A set of concerned parents came to see me with their 8-year-old daughter, the youngest of 3 girls. From our first introduction, it was obvious that the girl had many nervous twitches, such as blinking her eyes, gnashing her teeth and clapping her hands. She was a clear candidate for a diagnosis of OCD.
After a few minutes of introduction with the girl and her parents, I asked the mother to stay in the office while the girl and her father waited outside. Mother told me that the tics and nervous behaviors began about a year ago and gradually became more pronounced during the school year. She lamented that her daughter’s condition had taken a turn for the worse in the last few months, interfering with most of her activities so she could hardly sit still to do homework, watch TV or eat, which was causing disturbance for the whole family. She added there were other nervous behaviors too, such as shrugging her shoulders, shaking her head and so on.
Treatment for this girl lasted 8 sessions. As per my usual protocol of seeing family members separately and in small groups, at various times I saw the father and mother on their own and together, and the girl with each of her parents. However, most of the therapy took place with the little girl herself. With my knowledge of DOLF I suspected this might be a third-daughter problem where the youngest is of a gentle, Favored nature and is targeted for torment by one of her two older siblings. Since I thought this was likely, I saw no reason to ask the other siblings to participate in the treatment, though I did ask the parents about their temperaments. (See the blog titled: Cases of Vulnerable Third-Sibling Girls for more explanation.) After a few questions I determined that, of the two, the oldest girl was the one with the more passive, gentle and Favored behavioral style, while the second was the one with the more demanding, difficult-to-manage Disfavored temperament.
When I asked about their schedules. I learned that the mother worked regular hours at her job and attended a social club on Tuesday evenings. She would visit her elderly mother most Thursday evenings and also liked to go shopping with her sister on Saturday afternoons while the father took over the household. She confided that she sometimes got fed up with her chores and sought refuge at her social club, where she enjoyed playing cards for a few hours. She mentioned that her oldest daughter often had dance class, which left the middle girl in charge of the youngest one for a few hours until the father came home.
Father said he worked shift hours and acknowledged he felt badly because he arrived home at 9pm and had little time to spend with his girls except on weekends and holidays. It meant the girls were on their own on the two nights when their mother was out, as well as when she went to do errands, and that in fact they saw very little of their father.
Searching to confirm the Favoritism pattern, I learned that the oldest sister, aged 14, besides being a mild-tempered teenager, required some special help with academics and attended extra classes after school. She was also busy with dance classes twice a week. On the other hand, the 12-year-old excelled in her school subjects and mother described her as very determined and demanding, saying: “She’s the one who “always fights for what she wants – and gets it!” These traits fit well into my thoughts that the middle one was Disfavored. She seemed to harbor the Anger (aggressive behavior) and Anxiety (agitation and competitiveness) of a Disfavored personality compared with her intellectually less competent, but more gentle-natured older sister.
In the third session with the little girl alone, I asked her if she had a choice, which parent she would like to have more contact with. Unhesitating, she named her father as the parent whose company she most enjoyed and remarked that of all the family members she most longed to spend more time with him. She added that she would wait for him to come home so they could play together, even though it was close to bedtime. To me this meant he was the Prime Love Giver or PLG for the family. She also informed me that she found it very “boring” to have her middle sister babysit her because her sister would sometimes have a friend over to play but wouldn’t include her in their games, and made her stay in her room by herself. She confided that this made her feel very bad. She noted that her oldest sister also had a neighbor and best friend close by, with whom she would often go to socialize or do homework. She told me that when the father came home, he would help her older sisters with their homework, and since her middle sister did not want her around when she was doing homework, it left her with little to do but play by herself or go to bed.
When I spoke with the father, I delicately made him aware that, as a PLG parent, his personal input was psychologically very important all his girls. I stressed that, without undermining his wife’s equally important contribution to the family’s overall welfare, he was the parent on whom ALL the girls were Emotionally dependent. I explained that his youngest daughter’s symptoms would subside considerably if he were able to make himself more available to her, as she had expressed her longing for him. He professed that he is aware of the problem and does his best to make time for all his daughters, but that his work posed a major setback because of his unusual hours. However, he clearly understood my thinking when I described how each girl was feeling, and how much each one of them needed him in her own way. He stated that in particular he would try to devote as much of his time and attention as possible to his littlest daughter, who seemed to be suffering most right now. I made certain to make him aware as well that he needed to direct some more of his LOVE and attention toward his middle girl who, because of her Anger and agitation in her rivalry with the eldest one, was putting pressure on the youngest. I explained that this was due to his warmer connection with the oldest child than with the middle one. Somewhat taken aback, he remarked that this was all very new to him, and besides, it was “a very tall order!”
I made a point of explaining to both parents that leaving the youngest child in the care of her older sisters, especially the middle one as babysitter, was a major cause of the problems for their youngest. I emphasized that although babysitting seemed to be the most practical solution for them, it was highly toxic for their youngest one, who was exposed to the Anxious frustration and bitter Anger of the middle one. I informed them that their middle daughter was suffering from her own upset feelings of lacking the LOVE and attention that her older sister enjoyed, and that this was the source of her discontent, frustration and animosity toward the youngest one. They agreed, remarking they have always noticed that the middle one teases, belittles and bosses their youngest daughter. In this regard I informed them that they should not hesitate to intervene to stop any such comments or behavior because they are very damaging, and that they should minimize the conditions under which the teasing and bossing could occur. I advised them that it would be much preferable and safer to leave the oldest, better-natured girl to babysit the youngest one more often.
In view of my recommendations we decided that these parents’ primary strategy should be to avoid leaving the middle one in charge of the youngest. Their second strategy would be to minimize the contact between the middle and oldest girls, since this was a great source of agitation for the middle one because of the primary instinctual Sibling Rivalry between these two. I also mentioned that physical contact such as hugs, pats on the head or touches on the shoulder, as well as any positive verbal encouragement for all the girls would go a long way toward increasing each one’s sense of security and self-confidence. As a third tactic, they should try their best to intervene to stop all teasing, fighting or undermining of one sibling toward another. I mentioned they should watch out for these quarrels and negative name-callings, which are always intended to be highly cutting and are actually very psychologically damaging for whomever they target.
In my meetings with the young girl, she told me she loved her paternal grandmother and would like to invite her to attend a session. I agreed, and we discussed what they like to do together, why they enjoy each other’s company and the general family goings-on. I understood that the grandmother, like her son, was very loving of her granddaughter and very concerned about her welfare. At the same time, my personal research has always shown me that, although grandparents and other benevolent individuals such as caregivers may help raise children and truly love them, the children themselves are NOT as psychologically attached to these caregivers as they are to their own parents. I have found that children always long for their actual parents, have an uncanny instinct for who their own natural parents are, and have a profound basic psychological attachment to them. Just as they can distinguish between PLG and ALG, they seem to be instinctively programmed to seek out most of their loving attention exclusively from their own parents.
As a result of our conversations, this father resolved to spend as much time as he could spare with his youngest daughter. I advised him that he could even take the two younger ones out on their own, since the middle one mainly had a Sibling Rivalry problem with her older, Favored sister, and NOT with her younger sister. This would provide the second one with more of the attention she craved, and reduce her agitation. I explained that in spite of all her vocal protests about her youngest sister, the youngest one did NOT pose a psychological threat to the middle girl, but it was the oldest one who was the real competitor for the middle child. Father in fact mentioned to me that he had taken the two younger ones out for an afternoon since we spoke, and that things had gone very satisfactorily for all concerned. It was also suggested to the mother that if father was there on the weekend, she could take the oldest girl out on her own either to see their maternal grandmother, socialize with her aunt or go shopping with the ladies.
By the time our sessions ended, I could see that this girl’s nervous actions had subsided considerably. Her grandmother called to thank me for helping her granddaughter overcome these terrible symptoms. She remarked that there had been a dramatic change, that the girl was much happier and was doing much better in school. She extended the gratitude of the entire family and mentioned that others too had commented about the improvements in all her granddaughters, especially the teacher of this youngest girl.
