Reflections on Family


By Sandy Berenbaum

Ideally, the family is a safe, protective, nurturing unit in which a child develops and grows. The early

years are demanding for parents, who, in addition to bonding with their child, must make daily

decisions that are vital to their child's life and growth. In contrast, the adolescent years are

emotionally challenging, as parents struggle to remain connected, supporting their children’s bid for

independence, while protecting them from making sometimes disastrous choices, as the child

struggles to develop her own ideas and direction.

Let’s add Lyme disease to this picture. Parents of children with Lyme disease carry an enormous

burden, far greater than those outside the Lyme community are likely to understand. They worry

about accuracy of diagnosis, selecting the right doctor and treatment approach, paying for treatment

that is very costly, and the complexities of identifying and advocating for educational supports that

may be necessary for a child to make it through school.

Other members of the family may be ill as well, often the case with Lyme disease. Aside from the

increased financial burden, there is the stress of trying to meet the needs of several Lyme disease

patients in one family. It is particularly difficult when one of those Lyme patients is a parent, and

when the ill parent suffers from neuropsychiatric problems!

Given the complexity and unpredictability of symptoms, and the inadequate understanding of this

illness in the greater community, parents often find that they do not have the support of family and

friends, as they struggle to cope. Unwittingly, some well-meaning family members may make

comments that undermine parents, even challenging the medical decisions that they make. At times,

family members mistakenly attribute the child’s symptoms and behaviors to willfulness on the part

of the child, or inadequate structure and limits on the part of the parents. Failing to appreciate the

complex, debilitating nature of this illness, they do not acknowledge the struggle the family is going

through, and are therefore not a reliable source of support. This reality in the life of the family of a

child with Lyme can be particularly disappointing and painful!

Behavioral problems are not uncommon in children with chronic Lyme. If the child is subject to

rages or other severe psychiatric symptoms, this increases the stress level in the family, and makes

the family’s day to day life far more complex. Lacking the support and help they would have hoped

to get from their family and friends, parents truly feel isolated. They are often out on a limb with

their child, but they are also out there alone.

Where a young child is concerned, although his parents do their best to help him feel safe and

protected, hiding their worries and fears, the child surely senses that something is very wrong.

Parents can’t help but worry about whether their child will ever fully recover. What might the

residual damage be…to his body, to his brain, to his experience of life? On some level, the young

child is keenly aware that he is not growing up in the carefree environment that peers may be

experiencing. Worries certainly permeate the household. Even deciding whether to allow a child to

go on a school field trip, or give permission for a teenager to go hiking with friends may be a

struggle for parents, who worry that their child, already very ill, might be re-infected. A sense of

normalcy is lost.

Where the adolescent is concerned, a primary issue is how to support the teenager in her efforts to

individuate and move toward independence, while taking appropriate precautions for treating the

illness. The physical and emotional dependency of a sick teenager may delay or interfere with the

task of individuating. Or, the teenager, supported by inaccurate information that is all around them,

may separate by challenging the Lyme diagnosis or treatment, and refusing to go to the doctors or

take prescribed medications. In denying their illness, teenagers may even come to believe that their

symptoms represent who they are, as they lose touch with the fact that these symptoms are caused by a

treatable medical illness. They may therefore see themselves as lazy, not very bright, quick to anger,

moody. And, in the process of individuating, they might not believe the evidence their parents and

doctors present that these are merely symptoms of the illnes, and not a manifestation of who they

really are. How terrifying this is can be for parents!

A child’s illness may call on parents to grow in unaccustomed ways. Parents may find themselves

thrust into situations beyond their own comfort level, needing to be more assertive with previously

trusted school and medical authority figures or more conciliatory with insurers and others, in order

to acheive important goals. The needs of their children often push parents far beyond their

comfort zone in these areas. It is important that parents recognize where that comfort zone is, and

work to move beyond it, for the sake of their child, and his recovery.

In this complex, demanding world, we need to have compassion, empathy, and understanding for

those who are struggling to raise children who have chronic Lyme disease. If we can appreciate the

challenges that face them, and respect their decisions, perhaps we can make their world a little bit


Parenting Strategies from the Trenches

After years of helping parents, children, adolescents and families deal with some of these issues, I

have developed the following strategies, to help parents ease their journey:

Maintain a problem-focused approach as you make decisions about diagnosis, doctors, and


Work at developing a consensus between you and your child’s other parent, whether or not you

are still together!

Stay focused on current problems to be solved, and keep worries on the back burner.

Explain what’s going on to your child in concrete, age-appropriate terms.

Maintain your credibility with your child by being truthful.

Be careful with the words you use. Avoid words like "psychotic episode", "manic", or

"incurable". Lyme disease is a scary illness. Keep your words from making it scarier.

Be firm when you need to be, but give choices when you can, lots of choices.

Establish and maintain protective boundaries, protecting yourself and your child from family

members and friends who doubt your judgment and parenting decisions. Let others know what

they can and cannot say.

Build a supportive network - educate your family and friends about Lyme, but don't overload

them. Remember, this is your issue, not theirs.

Be open to support, but make it clear that you're not open to being second-guessed. Allow

people to help in concrete ways when you're overwhelmed. Let them make meals, pick up the

kids, or shop for groceries..

Psychotherapy or family therapy, with a Lyme-knowledgeable therapist, can be an important

adjunctive treatment, to help you and your children get through the hard times without residual

damage. The model I use is helping Lyme patients and their families go from being victims, to

survivors, to thrivers. There’s nowhere that this model is needed more than with families coping

with Lyme disease.

Published in Lyme Times Children’s Treatment Issue

#42 – Summer, 2005

Sandy Berenbaum, LCSW, BCD, Lyme-Literate Psychotherapist

Family Connections Center For Counseling

Offices in Brewster, NY and Southbury, CT

Phone: (203) 240-7787