Ask Dr. Gramma Karen: Aunt Has Issues with Her Niece


I live in a multi-generational home with my mother, her husband, and my sister and her two daughters, ages two and nine. The problem I need help with is in regards to my nine-year-old niece, Emmy.

Some background: My sister is 38 and I am 36. She is a good provider and we do get along for the most part. I do not agree with her parenting style but I keep my thoughts and opinions to myself. When I choose to voice my suggestions, no matter the approach, it always ends in an argument.

Ever since Emmy was about 2 years old, she picked every little scratch and bug bite until it became infected. When we asked her to tell us why she did this, she said she didn’t know why, but she couldn’t help it. We all wonder if this is the beginning stage of depression.

I suggested that my sister take Emmy to see a therapist. It wasn’t until her 8th birthday that she began her sessions. In the past six months she has stopped 90% of her picking. Therapy seems to be going well according to my sister and Emmy.

I’ve noticed that Emmy is extremely lazy when it comes to doing chores and homework and completing simple hygiene tasks, such as taking a shower. Her room is always a mess, even after my mom spent time and money decorating it. Emmy makes little effort at all to try and complete any task or assignment given to her.

So, I guess my question is what should I do as an aunt who is very much involved in my niece’s life? For that reason, I want to figure out the best way possible to get her moving in the right direction and be responsible for her actions and to be accountable when she does not complete tasks without manipulating authority in the household.

I think I can be most helpful by focusing on two main areas in the situation your present: (1) Emmy’s circumstances; (2) your role in your family.

Emmy’s Situation

To help better understand Emmy’s issues, I consulted with Tammy Fletcher, Ph.D., a marriage and family therapist with a special interest in working with body focused repetitive behaviors. Dr. Fletcher offers her insights: “Emmy may or may not have dermatillomania, also known as excoriation or chronic skin picking. It’s important to know that even though she began picking at her skin at age two, this could be due to any number of reasons, including skin allergies or other systemic problems.”

To learn more about dermatillomania, I refer you to two videos Dr. Fletcher has produced that provide detailed information on its possible causes, diagnosis, physical and emotional implications, and treatments.  You can find these videos here and here.

You mention that you and other family members wonder if Emmy perhaps suffers from depression. Dr. Fletcher comments: “As for possible depression, beginning at age two  – this is an area of some controversy. Some developmental psychologists believe that children that young do not have the emotional or cognitive development to be diagnosed with depression. Others argue that new research with children shows brain activity similar to adults with depression.”

In support of this last point, the American Academy of Child and Adolescent Psychiatry (AACAP) estimates that “1 out of 10 children have difficulty escaping the symptoms of depression for long periods of time. The rate of depression is markedly lower (1%) in children ages 1 to 6 years old. The rate is higher in older children ages 9 to 12 years (12%), with as many as one in 20 children and adolescents is depressed.”

So yes, it is possible that your niece suffers from two disorders – dermatillomania and depression – that may or may not be interrelated. Only trained medical-psychiatric specialists can answer questions definitively about any possible disorders Emmy is dealing with.

Your Role in the Family

I want to offer some comments and suggestions regarding your family and your role. Because you are part of a multi-generational family comprising four adults and two children, dynamics regarding the parenting and disciplining of your two nieces will inevitably get confusing for everyone if roles are not explicitly defined. Although you try not to step on your sister’s toes about her parenting, you also say that when you do offer your parenting advice, it always ends up in an argument. Your suggestions probably sound like criticism, hence, your sister’s anger towards you. In addition, you may be creating confusion for your nieces about who is in charge.

Your sister, as their mother, is their primary parent who decides what she wants in terms of parenting practices. Your role as an aunt, and the role of the grandparents, is to support and carry out your sister’s parenting preferences. It is not your role not to question them and/or impose your own parenting practices.

I suggest that you are a family that could perhaps benefit from working with a family therapist who can provide you some psycho-education on Emmy’s disorders and challenges, as well as facilitate important discussions on what each of you in your designated roles (e.g., aunt, mother, grandparent) should and should not be doing when it comes to parenting and disciplining your sister’s two girls. Emmy’s current therapist might be a good resource to pursue this suggestion.

Therefore, in answer to your question about what you might do as a concerned aunt who is very much involved in your nieces’ lives, I offer these specific suggestions:

  • Try to view Emmy not as obstinate, lazy, and spoiled, but rather as a young girl who may be dealing with some disorders. (It is encouraging that you report Emmy is getting professional help that seems to be benefiting her.)
  • Acknowledge to your sister that going forward you want to support her parenting practices and not presume to know what is best for her girls, as you have perhaps done in the past.
  • Assure your sister that in the future you are not going to offer unsolicited parenting advice. Let her know that she can ask for your advice and opinions at any time.
  • Ask your sister to help you understand specific things you can say and do to be supportive of her.
  • Ask your sister for her ideas on what you might do as a family to better understand Emmy’s specific challenges and how each of you can help her deal with them as effectively as possible.

I know I am suggesting some major changes in your attitudes and behavior, but the outcomes could be significant. First, your relationship with your sister may become more comfortable with both of you clear on your roles and working together for what is best for both your nieces, especially for Emmy right now.

You may find over time that your sister is more comfortable asking for your parenting advice when she views you as a helpmate, and not as someone who is perhaps judging her as a parent. It will be clear to both you and your sister that you will always be there for her, helping and supporting by carrying through with her parenting wishes and decisions.

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