I really debated about whether or not to write this for some time, but what I came down to is this: the area of family is a very raw topic amongst the chronically ill community, and sometimes, it becomes more of a thorn to the chronically ill than the illness itself.  It came to the point where I just couldn’t ignore the area of hurt with family dysfunction and chronic illness if my main audience is comprised of people with ongoing medical conditions.  Almost every time my husband, Michael or I visit a Facebook group devoted to the chronically ill, we will see another member announcing family issues: “they disowned me,”  “spread slander about me,” “they tell me it’s ‘all in my head’ or that I’m just too lazy.”


Why is this though? Why is it that our family who is supposed to celebrate with us in joyous moments and lean in with us in the trying times becomes instead, our greatest antagonist? 


Many times, this issue of family dysfunction and chronic illness all comes down to this: who you were in the family before you became chronically ill. Dysfunctional families have a pattern they play out, molding each member into specific roles as an unhealthy means to cope with family dysfunction. I’ll share some of the main roles. Keep in mind that someone may be a blend of more than one role and it’s also worth noting that family roles can shift if an adult child moves out from the home. 

Many times, this issue of family dysfunction and chronic illness all comes down to this: who you were in the family before you became chronically ill. Click to Tweet


Family Dysfunction and Chronic Illness, the Family Roles:

Hero Child/ Star Child: This child is needed in the family to save the family image and it is this child that the parent/parents can proudly tout, “See, look I’m a good parent because my child here is successful.” Sometimes the child truly has been successful through this molding as a means of self-fulfilled prophecy. When this to Shall Pass Never Comes (19)They’re expected to do well, so they, in turn, succeed. Other times, they’re a perceived shining star. Meaning, they have been given such high praise over the years that they are allowed to squeak by without producing much in the form of tangible success. It’s important to remember on the note of success that this can mean different things to different families and this can be reflected in what the star/hero child aims at to become successful.  When it comes to family dysfunction and chronic illness, the hero/star child will sometimes feel so much pressure in life to excel that they develop health disorders spurred on by stress. 


Scapegoat: This is the child who is said to have all the problems. In family counseling, this is the child that the dysfunctional parent/parents will focus on with the counselor saying it’s their fault that the family is having so many issues or, the parent/parents won’t even bother to take the other family members to counseling. Why would they if Mark is the kid with all the issues? Why is this child called a scapegoat? Well, if a dysfunctional family needs to have a child to raise up on a pedestal to be the model reflecting the good of the family, they also need a sacrifice. They need someone to take all of the blame for why they are so dysfunctional.


Unlike the star or hero child who will not disclose the family’s secret dysfunction, the scapegoat will tell the truth about the family. This leads the parents to say that the scapegoat child is the liar or just plain “crazy,” when in truth, they’re at times the sanest person in the family because they are not in denial of reality. The scapegoat child also typically does not achieve success in school because they know neglecting their school work will give them attention, even though they know it will be in the form of negative attention. The scapegoat may come in two different forms: a fragile sickly child or a headstrong defiant child.


The Lost Child: While the star/hero child garners attention in both positive and negative ways, the lost child is cast to the side, living in their own private world. This child pulls away from family interaction and recedes into themselves. The lost child oftentimes has poor social skills and communication in general which consequently leads to impairment in long-term relationships. The way the lost child deals with family dysfunction is evident: they run away from reality and their own emotions, oftentimes even claiming they don’t “feel anything.” 


The Mascot:  The mascot’s main duty to salve the pains of dysfunction is through his or her humor. Life in a dysfunctional family is downright painful, so the mascot steps in to entertain the family members through infusing humor into the day. The mascot may even use humor as a way of coping for him/herself with dysfunction by lightheartedly telling jokes conveying the stark reality of their life behind closed doors. As far as relationships are concerned, the mascot has a difficult time forming mutual give-and-take relationships and will instead, opt for relationships that will put him/her on the end of rescuing their friends most likely because they felt they had to rescue their family throughout childhood. Like the scapegoat, the mascot does not typically excel in school. Instead, they default to playing out the mascot as the class clown in school.


If you had a dysfunctional family and chronic illness, do you recognize yourself in any of these roles? What about your siblings? How do you feel like this plays into your life with chronic illness and having a relationship with your family? We’ll explore here soon the uniqueness of each role and what can possibly happen to each if a chronic health issue occurred. 




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