Dear Therapist: I Feel Tremendously Guilty for Not Taking Care of My Aging, Alcoholic Mother

Dear Therapist,

I am the adult child of an alcoholic mother, and now I am a mother myself. I love my mom, and we have a very close (albeit tumultuous at times) relationship. My upbringing wasn’t by any means all bad. My family was incredibly dysfunctional and maybe a little toxic, but also loving and supportive in our own weird way.

Still, my life has been defined, influenced, and certainly scarred by my mother’s drinking, behavior, and mental-health issues—denial being chief among them. In my late 20s, I gave up trying to help her and went about the business of breaking out of the chains and cycles of my family. Distancing myself from my mother and family was heart-wrenching, but I am living a healthy, positive, and deeply fulfilling life because of what I did.

I am now 43 years old with a 3-year-old daughter, and we live a few thousand miles away from my family. I own my home and work full-time, and I’m a single mom by choice. Life is wonderful, except for the fact that my mother, now 72, is deteriorating both mentally and physically. Her living situation is awful. She’s something of a hoarder, her house is dilapidated and dirty, and her drinking has begun to take a toll on her health in myriad ways. Recently, while highly intoxicated, she fell down the stairs in her home.

She has been asking me for years to move home, and I’ve always been very clear that I would not. But now I am so conflicted. I feel this tremendous guilt for no longer taking care of my mother. I know she needs me. But when I had my daughter, I made a promise to her, and to myself, that she would never grow up in the chaos that I did. I want to protect her from that. I don’t want her to see her grandmother like this either. But am I just sentencing her to a different type of damage? The damage of teaching her to walk away from family in their time of need, and of denying her a relationship with a grandma who, despite being deeply flawed, loves her? I don’t want that for her either.

I just don’t know what to do. For me, when it comes to my mom, the damage is long done. But my daughter has a clean slate. How can I protect her without also harming her in the process?

Anonymous

Dear Anonymous,

Growing up with a parent who struggles with addiction can affect a child in many ways, and the repercussions can persist into adulthood. In addition to the sense of chaos you say you experienced, there is often also confusion, especially around knowing what responsibilities belong to the parent and not the child. Many children of alcoholic parents become what’s called “parentified,” which means that the child takes on a caregiving role, whether that’s attempting to keep the parent safe or fending for oneself when the parent isn’t able to function as one. Clarifying appropriate roles and boundaries can be an ongoing struggle.

Then there’s the question of how to love this parent who might at times be attentive and caring, and at other times frightening, unpredictable, unavailable, or out of control. A child can experience an array of feelings toward this parent, ranging from anger to compassion, along with a sense of guilt that leads to a tendency to put others’ needs above one’s own. This is another pattern that can be hard to let go of later on.

Read: When kids have to act like parents, it affects them for life

Given the ripple effects from a parent’s addiction, many people consider substance-use disorders to be family disorders, because they affect the entire family system. You seem to have come to this realization in your late 20s, and I can imagine how challenging it must have been for you to leave that environment and carve out a full, healthy life of your own. Making that choice took tremendous courage, and it sounds like you accomplished your goal of ending the family cycle you hoped to break out of.

A strong sign of your healing is that rather than seeing your family as all good or all bad, you’re able to hold its contradictions. You view your family as both “supportive” and “dysfunctional.” You understand that having a “close” relationship with your mom doesn’t erase how “tumultuous” it is, or vice versa. Getting to a place of “both/and” requires hard work, especially when a person grew up with some trauma.

What’s interesting, though, is that instead of looking at your current options with that same expansiveness, you present your choices as binary. In your mind, they look like this:

In other words, you’re setting up this situation as either you help (by moving home) or you don’t (by not moving home), and each of these choices has a single, clear consequence for you and your daughter. But what if there’s a way to care for your mother while also caring for yourself and your daughter?

Let’s start with the guilt you feel when you tell yourself that you’re abandoning your mother. I want to begin there, because alleviating this guilt seems like the biggest factor pushing you toward moving home. Not only is your sense of abandoning your mother an old, faulty narrative left over from childhood, but avoiding guilt is rarely a good reason to make a big life decision. By contrast, you have very reasonable and compelling reasons for staying where you are: maintaining the hard-earned, happy, stable life and family you created and not going back into the chaos. The part of you that broke free from the family dysfunction is the same part of you that knows going home isn’t a viable option for you and your daughter.

Given this, let’s think instead about whether you might be able to care for your mom without upending your family’s life. I suspect that recent events have surfaced the part of you that feels like a child worried about her inebriated mom, and that child is used to making a choice about whose needs matter more. The dilemma you might have faced as a child was that in choosing your own needs, you would leave your mom’s needs unmet. But once you dispel that binary framework, you might see that taking care of yourself doesn’t mean abandoning your mom.

Here’s why: Even if you moved home, you couldn’t accomplish what I believe you imagine you would. Nobody can help your mom get treatment for her alcoholism if she’s in denial about it, or is aware of it but doesn’t want to face it. With a job and a young daughter, you couldn’t be there 24/7 to make sure she doesn’t fall down the stairs after drinking, or stop her from hoarding. Most of the things you can do to help her can be done from either city, such as offering her information on treatment programs, therapists who specialize in addiction, or local 12-step meetings (all of which she will likely reject); hiring someone to come in and check on her or clean the house; suggesting that she move to a one-story home or communal-living situation that might be safer as she ages; interfacing regularly with her medical team; and having groceries, meals, or other items she needs delivered to her doorstep. (Of course, some of these things can cost a lot of money, and although I don’t know your financial situation, moving closer to your mom won’t change that you’ll need to outsource much of this work if you plan to maintain a job and have time for your young daughter.) Once you let go of the childhood fantasy of saving your mom, you will see that part of being an adult is letting go of the hope of finding a perfect solution and accepting—and working with—what is.

Read: Gen-X women are caught in a generational tug-of-war

Meanwhile, you and your daughter can still visit your mom and have a nice relationship with her—but in a way that feels stable and safe. Rather than moving home and sending your daughter the message that it’s okay to give up your sense of balance for people who live chaotic lives, you’re ending the generational cycle of dysfunction by being a reliable, sturdy mother who maintains healthy boundaries with a flawed but loving family member. You’re showing her that you can have compassion for someone’s challenges without being sucked into them, and that you get to set your own limits based on reasonable wants and needs in order to create the possibility of a healthy relationship (“We’re happy to visit you, but not when you’ve been drinking”).

I’m sorry that in some ways you had to parent yourself growing up, and that you struggle to entirely trust yourself as a result. But you know the answer here—and I know that you know it. You just have to access the voice of the magnificent, healthy parent you’ve become, and let yourself listen to the soothing words of this wise, resilient mother who moved away in her late 20s. Your daughter is lucky to have her—and so are you.

Dear Therapist is for informational purposes only, does not constitute medical advice, and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, mental-health professional, or other qualified health provider with any questions you may have regarding a medical condition. By submitting a letter, you are agreeing to let The Atlantic use it—in part or in full—and we may edit it for length and/or clarity.