Disagreement Over a Diagnosis (When Parents React Differently to the Diagnosis)

A diagnostic disagreement refers to a situation in which two parents react differently to the same diagnosis for their child and process it at different paces. One parent immediately begins searching for treatments, appointments, and literature. The other doubts the diagnosis or brushes it aside. Both have the child’s best interests at heart. Nevertheless, two camps emerge under one roof.

From a professional standpoint, this type of family strain is classified in the ICD-10 under Z63, the codes for problems within the immediate family and in intimate relationships. The child’s diagnosis itself is not in question. The issue is who accepts it as real and when, and what should follow from that. This phase can last a few weeks or drag on for months.

After receiving a diagnosis, many parents go through something similar to the grieving process. It often begins with shock and disbelief—more on this under “Diagnosis Shock.” For some, this is followed by anger, bargaining, or withdrawal. The pace is different for everyone.

A mother who cares for the child during the day often notices symptoms earlier and comes to terms with the diagnosis more quickly. A father who spends less time with the child in daily life often takes longer to process the news. Specialized agencies report that fathers suffer just as much from their child’s illness, but find it harder to express their concerns outwardly. Their own life experiences also play a role. Someone who was diagnosed as a child reacts differently than someone for whom the issue is new.

At first, denial acts as a defense against feeling overwhelmed. It rarely means that the parent is indifferent to the child.

When one parent takes action and the other holds them back, accusations arise. The proactive parent feels left alone to deal with paperwork, doctor’s appointments, and worries. The hesitant parent feels pressured and overwhelmed. Both are exhausted, yet they speak different languages when it comes to the same child.

Reports on the situation of families with chronically ill children describe how conflicts between parents and difficulties adapting can increase over time. A large proportion of these couples experience severe emotional stress at times. On top of that comes the daily grind. Those who lie awake at night and function during the day have little energy left for a calm conversation—hence the exhaustion.

The quality of the couple’s relationship declines. Intimacy, shared breaks, and tenderness are the first things to fall by the wayside. Some couples end up in an exhausted partnership where each partner merely goes through the motions. Children sense the tension between their parents early on and sometimes respond with symptoms of their own.

There’s no denying that they move at different paces. It helps to separate the argument about the right approach from what’s best for the child.

• Separate the issue from the timeline. Give the slower-paced parent room to catch up, but don’t postpone necessary appointments for the child.
• Divide up tasks instead of trying to convince each other. One parent handles doctor’s appointments, the other takes care of school or siblings. Specific responsibilities reduce the pressure to constantly agree.
• Set aside time for discussion. Twenty quiet minutes a week without the child, without cell phones—stick to one topic and let each other finish speaking.
• Attend appointments together. When both parents are present at the same consultation at the doctor’s office, both hear the same facts. This prevents one parent from being the sole messenger.

Outwardly, it’s important to speak with one calm, unified voice. Before you talk to your child about the diagnosis, agree among yourselves on what will be said—see “Communicating the Diagnosis to Your Child.” A child who sees their parents at odds is more likely to get caught in the middle.

Parenting and family counseling centers run by Caritas, Diakonie, and local agencies offer free and confidential counseling, including for conflicts between parents. These centers are staffed by psychologists and social workers. Through the Federal Conference for Parenting Counseling, you can find a center near you as well as anonymous online counseling.

If the conflict has firmly taken hold of the couple’s relationship, couples therapy can provide a safe space to resume communication. For your day-to-day life as parents, Rückenwind offers coaching to guide you through this phase so that you can continue to function effectively as a team.

Only a child and adolescent psychiatry (KJP) practice or a medical or psychotherapeutic specialist can assess a child’s condition and make a diagnosis.