Dealing with unhealthy family & friend relationships: A brief how-to.


The problem of how best to deal with difficult family members or friends comes up routinely in therapy sessions. This applies to relationships that are sometimes manipulative, shaming, lacking in boundaries, or emotionally abusive. There’s often a heavy dose of the “shoulds” in these sessions: “I should be able to attend this family gathering; I shouldn’t care what my mom thinks, I should be able to talk to x on the phone for ten minutes, etcetera. The fact is that wanting health in one’s relationships with one’s family and friends is a very normal desire, and fair to aspire to. 

How to approach taking care of yourself when dealing with unhealthy family/friend relationships? Here’s a few suggestions:

Prioritize Yourself First.

If this suggestions sounds nutty to you, there’s a good chance that your relationship could use some tweaking. As I’ve mentioned in many previous posts, self-prioritization is not the same thing as selfishness. Even if your mother tells you otherwise.

Take care of yourself first, and then decide how you might be able to extend yourself to others. Make sure your health is prioritized. Take time for relaxation, socialization, exercise. Rest. Consider what’s being asked of you, and decide if it makes sense for you or not. Then, after all of that, attend to what’s being asked of you (if you choose to). This is respectful to all involved. Including you.

Say No. Often. With Gusto. 

Saying No can be a real challenge when our friend or family member lacks boundaries, applies guilt tactics, or doesn’t accept No as an answer. This does not mean that we default to saying Yes to avoid all the trouble of the No. This means that we gently try out No in ways that feel comfortable to us, until we can apply the No more regularly and comfortably. 

No is a complete sentence. You do not need to provide a lengthy explanation or validate your No. If something feels wrong for you, practice applying a direct, firm NO and see how it feels. Word has it that No gets easier with practice. 

Listen to Your Insides.

Your gut knows what’s up. Chances are, if you feel twisted, anxious, fearful, physically ill, etc. about something, it’s because there is a part of you that would have a hard time with doing it, and doesn’t want to do it. We don’t always need to do exactly what our parts tell us, but it is important to give them the respect of air time, hear out what they have to say, and then decide from our calm, rational Self how to best take care of them. 

This means you don’t ignore our feelings, tough it out, get over it, (wo)man up, or whatever other unhelpful phrase might be employed here. Respect your feelings enough to listen to them, and take measures to take care of them. Sometimes this means not taking a phone call. Sometimes this means opting out of an unhealthy conversation. Sometimes this means setting a strong boundary at holidays. All of this is okay.

Let the Cat Out of the Bag.

There is often a rule in unhealthy family systems that we don’t talk about our problems with other people.To my mind, this is the most dangerous element in unhealthy family systems, and the most telling. This rule acknowledges that something is going on that is not okay, and then asks the child (adult or otherwise) to pretend that this isn’t the case, or not to air out their dirty laundry. 

To quote Ann Lamott, “You own everything that happened to you. Tell your stories. If people wanted you to write warmly about them, they should have behaved better.”

Your family (or friendship) is not Fight Club. There is nothing to protect here. Telling your story is healing, so tell everybody. Tell your trusted friends and family members, tell your therapist. Tell the press if you want to. Don’t hide secrets for unhealthy people. 

If All Else Fails, Limit Contact.

Limiting contact is the final frontier, and can be a hard choice to make. This is hard, and that is fair and also okay, and a good reason to be gentle with yourself if you are considering communicating with someone less, or cutting them out altogether. 

I want to be very clear in strongly validating that it is a completely healthy and viable choice to remove someone from your life that is causing you emotional harm. The bar does not have to be set at physical harm (which it often seems to be, for some reason). If a person in your life is emotionally damaging you, it’s reasonable to consider making the cut. Consider sharing your experience with trusted people (see Let the Cat Out of the Bag) and allow their validations to support you if you make this tough choice. 

Navigating unhealthy relationships can be emotionally taxing at best, and damage one’s physical and mental health at worst. You can take steps to protect and care for yourself. Consider it. 

Originally posted on my blog, Common Humanity, at Psych To read more, visit

Useful Information

Some frequently asked questions and useful answers.

Online therapy works in the same way as in-office therapy, but is done online, similar to a Skype or FaceTime conversation. Clients are able to have sessions from home, work, or any other convenient location. We meet with clients using a HIPAA-compliant secure platform.

Online therapy allows you to work with us from the comfort of home, or any private location of your choosing. For some, the screen provides an added layer of comfort that makes the challenging work of being vulnerable in therapy a little easier.

Online therapy also creates the unique opportunity for you to work with us without the constraints of proximity! The practice was born in Keene, New Hampshire, but has since grown to service clients anywhere in Massachusetts, Pennsylvania, Connecticut, Vermont, New Jersey, Florida, and New Hampshire.

Online therapy is a great option for clients that travel for work, for college students that go home during the summertime and do not want a break in their sessions, and for anyone with a challenging or inconsistent day-to-day schedule. It is an excellent choice for clients seeking a therapist with a particular specialty that they are unable to find support for locally. Some of our clients report that online therapy makes the vulnerability element of therapy a bit less intimidating.

No. For some clients with more complex symptoms or safety concerns, having a local therapist that is readily available is important in case of crisis or the need for a higher level of care. Online therapy is also a challenge for clients that do not have access to a private, quiet space to be “in session” for the hour, or for those that do not have adequate internet connectivity.

There are several reasons why we don’t accept insurance. The most important are:

Confidentiality. Insurance companies require that your information be shared with them in order to pay for services. We prefer that clients’ information is kept as confidential as possible.

The pressure to diagnose. Insurance companies require that clients are given a mental health diagnosis in order to pay for therapy. We have found that many clients benefit from therapy, but do not meet criteria for a diagnosis. Not using insurance allows clients to access therapy without being given a mental health diagnosis.

Flexibility and freedom. Insurance companies dictate the length and number of sessions they will authorize, as well as when a client is no longer eligible for the benefits of therapy. Because we do not work with insurance panels, you and we can collaborate to determine your individual needs regarding session length, frequency of sessions, and when to terminate therapy.

While we do not accept insurance, many clients choose to submit receipts to their insurance companies to receive reimbursement via out-of-network benefits. We are happy to provide these receipts for you! Please check with your insurance company for details on your benefits.



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