“Aren’t You Better Yet?” – A Mother and Daughter’s Journey through Cancer, Coping, and Communication
June 7th, 2010
By Norma Lee M.A., M.D., Cancer Topic Expert Contributor
Click here to contact Norma and/or see her GoodTherapy.org Profile
Christa, 35, initially presented to therapy because she wanted a place where her ten year old daughter, Nina, could share her feelings about Christa’s breast cancer.
Christa’s prognosis was good, but she was having a number of residual side effects from her chemotherapy, i.e., debilitating fatigue, achiness and difficulty getting moving in the morning. Christa felt Nina wasn’t very supportive of her and what she was going through. Christa was also concerned for Nina because she and Nina’s father were divorced, and he wasn’t very involved in Nina’s life.
Nina was a precocious girl who loved to draw. The therapist always had art supplies available to Nina during sessions, and, at the first session, asked Nina to draw a picture of her family. The therapist gave no other instructions. Often a child asks who should be in the picture, and the therapist replies it should be whomever the child thinks of when they think of their family. Nina drew a happy scene, placing herself very close to her mother, with her grandparents nearby. Of note, Nina’s father was not in the picture. Thus, without words, Christa’s concern about Nina’s relationship with her father was validated.
Nina expressed that she thought Christa should be “all better now,” since the cancer was removed and chemotherapy was over. Given Nina’s developmental stage, this was not surprising. She was nearing the age where she would begin to have more ability for abstract thinking, but she wasn’t there yet. Also, Nina missed the time she and Christa used to spend together before Christa got sick. Previously, they were very active outdoors, going camping and playing softball together.
The therapist had Nina draw pictures of her life and herself before and after Christa got cancer. The before pictures were very colorful, with butterflies and sunshine and a cheerful Nina. The after pictures were in black, the sun behind a cloud, with dead flowers and a much smaller Nina with a grim expression.
The therapist alternated sessions so that sometimes she met alone with Nina or Christa, and sometimes saw them together. Christa had limited support from family and friends, so her solo sessions gave her an opportunity to express her sadness, grief, feelings of being overwhelmed, concern for Nina, and sense of loss of control over her life. These feelings are very common for people dealing with cancer. Not only does cancer rob the patient of control, but also everyone else in the family.
Wherever a client or family member can gain a sense of control, no matter how small, it is crucial for them to seize it; it helps to preserve a modicum of order in the chaos that cancer brings.
Christa was taught about the developmental stage Nina was in, and how important it was for Christa to let Nina be a child, and not Christa’s main support person. (Nina had previously shared that hearing about the details of their financial difficulties was really stressful for her, and that she was tired of hearing Christa talk about not feeling well.) Christa had no idea that Nina was feeling this way. She and Nina came up with a code word that Nina could use whenever she needed to let Christa know she didn’t want to hear about Christa’s illness anymore.
As a pre-adolescent and the child of a cancer patient, Nina needed to be able to have more control over her life in a reasonable way. Nina’s biggest complaint was having to clean her room daily. Christa shared that a messy room made her anxious. Nina and Christa were able to come to a compromise in which Nina cleaned her room twice a week and chose which days to do it.
As a result of these interventions, the bickering between Christa and Nina decreased significantly. Christa continues to educate herself regarding the developmental needs of pre-adolescents, and Nina is able to set parameters around how much Christa’s illness experience is a part of her life.
©Copyright 2010 by Norma Lee, MA, MD, therapist in Bellevue, WA. All Rights Reserved.
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Comments
How terrible for this ten year old to have to be going through this and watching her mother suffer and on top of that trying to be a support system for her.
Sometimes I think we are all guilty of putting way too much responsibility in the hands of a child who is just not ready for that- who did not ask for that and who really does not have the ability to handle all that goes along with it.
It is great to make your child a part of everything that is going on and to keep her informed about things but to make her that major source of support is simply too difficult for her to have to bear. Looks like great solutions are ahead for this family.
It must have been very difficult for both the mother and daughter here because they are having their own sets of problems and they are not able to even enjoy the company of one another to tide over those problems.It may well be resolved with individual as well as a group therapy for them as illustrated above,therapy has worked and hope people can learn something from this…both parents and kids.
Cancer is a tough thing for any adult to face much less a kid. There are so many unknowns and children, like most of us, like certainity, not the unknowns that cancer so often brings. It is wonderful that this mother daughter team is trying so hard to work out their issues- think of how strong and powerful that relationship will be for the both of them when this mom overcomes her illness and they can get back to living a normal life together!
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