Sibling Therapy: The Ghosts From Childhood That Haunt Your Clients’ Love and Work

Karen Gail Lewis, Ed.D., M.S.W., is a distinguished author and family therapist known for her insightful contributions to the understanding of family dynamics, sibling relationships, and single adulthood. With a career spanning 50 years, Dr. Lewis has written extensively on the complex interactions within families, particularly focusing on adult siblings and the unique challenges they face. Her work often addresses the psychological and emotional complexities that arise from family roles and communication patterns. Dr. Lewis’ expertise is widely recognized in both academic and therapy communities, making her a leading figure in the field of family therapy.

Her latest book, Sibling Therapy: The Ghosts From Childhood That Haunt Your Clients’ Love and Work, is designed for therapists working with adults, couples, or families across various psychotherapeutic modalities. In this comprehensive guide, Dr. Lewis integrates psychodynamic principles with cognitive-behavioral techniques, offering practical strategies for addressing sibling-related issues in therapy. Because the book provides insights and strategies that can be applied in personal contexts, it may also appeal to individuals who are interested in understanding and improving their own sibling relationships.

Like any good therapist, Dr. Lewis begins with a framework and context for her work. She describes her training and how it developed into a specialty of working with siblings. Although the client stories in her book are composites, Dr. Lewis provides the general demographic characteristics for the siblings she treats, including their age, race, ethnicity, socioeconomic status, and degree of dysfunction. Most useful is her description of the four concepts or “ghosts” she most commonly encounters in sibling therapy: frozen images, crystalized roles, unhealthy loyalty, and sibling transferences. After introducing these concepts, she provides numerous case examples and suggestions for how to identify these ghosts in clients’ lives. The second half of the book provides practical tips based on Dr. Lewis’ experience. She shares her own successes and failures, describes components of unique retreats she conducts for siblings, and includes a clinical toolbox with exercises and strategies that she uses in treatment. She also includes appendixes of 14 case studies cross-referenced to examples in the text, an explanation on how to create a genogram, and an explanation of the hourglass pattern of sibling relationships.

At first, I (D.P.) was struck by Dr. Lewis’ choice of the words “ghosts” and “haunt” in the title, but on reading her text, I realized how appropriate the terms are. Like ghosts, clients’ psychological issues rooted in childhood are often invisible to them until an event or a memory reminds them (as adults) of past pain or trauma, causing them to feel overwhelmed or distressed. Certainly, the idea of something from childhood having an impact on people’s adult lives is nothing new in therapy, but what is new is Dr. Lewis’ framework and approach to these ghosts. In training, most mental health professionals are taught to focus on their clients’ parents, their romantic relationships, or their work. Rarely do therapists systematically focus on siblings, but as Dr. Lewis’ work demonstrates, they should. Often, siblings are the people in clients’ lives who have known them the longest and share a history. While reading the book, I (D.P.) was haunted by the thought that my clients’ siblings have been an influential yet silent tool throughout the therapy, unnoticed the entire time. Just as unconscious material needs to be made conscious to be effectively addressed, Dr. Lewis’ approach and techniques make sibling and individual issues more visible and manageable. Overall, Sibling Therapy is a book from which people of all backgrounds and therapists at any stage of their career can benefit.