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Children look first to their parents for security and love. This attachment can have a profound and far-reaching impact on children’s development, affecting their mental health in adulthood — for better and for worse.
When a child feels insecure in this most formative relationship in their life, it might be for different reasons, one of which is “parentification.” The phenomenon is quite common, reportedly affecting 30 percent of youth globally.
What is parentification, how does it happen, and what are the mental health effects? For answers to these and other questions, we reached out to Chief Clinical Officer Dr. Beau A. Nelson, DBH, LCSW. Dr. Nelson has decades of experience helping clients address mental health challenges that have roots in childhood, many of which involve some form of parentification. In the below interview, he answered frequently asked questions about parentification and its mental health effects.
What Is Parentification, and Why Does It Happen?
“Parentification occurs when a child takes on roles and responsibilities typically met by a parent or adult in the family,” Dr. Nelson said.
Why does this role reversal, also called “adultification,” “spousification,” or “child carers,’ happen? Dr. Nelson named several causes, including “parental illness, addiction, mental health challenges, financial hardship, or cultural norms that prioritize family loyalty and caregiving by children.”
Types of Parentification: Instrumental and Emotional
Parentification can take two forms, “instrumental” and “emotional” parentification, Dr. Nelson said:
- With instrumental parentification, the child may manage household tasks such as cooking meals, caring for siblings, or managing finances.
- With emotional parentification, the child provides emotional support to a parent. This might manifest in different ways, such as having to comfort mom or dad, act as their confidante, or mediate between parents.
Real-Life Examples of Parentification
When we invited Dr. Nelson to give some real-life examples of parentification from his work with clients, he shared these scenarios:
- A 12-year-old girl becomes the primary caregiver for her younger siblings because her single parent works multiple jobs.
- A teenage boy emotionally supports his mother through her divorce, becoming her confidant and shoulder to cry on.
- A teenager comforts and supports a parent at the death of the other parent, unable to process their own grief reaction.
The Effects of Parentification on Emotional Development
How does parentification affect a child’s emotional development? “Parentified children often develop maturity and independence early, but at a cost,” Dr. Nelson said. “They may struggle with unmet emotional needs, feelings of abandonment, or suppressed emotions. This imbalance can lead to anxiety, perfectionism, or difficulty understanding their own boundaries.”
Mental Health Issues Related to Parentification
Parentification can lead to a range of mental health issues, the severity of which can depend on factors such as the extent of the parentification, a child’s genetic predisposition for certain conditions, and their innate resilience:
- Anxiety
- Depression
- Low self-esteem
- Difficulties regulating emotions
- Poor boundaries
- People pleasing
- Anger issues
- Troubles trusting others and forming close relationships
- Codependency, or an unhealthy reliance on validation from other people at the expense of one’s own needs
- Post-traumatic stress disorder
When a child’s responsibilities “are excessive or ongoing,” they “often lead to emotional distress, burnout, or difficulty forming a stable sense of self,” Dr. Nelson said, which is why “it is best [for parents] to not overestimate, check-in frequently, and be alert.”
Is parentification always harmful to mental health? we wondered. Not always, according to Dr. Nelson:
In some cases, parentification can foster resilience, empathy, and leadership skills. Responsibility, especially for older adolescents, can bolster self-esteem and self-confidence when age appropriate and affirming.
Signs That Someone Was Parentified as a Child
What are some signs that someone was parentified as a child? Dr. Nelson listed several:
- Chronic people-pleasing or over-responsibility for others
- Difficulty asking for help or trusting others
- Feeling guilty when prioritizing personal needs
- A tendency to over-identify with caregiving roles in personal or professional settings
How Parentification Impacts Adult Relationships
“Adults who were parentified as children may struggle with setting boundaries, trusting others, or expressing their needs,” Dr. Nelson said. They might over-function in relationships, take on excessive caretaking roles, or avoid vulnerability due to their fear of rejection. When parentified adults feel overburdened in their relationships, they might experience resentment or emotional exhaustion, especially if their needs go unmet.”
Advice for How to Manage the Effects of Parentification
What advice did Dr. Nelson have for how to manage the effects of parentification as an adult? He shared these tips:
- Acknowledge your experiences and the impact they’ve had on you.
- Be aware of seeking outside validation or self-worth, how do you care for yourself?
- Practice self-compassion and recognize that your worth is not tied to taking care of others.
- Learn to set boundaries and identify your own needs, even if it feels uncomfortable at first.
Therapy and Recovery from Parentification
Therapy can support this process, by facilitating self-awareness and self-care on the path toward healing and recovery. Here is how Dr. Nelson described the role of therapy in addressing parentification:
Therapy offers a safe space to explore the effects of parentification, process emotions like guilt or resentment, and develop healthier coping strategies. A therapist can also help you learn to set boundaries and rebuild your sense of identity outside of caregiving roles. By naming and recognizing the process of meeting others needs before your own, we can learn to empower ourselves to make healthier choices today.
Differences Between Healthy Responsibility and Parentification
What are the differences between healthy responsibility and parentification? we asked.
“Healthy responsibility supports a child’s development, such as completing chores or helping siblings occasionally,” Dr. Nelson said. “Parentification, by contrast, involves adult-level responsibilities that place undue emotional or physical stress on the child, depriving them of a normal childhood.”
Tips for Preventing Parentification in Families
Those who were subjected to parentification growing up and now have families of their own do not have to repeat the same cycle but can instead chart a healthier course. Dr. Nelson suggested the following preventative measures:
- Provide age-appropriate responsibilities for children.
- Seek out external support during family crises with adult friends/family or with a professional school counselor or a therapist.
- Encourage open communication about family roles and the importance of balance.
- Identify how older or generally more responsible kids have hobbies or interests, and get their needs met, outside of helping in the family.
Dr. Nelson ended his remarks on a positive note: “As a therapist, I emphasize that awareness and support can transform the challenges of parentification into opportunities for healing and growth. Families can thrive when roles are balanced and everyone’s needs are valued.”
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