Why Don’t Therapists Talk More About Emotional Neglect?

José Manuel Ríos ValienteChildhood Emotional Neglect (CEN): A parent’s failure to respond enough to a child’s emotional needs.

“After reading Running on Empty I told my therapist that I’m pretty sure I was emotionally neglected as a child. He understood what I meant but he never mentioned it again”.

“I’ve been seeing my therapist for a year and she has never mentioned Emotional Neglect to me.”

“I live in San Francisco. I can’t find a therapist who is an expert in Childhood Emotional Neglect!”

Since I first started speaking and writing about Childhood Emotional Neglect (CEN) in 2012 I’ve heard the above comments many times, from people all over the world.

Yes. In a way, it is puzzling. CEN is so widespread and causes so much pain. Why don’t therapists talk about it more directly and more often? Why aren’t there Emotional Neglect specialists? Emotional Neglect articles and workshops?

This is one of the main reasons that I took up the cause of CEN. After talking with other mental health professionals and doing an exhaustive literature search, I could find virtually no research or writings specifically about Emotional Neglect. And I couldn’t identify a recognized, accepted, universal term for the concept that meant the same thing to every mental health professional.

It seems that just as an instance of CEN goes unseen and unnoticed, so does the CEN child himself. In a case of parallel process, so does the concept of CEN. But for therapists, the concept is not surprising or new. Remarkably, I think that’s part of the reason that therapists don’t talk about it. For us, it hides in plain sight.

Here are the main reasons I’ve identified for the lack of direct attention to Emotional Neglect by mental health professionals:

  1. For therapists, CEN hides in plain sight. It’s so ubiquitous and such an integral part of Attachment Theory (a basic tenet for mental health professionals) that therapists just know it. It’s like the blurred backdrop behind the picture. In the mind of a therapist, CEN is not a thing. It just is. So we’ve never bothered to give it a specific name.
  2. Research. Therapists don’t necessarily think of CEN as the cause of the specific pattern of adult symptoms that I have identified and described in my book, Running on Empty: Overcome Your Childhood Emotional Neglect. So as of now, there is no body of literature or research for them to consult. Establishing research data to support the pattern is my next goal. In the meantime, the only source of this full picture is the book, Running on Empty.
  3. Memories. Most therapists like to deal with memories and facts as much as possible. CEN often offers neither.
  4. Eclipsed and Blurred – “Child Abuse and Neglect.” When I scoured the professional literature for mentions of Emotional Neglect, I found many references. But it was virtually always as part of this phrase: “child abuse and neglect.” I realized that this phrase has contributed to CEN being so overlooked. Unfortunately, the ubiquitous use of “child abuse and neglect” has taken the concept of Emotional Neglect and thrown it into a pot mixed with three other things which are far more visible and memorable:
    1. Physical abuse: hitting, physical threatening of a child.
    2. Physical neglect: not providing enough food, shelter or warm clothing, for example.
    3. Emotional abuse: actively saying damaging things to a child, calling her names for example.

In this way, I think the phrase “child abuse and neglect,” which is so ubiquitous and useful, has actually done an inordinate amount of untold damage by blurring awareness of CEN.

For me, right now, my goals are unwaveringly clear. I want to make CEN a part of everyday conversation in this world. I want parents to know how to meet their children’s emotional needs, and why it matters.

I want every single person to be able talk openly and directly about CEN with his therapist.

I want every therapist to mean the exact same thing when they use or hear the term Childhood Emotional Neglect.

Think of all the children who are, at this very moment, growing up surrounded by Emotional Neglect. And all the adults who are suffering in silence, baffled by their pain.

If I could speak for all the therapists in the world, here is what we would say to them:

Your pain is real. It’s not nothing. You have it for a reason. It’s not your fault.

You feel invisible, but we see you. You can speak, and we will listen. So stand up and talk. And let us help you heal.

To learn if CEN is a part of your life, Take The Childhood Emotional Neglect Questionnaire. It’s free.

If you are a therapist and would like to join the CEN Network and receive referrals from me, I invite you to Fill Out The CEN Therapist Form.

To learn more about Childhood Emotional Neglect, see my first book Running on Empty. 


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Tom of Finland - June 25, 2017 Reply

Hi dr,

I read your book Running on empty with great interest since this issue has touched my life also. I’ve gone through a 3 year therapy. However, i’m a bit baffled by this question: this concept of yours, CEN, isn’t it just a new label for the thing that is the basic insight of psychology: how your parents & upbringing affect you and your relationship to your emotions? We talked about exactly these issues during my therapy, we just didn’t call it CEN.

So, instead of it being a new insight, isn’t it just a new label? And I dont mean to belittle your work, as i said I read your book with great interest!

    Jonice Webb PhD - June 25, 2017 Reply

    Hi Tom of Finland. I am not trying to call attention to what most good therapists primarily focus on: what happened to their clients in childhood, like trauma and abuse. I’m trying to get therapists to pay more attention to the vital thing that failed to happen for the child: enough emotional responsiveness. It’s not that it’s a brand new concept; it’s that it gets overlooked far too often. Calling it CEN is a way to give this under-addressed, yet damaging experience a common name that we can all use to finally talk about it clearly with our clients and each other. All the best.

thanks for giving the emotionally neglected words - June 30, 2016 Reply

I’m scared of trying therapy because my emotional neglect past is dressed as a child having strict parents. I don’t want to talk to a stranger first off, and I’m interested in finding someone who has ways I’m familiar and onboard with. That’s why, I’m going to try therapy for the very first time with my one of my friends as my aide. Parents: Koreans, educated… look like they’ve supported me always. Really, they’re metaphorically, selectively deaf, to my feelings, especially those of increasing workload overwhelm and need of empathy from them.

Mclaire - May 23, 2016 Reply

There’s a book by Daniel Shaw, Traumatic Narcissism: Relationships of Subjugation, that describes both emotional neglect and emotional abuse in the language of psychoanalytical psychotherapy. I read it before reading Webb, and it was quite revealing. I think both books are valuable read together, though Shaw’s book may only appeal to psychotherapists (I’m not one) while Webb’s book can appeal to both therapists and clients.

tigre - September 14, 2015 Reply

The only therapist I’ve ever really spent quality time with pointed this out to me, that not having guidance or emotional support as a child can be very damaging. This was ten years ago or so, and I’m not sure I was ready to understand or accept the concept then. At the time, I still felt very guilty for any criticism of my childhood, because I wasn’t overtly abused or abandoned, as my parents were. I think I’m finally getting it now. I don’t have to compete with my parents over who had the worse childhood (something my mom is apt to do with me) in order to acknowledge that I missed out on the kind of emotional connectedness that many other kids get.

Silla - October 13, 2014 Reply

I wonder if the concept of Childhood Emotional Neglect is the same as the concept of invalidation that often occurs in childhood? I understand that DBT has as one of its assumptions of the etiology of borderline personality disorder, that of the experience of having been invalidated during childhood. One of the characteristic symptoms of BPD is also the experience of ’emptiness’ that you have written about and posit results from CEN. It seems to me that the concepts are much the same (of course, I could be wrong). In which case, there are many therapists (such as DBT therapists and I also understand addressing alexithymia is common in some of the mindfulness approaches) that incorporate the notion of CEN into their case conceptualization and treatment of patients.

    Jonice Webb - October 13, 2014 Reply

    Hi Silla, your questions are all excellent. I think that the feeling of emptiness can be similar between CEN and borderline, but the cause is somewhat different. It’s the difference between saying to a child, “Your feeling is wrong,” and simply not noticing or responding to the child’s emotion at all. It gets a bit complicated, because parents who do the former typically also do the latter. So the concept of CEN does apply to personality disorder, but there are vast quantities of people who didn’t get the former. Their emotional needs weren’t actively invalidated; they were simply ignored. These are the people who remember a “happy” childhood (because we don’t remember a parent’s failure to act), but who are struggling. These are the people my book is about because they fall between the cracks. I hope this answers your question! All the best.

vineeta patnaik - September 4, 2014 Reply

its a great thing that you have brought out so clearly and explicitly , I have been working on this with my students and have observed a number of them experience delinquency as they have missed out on age appropriate emotional needs as I call it.

David W. Peace - September 3, 2014 Reply

A huge pattern I have seen since working with children and families is the disconnect, each family member going through the day at random. It’s like seeing a number of vibration circles in the room, without any of the circles sharing. This is often why I put objectives for mutual goals on a treatment plan (with the client’s agreement of course). The same patterns of behavior will continue until there is a flow of emotional recognition and connection happening. I look forward to getting the book.

    Gina - September 18, 2014 Reply

    Agree. It seems to me that this is the same in all families in the world. All parents need professional help, the only question is whether there are trained professionals who will help them and whether parents recognize that they need help.

Deb - September 3, 2014 Reply

This was such a good read, now it’s
time to get the book. Your work is essential and may help to heal many silenced souls.

annonmous - September 2, 2014 Reply

I was wondering if you had looked into the concept of parentification. I think it overlaps with emotional neglect. They are not always the same but sometimes happen at the same time.

    Jonice Webb - September 2, 2014 Reply

    Yes parentification is one way that Emotional Neglect happens. It is one of the parent types described in my book.

Denise W. Anderson - September 1, 2014 Reply

I think that the reason for the lack of conversation on Childhood Emotional Neglect is the lack of understanding of emotional health in general. We think that mental health covers all aspects of our emotional being, but when we think of mental health, we think in terms of disease, and what goes wrong in the brain. Emotional health has everything to do with wellness. It encompasses our entire being.

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