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Working therapeutically with adolescents over two decades, I have had the privilege of hearing from many who are grieving a sibling who has either died, left home or received a serious mental or physical health diagnosis, all catalysing huge shifts within the family system, in a myriad of ways. A common feature in my work with these young clients has been the realisation that the sympathy, recognition and support from others is largely parent focused, while siblings are, by default, expected to grieve silently, while adapting to their new reality and navigating a new position within the family. The purpose of this article is to examine sibling loss in adolescent clients, in three very different but equally challenging and life-altering situations.Ìý

When a sibling dies

The death of a sibling during adolescence, a significant period of identity development, can hugely impact a young person’s independence, growth and long-term mental wellbeing. Following the death of a young person, sudden or otherwise, it is usual for there to be an initial outpouring of collective grief, while extended family members, friends and community converge, offering support to the grieving parents including, in some situations, help with younger siblings, such as childcare, the school run and cooking meals. Grieving adolescent siblings, however, by virtue of their life-stage, are stuck in between their childhood and adulthood, enjoying neither the innocence of being a child nor the responsibilities of being an adult, so miss out on the support they might crave. Their grief is often termed ‘disenfranchised’ or ‘misunderstood’.

Little research has been carried out on the possible effects of sibling bereavement in adolescence, but at the 2016 Australian Psychological Society Congress, researchers Jan-Louise Godfrey and Associate Professor Roger Cook, from Swinburne University of Technology, presented a paper on their study that examined how sibling loss affects development during adolescence and beyond. They say, ‘People often don’t recognise the intensity of the grief that the adolescent is experiencing and sometimes overlook just how important the relationship with their sibling was to them.’¹ Godfrey talks about the mix of disenfranchised grief and trauma that can lead to mental health issues such as anxiety, depression and eating disorders. If not supported to grieve, the young person can be left to carry their confusion and pain into adulthood, with all the consequences of supressed sadness. If the deceased had only one sibling, the surviving one becomes an only child, and the prospect of not having their sibling there, particularly at milestone life events, can be lonely. A child losing a parent, or vice versa, leads to intense grief over generational loss. However, loss of a sibling for an adolescent creates ‘horizontal’ grief, in which both shared pasts and futures are ruptured. They lose their witness to family history, and the ensuing uncertainty, fragility and insecurity can be misunderstood. Consequently, surviving siblings may suffer from long-term depression. The term ‘forgotten mourners’ feels apposite. There could be an expectation that surviving siblings will resume their normal lives while their parents grieve. But siblings need to grieve too, in whatever way they can. Sometimes parents and other family members become over-protective and restrictive towards surviving children, so as to prevent what has happened to their deceased child happening to the other/s.

When a sibling leaves home

When a sibling leaves home, similar emotions to those following a death may be felt by the remaining sibling(s), who may benefit from help to navigate them.

As Dr Diane Zosky, professor of social work, says, ‘Everyone in a system is connected, and when one family member leaves the home it can disrupt the entire system, change the roles in a family, and families can experience a loss of what were their norms and typical routine.’²

When a sibling has a mental or physical illness or injury

Another experience of mourning happens when a sibling receives a diagnosis, and the other children in the family feel unwittingly sidelined and that their feelings have been dismissed. When a child receives a diagnosis that requires complex medical and/or psychological intervention, families become submerged into unfamiliar and frightening territory. This puts huge stress on the entire family, and the sibling(s) of the unwell family member can be deeply impacted, which is often unacknowledged by parents or even by the sibling(s) themselves.

A significant part of our work was to allow Emma to grant herself permission to carry on ‘being Emma’, to enjoy time away from home to reenergise, and to periodically switch off from oppressive thoughts about her twin’s illness.

Serving the forgotten mourners

It is worth remembering that one size does not fit all in terms of therapeutic interventions, but offering a regular space the sibling can claim as their own, with someone who can hear their story from their unique position, can provide comfort. Supporting siblings to cope with change and loss, and helping them to reclaim their role in the family, are paramount. Bearing in mind the nature of the young person’s loss, the therapist can help them reframe it in a way that is more tolerable, and support the development of protective factors and coping mechanisms. Also important is acknowledging that it’s OK to be angry about their experience of being overlooked and silenced. I have found grief counsellor Tonkin’s Growing Around Grief³ helpful in supporting siblings to think about what their future grief journey might hold. The model challenges the notion that grief eventually shrinks, instead suggesting that over time it largely remains unchanged, but that life gradually grows around it as small moments of enjoyment begin to be experienced. Slowly, these moments become more frequent, and a life, albeit a different one, can be lived.