- Parentification comprises a series of role reversals in which a child needs to care for a parent.
- Parentified children may have difficulty with relationships, poor boundaries, and anxiety in adulthood.
- Once parentification is recognised, it can be processed with a therapist.
Emotional abuse within families can take many forms, some of which are overt, such as name-calling, belittling, criticising, or control. One of the more common, and highly covert forms of abuse experienced by survivors of relational trauma, involves parentification. Parentification comprises a series of role reversals, where a child is placed in the role of needing to care (either physically or psychologically) for a parent. This phrase was first coined by the psychiatrist Ivan Boszormenyi-Nagy and aptly describes the role reversals that occurs within certain families.
Parentification can occur for a range of reasons, including:
- Parental ill-health
- Parental substance use
- Parental mental health difficulties
- Lack of appropriate support from the parent(s) by other adults
Sometimes subtler difficulties underpin the development of this dynamic, including parents who may struggle with complex personality dynamics such as dependent traits ("I am helpless, I can't do anything without support"), and project these difficulties onto children in the absence of appropriate supports. Similarly, children of narcissistic parents often report that they felt like they needed to be “perfect” and a reflection of their parent's success in the parental role and thus carried the weight of maintaining their parent's fragile self-esteem—this is a subtle form of parentification as a child takes on the task of supporting and maintaining their parent's psychological integrity, which is an adult task.
Parentification can involve a range of behaviours, from the overt—making children engage in physical tasks that typically fall to adults in the family, including tasks such as cooking and cleaning, caring for siblings or caring for the parent themselves, to the subtler—confiding in a child in a manner that is not age-appropriate, seeking emotional support from a child, expecting tasks of a child beyond their developmental capacity, seeking advice from children, using them as mediators or buffers, and involving them in family conflicts. Equally, expecting a child to maintain and hold family secrets (e.g., a parent with alcohol use difficulties) such that they cannot seek supports for themselves places them within a parentified role.
In emotionally healthy families, parents recognise that their role involves caring for a child, meeting the child’s developmental needs, scaffolding a child to build new skills, and supporting individuation and separation from the family. Within families characterised by parentification, the emotional emphasis remains on the parents physical and psychological needs, which typically results in children operating at a level far beyond their developmental capacity. Parentified children are usually exposed to issues that they cannot fully comprehend (such as parental substance use or mental health issues), may be required to manage problems that feel scary or that are too complex for a child to manage, may be required to place their own needs aside in an attempt to care for a parent, may feel responsible for a parent’s well-being and are usually unable to engage in the usual tasks of childhood, such as play, education, and building peer relationships. Sometimes, parentified children are praised for these behaviours and are seen by their own parents and other adults as being “mature” or “wise for their age”.
The impact of parentification on children can be vast. Parentified children may experience a range of difficulties in adulthood, including; enmeshed roles within the family, difficulties with establishing boundaries, a pervasive need to please other people, anxiety, perfectionism, difficulties forming and maintaining intimate or platonic relationships, missed developmental milestones, grief, and passive styles of communication. At their core, all of these difficulties arise from a range of psychological needs that were subverted in childhood, including needs for a relationship with a stable caregiver, independence, autonomy, agency, and spontaneity. Parentified children learn to discount their own needs in pursuit of caring for their parent and often carry distorted scripts about the importance of being ‘unselfish’ or placing one’s own needs aside. Missed age-appropriate milestones, such as the formation of close peer groups can lead to a lack of opportunity to build soft skills (such as communication) and can result in difficulties with managing these relationships in adulthood. Anxiety remains a highly common feature of the experiences of parentified children, as they were faced with understanding and managing difficulties too complex for their developmental levels and thus typically developed a sense that the world was difficult and dangerous, and that no one else would be able to provide support or help, thus resulting in a sense of fear, isolation, and helplessness. This can often underpin difficulties with generalised anxiety or social anxiety in adulthood.
While parentification has far-reaching impacts, once it is recognised and named, it can be processed in work with a competent therapist trained in managing relational traumas. When working with a therapist on these issues, it can be beneficial to fully explore the range of behaviours and dynamics that characterised the specific family environment one was raised in, how one perceived these issues at the time and the impacts that these difficulties may have had. Some specific areas to explore include self-esteem, boundary-formation, peer relationships, responsibility, perfectionism, and hyper-independence/self-reliance. It is also helpful to allow space to focus on exploring the range of emotions that might arise once someone has identified that they were parentified, including anger and grief. Finally, it is difficult to heal from parentification while enmeshed in boundary-crossing relationships (including with the parent who created this dynamic) and this work will necessarily include examining extant relationships, to support the adult parentified child with creating mutual, healthy, supportive, and boundaried relationships.
 I note that this extends in scope beyond the usual chores allocated to children in most families to teach them responsibility.