The Effects of Sibling Death on the Surviving Child: A Family Perspective

Abstract

The death of a child invariably affects the family, who in effect become survivors. Adaptations are made in order to secure a new family equilibrium attendant upon such a loss. Surviving siblings not infrequently become the focus of maneuvers unconsciously designed to alleviate guilt and control fate through silence and efforts to maintain silence, through substitution for the lost child, and through endowing the survivor-child with qualities of the deceased. Three types of clinically identifiable types of survivor-children are described. Families that emphasize silence and focus on guilt, families in which the child becomes incomparably precious, and families in which substitution and replacement provide the major theme lead respectively to the "haunted," "bound," and "resurrected" child. These children share many features, as do their families, but there appears to be a connection between the family defensive maneuver and the specific consequences for a child of the bereaved family.

?My crooked vision?: The well sib views ataxia-telangiectasia

“…Sibs of individuals affected by various disorders have experienced considerable survivor guilt [Binger et al, 1969;Cain et al, 1964;Krell and Rabkin, 1979]. Modell et al [1983] theorized there is an unconscious bookkeeping system within a nuclear family such that the fate of particular individuals determines how much good is left over for others.…”

“…Investigators have explored sib reactions to serious illness and death from various illnesses [Koch-Hattem, 1986;Krell and Rabkin, 1979;Martinson and Campos, 1991;Pollock, 1986;Spinetta, 1981]. In X-linked disorders (e.g., hemophilia), Oremland [1988] found the well sib overwhelmed with helping tasks, and noted the expectation for sibs was to place no further demands on the overburdened family.…”

Supporting the Grieving Child and Family

“…Guilt of other family members may also lead to difficulties: for example, it can distort the relationships between parents and surviving children after the death of a sibling. 22 It is helpful for pediatricians to approach children who have lost a loved one to presume that guilt may be present, even when there is no logical reason for it. Pediatricians can explain that they know there is nothing that the child did, failed to do, or could have done to change the outcome but wonder if the child ever believes that he or she somehow contributed to the death as many children do in similar situations.…”

Grief: The Social Context of Private Feelings

“…The theoretical analysis leads to discussion of difficulties in providing social support and social services for the bereaved, Although scholars, practitioners, and the public may presume there is something invariantly biological about grieving, grief is shaped by the social context in which it occurs (Averill, 1968). Two theories especially useful in providing a perspective on the social context of grief and in organizing research findings in the area are symbolic interaction theory (e.g., Berger & Kellner, 1964;Lofland, 1985;Marris, 1974;Rosenblatt & Wright, 1984) and family systems theory (e.g., Berkowitz, 1977;Krell & Rabkin, 1979;Rosenblatt, 1983, chap. 10).…”