For people stuck in old roles, guilt, conflict avoidance, or family pressure
Family dynamics can trigger intense emotion and old coping strategies quickly, even as an adult. Many people feel stuck between loyalty, guilt, responsibility, and resentment.
I offer therapy for family issues in Central London (W1 / W1W) and online, helping adults change patterns that repeat with parents, siblings, or extended family.
My work integrates ISTDP, DIT, CBT and psychodynamic therapy, focusing on boundaries, emotional clarity, and repeating relational cycles.
When family issues become a mental health issue
You might recognise:
- guilt when you set boundaries
- feeling responsible for others’ emotions
- conflict avoidance and “keeping the peace”
- resentment from overgiving
- feeling treated like a child or stuck in a role
- family contact leaving you drained or anxious
The family pattern cycle
- Family trigger (criticism, expectation, withdrawal, conflict)
- Emotion rises (anger, hurt, fear, shame)
- Strategy:
- appease / people-please
- withdraw / shutdown
- overfunction / rescue
- explode then feel guilty
- Short relief
- Long-term cost (resentment, anxiety, distance)
How ISTDP understands family patterns
From an ISTDP perspective, old family patterns often persist because:
- certain feelings felt unsafe historically (anger, need, sadness)
- anxiety rises when emotions are activated
- defences (appeasing/withdrawing) run automatically
Therapy helps increase capacity to feel and respond differently, so boundaries become possible without collapse or guilt-driven reversal.
How therapy helps
We work to:
- identify roles and triggers
- build boundary clarity and assertiveness
- reduce guilt/shame cycles
- work with grief, anger, or unmet needs
- practise new ways of relating that protect your wellbeing
What sessions usually look like
Early sessions:
- map the family roles and emotional triggers
Ongoing work:
- work directly with guilt/anxiety patterns
- practise boundaries and communication
Related ways I work
- DIT – focused work on relational themes
- Psychodynamic therapy – understanding longstanding roles
- ISTDP – emotional inhibition and guilt/anxiety cycles
You may also find these pages helpful:
Frequently asked questions
Can therapy help even if my family won’t change?
Yes. Therapy focuses on what you can change: responses, boundaries, choices.
What if I feel guilty setting boundaries?
That’s a common cycle we work with directly.
W1W or online?
Both available.
Insurance?
See Fees & Insurance.
Next steps
If family dynamics are impacting your wellbeing, therapy can help you shift the pattern.
- Book an initial consultation
- Request a brief call
- View Fees & Insurance
