For Siblings of the Medically Complex and Disabled

An interview with Johanna Dobrich, award-winning author, therapist and psychoanalyst, expert in working with siblings of disabled persons

Recently, I had a chance to conduct an email interview with Johanna Dobrich, LCSW, author of Working With Sibling Survivors In Psychoanalysis, a rich clinical and theoretical book discussing her work with people who have disabled siblings. We hope this will be useful to readers.

What does it mean to be a “sibling survivor”?

Recent trends in trauma research and clinical knowledge emphasize the role of ACEs ( adverse childhood experiences) on human development over the lifespan. Ongoing medical trauma is typically not included in the obvious list of environmental conditions that create and contribute to an experience of having survived something, particularly from the vantage point of children who witness it.

Survivor siblings refer to the experience of those siblings who grow up alongside the presence of a sibling with a chronic, life-limiting, severe disability, often accompanied by medical complications. The survivor siblings are rarely the protagonist in anyone’s understanding or mind, and yet what they witness and encounter while growing up alters the course of their intrapsychic and interpersonal development.

What are the most common growth opportunities for sibling survivors in therapy and in life?

Survivor siblings benefit enormously from relationships in which they can experience the loss and pain of being different from their disabled siblings, as well as the gifts that relating across difference early on and throughout life brings forth. Relationships that can hold complexity without polarizing or collapsing into only noticing what’s good or difficult about these early life experiences next to medical complexity and difference are essential to growth. Therapy that engages space for survivor sibs to encounter the full range of emotions that growing up in proximity to illness, death, instability, and difference provoke can be hugely growth-enhancing.

These kinds of relationships offer an opportunity for survivor sibs to let others care for them; rather…