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“Ellen” is six years old. Her mother has stage four breast cancer, which she has been living with for a couple of years. However, her health is starting to decline. She is starting to have a lot of bone pain, and feeling quite fatigued. Recently, she has had episodes of confusion, due to the metastases in her brain. Ellen knows something is wrong with mommy, but when she asks her parents, they tell her everything is fine and that mommy will be all better soon. They don’t want Ellen to worry. They believe that by not talking about her mother’s illness, Ellen won’t think about it. When Ellen says she is sad because mommy doesn’t play with her as much as she used to and she stays in bed a lot, her parents tell her she should be happy because mommy doesn’t have to be at work anymore. They think they are protecting Ellen from the fact that her mother is dying, and that that is the best thing to do for a child.
Are Ellen’s parents well intentioned? Yes. Do they have Ellen’s best interests at heart? Yes. Are they going about things the right way? No. Ellen’s parents are telling her things that are the opposite of what she is seeing and feeling. This is very confusing to a child. Children are in the process of learning the language of feelings and identifying how they feel about something isn’t always easy. In fact, many adults still struggle with identifying feelings. So, to have a child share a feeling (in this case, sadness) and have a parent negate it tells the child they should ignore how they feel inside and let someone else tell them how to feel. How then do they learn to identify what they’re feeling when their strongest role models are in effect telling them they’re doing it wrong?
Additionally, Ellen’s parents are telling her things that contradict what she is seeing. If mommy is spending increasing amounts of time in bed, she is not getting better. Seeing a parent (who is all-knowing to a child this age) experiencing confusion can be extremely upsetting. If parents do not share the truth about what is going on, the child will concoct stories in their minds that may be even more upsetting to them than the truth, i.e., “I’m afraid to go to bed because if I do I will get sick like mommy.”
What should parents do? Like any discussion on a serious topic (sex education, drugs and alcohol, etc.), parents should have a series of conversations that are brief and age appropriate. Start by asking if the child has any questions about what is going on. Ideally, in this situation, Ellen would have started getting information when her mom was first diagnosed (i.e., “Mommy has cancer in her breast. The doctors are going to take it out. You can’t catch it from her like a cold. She will need to take some medicine so it won’t come back.”), with updates along the way as needed (“The medicine mommy is going to take is going to make her hair fall out, but it will grow back.”). It is important to use the word cancer to distinguish it from any other type of illness.
It is extremely important that when a child asks parents about their health that parents answer honestly, even if the answer is not good news. In Ellen’s case, knowing that her mother’s health is declining provides her the opportunity to make the most of what’s left of the time the two of them have together. Not only that, it allows Ellen to have the opportunity to share her feelings about what is happening.
Children can only handle intense feelings for brief periods of time, so it is not unusual for them to be very sad and then playing as though nothing is wrong a few minutes later. This does not mean they have forgotten what is going on or don’t care; it’s just that they don’t yet have the emotional capacity to linger in feelings of grief or sadness like we do.
In closing, while we as adults may think we are doing our children favors by “protecting” them from emotionally wrought situations such as a parent’s cancer and/or terminal illness, in fact we are not. On an intuitive level, they know something is not right. If we tell them they are incorrect, we create a very confusing situation for them, but, even more importantly, we rob them of the ability to talk about their feelings and deepen their connection to their ill parent and the rest of their family.
© Copyright 2011 by Norma Lee, MA, MD, LMFT, therapist in Bellevue, Washington. All Rights Reserved. Permission to publish granted to GoodTherapy.org.
The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.
