Falling out with a lover or a close friend can be devastating. Friends and family rally and though that doesn't fix the pain it can help it feel like it's out in the open.
But family estrangements carry their own brand of secrecy and mortification.
There is a stigma attached and the lack of studies on what is a painful and common topic actually camouflages the real rates.
A cultural mandate that "blood is thicker than water" and "family are on our side" prevails.
Take *Karl, who came to see me recently. He's struggling with a difficult emotional estrangement from his brother. The siblings are from a previously tight family live in the same neighbourhood, share friends and have children at the same school and sports teams.
His hurt feelings - and mortification lest this becomes obvious in the community - are making his situation almost unendurable for him.
Extraordinarily painful and devastating, these rifts are usually a reaction to intense emotion and conflict.
Sometimes that conflict is unspoken - which can make the situation feel even worse.
Physical estrangement is the non-contact variety of distancing while emotional estrangement is the "treading on eggshells" version. This is the type Karl has to deal with on a daily basis.
It's all so common: In our own communities and workplaces as well as amongst glittery celebrities such as Angelina Jolie, Drew Barrymore, Tom Cruise, and Demi Moore - to name but a few.
Not only is there little research on this phenomenon, its impact intergenerationally is under reported.
For example, what happens to children's sense of the world when a parent is estranged from their grandparents or other significant blood relatives?
The interpretation that Karl's children will make of their relationship to their cousins was a question causing Karl further anguish.
This is not about the sharp end of estrangement or alienation caused by abuse, neglect, addiction or personality disorders.
These latter states are patterns that might well make it neither possible nor safe to cross the gulf.
In such circumstances a victim has every right to stop interacting and take the time to heal and work on the major impact of these issues.
But the even more common causes still have devastating results for families in general, and the individual in particular.
There is a long and colourful list: hurt feelings, lifestyle choices, families strained by remarriage, resentment about being the one to shoulder responsibilities, parents cut off by grown children, re-emerged sibling rivalries, uneven inheritances.
Too often these breaks come with a steep psychological price which can strain the emotional budget.
A terrible sadness can descend unbidden, especially at key times -birthdays, Christmas, funerals, Mothers Day and anniversaries.
Brain science makes sure that biologically and culturally we simply don't expect estrangement. And the ambiguity of the person being physically absent but psychologically present is difficult, to say the least.
Those impacted talk about their sense of feeling powerless, about being unable to tell their side of the story, or to ask questions or to apologise.
Reflecting on the truth, with no means of discovering it, is very painful. Without a culture of what we have come to term "closure", there is frequently unhappiness and indeed, illness, physical and mental.
Often in my practice, someone comes to talk about an issue and in doing so real grief is exposed as having deep roots in an estrangement of just this type.
And the problem is, if we can't envision any way of changing a situation, then everything stays stuck and the pain and rumination - clear as a bell - repeats the dull refrain in our moments of reflection.
British policy analyst and author Jeffry Galper says:
"The anticipation of no way to act limits the possibility of change."
Time won't always heal wounds - and it's very hard to move on from the ties that bind - you can choose your friends but family is the hand you were dealt.
And whilst not every problem has a solution - sometimes words are the most effective balm of all.
The path to greater emotional resolution, if not reconciliation, can really be quite formulaic.
That burning need to air the grievance and set the record straight, to forge a rapport and dissolve a grudge is healthy and wise.
Someone needs make a move to break an impasse - or even to chip at one. It can be a carefully written letter, a meeting for a meal or a drink - or a mediated or facilitated discussion with a trusted acquaintance or professional.
In the end we don't have to agree, but we do need to hear and be heard.
"Seek first to understand, then to be understood", a wise aphorism attributed to Steven Covey
The great bard Shakespeare was so right when he said: "Give sorrow words; the grief that does not speak whispers the o'er -fraught heart and bids it break."
A note slipped, as it were, into the crack in the boulder between two people may well be the thing that can bring some peace to your feeling about the landscape.
*Karl's name has been changed.