The question of how to talk about your child’s mental illness to his or her “well-siblings” is a thorny one. You may feel uncomfortable violating the ill-sibling’s privacy and before talking to the well-siblings you should gently explain to your ill one why you feel it will not only be helpful but is actually crucial for her well-siblings’ continued well-being. Suffice it to say, that in most cases, by ostensibly violating this privacy, you will immeasurably help both your well-siblings and your ill one by creating a more validating and understanding environment for everyone.
Well-siblings often live with a chronic sense of confusion, sadness, fear, and anger, asking “Why is my life like this? Why can’t my parents fix the situation? I did not do anything to deserve this life. My crazy sibling is always upsetting the apple cart, ruining dinners, parties, weddings, making everyone else go crazy and/or do her bidding. The normal rules don’t apply to her, just to me.” These feelings need to be addressed and validated so that well-siblings can grow and flourish without being overly weighed down by unavoidable family baggage. They may even learn that as painful as having an ill-sibling is, the experience can also teach them some very important life lessons.
Michael Hollander (Helping Teens Who Cut, 2008, pages 179-184 referenced below) begins his discussion of parenting well-siblings by noting that the amount and type of information with which you provide well-siblings—more global and general for younger children vs. more detailed and specific for older children—will depend on your other children’s ages and level of maturity. You must not provide young children with more than they can handle. And you must be aware that the children’s relationship with their suffering sibling, their own level of emotional sensitivity, their access to other outlets for their difficult emotions (having a school counselor, a coach, an aunt or another close family member to confide in), and their resilience will impact upon how they are affected and need to be helped. In addition, some children find it helpful to talk about their emotions and others do not. This also needs to be taken into account.
Whenever or whatever you choose to tell your other children, the key according to Hollander is to ensure that they do not “struggle with their anxieties alone,” a situation that may leave them feeling that something “so awful as to be unspeakable is going on” (181). Establishing a culture of talking about the disorder is crucial. You need to be extremely patient with them, help them understand what is going on, and demonstrate to them that you are not falling down on the job, that their sibling is getting the help he or she needs (with younger children, you should show that “you are in charge and can manage the situation”); with older ones, you can share more detailed information), and assure them that they can express their feelings and whatever questions and concerns they have. You are not too frail or too preoccupied to attend to their needs as well!
Indeed, as Susan Swick has pointed out (in her helpful summary of the topic at the Parenting At a Challenging Time (PACT) Program) encouraging your children to talk and ask questions is crucial because this will allow you to clear up any misconceptions they might have and allow you to validate any guilt they may be feeling. Perhaps, if they are younger, they may think that mental illness is contagious, or, if they are older, realize that life is a genetic lottery and they may get the disorder too. Perhaps, if they are younger, they may remember something they once did to their sibling and think that they are responsible for all their sibling’s odd behavior. You need to explicitly tell them that this is not the case and that worries should be shared: “no one should ever worry alone.”
Warmly remind them that their tribulations and triumphs, their worries and concerns are still a priority for you! They are not just a distraction from your real priority: taking care of their ill sibling. Such an approach may prevent what Rex Dickens, a sibling, has grimly described as “frozen souls” in his introduction to Anguished Voices (1994): “You [the sibling] sort of shut down, emotionally, in part of your life and that carries over to other areas. You can’t trust, you can’t feel, you can’t talk. There’s a core that gets frozen in time, maybe to be dealt with later, but it never does get dealt with” (Dickens in Marsh & Dickens, Troubled Journeys, 1997).
Finally, as Hollander points out, for siblings who are in their teenage years or older, the question of what part they wish (or do not wish) to take in their sibling’s rehabilitation should also be addressed. As others have noted, some older siblings feel that they should be their sibling’s caregiver (or even primary caregiver, since they truly understand them), while others completely reject the role and would rather cut off any ties. In addition, older siblings may be concerned about who will take care of their ill sibling as their parents grow older. These concerns need to be explicitly addressed.
Hollander wisely suggests that, information aside, you heavily validate your other children’s emotions, be they anger, jealousy, fear, confusion, or even (as other’s have noted) hatred and guilt about wishing their sibling dead. Ultimately, taking the aforementioned steps will re-empower parents in their other children’s eyes and aid the other children as they learn that their sibling is actually ill—not just poorly parented or lacking good impulse control—and that their own intense feelings are reasonable and normative. “The trick [Hollander concludes] is to find the middle path between not burdening the children and respecting their capacity to handle [and, even grow in,] a difficult situation.” (184)
Susan Swick, echoing Hollander on her web page, helpfully writes: “If you can introduce the concept that there is a treatable illness causing your children’s sibling to think, feel, or behave a certain way, compassionately acknowledge that this is difficult for everyone, and provide reassurance that things will get better, you have already succeeded.” You do not need to be perfect or provide all the answers.
While allowing the siblings to express their feelings, validating them, and providing them with a sense of security are the first steps, I believe that additional steps can be taken. Joining a support group can be helpful, and joining an age-appropriate psychoeducation, support, and skills group (like the NEABPD’s Family Connections) can be even more helpful. Sometimes speaking to an individual therapist or counselor is also called for. Just like the parents and other family members of sufferers who take the Family Connections course, siblings can be provided with more knowledge about the disorder and they can be taught certain skills to help themselves cope with the difficult situation they find themselves in—to empower themselves and allow themselves to grow—and to address their sibling’s erratic and oftentimes frightening behavior in the most effective manner, so that both they and their siblings can gain from this developmentally crucial but terribly fraught sibling relationship.