Parentification or parent–child role reversal is the process of role reversal whereby a child or adolescent is obliged to act as parent to their own parent or sibling. Two distinct types of parentification have been identified technically: instrumental parentification and emotional parentification. Instrumental parentification involves the child completing physical tasks for the family, such as looking after a sick relative, paying bills, or providing assistance to younger siblings that would normally be provided by a parent. Emotional parentification occurs when a child or adolescent must take on the role of a confidante or mediator for (or between) parents or family members. Background Melitta Schmideberg noted in 1948 how emotional deprivation could lead parents to treat their children (unconsciously) as substitute parent figures. Minuchin et al. introduced the term parentification in 1967. Boszormenyi-Nagy et al. defined it in 1973 as "a parental figure's expectation that a child fulfill the role of a parent within the family subsystem." "Spousification" and "parental child" (Minuchin) offered alternative concepts exploring the same phenomenon, while the theme of intergenerational continuity in such violations of personal boundaries was further examined. Eric Berne touched on the dangers of parents and children having a symmetrical, rather than asymmetrical relationship, as when an absent spouse is replaced by the eldest child; and Virginia Satir wrote of "the role-function discrepancy...where the son gets into a head-of-the-family role, commonly that of the father". Object relations theory highlighted how the child's false self is called into being when it is forced prematurely to take excessive care of the parental object; and John Bowlby looked at what he called "compulsive caregiving" among the anxiously attached, as a result of a parent inverting the normal relationship and pressuring the child to be an attachment figure for them. All such aspects of disturbed and inverted parenting patterns have been drawn under the umbrella of the wider phenomenon of parentification – with the result (critics suggest) that on occasion "ironically the concept of parentification has...been as over-burdened as the child it often describes". Choice of child Elder children, often firstborns, are chosen for the familial parental role. Often, a younger sibling then takes on the firstborn role. Gender considerations mean that sometimes the eldest boy or eldest girl is selected, even if they are not the oldest child overall, for such reasons as the preference to match the sex of the missing parent. Girls, especially those who