This thought about having a single child is in my mind for a long time.

One young man was brought to me for consultation. He had a lack of concentration in studies, confused about his choice of subject, had many arrears. He couldn’t be assertive and had very little social life. He was obsessive and had a body image issue also. While in consultation mother cried a lot. Said, Sir, Help my son. He is my only son, and He was born after long years of marriage. We petted him much. We always want him to have the best, educate him in the best school.

The boy said, “They did all the best they could do, but they failed to understand my interest”. The mother then said all we want him to be an engineer. So, we join an engineering college. But he said he was not interested. Only on their pressure, he joined hesitantly. The parents kept crying, which made the boy also to weep. 

Another teenager girl was brought for consultation. She was very inflexible, demanding, always hooked to mobile, highly disrespectful to parents, elders and teachers, talks to her boyfriend even at night, doesn’t do any help to mother. The parents got lots of complaints from the college that her behaviour in class is not good. She formed a group and spent a lot for them.

The parents were highly distraught about her behaviour. They worried that she is their only precious child. They agreed that they were too lenient on her, never conditioned her so far. 

One other young man was brought to us. He refused to be interviewed and claimed that parents had dodged him to bring to a psychiatrist. The parents’ even before starting the session, cried and fell on my feet and pleaded to save their son. 

One week back, he was taken to police custody to interrogate about substance abuse & illegal selling. With their influence, he was freed without any legal formalities. They reported his behaviour typical of an antisocial personality, drug dependence, cannabis and occasionally abused Pentazocine injection. According to them till his school days, he was very obedient, submissive & fearing boy, got good mark & loyal name. 

Six months after he joined the engineering college. The college authorities called the parents & accused him of many misdeeds. Despite advising, begging overall efforts, he didn’t change. They lived with extreme anxiety, and only the police investigation led them to take him to a psychiatrist. 

The client denied to admit all the accusations and said he abused drugs only for a month. He blamed the parents squarely that they were too restrictive in school days, always wanted to be the best boy and forced me to do what they wished. I couldn’t continue anymore. 

After the consultation, the parents came to see alone and disclosed that he is their adopted son. Their marriage was a delayed one, and their infertility issue needs them to take adoption. Till now he didn’t know that. 

These are some of the clinical scenarios I frequently encounter. I have always been worried about the outcome of the clients & the state of parents. 

I have reviewed literature in journals and books about single child psychopathology and psychopathology of parents with a single child. Only for the first question, I got some answers. I am seriously thinking of undertaking a study.

Characteristics of parents:

Do you Know

-China has the highest rate of a single child.

-USA -20% of parents have an only child

-In India, 10% of parents have a single child.

To be a parent is the pride everyone likes to have. In recent periods, the rate of infertility has also gone up steeply. Even people’s marriage age also increases, which added to the infertility issue.  

I have seen parents, and mostly mothers show increased anxiety. In my experience, psychopathology is more among these parents. The chances increased more when the parent’s age is higher, and the apprehension is more if the sibling has died due to some medical problems or accident and suicide. 

The picture is still worse if the deceased sibling is an adult. Then their whole affection shifts to the alive child. Also, the psychological burden is more if the child is an adopted one. We also see more anxiety if the parent is single (mostly females), widowed or divorced or the child born due to assisted reproduction. 

Secondly, in psychology, we describe extended umbilical cord syndrome (difference from parent umbilical cord which is a medical condition). We all know that a child is the extension of one’s ego. Their whole purpose of life revolves around protecting their ego object (child). Many times the mother psychologically doesn’t desire to cut the umbilical cord, which is the norm to declare that the child is a separate life. This psychological binding doesn’t allow them to separate from the child physical & psychologically and are extremely possessive. This later lead to psychopathology in the child. 

The other common characteristics are, they tend to be perfectionist, disciplinarian. They are also guilt-prone. They never want to make any mistake with regards to their child. They like to give the best, expect the child to be super intelligent. He cannot fail in anything. They cannot tolerate that. For them, they have invested heavily on the child. The child is also obliged to reciprocate. They tend to protect him so much that they give less space for socialization. They also have a big question who after me?

Parents get breakdown if the child gets sick, have some medical morbidity or mental illness. Their whole ego is shattered. 

These characteristics are not from a conscious state but from the unconscious. They fail to understand their over-protection. The adult (child) will be thrown into a chaotic society without proper learning. They may go to bad habits, pick up mental illness. 

All these are not the characteristics of every parent. Some are very mature enough to understand reality and are conscious of their upbringing. 

Characteristics of the single child: 

Lots of research had been done over single child personality (one child syndrome)

Overall the following are the findings.

• They have high I.Q
• Their verbal skills are better because they have been read more often. 
• They show low social interaction, low self-concept, less sharing with peers, more selfish, highly sensitive, very private, bossy, slightly boring, they don’t like confrontation, and they need continuous attention, and they have high ambitions. 
• All these are not the prototype for every single child. Variation is the rule. 

Psychological issues faced by a single child:

Parents take the utmost care to bring their child to flourish in life. But certain features are unique to an only child. The below-given issues are both my personal experience and literature reviews.

As described previously, since the single child is highly protected and less socialized in early life, they develop social anxiety, difficult to mingle with peers though they like to. When they reach adolescents in a way to show their independence, they develop resistance behaviour to his parents & to be part of peers drift to substance abuse. 

To satisfy the parents’ expectation, they put much pressure on themselves to prove their worth, sometimes to for a breakdown if they fail. In a study at GSVM Medical College, Kanpur on students between 17-18 years who are single child to their parents. The study found that 35% of them face psychosocial problems and traits like aggression, loneliness and another 25% have features of depression.

Granville Stanly Hall, the first president of the American Psychological Association and First president of Clark University has stated that “being an only child is a disease in itself”.  But I don’t agree with him. We have seen many successful and inspiring personalities have been born single. 

What I have personally witnessed is that these people show excess performance anxiety, and they need to be motivated often. They also have apprehension about taking care of parents at old age. 

Other issues I have seen are when the child get married more so in males, Mother is too possessive of her child, wants to fulfil their obligation of marrying him to good lady, but at the same time has anxiety if the son doesn’t care them. There comes the ego clash between mother-in-law and daughter-in-law.

Their interpersonal issues are displaced to son. He is at a loss whom to support. I have seen quite a few divorces due to this very saddening conflict. 

When any medical problems, more so if the child gets a mental health issue like schizophrenia, the parents get devastated. Their only apprehension is “who after me?” which is very natural but unfortunately they get more protective and robbing of the remaining social skills of the child. 

Some tips to parents & child

To the parents

• – I know very well that all parents are very knowledgeable, loving & determined to bring up their child. This is just a supplement to put them in the right spirit.
• – Your child is precious to you but doesn’t overburden yourself to be responsible for all the future events. Destiny will take its own course. 
• – Don’t be critical of your partner for any unintentional errors of omission or commission. This may lead to interpersonal conflict, which may be a hurdle to the child’s growth. 
• – Allow your child for socialization to compensate for a sibling. 
• – Be brave. When he falls sick. He needs you. If you breakdown who will care him.
• – Don’t load the child with too much perfection, details, expectation. Allow him his space, freedom to evolve. Don’t encourage dependency. 
• – Only prayers will make him sail in his journey comfortably.
• – Allow him to learn from his mistakes, regret his faults, interact and guide him to mature & be independent. 
• – If you find any of his behaviour abnormal or excessive and needs attention, don’t hesitate to take him to a psychiatrist & psychologist. Early intervention is always better.

To the precious child:

• – Be happy that you are lucky to have your parents who will show all their attention only to you.
• – As you grow, have good peer companions. 
• – Don’t put too much burden on yourself that you must always be successful. You should lose sometimes. Your achievements are not so important at the cost of your happiness.
• – Enjoy in good relationship with all around you. You need friends. 
• – Engage in team games, recreation etc.
• – Do what brings joy to you without hurting others. Choose your own career.
• – Don’t get involved in bad company and get into addiction. 
• – Always stay positive & inspired.
• – At any point of time, if you feel lonely and sad talk to your friends & communicate with your parents & seek mental health ­­­­­­­­­­­­­­­­professionals, early intervention is very crucial.
• – If ever your parents get sick, don’t get panic.
• – Get your friends to help! GOD will guide you.
• – Connect to God. 

Happy Parenting

–Dr. K. Ramakrishnan

Chief Psychiatrist,

Managing Director,

Athma Hospitals