The question My father was violent and my mother emotionally fragile. I took on a parental role from the age of around 11, trying to manage my dad’s moods, keep my mum’s spirits up and take care of my younger brother. Mum often leaned on me and I felt responsible for her stability. We were often punished in cruel ways. I was also abused sexually by a family “friend”. When we finally escaped our father, Mum moved this friend into our first “safe” home as her partner, where he continued to abuse me. As adults, my brother and I maintain strict boundaries and there is judgment from the wider family for this.

With a lot of therapy I have managed to forge a life for myself, which can still feel as though it shouldn’t belong to me, with a loving partner and warm friends. I have worked in a professional role for 15 years. Yet I struggle to feel confident and competent. I often fear losing the life I’ve built. I maintain contact with Mum, because I don’t want to hurt her and I know she doesn’t recognise how things were, but I don’t feel the “normal” feelings people feel towards their parents.

Mum has developed a deteriorating health condition. She is fragile and will need support. I feel conflict between wanting to do the right thing and how challenging it is to be in her company. It is exhausting and anxiety-provoking. I can feel myself being pulled back into my old ways of coping, such as allowing my anorexia to resurface.

Philippa’s answer You have worked so hard to build yourself an amazing life and you still must be diligent to keep impostor syndrome at bay, so as not to slip back into the mindset your childhood left you with. If you spend more time with the person who did not protect you – who neglected your needs but nevertheless, as a child, you had to look after hers – you will be going back to the source of the mental-health setbacks you suffered and that would be like returning into the fire after you have spent so long recovering from being badly burned. It seems when you are around your mother, her hold over you is such that you may feel compelled to regain equilibrium by controlling what you can, which is your food, and if you get re-triggered into an anorexic mindset again, you might even shorten your own life.

It might look bad to the outside world if you are not hands-on when looking after your mother, but you must prioritise your own health. If she cannot take care of herself, you can inform adult social services where she lives, but I would feel uneasy about you going back to the source of most of your troubles. Never mind what expectations the world has for yourself and your brother. If your mother is drowning, do not drown yourself in trying to save her.

It won’t just be the wider family’s judgment that makes your decision hard, it is difficult because you still have a bond with her of sorts. So I can understand why you feel so conflicted. If you want to help, then manage her care from a distance and don’t risk compromising the life you have worked so hard to build by getting sucked into her orbit once more. You can explain to her local adult social services – if they are willing to listen – that you and your brother were neglected and abused and although you both function OK now, if you re-enter her world, you would be endangering your mental health. Don’t hesitate in getting legal advice about the situation as well. And if you feel you need therapy again to help keep your boundaries, then please get some (ukcp.org.uk).

Your wider family does not seem to understand what it was like for you and your brother growing up, nor the legacy it has left you with and why you both need, for the sake of your health, the boundaries you have managed to put in place. If it doesn’t feel safe to confide in these people, then I would encourage you to maintain a distance from them, too.

Other people can find it hard to understand why we may still be afraid after the dangers have passed, because the effects of trauma are often misunderstood. You can tell yourself you are now safe and in charge of your own life, but that won’t necessarily reach the part of you that still feels overwhelmed by your mother. “The body,” as Bessel van der Kolk reminds us in the title of his book about the effects and treatment of trauma, “keeps the score.” If I were you, I would look after it by not re-entering the lion’s den.

Recommended reading: The Body Keeps the Score by Bessel van der Kolk.

If you have been affected by any of these issues, please contact Samaritans on 116 123, or Mind on 0300 123 3393

Philippa Perry will be appearing at the Also Festival, 12-14 July 2024 (also-festival.com)

Every week Philippa Perry addresses a personal problem sent in by a reader. If you would like advice from Philippa, please send your problem to askphilippa@guardian.co.uk. Submissions are subject to our terms and conditions