Dearest Sister,

I had seen this patient for therapy for about 3 years. We stopped after she moved out of the province. She recently wrote me a letter updating me on her life, and gave me consent to publish a part of the letter here. In this excerpt, she reflects on a relationship that we had talked about at length in her therapy with me. I have changed some details to protect her confidentiality.

"Dear Dr. Chan,

...It has dawned on me that my sister's conclusion that she is a bad parent is a reflection of when she had to take care of me emotionally during a time in our lives and that she must believe she did not do a good job. I say she did not do a good job NOT because it is true, but because I now realize that I made her feel that way. I was always commenting on how absent she was and how unreliable she was. I saw myself for the longest time as being in her shadow and that she possessed the self-esteem and self-worth I did not. I realize that I wanted to take these from her. She really tried to be there for me. She really did. This dynamic took root when we were living together with our family before university. Sure, I remember completing her homework for her and making her lunches. When we lived together once more in graduate school, I was doing the lion's share of cleaning, grocery shopping and cooking. For most of my life I saw myself as the nurturer and her as the incompetent and useless sister.

But the trade-off that I could not see until I entered therapy was that she shouldered much of my emotional difficulties when no one else would. I remember her reassuring me when I confided in her that I felt totally ignored and friendless in high school. She would tell me how she had even fewer friends and how she did not like anybody, to make me feel better. She would remind me that I had many things of value and that I needed to accept and love all of myself. She taught me that flaws and strengths create a whole person, that we are more than just some traits picked from a menu. You take away a flaw, and the strengths are jeopardized. She said this when she was only 14. I always felt ugly and I believe consciously or unconsciously she gave up on her appearances too, never wearing make-up or nice clothes, so I wouldn't feel worse about myself. I remember crying to her and her listening to me patiently. There was only a 15 month age difference and yet there she was, my first therapist.

When we got older, the mutually rewarding relationship we had formed in high school grew as hormonal and labile as we did. I took on more in terms of her functional needs, and I expected her to take on more of my emotional needs, to fix me. I reflect now and see how difficult I must have been to live and deal with: never happy with what she could provide me, angry and resentful that I felt she got all the good things in life (looks, talents, smarts, friends, attention). I had enough anger and hurt to sink us both. And I did. Those years in graduate school are some of the worst for our relationship in our entire lives. I think to save herself, my sister threw herself more into her work, something that actually rewarded her proportionately for the effort she put in. She hung out with me less, she found a boyfriend. I saw her success and I could not be happy for her. All the while, we would tell one another we were best friends and that we would always be there for one another.

She now worries that she can not be a good mother, that she does not have what it takes and I admit my instinct is to get annoyed. I can hear my primitive self saying, "jeez, you have the more respectable job, the more expensive house, better pay, just get over yourself!" This is what a younger version of me would have acted out passive-aggressively in my attempts to support and maintain a relationship with my sister. Predictably, these interactions would never feel good for either us, but would somehow still confirm that we were still best of friends.

I am no longer that person and I can't help but wonder where my sister's doubt in herself comes. When was my sister first in the caretaker role? Suddenly, I appear. But a version of me that is seething, angry and insatiable. A version of me that was always hurting, always hurting her, always making her feel guilty for no reason she was actually responsible for. How confusing it must have been for her. How burdensome and impossible.

I sent her this letter, because I want her to know what a great job she did and what a great sister she was and is. I want her to know that she was tasked with something too big for her to handle, that though it was not her job, should not have been, she still took it on and tried to save me. She loved me the best she could and I know that now. I want her to know that I see it and I am so grateful.

I sent you this letter Dr. Chan, because I wanted you to know I appreciate how blinding pain, anger, and hurt can be, and their impacts on those closest to us. I am sure this played out in the relationship I was building with you.

My sister and I have been able to forge a new kind of relationship now. We are both adults, both married and both starting families of our own. I want her to know that because of how she looked after me when I needed it most, that she is going to be a gosh darn amazing parent and unlike me, her children will appreciate it and flourish.

I love my sister very much. I can now say without a doubt that we are the best of friends. I have therapy to thank for that."