Incomplete psychological separation between mother and child, and the symptoms that can emerge from this relative state of undifferentiation, is increasingly appearing in the patients and families I treat as a common element in their histories and present lives. Co-sleeping, extended breast feeding, dependence on the mother for toileting, and marked separation anxiety are not uncommon features in this type of dyad, and often we also see some combination of impulsivity, aggression, low capacity for frustration and empathy, learning problems in school and socially, and so on, which can be organized under the general category of impoverished capacity to independently regulate affects, or feelings. Sometimes, these dyads must be treated therapeutically as a couple in parent-child psychotherapy if separation is not possible or is too traumatic for the child or the mother, a treatment which can evolve into individual therapy for the child, and perhaps also for the mother.
Almost inevitably, enmeshed mother-child dyads have a history of early trauma in either the childs and/or the mothers history. Often I have found that both mother and child experienced trauma (abuse of the mother or the child by a third party, birth trauma, adoption (traumatic loss or separation) medical illness, colic, hospitalization, post-partum depression, etc) in the childs early months and years, and occasionally this experience was a repetition of something the mother experienced in her early years with her own mother (enmeshed mother-child dyads are often passed down generationally and also culturally, i.e. these dyads may be more common in cultures where family enmeshment is the normal expectation. Enmeshment may not necessarily be the result of trauma but perhaps can also be a much sought after cultural value).