A sibling's narrative of recovery from addiction trauma and loss in the family.

WHAT IS KNOWN ON THE SUBJECT?: Addiction has a devastating impact in the lives of millions of people worldwide. Siblings constitute a hidden population. Siblings' attitudes to addiction in the family vary widely from overinvolvement to disengagement among different individuals and across time-line points during the long history of addiction. Female siblings report more negative feelings and attitudes towards drugs and alcohol. Previous research has described the process of a sibling's substance abuse through the eyes of a co-sibling but did not focus on how co-siblings are affected personally. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Addiction can have a damaging traumatic impact on female siblings which is enhanced by social and self-stigmatizing processes related to the "code of silence." The anxiety provoking secret may devour the ability to communicate and connect with other members of their family and community if selective revelation proves to be unsuccessful. Ambiguous loss can occur when one's sibling abuses substances, as the sibling may be physically present yet be psychologically absent in terms of the co-sibling (and the family). Ambiguous loss is connected to the lack of understanding of the real impact of addiction on a sibling's personal development. Addiction constitutes a family trauma which may severely shake the siblings' beliefs and values and undermine their self-esteem, security and trust in life and the future. Lack of focus on a sibling's feelings during addiction may severely impact on his/her psychological health and identity development. IMPLICATIONS FOR PRACTICE: Understanding the experience of siblings may help health and social care professionals to develop compassion, patience and empathy towards family members of persons with addictions. Mental health nurses need to be aware of the devastating impact of addiction on all family members in order to validate their experiences and support them in recovering from trauma and loss in the family. Due to the current context of addiction services i.e. individualized approaches and limited resources, organizations should consider the need to provide effective clinical supervision to young mental health professionals at an individual, group or multidisciplinary level.