Navigating Boundaries and Grief: Dr. Caitlin Fang's Journey Through Family Mental Health Challenges

When faced with the heart-wrenching decision to set boundaries with a loved one battling mental health issues, the choice is never easy. Many of us choose to estrange ourselves and cut off contact with difficult parents for our own wellbeing, but we also risk losing them forever. In this special episode, psychotherapist Dr. Caitlin Fang returns to share her deeply personal experiences with her mother, who struggled with depression, substance abuse, and schizoaffective disorder. She takes us through the emotional labyrinth of setting boundaries to protect herself and her child, while navigating the turbulent waters of unresolved grief after her mother's passing.

Dr. Fang's story sheds light on the complex dynamics of mental health within families. As she reflects on her upbringing, Caitlin shares insights into how her mother's mental health challenges shaped her resilience and empathy as a therapist. We explore the difficult balance between anger and forgiveness, the emotional tug-of-war of supporting a parent in crisis, and the profound realization of not being able to save a loved one from their struggles.

***Thinking of setting boundaries with a difficult family member or a loved one with mental illness? Book a free call with Dr. Kibby to get the support you need

Chapters

• 0:15 Dealing With Complex Family Grief
• 16:31 Navigating Family Mental Health Struggles
• 21:02 Exploring Complex Mother-Daughter Relationship
• 34:24 Navigating Family Mental Health Decisions
• 45:27 Navigating Complex Grief and Change
• 50:22 Navigating Unexpected Grief Reactions
• 54:36 Navigating Family Grief Logistics
• 1:07:11 Establishing Boundaries in Parent-Child Relationships

Transcript

Jacqueline Trumbull: 0:15

Hey, little Helpers. We've done quite a few episodes now about having complicated family members. We've talked about what it's like to set boundaries with those family members, what it's like to kind of be in relationship to them and try to help them, and we've talked about what it's like to be estranged from them, and now we're going to talk about what it's like to grieve them. So we have the guest from our, I believe, most popular episode to date, dr Caitlin Fang, back with us today to talk to us about her experience with her mom. So welcome back, caitlin. Thanks guys, can you tell us a little bit about what your relationship with your mom was like?

Dr. Caitlin Fang: 1:02

Yeah, big time. So this may be redundant, redundant and that's okay. My mom struggled a lot. She had a lot of really significant trauma when she was quite young and developed depression and substance abuse that ultimately devolved into pretty severe psychosis and delusions and paranoia that we were out to get her and assault her and kill her.

Dr. Caitlin Fang: 1:35

Um and so we have been dealing with like lots and lots of hospitalizations, all of the like urgent care things that as a psychologist, I was like pretty well equipped to handle through college, through grad school, lots and lots of suicide attempts and lots of like angry accusations paired with like desperate loving. And then, man, I guess it was almost three years ago I got pregnant and all of a sudden was like some like really deep set biological drive kicked in where I was like nope, I am going to protect this little being at all costs and I am never going to have her go through what I'm going through, all costs, and I am never going to have her go through what I'm going through. And also like I need my resources that I've been devoting for two plus decades to go into raising this kid. And so I gave her an ultimatum of sorts where it's like hey, I really love you and, like you struggle with schizoaffective disorder. We'd had this conversation many times. She goes in and out of like either being really paranoid that I'm out to get her or being like, oh, I see it With like increasing frequency of psychosis over the years. But I told her like hey, like I need you to seek long-term therapy here's a list of people who are qualified in the area and I need you to be on medication for this and if not, like you cannot be in my life. And so I will check in once every six weeks and like, if you have not done it, then I am going to like block you again and we'll check back in. And it is not that I hate you or I'm mad at you. It just is like I really need you to step up and you to take care of yourself in order to like be a healthy influence in my world.

Dr. Caitlin Fang: 3:39

Sadly, she never did, and so, yeah, at first I think she was blocked for the first year of my kid's life and like most of my pregnancy, with every six weeks checking in. And then I was like a little more resilient, was like a little more resilient and so unblocked her and got a bunch of like crazy, crazy voicemails every couple weeks, being like I know what you're doing and I've contacted a lawyer about the deed fraud and the police will be at your house any moment. To like sobbing I love you, please don't let me let them kill me. I just love you so much, and just like cycling through.

Dr. Caitlin Fang: 4:30

There were times where I listened to them, times when I forward them to a friend to see, like does she need to be in the hospital imminently? And like, offered for her to meet my kid, really hoped that would be the hook, and she was, like I can't go out in public, I can't go to a park, so I can't meet her, um. And then she died a few weeks ago, um, and there was no beautiful bow that tied it together and she died scared. And she wasn't alone. She had a partner, but one who really didn't understand mental health and didn't know what she needed, and so she really just like was psychotic most of the time.

Dr. Kibby McMahon: 5:19

You could share how much you want to, but how did she die? What were the circumstances?

Dr. Caitlin Fang: 5:26

great question, kibbs. Um, she died in the night and we don't know it. Like we could have gotten an autopsy. They didn't perform one, um, and my impulse was like yep, yep, cause like she was 57, she was pretty young, she was so, so ill and also like very cockroachy. Like I knew this was the end, but there was no like imminent thing that happened. And so I talked to a bunch of people and they're like is there an answer that would bring you peace? Like would it help you to know she died of a heart attack or an overdose or like some medical malpractice? And like there just wasn't an answer that would help outside of like being able to latch on to anger instead of sadness, and so we didn't do it, and now there's just like a hovering question mark. But I was pretty sure from a very young age that she would die by suicide and like I imagine it as a consequence of many, many years of really significant drug abuse.

Jacqueline Trumbull: 6:50

When I think about losing my own mother. I'd be losing somebody who always took care of me and was there for me, and there's something terrifying about that. But that is not the relationship you had with your mother.

Dr. Caitlin Fang: 7:03

It sure is not. No, in fact, like quite the opposite. I think when I was young she I don't really remember, but I think that was the toughest part was getting ready for funeral. I pulled as many photos as I could. I like learned about it in the morning and had to be up there at night, so just like randomly pulled every shred of thing I could because we were making a slideshow and I just saw this one.

Dr. Caitlin Fang: 7:34

She had me when she was so young I think she was 19 when I was born, 18 when she got pregnant with me. Then I saw this one picture of her and like these hideous jammies, like a full, like jam set, and she was like 19, clearly exhausted, like that, like look that you have as a new parent, where it's just like deliriously tired, surrounded by toys and like knowing what I know about her. I think she really rocked like young childhood because she was a kid and it was fun and it was silly, um. But as soon as I hit four or five, I think like it reached a place where I had my own thoughts and my own things and I wasn't this like built-in playmate and so I just kept getting harder for her and I think by the time I was 11, I was making sure we were eating. I was getting myself to school. I was like stealing food from the food cafe, from the school cafeteria, like I was pretty self-sufficient, pretty young what do you remember from that like, can you give me?

Dr. Kibby McMahon: 8:52

I mean, I can't even imagine what that's like as like a four or five year old actually good kind of candid voice, but what did that feel like back then?

Dr. Caitlin Fang: 9:03

it felt totally normal, honestly like siblings, and so it was my whole frame of reference. I think like parents would get into really explosive fights. I was often in the middle of them, like literally like they would like come in and she'd be like he's trying to hurt me, call the cops if he moves towards me. And he'd be like he's trying to hurt me, call the cops if he moves towards me. And he'd be like she's crazy, don't do that. And I would just be in my bed being like what, what are we doing, team? And like some psychotic episodes, like she tried to kill me at some point because she was really psychotic, like really significant, severe stuff, but without any frame of reference.

Dr. Caitlin Fang: 9:46

It was truly just like normal life until one day I was telling my friend some story that was like I was locked in a bathroom by my mom and was just like like Tuesday, you know, like truly did not even think it was weird, and they like reported it to guidance counselor.

Dr. Caitlin Fang: 10:06

I had to go ahead. And they were like we might have to call CPS and I was like, oh okay, this is like not what's just happening at everyone's house and it actually became like a lot more distressing, like in the I, I didn't know anything other than to be really independent, and I had a lot of life where I was just like my dad was very wealthy and would kind of buy things to uh, make up for the rest of my life, and so, like I had a giant Beanie Babies collection. I had really cool video games. Everyone loved my house because my mom's always like asleep and we could eat a bunch of dunkaroos and do whatever we wanted, and so it wasn't until, like the curtain was pulled where I was like oh, oh, that it started to be like wait. So like what is everyone else doing? They're literally having family dinners and like talking about their feelings. Are you kidding me?

Jacqueline Trumbull: 11:02

um, yeah, what do you remember about your affect back then? I mean you're saying it's normal but at the same time it's hard to imagine you could have had a happy childhood if you, if your mother's trying to kill you.

Dr. Caitlin Fang: 11:17

I hear you and also I don't. I I really don't have like a lot of memories from inside of my body. I think it's part of how my brain works which is like quite bad at visualizing, but I think like like I was like the class president and the star of the school play and all the teachers loved me and like kind of like my impression when you guys met me in grad school where people were like wow, she's just like happy all the time and I'm like what? So I think just like really good at masking. I don't remember a lot of like distress. I remember some moments where I would like go out to the woods and like camp out there, which I assume was in response to something distressing.

Dr. Caitlin Fang: 12:06

But even that felt like this, like little adventure, because I grew up in this like posh thing with like a little enclave in my backyard and it was just like this is what we do and we make up lots of fun stories and go with it and so like high school was a mess. Like once I figured out, everything was a mess and I was able to start trying to set boundaries. Things like really went dark. But I think I was legitimately a happy kid, I think I like I got to go and see a bunch of Broadway plays, I got to hang out with my friends a lot. I went to sleep away summer camp for like eight weeks every summer. Like things felt normal, until high school where it was like oh, you have to hide this, like this is bad. And then I think the shame was like oh, we're the broken family, we're something is wrong with like all of us, and I think that was what felt much worse than just like you gotta hide from your mom. Sometimes that's just what we do.

Dr. Kibby McMahon: 13:16

So interesting Cause I recently was talking to my therapist about what would it have been like if she called CPS, knowing the things that I went through, and we kind of thought about like whether that would be helpful or not to kind of to learn. I mean, we see this with patients sometimes too, where they're describing family events or their childhood and you're like, oh my God, that kid was traumatized and they're just like, yeah, this is what dad was like, blah, blah, blah. What do you? What do you think it did to you to learn about that? That something was abnormal back then.

Dr. Caitlin Fang: 13:58

I think like there was no part of me that wanted to be taken like that Like Ooh, we have to call CPS and you probably won't be with your family was enough to just be like shut the heck up and don't talk to anyone about this. It wasn't like my wish Someone would save me. It was like there was enough good or at least like familiarity. Truly, I could do whatever I wanted. I could stay up until 3am Like I could order whatever food from the menus and have it delivered and have like a credit card. And so like yes, looking back on it, oh my God, like wow, that is so. That is not something I would ever want someone to experience. And like in living it, it wasn't bad.

Dr. Caitlin Fang: 14:51

But I do think the like people trying to help me it tended to lead to just more like secrecy and more like I couldn't seek out support because I didn't know like which friends would tell on me I had my like core, like ride or die people, but outside of that it was just like nope, you can't come to my house. We can't ever talk about family outside of like yeah, my mom's a little out there, but it was. I think like it really drilled in. Something is wrong and like I think I also got, like I grew up in a very wealthy, very waspy community and so there's very much the like. Don't associate with that girl because she's not from the wrong side of the tracks, even though, like we had money, like we were, I was a pretty freaking normal kid, but there was also this like stuff happens there, don't go near her. She might introduce you to the pot, which is I'm not a freaking good kid.

Jacqueline Trumbull: 16:02

That's fucking sad. So you have to protect yourself from your mom and also the people who are trying to protect you from your mom yeah, and like I don't know if it would have been better, but in my mind it was just like, absolutely not.

Dr. Caitlin Fang: 16:18

Like I know how to handle this. I've been handling this since I was very young. There's no way I'm going to leave this world and all my friends and like go to a question mark.

Dr. Kibby McMahon: 16:31

Do you remember when they use I mean you mentioned like things got dark or things got harder, or then she started to become psychotic. Do you remember any moments in your life when things turn in terms of her mental health?

Dr. Caitlin Fang: 16:53

Again, my temporal memory is quite poor. I know she started having seizures, like grand mal seizures, when I was in fifth grade and I think that's around the same time. What I didn't know was she was on a lot of drugs and also in the beginning her psychosis was delusional, not like hallucinatory, and so it would be like your dad is cheating with this many people. He's so bad. He like yells at me and there was like enough that I was like oh yeah, and so I just hated my dad for a while. It wasn't like years later that I was like oh I'm some of that was true, like I. They fought, and I have seen that, but also a lot of it is like so, in line with the delusions that persisted that I had to be like well, how, I really don't know my dad.

Dr. Caitlin Fang: 17:51

I have just been like get away from me for a long time and I don't know if that is justified or not, but I do think I was kind of her anchor through high school, which sounds crazy pants because like she's super unwell then.

Dr. Caitlin Fang: 18:12

But really when I left, the like frequency and intensity of the hallucinations really increased. When she is like with you, she has enough reality testing to be like, oh, you're not actively trying to kill me most of the time, but like, the further you get. Like I had to like send her pictures of myself with the newspaper with today's date. To be like, look, I'm in North Carolina, here's my house, and like man, I did that for years and years and years. Or just be like I know you're outside and I hear you and your friends and I'd have to be like, look like, facetime me. And she didn't trust technology. So it'd be like here I am with today's paper, which I don't even know where I got paper, but like, and that would like calm her down, ground her and we would get like another two weeks of lucidity and then it would dip again. So, yeah, it really. Without the like constant maintenance, she falls pretty quickly.

Jacqueline Trumbull: 19:18

I think about this with you too, kibbe, but how do you manage having somebody who caused you a lot of pain and who in some ways could have helped herself and in other ways couldn't? I mean, I see this with friends and patients who are very, very angry with their parents for fucking them up in certain ways, and that's very angry with their parents for fucking them up in certain ways, and that's of course and having to at some point recognize the limitations that their parents had as well and, in order to forgive, accept, move on. I don't know how has that process been for you?

Dr. Caitlin Fang: 20:00

honestly, like I have dipped in and out of anger ever since setting limits, anger has really died down, like I actually think it was the like justified fueling anchor where it was like this is really taking from you in a really significant way, where, like you always have one step Wondering if you don't answer the phone, the phone like is that going to be the time they're going to be your fault, um, and I think, like in the beginning, I have never actually had anger at her for fucking me up, like I I actually think, like everyone's like oh my god, considering where you came from, you're great, and like I think that right, like I actually think that I turned out to be a really good person and really grateful that I went through a bunch of really tough stuff, because, like I think it makes me a baller therapist. Like I think that nobody can understand anyone's particular flavor of trauma. But to know, just like the fringes of human experience, I think like really deeply informed, my ability to relate to people, to understand and to be like really non-judgmental, and so like I would never wish that on myself or anyone else, but I am really glad that I had some of those experiences, just because, like it is human experience and I have a very rich tapestry of human experience. Now the things I felt mad about were, um the like active passivity and try to give myself for like a lot of contempt where it was just like I would view her as kind of an annoying younger sister who, like didn't know how to feed herself, didn't know how to like read her email on a phone and like none of it like really compared at all to the severe mental illness and like neglect. But those were the things that would spark like the the like resentment anchor.

Dr. Caitlin Fang: 22:17

I was just like you need to grow up, like I get. There are things that you can't control. There also are so many things you could and like ways you could show up and grow up. And I think when I first had my kid, I went through a huge phase of like fury with her because, like loving my kid is just so easy and like I really believe I would do anything Like if she were like you need to go to this crazy person therapy. It's just like okay, because you you do what you have to, so like take care of yourself, be a full person, even if that sucks. And so I went through a big like oh my God, this was your moment to be like. I will change so I can be a part of my granddaughter's life. And she just didn't over and over again. And so I was just like, man, I can't. I can't keep saving you If you are not going to, like, take the life raft that I keep throwing out. I can't keep throwing it Like I gotta, gotta.

Jacqueline Trumbull: 23:25

I gotta mention going to a park wedding a week after she said that she couldn't meet you in the park with your baby.

Dr. Caitlin Fang: 23:31

Oh, do you know, jacqueline, that's the last text we exchanged.

Dr. Caitlin Fang: 23:34

Oh shit, I'm sorry, huge bummer, but yes, um, but then I think like one of the beautiful things about having space and and actually like the most poignant thing that has happened since she has died is not actually grieving what I have lost, not actually like missing her as a person, but I feel just like so sad about her existence and like so sad that I work with some patients like that who are able to like show up as parents and as friends, and that, for whatever reason, she never got that and her world was scary and she lashed out at everyone she loved, and that makes me feel just like really deeply sad.

Dr. Caitlin Fang: 24:32

I don't, I don't really know how much I have to forgive. I think I have done that, but like that was a really helpful, just like even seeing the people who loved her, like they all knew and were, just like. I think it is sad that I didn't get care. I don't have like a grandparent, I don't have those things, but it hasn't really been a struggle to let go of anger, which is nice. I think I've been doing that for a very long time why do you think she didn't get treatment?

Dr. Kibby McMahon: 25:11

why do you think she didn't change and get help?

Dr. Caitlin Fang: 25:15

I think like part of her illness was deep suspicion and paranoia and so like I think, anytime someone gave her meds or poked at things, it was easier to just be like you're part of the conspiracy, I'm out. Um, yeah, I don't know. I think there were times when she was willing to try antipsychotics, but like she gained weight and she didn't like that and so she stopped taking them, and or like she would miss a few doses and then all of a sudden the pills were poison, and so I think like I don't know crappy emergency inpatient who would release her consistently 48 hours later because she would lie, she would call me and be like we can't talk by, like whisper, like we normally do, I have to use the phone this time and then she'd be released that day. Guys.

Dr. Kibby McMahon: 26:43

Guys, she's poorly psychotic, but kids who have parents with mental illness, especially ones that are that severe, sometimes have this fantasy, whether they're aware of it or not, that their parent will finally see, finally actually come out and connect and be there and see and be that parent. So much so that the fantasy will make you wish, or make you like hope, that there is a mom, that's the mom that you want in there, and if you could only get them treatment or they could, or if the kid does the right things, they could finally get that at that mom. Did you ever feel that? Or did? Were you just like? There's no mom here?

Dr. Caitlin Fang: 27:34

I think the tough part is my grandmother was like a really severe alcoholic for most of my mom's life and then, when she was pregnant with me, she was like, hey, you have to stop drinking or you will never meet your granddaughter. And my grandmother did, and she truly was like a mother to me she was the best. She never did anything to harm me. She was so consistent and so present and so like that was. My model was like parents might not take care of their kids, but like you show up for your grandparents.

Dr. Caitlin Fang: 28:10

And so it wasn't even like a, a thought like all of a sudden I'll have a mom, but it was this like, if anything is going to motivate her, god, that woman has wanted me to have grandchildren or children since I was like 16. And I was like all right, well, like this is it? And then the disappointment of like oh, that wasn't enough, and I know like logically that isn't at all what was happening, but emotionally it was like man, that was my like final effort and I I did have this image of like she could turn it around for my kid, and so that was bummer so your last communication was you offering to introduce your child to her?

Jacqueline Trumbull: 29:01

her saying no, I can't be in public in parks. And then, a week later, her sending you a picture of her in a park at a party of some sort, wedding or some sort. I mean what an illustration of the disappointment of this relationship. And I mean, how does it feel to end on that note? How are you dealing with that?

Dr. Caitlin Fang: 29:25

it's such a bummer like that. There is no like nice redemption story, right? Like I think, like practically like I look back, I listen to all my voicemails and the last neutral one I found was from 2021. Um, and everything since then has been psychotic and so, like it isn't surprising. It just like I don't know, I'm not like a religious person or a spiritual person, but like I find myself wondering, like can she see me now? Because like so clouded with psychosis and delusions, with psychosis and delusions, and like I find myself being like what would she think of me? Because she, she hasn't been able to know me for so long, and so it's less like it doesn't feel like a sour note, because it just like was the note it feels more like like I just wish I could have known her without that part of her brain.

Dr. Caitlin Fang: 30:32

I think she still would be like a deeply flawed human because, like she was a child and she never really had to grow up, my dad was really wealthy and much older and kind of treated her as like this little pet and so I think there still would have been stuff. But just I really think she never could have known me and yeah, that is like a tough thing to wonder about do you have any sense of who she was if you peeled back the psychosis?

Jacqueline Trumbull: 31:07

or was it just to?

Dr. Caitlin Fang: 31:10

yeah, like her funeral was interesting. It's so consistent. She she's like, a wonderful, generous nine-year-old she is. She just like, loved fun and trusted anyone and like would be really generous with her friends and really playful. She loved drinking prosecco at any hour of the day and singing along to musicals. She never had this like drive or purpose or ambition, but like was just a like childlike fun entity outside of psychosis, like I imagine we could have been well, I imagine she would have been much better as a friend than a mother um and like if I leaned into that when we were hanging out, it was much more lovely.

Dr. Caitlin Fang: 32:17

Like you would like take you shopping and go wine tasting and be like in awe of basic knowledge that I would share with her and like loved me so much, valued me so much, just in like really different ways than a typical mom.

Jacqueline Trumbull: 32:39

I mean, I see you. Your eyes are getting misty and I've been thinking about you through this interview because you're in such a tough place with your mom. Can I ask what you're feeling as you hear this?

Dr. Kibby McMahon: 32:49

You're talking to me, yeah, as you hear this, you're talking to me, yeah, yeah, I'm starting to cry because I'm.

Dr. Kibby McMahon: 32:52

I'm remembering your eulogy, um, caitlin, and I was just thinking about, like how Alex and I started crying during it. Just, um, I think I heard you go through such hardship with your mom for so long and then you gave such a beautiful speech about just like singing songs and going to musicals and seeing rent and playing games, and I just like there's so much of the beautiful parts of you that like has this, like joyous, like love of life, and to picture that that's what your mom gave you and that she couldn't do more. She couldn't like. I mean, it was just beautiful to hear that. It was just beautiful to hear that you did have that from her and that that's something that you'll keep from her.

Dr. Kibby McMahon: 33:49

Um, but it's just yeah, it was just also sad because you know, there's all these speeches about how like fun she was and how fun loving, and it really was like people describing a child like she's she loves gambling and games and you know, you know giggling and whatever and then there was just such sadness. So it just yeah, I'm just just thinking about that and crying on your behalf.

Dr. Caitlin Fang: 34:21

I don't know like thanks.

Dr. Caitlin Fang: 34:24

Yeah, I think like one of the most quintessential examples is my grandmother died during the pandemic and I went up to deal with her estate stuff and booked this hotel for me and my mom to like sort through stuff and it was like one of the worst times of my life and I think for her it was just like a time to be with me and so for years after she'd be like let's meet up at the wayfinder in Newport and I was just like I'm sorry, the like random kind of crappy hotel that I picked to be close to a funeral home.

Dr. Caitlin Fang: 35:05

Like that is like your happy place now, and but it was. It was like for her we would like have sangria and chat in between me doing a lot of paperwork and like I think she just pairs that with like what a nice memory, like it just it's so reflective of who she was. She would take these moments that were so painful to me, but for for her, we're just like like remember that time we did this thing and in my mind it would be like, yeah, we had this horrible fight and like you did all of these crazy things and we're threatening, and she would be like she just like wouldn't remember those parts. She would select and remember the parts that felt good and like, on some levels, knew that there was craziness, and would laugh about it and be like ha ha ha.

Dr. Kibby McMahon: 36:03

Yep, I do have those thoughts, but she like couldn't, she couldn't take it seriously what is it like to be the one who holds the bad side of those memories?

Dr. Caitlin Fang: 36:19

I think, like it is, it has been interesting in the grief process because I don't think anyone, including her, understood my decision to not talk to her and like in my mind it was this like really clear contingency where it was like you have so many chances.

Dr. Caitlin Fang: 36:38

I do not dislike you, I do not hate you, I am not your enemy like if you do this thing you have full access to me. But that wasn't translated and so it like kind of felt like I was walking into this room as like the prodigal daughter who sucks mom off. And so there is this like interesting tension where like it was nice that you showed up, like an interesting thing where I was just like guys, those so much my life, like yes, I have set limits in the past two years, and also like that is like a tiny drop in our relationship and so that heart part felt hard, the actual holding it. I think like thank God I'm a DBT therapist because, like it very much is the dialectic where, like I can fully recognize how deeply that sucked for me and also for her.

Jacqueline Trumbull: 37:53

Your limits.

Dr. Kibby McMahon: 37:57

Oh sorry, kip, you were gonna.

Dr. Kibby McMahon: 37:58

No, I mean I just, I I'm just thinking about how sad that is. I mean I, I, in my experience I had similar things where, yeah, I think it's so hard with the parent or family member with mental health issues because saying no to them or saying or cutting them off or setting limits for them might feel like, wait you just, you don't accept me, you don't accept all of me, right? Especially if they don't understand that it's a mental illness or they identify this is me, right, and then and then. So all they see is you cutting them off for no reason for just them being them, and but you have to hold all the trauma, all the pain, all the frustration, all the calling the doctors, like all the terror, and that's just such a different reality and you're just left with that reality. I that, that's the part that makes me feel like so frustrated in my past, but you, you seem to hold it with with grace, or I mean it's just hard. I don't know, I'm maybe just projecting all over you, but no, I think like that resonates.

Dr. Caitlin Fang: 39:05

I think the toughest part was the moment I realized that she didn't know that I cut her off. I call her on Mother's Day, on Christmas, and like I man, I can't even remember what she said, but there was a oh yeah, it was over Christmas. She was in the hospital and like got ahold of me from a non-blocked number and it was just so clear that in her mind we've been talking that whole time. And it was just so clear that in her mind we've been talking that whole time like be a telepathy or a ceiling fan or something. And so it's just like, oh crap, my contingency won't work. Like she does not know that I am holding this thing back in order to like get this other thing. She just has no awareness. It will never work.

Dr. Caitlin Fang: 39:50

And like that was a really shitty moment because up until then it was like you're being a behaviorist, you're doing the thing you like have a really clear thing that is not an unreasonable ask, you have a boundary you can maintain and you're willing to like stick to it. But in that moment it was just like, oh you, you can't. Like you, you don't have the capability to understand like what is happening enough to do the thing I would need, and so then it really did feel like this like I'm putting my oxygen mask on and like I hope you do too, but like I can't keep doing it for you. I gotta like put these other eight people's masks on and I need you to do it, and I think she just couldn't, and that's really I think I mean listening to this.

Jacqueline Trumbull: 40:45

It's clear that that was super justifiable and, um, I don't know how you could have continued to put her oxygen mask on. But are you dealing with guilt or regret about that?

Dr. Caitlin Fang: 40:56

It's so interesting. I think, like up until I cut her off, I have had so many conversations with like incredible brilliant friends and psychologists that I know and trust, who are all like you are not responsible for keeping her alive, and I'd be like, yeah, okay, and also like I am like that's a really cute thing, but I can, I can keep her alive and I could, and I did for like a really long time. And so it was this like interesting emotional chicken feeling where it was just like okay, I know that there are risks in this and it still is what I am going to do, and she did.

Dr. Caitlin Fang: 41:42

She went totally nuts and like I don't know if it was, like I don't think I could have done it without being a mom, but it was just so clear to me that it was like you can't, like you cannot have this child, this like fully grown child. You have an actual child and she deserves all the parts of you you've been giving to your mom for so many years. And like if it were just me, I think I probably would have continued that for way, way, way longer. I expected to feel that guilt when she died, because it was like years later and she had had all these like positive, enriching experiences and no one saw it coming. It wasn't like, oh my god, she devolved into madness and then clearly killed herself. It was this like I don't know, she died sleeping and so like I don't know if I ever fully embraced the.

Dr. Kibby McMahon: 42:52

if she kills herself, it is not your responsibility, but it viscerally feels true that like this would have happened even if I were doing all the things because she couldn't or wouldn't get the help she needed to stop it she couldn't or wouldn't get the help she needed to stop it, like, yeah, that's such an important message because I've definitely felt that a lot of patients and people, especially with family members, who are doing things that are dangerous, like either suicidal, um, or, you know, addicted, and you know they, the loved ones think, okay, if I have to cut them off because they're you know, they're acting out in ways that are not healthy for me, but then if I cut them off and cut off contact, what if they die?

Dr. Kibby McMahon: 43:45

What if, like, what if they get so depressed because of what happened that they killed themselves or they overdose or something, and that that fear looms large, right, like that, that fear of getting that phone call from a hospital or something is like every loved one's nightmare. And so it's interesting to hear you go on the you be on the other side and say that's something that you feared for a long time, but you recognize like she had a choice and she was able to get help or not. And that's not on, that's not your responsibility to keep your mother alive that way.

Dr. Caitlin Fang: 44:24

Totally and like especially. I feel that now that I am a mom, like I would never want my kid to be in that position. It like ha haunts me, the idea that she would put her life on hold, like no matter what I was going through. It just is like so not what I would want for her or for like anyone. I love to feel scared all the time and like anything you say could be the thing that sets them off. It just it keeps you from living and I think that was a big thing.

Dr. Caitlin Fang: 44:57

That like felt burdensome for so long and like I don't know what you would want. But I would like to think that the part of her that like was in that photo when she was exhausted and doing the mom thing. I would hope that's what she would want to. It's like you go and you build your family and you like live and like that is so much easier said than done. Like I think honestly, the part of cutting her off was in many ways harder than grieving her death, because that was a choice and this is one of the. It sucks, but like it happened and so we cope with it.

Jacqueline Trumbull: 45:42

My emotions always turn on when I turn humans into animals. So I just have this image of you having this like aggressive pet dog and knowing that you have to lock it out and let it fend for itself in the wild and just you have no choice. But you also don't believe that it can do it and there's just no other, and it's just like what a fucking horrific choice to have to make, to have to cut her off, and that's how you buy your peace of mind and freedom. Is there relief in this?

Dr. Caitlin Fang: 46:14

that's a really good question. I again like I think it would have been so much more devastating and relieving when I was actively involved. I think there is like a different form of relief than I would have expected, where it's just like god she was suffering for so long. I have no idea what happens when you die, but like it has to be better than what her reality was Like every night, just imagining people are coming to get you and like so much suffering and so many attempts to die and like not, I would never recommend that to everyone. There's always a way to get better. And also like I do feel relief that that has ended for her, for me a little bit, but like I built up a wall pretty intensely when I cut her off and so like it feels more sad than relieving, I think, outside of like I am so glad that is not your reality anymore.

Dr. Kibby McMahon: 47:29

What does grieving look like for you now? And I mean I mean that emotionally, um, but I also mean, like, what kind of changes like losing a parent we're losing someone important to you produces a lot of changes or shifts things in ways that you don't expect. Like, what does grieving look like to you now? Or what? What do you imagine it to be like in the next couple months, years?

Dr. Caitlin Fang: 47:55

oh my gosh, it's been so fascinating. Guys like this is why I thought about reaching out to you in the first place. It's because it looks so different. Like I keep waiting for this, like wow, it's going to hit. Like there is some idea of grief where it just like is a wave that knocks you over and you're underwater, and like I just keep waiting for that moment where, like I can't function and in fact, being like come on, like I am surrounded by everyone I love, like let's do this, like bring the feelings before I have to go back to work and be a therapist and take care of everyone else's feelings, and it just like it didn't happen.

Dr. Caitlin Fang: 48:39

I think I have been feeling so many things. The one moment of sadness was like of like intense sadness, was wondering whether she knew she loved me, and like that question really haunted me for like an hour. Like it doesn't paralyze me, but I think that was the purest sadness. And like sobbing that I felt, like sobbing that I felt. And outside of that, it has been like a interesting mix of like managing people, like all of the other people who are really distraught, and trying to be like the appropriate level of distraught, but not not like method act and be like like trying to be genuine to what I was feeling, which was like shock. I saw her body and that really haunted me, like I just like the image of she was so many things, but like always very full of life, like many of my memories are tinged with contempt, but like they're always her like prancing drunk around a field and then like I suppose, with her being dead, was really stark and really really sad, and I think like it brought up a lot of grief from my grandmother, which I didn't really anticipate. Instead of like grieving her, it was like bringing sadness to a mother figure. Um, and I think just like it doesn't look the same as the thing, like I counsel people through grief all the time and I'm like you gotta feel it, man, you gotta like work through it, and so I'm like okay, feel it, like let's go, and it just it's so different than I expect their moment, like the deepest sadness is really for her and like how hard her life was, just like zooming out and being able to see all of the things stacked against her and how like I just have so much compassion and like deep sadness for how broken her brain was and that feels like really palpable and really real. And that feels like really palpable and really real.

Dr. Caitlin Fang: 51:15

I do have like sadness over the narrative where there isn't that redemption arc where one day she comes around, or even like we have this moment where she has clarity and can see and be like and like I see you, I forgive you, like all of those things will never happen. But the like actual thing you associate with loss of those things will never happen. But the like actual thing you associate with loss of like I'll never see that person again or I'll miss their voice, like that that happened two years ago and so it just feels so different than I would have anticipated.

Dr. Caitlin Fang: 51:49

There's guilt in different ways where I'm like I have to deal with all your money and like bills and estate and like thinking about that makes me feel really guilty. Or it's like you should be sad about the person and instead you're like an estate lawyer and like I have to get a fricking tax identification number for a bank account but doesn't really exist but now does like all of that and so I have some like ew. That's a gross thing to be thinking about right now and yet like that is reality. So that feels tough, but mostly just like continuing to expect this big thing and people being like, well, it could hit at any time and I'm like okay, in some ways that would feel so comforting and so human to like be hit and paralyzed and like coming to terms with that. It's just not, at least to this point, the way my grief is going. And then the like, yeah, sorry, go, I was just going to ask how you're interpreting that.

Jacqueline Trumbull: 52:52

Like you say, it would be nice to have that hit and it seems like it means something to you that it hasn't.

Dr. Caitlin Fang: 52:59

Yeah, I mean I've been thinking about my mom dying for a long time and like had always had the assumption it would like wreck me on so many layers and had such an awareness of all the intricacies, and so it kind of feels like sounds fucked up, but like a little anticlimactic, where it's just like this is the doomy thing you've been trying to stop for your whole life and there's just like the absence of grief, or at least the absence of grief in the like way we picture it in movies or the way that it hits when, like, your most beloved thing dies.

Dr. Caitlin Fang: 53:43

And so it's just been like odd, it has felt weird. I I get why it isn't like it makes sense to me that my experience would be really different and that I've been grieving for a long time. And people say that a lot and I get that like that is what I would say to someone who lost someone with Alzheimer's. But I think that the tough part is like the mental wall I've had to build up was not based on grief. It was based on, like, self-preservation, and so it feels like like I can't tell how much it is like you built up a wall so well that you're not letting the feelings in, or like just one of those normal. Yeah, they're not there because this has been expected for so long, and so I think there's like a shame element associated.

Jacqueline Trumbull: 54:36

Yeah when I heard that she died my first thought wasn't that you guys would be sad. It was like, oh fuck, I wonder if they're going to feel shame or guilt.

Dr. Caitlin Fang: 54:59

Yeah, yes, I do Not like intensely, but there is this like this, like uh-oh, is something wrong with me where, like, yeah, I think it would be so welcome to grieve in a traditional way and I, I just like don't have those memories that like one would miss, like I've been like searching for a pure memory.

Dr. Caitlin Fang: 55:26

It's just like this is when you were the person I wish you could be or wanted you to be, but for so long, for as long as I can remember, even the good things are tinged with like, but that's not an okay thing for a mom to be doing. Like, yeah, you gave me a bunch of tequila shots on my 18th birthday, like that was fun. And also like, oh, like that that probably wasn't the thing. Or like when we would hang out, she would just tell me like gory details of her sex life and like she was sweet and and like engaged and loved me so much. And also it was just like, oh, I'm not like your college roommate. You stop please. No, I don't want to hear any of this. And so it's really hard to find a thing to grieve in the traditional sense outside of like, oh, that's a bummer that you didn't know how to do that, and that's a bummer for me that I didn't have that yeah, I I also think that that's not uncommon with any loss.

Dr. Kibby McMahon: 56:40

I I feel like there's such a movie trope around the big sadness and big grief. But people who have lost a variety of different family members or loved ones will say that you know, it doesn't happen that way, like they'll have like moments of sadness but also a lot of other stuff, like frustration or panic at the logistics of it or sadness at you know, when they heard that their parent is sick or passing, but then afterwards felt like more just tired or you know. So I think grief is just a way more complex than we expect and especially in your case, expect and especially in your case. But I do. I do remember the way I I've only met your mom a couple times, but I do remember at your wedding she was dancing around and I said like oh, isn't this great?

Dr. Kibby McMahon: 57:39

Or I just like said hello to her, her and she just like had the biggest smile. She was like she's so beautiful, she looks so beautiful. I'm so happy. And I think that was the last time I saw her and it's. It's a nice way to remember her at least. You know. I know there's a lot of darkness around around that, but she was just purely happy to be there with you, yep I did want to ask about the logistics part.

Jacqueline Trumbull: 58:09

It's interesting, you know, I had um, a patient who when um, when her father died, she had to then deal with like the house and figuring out what to do with the house, and actually a lot of the kind of trauma surrounding the death was about making decisions about the house. And I just I think when before a parent dies, you don't realize that logistics hit immediately and that you have to immediately pivot from grief to dealing with things that are not interesting to deal with and are very difficult to deal with yeah, that is for sure.

Dr. Caitlin Fang: 58:58

The most distressing part is like immediately when she died, before I even went to the funeral, people were like you need an estate lawyer, here's the name, Go contact them. I was just like I don't like so much of me doesn't give a crap. And also like, yeah, like she has so many psych bills, she has so many things, like she would open a bunch of lock boxes or security deposit boxes across the like New England to just like squirrel things. And I was just like, oh no, like I think she has this like five thousand dollar a month security system. That I'm pretty sure is a scam. That I was just like, oh my God, I have to cancel that.

Dr. Caitlin Fang: 59:49

But like you can't, because until you're appointed executor or now called personal representative, you don't have the power to do that. And so there's this whole giant process where the lawyer talked to me for like an hour and was just like yeah, and so like, don't worry, then they'll put in a claim. And if they don't put in a claim, you don't have to pay them. And they're all going to be really mad and send you a bunch of letters. But like, don't pay them, but then they're going to sue you and then you do have to pay them, so you can't actually touch anything in the estate except these other. And I was just like what? And he's like, yeah, and there are estate taxes which, like I don't know if they'll be relevant for you.

Jacqueline Trumbull: 1:00:15

I would just burst into tears. I would feel so.

Dr. Caitlin Fang: 1:00:22

It's crazy pants and like obligating, like she was living with a partner she wasn't married to, who was like don't worry, I'll take care of you, you can have my car. And so he's like driving her car but it's not on the title and so technically that belongs to me. But it feels super weird to be like, hey, dude, I know you love your life. Like give me the car and just and like I'm just managing. Like he had all of her important documents and all the things that I like legally have to report and manage, and he was just like well, I know like you didn't know her, but I'm sad right now and so like I really can't handle that and like trying to balance like compassion, where it's like, oh my god, like of course, you just like lost the person you were living with, you like gave her CPR for like three hours while waiting for paramedics to arrive, like you were deeply traumatized and also like I am legally responsible and I live in a different state and so if you don't give these to me now, I have to fly up in two weeks to get paperwork. That is just like sitting on your desk, like please give them to me. And yeah, it just like all felt like so skeezy. I felt like I was like trying to get things when in reality it was just like I have no idea if you have any money, like I have no idea if we owe hundreds of thousands of dollars, like I don't know. Know, but I need to because, like I am the only person legally tied to her and so like I have to cancel her cell phone, like I have to do things.

Dr. Caitlin Fang: 1:01:51

And it has just been like feeling like this villain coming in and trying to like take all her upsets while everybody else is so sad, like I don't want to do this, like this is not my fault, this is the law. And I mean like well, like I, she would have given all of her stuff away. They're just trying to swindle. She never trusted lawyers and it's like right. And also the law is like a like I don't know, I don't want to go to like probate jail because I've bricked something up, because you don't want to deal with those Right.

Dr. Caitlin Fang: 1:02:27

So like the logistics has been and just knowing like that is coming, and as soon as I do have this power, I do have to track down like all the things she was associated with somehow I don't know how, and then send death certificates and cancel them all and it's just, it really feels like a full-time job. And there are so many things where I'm like wait, lawyer, are you going to do that? Or like are you just saying all the things that I have to do? And like I have no idea. And so it's this whole new world where, like thank God, I am not like bowled over by grief, like I can't imagine like a pure grieving situation and having to do this. It would be horrific. My brain is like really good at a task and so like I actually think I'm pretty well suited to this, where it's just like do the thing, check the box, focus on a thing, but it's a lot.

Jacqueline Trumbull: 1:03:25

I'm so glad I have siblings because I honestly think my mother's death is gonna like shred the fabric of my universe and I cannot imagine having to pivot into this yep, and I'm not good at a task, so it's really unbelievable that this is just how it goes, but I feel like not to be dark but, like guys, make a will.

Dr. Caitlin Fang: 1:03:47

It would have been so much easier if there were a will that outlined what happened yeah or like a master document with all of your information. Do you have insurance? Here's the contact. Like again, dark, but especially if you have kids, please do it.

Dr. Kibby McMahon: 1:04:02

Organize.

Dr. Caitlin Fang: 1:04:05

Organize Filing cabinet.

Jacqueline Trumbull: 1:04:16

Yes, well, kibbe, can I just ask you because we're talking, I'm imagining our listeners, and the listeners who this is really relevant to are the listeners with parents who are extremely complicated. But right now in this room, there's a listener with the parent who's extremely complicated, who is not dead, but you've been trying to set limits and boundaries with, I mean, like, what comes up for you when you hear about this. It's a good question.

Dr. Kibby McMahon: 1:04:41

I mean it's a weird. This is what I'm talking about in therapy. It's a good question. I mean it's a weird. This is what I'm talking about in therapy. It's a weird thing for best friend to suffer this loss and then also to distance myself from a similar kind of situation and kind of cut off contact, um, and there is that fear of like and kind of cut off contact, um, and there is that fear of like, what if she's? What if she's dead? Like what if I get that call? I will. She's been sober for so many years but I still fear of that call.

Dr. Kibby McMahon: 1:05:12

But I do understand what caitlin's saying and it's like there's something that shifts when you have a kid. There's one, there's all these things like Caitlin was talking about, where there's just you just feel like all the craziness of that kind of relationship is normal and that you can handle it like we grew up in that. We grew up in that background, so like I can take that heat, but then the idea of my son taking that or my husband, I like that was intolerable to me. So like the, the separating felt a little bit more like no, I can't, I can't be responsible. I can't be responsible for this. I can't be tied to this anymore. I got I have to protect my family. So that shifts it and I hope nothing bad happens or I hope for the best, but it's yeah, I think I think that protect the mommy, bear, protective, um thing kicks in and like, for the record, I I don't regret that.

Dr. Caitlin Fang: 1:06:17

Like I think the worst case happened and I just I really don't believe. I think it was this nice narrative that like I was keeping her alive and also we know that's not anyone's job. We can give all the resources we can encourage them, we can be their cheerleader, but like people have to choose to live, we cannot be the one like dragging them through life forever. That's also not living, not just for us but for them. Like that is keeping them alive and at some point, like man, you got to pick a life worth living. You got to like, you got to choose. I want to. I I want to live, I want to have a full life and it can't be my kid is keeping me alive.

Dr. Caitlin Fang: 1:07:11

Like I, or friend or whoever it is like I really believe that is my nightmare is like my daughter feels responsible for my happiness, like it is.

Dr. Caitlin Fang: 1:07:24

That is one of the big shifts give you're asking about action items and like I have to build up my own life.

Dr. Caitlin Fang: 1:07:32

It isn't enough to like love her so deeply and it really it is enough for me to just like I love being with my daughter with like this ferocity where all I want to do is like pour everything into her and then like watch some trashy TV and go to bed, but it's like no, no, you can't, because at some point she will be grown, and like if she was your whole world that is, that is a burden to her, and it is important for people to like take responsibility for their own mental health outside of relationships and be a full person and and so like. Yeah, it is a really tough thing and it feels cruel and mean and also like it isn't out of spite or anger. It is like I need you to swim. I like I so hope you and I will do literally anything to like throw you the things you need to learn how to swim, but if you're just going to stay there treading water, like I got to go swim, Well, I think that's the note to end on.

Jacqueline Trumbull: 1:08:40

I mean, I hope our listeners heard in this account that it is okay to not feel the way you're supposed to feel, quote unquote supposed to feel that it is okay to set and keep the boundary, that it's necessary to live your own life and expect that of others and to not be the savior. Um, yeah, I'm sorry you've been going through this. Thanks, friend, and thanks for coming.

Dr. Caitlin Fang: 1:09:14

I really do make good friends and have a lot of space for whatever I'm feeling and not try to make it go away or make it okay, and that is like a really huge gift people can give people they're like. You don't have to make it go away or make it okay, and that is like a really huge gift people can give people they're like.

Dr. Caitlin Fang: 1:09:26

You don't have to make them not sad or mad or indifferent and it's so lovely to see how many people I have who just like, are like yep, whatever you're feeling, I am here, for we love you.

Jacqueline Trumbull: 1:09:46

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