TL;DR:
Family estrangement is both common and complex. Research shows that for most people, cutting off a toxic family member isn’t impulsive—it’s a last resort after years of boundary violations, emotional harm, or unresolved conflict.
While ditching a toxic family member can lead to improved mental and physical health, staying connected is also valid—when it’s done consciously and safely. This article unpacks the science behind estrangement, the emotional toll it takes, and the practical tools you need—whether you choose to stay, leave, or live in the grey.
It won’t tell you what to do. It will give you the insight you need to make the choice that’s right for you.
Over the last few years, I’ve done a lot of research on family estrangement. I’ve worked with dozens of clients navigating toxic dynamics—and, unfortunately, lived it myself. After all those hours of reading studies, listening to stories, and spending hundreds of dollars in therapy processing my own (extensive) rage, here's the one thing I know for sure:
People in your life will have an opinion about your toxic family. Your therapist may even have an opinion on what to do about your toxic family.
Those people will be full of shit, and your therapist may be full of shit. I say that confidently as a therapist who has, at times, been full of shit.
Because here's the thing: no one—no therapist, no friend, no family member—can tell you what to do when you're deciding whether or not to cut off someone you love. They don't live in your body. They don't carry your memories. They won't have to live with the consequences of your choice.
People will be certain about what you "should" do. And the fact is, there’s no should in this. There’s what you do and what you don’t do (Yoda, 1977).
This article isn't here to tell you what to do. I don't know what's right for you. What I will tell you is what the research says—about mental health, trauma, boundaries, grief—and offer ways to live with the consequences of whatever decision you make.
Why People Cut Off Family
Estrangement is more common than many of us think. A landmark 2020 study by Karl Pillemer found that 1 in 4 Americans are estranged from a family member.
One in four!
Within that 27% of the population, about 10% are estranged from parents, 8% from siblings, and 9% from extended family (including in-laws). What I found particularly striking is that most of these cutoffs are initiated by younger generations. As boundaries become more normalized, people are more willing to remove toxic individuals from their lives rather than hang on out of obligation.
Pillemer's research also shows that estrangement doesn’t usually happen after one big fight—it happens after years (or decades) of conflict, disrespect, and hurt. It's the emotional equivalent of a thousand paper cuts.
One more time: for the vast majority of people, estrangement is a last resort. It is not a rash decision. Please. Stop treating people like it is easy.
When people do make the tough decision, the most common reasons are:
Abuse or neglect—especially emotional abuse (manipulation, invalidation, gaslighting, lack of support).
Boundary violations, such as over-involvement, controlling behavior, and disrespecting privacy.
Persistent conflict which looks like emotional manipulation, and unresolved tension that keeps repeating. Instead of repair, there’s blame, denial, and pressure to “keep the peace” at any cost.
Diverging values, particularly around sexuality, politics, or religion.
Unaddressed mental health or substance use issues that create instability or danger.
The Research Behind Leaving
One of the most common reasons people choose to distance themselves from family is the impact those relationships have on their mental health. Research by Greenfield and Marks (2010) found that negative parent–child dynamics are strongly linked to higher rates of depression and anxiety in adulthood. Chronic interpersonal stress in families (that feeling of ‘walking on eggshells’) is also closely tied to symptoms of PTSD.
But it doesn't stop there. Chronic family stress has also been linked to physical health issues. The ACE (Adverse Childhood Experiences) study (Felitti et al., 1998) showed that childhood trauma predicts:
Chronic pain
Autoimmune disorders
Sleep difficulties
Digestive issues
Heart disease
Those with an ACE score of four or more are twice as likely to have chronic pain and three times as likely to suffer from gastrointestinal symptoms. (The ACE scale is what we use to measure childhood trauma, if you haven’t taken it, you can here).
Why Chronic Family Trauma Affects the Body
Linking a father who neglects or mocks you to chronic illness might sound like a stretch—until you understand the neuropsychology of what chronic stress does to your brain and body. (Skip ahead if brain science isn’t your thing—but I love it, and it’s my article.)
The hypothalamus, located in your brain, helps regulate essential functions like temperature, hunger, heart rate, and stress. When it detects a threat—physical or emotional—it sends a signal to the pituitary gland, which sits just below it. The pituitary then releases a hormone called ACTH, which travels through the bloodstream to the adrenal glands (located on top of your kidneys). In response, your adrenals release cortisol, the body’s primary stress hormone. Cortisol helps you deal with danger by increasing blood sugar, energy, and alertness—so you can react quickly and survive. This is called your HPA axis.
But if you grow up in a chronically stressful home—one filled with emotional neglect, rage, control, criticism, or abuse—your HPA axis gets triggered repeatedly. Your body never gets the chance to fully calm down. Over time, this leads to cortisol dysregulation in adulthood.
For some, cortisol dysregulation looks like constantly high cortisol, which shows up as hypervigilance, anxiety, insomnia, brain fog, or weight gain. For others, it means blunted or low cortisol, leading to exhaustion, burnout, poor concentration, or depression. It could also be a combination of the two.
And it doesn’t stop there.
Chronic high cortisol can change your brain, or keep it from fully developing in childhood. This stress can shrink the hippocampus (which helps with memory and emotional regulation) and amplify the amygdala (your brain’s fear and threat detector). That’s why many trauma survivors—especially those from chaotic families—struggle with memory lapses, emotional overwhelm, or sudden outbursts.
Impact on LGBTQ+ Individuals
While not the focus of this particular article, given our current client I think it’s important to recognize the 2009 study by Ryan et al., which found that LGBTQ+ youth who experienced family rejection were:
8.4x more likely to attempt suicide
5.9x more likely to suffer from depression
3.4x more likely to use illegal drugs
Once again, I’m not here to tell you what to do, but if you are a member of the LGBTQ+ community you may have a particularly strong reason to consider leaving your toxic family.
Healthy Relationships Predict Long-Term Health
One of my favorite studies has been running for over 80 years (Waldinger & Schulz, 2023). It’s the longest-running research on human happiness, and its conclusion is simple: the clearest predictor of long-term health and well-being isn’t money, success, or fame. It’s the quality of your relationships.
That’s it. Not your paycheck. Not your degrees. Not unquestioning loyalty to your family.
And yet, so many of my clients, friends, and loved ones raised in toxic homes were told the opposite. “Family is everything.” “No one will ever love you like your family.” Over time, that message sinks in: blood comes first—even if it bleeds you dry.
Make no mistake: familial bonds can be powerful and life-giving—but only when they’re safe, reciprocal, and emotionally grounded. Staying in a relationship that repeatedly harms or invalidates you doesn’t protect your mental health, it erodes it.
You deserve relationships that regulate your nervous system, not ones that keep it in fight-or-flight. And those relationships, contrary to what you may have been told, don’t have to be biological.
Post-Estrangement Growth
A 2017 study by Lucy Blake and Becca Bland found that many estranged individuals reported positive psychological changes after cutting contact. Participants described feeling more authentic and more in control of their lives—"finally allowed to be me."
There’s life after estrangement, and the research shows it is probably a pretty good one. Keep reading to hear more about how to leave well.
What Makes Staying Worth It?
Not everyone walks away from a toxic family—and not everyone should. Staying can be a valid, values-driven choice, especially when it’s made with clarity about the risks and rewards.
Why People Stay
Attachment wiring: Bowlby (1969) and Freyd (1996) showed that humans are wired to bond with caregivers, even when they're abusive. This is evolutionary: for our primitive ancestors, an abusive caregiver was actually much safer than being alone in the wild to face a saber-tooth tiger.
Cultural or religious reasons: Concepts like filial piety, familismo, or Christian duty often prioritize family unity over personal well-being. This is in sharp contrast to western culture which prioritizes individuality over the collective. However, some studies suggest that preserving family ties—even difficult ones—can contribute to identity stability, especially in collectivist cultures (Peisah et al., 2020).
Your personal values: We all prioritize different values. For some, preserving family ties is the highest priority… and that’s okay. If you’re seeking more clarity around your own values, I recommend starting with something like Brené Brown’s values list or using a values card deck like this one.
Financial or caregiving obligations: Shared housing, caretaking for siblings, or financial entanglement can make leaving feel impossible.
The relationship adds a lot of meaningful connection despite its complexities. It is also possible the person is taking small steps or the harmful behavior has diminished over time.
You’ve developed good coping skills which allows you to be present in the relationships without significant impact to you or your spouse/children.
If these reasons feel like you… I see you. I hear you. They are valid. Ultimately, mental health is not solely about cutting ties with things that feel bad, but about making choices that align with one's sense of safety, authenticity, and well-being. Keep reading to hear about how to stay with an increased sense of safety.
I Decided to Leave... Now What?
Blocking a toxic family member can bring immediate relief—less anxiety, fewer panic attacks, better sleep. But over time, the grief can creep in. You may miss what you never had, feel guilty for breaking the family’s unspoken rules, or feel a deep loneliness during holidays and milestones. In my own family, those are the hardest moments, the holidays and milestones that stir up old hope and spark the biggest conversations about reconciliation.
Expect Pushback
You should expect pushback—from others, from your family, and even from your inner critic.
Estrangement is a disenfranchised grief—a grief society doesn’t "allow." People don’t take care of you the way they would if someone died. There’s no “I’m sorry your mom is a codependent asshole” Hallmark card, and you probably won’t get a casserole expressing condolences when you finally tell your sibling enough is enough.
Well-meaning family members might call you and say things like:
"But it's your mom!"
"Family is everything!"
"It’s your job to reconcile.”
"Can't you just forgive and forget?"
This voice doesn’t always come from others, there’s a good chance it’ll come from you too. Be kind with yourself. You’ve been conditioned to keep the peace, even at your own expense. That kind of wiring takes time to change.
To help with the well-meaners in your life, preparing some phrases you feel comfortable using may help. Something examples might be:
"Thanks for caring, but I’ve made this choice carefully."
"I appreciate your concern, but I’m at peace with the way things stand."
"It wasn’t an easy choice, but a necessary one."
"Thank you for caring. I hope one day I can explain more, but not right now."
"That door isn’t locked, but it’s not going to open without real effort on their end."
And here are some phrases when people keep pushing after you’ve been nice:
"Let’s agree to disagree on this one. My life/peace/mental health isn’t up for consensus."
"I don’t talk about that."
"It’s interesting you’d see it that way." (Thanks to my husband for that one)
[Uncomfortable ‘are you an idiot?’ stare]
What Helps After You Leave
Before, during, or after leaving, find a therapist you trust. If they tell you to work it out against your better judgment—find a new one. You are the expert on your own life. A good therapist’s job is to equip you with the tools and support to make the choices that feel right to you. Don’t trade one controlling relationship for another
Look for online support groups—Reddit's r/EstrangedAdultChild is a good one.
Depending on the nature of your estrangement, you may have legal or financial consequences (shared property, etc). If this is you, I’d highly recommend checking in with an attorney before going no contact.
Expect the holidays, birthdays, and anniversaries of going no contact to bring waves of grief, nostalgia, or second-guessing. Find ways to mark these days meaningfully: a fancy dinner with a friend, journaling, volunteering, going on a trip—whatever feels right to you.
It’s not all hard, as they heal many people report feeling more energized, clear-minded, and emotionally regulated after cutting contact. Keep track of your improvement over time by logging your anxiety, physical symptoms, or overall well-being. The iphone’s Health app is great for this.
A Note on Forgiveness
Forgiveness doesn’t require reconciliation. They’re two separate things—and both are deeply personal. You can let go of resentment and still choose not to engage with the people who hurt you.
If reconciliation feels possible someday, take time now to define what it would require. Write it down. Keep it somewhere safe. Make it clear—to yourself and to others—that reconciliation is only possible if there’s real change, accountability, and safety. Pressure and guilt are no longer valid tools for changing your mind.
I’ve Decided to Stay... Now What?
If you decide to stay, that doesn’t mean everything is fine—and it doesn’t mean you have to be emotionally close to the people who hurt you. You can be around your family without giving in to enmeshment.
Relationships exist on a spectrum. Between full contact and no contact, here are a few options:
Limited Contact: Set clear time limits for visits. Stay at a hotel or with a friend instead of at a family member’s home. Decide what kind of contact feels manageable— and what kind pushes you to your emotional edge.
Emotional Distance: This means caring about someone without being consumed by them. It’s a skill, not a switch. It takes time, but it gets easier with practice.
Gray Rocking: A highly effective tool for maintaining detachment, especially when dealing with individuals who exhibit narcissistic or borderline traits. It involves being neutral and non-reactive—like a “gray rock”—so you don’t get pulled into emotional drama. This one is my favorite.
Grounding Practices: Keep your nervous system from shooting that cortisol into your body as much as possible.Use mindfulness, journaling, breathwork, or movement to help regulate your nervous system when things feel activating.
Conditional Connection: Set clear boundaries as the price of admission for continued contact—and stick to them. Don’t offer ultimatums you’re not ready to enforce. Boundaries might include:
No name-calling
No yelling
No political conversations
Strategies if You Decide to Stay
If you decide to stay, find a therapist who respects that decision. If you’ve made it clear that staying is what you’ve chosen, and your therapist keeps pressuring you to leave, it’s time to find someone new.
The only exception—at least in my practice—is when I have real concerns about a client’s physical safety. In those cases, I name it clearly. But otherwise, our role is to support your autonomy, not override it. You get that enough from your family.
When interviewing a new therapist ask if they have experience with complex family systems, if they are trauma informed, if they are familiar with your cultural background, or if they have experience in something like narrative therapy that can help you rewrite your story.
When you go to visit your family send yourself into these situations with prepared scripts and boundaries. Practice them with a therapist or trusted friend. Be clear about how you want to respond to difficult conversations.
Have rituals of decompression before and after family contact that help you re-regulate your nervous system. Maybe that’s music, making art, grabbing coffee with a friend, or getting a good workout in. Do whatever helps you come back to yourself and reduce your cortisol.
A lot of people won’t understand your decision to stay—and that’s okay. They don’t have to.
Stay safe. And in the meantime, surround yourself with people who are healthy, who can help you co-regulate, and who provide the kinds of safe, connected relationships that research shows predict long-term happiness and health.
Even if your family is chaotic, you can still experience the benefits of healthy relationships elsewhere.
Final Thoughts
Whenever I write or give speeches, I try to lead with my own life. I firmly believe vulnerability breeds connection and normalizes other people telling their own stories. However, with this particular article, I found that every time I sat down to write my own story, I shut down. Not because I don’t have a humdinger of a story to tell—but because it doesn’t feel like a clean story to tell. It’s not linear. It’s full of backdoors and trapdoors and winding side streets that I’m not sure would leave either of us feeling better for having gone down them.
I imagine your story is similar. It’s what makes it so hard to explain to outsiders the decision you’ve made.
So, you’ll have no clear advice here. Instead, I hope you’ve found research, validation, and a little light in the fog. You are the author of your own story—take what the research says, and write a good one.
Works Cited:
Blake, L., & Bland, B. (2017). Parent–child estrangement: Correlates and experiences of estranged parents. Journal of Family Issues, 39(12), 3301–3326. https://doi.org/10.1177/0192513X17710284
Boss, P. (2006). Loss, trauma, and resilience: Therapeutic work with ambiguous loss. W. W. Norton & Company.
Bowlby, J. (1969). Attachment and loss: Vol. 1. Attachment. Basic Books.
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine, 14(4), 245–258. https://doi.org/10.1016/S0749-3797(98)00017-8
Freyd, J. J. (1996). Betrayal trauma: The logic of forgetting childhood abuse. Harvard University Press.
Greenfield, E. A., & Marks, N. F. (2010). Continuity and change in relationships with parents: Implications for the psychological well-being of adult children. Journal of Marriage and Family, 72(5), 1178–1196. https://doi.org/10.1111/j.1741-3737.2010.00757.x
McEwen, B. S. (2007). Physiology and neurobiology of stress and adaptation: Central role of the brain. Physiological Reviews, 87(3), 873–904. https://doi.org/10.1152/physrev.00041.2006
Peisah, C., Brodaty, H., Luscombe, G., & Anstey, K. J. (2020). Family conflict in later life: A retrospective survey of estranged older Australians. International Psychogeriatrics, 32(10), 1165–1173. https://doi.org/10.1017/S1041610219001992
Pillemer, K. (2020). Fault lines: Fractured families and how to mend them. Avery.
Ryan, C., Russell, S. T., Huebner, D., Diaz, R., & Sanchez, J. (2009). Family acceptance in adolescence and the health of LGBT young adults. Journal of Child and Adolescent Psychiatric Nursing, 23(4), 205–213. https://doi.org/10.1111/j.1744-6171.2009.00201.x
van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Viking.
Waldinger, R., & Schulz, M. (2023). The good life: Lessons from the world’s longest scientific study of happiness. Simon & Schuster.
Helpful Reading:
For Estrangement and Family Boundaries
Fault Lines by Karl Pillemer
You're Not Crazy—It's Your Mother by Danu Morrigan
Toxic Parents by Susan Forward
Adult Children of Emotionally Immature Parents by Lindsay Gibson
For Staying with Your Family
Set Boundaries, Find Peace by Nedra Glover Tawwab
The Emotionally Absent Mother by Jasmin Lee Cori
Stop Walking on Eggshells by Paul T. Mason & Randi Kreger
Nonviolent Communication by Marshall B. Rosenberg
Walking on Eggshells by Jane Isay
It’s Not You: Identifying and Healing from Narcissistic People by Dr. Ramani Durvasula
It Didn’t Start With You by Mark Wolynn
Loving Someone Who Hurts You by Dr. Kevin Skinner
For Trauma and Healing
The Body Keeps the Score by Bessel van der Kolk
What Happened to You? by Oprah Winfrey & Bruce Perry
Complex PTSD: From Surviving to Thriving by Pete Walker
For Grief and Ambiguous Loss
Ambiguous Loss by Pauline Boss
The Grief Recovery Handbook by John W. James & Russell Friedman
For LGBTQ+ Mental Health and Family Dynamics
Queer Psychology edited by Jack Drescher et al.
Families Like Mine by Abigail Garner
I’ve enjoying your pieces. Am curious, if you can cover, the experience of people who are on the receiving end of estrangement. So much public discourse seems to praise the choice to cut off toxic people (totally support) but what about when those cut off were in fact not toxic but casualties of the other’s negative fantasies- ie what does research say about enduring being cut off from a toxic loved one?