Q. As a result of being born with PHACES syndrome, my 2-year-old daughter has had numerous facial and eye operations. Because of all the stress, she is very attached to me. Her brothers are 18, 16, 13 and 9. Some days she will choose one of them to be close to, her usual favorite being the oldest.

Other days she won't want affection from any of them. She seems to have a particular dislike for the 16-year-old. He tries desperately to get her to give him a hug or let him read to or play with her, but she'll have nothing to do with him. She also has a strong dislike for her father. On the other hand, she is very secure in going to any nursery or Sunday school program run by ladies and likes to play with little girls. I think all this is related to the early stress brought on by her medical condition, but I'm at a loss as to how to get her to begin showing love toward her brother and her father.

A. The fact that your daughter is selective about which members of the family she chooses to reject says that this issue is not directly related to the medical issues of her infancy. Besides, I've heard of "selective rejection syndrome" developing in young children who've had no early health problems. The more likely explanation has to do with the huge amount of attention she received and is obviously still receiving from family members. Under the circumstances, even a very young child quickly learns how to sustain a cyclone of concern and anxiety swirling around her.

By no means am I suggesting that your daughter is manipulating the family. She's much too young to be thinking this through. I suspect this issue came about by accident and was simply one of many that could have developed otherwise. One day, she may have become upset when her father or brother tried to pick her up and cuddle with her. Everyone present reacted with great concern, and the proverbial dominoes began falling. From there, the more selective she became about whom she accepted affection from, the more concern and attention she received, and the more selective she became. And so on.

At this point, the well-intentioned effort family members are making to get her to stop rejecting the affections of her father and middle brother are only feeding the problem. The good news is that this issue has not had time to embed itself so deeply in the family dynamic that it can't be exorcised fairly easily.

The solution is for your husband and the 16-year-old to stop making any and all affectionate overtures toward her. That should cause your daughter to begin wanting attention from them, which they should be very conservative about giving, especially at first. In the meantime, I strongly recommend that everyone begin treating her as if she's simply another child instead of a special case who needs to be handled with kid gloves. If you don't, then her early medical issues will pale in comparison to the tyrant she is capable of developing into.

Family psychologist John Rosemond answers parents' questions on his Web site, www.rosemond.com.