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Sibling Abuse Among Twins

A question was submitted by a thirteen year old girl who is being abused by her twin brother. She is not getting any help from her parents or school counselors. Sibling abuse is very common and I have seen it in my own practice and among children and adults of all ages. Many of the abused siblings feel powerless, suffer alone, and become isolated and ultimately depressed. There are many options available to abused children; the key is to be aware of what options are available.

Dear Doctor Life Advice,

I am a thirteen year old girl and I am having a lot of trouble with my parents and twin brother. My brother started attacking me physically when we were in third grade. I asked my parents for help, but they told me to wait it out and that he would grow out of it. We found out in sixth grade that he has a learning disability. This has given him even more excuses to act out, make a fuss, and hit me. He has also tried to hit our father, but our father is stronger. I even talked to our school’s counselor, but didn’t get any help. My grades are dropping and my parents and I are fighting more because of it. I have been spending more of my time alone in my room. I don’t invite my friends over because I am afraid of my brother’s behavior in front of them. My parents don’t know what else to do because my brother is already seeing a therapist.

Signed Unsure What To Do

Dear Unsure What To Do,

This is a terrible situation you are in, and my heart goes out to you and your parents. Unfortunately, as your brother gets older, he is going to get larger and stronger and the problem will only escalate. The time to act is now, and you will need to make some tough decisions and act strongly. It is important for you to understand a few important facts. First, as tired as your parents are, they have two children, and are obligated by law to protect both of them. It is not an option for your parents to tell you to tough it out, or wait until he grows out of it. They must take all action necessary to keep you safe. Second, you must understand that you are not helpless. The actions that I will advise you to take may seem harsh at first glace, but they will benefit you and the rest of your family in the long run. Third, I want you to know that you are in danger of developing depression. You are already beginning to show early signs such as dropping grades, isolating yourself in your room, and not inviting friends over. Your brother is getting help from a therapist; I think you and your parents should be getting help too. Last but not least, I noticed you didn’t use the word “abuse” in your question. You must understand that your brother’s behavior towards you is abusive. Under no circumstances should he be hitting you, and if he is, then he is abusing you. Here are some options for you to consider. I strongly recommend that you consider doing all of the following.

Document Your Brother’s Behavior

If your brother ever leaves bruises or marks on you when he hits you, take ample pictures of the bruises and marks. Keep a camera with you at all times. Either video or audio tape your brother’s outbursts. You have reached out to others for help and have not been helped. If you can show them what you are going through, the same people will be much more likely to pay serious attention to you.

Talk to Your School Counselor Again

I am shocked that your school counselor did not help you. School counselors are required by law to report abuse to the Child Protective Services (CPS). I can only guess that when you talked to the counselor, she or he did not understand the extent of what you are going through. If your brother is hitting you, and your parents can not protect you, then CPS must get involved. Your brother is not a small child any more and can do real harm. CPS needs to be involved before he becomes dangerous. Talk to your counselor again, and use the word “abuse.” Perhaps that will get his or her attention.

Insist on Talking to Your Brother’s Therapist

Therapists are also obligated by law to report any case of suspected abuse. If your brother is seeing his therapist by himself, then the therapist may be completely unaware of how your brother is treating you. I know that in my practice, if a patient or his family do not give me the crucial information, then my treatment of that patient will be missing key elements. Your brother’s therapist cannot help him with his violent anger outbursts if the therapist does not know about them. Make sure the therapist knows what you are going through.

Make Sure Your Parents Take Your Brother to a Psychiatrist

A psychiatrist is a physician that specializes in the field of psychiatry. Only a physician can prescribe medication to his or her patients. I don’t know how severe your brother’s outbursts are, but from what you have written, I think a psychiatric evaluation is in order. You stated that your brother has a learning disability. How was that determined? Did he see a psychiatrist, and/or did he have formal testing done? Sometimes schools do their own formal testing using the school counselor, and then recommend a therapist. That is very good, however, in this process, the person being tested is never evaluated for the possibility of medication management. If your brother’s behavior is impulsive and severe, he may be suffering from a psychiatric condition that requires medication treatment. In that case, there are medications that help reduce the frequency and severity of episodes of outburst. Your brother needs to be evaluated by a child psychiatrist to determine if medications will help improve his condition.

Insist on Getting Family and/or Personal Therapy

Your parents seem to be at a loss as to what to do. Your brother is getting away with abusing you, and he is even trying to hit your father. If your brother is not stopped, the time will come that he will be strong enough to even over-power your father. I also think that sooner or later he may hit your mother as well. As your brother gets older, your parents will have less and less control over him. They are running out of time, and they need serious help on learning how to deal with his behavior. They must get help. A family therapist will teach your parents to set firm limits for your brother. It will be hard work at first, because your brother won’t like new rules and new limits. Over time, however, he will learn to behave differently and within the limits. I also encourage you to find personal therapy in case my concerns are correct and you are developing depression. A child your age should be out there enjoying her life. Do not let yourself get depressed.

Learn Management of Aggressive Behavior

When I was starting my residency in psychiatry, I was required to take a class called Management of Aggressive Behavior (MAB). This class is similar to self-defense, but the key difference is that the goal of MAB is to learn to protect yourself without hurting your attacker. In self-defense, you assume that you are being attacked by someone malicious that means to intentionally harm you. In MAB, you do not make that assumption; you just learn how to most effectively get away from an attacker. In mental health, we learned MAB because sometimes our patients may get agitated and violent. You have a brother that does the same. You need to learn how to get away from him without either of you getting harmed.

Call the Police Next Time

Inform your brother and the rest of your family that the next time your brother hits you, you will call 911. Make sure they will take you seriously. Remember, if you decide on this path, then you must call the police next time your brother hits you, or your family will never believe you. This action seems harsh. I know you love your family and do not want to get the Police involved. I am hoping that when you inform your family of your intentions, they will take all measures necessary to keep you out of harm’s way. However, if a simple warning is not enough, then involving the authorities will have long term positive effects. This about it this way, calling the police when your brother hits you now will result in the police showing up and diffusing the situation. It will also let your brother and parents know that you are determined not to take any more abuse. On the other hand, if you let your brother’s behavior continue, then there may come a time that the neighbors will call the police, or your brother will do serious harm to someone. Then your brother would face jail time. It is better to show him there are serious consequences to his actions now, before he becomes more dangerous.

Contact Child Protective Services (CPS)

If all else fails, always remember Child Protective Services (CPS). CPS is a government agency that is available in most states. In some states, it may be under a different name, but still will be easy to find. Use any internet search engine and enter the words “child protective services” and the name of your state. People in general are very afraid of calling CPS, because they think that the children will be taken away from their parents. This is a misconception. The goal of CPS is to ensure the safety of the children first within the family home. The first thing they do is interview the children and assess the situation. Usually, a Social Worker or a Case Manager will be assigned to work with the family. They will help the family get the resources they need to keep the children safe. They may even involve the extended family in getting help. Again, your family may resent you in the short term for getting CPS involved, but in the long term, you may be saving the whole family a lot of trouble by preventing your brother from becoming more violent.

In conclusion, I stress again that you are in a very difficult situation. Allowing the abuse to continue is not an option. Your brother and parents will benefit as much as you from stopping the abuse now. You have asked for help without success, it is time to let the grown ups know that you will not tolerate the violence any more.

Doctor Life Advice

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Sayeh Beheshti, M.D.