"There was a time when people didn't believe that children mourn," says Chicago psychotherapist Jerry Rothman. "And until recently many psychologists tended to downplay the importance of siblings to one another." Unfortunately, Rothman knew better. When he was 11, his older brother Joseph died from an accidental gunshot wound while practicing target shooting, and it took Rothman more than 25years to come to terms with the loss. Later, years of work with emotionally disturbed children convinced him that his problem was hardly unique. "Twenty to 25percent of the kids I saw had experienced the death of a brother or sister, "says Rothman, "and I began to notice that the loss was an unrecognized cause of many of the problems they had." In July 1985 Rothman and lawyer Tom Cole, who had also lost a brother in childhood, established the Rothman-Cole Center for Sibling Loss, in Chicago. The center, which provides individual and family counseling, is believed to be the only one in the country to focus solely on the issue of sibling bereavement. Rothman, 47, discussed his work with correspondent Civia Tamarkin.

How did your brother's death affect your behavior as a child?

When Joseph died I was in 6th grade and I had a terrible time in school. I got into trouble and did outrageous things to get attention, because from the time he died I felt pretty much neglected by my parents. Everyone idealized my brother and made me feel I had to follow in his footsteps, so I went to the opposite extreme. Somehow I felt I couldn't show my grief. Part of it was the feeling that it would make my parents more upset if I was sad, so I replaced the sadness with acting out. I had a lot of fear and a lot of anger—anger at my brother for dying, anger at my parents for allowing it.

What were some of the lingering effects of your brother's death?

I had this distorted notion that I would die at 18 just like my brother did. So my birthdays became a difficult time. I couldn't enjoy accepting gifts and I couldn't have fun. Also, every year around Christmas, I would become depressed and angry. I didn't know why. Now I realize I was having an anniversary reaction because my brother was shot just before Christmas.

Were your responses typical of the way most children react to sibling loss?

Children respond to the death of a sibling with a wide range of feelings, from anger to grief to frustration. They feel vulnerable and unsafe, and there is often survivor's guilt, as in war. How come this happened to my brother or sister and not to me? In cases where sibling rivalry was intense, survivors often carry the irrational guilt of feeling that they somehow caused the death by wanting to get a sibling out of the picture so they could get more attention from their parents.

Do children have a more difficult time coping with the death of a sibling than with the death of a parent?

People don't always view a sibling loss as being as significant to a child as the loss of a parent. So they tend to be far less comforting. Kids will often say, "I got left out. Everybody came and comforted my parents, but nobody came and said anything to me." With sibling loss, there is often less opportunity for children to talk about their grief, to work through it and express their feelings. For most kids, the loss of a sibling becomes a double loss. They also lose their parents, who get involved in their own grief and withdraw.

What happens next with the surviving children?

After the death of a child, there is a tendency for parents to become over-protective and rein in the surviving kids, allowing them to take fewer risks. So the surviving child not only has to deal with his own trauma but with the constraints the parents then put on his growth. This overprotectiveness can even interfere with the child's future relationships. One of the few studies done recently has shown that children who have lost a sibling are less likely to marry when they grow up, and if they do marry they are less likely to have children. They are so terrified by the pain of loss they suffered that they don't want to run the risk of it happening again.

What other pressures does a surviving child face?

The loss of a sibling creates a huge change in a child's environment, and that is often compounded by divorce. The chances of marital breakup are high after the death of a child. In other cases, parents may try to replace the dead child by having another and will dote on the new baby more than the surviving sibling. Often, parents try to push the surviving sibling into the role of the dead child. When that happens, a child may either rebel or distort his own personality to accommodate his parents. No child can live up to the idealized memory of his dead brother or sister.

What can parents do to help ease the grief for their surviving children?

One of the best things they can do is express their own emotions, so their kids see that it's okay to express feelings. They should also make sure that surviving children get enough attention from relatives and family friends. Children express pain and loss differently than adults do. A child might cry for two or three minutes and then be done and go to play. Unlike adults, who sustain an emotion, children mourn in piecemeal fashion and will return to their grief later on. Adults should not minimize a child's sense of loss just because he doesn't continue showing his sadness. Nor should parents and teachers have rigid ideas about grief and how long it should last. I know of an instance where a teacher told a child, "Your brother died six weeks ago, you should be over that by now." Because of his desire to please the teacher, the kid tried to suppress his feelings, which later erupted into explosive behavior, like fighting with his classmates.

Are some kinds of death more difficult to cope with than others?

The unexpectedness of a death adds to the trauma. So does a violent death, and a suicide compounds it even more. Family members of suicides have been shown to have a higher suicide risk themselves. Some experts speculate that guilt feelings may play a strong role in this. Murders are also very difficult for people to cope with, and the inefficiency of the justice system often makes the situation worse. Parents may become obsessed with court proceedings and retribution, and parents on a crusade have less time physically and emotionally for their surviving children.

In general, what are the chances of a surviving sibling growing up without any problems?

Poor. Most have no psychological services to help them, and the public has never been aware that this is a devastating event. Most surviving siblings repress their feeling of loss, but it is there to be reawakened when they are placed under stress. These children repress a lot of memories rather than processing them and growing from them. Survivors may become highly neurotic, and some may move into delinquency. Without help they have difficulty becoming healthy functioning people.

At what age are children most vulnerable to the loss of a sibling?

Children under 10 have fewer intellectual and emotional tools to help them understand what happened. However, the loss can be just as traumatic for teenagers, depending on how they are managing their adolescence and how much support they get from their families.

Why are people only now starting to focus attention on sibling loss?

The problem is more pervasive today because of the epidemic rise in child and adolescent deaths due to drugs, murder and suicide. Also, more studies are stressing the importance of sibling relationships. After the death of a sibling, people will say, "I feel as if I lost part of me." It isn't just our parents who shape our identity. New research shows that siblings shape each other's personalities. So the death of a sibling can prevent the surviving child from growing intellectually, emotionally and socially.