I always feel like I will be the one looking after … me and my brother, I will always … I'll sort of take on a carer sister role … and I'm not upset about doing that at all, I want to do that, I want to do that for him. Participant 7. Having this belief provided Participants 2 and 7, among others, with a role in their sibling's life, and because they felt responsible, it supported the closeness of the relationship.
Likewise, Participant 1 expressed how playing a carer role, enabled her to feel at ease with where her brother was and what he was doing:. My whole thing with him was that if he was living with me at least I'd know where he'll be, he's got a roof over his head, I can get food into him when I can. Ten of the participants mentioned feeling this strong, innate sense of protection towards their parents and sibling, which resulted in emotional conflict.
This was highlighted by one of the participants who expressed "an incredible pressure … to be just, so okay, all the time DeFrain and Asay discussed commitment in a strong family, and emphasised the importance of all family members showing one another how important they are in each other's lives. While participants did have this strong sense of protectiveness, which ultimately demonstrated commitment and love, not feeling as though their parents or sibling returned the same feelings was often expressed.
I feel like there's an incredible pressure on me to be just, so okay, all the time. Because, you know … if anything, if I was to get sick, if I was to do something stupid or get in trouble, that would be like putting a gun to my parents' heads.
And for me, that's an incredible pressure to bear on a daily basis. This theme of being protective and the struggle with roles is consistent with findings from Howard et al. A participant in that study felt that her brother's problematic alcohol use made her feel as though her entire family dynamic had changed, and she was not only playing her role as a daughter and sibling, but had to also play her brother's role. This created a great struggle in terms of responsibility, protecting her parents and her own sense of identity.
Likewise, many of the participants in the present study, felt their own sense of wellbeing and identity was affected by their sibling's problematic substance use. The second theme, family challenges , also had three sub-themes, the first being "sadness, despair and frustration".
Participants reflected on a wide range of challenges that they felt were harmful to their relationship with their sibling and parents. For 10 participants, their sibling's problematic substance use made them feel extremely sad at the loss of the pre-use relationship. The overwhelming stress and worry resulted in these participants feeling a sense of helplessness and despair, particularly when looking in to the future.
In contrast, the other three participants talked about how they were ashamed of their sibling, angry at the situation and had "given up" on the idea of having a relationship with them.
In these three interviews, participants felt their sibling's problematic substance use was a direct reason why they had withdrawn from their sibling and lost a lot of the closeness in their relationship. This withdrawal subsequently impacted on the way they communicated and engaged with their sibling. In my teenage years, I was more inclined to try and talk to her and try to get her to see what was going on, and try to get her to stop … in more recent times I've sort of given up and just try to ignore her, for the most part, I don't really feel like anything I say is going to do anything.
Participant 8. Similar to Participant 8's feelings, others felt almost powerless when it came to communicating with their brother or sister, and this made them feel frustrated, "… I'll get frustrated and I, I actually feel very sad … I can't do anything …" When looking at frustration and difficulty in communicating in the family, DeFrain and DeFrain and Asay talked about how a key factor in strong families is that they are able to get through a difficult time or stressful situation efficiently and with minimal damage.
Using DeFrain's model, problematic substance use can be seen as a form of family crisis. For many participants, it was very difficult to effectively work through this crisis as there were barriers in communication, and the sadness or anger experienced impeded their ability to help their sibling.
This often left participants feeling like their relationship was "permanently damaged". It's actually quite sad … to think about … the lovely things that we used to do as kids … the drug use has definitely robbed us of a lot of those lovely things that we used to do together and lovely times … we have a very damaged relationship, and I think when she gets clean it's gonna take a long time to build that up to what it could possibly be, because … it's a matter of years and years lost, lost relationship, of lost time, of missed opportunities.
Participants' feelings of sadness, despair and frustration in the current study were significant barriers in the sibling relationship. In summary, the 13 women in the present study experienced similar feelings to those noted by Howard et al. In the present study, these feelings were also associated with withdrawal and a need to disconnect from the sibling with the problematic substance use. I have virtually no trust for him … if he approached me asking for help, I would greet that with skepticism and with distrust … I think our relationship is permanently damaged.
The second sub-theme was "distrust and secrecy". Participants were asked about their relationship with their sibling from early childhood, and questions around trust and privacy were used to understand how their sibling's substance use might have affected these aspects of their relationship over time.
Eight participants felt their sibling's problematic substance use resulted in distrust, lies and secrecy in their relationship, consequently impacting on their time spent together and communication. For the other five participants, when asked about trust, they talked about communication with their parents and other family and friends.
These participants expressed feelings of shame, embarrassment and denial. She would just lie … the constant lying and the constant manipulation, and dishonesty and distrust, I just went, you know what, do what you have to do, at the end of the day I'm not going to bust my guts for you anymore.
When placing these findings in context with DeFrain's Family Strengths Model, these themes of distrust and secrecy in the family are likely to create an enormous obstacle for siblings in terms of communication, their time spent together and their closeness. Another important element that added to this obstacle was that for all participants, their siblings had poor mental health. Four participants perceived their sibling to have had pre-existing low mood and anxiety during adolescence, and that their substance use had exacerbated their symptoms.
Four other participants perceived their sibling to have not experienced a serious mental health problem before their substance use, but to now suffer from a mental disorder such as schizophrenia, bipolar or depression. For other participants, not only did their sibling have a mental illness, but the participants also experienced their own mental health problems such as depression and anxiety.
The comorbidity experienced by the participants' sibling, and the participants' own mental health issues, created additional challenges for sibling communication and trust. After his drug use and then his schizophrenia, he started communicating very differently … there are aspects of his communication that are very childlike … his behaviour changed a lot, it wasn't just about erratic mood swings … when the mental illness came about … much more difficult of course, when there's two dialogues in his head, and you're trying to have a discussion, really difficult, and you know the paranoia, and the behaviour that is expressed with that, is much more difficult to manage.
Participant 6. A study by Gorka, Shankman, Seeley, and Lewinsohn found that children living with a parent with a substance use issue were significantly more likely to experience depression. Similarly, for participants in the present study, many experienced depression, which they felt was due to their sibling's substance use and the anxiety their sibling's use created.
This finding may suggest that not only are mental health issues likely to occur for the person using the drugs but, subsequently, members of the family are at greater risk of experiencing their own mental health issues.
For Participant 6, who talked above about her brother's schizophrenia, there is the potential that low mood and attenuated psychotic symptoms may have been present before his cannabis use, and that his substance use may have transitioned him into psychosis. As she said, that behaviour change created problems for their communication. Also looking at dual-diagnosis, Boscarino et al. The comorbidity between mental health and substance use was present in the current study, with many participants' siblings experiencing depression and other mental health problems from their substance use and dependence.
Furthermore, while Gorka et al. It is evident that distrust and secrecy are experienced in the sibling relationship, and perhaps even more so when mental illness is a factor. The final sub-theme for family challenges was "overlooked and not validated".
The feeling of being "overlooked" was a substantial theme throughout the 13 interviews. For all participants this encompassed feeling ignored and as though their experiences were not validated.
Many participants struggled with feeling ostracised and isolated from their families because their parents' primary concern and "fixation" was with their brother or sister. It can go months where we don't talk about much else but her, or what's happening or what can be done, and how we can best support her … it can often be that we really don't talk about anything but her. And that's really hard to think that they aren't interested in me, or what's happening in my life. Participants weren't directly asked about whether they felt overlooked by their parents or family, yet this theme appeared in each interview.
Ten participants said feeling this way had a negative impact on their relationship with their sibling in terms of their closeness and time spent together.
For Participant 10, in particular, when she talked about her brother's problematic cannabis and codeine use, she explained that at times she felt she could not engage with him because it made her feel scared and anxious.
This participant also reflected on the lack of parental support and feeling alienated from her parents. I was basically condemned by them … and ostracised to the point where, you know, I was told I was disgusting for not supporting my brother, that I was a bad sister.
I would say that it damaged my relationship with my parents. Feeling as though you are appreciated, and having family members show each other commitment and care is a fundamental principle of a strong family DeFrain, When members of the family feel left out and overlooked, this suggests that not all family members are equally committed to each other, and shown in the present study's findings, can damage relationships and openness within the family.
This is reflected in the interviews where participants talked about feeling like their own interests and lives were not as important as looking after their sibling and ensuring their sibling was safe and out of trouble. After so many years of this, you sort of only just have that realisation that they [participant's parents] don't know much about what's going on with me I think that's one of the hardest things of having a sibling with a serious addiction.
The present findings can be considered in relation to research in to siblings with a brother or sister with a disability or chronic illness. McCullough and Simon found that siblings with a brother or sister with a disability felt overlooked and ignored when it came to the provision of support in the family.
Just as participants in this previous study felt isolated and experienced a lack of communication with their sibling, the 13 women in the present study struggled with having a voice in their family, and sharing their own lives with their parents or sibling. For some participants, this resulted in choosing not to share their own lives with their family, and dealing with their own battles alone. There's a real sense of your experience not being validated … of being overlooked, and even when you are engaging with drug services, they are so stretched, and you can't guarantee a good experience.
The final theme that was evident in all 13 interviews was support. Participants were asked questions around how they communicated with their sibling in difficult times, and how they supported their sibling and themselves. In the study, three of the younger participants had not sought any external support to help them make sense of, or deal with, their sibling's substance use.
These three participants were also less involved in their sibling's support and treatment. I've never really felt like I've needed to [seek support] … I'm sort of … a more solitary person I guess you'd say, I sort of deal with things on my own.
For four participants trying to help their sibling receive treatment, seeking support was a significant part of their lives.
Of importance, both Participants 5 and 10 reflected on how they had been to support meetings and had never met another sibling. This resulted in feeling alone and as though their feelings were not recognised by their parents or support groups. Participant 10 talked about going to a meeting and remembered that:.
Everyone was really astounded by what I was saying, and it was kind of a wakeup call to them, like oh my god, my other children are damaged, and I didn't realise. Participant 10, like many of the other participants, felt as though greater attention is placed on the sibling with the problematic substance use, and that it often feels as though their own issues are ignored by their parents.
The present study's findings suggest that because of this perceived lack of parental support and feeling overlooked, participants were less likely to seek support externally. In contrast to the other interviews in the present study, Participant 12 had lost her sister to suicide, after her sister had problematic cannabis use and mental illness thought to be induced by the prolonged cannabis use.
A huge struggle for Participant 12 was the issue of whether her sister received sufficient support when she was experiencing not only problematic substance use but also a mental illness. There's real distrust … we didn't know what to ask and we didn't know what was happening … we weren't given information, we weren't allowed in the process. Related to this point, a theme identified by Flaherty and Donato-Hunt was that participants felt that their families were not sufficiently involved with support services.
This was also found in the current study, with many participants feeling left out by support services and overlooked by their families and support agencies. Ultimately, these findings have potential implications for how families come together during the treatment phase and beyond, if services are not sufficiently supporting families and involving them in the treatment process. A final pattern within the theme of support in the present study was that nine of the participants had gone on to work in the area of addiction, social work, psychology or therapy.
As a number of the participants had a history of some kind of addiction in their family, working in the area enabled many to feel greater empathy and compassion for their sibling and family, and gave them "motivation" to understand the drives behind their sibling's substance use.
Now I've gone into counselling and therapy, so I know all this stuff that I didn't know then. There were some limitations to this study. Only 13 participants were recruited, and therefore data saturation was not achieved. However, this was not an aim of the study. Similarly, the findings cannot be generalised to the wider community. The findings suggest, however, that if this is how some siblings feel, perhaps others also share these feelings. Therefore, the study provides some suggestions to family practitioners regarding what to consider when working with people who have had these experiences.
The telephone interviews could also be seen as a potential limitation, as the researcher could not observe the participant's body language. Due to the nature of the study, however, many participants felt more comfortable undertaking a telephone interview, and the results showed that an in-depth insight into the lived experiences of participants was still achieved, regardless of whether interviews were conducted face-to-face or via telephone.
Furthermore, as only females volunteered for participation in the study, respondent bias may have been a possible limitation and impacted on the study's findings.
A recent study investigating the harms experienced by people as a result of others' alcohol consumption suggested that females were more likely to report being negatively affected by a relative's alcohol use Laslett et al. It would be important for males to also have their stories heard, to gain a better understanding into how sibling relationships are impacted, and to also look into how sibling gender affects these issues.
I'm not very good with one-to-one relationships …. PW: I'm like that, I feel people will let me down. Maybe adoption would have given that security? There were other people in our town who were fostered, but it was usually something like, this person's mum was a teenage mum, or this person's mum is an alcoholic. But I would see my mum with a decent home and enough money … I spent a lot of years resenting my foster mum for not teaching me anything about being a black woman.
Then when she was really old, she started talking about race, saying we had never really addressed it. I think I appreciate her more now. But the race thing loomed so large, and it took me so many years to deal with it. DA: My dad passed away a number of years ago, but I've got letters from him going back to when I was five or six. It was never enough for me as a boy, I even went and smashed up one of his cars when I was 19 because I was so angry.
But I made a documentary about my childhood and I was so lucky he got involved. I had a bike stolen and my dad turned up the next morning with a big grin on his face and a brand new bike. I was 30, but it made me feel like a child because I'd never had that. So we had eight really positive years before he died, but I spent a lot of my adult life angry with him.
PW: It's really sad, isn't it? I feel with my birth mother that it's a lot like that. She must have looked at the situation with me and her, and how horribly wrong it went, and it's almost like she just decided to walk away and start again with a new family.
I applied to university and was accepted at Oxford, and they made it clear I couldn't bring a baby with me, so instead of perhaps going to a different university I left my daughter to be raised during term-time by my foster mother's daughter, who I was very close to. So I didn't really step up and become the parent I wanted to be. It's easy for people to get into cycles, and I think that's really sad. DA: I get so angry — we give families chance after chance after chance, particularly those who are involved with drugs or prostitution.
The most important person in my life is a social worker, Jenny. Single parent family - consists of a parent not living with a partner, who has most of the day-to-day responsibilities for raising the children. The children will live with this single parent for the majority of the time, but they may still have contact with their other parent.
Same-sex family - since civil partnerships were legalised in , the number of same sex families has been growing same-sex marriage was legalised in Same-sex couples cannot conceive together, so their children may be adopted or be the biological children of one member of the couple. They may also be from a sperm donor or a surrogate birth mother.
0コメント