She ain't heavy

There is a recent news report about a 12 year old girl in China who died when she laid on top of her younger sibling while a fire engulfed their house. The girl was apparently the caregiver as her parents were often not around. This made me recall a session I had with a pair of siblings at the Children's Home, an 8 year old boy and his 6 year old sister.

The boy was recommended for play therapy as he had increasingly been throwing tantrum. For several sessions the underlying theme about his stories at play was the need to be safe, secure and protected. Hence he would build a nice home with  toy beds and furniture for the little toy children  but also ensured the home was well barricaded such that no one could attack the children. He even had fierce animals guarding the gates.

Of late his play has a more nurturing theme (eg. cooking and feeding). This is a good development. Soon he requested that his younger sister joins in the play therapy. With the social worker's approval I now work with both siblings together. During the first session I had the impression the boy was often bossing his sister around, occasionally shouting at her and making her wailed in tears. I then told him to be more gentle and loving.

At the recent session, the second I had with them, I discovered more about his predicament. The session started off badly with the sister cutting her foot as she rushed barefooted to the therapy room. When the staff sent her to my room after dressing the bruised foot, she was already in a crying mood. Throughout the session she would start wailing when she did not get what she wanted. I noticed when the girl started to cry the boy would get very agitated. He would shout at her to stop crying while trying to accommodate her wishes. He told her he would only give in on condition that she stopped crying immediately. However his shouting only made her wail louder and he seemed so emotionally overwhelmed when she continued wailing and shrieking. Even when she got what she wanted she still sobbed continuously remarking that the brother was still angry with her. I then made him hugged her instead of shouting at her which worked for a short while. When the sister started to cry again over a toy which was out of battery, he was visibly distressed again. I pulled him aside and told him it is alright to ignore her crying and leave her alone when her demands are unreasonable. He looked a bit surprised when I told him that and he played on his own before another episode started again.

It is quite heart breaking to see this pair of emotionally co-dependent siblings trying to survive in an institution away from home and their parents. I can see that the boy feels responsible for taking care of his sister but is often overwhelmed and does not know how to handle the shrieks of a 6 year old. His inability to calm her down makes him panicky thus resorting to shouting at her. We must not forget that he himself is only 8 years old and is feeling insecure himself as indicated in the theme of his sandplay. I have a feeling that her cries may also remind and surface his own inner fears and sadness. The sister is evidently dependent on the brother for emotional support hence sobbing often about his anger towards her. I therefore have to teach him to set boundaries for himself while validating his care and concern for his sister.

Psychologists have often cited the negative effects of "parentification" which is a form of emotional distress when a child has to become the caregiver of a sibling. I think the emotional toll can be exacting. Apparently children who grow up parenting their parents or siblings are more likely to suffer from anxiety and depression.

Immediately after the second session, I was considering engaging the siblings separately  in the coming sessions as it was quite challenging having them together. However now that I reflect on it, I feel the more I should be helping them interact, as in helping the boy develop some emotional boundaries while at the same time showing affections when his sister requires it.

Though "she ain't heavy, she's my sister",
"the road is long with many a winding turn"