Siblings,Identity Development,and Clinical Process

Rosemary Balsam set an engaging tone as she introduced this panel’s multidimensional conceptualizations of siblings, identity development, and analytic process. While noting the scarcity of psychoanalytic literature on siblings, Balsam acclimated the audience to this panel’s in-depth look at “only children,” “psychoanalytic siblings,” and the “lateral dimension” of identity development via sibling interactions throughout life. Each panelist presented for approximately twenty minutes. Between presentations, Salman Akhtar commented, and one question was taken from the audience. An overall discussion ensued at the end.

Christine Kieffer presented the first paper, challenging the narrow view that “only children” are at a psychological disadvantage. Kieffer posited that missing siblings can “loom larger than life” in families, more so than actual siblings. Patients who know of but don’t see other patients (or see them only briefly) bring this knowledge into the analytic encounter, where it can play into transference themes.

Kieffer differentiated sibling rivalry from the mirroring and regulatory features of siblingship. In that relationship can be found both conflictual relations and a conflict-free sphere. Kieffer noted that “sibling as mirror” lends a “potentiating” aspect to development. Siblings as peers offer more accessible models for comparison, identification, and feedback.

Kieffer presented the clinical vignette of Erica, an “only child” adopted by her grandparents after enduring abuse and neglect her first seven years. In her initial clinical engagement with the analyst she was dismissive, and often threatened to end the analysis. Although Erica’s peers found her attractive at first, they would soon come to dislike her.

Two years into the analysis, Erica began to catch glimpses of other patients, about whom she made critical comments. One day she encountered a young boy, Thomas (age seven), about whom she could find nothing to criticize. Erica brought this issue into the analysis, exclaiming, “I hate Thomas!” In elaboration, she expressed her fantasy that Thomas had a perfect life. What later emerged was the fantasy that she was Kieffer’s only patient. Meanwhile, outside the analysis, Erica was struggling with the experience of attention being shifted away from her, as she would at first be befriended, only then to be rejected.

One day Thomas abruptly stopped coming to treatment, which Erica immediately noticed, exclaiming with delight at his absence. Later Erica became anxious that her hatred had destroyed him. Eventually she began to miss Thomas. Over time, Erica came to evince a connectedness and “solidarity” with her analyst’s other patients. She also began to experience a deeper sense of reliability in the analysis, which helped her in working through her losses and traumas.

Kieffer cogently explained how twinship selfobject experiences “might serve as way stations on the road to mutual recognition” and how a theory is needed to engage both the conflictual and the “narcissistic extension” sides of sibling relationships.

Here Kieffer referenced Juliet Mitchell’s work on sibling relationships. Mitchell maintains that the affects of desire and destruction are directed simultaneously toward the same person. When the younger child is born, the older feels both love and hate, and violence needs to be transformed into love. The older child loses his or her special place and begins to experience annihilation anxiety, which can lead to murderous impulses toward the baby. At the deepest level this is a form of narcissistic hatred that can be resolved, according to Kieffer, by extending one’s narcissism to include the younger sibling.

Kieffer surmised that Erica’s ability to engage with her “psychoanalytic siblings” allowed her the opportunity to deal with developmental concerns and master her annihilation anxiety. In closing, Kieffer related how the lateral dimension of siblinghood (including psychoanalytic siblings) is more than a defensive retreat. It offers multidimensional experiences that foster developmental growth.

Akhtar, in responding to Kieffer’s presentation, was struck by the various functions a sibling bond may serve; it may, for instance, serve as a substitute parent, facilitate or impede development, or provide objects for consolidation. He then examined the issue of a single child’s fantasy of being the only one, which could evoke a myriad of fantasies, thoughts, and questions about why that is. Akhtar then briefly examined the idea of “psychoanalytic siblings” and “psychoanalytic sorority/fraternity” among candidates. He expressed a concern that candidates do not always have the opportunity to enter analysis with an analyst of shared cultural background.

Akhtar was struck by the image of the good-looking boy Erica encountered in the waiting room. While acknowledging his countertransference reaction of envy, Akhtar commented on her reaction to the reality of Thomas’s good looks. In the interlacing of transference and reality, Akhtar argued, interpretations should initially be pitched at the “extratransference realm.”

At this point, Joseph Lichtenberg spoke from the panel in reply to a question regarding only children. He outlined two sets of fantasies: “I got rid of my siblings; now I’m the only one” and “I’m lonely and want a companion.” It is this common fantasy dialectic of the singleton that leads to feeling both special and deprived.

Jeanine Vivona next presented a paper on sibling identity formation and the “lateral dimension.” Vivona prefaced her clinical examples with a meditation on sibling recognition and identity development. Each of her cases involved sisters struggling to incorporate aspects of themselves unacceptable to both of them. Each of these women, both psychotherapy patients, hungered for her sister’s acceptance and validation, a theme that eventually wove its way into the transference.

Vivona highlighted Juliet Mitchell’s work on “non-uniqueness” and the “lateral dimension” of psychic life as a model with which to understand the uniqueness of sibling relationships and identity formation. All people, Vivona said, believe they are the only ones until they come to know there are siblings to contend with. With this comes an awareness of their non-uniqueness, which precipitates a crisis involving a refinding, via the lateral dimension, of one’s special position within the family constellation. Thus, Vivona presented an important aspect of identity as being the psychological manifestation of position. This striving is evoked in such statements as “I am the pretty one: you are the smart one.”

The first of Vivona’s two cases was that of Anne, who felt fundamentally different amid her family and had a particular tie to her sister Nancy. In the course of therapy it became clear that Nancy was an impossible ideal for Anne, one she could not live up to. Their differences occupied much of Anne’s mental space. She voiced a concern for Nancy’s approval, which went to the point of sharing her sister’s interests, even those she did not enjoy.

Nancy was the neat, organized one, while Anne was the messy one. Anne had felt, throughout her life, how much Nancy did not value fundamental aspects of her sister. It was clear that Nancy wanted to change Anne rather than accept her differences.

Interestingly, their mother was accepting of certain aspects of Anne that Nancy criticized. Apart from the maternal dynamics that played out in Anne and Nancy’s sisterhood, Anne had a deep sense that there was “something more.” This “something” existed beyond a simple displacement of the mother relationship and carried into adulthood and into Anne’s therapy. Whereas she felt a great sense of difference from her sister, she enjoyed a sense of similarity to Vivona. She found special ways to be connected to her therapist, beyond the usual social norms and rules.

Vivona’s second case was Bethany, an adult woman who like Anne was dealing with lifelong issues concerning her relationship with a sister. The sister, Julie, was described as a prototypical firstborn who hated the adoration accorded the newborn baby. Both parents were quick to describe Julie as “formidable,” while Bethany was “the easy one.” This distinction was supported by her mother’s advice that Bethany try to remain “under the radar.”

A key issue, as Vivona defined it, was Bethany’s wish to be accepted for who she was. Vivona elaborated on Bethany’s bid for something more than family acceptance, something that was sought through an attempt at differentiation along the lateral dimension. Bethany attempted to adapt to her sister’s resentment of her by being cooperative and remaining in the shadows, even by rendering herself invisible. Vivona conveyed how this early sisterhood-way-of-being carried itself forward into adulthood.

Vivona viewed both of her patients as experiencing themselves as fundamentally different from their sibling. Both struggled for recognition, a striving that affected their current lateral relationships. Even though Anne was oppositional and Bethany cooperative, each mode of relating had been an attempt to achieve a harmonious symmetry, or at least a stasis.

Vivona challenged the notion that the sisters’ relation to one another was merely a displacement of their relations to their parents. She reminded us that there is a dimension of sibling identity development that is independent of parental influences. Moreover, sibling rivalry may work against identification with parents.

Akhtar’s comments were focused primarily on Vivona’s clinical vignettes. He wondered how far apart in age the siblings had been in the two cases. He noted that there can be a variety of influences, depending on the exact time frame, which may affect maternal availability on micro-levels.

Akhtar proposed that Anne’s messiness (for example, leaving drawers half-open) may have been a way of staying connected with her mother. He encouraged Vivona to expand on the “something more” that exists in sibling identity development and the realm of recognition. To expand these notions further would give psychoanalysts a more complex understanding of sibling relationships.

Returning to the topic of the only child, Akhtar raised the issue of how these children deal with the outside world. He said having siblings is helpful in issues such as learning to modulate aggression. Akhtar also asked where the fathers were in both cases.

Vivona, in response to a question from the audience, expanded on how Anne’s sister and mother had influenced various aspects of her identity, noting again how the mother was accepting of things her sister was not. The transference, Vivona thought, was pitched laterally toward sibling as love object.

Joseph Lichtenberg then delivered the final paper, asserting first that psychoanalysts have underestimated the significance of sibling relationships. The vast array of configurations they can show distinguishes them from oedipal and preoedipal ones. Consequently, siblingships emerge “within the context of family life.” Finally, the apportionment of attributes among siblings and comparisons with different family members have an indelible effect on a person’s identity.

Lichtenberg introduced the case of Mrs. H., who came to analysis out of a fear of cancer and, later, of pregnancy. Mrs. H. had a twin sister, ten minutes younger, and it was apparent that they were assigned discrete roles by the family. That is, Mrs. H. was the “smart, capable one,” while her twin was the “pretty one.” The analysis was characterized by frequent silences, and Mrs. H. was described as tense, inhibited, and ashamed.

During the fifth year of analysis, Mrs. H. became pregnant and gave birth to her daughter Liz. One day, as Liz played with another little girl her age, Mrs. H. became anxious about the aggressive quality of the play. Lichtenberg picked up on Mrs. H.’s identification with the smaller of the two little girls. This belied her original description of the sibling rivalry with her twin, in which she was presented as the superior one, thus suggesting that she had sequestered all memory of her sister’s having been dominant. In fact, her sister was larger at birth and had developed at a more rapid rate. Through this exploration, Lichtenberg was able to create a fuller picture of how Mrs. H. organized her experience around the theme of “catching up and surpassing.”

A fascinating symptom developed in the analysis whereby she would open her mouth and not be able to close it. Two months before termination, she told of how Liz wished to give a bottle to her three-month-old baby sister. Mrs. H. noted how Liz struggled to keep the bottle steady. Just before Mrs. H. described how the nipple went in too far, the analyst himself had the symptom of opening and being unable to close his mouth. Lichtenberg communicated his understanding, to which Mrs. H. reacted with the same symptom. She then shared how her older sister recalled how their mom would feed the more responsive twin and give Mrs. H. to her.

Lichtenberg saw the symptom as a somatic representation of preferential treatment of the twin sister by her mother and of unintentional forceful feeds by the older sister. In the transference, this played out in the patient’s belief that the analyst would prefer an “easier” analysand. During the hours of silence, this was alive in her being the “difficult, finicky” child and he the “inept, puzzled feeder.”

Lichtenberg then presented two brief descriptions of sibling configurations. First was Harold, the oldest of three, who consistently protected the younger ones from an abusive father. He was known as the “protector,” which was transformed in adulthood into his being the financial advisor for the entire family. His life was organized around being a caregiver.

Next was the case of Nancy, who had been abused sexually by her older brothers. When her mother became ill, Nancy was cared for by her father’s family. After her mother recovered, Nancy complained to her about the abuse, only to be advised to avoid her brothers. Later, Nancy’s brothers got interested in other girls, which led to her tendency to take up with men who were unavailable.

Lichtenberg concluded by stating succinctly that while identity formation is universal, the form in which it happens is unique for each individual.

Echoing Lichtenberg, Akhtar noted the array of diversity in relatedness that occurs in siblingships. With twins, for example, some parents take great pride in making them different, while others encourage similarity. Akhtar elucidated how parents assign roles to different children, creating micro-splits.

He reflected on Lichtenberg’s open-mouth countertransference re- action in the light of Bion’s concept of “O.” Akhtar explained that Bion was raised as a little boy in India and had more than likely heard the word omm until age eight, when he was sent to boarding school in England. In India, he was with his nursemaid, the round breast, and the open mouth; but once you pronounce the mm in omm you have closed your mouth. This action creates a separation between child and mother/nursemaid.

During the general discussion, a member of the audience observed that the panel had elicited personal stories from many in attendance. She added that this speaks not only to how underrepresented this topic has been, but to how illuminating a psychoanalytic perspective may be in understanding siblings.

In summary, the panel provided a window into understanding sibling relationships, sibling identity development, and its many transformations throughout life, as well as how it may be manifested in the clinical encounter.