What Oldest Siblings Bring Up Most In Therapy

From struggles with perfectionism to feelings of imposter syndrome, here's what oldest children need help with.
The seemingly simple act of caring for younger siblings affects the oldest child all their life.
Klaus Vedfelt via Getty Images
The seemingly simple act of caring for younger siblings affects the oldest child all their life.

“Fiercely independent,” “driven,” “responsible” and “caretakers” are words that are often used to describe oldest siblings.

From a young age, firstborn children are tasked with watching out for their siblings while also being raised by first-time parents, which are experiences that show up in many ways, including in certain topics and beliefs that come out in therapy.

What’s more, there are no other children around when the oldest child is born, which means their role models are adults, their caregivers, according to Aparna Sagaram, a licensed marriage and family therapist and owner of Space to Reflect in Philadelphia.

Younger siblings, on the other hand, have their older siblings around and look at them as role models.

“Generally, they say younger siblings are more relaxed and more carefree — it’s interesting because their role models [are] actually a child,” Sagaram said.

Combined with the lived experiences oldest children have, this creates specific challenges that are often discussed in therapy. Below are some of the most common issues oldest siblings bring up in sessions:

Struggles with perfectionism

With the oldest child, there is a lot of trial-and-error parenting — new parents are learning how to raise their firstborn and don’t yet have the knowledge that they’ll bring to raising their younger children, said Altheresa Clark, a licensed clinical social worker and the founder of Inspire4Purpose in Florida.

This may mean oldest children have to deal with extreme parenting styles, like a strict upbringing with lots of rules and expectations. “So, how that translates to the oldest child, they now have to grow up and there are a lot of expectations. A lot of times [this creates a] Type A personality where they become perfectionists,” Clark said.

Clark said she helps her oldest-sibling patients connect the dots and dismantle the perfectionist belief systems that have been with them for decades. “We’re helping them say, well, your parent was hard on you as the oldest child, which then translated as you had to be the best, you’re a perfectionist, you’re very self-critical.”

It’s important for oldest siblings to realise this connection to be easier on themselves when they don’t meet their high expectations, she said.

“If they don’t show up the way their parents enforced in them, they’re very, very hard on themselves,” Clark said.

Feelings of imposter syndrome

When you’re very self-critical and constantly striving for more, it can be hard to ever feel like you’re good enough, which can lead to imposter syndrome, according to Clark.

When it comes to success or recognition, firstborn children may feel they “don’t deserve it because of this harsh self-critical analysis ... because of their strict upbringing or the expectations that their parents had [for] them,” Clark said. She added that she especially sees this in her high-achieving Black clients.

Experiences With ‘parentification’

According to Sagaram, many oldest children dealt with “parentification” starting at a young age. This means they were given adult responsibilities to help their parents who either worked a lot, were emotionally unavailable or physically unavailable.

“So, having to take care of younger siblings, prepare their meals, put them to bed, watch them” are all examples of parentification, Sagaram said.

What’s tough about this, though, is in many cultures, helping your parents out is innate, Clark said. Especially in BIPOC communities where “you are supposed to help your younger sibling — it’s just expected of you to serve in those roles,” Clark added.

Sagaram said children who are parentified grow into adults who aren’t able to fully relax, constantly worry about other people and always feel like they have to be caretakers for their loved ones. And this shows up in both men and women, Sagaram said.

Oldest children often struggle with the need to overachieve because of the pressure they dealt with from their parents.
Gpointstudio via Getty Images
Oldest children often struggle with the need to overachieve because of the pressure they dealt with from their parents.

Jealousy toward younger siblings

Sagaram said oldest siblings often feel like they had to pave the way for their younger siblings and can feel like their little sister or brother has it easier.

For older siblings, both Sagaram and Clark noted, this can lead to feelings of jealousy or resentment.

Oldest siblings may be jealous of the ease younger siblings feel around certain situations — like bad grades or breaking curfew — and may wish they got to experience life that way, too.

In the end, it can feel like unfair treatment for the oldest sibling.

Trouble asking for help

“Oldest siblings feel like they can’t rely on others for support, or they feel like they have to have it all figured out on their own,” Sagaram said.

This affects work, relationships and all parts of an eldest child’s life, she said.
“When I’m working with oldest children, it’s something we try to unlearn. Asking for help is OK; it doesn’t mean you’re weak in any way,” Sagaram noted.

What’s more, oldest siblings who outwardly seem to have a handle on their professional and personal lives have a hard time expressing when they are feeling down, Clark said.

Oftentimes, when they do share their struggles, they are met with responses like “but you make good money; why are you upset?” This further forces eldest children to hide any mental struggles.

You can’t change your birth order, but you van treat your struggles

“Birth order is definitely something a lot of people talk about on social media, and it does play a role in how we are as people and especially the relationship with our parents,” Sagaram said, but “it’s definitely not the only factor.”

If you have a strained relationship with people in your family and you want to blame your birth order, you can do that, but there are also ways to heal the relationship, she said.

“We can’t change birth order. It’s something that we were born into — to dwell on something like that can cause more harm,” Sagaram said.

Regardless of your birth order, it’s possible to have good and healthy relationships with your parents and your siblings, she said.

If you’re struggling, therapy is a tool for healing

“I would definitely say if [you] are an oldest sibling and [you’re] experiencing some of those things — being a perfectionist, imposter syndrome, feeling immense amounts of pressure to perform ... going to therapy is helpful,” Clark said.

Therapy can help you deal with unhealed trauma, connect your behaviours to things in your childhood and uncover patterns in your life that need to change, she said.

If you come from a family with broken bonds and toxic relationships, family therapy is an extra tool that can help improve your relationships with your loved ones, Clark added.

If you need support, you can find mental health professionals through the American Psychiatric Association’s search tool, on Psychology Today’s database or through resources like Inclusive Therapists and Therapy for Black Girls.

Help and support:

  • Mind, open Monday to Friday, 9am-6pm on 0300 123 3393.
  • Samaritans offers a listening service which is open 24 hours a day, on 116 123 (UK and ROI - this number is FREE to call and will not appear on your phone bill).
  • CALM (the Campaign Against Living Miserably) offer a helpline open 5pm-midnight, 365 days a year, on 0800 58 58 58, and a webchat service.
  • The Mix is a free support service for people under 25. Call 0808 808 4994 or email help@themix.org.uk
  • Rethink Mental Illness offers practical help through its advice line which can be reached on 0808 801 0525 (Monday to Friday 10am-4pm). More info can be found on rethink.org.