Practice in Action : Estrangement Should be the Nuclear Option

Social media often makes it sound like there’s only one answer to difficult family relationships: cut them off. But is that always the healthiest choice?

In this episode, Paul Wagner and Dr. Ray Christner take a thoughtful look at family estrangement, toxic relationships, and the role of boundaries in protecting your well-being. They explore why the word “toxic” has become so common, how clinicians can avoid black-and-white thinking, and why firm but flexible boundaries often deserve consideration before permanent no-contact decisions.

You’ll hear practical ways to think through difficult family dynamics, the potential long-term costs of estrangement, situations where immediate separation is appropriate, and how therapists can support clients without steering them toward a predetermined outcome.

Whether you’re a mental health professional or someone navigating a challenging family relationship, this conversation offers a balanced, compassionate framework for making decisions that align with your values instead of reacting from the moment.

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To hear more and stay up to date with Paul Wagner, MS, LPC and Ray Christner, Psy.D., NCSP, ABPP visit our website at: 

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“Be well, and stay psyched"

Transcript

SPEAKER_01 1:21

Hello, and welcome to the Psych2 Practice Podcast, your one-stop for practical and useful clinical information, masterful insight from experts in the field and a guide to daily living. I'm your host, Paul Wagner, joining me as always.

SPEAKER_00 1:32

Ray Christner.

SPEAKER_01 1:34

And we have kind of, I think, an interesting and maybe, well, topical, but also there's some history behind this topic. Talking about when we are cutting individuals out of our lives, and I think especially kind of focusing it on family, but we can kind of branch out. And this really kind of came from kind of a just a recent kind of social media push that I saw surrounding, like, you know, removing toxicity, and then also kind of thankfully a counter push that said, we're overly normalizing this full cutting people out or full estrangement, and how that should really be reserved for some, like there are certain situations and times where that is warranted, but how normalized that has been. And it really just kind of sat with me with how often I'm I have clients coming in, either asking if that's, you know, oh, I I want your opinion if I should be cutting them out, or I have cut them out, and and talking about like kind of what are the benefits of doing this, what are the risks that are involved, and kind of why is this coming up so frequently? And it is it something that we should really be pushing for, or really kind of pulling back and having a having some other tools in our arsenal besides just, you know, you have to deal with it or you have to cut them out.

SPEAKER_00 2:44

Yeah, and I think this, I mean, I think it's timely uh that we maybe kind of address this a little bit because yeah, I mean, I see it a lot. You know, the interesting part when when this kind of came up about doing this topic, I was surprised how many books in the last year are about toxic relationships, eliminating in your life. Like the word toxic just gets thrown around. You know, I I don't think any you can go on social media without some feed that you know talks that has somebody talking about you know this idea of just estrangement from family. And and it is a such a complex topic. And I think that it, you know, the more I see it in kind of popular media, the more concern I have. And you know, I just recently um you know, I was traveling, and when I travel, I tend to try to read news more just to keep my mind going. And you know, there was uh I think it was the Wall Street Journal or one of those those magazines just within the last month ago, so July 2026, that did an article about estrangement where they they looked at like some survey data. And I mean it was a large number, like I want to say there were thousands of people in this this survey. But the thing that threw me off or kind of caught me off guard was the comment that about a one-third of the estranged parents from the survey believed that their adult child's therapist influenced them being cut out of their child's life. And that just seemed like a really large number to me. Like I, you know, in 30 years, I've processed a lot of wild child parent relationships for both you know children and and adult children. And man, I just don't think my number's a third. Like that just seemed like that was just such a high number for me. So, you know, again, that number is only the parents' perception. Like, I don't think there was anything in the article that established like therapists actually do it, or but it did make me question. And then as I see more books coming out, and as I see even professionals who on social media are talking more about it, I wonder if that's becoming more of a default strategy. And I I think that you know the idea of how we process that and how we think through that, and listen, there were times that it's necessary. Like I don't think anybody's doubt denying that. I mean, there are there are times that I have that's been the outcome of a therapy session, but I think that putting on the brakes and being more thoughtful and intentional in how we help people through that process are important because I don't know the outcomes of estrangement are as good as what we think they are. So I think you know, research hasn't proven that. Uh a lot, it's all over the map when you look at that. So, yeah, I think it's an interesting kind of topic. So, can I just I guess maybe I'm gonna I'm kind of your curious of your opinion. Like we mentioned that both of us use the word toxic. What's what's your view of that word?

SPEAKER_01 6:10

Like, you know, we keep having these episodes on like words matter, so yes, why not tease the word out here a second to to maybe borrow from another word that I'm not really the biggest fan of, um, the word toxic to me oftentimes has like a cringy experience with it because I feel like it can be overly generalized, and because there can be a personalized experience of it, but it it might also just capture an idea without really defining it so well that it just ends up being overly used. And I would say almost in a similar sense where the term narcissistic really seemingly has drifted away from that true diagnostic criteria of narcissistic personality disorder. And when someone is acting selfishly, they're not like they we can view that in a narcissistic way. And I think toxic kind of follows along that same focus. And then it I think, well, unlike narcissism, toxic is not a mental health diagnosis, but it in some ways it almost kind of gets used as that, or it gets thrown around in some similar ways. And and I think you know, being able to, when working with individuals that are talking about toxic relationships or especially toxic family interactions, I really try to like break down like what are the behavioral like patterns that we're seeing? Like, let's really try to define this so like we can refer it, refer to it as toxic, but like how? Like what's the actual action or behavior behind it? So is it, you know, am I feeling like there's just constant criticism? Am I feeling manipulated? Am I feeling like I'm just being made to feel guilty? Or is there a reactive anger that's kind of feeling like it's being pushed towards me? Am I being invalidated? Like those are all I think traits and behaviors that can that that are associated with toxic. But again, I don't know that when we're just saying toxic, that there's oftentimes one singular experience of it other than it's you know it's negative and something that we don't want in our lives type of experience.

SPEAKER_00 8:07

Yeah.

SPEAKER_01 8:08

How about you feel right?

SPEAKER_00 8:09

Like, yeah, I'm I'm I'm with you. I I kind of I I yeah it's it's interesting because it's a word that I think in the last year has has bothered me because uh it's just one of those words. And I I I recall myself using it in a situation one day and almost having like a little knee-jerk reaction, like, wow, like what's that mean? Like, what is that you know that that piece of it? And you know, I I think my reaction to it is because it's so variable. Like I've seen people who, you know, their sibling irritates them and they're like, oh, he's toxic. Again, kind of a big word. And I've had people who have been stalked and threatened and have been victims of significant violence that use the same word. And I'm like, these are really different things. So yeah, I I like how you you kind of framed it. Like as you were talking, I almost kind of took what you were saying as the word toxic's a warning word of about our experience, right? It's it's a it's a it's a word that we can say is okay, this it's it's capturing that something's happening. But I don't think it tells us what's happening, and I think that the leaving it there is is concerning. And I'm gonna jump to social media a second because I just over this past weekend, I I was for some reason just kind of Facebook scrolling, and someone in my friend circle, I don't even want to say they're a friend, there's they're somebody I have a contact with. They they made a post about um about a about their mother, and their mother was was you know, my mom's being toxic again. I can't stand it, something like that. No details, which I'm glad they didn't put details, but the hundreds of comments from people of you shouldn't go through this, you should like it was almost like kind of overwhelming, and I'm like, they don't know what that means. That could have been their mom saying, get a job, and that was viewed as toxic, or it could be this really horrible behavior from the mom that is dangerous. None of us knew that, but the amount of people that validated it, and so while I'm not against people getting validated, I do wonder if we validate it the wrong way, does that create more kind of fuel for estrangement down the line? So it just it just raised concern for me.

SPEAKER_01 10:42

So and I think an important piece is that we can't control the social media uh spheres, but but I do think that there's almost this automatic assumption of some form of abuse when we're using that term toxic. And I think we as clinicians really need to kind of like delineate and distinguish, like, okay, uh abuse certainly can be toxic, but not all not not all toxicity is abuse. And so being able to really make sure that in the session we are kind of clarifying and we're being very specific. I I think just kind of in best practice trying to not that we can't use the term, but I think we can't use the term in isolation and we really need to dig deeper. Of I I like uh kind of that it's it's that screening tool, it's that it's that sign that there is concern, but how do we then take it further and really have it be better defined? Because if not, you know, what is it that we're validating uh here on social media? And again, if it's hey, you might, you know, I think you should get a job, that's uncomfortable, but that's maybe not the worst thing to, you know, the the worst suggestion there, but again, so and certainly kind of being able to uh have that nuance and um yeah, yeah.

SPEAKER_00 11:53

So one of the things I you know when while I'm not really a relationship therapist, never claim to be, you know, when I do work with someone and relationship issues come up, yeah, something I say often is this idea that not every painful relationship is abusive, but also that not every nonviolent relationship means it's safe. In this idea that, you know, it when we're talking about unsafe relationships, sometimes it can be emotional. Like there are there are those that reach that level, but just because it's an uncomfortable relationship doesn't equal that level. And and I think that's important, especially again, the word toxic just feels so heavy to me that it's uh you know, trying to get people to think through what that means, I think is important.

SPEAKER_01 12:41

And I I guess along those lines, like I think trying to talk about or discuss like family, like when we're talking about family, like family, I think inherently has a much higher risk of just being like creating frustrations, creating conflict because, well, there's so many different factors there, but recognizing also the value of family. And I don't want to put family up on a pedestal necessarily, but I do think there's so many beneficial factors that are there, and that if we're just really quick to cut them off, like we might be increasing uh distress, isolation, loneliness, like it and aspects that maybe feel validated in the very beginning, but we end up maybe we habituate to it, but maybe it's it doesn't really end up being helpful or supportive in that way. And you were kind of mentioning that earlier, and I think that's an important piece of like I did not this wasn't my phrasing, but I really liked it of like estrangement should be the nuclear option. Doesn't mean that we don't use it, but we do we want to make sure, like, and if we can, let's go through other steps first. I don't want to start with the nuclear option there. And you know, I I think there's so many reasons, especially in the moment why it can feel so valid, but again, I want to I do want to identify like what are those, what are those circumstances that are coming up arising that are leading to this push for us and like really stopping and trying to take that third, or we as clinicians trying to work with the clients to take that third person perspective back and saying, okay, what's this overall impact and what is it that how's it influencing me and what can I tolerate and what can't I tolerate? And so being able to make it more of this nuanced conversation, and I know we've somewhat recently done an episode on boundaries, and I think that's such an important piece of like how do we have firm but flexible boundaries and letting that be some of this behavioral experimenting it or implementing it versus let's not go nuclear in the very beginning.

SPEAKER_00 14:29

Yeah. I I I like the idea of that. I mean, and and the the nuclear option, I think, yeah, it sounds really important. And sometimes we can reach the nuclear option quick. I don't necessarily mean think that people have to tolerate something that's dangerous for a long time. But again, I think when I read that article that I mentioned, you know, the thing for me when I kind of about a therapist's role in it is, you know, are are we really exploring all of that before it gets there? What's that that process? And I think boundaries and looking at boundaries on a continuum is really important. And listen, that I have had people in my life that I set boundaries and they challenged them. Like that they weren't really good at at keeping those. But that was then me changing some other variables. You know, some of those people, I don't want to say I cut them off, but I don't see them very often. It's it's very managed. And others, I I have other kind of controls. So yeah, I think that's that's a great starting point. I think looking at at the boundaries, and I think, again, I evaluating up front what is the danger level in the relationship, because there are certain things that we're going to cut off automatically and say, listen, you're not safe. We have to set this immediately. But also, you know, all the great work that DBT has done has done on distress tolerance and looking at if the relationship's distressing, is there a therapeutic approach that we may reach prior to that full estrangement? And again, I go back to the research isn't convincing. Um, you know, it's while people want to push certain studies and go, oh, this shows when we really look at the body of research out there, it's more mixed. Um, you know, a lot of it's that we may have this emotional relief at first, but then the long-term piece of it. You know, I I have someone who I see for therapy who recently lost their mother and they were estranged for 20 years. The impact of that has been great, and it's been a challenge. And the the now consequence is is maybe more emotional than than what happened 20 years ago. And so, yeah, I think I think we have to we have to think about that continuum of boundaries first. That has to be our starting point.

SPEAKER_01 17:03

And I think along the continuum, really maybe even trying to implement like that cost-benefit analysis of each, and what are we predicting, and maybe even like short-term and long-term. So, what's the short-term you know benefit? What's the short-term cost, but also long-term? And so when you have that 20-year estrangement, there is a cost. And that cost can be if something unexpected happens and there's not a resolution, how do we sit with that experience there? And there can be mixed emotions, but if there is a sense of regret, we maybe lose a significant avenue of finding maybe not full resolution, but some sense of you know, a modicum of resolution where now it's far more kind of an individualized work that's there.

SPEAKER_00 17:47

Yeah. Yeah, it it's I think there's another another piece I just want to kind of throw in. Yeah, I I think as people are thinking through this, you know, there's this I don't want to say it. There's this this feel that they have to make a decision about the continued relationship. And I I just had this in a conversation with somebody that I was uh actually doing an evaluation on that turned much more into a therapy session. But um, you know, it the individual said, you know, I have to be decisive. And I made the contact, the comment to him like having low contact with somebody is not indecision. That when we decide to have low contact with somebody, it's calibrated connection. And, you know, this idea that we can calibrate how we interact with people. And I think that's the view that I I kind of view this as is how do how do we calibrate our connection with people? That's that's kind of the view. And it was interesting, you know, again, it wasn't a therapy session, but he was like, oh my gosh, I needed to hear that. Like I needed to hear that it wasn't me being wishy-washy. And he has a a significant other in his life who's like, cut them off, cut them off, cut them off. They're terrible to you. You don't, yeah, and it's just that, and you know, make a decision already. And and he's not ready for that. Like he's it just wasn't. And so when I said like, listen, that doesn't mean you're indecisive. Like you can a decision is made in how you decide that the interaction goes, and maybe that's the start point. And maybe that still doesn't help. And then you have to calibrate more. But if we think of it in that way and we think about our decisions calibrates the connection, we're we're gonna feel more in control. And I think that's important in these situations. Like we control is a piece of it, feeling like that we have a voice in the interaction. So we can do that, I think.

SPEAKER_01 19:51

And it also to maybe piggyback on that a little bit, like the that calibrated control uh is a decision. And so it's kind of like hurry up and make it this you make a decision. It's like my decision is I'm going to reduce maybe the frequency or the duration, and I'm gonna see what that experience is like. And I and I really do think oftentimes it as long as there aren't any of those, I would say, kind of more immediate and emerging concerns. So maybe I should start there. Like the times in which I I do think whether it's ongoing or just at the very least, immediate estrangement is valuable, and you kind of mentioned some of these, but I think it's it is abuse, it's physical danger, yeah. Feeling that there's not so much like just kind of like a manipulation, but almost this like overly coercive, like uh kind of like trying to be very controlling. Um, I think you mentioned stalking, and that's that wasn't on my list, but like that, I think that certainly was one. Yeah. And uh when an individual is experiencing like a sense of like a refusal to respect kind of not maybe every boundary, but especially their their safety boundaries. And and so in those moments, let's create the space, but also that doesn't mean it's going to stay that we're going to keep it that way, but let's create that. But if we're not hitting some of those higher risk concerns, let's take our like not dragging the process out, but like let's run some experiments there. And so uh I don't think this was actually ever in a recording, but you said something and uh I I had it jotted down here. It's like maybe we limit it to two hours, maybe we limit it to five minutes, you know. And so like we just have this kind of I'm gonna see what this is like and I'm going to like if I'm making this prediction, but let me not also fortune tell. So like I think challenging automatic thoughts of like, oh, if I go there, I'm gonna have to be there all day, or I'm gonna have like, do we have to? Or like can we like what does that establish in the boundary? And part of that might be we're establishing and like kind of practicing, creating a sense of assertiveness to kind of maintain that boundary, or how do we follow through even when it's uncomfortable in certain circumstances? But that's kind of this nuanced approach that I think is so valuable. And again, um, I I think I think a lot of clinicians do good work with it, but I think in the social media realm or zeitgeist, it becomes that black and white of cut them out, you know, cut them off in that way when really the answer is far more nuanced.

SPEAKER_00 22:18

Absolutely. I mean, I think that, you know, I view it as contact has its costs, right? Like, I mean, we there are certain people, but cutoff has costs as well. And there are some negative things. And again, we don't know for some people what that long term is. But I think that's where good therapy comes in. Like, I think good therapy helps people see both of those columns. There's there's costs on both ends. And how do we, you know, whether we use the word balance them, create harmony with them, whatever it is, or maybe we just explore them. Maybe that's we're just exploring both columns at the first part of therapy. But it's important. And I think, and I'll go a step further. I think there are. Times where and and I I don't know what the research literature says on this. So I'm gonna say this, and somebody may completely tell me I'm wrong on this, but I also think that estrangement is more fluid than it is permanent, meaning that there may be situations where estrangement is necessary for a time period. And that and that may be the healthiest option, but we don't have to view it that I can never see this person again. Instead, looking at it as that it may be a necessary reset and it may be a way to then integrate it back slowly. And and and again, while that's not my my specialty, I over my my time doing therapy, I've had people who have navigated that that temporary kind of cutoff, and then a much more healthy way to slowly integrate that person back in their life and do it almost in a desensitizing kind of way, like this gradual, like, you know, um let's start with breakfast, let's have a cup of coffee together. And when the coffee cup's empty, it's time to end our interaction for that day. And and that may just help that may be where it's at. Um and maybe it never goes beyond that. But it's that, I think that idea of some fluidity, and again, not sure on the research on that, but I think it's an important piece that it doesn't have to be permanent.

SPEAKER_01 25:14

And to piggyback off what uh when you're talking about the fluidity of estrangement, I think it can also, if the circumstance allows for it, like asking about what does it look like when we re like we reconnect or we are coming back together? Because I think at times if we don't have a conversation ahead of time, we can take this step, we can feel liberated. And then as time goes on, the thought of reconnecting, it can bring about, I don't even know how I would do that, or is it has it been enough? Like and we don't necessarily define like what is it that we're looking to get from the estrangement. And so if we set some time frames or if we set some parameters of like what are the things that we're looking to experience, and once those are met, how do we then almost before we ever do it, plan reintegration or reconnection in certain ways? Because I think it it then helps to bring the structure rather than well, it's been a year then I haven't talked to them. I don't I don't even know if they would want to talk to me or I don't even know where I would be beginning. But if it's hey, it's been a year, let me check, like let me see how things are going. And so if we have that conversation ahead of time, I think it makes that reapproaching just feel more within rap in grasp and reach rather than it feeling like it becomes this needing to kind of reinvent the relationship, so to speak.

SPEAKER_00 26:31

Yeah, I mean I think that's again where good therapy comes in. Like that should be part of, you know, and and I think that's part of the discussion in no matter if that if the estrangement is is something or the the no contact is something that's initiated. I think going through some some dialogue and some kind of idea of what might reconciliation look like, and what would it look like in a healthy way? How would it look if it's not healthy? Like sometimes we try to reconcile and it's not healthy. Do we have to have complete reconciliation? Is it partial? Is it permanent? Maybe not. Maybe it's, you know, I have a relationship in my life that is a not a family member, but a friend. And it's a person that means a lot to me, but it's a person that's not a good relationship for me, nor do I think it's a good relationship for them. Like I think it's just one of these things where we're good for a certain amount of time and that's kind of it. And we have had moments of no contact. And now we have moments of temporary reconciliation, where it's some years will pass. We'll see each other, we spend an evening, have dinner, kind of catch up. Um, it's meaningful to me. I think it's probably meaningful to them, but it's not a it's not a part, it's it's not like we're gonna go, hey, this was great. Let's do it again next weekend. Both of us, I think, go, hey, this was great. It's probably gonna be great in a few years if we cross paths. Like it's and it's funny because I was telling somebody about that relationship, and they're like, well, why even talk to the person? And I'm like, just because there are differences that make it a challenging relationship doesn't mean that person's not important to me. Like they are important to me. Um, and but the challenges that come with it aren't good for either of us. And there's a way that we found that it works. And we do some other communication, not in person through texting or social media or things like that. But it's but it's interesting because I've I've told that to people, and they're like, that is the weirdest relationship. Maybe, but it's it's still a relationship that's important, and and I'm not willing to cut it off completely because I do enjoy the time that we have, but I understand the underlying reasons why it's not good more than that. And so I think that we can redefine what that reconciliation looks like.

SPEAKER_01 29:13

And I I think the ability to connect is so valuable. And so if it was no contact, if there is a thought or if there is a desire to see that individual, where do you even start? However, because it might be limited, it might be years, but it's not no contact. And in that way, if the opportunity presents itself or if there's a thought or something that does bring it about, it's not a starting over, but it's a picking back up of where things were. And it and again, I think that's where it's like that can be such a valuable piece. And so something that might emulate in some certain ways, you know, estrangement, it's just more we take time and space in between the interactions, and that works well for us. And I and again, I think that's that's going, you know, you've kind of shared that, but I think therapeutically those are the types of dynamics we need to be willing to explore and discuss and talk about when it's not those crucial moments where you know safety is at risk. Let's really then not be hasty in our decision making because it it is I I almost think it it can be really easy to cut individuals off, and I think that has an allure to it. It it's the easy button of discomfort and distress, but the lasting consequences end up making things far more challenging. And so I I think another aspect like being able to just kind of talking about the individuals we're working with and like what are their values and where do they align? And I I think values is an important piece when it comes to considering estrangement because it's kind of the overall individual's experience, but maybe it's instead of asking ourselves, you know, should I cut them off? It's like, what's the level of contact that you know best supports my, you know, my experience while also remaining consistent with my values? And so it it does become less of this black and white and far more shades of gray. Right, right, absolutely.

SPEAKER_00 31:09

There and I think that's why I think it's such a complex question. Yeah, I think it's such an issue, is that and why these knee-jerk reactions we have to process through, because yeah, I mean, I think all of that, and again, kind of the the example I gave, there's a value component to for me. And it's it would, to be honest, be easier to just have a complete no contact. Um, because there's a lot of time and thought. But I look at the boundary as as a way to protect today's reality, but it doesn't really predict the future. And what I find is over time, because this person had a lot of importance in my life, I think about them. Like there's things that'll come up. And my value is the unknown is is not worth it. Like I do care about them. So I value, again, I value dosing it a certain way. Um, and but it also when those moments come where I'm like, oh, you know what? I really we should really catch up a little bit more personally, uh, that there's there's a there's a reason behind.

SPEAKER_01 32:23

So and maybe just one more factor, like for for you at home listening, that I think is important is is also kind of the shock factor with certain experiences or stories, and just again, being mindful of that, and whether that that's coming from a cultural experience or just someone's personal lived experience that is their norm, and even if if that's outside of our typical range. And I'm thinking of a personal experience. Actually, when when I was younger, a really close uh uh friend of mine, um, when I first went over to his house, I heard his uh both of his parents yelling back and forth at each other, as well as kind of towards him at times, and it was I think it would make sailors blush, some of the language that was being used in that. And I was like, how is he dealing with this? Like what and because in the friendship, I that wasn't really a behavior I had seen him, yet he would make sailors blush when he was talking right back, and so that was a bit of a normed reaction. But if like in hearing, like if he was just sharing the story, talking about my mom said that, and and for him, his experience of it, I don't think there was a personalization behind some of the language that was there, and it became then like this that's profanity was used pretty liberally. And so it became like hearing that initially it was jarring for me, however, it was the norm, and it wasn't a distressing norm. And so I also think it's important for us to be considerate of like when we're hearing some of these things, let's also make sure we're we're exploring what is it that the other person's experience is with the events that are happening. Because if we're like, are you okay, you know, are you okay? Like, you know, is that something that you should really be around? I I don't think that we should be inadvertently pushing. I think we can be curious and asking about it without it being something that our own biases are kind of pushing for, or being like, Whoa, I don't think anyone should, you know, have someone yell, what the fuck is wrong with you? But if they're gonna yell right back, you know, shut the fuck up, then maybe they have it. Maybe that is a bit more of a normalized response for them.

SPEAKER_00 34:18

Right. Well, I I think that's and I think that's important in our role as therapists. Like, I mean, gosh, reality is is we are gonna hear something that's outside of our norm. And it's easy to assume that it's unhealthy. And sometimes it may be, but uh, it's but you're right. I mean, I think there's a lot of a lot of things that come into play. And I think that's for me, like when we were deciding to talk about this, I think that's part of the reason of the importance, because from a therapy standpoint, it's easy to get tied into the story, and you know, and and listen, we're hearing one side and we're creating you know what we think that actually looks like. And and maybe at times we've even observed more than that, but jumping to a conclusion about it, we we can, you know, we can not help the we may not help the process. We may make it worse. And and again, I think uh, you know, from the therapy end of this, you know, our job's really not to help the person choose what to do. Um we're not trying to, we're not trying to create a verdict, right? It's not like, oh, you need to do this or that, even if people want it. But instead, you know, it's really it's to create insight and it's to get people to widen their choices and not replace like pressure or to try to create pressure on it. It's validate the pain that they may be experiencing and help them interpret it in a way that they can then make choices that that are easier over time to live with. And it may get to estrangement as the right choice. Like, I don't want people to think I I there are times I think that is it. Um, and but with all that's out there, it seems like too simple of a choice to me sometimes. It's much harder to work on our own emotional stress tolerance and how we handle that and to to set boundaries that may upset people, but like that's hard work. It's hard to tell somebody, you know, I I need a break from you, like I need, you know, or I'm only coming for two hours. And yeah, there may be a guilt trip that comes with that. Like it's so there's all these these pieces, but I think that's again, when we we look at the therapy end of it, I think that's important. Again, I'm I'm not a whiz at the literature in this, but you know, the literature I have read is when when individuals are in therapy, and and a lot of this is qualitative data, which is great. I think some qualitative data is wonderful, but when someone is estranged and in therapy, what they find the most helpful is one that there that the clinician understood estrangement to begin with, why we have these kind of conversations, I guess. That the therapist didn't give an opinion, but really worked on insight and then really supported them in how to make the decision. So it really was this problem-solving approach, and that there was not this, these comments that would affect that the person should think, act a certain way. And so again, it's that guided discovery, it's that curiosity that we can create in therapy that will help bring insight to people. And I think, you know, that's not an easy path, though. I mean, it's it's it's a lot of hard work, but when we do it well, we really do empower people in situations like this. And I think that's you can't beat that.

SPEAKER_01 37:56

I I guess I'm curious, like I absolutely agree with what you're saying here, and I'm curious of I guess a circumstance where if someone has already arrived at this decision before ever walking in the therapist's like office, and so they're not looking at the decision, but they're rather looking at how do I do this? Like my part of my thought goes to okay, as a therapist, we can talk about some harm reduction techniques of like how do you go about doing this in a way that can help preserve or help allow for that temporary space taking or kind of setting those boundaries in a way that's going to be maybe hopefully most effective. But also, I I do think there's an element of like being able to discuss how did they arrive at that decision, not necessarily to question, but to also hear the full scope of it. But I'm curious, like, what are your thoughts if if clinicians put in that position there?

SPEAKER_00 38:47

Yeah, I think it's I that's a great point because I think that's probably what most people are put in. I think there are people who come in with a idea, and yeah, it's again, people may have a different opinion. I'm not a how-to manual. So like I I look at it as that, yeah, and and I think I would, and I probably wouldn't say it like that in therapy, but I would kind of go, you know, my role is not going to be to kind of say, do this, do this, do this. For me to help you, um, I think works best for me is to first try to get an understanding of how you got here. And like let's let's maybe take a pause and let's let's try to get a little to the front-end story of how you got here. And then once we have that, then let's talk about what are the steps that you feel comfortable with to get there and to not try to talk them out of it, but not also to go, you know, I could probably easily say, well, hey, you can do this, this, and this, this is the healthier way. But I don't know that that I don't view therapy like that. I don't view therapy as let's just give you advice on the best things. It's I think to help people think through the approach that they want to take. So I would probably pause that. I so for me, I I think I would just kind of pause and go, you know, I for me to move forward, I think we need to go back and we need to kind of I need to understand of how you got here, what were some of the thoughts that have gone through your mind, what are some things that you've tried? And again, not not judging whether it's a right decision or not, but processing it. Um, I can't say that I've had enough cases that I could to that I could really go, this absolutely works. But the cases I have had, when we started processing it, the conversation, conversation went moved away from the how-to. And it was more, you know, so we actually never really got there. Sometimes it still ended for them. That there was still a reason to end a relationship, but it wasn't me going, here's the best steps to take. It was more them. So that's just my approach. Like I I would I would get more into some guided empiricism and some, you know, really kind of thinking through things and trying to understand it. And again, create some insight on some level of the decision and then kind of probably go from there. Uh do you handle it?

SPEAKER_01 41:21

I get I I think I've been put in a position, and it was early on in my career where I did, I think I fell into the how-to out of a kind of not necessarily having my own voice necessarily therapeutically yet, but I think after that experience, it felt like there was a lot of concern. And actually, I brought that up, I think, in some future sessions. And I I don't even think that the individual ended up following through with that that process there. But it I think it's one of those things that, well, there's so many ways that we we're separate from AI chat bots, but uh I I like to, I'm not a how-to, like it, and when you said that, it just brought to mind if I throw that into like a chat GPT or something, it's probably gonna tell me and it it'll, you know, it'll give that. And so I I think the the human interaction there and the ability to say, hey, like walk me through this so I can get the full scope of it, but also for you to get the full experience of my professional input, it doesn't work this way. I'm I'm not, you know, I'm not an AI, like just ask me a question, I'm gonna tell you this, but uh let me hear the full experience of it so we can both collaboratively make an informed decision together.

SPEAKER_00 42:26

Yeah, I I yeah, I I agree. And it really, as a therapist, is a balancing act. You know, I mean, I think that it it's it's dangerous when our curiosity might invalidate a person. And so we have to be careful on that too. Like that weren't like that they're like, hey, I came in and I I know what I want, like I don't need to go through this. So we have to approach it in a way that that our curiosity about it doesn't invalidate their experience. And I think on the other end of it though, I think we have to make sure that our certainty in things isn't mistaken for support. And that's where it really comes, you know. I think as a therapist, it is so much of a balance where, you know, it's easy, even yeah, I think I said something like this in a previous recording we did, but yeah, I remember when I was doing my initial therapy training, I had a professor who was would have us listen. I mean, at this point it was like cassette tapes, of snippets that he recorded, and for us to watch ourselves in a mirror in how we reacted. Um, and I mean they were some terrible things, like things where it was like, oh my God, no one like people are gonna say this in therapy. But it was to pay attention to our facial expressions and um, you know, to pay attention to ourselves, and then for us to say words and to see what our reactions were. And his whole thing was even our simple, like, we raise our eyes can be validation or invalidation. It could be support or non-support. And I I always thought it was such a valuable lesson in my training, was like, I was like, oh my gosh, how brilliant that was because I I now am very aware of very subtle facial movements that I make and things when, especially when I'm in therapy, because again, we we have to balance this. So what we say and even how we react to it, you know, it is in a non-verbal sense can can impact. And so yeah, I just think it it it these are tough conversations. And it's it's it's also I think the conversations of of when we do therapy well, that we we really can get people to the right decision for them. And and in a way that, you know, again, research is mixed, but if by processing things with people, we can get them to not only short-term emotional resolution, but really move toward wellness for the long term based on their decision, no matter where on that continuum it falls, we've done our job. And I think that that's how we should view it.

SPEAKER_01 45:23

And you know, maybe as a closing takeaway, I think it it is really complicated, and so it shouldn't be this black and do we cut them out or not? And even it when there are concerns that do warrant that we need to do our due diligence as clinicians to investigate that further. If not, we'll we're we're doing a disservice to our clients, and so taking the time to sit in the mess and work through it and uh exploring the short term as well as what those long-term elements are there.

SPEAKER_00 45:54

Yeah, I I agree.

SPEAKER_01 45:57

With that, we hope you enjoyed this conversation and tune in next week as uh Beyond the Bot with uh Dr. Dan Florel and Adam Lockwood will be here on the feed as a part of the Psych to Practice family. And you can hear Ray and I then again in two weeks. But with that, we hope you enjoyed this episode. Be well. Stay psyched.