Working Therapeutically with Family Estrangement
28 June 2024

By Letticia Banton
Photo by Marianna Smiley


It’s starting to get dark early.” After several years of working together, I knew this was my client’s code for ‘Christmas is coming’, which for him meant a reminder of his family’s estrangement and the prospect of spending another festive season alone, with intense feelings of loneliness, grief and shame resurfacing.

‘Family estrangement’ is a term used to describe the breakdown of a relationship between family members. In the UK, it is estimated that 1 in 5 people are estranged from their family, with numbers on the rise (Stand Alone, 2015). Yet it is an area of relationships that has received little attention by psychotherapeutic theory, research and training. To help address this gap, the Inner Citadel Institute welcomed Dr Samantha Barcham for a two-part CPD on family estrangement. Dr Barcham (2021) has conducted doctoral research into this area, and it is her specialism in clinical practice.

While every person’s experience is unique, Dr Barcham emphasised that “family estrangement often comes with incredible sadness and heartache for all those involved, and it is not something done on a ‘whim.’” Her research describes estrangement as a ‘relational injury’ or trauma (Barcham, 2021). As relational beings, a person’s sense of self-confidence and self-worth may be significantly impacted by family estrangement. Exploring a person’s lived experience of family estrangement and its impact on their sense of self in psychotherapy is nuanced work. In this blog post, we share six takeaways from the CPD sessions on working therapeutically with people who are estranged from, or estranged by, their families:

  1. Reflect on your own assumptions towards family estrangement

Family estrangement is an area that may not have been explored during core psychotherapy trainings so therapists may not have taken the time and space for self-enquiry into the topic. Drawing on Blake’s (2020) research, Dr Barcham highlighted several common biases that people carry toward those who are estranged from their families, which are important for therapists to bring into awareness before working with a client:

  • Reconciliation bias: Are you encouraging reconciliation, pushing the client to reconnect and make amends? Why might you hold this agenda?
  • Estrangement bias: Do you believe the client should ‘just walk away’ without exploring this fully and the consequences? Why might you be holding this position?
  • Perspective bias: Do you hold one side at fault? Why? How much does being human and always thinking one person is ultimately to blame factor in your perspective?
  • Forgiveness bias: Are you pushing your client to forgive to move on? Or encouraging them to make an apology, even if they don’t mean it? Why might this be the case?
  1. Recognising and holding the complexity of family estrangement is important

Pathways to estrangement can be multifaceted and complex. These can include harsh or poor parenting, divorce, a problematic child-in-law, mental illness or addiction, as well as divergence in values and lifestyles, such as gender, sexuality, religious and political beliefs. For some people estrangement might mean no contact, while for others it could be infrequent communication.

For others still, there could be physical proximity but an emotional distance. As a therapist it is important to demonstrate insight into this complexity, rather than hold a singular conceptualisation of ‘family estrangement’. During the process of therapy, collaborative and phenomenological inquiry can help to build a picture of what is known and unknown about a client’s family and their idiographic experience of estrangement.

  1. The therapeutic relationship may play a reparative role

While the quality of the therapeutic relationship lies at the heart of any effective therapy, for people who have experienced family estrangement, an attuned, trusting and lasting relationship with their therapist really matters and carries reparative potential. While the client’s family relationships and attachment-bonds may have broken down the expression of intense feelings and conflicts, a good-enough therapeutic relationship can withstand this.

The therapeutic relationship may play a pivotal role in offering a relational experience that was missing in the client’s family-of-origin and self-development. For example, it can offer warmth and compassion when the family environment may have been harsh and cold. Or flexibility when the family may have been rule-based and rigid. A safe and trusting therapeutic relationship can also help a client to face disavowed or shadow parts, which may be particularly painful to revisit. For example, their role in the estrangement, or the experience of ambiguous loss of grieving for someone who still lives.

  1. Left-brain and right-brain interventions are important

Using therapy as a space to dialogue about a client’s felt experience rather than to repeat narratives can help them to process complex and difficult emotions about their estrangement, including shame, guilt and anger. As well as left-brain dialogue to enhance insight, right-brain interventions can expand a person’s capacity to ‘be in relationship’ so they can face, sit with and process difficult emotions with their therapist, the relational ‘other’. For example, a therapist offering affective co-regulation through grounding and breathing exercises could be important developmentally for people who may not have had emotional co-regulation modelled in their family of origin.

  1. Working towards a form of acceptance

While fully accepting and moving beyond the immense pain of an estrangement may never be possible in a person’s heart, when someone learns to live with the reality of the estrangement, they can often feel a sense of relief and reduced suffering. Accepting the lived reality of the estrangement can help someone regain a better sense of control and begin to grieve the ambiguous loss they may feel around being estranged from a family member.

It may also enable them to step back and have more insight and perspective into how the estrangement took place. A therapist can play an important role in helping a client to turn toward rather than away from the complex feelings they may hold around the estrangement so they can move toward a place of acceptance. Through acceptance often comes a stronger sense of agency.

  1. Reconciliation as a process not an event

Parents with estranged children may often come to therapy with the hope of working toward a reconciliation but reaching this point requires both parties being able and willing to participate and does not happen overnight. For parents estranged from their children, being able to empathise with the child’s experience and make amends for the way they were hurt, abused or neglected, will require parents to dig deep and process all the difficult feelings this may entail, including guilt and shame, rather than staying in a defensive position.

There is also the risk that the reconciliation may take more time than anticipated or in some cases it may never be possible. Being able to stay with a client through the uncertainty a reconciliation process can entail, rather than reaching for answers, is central to the therapeutic work. 

If you would like to learn more about family estrangement, you can join Dr Barcham’s next CPD course, taking place in September 2024, or you can also visit Dr Barcham’s website, which has lots of helpful resources here:


Barcham, S. (2021). A mother without a mother: Women’s experiences of maternal estrangement in motherhood [Doctoral dissertation, Metanoia Institute].

Blake, L., Bland, B., & Imrie, S. (2020). The counseling experiences of individuals who are estranged from a family member. Family Relations: An Interdisciplinary Journal of Applied Family Studies, 69(4), 820–831.

Standalone (2015). Hidden Voices: Family Estrangement in Adulthood.