Grieving, Subsequent Children, and the Replacement Child, After the Death of a Child

Abigail Brenner, M.D.Guest interview with Abigail Brenner, M.D.

I conducted this interview with Abigail Brenner, M.D., several weeks ago. It now seems to have a new relevance in light of the Newtown tragedy as I asked her the questions I so often hear concerning replacement children.

Dr. Brenner is a psychiatrist in private practice. A board certified psychiatrist in practice for more than 30 years, Dr. Brenner is a Fellow of the American Psychiatric Association. Her work has focused on understanding change and the challenges and opportunities afforded by change in relationship to major life transitions. She is the author of Transitions: How Women Embrace Change and Celebrate Life, SHIFT: How to Deal When Life Changes, and co-author of The Essential Guide to Baby’s First Year (Alpha Books, a member of the Penguin Group).

Judy: Dr. Brenner, thanks so much for sharing some of your insights with my readers. I understand that you are doing research right now, along with your co-author, for a new book about replacement children; children who are born after the death of another child in the family. Can you explain what brought you to the subject, and why you feel it’s an important topic to research and write about now?

Dr. Brenner:  A very dear friend is a replacement child and through many conversations with her I’ve become aware of the many issues replacement children face. Since I’ve written several other books she thought it would be good to work together writing about replacement children. When I began to do research on the topic I realized how little exists on the topic.

My co-author has since been in touch with other replacement children, many as adults, and it became apparent that there are so many issues the replacement child has to face, often moving forward through their lives.

Judy: Do you have any personal experience as a replacement child, or with replacement children?

Dr. Brenner: I am not a replacement child and most of my initial understanding has come from the friend I just mentioned, plus the replacement children I’ve been in touch with since.

Judy: How about in your practice? Have you treated replacement children, or parents of replacement children? And, if so, have you found similarities among them as to the issues they face? What are some of them that you find most often?

Dr. Brenner: It’s interesting, but I don’t believe I’ve treated replacement children during my years of practice. I say, believe, because although I’ve known many people who have had “subsequent” children, I was not aware of the phenomenon of a child born to specifically replace a child who had passed away.

I use the term “subsequent” to describe a child born after another child in the family has died, but in this scenario, the parents want that child and have carefully thought out what having another child would mean for the family. That child is a unique individual unto themselves and is not meant to serve as a replacement for another child.

In interviews with several replacement children there appears to be a spectrum of issues and symptoms—which I talk about a little later on.

Judy: Do you find that parents are aware that they are having, or have had, a replacement child? And do they usually prefer the term ‘subsequent child?’

Dr. Brenner: Many people are totally unaware that they are having another child to make up for the loss of a child who has passed away. Many parents have been urged by their doctors and family to have another child to make up for the loss. When you search the literature about the profound grief that surrounds the death of a child, especially an infant who is stillborn or a child who dies shortly after birth, you find little understanding about the absolute necessity for the grieving process. Many people have another child and have not grieved for the lost child. Sometimes there is incomplete grief that lasts a lifetime.

Judy: Can you talk about the spectrum of issues you see with replacement children? Some who may have more issues than others, and why there is that difference?

Dr. Brenner: There appears to be a constellation of issues and symptoms. The experience of a replacement child seems to exist along a continuum—from the most extreme, to individuals barely aware that they are replacement children, to a larger population of individuals who recognize themselves in a middle-of-the-road position. We want to talk about all of these in our book.

Classically, parents often don’t complete the grieving process and continue to mourn the death of their child. The replacement child often feels inadequate to compete with the deceased child since they are often compared to an idealized version of the child who has died. To the parents, these children would have been perfect and brilliant in every way and the replacement child often feels the need to be perfect to be able to compete with their idealized sibling. Parents are often overprotective, controlling, and intrusive in the lives of children (especially replacement children) after they have suffered the loss of another child.

Replacement children sometimes don’t acknowledge their own need for help, have difficulty with guilt, are frequently aware of their parents’ vulnerability and attempt to take care of their parents’ fragile emotional state.

Judy: I have to say that I relate to all of what you’ve just said, as a replacement child, which I never thought of myself as until writing my memoir and facing many of those issues. Are there measures that you believe parents can take to minimize any negative effects of having a child subsequent to another child’s death? What would you advise parents to look out for?

Dr. Brenner: I would advise parents to take the time necessary to understand what has happened to them and to get professional help, if necessary, BEFORE they have a subsequent child. I would tell parents that grief is absolutely expected but that working through this process is essential for being able to move on—to never forget, but to be able to move on in life in a healthy way.

Judy: Are there any surprises as yet with your research? Things about replacement children or their parents that you did not expect?

Dr. Brenner: I am surprised that the therapeutic community, until relatively recently, has not understood the grieving process for parents who have lost a child.  I’m also surprised at the lack of research necessary to help parents work through their “unfinished business”— before they decide to become parents once again, for any subsequent child.

Judy: What is your advice to those who discover that being a replacement child may have had a negative effect on their life?

Dr. Brenner: Hopefully, with the publication of your memoir, Replacement Child, Judy, and our book, people will find explanations and resources for many issues they had not been aware of for much of their lives. Perhaps, you and I can put together some resources such as therapists that are familiar with and/or have treated replacement children and/or support groups for those who are searching for answers.

Approaching therapy (especially for those who have been in therapy previously when they were not aware) with the recognition that many factors may have influenced how they’ve lived their life up to now may help focus on those specific issues that may shed new light and allow for a new and broader perspective.

Judy: Thanks so much Abigail.

You may also be interested in Dr. Brenner’s latest blog addressing issues of siblings who have lost a brother or sister to the Newtown tragedy:

The Forgotten Mourners: Strategies to Help Bereaved Surviving Siblings

http://www.psychologytoday.com/blog/in-flux/201212/the-forgotten-mourners

Her website is: www.abigailbrenner.com

 

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