Dear Therapist:

​ Our 9-year-old daughter was recently diagnosed with juvenile diabetes. This has been very difficult adjustment for her and she is having a very hard time sticking to the diet and medication regimen that she has been prescribed. She also has been complaining a lot of the unfairness of it all. We have a large family and this has also caused some friction between her and her siblings and we are struggling to maintain the balance between being sensitive to her dietary needs and not unnecessarily restricting the rest of the family.  Can you please give us some guidance as to how to help support her, get her to be more willing to deal with this issue, and balance her needs with that her siblings? Thank you. 

Response:

Juggling the needs of various children can be a daunting task. When the needs of one child appear to conflict with those of another, the juggling act can seem insurmountable. How do we tell one child that they are to be treated differently than the others? Or, how do we tell the other children that they need to make sacrifices for one of their siblings?

A sense of fairness and equity is typical in the minds of young children. “Why do I need to go to bed earlier than my friends?” “Everyone else has a phone,” and “Why can’t we go on vacation like everyone else?” are common refrains.

To some degree, the issue is not as problematic for the children as it is for the parents. If you were to clearly decide on an unwavering course of action—and strictly enforce it—how emotionally detrimental would this ultimately be for any family member? For how long?

I don’t know whether the pushback that you are receiving is your kids’ initial instinctive reaction, or if it has been a bit more persistent and prolonged. Are you being firm, or do your children sense your hesitancy? If your kids feel that you are not resolute, they are more likely to pry at this—leading to further complaints, and to your sense that they are being negatively affected by the situation. Similarly, if your spouse and you are not in sync—and your kids can sense that your resolve is not firm—they may continue to complain.

As you mentioned, your daughter’s diagnosis is a recent occurrence. When new rules and restrictions are imposed, it is normal for children to push back. Over time, however, new rules generally become old rules—and an accepted part of family life. It is important that your spouse and you maintain a united, firm front.

That being said, there should be a balance of resoluteness, understanding, and explanation. Depending on factors like age, maturity level, personality, and relationships, discussions can be had with each child. For some children, appealing to their sense of maturity and responsibility can help them feel more positive about making sacrifices for the good of the family or for a particular sibling. For others, it is important that they feel heard—even if the ultimate result is not what they were asking for (at least outwardly).

For the most part, you will likely find that a combination of understanding and explanation will be indicated. However, this should probably be preceded by a clear message about what will be changing. If you can cater to each child’s emotional needs, the tangible changes will likely become trivialized over time.

-Yehuda Lieberman, LCSW

  psychotherapist in private practice

  Woodmere, NY

  adjunct professor at Touro College

  Graduate School of Social Work

  author of Self-Esteem: A Primer

  www.ylcsw.com / 516-218-4200

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