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Not forgetting the sibling experience: feelings in siblings impacted by CHD

Updated: Nov 20

Austin E. Wilmot, M.S.W., L.C.S.W.


Siblings, whether younger or older, have their own experience of having a brother or sister with CHD. Because of the increased attention and concern on the infant or child with CHD by parents (and parents also dealing with their own feelings), siblings are at risk of getting lost in the shuffle with their emotional needs sidelined. Depending on the age and developmental level of the sibling, it can be difficult (if not impossible) for the child to understand why mommy and daddy appear worried about sister, spend more time with sister or don't do certain activities as a whole family. Siblings can develop feelings of jealousy, feel insecure, left out or resentful of their brother or sister with CHD. Without being addressed, these feelings can manifest in behavioral problems and other issues (that would function also as a broadcast for that child's need for help and understanding). A sibling is also challenged by two-way feelings: that love for sister exists alongside anger, sadness and worry. A sibling may feel guilty for having such feelings if not helped to identify those feelings and feel heard and acknowledged by the parents. Any differences in how the parents set limits, attend to, support or favor/disfavor any siblings will be felt by all siblings. Unresolved guilt in parents may contribute to parenting choices that amplify discord between siblings and imbalances felt in the family system.


Towards understanding and valuing the sibling experience

Helping siblings begins with a parental self-evaluation about one's own feelings, parenting, how parents themselves were raised and the realities of how family life has been impacted by having a child with CHD. Below are some questions that may be helpful for a parent to reflect on. Also, refer to this article in preparation for the drawing activity later and ways to think about the different elements of the drawings.


  • What do you feel towards your child with CHD that you do and do not feel towards their sibling(s)?

  • How are your functions as a parent carried out differently with your child with CHD versus their sibling(s)?

  • What expectations do you have of your children that you do and do not have with their sibling with CHD?

  • How has your parenting been influenced by how you were parented? Other experiences, traumas?

  • How has family life been impacted by having a child with CHD?

  • From the vantage point of the sibling(s), what would you imagine the experience to be for each of the questions above?

A drawing activity, depending on the developmental level and age, with sibling(s) (on an individual basis, not with the child with CHD or other siblings) may help to open dialogue about difficult feelings:


  1. On a sheet of paper, draw a family. Then, ask for a small story about the picture they drew and write it on the page.

  2. On a sheet of paper, draw your family. Then, ask for a small story about the picture they drew and write it on the page.

  3. On a sheet of paper, draw yourself. Then, ask for a small story about the picture they drew and write it on the page.

  4. On a sheet of paper, draw anything. Then, ask for a small story about the picture they drew and write it on the page.

  5. On a sheet of paper, write/draw all the feelings you know.

  6. On a sheet of paper, draw you with your sibling(s). Then, ask for a small story about the picture they drew and write it on the page.

  7. On a sheet of paper, draw you and _________ (your sibling with CHD). Then, ask for a small story about the picture they drew and write it on the page.

Once completed, use the first two drawings to explore and understand anything that might stand out to you. How did they draw either family? Is anyone left out? Who is closer to whom? How do the stories compare? What does this all say about what might be going on currently?


Use the third and fourth drawings to explore and understanding anything that might stand out to you about themselves. How did they draw themselves? When given the chance to draw anything, what did they choose? What are the stories about?


Use the remaining drawings to explore how any of the feelings named in #5 happen in #6 and #7. Empathizing and understanding is the goal. Ask specifically about more feelings they have towards their sibling in #7 and mom/dad as it relates to feeling left out, jealous, angry or worried about their sibling's health/heart. You could ask them to draw how they understand their sibling's heart problem and any feelings they have about it. Suggesting ways that they might have felt at different times related to the attention and care their sibling received is okay to do. It is important to convey that you can handle all their big feelings no matter what they are about anyone. This activity is meant to help guide the direction of some possible conversation, but it is up to your child where they need to go the most. If some important feelings are brushed aside that you think are there, at least you planted to seed that you are listening and interested. It is okay to bring up feelings that your children do not bring up themselves as a way to gauge where they are and send the message that you can talk about anything.

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