As a mental health provider, I lacked the skills to successfully treat the grief stricken. My outpatient practice relied more on medication management than therapy, and I came to learn that this approach may ultimately mask the grief, numb the feelings, and inhibit the healing. Although referrals were made to community grief counselors, more often than not individuals declined to share their story with yet another person. Within a short spate of time, several young adults sought my help after the loss of a sibling. Having recently lost two of my older sisters unexpectedly as well, I wanted to be able offer more than empathy, medications, and referrals. This prompted my enrollment in a university-based, grief specialist certification program.

Sibling relationships

All relationships change over time, but some childhood bonds last a lifetime. Brothers and sisters are generally our first playmates, confidantes, and role models. They can be our friends, rivals, or substitute parents.

Intimate access to another person from birth — whether it is congenial or contentious — establishes a connection whether welcomed or not by either individual. When the connection is severed, reactions vary based on several factors, including the age of both at the time of death and the nature of the attachment to each other. Regardless, White (2008) offered that guilt is often experienced by sibling survivors when revisiting old childhood arguments or name-calling incidents.

As a child, my oldest sister (twelve years senior) was like a second mother to me. As an adult, she adopted the role of relationship advisor, career cheerleader, and fashion guru. With her death, came not only the loss of a shared history, but a large part of my present and future. While I literally and figuratively survived her death, my second oldest sister did not. Within four months, my other sister died. Both passed away unexpectedly after medical condition complications. As Rostila and colleagues (2012) reported, there is a higher mortality risk associated with sibling deaths. Their research suggested the level of sibling grief is equal to or greater than that of other familial losses. And both may be due to stronger feelings of grief, greater difficulty with acceptance, and fewer offered coping strategies.

Sibling grief

Grief is any emotional reaction after a loss. Mourning is how the reactions are expressed. There is no right or wrong way to grieve or mourn. Also there is no specific time limit; it moves at its own pace distinct to the survivor. Reactive feelings (shock, denial, anger, sadness, anxiety) will come in waves, may be triggered by seemingly unexpected things, and whose level of intensity decreases over time.

Several months after my oldest sister’s death, I was shopping in an outdoor mall. As I stood outside a store deciding whether or not to enter, suddenly the door opened, the scent of gardenia filled the air, and my eyes welled with tears. Gardenia was my sister’s signature scent. I did not go in the store. But now a few years have passed and I can smell gardenias and smile at the memory of my sister, especially the time about how we once got kicked out of a restaurant for laughing too much.

Sibling grief is often referred to as forgotten grief, and classified as disenfranchised, feeling marginalized. The bulk of society’s attention is directed more to the loss of a child, spouse or parent. As such, often the sibling puts their grief on hold to support the surviving parent(s), and when left alone in their grief, may experience a loss of identity.

Grief intensity is generally effected by three things: 1) birth order; for instance, a first born might feel like they failed to protect their baby brother or sister; 2) the level of familial closeness, trust, and support during crucial childhood years, which can result in a positive, negative or paradoxical effect; and 3) the amount of shared time growing up together. The level of intensity is directly related to reactive emotions. The tighter the bond, the stronger the grief.

Sibling survival

One of the young adults that sought my help didn’t show up until nearly a year after her sister’s death. She couldn’t figure out why she didn’t “get over it.” Voiced confusion about the continual crying, lack of motivation, and overt avoidance of friends and socializing. Maybe got drunk one too many times. Started smoking. Plagued by nightmares. Stopped going to the gym, gained weight and no longer wore make-up.

Though their life paths differed, she had lost her baby sister — a piece of her youth, a part of her future — thus leaving an emptiness in her present. The emptiness can’t be ignored, avoided, or “gotten over.” It has to be acknowledged, validated, and worked through. If not, studies show that more permanent psychiatric symptoms may ensue, including major depression.

Engaging in cultural rituals — mourning practices — have meaning. Wear black or red — because they loved you in it. Write a letter of apology or appreciation; journal feelings. Light a candle or bake a cake on their birthday. Acknowledge the deathaversary with a life affirming celebration — release balloons, put flowers on a grave, eat at a favorite restaurant. Having shared an appreciation of good wine with my sister, whenever I lift a glass, I still say a toast to her — wherever she is. When looking for clothes or shoes — I laugh and tell her I am shopping unsupervised. When talking to others, I found out I have friends who have also lost siblings — some to murder, accidental overdoses, and motor vehicle accidents. In other words, don’t let your grief become forgotten. Be active. Fill the emptiness. Acknowledge the pain. Address the emotions. Accept the loss. Heal.


Packman, W., Horsley, H, Davies, B, & Kramer, R. (2006). Sibling bereavement and continuing bonds. Death Studies, 30, 817-841. Retrieved August 21, 2016 from

Rostilla, M., Saarela, J., & Kawachi, I. (2012). The forgotten griever: A nationwide follow-up study of mortality subsequent to the death of a sibling. British Medical Journal(Electronic version) Retrieved August 17, 2016 from

White, P. Sibling grief: Healing after the death of a sister or brother. Bloomington, IN: iUniverse.