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Elder Care

by Jeanne Safer
Delta, 2002
Review by Christian Perring, Ph.D. on Jan 3rd 2003

The Normal One

The effect of the illness, impairment, and difficult behavior of one person on his or her family is starting to gain more recognition.  Some have suggested that when one family member is disabled, then the whole family can often become disabled, especially when there is little social support and the family is left on its own to cope.  For example, in his excellent memoir Imagining Robert, Jay Neugeboren recounts his experiences growing up with his brother who had major mental illness, the feelings that he went through, and the battles he has had to fight on his brother’s behalf with doctors and administrators.  In her wonderful memoir Daughter of the Queen of Sheba, Jackie Lyden explains what it was like to grow up and contend with her mother’s manic depression.  There’s no doubt that living with a family member who has more than his or her fair share of difficulties can have many knock on effects for the rest of the family, especially other children.  This is the topic of psychoanalyst Jeanne Safer’s The Normal One.  Unfortunately, it is a problematic and flawed treatment of this important issue. 

We can start with the title, The Normal One: Life with a Difficult or Damaged Sibling.  Safer assumes a clear distinction between who is normal and who is difficult or damaged.  All through the book, she uses words such as abnormal, dysfunctional, and disturbed, to refer to siblings with problems, and often applies adjectives to them such as whiny, inept, and retarded, psychopathic, drug-addicted, and borderline.  She bring up the same people in different cases, and will refer back to them by the description of the sibling’s most unpleasant behavior; for example, she talks about a lawyer “whose paranoid schizophrenic brother broke down her office door and gave her daughters the penis-shaped nutcracker” (p.171).  In the Introduction, Safer explains that she uses “the terms normal, abnormal, intact, and damaged not to make value judgments but to reflect more accurately the point of view of higher-functioning siblings” (p. xvii).  This claim is not well supported by her quotations from interviewees.  Furthermore, the cumulative effect of Safer’s language is to express a strong sense of disdain and even anger.  Safer says she takes issue with the politically correct euphemism of  “special needs” children, and she seems to be making a point in using plain language.  But she does not make a strong case that such language is called for, and it will strike many readers as insensitive and even offensive.

A related problem concerns the scope of the book.  The kinds of “damage” she considers include severe mental illness, brain injuries, attention deficit and hyperactivity, learning disorders, and tendencies toward criminal behavior including sexual abuse and murder.  Sometimes the “difficult” behavior of siblings amounts to little more than dropping out of college or having unstable personal lives, while in other cases the siblings have chronically disabling diseases.  It’s hard to believe that there are simple generalizations about the families with such diverse members.  Yet Safer makes many sweeping claims, such as “Every intact sibling secretly wonders, ‘Why didn’t it happen to me—or when will it’” (p. 63), “Normal siblings are inundated daily with behavior that is not only noxious but also frightening, incomprehensible, and wretchedly sad” (p. 73) or “Relationships with damaged siblings reverberate through many generations” (p.133).  At other times, Safer is vague, suggesting that having a damaged sibling tends to cause certain psychological reactions, but making no absolute claim.

Indeed, the whole of the book seems to largely consist of Safer’s personal opinion and generalizations from her experience with her own brother, her patients, and interviewees.  There is a short bibliography that lists mostly articles from psychoanalytic journals, and of course the evidential basis of psychoanalytic theory is very questionable.  Safer uses many examples of dreams to illustrate the repressed fantasies of people with damaged siblings, but her interpretation of those dreams is entirely subjective, lacking even the sort of methodology proposed by Freud.  At most, Safer collects some interesting ideas about the psychodynamics within families with troubled or impaired children, that may provide some suggestions for further research.

Maybe the most disappointing feature of The Normal One is its lack of suggestions for how to improve the unhappy relationships between siblings when one of them has significant physical or mental problems.  She does say that it can be helpful for people to understand that many people in similar circumstances share their repressed fantasies and that it is important to recognize frequent patterns within such families.  She discusses what she calls the “Caliban Syndrome” which “affects every normal child” with a damaged sibling (p. 159).  This has four symptoms, which “affect everyone differently, but no one escapes” (p. 160): premature maturity, survivor guilt, compulsion to achieve, and fear of contagion.  Normal siblings try to make themselves as different as possible from their damaged relatives, according to Safer.  Safer assumes that understanding one’s irrational reactions to one’s sibling should reduce the symptoms of the Caliban Syndrome.  But Safer does not promise much improvement.  Indeed, she says that her relationship with her own brother is still not good, although she is now much more ready to admit her brother’s existence and to acknowledge the dysfunctional ways that her family responded to her brother’s troubles. 

In short, The Normal One is sensationalist, unconvincing in its general claims, and is unlikely to be helpful to people with troubled or impaired siblings.  Safer’s claims don’t fit very well with the pictures of families of people with illness or disability presented in many memoirs.  There are some obvious gaps in her treatment of sibling relationships.  She says little about how one child in a family can take on the role of the needy or sick person, giving others in the family the role of caretakers or allowing them to feel good about themselves in comparison.  She does not address at any length the fact that some families can be the cause of a child’s problems.  She does not discuss the way that the gender of the “healthy” sibling makes a difference to his or her experience.  Those seeking a thoughtful discussion of relationships between a troubled or impaired people and their more successful siblings should look elsewhere.

 © 2003 Christian Perring. All rights reserved.
Christian Perring, Ph.D., is Chair of the Philosophy Department at Dowling College, Long Island, and editor of Metapsychology Online Review. His main research is on philosophical issues in medicine, psychiatry and psychology.

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