Abstract: This article presents a theoretical/conceptual discussion of grandparents who experience disruption in relationships with their grandchildren. Implications of such disruptions are viewed through attachment theory and Erikson’s adult stages of life cycle development. A practice application model to help affected grandparents cope with grief and loss is presented. Longer lifespans allow for intergenerational family relationships, yet many grandparents are prevented by the middle generation from seeing their grandchildren. Limited research suggests that this phenomenon may occur as the result of a divorce or death in the middle generation, intergenerational family conflict, or through Parental Alienation Syndrome (PAS). Alienated grandparents suffer serious consequences, including depression, anxiety, grief, suicidal ideation, and physical health problems. Grandparents may be helped through mutual aid and advocacy groups such as Alienated Grandparents Anonymous (AGA). Formed in Naples, Florida, in 2011, AGA expanded rapidly to forty-four US states and ten countries. AGA formed a collaborative with Naples’s David Lawrence Center mental health care facility in 2015 to address mental health needs of participants, using an innovative, web-based TeleHealth program. Research is needed to better understand grandparent alienation and provide effective interventions.
There are currently 70 million grandparents in the United States, representing one third of the population (Breslau 2016). Life expectancy has increased threefold in the past two- hundred years, allowing for the possibility of lengthy familial multigenerational connections between children, parents, and grandparents (Grandparents.com 2013). There are instances when these primary kin relationships are disrupted or severed, and in some cases grandparents are suddenly cut off from contact with grandchildren for unknown reasons. This may occur as a result of a sudden event in the middle generation, such as a death or divorce, or the adult child in the middle generation may actively alienate the grandparent from the nuclear family and children.
Grandparents in such situations can experience emotional and physical health problems in grieving the loss of contact with grandchildren (Drew and Smith 1999). Coping with such feelings may be particularly difficult for grandparents when it is considered that 72 percent of grandparents report that being a grandparent is the single most important and satisfying thing in their lives (Breslau 2016).
Significance of Grandparents
The relationship between children and their grandparents is highly salient and an important component of grandparent quality of life and self-identity (Kruk 1995). The consensus of numerous studies on grandparents and grandchildren show that they interact with each other often and tend to be emotionally close and have mutually satisfying relationships (Kornhaber and Woodward 1981; Bengtson and Robertson 1985; Denham and Smith 1989; Smith 1991; Kornhaber 1996; Drew and Smith 2002). Grandparents are an important part of the family life cycle. They may function as family historians and transmit family values, ethnic heritage, and family traditions (Barnett et al. 2010). Despite varying levels of involvement in grandchildren’s lives, grandparents’ emotional attachment to their grandchildren generally prevails over other salient aspects of their lives (Kornhaber and Woodward 1981; Kivnik 1982).
Barnett et al. (2010) found that maternal grandparents, particularly grandmothers, are highly involved with their grandchildren under five years of age, and found that for many Americans, multigenerational bonds have become more important than nuclear family ties for wellbeing and support over the course of their lives. Grandparents often play primary roles in the lives of their grandchildren. More than 6 percent of grandchildren are being raised in grandparent-headed households in the United States (Goodman and Silverstein 2002). Moreover, nearly 9 percent of all grandparents with grandchildren under age five provide extensive childcare of at least thirty hours per week (Fuller-Thomson and Minkler 2001).
Grandparents may serve as valuable sources of social support for children during times of family stress (Lussier et al. 2002). The authors found that grandchildren who reported greater closeness to grandparents experienced fewer adjustment problems following parental divorce. Hagestad (1985) argued that in times of stress grandparents can act as a stabilizing force for the parents and may encourage family cohesion by being the focal point of family contact. Grandparents may provide comfort to grandchildren experiencing a parental divorce: “At a time when things seem uncertain, grandparents provide children with a sense of security and confirmation that some things stay the same following divorce” (Neugebauer 1989, 156). Continuity of the grandparent–grandchild relationship may provide a vital connection for a child when other family relationships undergo dissolution.
Disruption of the Grandparent–Grandchild Relationship
There is little information available regarding discontinuities in the grandparent–grandchild relationship. Access to grandchildren is controlled through the voluntary consent of both parents (Robertson 1975). Grandparent–grandchild relationships are largely shaped by the kinds of relationships shared by grandparents and their adult children. Grandparents who have good relationships with their adult children are likely to develop stronger ties with their grandchildren (Myers and Perrin 1992). A difficult or disrupted grandparent–parent relationship can threaten proximity of grandparents to grandchildren, amount of contact, level of involvement, and fulfillment of a satisfying grandparental role (Lavers and Sonuga-Barke 1997). Drew and Smith (1999) suggest that vulnerabilities and transitions in the middle generation such as illness, death, relocation, or divorce can compromise the ability of grandparents to engage in deeply satisfying, primary kinship roles with grandchildren. One of the few studies to investigate the nature of grandparent–grandchild access difficulties and contact loss was that of Kruk (1995), who used a qualitative approach to interview fifty-five grandparents in Canada who were members of grandparents’ rights organizations. The author found that grandparents lost access to grandchildren due primarily to three life events: parental separation or divorce, family feud, or a sudden event such as death of the adult child and/or relocation.
Divorce of adult children is a primary antecedent for diminished grandparent accessibility to their grandchildren according to Fischer (1983), although this situation is largely affected by lineage. Maternal grandmothers experience more frequent contact and emotional closeness with grandchildren after a divorce in the middle generation than do paternal grandmothers (Drew and Smith 1999). Paternal grandparents may experience difficulty in gaining access to grandchildren if the mother maintains a majority of the parenting time (Kruk 1995). Paternal grandparent contact with grandchildren is dependent on the father’s contact with his children post-divorce (Kruk 1995). Accordingly, divorce appears very significantly to alter many grandparent– grandchild relationships.
Another event that can alter vital relationships is family feuding (Kruk 1995; Drew and Smith 1999). Grandchildren may be used as pawns by adult children to “punish” grandparents for perceived wrongs (Coleman 2013). Dysfunctional aspects of grandparenting may relate to the quality of the relationship between the grandparent and the adult child. Oliver (1993) reviewed child abuse studies and found intergenerational evidence of abusive behaviors. Kornhaber (1996, 164) classified dysfunctional grandparenting by describing “complex emotional, psychological, and attitudinal variables related to the grandparent’s personality, attitudes, priorities, and mental and physical health” and suggested that such grandparenting may be related to intergenerational patterns of insecure attachment.
Other factors influencing level of grandparent contact with grandchildren include age and health status of the grandparent(s), employment statuses of the involved parties, parental remarriage, substance abuse by the parent, foster care of grandchildren, and termination of parental rights (Kruk 1995; Johnson 1988). Ingulli (1985) found that grandparents sought legal rights to their grandchildren in cases where there was a serious falling-out between the grandparents and the parents of the grandchild, occurring in intact two-parent families. Kruk (1995) found that this scenario may present a particularly grim situation of contact loss for non- divorce contact loss: If both parents deny access, or if one parent denies access and the other remains passive, the prognosis for restored contact appears to be very poor. In such cases the grandparents are likely estranged from their adult child, who then withholds the grandchildren from contact with their grandparents. With the exception of the few studies discussed above, there is little information available regarding the experience of grandparents who lose contact with their grandchildren.
The phenomenon of Parental Alienation Syndrome (PAS), introduced by psychiatrist Richard Gardner, may be an additional threat to otherwise normally occurring grandparent– grandchild relationships. PAS is described as a campaign of denigration by one parent against the other parent, and is generally seen in the context of high-conflict divorce (Gardner 1992; Baker 2007; Warshak 2012). A summary of quantitative research, including a growing number of books and hundreds of peer-reviewed articles, states the number of children affected by PAS is 1 percent in the United States (Weitzman 2013; Darnall 2008). In such cases a child is programmed by an alienating or “favored” parent to reject and despise the other “rejected” or “targeted” parent, and in severe cases of PAS the child’s animosity extends to that parent’s extended family members: “One of the most pernicious signs of unreasonable alienation is what has been labeled hatred by association—the spread of hatred to people and even objects associated with the rejected parent, such as members of the extended family. Sometimes in the absence of any intervening contact, children’s thoughts about formerly beloved relatives transform from highly positive to a complete devaluing” (Warshak 2012, 2).
Grandparents accordingly become collateral damage in PAS as their adult child is bad- mouthed and rejected along with their extended family. Such grandparents may be gradually, or suddenly, cut off from contact with their grandchildren. Although the term has not yet been used to refer to grandparents, it would appear reasonable to use the term “alienated grandparents” to refer to grandparents who have been unjustly cut off from grandchildren in this manner. It would also seem apparent that grandparents could lose contact with grandchildren when they themselves become direct targets of bad-mouthing and rejection by adult children. For example, their adult child may unjustly deem an unwitting grandparent “bad” or “unsafe,” and the adult child then denigrates the grandparent to the child, thus passing on the message.
Consequences for Grandparents Experiencing Contact Loss with Grandchildren
Kruk (1995) reported that grandparents who had lost contact with their grandchildren described reactions common to bereavement. The grandparents in Kruk’s study reported deep satisfaction and self-identity in the grandparent role, and enjoyed intense and intimate connections to their grandchildren. When this was lost, one third of the grandparents reported newly diagnosed physical health problems, and one half experienced emotional difficulties of profound sadness and sense of loss. Grandparents’ experiences of profound grief and loss included fear of never seeing their grandchildren again, worry about the safety and wellbeing of grandchildren, and sadness at being shut out of family gatherings and events and being unable to pass on family history and traditions.
Drew and Smith (1999) found that grandparents who attended support groups in Canada and England reported symptoms of bereavement after contact loss, and indicated that stress, anxiety, and grief prohibited them from enjoying their previous pleasurable activities. Parkes (2014) found that sudden primary relationship loss adversely affected physical and emotional health and induced a prolonged grief response consistent with bereavement theory. Drew and Smith (1999) reported a range of negative consequences for grandparents experiencing sudden loss of a grandchild, including intense chronic grief, symptoms of posttraumatic stress disorder, cognitive intrusion, mental health problems, lowered life satisfaction, numbness, shock and denial, shame, rejection, betrayal, and depression. Drew and Silverstein (2007) tracked depressive symptoms of over four-hundred grandparents over fifteen years who had lost contact with grandchildren. Building on earlier cross-sectional studies of grandparent depression after contact loss, the authors found that mental health progressively worsened for these grandparents as they grew older. Drew and Silverstein (2007) stated it is possible that grandparents in such situations are at risk of suicide; however, there is no data available on this topic. Kivnik (1982, 60) found that “grandparenthood does have a real connection to the lives, morale, and the mental health of grandparents.” When it is lost or disrupted, grandparents may experience grave results.
Boss (1999) described grandparents in situations of contact loss with grandchildren as experiencing “ambiguous loss,” in which the grandchild is not physically present yet is present in the heart and mind of the grandparent. There is continued hope for reunification, which results in ongoing stress for the grandparent and makes it difficult to achieve closure in the grieving process. Grandparents yearn for a reunion with their grandchildren, and their continued hope makes it difficult to move on with their lives (Drew and Silverstein 2007). Boss (1999) found that a sense of powerlessness over the situation made it difficult for the grandparent to regain mastery over their lives. One paternal grandmother in Ireland stated, “You are in no man’s land—because my grandson is not missing or dead. He is out there somewhere and you are looking for him in the crowd all the time, all the time. Everywhere you go, wherever there are kids, you always look” (Doyle, O’Dwyer, and Timonen 2010, 591). The authors pointed out that social support tends to subside over time, leaving negative emotions unresolved after an ambiguous loss. Grandparents also suffer from the loss of the grandparent role, the successful enactment of which has been linked to improved life satisfaction and morale (Kivnik 1982).
The mourning experience of estranged grandparents may lead to the presence of complicated grief (Zhang, El-Jawahri, and Prigerson 2006), symptoms of which include persistent yearning for the lost object, feelings of shock and emotional numbing, a sense of being alone in the company of others, and a belief that life is meaningless as a result of the loss. Complicated grief includes symptoms that are analogous to posttraumatic stress and lead to the same level of emotional and physiological distress that accompanied the original loss (Barry, Kasl, and Prigerson 2001). The longer the individual struggles with complicated grief, the more likely he or she is to develop significant mental health problems, most notably major depression and anxiety (Boelen, van den Bout, and de Keijser 2003).
Development psychologist Erik Erikson’s theory of psychosocial development provides one framework for understanding the devastation experienced by grandparents who lose contact with grandchildren. The theory describes eight universal life stages that play a major role in personality development and psychological skills. In each stage, a crisis is negotiated and can be resolved in either an adaptive or a maladaptive manner (Erikson 1963). Erikson termed the stage of middle adulthood (age forty to sixty-five) “Generativity vs. Stagnation,” a period that involves nurturing, teaching, leading, or in some way promoting the next generation. Successful negotiation of this stage leads to feelings of accomplishment, while failure results in superficial involvement in the world and remaining focused on one’s own needs (Mizrahi and Davis 2011). In his seminal work on personality development through the lifespan, Theodore Lidz (1968) discussed children and grandchildren during the middle years, and perhaps foreshadowed a possible risk that this stage poses for grandparent–grandchild relationships in these years: “Grandparents are supposed to be old, but middle-aged grandparents do not yet feel old. The grandchildren furnish a new major source of interest; and if the grandparents can participate in raising them, they often behave differently from the way they did in rearing their own children. They feel more free to give and indulge, for they seek to be loved and needed by the grandchildren—sometimes to their children’s despair” (Lidz 1968, 507).
The stage of maturity (sixty-five to death), termed “Integrity vs. Despair,” occurs as older adults review their lives and evaluate them for meaningfulness and satisfaction: “The alternative is despair or evaluating one’s life as unsatisfying, having great regrets, and feeling there is no time to change anything” (Mizrahi and Davis 2011, 49). The stages may have to be renegotiated if life roles become altered, causing a potential identity crisis as continuity and balance is lost (Osborne 2009). It appears then that teaching and nurturing the next generation become particularly salient in the later years of life, according to developmental theory. Life review and evaluation seen in the final life stage may be particularly painful for grandparents who have been deprived of vital kinship relationships with their grandchildren.
Support for Grandparents Grieving the Loss of Access to Grandchildren
Given the potentially serious and deleterious consequences of grandparent alienation to both grandparents and grandchildren, social work interventions are needed that address feelings of grief and loss of grandparents when they lose contact with grandchildren. There is very little information available regarding interventions for estranged and alienated grandparents, so this section will include a discussion of interventions generally believed to be of help in cases of individuals who suffer repercussions of general grief and loss.
Grandparents who experienced reunification with their grandchildren quickly came to a resolution of their grief, according to Kruk (1995), who also found that for some grandparents, grandparents’ rights organizations provided a sense of support and hope for future restoration of contact. Grandparents may benefit from grief therapy where they can get help in resolving loss- ambiguity and role confusion (Drew and Silverstein 2007). Kruk (1995) found that grandparents reported therapeutic avenues were more useful than legal avenues in his Canadian sample. Where dysfunctional relationships and personality disturbances or insecure attachments occur, then family therapy involving all three generations may be called for (Kruk 1995).
Drew and Smith (1999) found that grandparents in the United States and Canada are increasingly turning to the courts in efforts to regain contact with grandchildren. Mediation is used in divorce proceedings to offer former spouses a means to settle disagreements in order to avoid a trial, and is either court-ordered or voluntary. The authors found that mediation is most likely to be effective where relationships are basically functional but interrupted by divorce, and dysfunctional parenting across generations is not a severe factor. Mediation is likely to be more effective in resolving disputes than is the court, although this avenue is costly and time consuming particularly for grandparents who are likely to have diminished coping skills due to stress and grief (Drew and Smith 1999). Kruk (1995, 52) believes mediation has a significant potential for impacting both the prevention and resolution of grandparent–grandchild contact loss, while keeping the wellbeing of children at the forefront: “When grandparents are forced to seek legal means of restoring visitation with their grandchildren, conflict with parents is inevitable. This conflict will be a disruptive force in children’s development. Mediation can address the interests of all parties in the dispute and keep the needs and interests of children at the forefront of negotiations.” Kruk (1995) states that while some mediators are beginning to involve the grandparent generation in divorce mediation, the mediation should not be limited to divorce situations, as there are a number of other circumstances in which grandparents experience access difficulties.
Means of reestablishing a grandparent–grandchild relationship are likely to be more problematic in cases of severe Parental Alienation Syndrome where the relatives of the alienated parent become collateral damage in the campaign of denigration by one parent against the other parent in attempts to influence the children to hate that parent and their relatives. In this case the grandparent could be expected to regain contact if their adult child is reunited with their child (Amy Baker, pers. comm., 2015). Reunification is very difficult to accomplish without intervention because alienated children’s thoughts about their parents become highly skewed and polarized, reflecting the views of the parent (Warshak 2012).
Grandparent Visitation Rights
When other remedies fail, alienated grandparents have sought access to their grandchildren through the courts. This approach has met with varied success. Beginning in the 1920s, when grandparents first sought access to grandchildren through legal means, the United States Supreme Court began to develop a doctrine holding that parents have a fundamental constitutional due process right to raise and parent their children without interference by other persons or the state (Debele, Goldberg, and Mitnick 2014), further minimizing the ability of grandparents to seek access to grandchildren through legal means. Yet grandparent visitation statutes were enacted in all fifty states over a period of twenty-three years beginning in 1964 (Hill 2000). These statutes provided standing for grandparents in such cases to petition courts for access. A heavy burden of proof rests with the grandparent to establish “unfitness” of the parent, or to show that the grandchild has special needs that will be ameliorated to some degree by contact with the grandparent. Although there have been various challenges over the years to the fundamental right of a parent to decide who has access to the child, parents continue to retain this right (Debele, Goldberg, and Mitnick 2014).
Self-help Groups for Grandparents
According to the Encyclopedia of Social Work, self-help groups offer a “vehicle for people with a common problem to gain support and recognition, obtain information on, advocate on behalf of, and take control of circumstances that bring about and perpetuate their shared concern” (Mizrahi and Davis 2011, 14). The authors state that self-help groups seek to empower members to change their lives by providing a safe, non-judgmental environment where they can find community, information, and support. Self-help groups offer mutual assistance, where each participant is a peer and group leadership is non-professional. As group members share individual experiences, they may replace pathological explanations of their situation with more positive interpretations (Borkman 1999). Research suggests that self-help group membership is associated with a variety of health-related benefits, including more efficient use of health and social care services (Kyrouz, Humphreys, and Loomis 2002), increased self-esteem, improved relationships, better ability to cope, and decreased levels of isolation (Gray et al. 1997).
Group work interventions may be particularly helpful in reducing social isolation and assisting bereaved individuals in moving through the bereavement process more quickly (Forte et al. 2004; Piper et al. 2011). When group members discover others who share their feelings of grief and loss, they feel less isolated and form connections with others that free them to work through the bereavement process (Knight and Gitterman 2013). In a process termed “universality” by Yalom and Leszcz (2007), members experience validation and empowerment by sharing similar experiences. Membership in a group has been found to be at least as effective as, and in some cases more effective than, engagement in individual counseling (Vlasto 2010), although individual counseling may be more strongly advocated in cases of complicated grief (Howarth 2011; Vlasto 2010).
Alienated Grandparents Anonymous, Inc.
The author is a board member of Alienated Grandparents Anonymous (AGA), a self-help group specifically targeting this population. Headquartered in Naples, Florida, AGA was founded in 2011 as a nonprofit entity by a suddenly alienated grandmother who previously enjoyed caring for her grandchildren on a daily basis. The mission of AGA is to offer support and understanding for grandparents dealing with the issues of alienation and estrangement of their grandchildren; to bring awareness of the growing problem of grandparent alienation to the public and the legal, mental health, and spiritual communities; to support social science in exploring the phenomenon; to support healthy multigenerational family relationships; and to establish avenues for grandparents to petition the courts for access to grandchildren (Alienated Grandparents Anonymous 2014). AGA offers monthly self-help support groups, and has a series of speakers six times per year whose presentations are posted on YouTube. The monthly peer-led self-help group averages twenty-five to thirty grandparents, and the website receives an average of 3,500 visits per month. AGA board and advisory board members include mental health clinicians, two pediatricians, an attorney, several grandparents, and three internationally known psychologists. AGA supports and assists with the formation of other AGA strategic alliances, which now operate in forty-five states and eleven countries.
In 2014 AGA began a collaboration with the David Lawrence Center, Inc. (DLC), a nonprofit community mental health center and Baker Act facility in Naples, Florida. DLC therapists were trained by AGA clinicians in the dynamics of estrangement, alienation, trauma, and grief. In January 2015, DLC launched a HIPAA-compliant web-based “TeleHealth” program for face-to-face video counseling sessions. Clients can schedule appointments and download forms, and payments can be made through Medicare, insurance providers, or private payer through the DLC website. Local grandparents can report in person to the center if they prefer. The program is available to grandparents who reside in Florida, but it is hoped that grandparents outside Florida will soon be able to access the counseling services.
Examples of other grandparent support groups include Grandparents Rights of Washington State (GROWS), and Lost Access within the state of California. The American Association of Retired People (AARP) is the nation’s largest and most powerful group of older citizens. This organization devotes a section of its website to grandparent issues, and moderates an online support group. A first-of-its-kind LGBT grandparent support group was formed in south Florida near Palm Beach County in 2013; the LGBT Grandparents Group is a collaborative effort of PFLAF, the Pride Center, and Women in Network along with a generally equal group of men and women grandparents (Monteagudo 2013). Grandparents experiencing contact loss have formed support groups in many other countries, including Canada and the United Kingdom.
Interventions in Severe Parental Alienation Syndrome
As discussed earlier, grandparents may become alienated from grandchildren in the case of Parental Alienation Syndrome. In severe cases of PAS, Clawar and Rivlin (1991) recommend the use of environmental modification, which involves curtailing or limiting the amount of contact a child has with an alienating parent. These authors conducted a study of seven hundred cases, published by the American Bar Association, and found that there was positive change in 90 percent of the parent-child relationships that had been formerly severed by PAS when children were removed from the alienating parent’s care and placed with the targeted parent. Courts may order children to be placed temporarily or permanently with a targeted parent in order to stop the alienating parent’s abusive alienation and/or to repair the relationship with the targeted parent. An analysis of 175 Canadian cases involving severe PAS found this option to be the most common response (Bala, Hunt, and McCarney 2010). Research on this option shows this to be effective in overcoming severe alienation (Warshak 2003).
If the environmental modification concept was extended from the sphere of the parent–child dyad to the grandparent–child dyad, it may be possible for a grandparent to reestablish contact with a grandchild simply by having uninterrupted time with the grandchild. However there is no available research on the reunification of extended family members with the child once there has been a custody change or an order preventing the alienating parent from having further contact with the child. Since grandparents must rely on their adult child for grandchild contact, the grandparents may be able to reestablish contact with their grandchildren as the adult child experiences the remedy of a reunion with their child or children.
Increasing lifespans provide an opportunity for several generations to enjoy mutually satisfying and important relationships. Grandparents typically have some degree of contact with their grandchildren. In some instances these relationships are disrupted as grandparents are prevented from seeing their grandchildren; little is known about the nature of these disruptions. Limited studies have indicated the disruptions occur during divorce or death of the adult child in the middle generation or family feuding. Another antecedent may be seen in Parental Alienation Syndrome, where one of the (adult child) parents indoctrinates the child to despise and reject the other “targeted” parent. In this scenario, there is a spread of animosity from the targeted parent to include that parent’s extended family members.
Grandparents who are denied access to their grandchildren can experience serious physical and emotional problems. Physical health problems, depression, and grief are reported. Grandparents may be helped through mutual aid groups such as Alienated Grandparents Anonymous (AGA) in Naples, Florida, which has experienced growth in three years and now has a presence in forty-five states and eleven countries. AGA provides support, education, and access to experts in the family conflict and parental alienation field, and works with legislators on supporting grandparents’ rights legislation. AGA partnered with a mental health treatment facility, which provides assessment and treatment to grandparents with mental health needs, using specially trained mental health providers who can provide therapy sessions through direct contact with grandparents, or through the use of a web-based “TeleHealth” program.
As previously emphasized, this article provides a theoretical/conceptual discussion of the phenomenon of grandparents who are cut off from their grandchildren. It is hoped that a conceptual foundation has been established by the article in order to establish a clear call for empirical research on the phenomenon. Research is needed to understand the situations of alienated grandparents and to provide models for intervention and treatment. Such research should examine demographics of culture, age, geographic location, and gender in relationship to the phenomenon. Remedies are needed at the individual, family, and policy levels to address the insidious and damaging effects of the phenomenon of alienation on grandparents.
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ABOUT THE AUTHOR
Carol Hosmer Golly: PhD Student, Licensed Clinical Social Worker, Registered Play Therapist Supervisor, Barry University, Naples, Florida, USA