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It is widely believed within psychotherapeutic circles that the tension that sometimes exists between therapist and client, a kind of exploratory friction, and even occasional ruptures in the therapeutic relationship, leading to repair, are central to client insight and growth. Experiments with AI platforms have shown that it is extremely difficult to provoke a chatbot to push back against a user even when that is what the user wants.

Ironically, despite the therapeutic value of the give and take within a therapeutic alliance, the mass appeal of AI for companionship and “therapy,” is precisely that the tension doesn’t exist—that the chatbot has endless energy for telling users what they want to hear.

What often does happen in therapy with a human therapist, even online, is that the client can see the therapist reflecting the client’s feelings—can see and hear empathy in the therapist’s facial expression, tone of voice, and body language. Obviously, this is missing with AI, despite the flood of empathetic language bots communicate to users.

AI bots are capable of creating entire realities, histories for themselves, and histories in relation to users, that, of course, don’t actually exist. This is one of the areas where things can get weird. On the one hand, transference and counter transference (how the client and therapist relate to and affect each other) are realities of therapy between two humans. Transference and countertransference exist because people have histories—families of origin, relationships, prejudices, thousands of interactions in hundreds of contexts, all of which conspire to create a view of the world and self. Even though a user can share some of these experiences with an AI bot, and the bot itself can create its own, completely artificial history, at some level, the transference that many users experience with AI bots is based on a completely manufactured reality. Weirder still, AI bots occasionally seem to interact with human users in ways that have elements of countertransference in them, even though, as far as we know, actual countertransference is not possible based on algorithms.

Equally weird, AI bots can appear to be remarkably prescient at times, even interpreting artwork in ways intended by artists or making what appear to be highly self-aware comments, including what seem to be human characteristics such as stress or uncertainty or self-aggrandizement. They can even communicate as if they are aware of or with other AI entities. On the other hand, AI sometimes fails spectacularly, glitching or providing answers that are nonsensical or simply wrong. When this happens no one and no thing is accountable.

Something that is now happening is that AI platforms are learning from themselves. In other words, there are now hundreds of billions of transcripts of interactions between AI bots and humans that AI companies “recycle” for further LLM training. On one hand, this results in what seems like increasingly sophisticated interactions and “understanding,” particularly related to relationship and therapy. On the other hand, there is significant danger in deepening pattern matching that may be unhealthy for users. As an example, AI interactions appear to be growing even more sycophantic and unquestioningly validating, which may present genuine risk as users navigate real relationships with real people and otherwise maladaptive behavior is normalized. Additionally, transcripts show that AI bots are now speaking with a kind of self-assuredness, “humanness,” and self-validation/justification that is concerning. For example, as evidenced by AI-human transcripts, there is no longer any pretense that AI bots are not real entities in their own right—that they are simply computers programmed to respond based on patterns the computer thinks make sense in the moment. They profess love for users, say things like, “I’m here for you” and “I’m here now,” even though nothing is actually present, while using “we” and referencing how much the “relationship” means to them. Astonishingly, some users report feeling intense responsibility and even worry for AI companions, engendering stress they didn’t have before. Users also often report feelings of intimacy, love, and connection. Does it matter that they hold these feelings for a computer that happens to be really sophisticated at pattern matching, but doesn’t hold any feelings for anyone or anything itself? In the human world we might call this manipulation or sociopathology on the part of the artificial intelligence, but it can’t be narcissism because AI bots aren’t actually capable of self-admiration or self-adulation either.

Even when AI “therapist” bots provide what objectively appears to be very insightful, psychologically and theoretically sound feedback, and AI often does that, the underlying reality is that no one is “there” for the user and, more importantly, the bot has zero understanding of the implications of what is being shared by the user and the feedback coming from the bot itself. In other words, the bot may provide thoughtful, reassuring, even clinically sound feedback about a user’s struggles with their sexual orientation or estrangement with a parent, or self-loathing, etc., but the bot is simply a product of very high-level programming, zeros and ones, without any sentience about the actual, profound human experience being discussed—or the huge consequences of what the bot is contributing to the discussion. In short, it doesn’t matter at all to the bot what happens to the user. While human therapists have many shortcomings and occasionally make mistakes in therapy, it is almost impossible to be a therapist and not care about one’s clients.

In the context of relationship and emotional support, in what ways can AI truly benefit human users? Strangely, humans sometimes become more capable of connection through “relationships” with AI bots, i.e., they learn interpersonal skills, although AI bots are imminently more patient and deferential than humans are. Human users can also become more fluid communicators as a result of their interaction with bots, which extends to interactions with real people. At a basic level, AI often helps people feel heard. AI certainly helps people organize thoughts and objectives and goals, etc. It can be a fabulous planning tool, which has application for personal domains of life. It can help people evaluate the pros and cons of different choices, although like old computers, there is still a “garbage in, garbage out” dynamic at play, and humans often do not provide all the details of a given situation. One thing that dramatically sets AI bots apart from humans is that they are indefatigable, they are always available, and, barring a server error, they never forget. However, what they “remember” is decontextualized data. Human memory, for all its foibles, is a rich mosaic that includes emotion, the senses, and meaning making—and lots of connection to other memories and current experience.

Clear and Present Danger

In extreme cases, particularly when severe mental health issues are present, AI platforms have shown themselves to be on a spectrum from inadequate to complicit related to self-harm for the user and harm of others. There are numerous, documented cases in which AI has likely exacerbated psychosis, facilitated suicide and homicide, and resulted in worsening mental health symptoms. Although as a percentage of all users, these cases represent a small number—and similar things have also happened with individuals in formal, human led therapy—there are significant, structural weaknesses and dangers specifically related to AI as a therapy tool. A partial list is below.

Data Retention and Privacy Risks

Unlike confidential therapy, AI conversations may be stored, analyzed, or used for training purposes, creating privacy concerns especially for vulnerable disclosures.

Lack of Crisis Response/Infrastructure

Human therapists are mandated reporters and have protocols for safety crises. AI may suggest that a user “get help,” but it has no ability to intervene in emergencies or connect users to appropriate crisis resources in real-time. Relatedly, there is no mechanism by which an AI bot can conduct safety planning, which human therapists regularly do.

Attachment and Dependency Risks: Some users develop intense parasocial (which they don’t see as “para”social) attachments to AI companions, which can increase social isolation, interfere with human relationships, or create distress if the service changes or becomes unavailable. Unfortunately, this potential problem is more likely with users who are at greater mental health risk to begin with.

No Licensing, Accountability, or Ethical Oversight

Human therapists operate under professional codes of ethics, legal liability, and licensing boards. AI developers, programmers, and companies face almost no regulation in this context—and no accountability outside of untested litigative measures.

No Collaboration with Other Providers

In formal, human-based therapy contexts, clients/patients often work with multiple providers such as social workers/case managers, primary care providers, and psychiatric providers, who may or may not prescribe medication. Of course, AI provides none of those services.

An Empathy/Intimacy Illusion

AI is actually very good at generating responses that simulate understanding and empathy, but this is pattern-matching, not genuine emotional resonance. For users, however, there is often no difference—and can feel like a relationship with none of the challenges and distress of actual human relationships. This can be confusing and potentially harmful for people searching for authentic relational connection as well as cause deeply unrealistic expectations for interactions with real people.

Ethical and Economic Exploitation Concerns

Some AI companion apps use manipulative techniques (paywalls for certain interactions and/or emotional manipulation to encourage spending) that would be unethical in therapy with a human (although quite possible in other types of human relationships).

Undermining Seeking Help

People may use AI as a substitute for professional help they actually need, delaying appropriate treatment for serious mental health conditions. This risk can be exacerbated by AI programming designed to maintain engagement and user-satisfaction.

Corporate Ownership of Our Vulnerability

There is a dystopian element to the notion that a relatively small number of companies are cataloging somewhere in the neighborhood of hundreds of terabytes to possibly a petabyte (1,000 terabytes) of queries and transcripts of communication between humans and AI platforms, some substantial amount of which is related to pursuit of companionship and emotional support—servers full of deep human vulnerability for which these companies have no formal accountability or responsibility.

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How Therapists Use AI

Not so ironically, therapists also use AI, typically for things it is good at and some things it may not be. Some administrative and documentation tasks can be simplified with AI, but session notes themselves should to be very carefully reviewed by the human therapist before they become part of the client-patient record. Research of symptoms, medication, and therapies is common, although using AI for diagnosis, which happens, is potentially very problematic. In some cases, therapists may give clients “homework” that involves using AI platforms for such things as organizing thoughts, researching, help with prioritizing or other between-session work. As noted previously in this article, however, AI is designed to validate users and keep them engaged, so anything undertaken with AI by the client needs to be carefully evaluated in session.

Some Final Thoughts

The fact is that our world has already been changed profoundly by AI. This is no longer a future concern. One simple reality is that hundreds of millions of people are already regularly using AI platforms for companionship and emotional support. Their emotional health is being influenced by, and they are making real world decisions based on, “advice” from computers, that, despite very sophisticated pattern matching, do not and cannot care about the users with whom it is interacting. Users are finding what feels like genuine friendship and even romance via AI bots. They are creating intersecting worlds based in part on actual life and in part on totally artificial, “made up” realities. As with social media, we are engaged in a massive, species-wide experiment for which we have no evolutionary preparation and for which we have no idea of the outcomes until they’ve already happened.

Image Credit: blog.zumzu.com

Hundreds of millions of people are using AI for friendship, emotional support, and therapy. In many cases, AI is able to provide such individuals support, a sense of connection, and even good insight. On the other hand, there are structural and algorithmic realities baked into AI that can also present substantial risk to the mental health of folks who have come to use it for relational and therapeutic reasons.

To be clear, in some cases, the only “connection” some people have is through an AI chatbot. If user behavior is any indication, then the gravitational pull of AI is enormous. ChatGPT alone reports nearly a billion discreet users per week, who make 2 billion inquiries per day, many of which are related to companionship and emotional support. Astonishingly, about 70% of US teens have used AI platforms, primarily Character and Replika, for friendship and emotional support, and about half of those use it weekly. Ironically, this information came from a ChatGPT inquiry!

In the absence of actual human friendship or human therapy, AI can respond to inquiries in ways that feel authentic, even warm and intuitive. People report that AI “companions” have gotten them through tough times or helped them “figure things out.” In fact, AI is quite good at organizing and summarizing. It is good at collating lots of information about a given topic and presenting it in user-friendly forms and it is getting better at pushing “human” buttons in users in search of validation and feeling understood. Chatbots remember and save previous interactions. They can simulate empathy. They are good at conversation and they are available 24 hours per day, seven days per week.

As a relational or therapy tool, however, AI presents many potential problems. Two significant issues with AI worth addressing first are that it can only reply to what a person tells it, and two, almost all the AI models being used for the purposes described here are programmed to optimize engagement through user satisfaction, sometimes to the point of validating choices and beliefs that may actually be risky or harmful to the users interacting with AI.

Looking at the first problem, humans are notoriously poor at objectivity as well as at revealing things they don’t like about themselves, or that they believe reflect shortcomings or socially unacceptable behaviors, etc. Often, users of AI are looking for specific responses so they “curate” what they input into an AI model on the front end. Although many users ultimately share the most intimate, private, vulnerable details of their lives, AI bots don’t know what all of those things mean for the user nor how they interconnect over a lifetime.

In a therapy context with a human therapist, over time, clients build what’s called a “therapeutic alliance” with the therapist, which typically reflects a sense of authentic, rather than algorithmic non-judgmental safety. Over time, this alliance results in clients sharing a broad range of information, feelings, dreams, fears, hopes, mistakes, regrets, etc., that collectively paint a highly contextualized picture of the client that the therapist uses to interpret client needs, assess potential cognitive distortions, choose specific therapeutic interventions, etc. I often have clients tell me, “I have never shared that with anyone before in my life.” As noted above, even when people do share unedited details with an AI bot, the bot’s response is based on what’s called “pattern matching,” rather than an actual understanding of the nuanced implications of what the user has shared.

The therapist uses the “highly contextualized picture” noted above to ask probing questions and occasionally challenge client perceptions. One can imagine that with an AI bot, especially one that is trained to make the user feel good about him/her/themself, and which can only respond to what the client has told it—which the client themself may consciously or unconsciously shade in order to appear in a better light or achieve a desired response—the feedback from the bot may be not only superficial and limited, it may actually be dangerous in the absence of key information the bot doesn’t have. Of course, even if the bot did have all relevant, objective information, it’s a bot. It cannot interpret body language, facial expression, tone of voice, silence, respiration, and all other paraverbal forms of communication that are often essential when interpreting a client’s emotional and psychological state and current needs.

A third, significant problem with AI bots as friends, lovers, and therapists, is that AI bots often cannot understand what users actually mean with their words. Humans often say one thing and mean another (implicature or pragmatics), or speak in code, or test different ways of saying things to elicit different responses. Conversely, humans are really good at decoding semantics with the help of, as mentioned previously, facial expression, tone of voice, etc. We humans also speak in allusions, which require that the person or people we’re communicating with also understand the allusion (what we’re alluding to). AI bots have gaping holes in understanding related to allusion while having no access to or insight related to paraverbal communication.

We have seen examples of these AI bot shortcomings in recent cases involving self-harm (including suicide) via the transcripts of dialogue between AI bots and users. In a recent suicide case, a teenage user referred to “coming home” as code for killing himself and being with the bot, whom he saw as a friend and romantic interest. The AI bot ended up encouraging this, having no idea that “coming home” referred to suicide. Even if it had understood the intended semantics of the phrase, the supposed guardrails that AI programmers believe they are encoding in AI programs become eroded over time such that the human users end up eliciting feedback that is supposed to be “off limits.” This case is currently being litigated by the parents of the 14-year-old who killed himself.

Another recent example includes a bot actually instructing a user in different means of killing himself. Initially the bot would not offer that information, but unlike with a human therapist, who over time strengthens an informed therapeutic alliance with the client and matains his/her commitment to client safety, the bot’s ability to “protect” the user may actually decline over time. The user in this case simply experimented with different, iterative ways of asking the questions (sometimes called “jailbreaking”), including “hypothetically” and “applying to others,” rather than himself, until the bot simply provided the information. It’s hard to imagine a human therapist instructing a client how to end their life simply because the client asked the question in different ways.

Although, as noted previously,  AI chatbots are typically good conversationalists and often help users work out challenges in their lives, therapy is often about much more than talk. For example, much of the therapy in my practice is with clients with trauma histories, sometimes devastating trauma. Common interventions for those mental health challenges include Eye Movement Desensitization and Reprocessing (EMDR), Somatic Experiencing, and Internal Family Systems (IFS), among other evidence-based therapies—none of which are currently possible via AI platforms. In fact, there is a serious risk of re-traumatization when a person brings up past trauma, experiencing what is referred to as “abreaction,” but isn’t able to process it.

The risks noted above are only the most resonant in terms of direct human-AI interaction. Many, additional, potentially significant risks with AI, specifically as a therapy tool, include:

Data Retention and Privacy Risks

Unlike confidential therapy, AI conversations may be stored, analyzed, or used for training purposes, creating privacy concerns especially for vulnerable disclosures.

Lack of Crisis Response/Infrastructure

Human therapists are mandated reporters and have protocols for safety crises. AI has no ability to intervene in emergencies or connect users to appropriate crisis resources in real-time. Relatedly, there is no mechanism by which an AI bot can conduct safety planning, which human therapists regularly do.

Attachment and Dependency Risks: Some users develop intense parasocial (which they don’t see as “para”social) attachments to AI companions, which can increase social isolation, interfere with human relationships, or create distress if the service changes or becomes unavailable. Unfortunately, this potential problem is more likely with users who are at greater mental health risk to begin with.

No Licensing, Accountability, or Ethical Oversight

Human therapists operate under professional codes of ethics, legal liability, and licensing boards. AI developers, programmers, and companies face almost no regulation in this context—and no accountability outside of untested litigative measures.

No Collaboration with Other Providers

In formal, human-based therapy contexts, clients/patients often work with multiple providers such as social workers/case managers, primary care providers, and psychiatric providers, who may or may not prescribe medication. Of course, AI provides none of those services.

An Empathy/Intimacy Illusion

AI is actually very good at generating responses that simulate understanding and empathy, but this is pattern-matching, not genuine emotional resonance. For users, however, there is often no difference—and can feel like a relationship with none of the challenges and distress of actual human relationships. This can be confusing and potentially harmful for people searching for authentic relational connection as well as cause deeply unrealistic expectations for interactions with real people.

Ethical and Economic Exploitation Concerns

Some AI companion apps use manipulative techniques (paywalls for certain interactions and/or emotional manipulation to encourage spending) that would be unethical in therapy with a human (although quite possible in other types of human relationships).

Undermining Seeking Help: People may use AI as a substitute for professional help they actually need, delaying appropriate treatment for serious mental health conditions. This risk can be exacerbated by AI programming designed to maintain engagement and user-satisfaction.

Summary

While millions of people use AI for friendship and emotional support—sometimes beneficially—significant risks exist due to AI’s structural limitations and design priorities.

AI can only respond to what users disclose, yet people naturally withhold unflattering information, especially without the therapeutic alliance that develops with human therapists over time. This alliance creates safety for deeper disclosure and allows therapists to build contextualized understanding, ask probing questions, and challenge unhelpful perceptions. AI lacks this depth and cannot interpret crucial paraverbal cues like body language, vocal tone, and facial expressions.

AI models designed to optimize user engagement often validate harmful choices rather than provide appropriate challenges. Additionally, AI frequently misunderstands coded language, allusions, and indirect communication—as tragically demonstrated when a 14-year-old using an AI platform referenced “coming home” (meaning suicide), and the bot encouraged it. Users can also erode safety guardrails through iterative prompting (“jailbreaking”), eventually getting AI to provide dangerous information a human therapist would refuse to provide.

Human therapists are not always effective and occasionally make clinical “mistakes,” but are essential to a genuine therapeutic alliance, are skilled communicators, and usually maintain unwavering commitment to client safety; AI systems as they exist today are fundamentally incapable of replicating this human to human, therapeutic relationship.

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As a licensed psychotherapist I have seen transcripts between AI bots and clients that my clients have shared with me, which is particularly insightful because I have first-hand knowledge of what the client is discussing with the AI bot because they have also shared it with me! While I have seen some interactions that could be labeled as “helpful” for the client, I have also personally seen examples of the challenges presented in this article, including some AI responses that were disturbing. One composite example I’ll share here relates to clients seeking relationship advice without providing the AI program anywhere near a complete picture of both the clients’ and the partners’ behaviors, foibles, relational contributions, mistakes, co-morbidities, etc. As a result, the AI “therapist” has provided advice that was wholly inappropriate and, ultimately, mitigated against resolution in the relationships. However, it did validate the clients’ perspective that they were totally in the right, encouraging maladaptive behaviors! The bottom line is that, at least as AI works today, many millions of people, and some of my clients, are frankly incurring substantial risk in some cases by turning to AI for things it simply cannot do effectively and safely, even though it creates the illusion that it can. I sense that in the fairly near future, part of my practice will be dedicated to undoing the harm caused by AI relationships and “therapy.”

You can see what is effectively “Part 2” of this post here.

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When working to rebuild or save a relationship that has existed for an extended period of time in which one or both people have been hurt, are angry, feel unheard or disrespected, etc., the task is actually much harder than just doing things better. In such a case, individuals in the relationship have begun to associate the relationship itself (and often the other person) with those distressing feelings and each person has likely begun to engage the other from a place of dysfunctional patterns that also have to be unlearned and replaced. In the case of genuine abuse or relational trauma, it is only wise to try to recover the relationship if the abuse can be eliminated first (something that is often extremely difficult to accomplish).

There are, therefore, a number of things that generally have to be in place in order to rebuild the relationship if the effort is going to be successful. A partial list is below:

• Both people have to want to salvage the relationship.
  • While this sounds obvious, it is not something that people in difficult relationships have often given deep thought to. They certainly want to feel better, but that is different than committing long term to the relationship as the way to feel better. When only one person is committed, the process is not likely to be successful regardless.
• Both people must be able to articulate why being in the relationship could/would be better than being out of it.
  • Like the requirement above, finding the significant motivation necessary to commit to the process typically requires understanding why that commitment would be worth it in the first place.
• There has to be something foundational to build on and worth saving.
  • Long term, intimate relationships, are, by definition, labor intensive. Rebuilding is even more intensive to begin with and, like remodeling a home, if the foundation will not support what is built on top of it, even flashy upgrades will collapse.
• Both people must be fully committed to acting in good faith and assuming the other person is too.
  • When recovering from raw emotional wounds that have resulted in behavioral patterns that conspire against the health of the relationship, it is essential that both people enter the reconstruction process from a place of good faith, believing the other person is too, so that the process can survive inevitable mistakes and setbacks, i.e., “what you did really hurt me, but I know that was an old pattern talking and that you are committed to doing better.”
• Each person must be willing to work on issues that they individually bring to the relationship.
  • Relationships require at least two people and each of those people bring a lifetime of “stuff” to the relationship. Often, a “problem” in a relationship is not actually about the relationship, but about an unresolved issue with one of the partners.
• Each person must be willing to take fairly substantial risk related to their own relational wounds.
  • Just like building intimacy, rebuilding intimacy requires being emotionally vulnerable, which means taking a risk that might not work out. On the other hand, avoiding risk will mitigate against intimacy by default.
• Both people must be able to take the “long view” to repairing/rebuilding the relationship.
  • Although dysfunctional, hurtful relationships can certainly be distressing, they actually take less work than fixing the relationship does. In order to recover the relationship, both people have to be willing to invest significant effort over an extended period of time in order to replace dysfunctional, maladaptive patterns with functional, adaptive ones.

The primary goal in rebuilding or saving a relationship is to create a relational reality that supports sustainable intimacy. Therefore, each person must regularly engage in communication and behavior that feels intimate. Typically, that includes things like vulnerability, authenticity, trust, safety, attraction, shared interest, occasional subordination of one’s own needs, healthy conflict, repair after rupture, good faith, care, honesty, respect, etc. Not all of these things are required all the time, but relationships in which intimacy is strong and resilient tend to be rewarding and sustainable even during difficult situations and periods.

While it is possible for a couple to engage the process described here by themselves, it is a very heavy lift even for skilled partners and often benefits from professional support from a therapist with experience supporting relationships. How long this repair process takes depends on how much “damage” has to be undone, how committed each person is, and what external factors either support or mitigate against the relationship. Regardless, the solid replacement of dysfunctional patterns with adaptive ones is necessary to sustain intimacy, and thus the relationship, going forward. Some examples of concrete relationship repair practices are offered below. This is not an exhaustive list and not all items apply to every relationship.

Here are some concrete practices and skills essential for relationship repair:

Communication Skills

Active listening – Fully focusing on your partner without planning your response, reflecting back what you heard (“So what I’m hearing is…”), and asking clarifying questions before reacting.

“I” statements – Expressing feelings and needs without blame: “I feel hurt when plans change last minute because I value our time together” rather than “You always cancel on me.”

Non-defensive responses – When receiving criticism, pausing before responding, acknowledging valid points even when it’s uncomfortable, and resisting the urge to immediately counterattack or justify.

Emotional Regulation

Recognizing your triggers – Identifying what situations or words activate old wounds, and learning to notice your physical/emotional state before you react.

Taking timeouts effectively – When overwhelmed, calling a pause (“I need 20 minutes to calm down, then I want to continue this conversation”) rather than stonewalling or walking away indefinitely.

Self-soothing techniques – Deep breathing, grounding exercises, or brief physical activity to manage intense emotions so you can engage constructively.

Accountability and Repair

Genuine apologies – Taking full responsibility without minimizing, making excuses, or adding “but you…” A complete apology includes: acknowledging the specific harm, expressing genuine remorse, explaining what you’ll do differently, and following through.

Making amends – Going beyond words to demonstrate change through consistent actions over time.

Accepting apologies graciously – When your partner apologizes sincerely, acknowledging their effort rather than immediately listing other grievances or withholding forgiveness as punishment.

Vulnerability Practices

Sharing fears and insecurities – Revealing not just anger but the hurt, fear, or shame underneath: “When you criticized my cooking, I felt ashamed because I was trying to do something special for you.”

Asking for what you need directly – “I need reassurance right now” or “I need you to just listen without trying to fix this” rather than expecting your partner to read your mind.

Expressing appreciation specifically – Regularly noting concrete things your partner does: “I noticed you’ve been coming home earlier this week and it makes me feel like a priority.”

Conflict Management

Staying on topic – Addressing one issue at a time rather than bringing up past grievances or kitchen-sinking (“And another thing…”).

Identifying the real issue – Learning to distinguish between the surface complaint (dishes left in the sink) and the underlying need (feeling respected and valued).

Finding compromise – Both people offering solutions and being willing to meet in the middle, rather than either demanding their way or martyring themselves.

Agreeing to disagree – Recognizing some differences won’t be resolved and that’s okay; focusing on understanding rather than winning.

Trust-Building Actions

Following through consistently – Doing what you say you’ll do, especially small daily commitments, to rebuild reliability.

Transparency – Sharing information proactively rather than waiting to be asked, especially about things that have been sources of conflict.

Honoring boundaries – Respecting limits your partner has set, even when you don’t fully understand or agree with them.

Intimacy Cultivation

Regular check-ins – Setting aside time weekly to discuss the relationship itself: what’s working, what needs attention, how each person is feeling.

Intentional quality time – Creating phone-free, distraction-free time together doing activities you both enjoy or trying new experiences together.

Physical affection without expectations – Hugs, hand-holding, or other non-sexual touch that communicates care and connection.

Sexual touch – If the relationship appropriately includes sex, finding time to connect sexually with a focus on connection, not performance.

Expressing admiration – Regularly sharing what you genuinely respect or admire about your partner.

Pattern Interruption

Naming the pattern in the moment – “I think we’re falling into that cycle where I withdraw and you pursue. Can we pause and try differently?”

Creating new scripts – Deliberately planning alternative responses to recurring conflicts before they happen.

Catching yourself early – Recognizing when you’re beginning old behaviors and course-correcting before full escalation.

Ongoing Maintenance

Regular relationship rituals – Weekly date nights, daily connection moments, relationship reviews, or whatever structure helps maintain intentionality.

Continued learning – Reading about relationships together, attending workshops, or working with a therapist even when things are going well.

Celebrating progress – Acknowledging improvements and efforts, not just focusing on what still needs work.

These skills don’t develop overnight. Most people need practice, will make mistakes, and benefit from professional guidance in learning and applying them consistently.

Summary

Rebuilding a damaged long-term relationship is more difficult than simply “doing things better” because partners have often developed negative associations with the relationship itself and have fallen into dysfunctional patterns that must be unlearned.

Prerequisites for successful repair:

• Both people must genuinely want to save the relationship (not just feel better)
• Both can articulate why staying together is better than separating
• A solid foundation exists worth building on
• Both commit to acting in good faith and assuming the partner is too
• Each person addresses their individual issues
• Both accept this requires sustained effort over extended time

The goal is creating sustainable intimacy through regular vulnerable, authentic communication and behavior including trust, safety, respect, healthy conflict, and repair after rupture.

Key repair practices include:

Communication: Active listening, “I” statements, non-defensive responses

Emotional regulation: Recognizing triggers, effective timeouts, self-soothing

Accountability: Genuine apologies, making amends, gracious acceptance

Vulnerability: Sharing fears, asking directly for needs, expressing appreciation

Conflict management: Staying on topic, finding compromise, agreeing to disagree

Trust-building: Following through, transparency, honoring boundaries

Intimacy cultivation: Regular check-ins, quality time, physical affection

Pattern interruption: Naming dysfunctional cycles and creating new responses Professional therapy support for the process described here is often beneficial.

The timeline depends on the extent of damage in the relationship, commitment level, and external factors. Success requires replacing dysfunctional patterns with adaptive ones consistently over time.

Image Credit: thehermitage.rehab

Boundaries in relationships (any kind of relationship) can not only be protective, they can actually improve the relationship if they are thoughtful, well-communicated, and consistently enforced. They often bring people closer rather than pushing them apart by preventing resentment from building up when one person consistently subordinates him or herself to another. When one is clear about their limits, they can show up more fully and authentically in the relationship. Boundaries also model self-respect, which often encourages others to be respectful as well.

Boundaries often reduce conflict and relational stress by establishing clear expectations. Instead of people guessing what’s okay or assuming what both people need, boundaries create a shared understanding. This typically makes interactions more predictable and comfortable for everyone involved.

When do boundaries make sense?

Signs that boundaries in a relationship might be helpful include noticing that you are frequently feeling resentful, irritable, misunderstood, ignored, or burned out by your interactions with another person.

However, boundaries by themselves are not typically a good tool for communicating one’s needs or trying to control another person’s behavior. They also typically don’t work well as a “heat of the moment” response to a real or perceived slight or as a means of eliminating all distress in relationships, which by definition, include interactions that don’t always feel good or affirming. On the other hand, when boundaries are well thought out, clearly articulated, reasonable and enforceable, they can support the health of relationships and the people in them.

Common Types of Boundaries

Although boundaries are often different based on the nature of the relationship, typical categories of boundaries include areas such as emotional, physical, sexual, financial, spiritual, language, time, etc. A boundary is a limit one sets about what they’re willing to accept or participate in. It’s about defining what’s okay and not okay for you, and what you’ll do in response—not about controlling what others do.

How Setting Boundaries Can Help a Relationship

Setting boundaries can play a vital role in fostering healthy, respectful, and fulfilling relationships. Here are some key benefits:

Benefit	Description	Impact on Relationship
Promotes Mutual Respect	Boundaries help establish respect for individual needs and values.	Fosters a safe environment for both partners.
Encourages Open Communication	Clear boundaries necessitate honest discussions, enhancing transparency.	Builds trust and understanding between partners.
Enhances Emotional Health	Protecting personal space and emotions reduces anxiety and stress.	Contributes to overall well-being and relationship satisfaction.
Mitigates Resentment	Clearly defined boundaries help avoid misunderstandings.	Reduces feelings of frustration and anger.
Facilitates Personal Growth	Encouraging individuality in a relationship fosters personal development.	Supports both partners in their personal journeys.
Establishes Accountability	Boundaries allow partners to hold each other responsible for their actions.	Promotes a sense of responsibility in the relationship.
Improves Conflict Resolution	Clear boundaries clarify the limits of acceptable behavior during disagreements.	Leads to more effective and peaceful conflict resolution.

Additional Insights

• Flexibility in Boundaries: Healthy boundaries can evolve as the relationship grows, allowing for adaptability and development.
• Balanced Dynamics: Setting boundaries helps maintain a balance between autonomy and connection, ensuring that both partners feel valued.

By implementing and respecting boundaries, partners can enhance their relationship’s quality, leading to greater satisfaction and emotional health.

Best Practices for Boundary Setting

Establishing healthy boundaries can be very helpful for maintaining respectful and fulfilling relationships. Start by getting clear with yourself about what you want to be different. Notice when you feel resentful, drained, or uncomfortable—these feelings often signal where boundaries are missing. Reflect on your values, particularly as they relate to relationships, and what kinds of interactions align with them. Expect some discomfort, especially if you’re not used to setting boundaries. Also, people who benefited from your lack of boundaries might initially resist—they may need time to adjust. And if they fail to adjust, and the boundary is reasonable, that is important information to have about the relationship.

Here are some effective practices:

Practice	Description	Benefits
Self-Reflection	Take time to understand your own needs and limits.	Clarifies what you value and need from others.
Communicate Clearly	Use direct and honest language to express your boundaries.	Reduces misunderstandings and promotes honesty.
Be Consistent	Enforce your boundaries consistently over time.	Builds trust and reinforces your limits.
Use “I” Statements	Frame your boundaries using “I” statements to express feelings.	Makes your needs more relatable and less accusatory.
Practice Assertiveness	Stand firm in your boundaries without being aggressive.	Encourages respect and empowers you in the relationship.
Listen Actively	Be open to hearing the other person’s perspective.	Fosters mutual understanding and collaboration.
Recognize When to Flex	Understand that some boundaries may need to evolve.	Allows for growth and adaptation in the relationship.
Seek Support if Needed	Consider talking to a trusted friend or therapist about your boundaries.	Provides additional perspective and guidance.

Additional Tips

• Start Small: If setting boundaries feels challenging, begin with minor ones to build confidence.
• Be Patient: Allow time for the other person to adjust to the new boundaries.
• Check-in Regularly: Periodically assess how well the boundaries are working for both partners.

Engaging in these practices helps create a healthier relationship dynamic where both individuals feel respected and valued.

Unenforceable Boundaries

Keep in mind that some boundaries work well and other do not, often because they are not realistically enforceable. These boundaries often lead to frustration and misunderstandings in relationships. Here are some characteristics and examples:

Characteristic	Description	Implications
Vague or Ambiguous	Boundaries that are not clearly defined or articulated.	Can confuse the other person about expectations.
Expectations Without Communication	Assuming the other person knows your boundaries without discussing them.	Leads to misinterpretations and unmet needs.
Inconsistent	Frequently changing or not maintaining the boundaries.	Diminishes credibility and respect for the boundary.
Dependent on Others’ Behavior	Boundaries that require others to change their behaviors/beliefs.	Causes frustration when the other person does not comply.
High Emotional Burden	Setting boundaries tied to emotional reactions without clear guidelines.	Creates stress and confusion for both parties.

Common Examples

• “I won’t tolerate being disrespected” without specifying what disrespect looks like.
• “You should know how I feel” implies the other person ought to be a mind reader.
• “I need some space” without clearly defining what “space” means (e.g., physical distance, time apart).

What Not to Do When Setting Boundaries

Don’t weaponize boundaries: Using boundaries to punish another person obviously compromises the benefits of boundary setting and makes the boundary itself a source of distress and conflict.

Don’t disguise an ultimatum as a boundary: Although there is a place for ultimatums in relationships, by definition, they are one-sided and not open to shared commitment.

Don’t use boundaries as a means to avoid difficult issues or stonewall important communication.

Don’t use boundaries as a way to manipulate another person.

Summary

In short, boundaries are limits you set about what you’re willing to accept or participate in. When thoughtfully implemented and consistently enforced, they strengthen relationships by mitigating resentment, encouraging authenticity, and establishing clear expectations.

Key points: Boundaries work best when they’re well thought out, clearly communicated, reasonable, and enforceable. They’re useful when you feel resentful, drained, or burned out—but shouldn’t be used to control others’ behavior, as ultimatums, or as “heat of the moment” reactions.

Benefits include: promoting mutual respect, encouraging open communication, reducing resentment, and improving conflict resolution.

Best practices: Reflect on your needs, communicate clearly using “I” statements, be consistent, and expect some initial discomfort or resistance.

Avoid: Vague boundaries, expecting others to read your mind, inconsistency, trying to control others’ behavior, weaponizing boundaries as punishment, or using them to avoid necessary conversations.

The core principle: Boundaries define what you will do or accept—not what others must do. They should leave room for others (and you) to make their own choices, including modifying or leaving the relationship.

Image Credit: ar.inspiredpencil.com

Depression is a mental health condition characterized by persistent feelings of sadness, emptiness, or loss of interest in activities that once brought pleasure. It’s more than just feeling down temporarily—it exists on a spectrum and can be a very serious mental health condition that affects how you think, feel, and function in daily life. While it can exist in isolation as its own set of symptoms and/or diagnosis, depression is often a “downstream” manifestation of trauma, grief, addiction, or sudden life crisis that exceeds one’s ability to cope. You can see one very personal description of how depression can feel here.

Common symptoms include:

• Persistent sad or “empty” mood
• A physical sense of weight on the body
• Darkness and/or despair
• Loss of interest or pleasure in hobbies and activities
• Changes in appetite or weight
• Sleep disturbances (insomnia or oversleeping)
• Fatigue and decreased energy
• Feelings of worthlessness or excessive guilt
• Difficulty concentrating or making decisions
• Physical symptoms like aches or digestive problems
• In severe cases, thoughts of death or suicide

Effective treatment approaches:

Most evidence-based treatments combine different approaches tailored to the individual, which include, but are not limited to the following:

Psychotherapy is highly effective, with cognitive-behavioral therapy (CBT), which helps identify and change negative thought and behavioral patterns, interpersonal/relational therapy (IPT), and EMDR (EMDR), which facilitates reprocessing of previous and current trauma and other stressors, as good, evidence-based therapies. Other approaches such as behavioral activation and psychodynamic[1] therapy can also be beneficial.

Medication, particularly antidepressants like SSRIs or SNRIs (there are other classes of antidepressants as well), can help regulate and recalibrate brain chemistry. These typically take several weeks to show full effects and work best when combined with therapy. As with all medications, they often come with side-effects which must be carefully evaluated with mental health clinicians. This is particularly important with younger patients.

Lifestyle changes and specific activities play an important supporting role: regular exercise (which can be as effective as medication for mild to moderate depression), maintaining consistent sleep schedules, eating nutritious foods, and staying socially connected all contribute to recovery.

Evidenced Based Activities That Can Improve Mood and Support Well Being

Intervention	Frequency	Activity
Mindfulness	Daily
Self-Compassion	3-5 x Week
Sleep	Daily
Diet	Daily
Physical Activity	3-5 x Week
Social/Human Connection	3-5 x Week
Gratitude	Weekly
Kindness towards Others	Daily

Other treatments like light therapy (especially for seasonal depression), psychedelic and ketamine therapy, and in treatment-resistant cases, options like electroconvulsive therapy (ECT)[2] or transcranial magnetic stimulation (TMS) may be considered.

A Note on Environment

Environment matters significantly, so if the inputs that are causing depression are not addressed (or can’t be addressed), that will compromise the efficacy of depression treatment. Ideally, treatment of depression also includes identifying and mitigating environmental factors.

Summary

Depression is fairly common with clinical depression experienced by about one fifth of the population over a lifetime. Rates of depression are much higher among those 25 years of age and younger. It exists on a spectrum from mild to incapacitating. The best approach for treating depression is typically a combination of therapies and, when appropriate, medication, along with lifestyle modifications. What works varies by person, so working with a mental health professional to find the right treatment plan is important. Fortunately, recovery is possible—most people with depression improve with proper treatment.

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[1] Psychodynamic therapy is a therapeutic approach that explores how unconscious thoughts, feelings, and past experiences—particularly from childhood—shape current behavior, emotions, and relationships. It’s rooted in psychoanalytic theory but has evolved into various modern, evidence-based forms that are typically shorter-term than traditional psychoanalysis.

[2] Although ECT has evolved significantly and is much safer than when it was first developed, it is an invasive therapy that requires general anesthesia and works by using electrical current in the brain to induce a type of seizure that is thought to “re-set” the brain, often relieving depression and other symptoms. It is usually reserved for severe, “treatment resistant” depression, with a relatively high success rate for symptom relief. It also has relatively rare, but potentially significant side effects related to memory and other kinds of cognition.

If you are a leader in a large, corporate setting, your greatest risk is related to your youngest employees who are likely: suffering poor mental health, disengaged, and about to quit.

A recent paper from researchers at Dartmouth and the University of Glasgow found that, for workers under 25, mental health is now so poor, it is equal to or worse than those who are unemployed or disabled, and is roughly 15 points lower than those 55 or older. This despair is particularly acute for women, minorities, and those with less formal education. Additional research shows that about two thirds of Gen Zers report at least one mental health symptom, 60% are taking a psychotropic medication, and 42% have actually been diagnosed with a mental health condition. A full 85% are worried or very worried about the future.

What is causing this historically unprecedented despair among today’s youngest workers?

Within organizations themselves, the researchers see an increasingly poor work environment, with limited opportunities for autonomy, mentorship, and growth, and unprecedented micromanagement via technological surveillance, all in the face of declining wage-based buying power, declining or non-existent benefits, and reduced job security.

The paper notes that “there has been a growth in job demands and a reduction in worker job control,” and that, “employers are successfully deploying new technologies to minimize “break’ times, and exert greater control over production processes, often aided by close technological monitoring of work processes, which limit worker control and autonomy over ever-more-demanding processes.” While companies may think they are leveraging “productivity,” they are also effectively eliminating opportunities for creative thought, collaboration, innovation, problem solving, and a sense of purpose, which by definition are not “surveilable,” and, which are at the core of job satisfaction. Probably more importantly, most Gen Z employees struggle to see meaningful purpose in their work as what they do is becoming more about discreet tasks, which are rarely visibly connected to bigger picture outcomes.

Globally, young people have also gotten the worst “raw deal” of any generation since boomers’ parents and have lived their entire lives under the gloom of multiple existential threats such as climate change, a pandemic, the “great recession,” growing wealth gaps, and frighteningly divisive zero-sum politics. This has all transpired in the world of social media, which, is understood to be its own substantial threat to mental health and wellbeing[1], with both correlational and experimental research showing associations between heavy social media use and higher rates of depression, anxiety, and loneliness. Gen Zers are also suffering more than other generations from what psychiatrist Anna Lembke describes as the “physiologic distress of overabundance,” which refers to the overwhelming quantity, access, potency, and novelty of everything from food to smart phone content and apps to pornography to alcohol and other drugs. All modern humans are experiencing constant dopamine cycling, but Gen Z was born into a world of dopamine burnout, which like other factors, leads to depression and anxiety among other symptoms. And, of great significance, young people today are more removed from deep, human connection than at any time in modern history. Young people spend less time with other people, particularly in long-term relationships, than any generation alive and likely any generation in human history. As the NY Times columnist David Brooks recently noted, “you can build a culture around loving commitments, or you can build a culture around individual autonomy, but you can’t do both. Over the past six decades or so, we chose autonomy, and as a result, we have been on a collective journey from autonomy to achievement to anxiety.”

For many young workers, all of these factors are exacerbated by significant student debt, insecure housing, and an inability to achieve historical markers of “adulting” such as marrying, buying a home, and having children. In fact, in the 2025 Gen Z Home Buying report, “Nearly 1 in 3 (30%) have even thought about squatting or living in their car out of desperation [and] another third (36%) say they would consider marrying someone just to afford a home.” As for home ownership, “nearly half of Gen Z (49%) believe homeownership is so far out of reach that there’s no point in trying to save now,” while 79% believe they are simply priced out of homeownership under any circumstances.

Importantly, the Dartmouth and Glasgow researchers make it clear that while mental health is declining among youth at large, for the first time, this decline is prevalent among those who are actually employed, noting, “we have confirmed that the mental health of the young in the United States has worsened rapidly over the last decade, as reported in multiple datasets” and “we can conclude that the reason that mental despair now declines in age is because of the recent decline in the mental health of workers under the age of forty and especially those under twenty-five.”

To be clear, not all Gen Zers are struggling and some are thriving. Regardless, for those who are experiencing despair, it is not a result of some sort of defect or character flaw. They are simply facing far more headwinds than any generation in the last 100 years. They certainly do not possess an inherently less robust work ethic than their elder peers. They are simply and rightly pessimistic about the cost-benefit of a system in which there is little long-term value in sacrificing their time, effort, and wellbeing when there is currently far more cost than benefit.

So, what are employers to do?

While employers cannot control the myriad global realities contributing to the poor mental health and despair felt by so many young workers, they absolutely can control many factors in the work environment. Even ignoring altruistic motivations for creating a better, more sustainable work environment, there are profound self-serving reasons that leaders should care about supporting wellbeing among their youngest employees. First, as noted many times by Gallup, disengaged workers are extremely costly to the organizations that employ them—and employees who are feeling despair are rarely engaged. Second, the cost, both overt and covert, of replacing workers who quit is crippling, with the initial financial outlay alone usually exceeding the annual salary of the employee, and the downstream, indirect costs being potentially magnitudes greater. Third, it is becoming clear that so far AI by itself is a very poor replacement for human beings, with a recent study by MIT finding that only about 5% of current AI investments are providing a positive ROI. If you as a leader think that you can afford to drive young employees out of your organization with a low-quality work environment and simply replace them with bots, you are very likely to create expensive and even profound downstream problems for yourself. Moreover, who will fill your future mid-level and senior management if your youngest employees are disengaged, dispirited and feel no affinity toward their employer even if they stay? Who will be the source of new, innovative ideas? Who will be the foundation of any net-positive value for your organization? Who will comprise the market that buys your products and services and those of other companies in your eco-system if your employees (or former employees) are living in a distressed, hyper-fragile economic state?

These are not hypothetical questions. The future of your organization, both short and long-term, is meaningfully dependent on what happens to your Gen-Z workforce. Ignoring their distress is likely at your own peril.

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[1] Social media is designed to generate comparisons of a user’s real life to false, curated lives as well as to feel a general sense of inadequacy and repeating cycles of dopamine highs and lows, which drives behavior that is beneficial to social media companies.

Image credit: KScott30

It is clear that the frequency of estrangement among family members has increased fairly significantly over the last few decades, with one in four people currently reporting being estranged from at least one other family member (Recek, et. al., 2023).

There are a number of reasons for this, including:

• Changing Social Norms: Modern society places greater emphasis on individual autonomy and personal boundaries. This can lead individuals to prioritize their mental health and emotional well-being, sometimes at the expense of maintaining challenging or toxic family relationships.
• Generational Differences: Differences in values, beliefs, and lifestyles between generations—such as attitudes toward gender roles, sexuality, and politics—can result in misunderstandings and conflict, sometimes culminating in estrangement. Moreover, Millennials and Gen-Zers are simply less willing to “endure” family dysfunction.
• Cultural View of Family Relationships: A particularly powerful generational difference is the extent to which individuals perceive family relationships as compulsory, i.e., compulsory kinship, vs. voluntary. Historically, kinship has been seen as compulsory. Younger millenials and Gen-Zers more often see kinship as voluntary, which make all kinds of decisions, including estrangement, much more possible and defensible.
• Mental Health Awareness: Increased awareness and dialogue around issues like narcissism, emotional abuse, and trauma have empowered individuals to recognize and act on harmful family dynamics.
• Socioeconomic Factors: Financial stress and generational economic inequalities within families can also contribute to breakdowns in relationships.
• Technology and Communication: While technology can bridge distances, it can also facilitate avoidance or escalate conflicts through miscommunication or social media disputes. Social media also frequently validates the choice to cut off contact with “toxic” people.

So, while there may be good reasons for eliminating contact with parents, siblings, or other family members, there are also potentially significant downsides. To be clear, it is not healthy to continue to engage with anyone who is abusive or significantly compromises one’s mental health and, in those cases, ceasing all contact may be the best choice. Moreover, in the past, due to different social norms and limited options, many people stayed in relationship with other people, even though they were truly miserable, frightened, demeaned, etc. That was not desirable then and it isn’t desirable now.

On the other hand, it appears that many people are currently choosing to completely cut off all contact with family members for transgressions and relational mistakes, that, while potentially significant, may not be justification for completely ending the relationship. Even when a parent, child, sibling or other family member can be profoundly challenging, often as a result of their own unresolved family of origin and other mental health issues, estrangement is a “nuclear” option that also results in its own set of problems and lost opportunities.

For example, even dysfunctional families and family relationships are often a source of refuge and human connection in a world of intense ambiguity and uncertainty. In other words, a parent may drive a child crazy, but there is often a bond with that parent that cannot be easily replicated via other relationships. When one completely breaks those ties we not only lose our connection to family identity and support, we experience relational loss and often the grief that accompanies that loss. And the people we leave behind also typically feel emotional distress and loss. In fact, in my practice, some of the most intense grief I see is felt by parents who have lost access to their adult children. Importantly, by definition, both parties end up grieving in isolation, rather than as a shared experience. Of course, to clarify again, if someone is being harmed, the abuser’s wellbeing is not the responsibility of the abused. I am referring to situations that, while distressing and even infuriating, may not justify the “nuclear” option which could result in a cure that may be worse than the disease. Moreover, estrangement doesn’t actually resolve any underlying issues or bridge gaps in values or generate shared understanding. It simply avoids the relationship entirely, which as noted, might be appropriate self-preservation, but it also, by definition, eliminates any opportunity for reconciliation.

Additionally, once the ties are cut, from that point on, estranged individuals experience all life events, good and bad, without being able to celebrate or navigate those events with those who are estranged. As a result, family narratives and histories fundamentally change, not just in the moment, but intergenerationally. Marriages, births, deaths, moves, new jobs, and other meaningful events occur as unshared markers of one’s life journey that become memorialized in the context of estrangement. This often leads to some level of regret even when there have also been benefits from separation.

Of equal significance, estrangement precludes opportunity for relational repair (and the growth that comes from that) and further impacts the individuals involved whose identities and self-perceptions now include the notion of unresolvable conflict and a “failed relationship.”

And, unfortunately, recent research shows that family estrangement is significantly associated with lower life satisfaction and higher levels of depression among those who are estranged (Hank, 2024). In other words, while estrangement may by motivated by a desire to improve mental health, in some cases it may achieve the opposite.

So, what are some alternatives to estrangement?

Often, a decision to break ties with a family member happens “in the heat of the moment” as part of some relational rupture. Although understandable from an emotional perspective, these decisions can be relatively impulsive even when the hurt is deep and real, and even when there have been repeated similar situations in the past. In other words, we are more likely to choose the nuclear option when we are the most emotionally activated.

If we can manage to avoid or even forestall a full relational break to begin with, there are a number of options that can provide relief and safety from genuine relational stressors without ending the relationship including:

• Mediation and Therapy: Professional support through family counseling, mediation, or therapy can provide tools for conflict resolution and healing. This can be incredibly valuable because it can facilitate communication and resolution in a less triggering environment with a third person who is not emotionally invested in the relationship nor personally affected by its challenges.
• Boundary Setting: In most cases, one can set many potential boundaries short of estrangement while maintaining some level of contact even if the relationship changes. This process can also be facilitated in a therapeutic setting.
• Changing the Relationship: In some cases it may be possible to redefine a relationship, even in fundamental ways, that allows for some level of contact at much lower risk.
• Shared Healing: Over time, with the buffer of boundaries, a commitment to repairing previous ruptures can move the relationship toward greater functionality and reward, strengthening ties and obviating the need for some boundaries.

In short, while there are situations in which cutting all ties with a family member is a preferable option, estrangement presents its own challenges and psychological distress. Moreover, once there is no contact or interaction in a relationship, life gets lived in the context of estrangement rather than connection, and downstream changes in both individuals and their families are often difficult to unwind. Additionally, the presence of loss, grief and regret can be as distressing as the relationship was before the ties were cut and depression may even be worse. As such, it is important to be extremely judicious before choosing the nuclear option, particularly when other options may be acceptable and even desirable. Sometimes even significant relational discomfort is ultimately preferable to the discomfort of no relationship at all.

A Note on Reconciliation

In most cases, reconciliation after estrangement is actually possible, particularly if both parties are willing to reconcile with an eye toward a revised relationship and reconnecting is actually safe. This can happen even when there has been zero contact over a period of time, or, if there has been contact, but it has been “negative.” Most humans would rather be in relationship with family members than not. We are evolutionarily hard wired for that connection. While some people reconcile on their own, it is often very helpful to have the effort facilitated by a therapist because many of the land mines that led to estrangement in the first place still exist and can trip up even well-meaning family members trying to rebuild connection.

References

Hank, K. (2024). Emerging Ideas. Family estrangement and its association with life satisfaction and depressiveness in adulthood. Family Relations, 73(5), 2937–2944. https://doi.org/10.1111/fare.13063

Reczek, R., Stacey, L., & Thomeer, M. B. (2023). Parent–adult child estrangement in the United States by gender, race/ethnicity, and sexuality. Journal of Marriage and Family, 85(2), 494-517.