Beyond Survival - The Therapy Podcast with Katie McKenna

What happens when you’re the one who always shows up, reaches out, and holds the family together — but the effort is never returned?

This week, we hear from a listener who grew up as the parentified daughter: the reliable one, the helper, the one expected to sacrifice, stay quiet, and keep showing up. 

She left home to build a life of her own, eventually moving abroad and discovering a freedom she’d never known. But distance came with blame, and despite years of trying, she’s still the one expected to chase connection with her siblings.

In this episode Katie and Ruth explore toxic family dynamics, sibling relationships, the guilt of choosing distance, and the complicated grief of letting go of the family connections you always hoped for. 

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Are you mad at me?  Did I do something wrong?

If you grew up in a dysfunctional family, your body learned to scan everything.

The shift in tone, the sigh, the silence that means you’re in trouble. 

You got very good at spotting it, because your survival depended on it.

This week I’m joined by my friend Kristen Carter, host of the I Have ADHD podcast, and author of the new book You’re Not in Trouble: The ADHD Guide to Building Healthy, Connected Relationships. 

To me, Kristen’s book speaks to something deeper than ADHD. It speaks to the relational wound so many of us carry from childhood: the belief that being in trouble is the default, and connection has to be earned.

If you’ve ever lived braced for the next “what did you do?”, this conversation is for you. 

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You're fluent in everyone's emotional language except your own.

If you grew up with a narcissistic parent, you probably have a PhD in reading other people. You can spot a shift in their mood, anticipate what they need, and know exactly which version of yourself keeps the peace.

But what about your own thesis? What do you feel, want and need?

The clench of your jaw when a friend cancels again. The lump you swallow down when a comment lands. The sting of resentment after yet another yes you didn't mean. Your body has been speaking all along. In this episode, we start listening.

This isn't about overanalysing yourself. It's about getting curious, trusting what your body tells you, and slowly building a relationship with the person you were never allowed to be.

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"It really made me feel like it was a kind of Dr. Jekyll, Mr. Hyde kind of life."

For two weeks of every month, Dr. Shubhangi Karmakar was thriving: studying medicine, completing a master's, and researching PMDD. 

The other two weeks of the month, they wanted to crawl out of their skin, and wondered what the point of it all was.

In this episode, we talk about PMDD – premenstrual dysphoric disorder – a severe hormonal mood disorder. 

Dr. Shubhangi is a practising clinician, psychiatry researcher, and barrister in Ireland, and they brings both their clinical expertise and their lived experience to the conversation.

We explore what PMDD can look like, from depression, hopelessness, and anxiety to sudden rage, exhaustion, sleep and appetite changes, and difficulty concentrating. 

We also talk about how it affects relationships and your sense of self, the relief that comes when symptoms lift, and why every person's experience is different. 

Whether you suspect you have PMDD, have a diagnosis, or want to support a friend, sister, partner, or daughter, this conversation offers understanding, validation, and practical next steps.

Resources mentioned, including a free, evidence-based PMDD self-assessment you can bring to your clinician, are linked in the show notes.

Form:

Gold Standard - Severity of Symptoms

Websites:

IAPMD.org

Clinics / Services:

Marblearchhealth.com

Drummartin Clinic

Kingsbridge Private Hospital

The Menopause hub

Well Woman Centre

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A narcissistic parent hands their child a mirror. 

The child job is to hold it up and reflect back whatever the parent needs to see. 

Beside it, the parent paints a canvas and says: this is you. Selfish. Difficult. Ungrateful. Cold. Unlovable.

None of that was ever you.

In this episode, I pull apart what it means to grow up invisible. Behind the mirror and behind that ugly painted canvas, there's a blank one. 

It isn't blank because there's nothing there. It's blank because you were never allowed to find out.

I explore why:

• You don't know what you actually feel, only what's "allowed"
• You mistake self-erasure for being "easygoing" or "low-maintenance"
• You confuse being needed with being loved
• You can't trust what happened until someone else confirms it.

You get to exist. Not for anyone else's benefit. For yours.

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Have you ever found yourself wondering, “Why is he doing this?”

You replay the argument. Question what you said. 

Apologise when you’re not even sure what you’ve done wrong. 

You explain away the silence, the accusations, the sudden shifts in mood.

He was stressed. He had a bad day. I could have said it differently.

But what happens when you stop looking at each moment on its own — and start looking at the pattern?

In this week’s episode of Beyond Survival, I’m joined by Lundy Bancroft, who has spent more than 30 years working with abusive men and their families and is the author of 'Why Does He Do That? - Inside The Minds of Angry and Controlling Men'

Lundy describes an abusive man as operating a little like a magician. The trick isn’t necessarily what he’s doing — it’s where he gets you to look.

While you’re focused on his feelings, his anger, his wounds and what you might have done to cause them, you can lose sight of what’s actually happening.

This conversation is about stepping back from the confusion of individual moments and noticing what happens when you look at them together.

Because sometimes, the things that are hardest to see are the things we’ve been living with for so long that they simply feel normal.

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In this solo episode I tackle the complex topic of grief. 

If you grew up in a narcissistic or dysfunctional family
system, the first roadblock to this grief is often minimising it. 

“It wasn't that bad”

“Other people had it worse” 

“I've nothing to complain about"

We say this so automatically, that we never even get to the feeling underneath it.

In the episode, I use an example that might surprise you —
Ireland's colonization, and what happened when we were denied our own language.

I know that sounds like a strange place to start a therapy podcast, but stay with me, because the parallel is exact: a narcissistic parent does the same thing to a child. 

They deny you the language of yourself — your own feelings, wants, preferences, boundaries — until you're so disconnected from them that you don't even know they were ever yours to have. 

And it's hard to grieve something you never knew you were missing.

This episode goes deeper into the invisible child, the cruelty of the inner critic, and how to start giving yourself the compassion you never got.

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In this episode, I speak with Irish psychologist and author A.J. Cosgrave about her deeply personal book, If You Knew Me Would You Love Me?, and her experience of living with Dissociative Identity Disorder (DID), formerly known as Multiple Personality Disorder.

DID is a condition that is often misunderstood, sensationalised, or reduced to the way it is portrayed in films and television. A.J.’s story offers something very different: an honest, thoughtful and remarkably accessible insight into what living with DID can actually look like.

We talk about her own journey, the realities and challenges of living with dissociation, the process of integration and recovery, and the importance of approaching the condition — and the people who live with it — with empathy rather than fear or stigma.

This conversation about identity, trauma, understanding ourselves and others, and ultimately learning to meet complexity with kindness and courage.

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Guilt is a natural emotional response. It can tell us when we've done something that doesn't align with our values and prompt us to repair, take responsibility and make things right.

But when guilt becomes excessive, it can become a heavy burden — creating an overwhelming sense of expectation and responsibility that isn't actually yours to carry.

In this final episode of the FOG — Fear, Obligation and Guilt — I look at what happens when guilt becomes the driving force behind your decisions.

You feel obligated to do something, and when you consider saying no, the guilt arrives before you've even made a decision.

You assume you've done something wrong.

You worry you've hurt someone.

You feel guilty for having needs, setting boundaries, disappointing someone or even thinking about saying no.

And so you give in.

Not because you want to — but because the fear of feeling guilty becomes more powerful than your own wants, needs or judgement.

If you grew up in an emotionally immature or emotionally abusive family, you may have learned to take responsibility for other people's feelings while questioning your own.

In this episode, I explore why guilt can become so powerful, how it gets tangled up with obligation and people-pleasing, and how to recognise when guilt is giving you useful information — and when it's controlling your choices.

Because feeling guilty doesn't always mean you've done something wrong.

Sometimes, it simply means you're doing something differently.

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Why saying no can feel selfish, even when you're exhausted from putting everyone else first.

If you grew up with an emotionally immature, narcissistic, or emotionally abusive parent, you may have learned early that other people's needs come before your own.

That learned sense of obligation can follow you into adulthood — shaping your relationships, parenting, boundaries and decisions. And obligation and guilt often go hand in hand: you feel you should do something, and when you consider saying no, your inner critic tells you you're selfish, difficult or letting someone down.

In this episode, I explore people-pleasing, guilt, obligation and the fear of conflict, and why you may find yourself over-explaining, justifying your needs or taking responsibility for other people's feelings.

Because having a need doesn't make you selfish.

And saying no doesn't make you a bad person.

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