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IT IS EVIDENT TO ALL WHO WORK WITH CHRONICALLY ILL OR HANDicapped children that their families are often threatened by predicaments which cannot be resolved. A number of surveys point to a high incidence of marital difficulties or breakdown in such families and the adverse effects on siblings. Some studies point to the unrealistic expectations which parents have of the healthy child to compensate for their disappointment, guilt, or feelings of failure in relation to the child who is handicapped. Yet it would appear that the physically healthy children in these families are rarely referred for treatment. Their problems may seem less weighty in comparison with the difficulties facing their ill or handicapped siblings; or recognition of their problems may be precluded by the need of the parents to defend against their own conflicts in relation to their damaged child.
Describing the reactions of parents to the birth of a defective child, Solnit and Stark (1961) speak of the mother's mourning reaction. She has to relinquish the image of an expected "perfect baby," and has to adapt to the "sudden" birth of a threatening