What do you do when a close family relationship, such as a parent or sibling, becomes so dysfunctional it's toxic?
For some, completely cutting off from that person can be the only solution for them to heal and move forward but it's by no means ever an easy one.
Blogger and mother-of-two Janet Camilleri, 51, is a survivor of a childhood overshadowed by violence and psychological abuse so profound that cutting her mother out of her life was the only conceivable way she could survive.
"My mother was violent, irrational ... her mood could change at the drop of a hat," she recalls. "I call it the Dr Jekyll and Mr Hyde personality because she was a very outgoing, extroverted, life-of-the-party type person in the company of others but at home she was like the devil and you just never knew what would trigger her.
"I would have ended up a basket case if I'd kept her in my life as just a phone call with her would reduce me to a quivering lump of jelly ... that was the effect she had on me. For the sake of my own marriage and children, I had to cut off to look after my own mental health.
My Mum, the narcissist
Janet describes her mother regularly sabotaging her school work, throwing things around the room in a rage, embarrassing her at school and in front of friends, playing favourites with her siblings, using her as a go-between to pitch venom at her father and regularly inflicting physical violence in the home.
In hindsight, Janet says she recognises that her mother had many severe narcissistic traits exacerbated by other personality disorders, and underlined by a clinical diagnosis of bipolar disorder.
Helen Gibbons, Director and Principal Psychologist of Australia's Autogenic Therapy and Training Institute, says that toxic behaviour in families can be identified by dysfunctional dynamics.
"Most commonly you see in any dysfunctional set up narcissistic traits in one or more family members that, in its most severe form, can result in premeditated abusive, manipulative and controlling behaviours," she says.
Narcissism is a condition that presents a set of personality traits such as arrogance, self-centredness, manipulation, a lack of empathy and remorse, dishonesty, dominance, a strong sense of entitlement, an inability to handle criticism and a grandiose sense of self.
When children grow up in the shadow of a severe narcissist, Ms Gibbons says their emotional needs are seldom met.
"These children are having their brains shaped based on a lack of positive stimulation, love and validation, which does seem to impact heavily on the formation of their limbic system and, in particular, the amygdala, the centre of emotional control in the brain," she says.
Janet describes her mother's behaviour becoming increasingly worse after her parents separated and, as her mother's mental health continued to deteriorate, at the age of just 10 years old, Janet was thrust into the role of 'carer' for her younger siblings.
"For a lot of it I protected the younger ones; I was like a mother figure to them because Mum just wasn't capable of it," she explains. "It was a lot of responsibility ... Mum dumped a lot of stuff on me that a kid that age should never be exposed to."
One Christmas, things came to a head and Janet says she stood up to her mother for the first time and told her she was leaving, to which her mother replied, 'If you leave, you will never be able to come back'.
"I was nearly 20 years old and I was like, 'I just can't do this anymore'. I cut off from her then and we didn't talk after that for about eight months," she says. "I had no money, no job and very little support; I just had to survive."
Janet tried to reinstate contact with her mum at least three times after that. "I tried really hard but it was always awkward and strained," she says. "She always upset me whenever we spoke on the phone."
Janet continued to walk on eggshells, as she had always done, and accommodated poor behaviour to keep the peace, even forgiving her mother for not attending her wedding. But just prior to the birth of her first child, after yet another argument, Janet decided enough was enough and cut off from her mother for the last time.
Cutting off communication
Ms Gibbons says that for people like Janet, any attempt to communicate and rectify problems in a rational way with the narcissistic family member would most likely result in even more abusive behaviour.
"Malignant narcissists are experts at blaming others and the family scapegoat is always the easiest target so cutting off contact may be the only option available to them for a peaceful life," she says. "No contact literally means no contact … You don't explain yourself, you disappear, block them on Facebook and don't return phone calls."
Once you've gone 'no contact', however, you can go into shock and potentially suffer from acute stress symptoms.
"It can be a very lonely and confusing time going no contact because you may find that you are not getting the understanding, support and validation you so desperately need from those around you," Ms Gibbons says. "When you tell your friends, a lot of people, even though they're well meaning, believe that all mothers love their children.
"A very common experience is that the friends that you want to believe and validate you will immediately try and support the mother in some way, by saying, 'Oh yes, but she loves you' or, 'Being a parent is difficult', so it can be very lonely and confusing."
Janet says the pressure she felt from her family, friends and colleagues to reconcile with her mother was significant. "I was part of a church and the pressure I felt was huge," she says. "In church, nobody could understand because it's like, 'Honour thy father and thy mother' and all that and I felt like the lowest of the low for not being able to do that.
"I remember talking to somebody at work once, an older fellow, I was pretty bitter and upset at the time, and I mentioned something about my mum that was probably not very nice and he turned to me and said, 'I think it's disgusting the way you talk about your mother'. I was just gobsmacked."
The toxic devastation
Janet went on to survive her childhood but says by the time she managed to escape it, the damage had already been done. "I just tried to be a good kid and to stay out of trouble … I didn't want to attract her attention because she'd thump me if I did," she says. "Growing up in a household like mine leads to a few issues so I've been and seen a psychologist to help me out at different times."
Ms Gibbons can't stress enough the importance of therapy for people who have experienced this kind of trauma.
"Therapy is really important for someone who has suffered abuse from narcissistic family members," she says. "It's so important to speak with a psychologist who is experienced in psychological abuse and to work through the impact that those relationships have had on you so that you can start to make better, healthier choices."
Janet suffered from Post Traumatic Stress Disorder (PTSD) after leaving home, which later developed into postnatal depression after the birth of both her children.
"I remember going shopping with my kids and seeing other young women with their babies and their mums by their side and just bursting into tears," she says. "I was like, 'Why don't I have a mum like that?' I have a wonderful, supportive husband but it very much felt like I was on my own at that time."
The final blow
It was five years after her mother's death that Janet first learnt of her passing by accident. And despite having been estranged from her mother for almost 20 years, her grief sent her into a spiral of total despair.
"I was just devastated ... I always thought I'd done my mourning when the kids were little because that was a really tough time and I'd grieved the loss of the relationship then, but I think deep down I always hoped that one day a miracle would happen and we'd work it out," she says. "Even though we were estranged, I never wished ill for her and I sincerely wanted Mum to be happy, despite everything."
To add insult to injury, Janet learned that she hadn't been told of her mother's death at the time because her mum had specifically requested she and her siblings not be. "To learn that she had been so bitter, so twisted and angry, right up until the moment of her death makes me very sad," she says.
Hope and healing
Despite the devastation she felt over her mother's passing, Janet says she has no regrets about cutting off communication.
"I didn't feel guilty when I found out because I knew I'd done everything I humanly could to try and have a relationship with my mother and that no matter what I did, I would never, ever have pleased her so it was never going to work," she says.
"It helped that I had my wonderful husband beside me saying, 'You need to get rid of this influence in your life' and he helped me to be strong and to realise that other people might not approve but that it was something I had to do."
Some years ago, while driving her young children to school, Janet recalls pulling up beside a bus that had an advertisement about child abuse. "A little voice from the back seat asked, 'That's what happened to you, didn't it, Mummy?' and I said, 'Yes, it was'," she says.
"And they'd replied, 'It's OK, Mummy, we love you now'."