Diagnose my brother
May 2, 2023 9:10 AM   Subscribe

This is a question about my brother and a look back to the 60s/70s/80s and wondering how his abusive issues and strange behavior as a sibling would be treated today.

My brother is six years older than me. He was pretty abusive to me growing up. Never liked me. He would tease, terrorize, hit and rage at me. Some of the abuse was bad enough that I thought he would surely kill me. We have a kind of middling relationship currently and it's clear that he had some issues in childhood (and now), and I'm sympathetic to the fact he did not get the attention for these issues that he needed. He was born in the late 60s and my parents thought discipline and "tough love" were the ways to go. But, what was going on with him and how would this be addressed if he were six today?

He was very emotionally closed off. My mom often talked about how he wouldn't really express joy at things but if you asked him if he liked a thing or was having fun he would be enthusiastic. He was a thrill seeker and has struggled with addiction issues his entire life. He was really into trying to scare me and provoke reactions. The only time he really smiled at me was when I was upset or hurt at something he had done. The worst times were when he would babysit me. It was common for the parents to come home to me crying and him yelling about how awful I had been. We'd both get punished. He has a strong stomach for gross things but is very kind to all animals. When I think about the times he was cruel to me, it was almost like he was just bored. I think he really did hate me and he wasn't too scared of getting in trouble for being awful even though my Dad was truly an abusive and authoritarian father. My father could never "get through" to my brother and only stopped trying to be physical with him when he got big enough that the threat of him hitting back was a deterrent. My brother has apologized a few times in adulthood for being "so awful" to me but I've never pressed him for an explanation or a deeper understanding.

He's been on and off medication for ADHD. He's self-medicated with all kinds of substances and has been in and out of sobriety programs since his teen years. It's clearly a struggle for him. He's an incredibly hard worker but he's also still a thrill-seeker and loves gross stuff and gets an evil glint in his eye. His friends are all pretty rough folks. He's a college graduate and smart but can be incredibly black and white about things.

So, what do we think? What was going on with this child at age 6 to be like this? Is ADHD a sufficient diagnosis in this day and age for impulse control, rage and lack of clear emotional response? We don't have family history because we were both adopted (different parents) but there was some talk that his birth mother was quite young and may have been taking drugs. I don't know why or how this would have been known or communicated or if that is even trustworthy or relevant information. It could have been conjecture. I'm not aware that he was abusive toward anyone else like this. How would this be handled today? Any better?
posted by amanda to Health & Fitness (22 answers total) 4 users marked this as a favorite
He may have an organic mental illness, not just neurotic responses to not great parenting. I was bullied by 1 sister, and she still does a ton of micro- and not-so-microaggression. I now recognize her as likely bi-polar; her behavior as a kid and as an adult gets extreme. My parents tried to keep us apart; I think they recognized that she was mean to me, but there were 6 of us, my Mom was tired and didn't much like being a Mom. Younger siblings have lower status in the family. Bullies always try to bully people they perceive as having lower standing. This is true at home, work, social life.

Being bullied makes you more likely to be bullied by others, so learning to stick up to bullies is a difficult but extremely useful skill.
posted by theora55 at 9:20 AM on May 2, 2023 [3 favorites]

Sometimes when children grow up in abusive environments they act out in violent ways themselves. If your dad was physically abusive to your brother, that seems like a big part of what was going on here.
posted by cakelite at 9:22 AM on May 2, 2023 [11 favorites]

Obviously you can't diagnose someone third-hand, over the Internet, and retroactively, but the behavior you've described sure does fit the pattern of antisocial personality disorder. Just...I'm not sure what you'd do with a theory like that.
posted by praemunire at 9:23 AM on May 2, 2023 [2 favorites]

Children react to abuse and violence in different ways. You had the same dad and home environment, but that doesn't mean you respond in the same way. A therapist today would be tallying up the ACEs score and approaching your brother's behaviors as a trauma/domestic abuse response.
posted by EllaEm at 9:24 AM on May 2, 2023 [8 favorites]

This is not answerable
posted by fluttering hellfire at 10:13 AM on May 2, 2023 [24 favorites]

There can be a tendency to want to pathologize one person, as if the dysfunction lives in them rather than being a result of a system. As others have mentioned, the responsible thing for a behavioral health professional to do with a six-year-old with this presentation would be looking at the entire family system and seeing a little kid acting out within it to be a symptom, not an individual pathology.
posted by lapis at 1:01 PM on May 2, 2023 [6 favorites]

(And none of that diminishes the abuse you experienced, too. It sounds like the entire system was both traumatized and traumatizing. I'm sorry.)
posted by lapis at 1:09 PM on May 2, 2023 [2 favorites]

Best answer: I'm not sure anyone could know - even if your brother went to a specialist today to try to figure this out for himself.

Given his adoption history, there is certainly a possibility of in-utero exposure to drugs and alcohol. Here is a list of the common symptoms of fetal alcohol exposure. Of course, even without that, he might have been born neuro-divergent in ways that might (not will, but might) contribute to some of his behavior issues.

Being raised by an abusive father is not good for any child but it will be particularly bad for a child who may have difficulty with attention, judgement and executive function. That child is more likely to upset the parent and therefore more likely to be the target of physical and emotional abuse.

To the extent that it happened today in a caring family with resources, i think you would see a mix of therapies targeting the parents (especially if the child is young) to help them learn how to help the child manage his feelings and behavior and also supporting them with the frustrations of raising a challenging child, working with the child directly and also taking a look at how other family members (ie you) are being impacted. Depending on the diagnosis, medication could also be part of the mix.
posted by metahawk at 1:19 PM on May 2, 2023 [2 favorites]

RE cause, I can't guess. RE treatment though, at least in my community, professional help for kids with those sorts of behaviors seems minimal. The choices seem to be "parents muddle along the best they can as therapists shrug" or "set up really punitive systems intended to promote positive behavior but actually increasing the kid's resentment and frustration." ADHD, if properly diagnosed, would likely get medicated which may improve some situations. General community norms towards bullying have changed so your parents may have tried harder to protect you.
posted by metasarah at 1:41 PM on May 2, 2023

Response by poster: Just one comment — I’m not looking for an answer, I’m looking for context and some conjecture to help me think about this complex issue. The fact that my parents approach did not work for him as a personality to the extent that it often was abusive is a given. But his behavior toward me was shocking and seems outside the norms of a regular sibling rivalry or mischief. Might not be enough parents here to get more insight on how this kind of behavior would be approached today. It certainly seems like there is a much wider breadth of thought and resources around personality types and disorders.
posted by amanda at 2:54 PM on May 2, 2023 [2 favorites]

Might not be enough parents here to get more insight on how this kind of behavior would be approached today.

If that will help, I have a close family friend whose son was exhibiting really difficult and scary behaviour. Not to a sibling because he didn't have one living with him, but to friends and cousins. At school he was given an unusual status that meant the school could restrain him, after he injured a teacher (he was also sent home a lot).

His parents pursued treatment including ADHD medication, but with a lot of other supports and assessments. He was diagnosed with both the ADHD and ODD. He and the family worked with various therapies and therapists, including some group work through the hospital clinic. He is very successfully finishing high school.

Some of the parents in my group said he wasn't okay around their kids, some were okay with it supervised. It was really tough for everyone (but especially him and his family.) I mention that to say that yes, those behaviours can be brutal and over the top.

FAS did come to mind as did the way you described your father. If you're wondering whether it would be possible to have two abused kids and have one act out and one not, that is possible (recognizing that you suffered really awful additional abuse at the hands of your sibling.) I do think it's probably not possible to diagnose your brother unless he wants to seek one and then share it. But it's truly okay to sit with the way your parents were not able to (for whatever reason) provide you with a safe home. That is awful.
posted by warriorqueen at 3:29 PM on May 2, 2023 [1 favorite]

As a parent of a kid with some of these impulse control issues and thrill seeking behaviors (albeit much less severe than what you describe) the big thing that jumps out at me is that I will not, and would not let him babysit his younger brother even though each child individually is old enough to be left home alone for short periods. It's pretty awful that your parents would ever leave you in his care knowing the relationship you had. It seems overall much less of a done thing, at least among my cohort, to leave one sibling in charge of another these days. I mean mine love each other immensely and still manage to get hurt playing together like 30% of the time. It's really important to have an adult around to give them their own space to be apart when things go too far.
posted by Jemstar at 3:34 PM on May 2, 2023 [2 favorites]

Best answer: Here is an article from Psychology Today that might help you put some labels on regular sibling rivalry versus sibling abuse that would warrant intervention. Do note the article says sibling abuse is currently under-reported and should get more attention.
posted by Narrow Harbor at 3:47 PM on May 2, 2023 [2 favorites]

The issue is that a reputable mental health professional should not (which doesn't mean "never does") treat a child who is actively being abused as if they have a mental-health condition separate from that. Also, being abused changes people's personalities and literal brain structures, so it becomes impossible to separate out pre-abuse organic issue from being-abused responses (which may have turned into organic issues).

The managers in our youth and family programs say consistently that when you're treating someone that young, you're treating the family, not the child.
posted by lapis at 4:13 PM on May 2, 2023 [2 favorites]

Best answer: Generally I would say you're looking at an unfortunate confluence of circumstances, not one disorder you can point at. Certainly neurodivergent kids are not inclined to thrive when abused, which is what "discipline and tough love" are.

Today (given a decent school system) he'd be assessed for spectrum disorders, learning disorders, abuse, and maybe also neurological issues if he didn't pass normal pediatric testing.

Something that we know NOW is that a lot of kids with serious challenges do learn how to mask at school where the extremes of their behavior won't be tolerated/are highly punished, which unfortunately means they are coming home from school (and family events, church, any "outside" activities) needing to let it all out in the "safe" space of closed doors and often behind the backs of adult authorities.

Parenting styles and expectations even up into the 90s came with an assumption that negative sibling interaction is always both-sided and is always normal. That's not fair, and a lot of people have suffered because of it, and I'm sorry it happened to you. I promise you don't need a diagnosis for your trauma to be real, valid, and treatable. You do not have to establish "bad enough", you get to say that it was bad and it did you harm, and while you can't make the other people involved agree or collaborate in repair, you can source your own recovery.

My mother's older sister tried to kill her multiple times, and I know so many people who had grim home lives because of sibling abuse. I don't think even today it's taken as seriously as it should be, probably because the adults who have the most to lose are in almost complete control of the narrative.
posted by Lyn Never at 5:37 PM on May 2, 2023 [3 favorites]

was he adopted as a newborn or when he was a bit older? not that there can't be traumatic aftereffects either way, but if he had already been abused by one set of parents as a very young child before your dad even got to him, that would make his behavior even less surprising.

if you were both adopted as infants and you six years later, I imagine he had the usual older sibling resentment of a new person coming into his family that he hadn't invited and couldn't keep out, possibly exacerbated by insecurity about the extent to which his family belonged to him in the first place (depending on how your parents talked about and thought about adoption.) 6 years is a bad age difference with an angry older brother - not small enough for him to treat you as a peer or friend, not big enough for him to have learned adult self-control. most kids wouldn't seriously mistreat a new sibling just out of resentment, but most kids don't have an abusive dad teaching them how to do it.

as to how it would be handled today - assuming that his issues were not all caused by his family or families? - his parents would not leave an unreadable angry uncontrollable older brother alone in charge of a much younger sister. not more than once.
posted by queenofbithynia at 7:07 PM on May 2, 2023 [1 favorite]

Response by poster: He was adopted very early. He was given up at birth, as far as I know.
posted by amanda at 8:19 PM on May 2, 2023

Best answer: Some random thoughts -

From what I've observed with friends' families, kids with serious behavioral issues get assessed - often around age 6 or 7 it seems - for stuff like autism spectrum, anxiety, and sensory processing issues, all of which can cause meltdowns, and ADHD, oppositional-defiant-disorder, and similar diagnoses that are associated with impulsive behaviours.

I know two kids who were labelled as very aggressive around age 6 (breaking the family tv, ripping up all their books and deliberately peeing on them, hitting people, etc) and both got ADHD + anxiety diagnoses. They calmed down considerably on stimulants. I always wondered about those diagnoses - most kids with ADHD don't do those things.

It would be much more unusual for most families to leave young siblings home alone together these days, especially if it didn't go well the first time. Most kids I know aren't home alone for any length of time until around age 10 and maybe 12 if the eldest is babysitting.

Most people's acceptance of casual violence has changed a lot. When I was a kid, most kids I knew got spanked routinely, and lots of dads punched their teenage sons once in a while. I know far fewer families who would hit their kids now. I think the idea of siblings fighting or "boys will be boys" as a normal acceptable thing has really changed, and physical fights between siblings would now be stopped with more urgency.

Some of what you describe sounds a bit sociopathic - lack of emotion, glint in eye around violence.

I know quite a few men who are "rough", violent, and have substance abuse and thrill-seeking personalities. I'm shocked how many of them experienced childhood sexual abuse. That's not an excuse for bad behaviour, though. We all know lots of people who were abused and didn't become violent towards others.

I'm really sorry your parents didn't protect you. I believe you, and you deserved much better.
posted by nouvelle-personne at 8:20 PM on May 2, 2023 [2 favorites]

Sociopathy or antisocial personality disorder can only be diagnosed when someone is 18 or older, and it requires evidence of Conduct Disorder before the age of 15. No one should be treating a six-year-old for it.
posted by lapis at 9:18 PM on May 2, 2023

It would probably be handled better today, particularly in locations where there's much more of an assumption that kids are badly behaved for a reason outside their control and that reason can often be addressed or ameliorated. But it's not a given, it depends quite a bit on the parents.

Where I live, if he was having behavioural difficulties at school, then this would get picked up and an assessment would be reasonably likely to follow. But there are waiting lists, and it would depend on your parents agreeing to such an assessment. The parental abuse you describe is not seen as tolerable nowadays as it did then and that probably means it happens in fewer families. But it's not non-existent and a parent abusing their child can still very easily slip through the radar, particularly a middle class parent. Also, because it's not seen as tolerable then a parent may be more likely to realise that any assessment could [accurately] label them as abusive.

I agree with others that sibling abuse still isn't as widely known about but on the upside, there's less of an assumption that siblings will babysit younger siblings - babysitters are older than they used to be, and there's a bigger age gap.

I think nowadays your brother could have gotten help earlier, and there's a good but not guaranteed chance that he would have abused you less.
posted by plonkee at 5:14 AM on May 3, 2023 [1 favorite]

Best answer: I could have written this, except our abuse came from our adoptive mother, not father. My brother's abuse of me only stopped when he was 19 and I was 17, the second time he chased me through the house with a butcher knife. I began dialing 911 with the intention to have the police intervene because our adoptive parents (not home at the time) had been advised to take a "settle it between yourselves" approach to my abuse at his hands. I totally get why you want to make more sense of what was happening. I know you don't need a diagnosis per se, which is good because it's not really possible. But understanding the context can help you with your trauma.

I encourage you to use the broadly descriptive shorthand phrase "mentally ill" or similar in the construction of your narrative about the context of experiencing abuse at the hands of your brother. In addition to things like ACE scores and trauma-informed approaches that didn't exist back when he could have had an early diagnosis, adoption may be a factor--both in his infancy & childhood behaviors, and his more considered emotions about it as an adult. I'm speaking as an adoption rights activist, not a scientist here: When a child is taken from their biological mother, the child's life begins in loss and grief. We know more about mother-child bonding now than we did back in the 1960s and 70s. Evidence such as mother-child recognition due to scent points toward an adopted infant lacking a connection with an adoptive parent than non-adopted babies don't experience.

It's really, really hard for people to relate to sibling abuse as anything but an exaggeration. This internet stranger is validating you. By the way, my brother's diagnoses, which began in the early 70s and evolved through the late 2010s, included: hyperactive, narcissistic personality disorder, clinical depression, anxiety, manic depressive (later bipolar), and schizoeffective disorder. He was always very angry at his biological mother for giving him up. He found her and communicated one time but never met her. He got a PhD and was a published poet but was never able to hold a regular job because of his wavering between psychotic episodes and mostly but not always controlled paranoia. I ended up forgiving him once he got his addictions under control and became a father. As a writer he was able to process much of what he felt and went through, and we were lucky to be able to have open conversations about his abusing me before he died in 2020. I encourage you, the next time your brother apologizes, to take him up on what I see as his offer to talk about it a little more. I wish you peace.
posted by ImproviseOrDie at 5:15 AM on May 3, 2023 [3 favorites]

Response by poster: Coming back to say thanks for those of you that were able to go with the conjecture and offer some ideas as well as some personal insight. It was really helpful to me.
posted by amanda at 6:43 PM on May 30, 2023 [1 favorite]

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