of quiet management running underneath the conversation: reading the parent’s mood from the first hello, choosing words carefully, steering twice around a subject that might set them off. That work has been going on, mostly invisibly, since childhood.
A composite of what comes up often, with a sibling: someone describes sitting down at a holiday table and feeling demoted to age twelve inside of ninety seconds. Cut off mid-sentence. Corrected, gently, in front of everyone. Watching a sibling get asked warmly about their week while their own news, a promotion they’d been sitting on for a month, stays on the table unmentioned. Nothing about the moment would look dramatic from the outside. What makes it land so hard is that it’s the same emotional seating chart that existed thirty years ago, and nobody at that table ever agreed it should still apply.
Naming either pattern out loud, the parent version or the sibling version, is often the first time it stops feeling like “just how family is” and starts feeling like something that can change.
Boundaries, or the Harder Decision
When a relationship with a parent or sibling has become genuinely toxic, two paths open up, and both are legitimate. The first is a real boundary: deciding specifically what you will and won’t accept, then holding that line through the discomfort, so your own needs stop getting trampled. This is where the work lands for most of the families we see, and it holds up better than people expect once they’ve had some practice. The second path, for when boundaries aren’t feasible or simply aren’t being respected, is stepping back from the relationship. Sometimes that means a defined period; sometimes it runs longer, until the relationship can be revisited on different terms. It happens far more often than the silence around it suggests, and people rarely arrive there lightly.
Neither path is a failure. The failure would be staying in a relationship that requires you to keep disappearing inside it, simply because nobody ever told you there was another option.
What Changes
Before
- Every visit or call requires managing a parent’s or sibling’s mood before your own
- Saying no feels like a betrayal, so you don’t
- You keep trying to force a closeness that was never actually there
- You’re terrified of repeating your parents’ mistakes with your own kids
After
- You can be present in the relationship without carrying it alone
- You can decline something reasonable without a guilt spiral afterward
- You have a realistic, sustainable relationship, closer or more distant, but no longer exhausting
- You have an actual, practiced sense of what you’re doing differently, and why
If any part of that right-hand column sounds like where you want to get to, we’re glad to talk it through with you.
Our Approach at Long Island Psychology
There’s no single script for this work, because the family that shaped you is specific to you. Treatment draws on several approaches, tailored to whatever is actually driving the pattern.
Cognitive Behavioral Therapy (CBT)
CBT identifies the specific automatic thoughts driving the guilt or dread (“I have to say yes”; “if I set a boundary, I’m the bad one”) and tests them against what’s actually true, rather than what an old family rule insists is true.
Acceptance and Commitment Therapy (ACT)
ACT helps you act in line with your own values in these relationships, whether that means showing up, stepping back, or setting a limit, even while the old guilt is still present. You don’t have to wait for it to disappear first.
Psychodynamic Therapy
Understanding where the pattern in your family started, whose expectations you’re still trying to satisfy, and why the relationship took the shape it did, is often the piece that makes everything else make sense.
Dynamic Experiential Learning (DEL)
Developed here at Long Island Psychology by Dr. Shulman, DEL works experientially with the guilt, dread, or obligation these relationships produce, rather than only discussing it. Most adults in this situation understand the pattern intellectually long before it stops running their behavior.
Positive Psychology
This work focuses on building the relationships actually available to you: a workable connection with a sibling, a healthier version of contact with a parent. That tends to be more useful than continuing to grieve the relationship you always wished you’d had.
This work also connects closely with our self-esteem therapy work, since a scapegoat role in a family very often produces adult self-criticism with no obvious present-day cause. It overlaps with couples therapy as well; patterns learned in a difficult family of origin have a way of reappearing in adult romantic relationships.
What to Expect in Your First Session
We spend the first session mapping which relationships are actually costing you the most right now, a parent, a sibling, or the fear of repeating something with your own kids, and where that specific pattern likely started. From there, we build a plan out of the specific mix of psychodynamic, DEL, CBT, ACT, and positive psychology work that fits your particular family history, rather than a generic template. Most patients leave that first hour with at least one way of looking at the relationship they didn’t walk in with.
Contact us to get started. There’s no obligation attached to that first conversation.
Frequently Asked Questions
Is this the same as "toxic family" content I've seen online?
Related, but more specific. Most toxic-family content assumes the only healthy outcome is cutting a parent or sibling off. In our experience, people are usually looking for a workable middle distance: real boundaries, and a relationship that doesn’t cost them their own wellbeing. Not an all-or-nothing choice.
What if I don't want to "process my childhood" and I just want the guilt to stop?
That’s a reasonable goal, and it’s often where we start. In practice, understanding where the guilt comes from tends to be what loosens it, rather than a separate, optional step you can skip.
Can I do this work without confronting my parent directly?
Yes. A great deal of meaningful change here happens entirely on your side of the relationship: how you respond, what you agree to, what you let land. No confrontation required, which matters, since many parents in this picture couldn’t hear one anyway.
I get along fine with my parents but struggle with a sibling. Is that still something you treat?
Very much so. Sibling relationships get far less attention than parent relationships in most family therapy content, despite being every bit as capable of producing real, lasting distress.
Do you treat this alongside anxiety or depression, or is it separate?
Usually alongside. Family-of-origin patterns are frequently what sits underneath anxiety, depression, or self-esteem issues that appear, on the surface, to have no current cause at all.
Does this pattern apply if I had a wonderful relationship with one parent and a genuinely difficult one with the other?
Very commonly, in fact. A warm relationship with one parent doesn’t cancel out the impact of a difficult one; if anything, the contrast can make the difficult relationship harder to name, since “my childhood wasn’t all bad” can end up minimizing a pattern that still deserves attention.
Can this pattern extend to grandparent relationships, either how a difficult grandparent treated me or how a parent's own difficult childhood shows up in how they parent my kids?
Yes, in both directions. Some adults are still managing a difficult grandparent’s dynamics with their own children; others notice their own parent repeating, as a grandparent, the exact pattern that made their own childhood hard in the first place.
How long does this kind of work typically take?
It varies with how deeply the pattern is woven into your relationships and how many of them it touches. Some people find real relief within a focused course of work; others, particularly those untangling both a parent and a sibling relationship at once, do better with a longer course of work.
Is any of this genetic, or is it entirely learned behavior passed down through parenting?
The clinical consensus leans heavily toward learned patterns rather than inherited ones. A parent’s own emotional immaturity, and the coping strategies a child develops in response to it, get transmitted through relationship and repetition, not through biology. That’s part of why the pattern is genuinely changeable.
What if my siblings remember our childhood completely differently than I do?
That’s extremely common, and it isn’t necessarily a sign anyone is lying. Siblings in the same household often occupied different roles, got different treatment, and therefore have accurate but genuinely different experiences of the same years.
Does birth order play any role in how these family patterns show up?
It can, though it isn’t the deciding factor. An oldest child is sometimes pulled into a parentified, responsible role earlier; a youngest sometimes absorbs a scapegoat role longer. The role a household assigns has more to do with a family’s specific dynamics than with birth order alone.
What does this cost, and how does billing work?
Long Island Psychology is a self-pay practice. We don’t bill insurance directly, but we provide a superbill, a receipt many out-of-network plans will reimburse against in part. Contact us and we can walk you through what that typically looks like for your plan.
- What Adult Children Actually Owe Difficult Parents
- Growing Up With a Narcissistic or Emotionally Immature Parent
- Boundaries, Not Ultimatums: Deciding How Close to Stay With a Difficult Parent
- Would You Choose Them as a Friend? Rethinking Adult Sibling Relationships
- “Am I Becoming Them?”: Parenting Differently Than You Were Parented
Getting Help in Nassau County
Maybe you’re still managing a parent’s moods at forty. Maybe you’re still hoping a sibling will become the friend you always wanted, or lying awake worried that you’re repeating something from your own childhood with your kids. None of that is a life sentence; it’s a pattern with an origin, and patterns with origins respond to treatment. Our offices are in Garden City and Rockville Centre, serving families throughout Nassau County, including Great Neck, Manhasset, Syosset, Mineola, Westbury, and the surrounding communities, with telehealth available statewide. A good number of the families we see pass Eisenhower Park on the way to a Sunday visit they’ve been dreading since Tuesday, or catch the LIRR from the Garden City station for a holiday they’ve already started bracing for. See our full list of Nassau County locations served here.
Contact us and we’ll match you with a therapist who fits.
