A cancer diagnosis comes with many challenging conversations, but one of the most challenging, is having to explain to your child that their sibling/parent/grandparent/friend/significant other has cancer or indeed having to explain to your child that they have cancer.
In this guest blog, Louise Hall from Voyage of Hope Therapy Services provides guidance on supporting a child as they, or a loved one, receives a cancer diagnosis.
As a Play Therapist, and as a woman, I regularly have conversations that most people would shy away from.It’s a little bit of a passion of mine, to address the elephant in the room, but playfully, carefully and sensitively.
Today I’m going to share some ideas that may help if you’re needing to have a conversation you’d rather not. It’s not a script, as each family is so different, and there are resources out there but more a consideration of what helps children, in particular, absorb information.
1. All being on the same page
Firstly, it is unlikely that you are the only adult in your child’s life (and whether you are or not, you can ask someone else to have this conversation alongside you). There may be other family members, nursery or school staff as they get older, activity leaders and so on.
Before you speak to your child, try and get it down to a few sentences the narrative you are happy with. For example, Grandma isn’t well and she needed a few tests to work out what was wrong. Now we know that it’s something called cancer. Have you heard of that? It means… (specifics of diagnoses can be shared in a child-appropriate way). You might feel robotic or you may have lots of emotion still loaded behind the words and that is okay.
The idea of making sure everyone sings off the same hymn sheet is because children ask questions, repeatedly, as they process things, and can be reassured when everyone is saying the same thing. Children are also natural story-tellers and you can always start by asking them what they feel has been going on? They may surprise you with how much they have taken in.
2. Activities while talking
One of the hardest conversations I’ve had so far with my now 8 year old was when he was about to turn 3 and we had to let him know that he would now only live with mummy, and daddy would be in another house. From that, many other difficult conversations follow but one thing that stuck with me in my furious and frantic google searches was to give your child an activity to do while you are talking. It gives them a focus point, and they don’t have to have direct eye contact which can be hard when they know, or feel upset or that you are.
A neutral activity, that is age appropriate, or a car ride, can be an excellent time to start the conversation you need to have. And maybe it can’t all be done in one simple conversation, and guess what? That’s okay! I’ve said it before and I’ll say it again – each family is so different. It’s not a one size fits all approach.
3. Remove blame
When we study and support in grief, loss and bereavement work, we’re introduced to a phrase called ‘magical thinking’. It’s the idea that your individual thoughts affect the whole world, and that you have caused this. It’s more common in children whose brain hasn’t fully developed, yet. It’s the child who believes they made their dad sick when they shouted, ‘I hope you die!’ It’s children who wonder if their siblings are going to die because they wished to be an only child again. It’s the adults who believed they caused a pandemic by saying they just needed some time off and more family time.
If you can explicitly state, “this is a fact- you didn’t cause this cancer” a child can breathe a bit more easily. Where you can state facts, or point to other families who have been experiencing this, it allows children time and space to see, yes, their thoughts are amazing but no, they didn’t cause this.
You might also need to remove some blame from yourself, too. You are not messing up your child by having a cancer diagnosis. You are showing them love, the kindness of others, strength and hope, amongst other things.
If your child has cancer, they are more than likely teaching you grace, joy and how short life is. These are things that are taught through life experiences, not textbooks or handbooks.
4. Allow all emotions
In our society, we’re not very good at letting children, and in turn adults, have what we consider negative emotions. ‘What have you got to be sad about, you’re just a child?’ is a phrase that springs to mind. Additionally, we don’t like to see children sad or angry and so may see them having fun with friends and say, see, they’re totally fine.
Both Childhood Bereavement Network and Winston’s Wish talk about how children ‘puddle jump’ – moving from grief to joy and back again quite easily. We find that in play, children can express emotions previously denied to them and this can improve emotional literacy.
You may notice my playmobil hospital set – it has an MRI bed and a surgery ward, amongst other things.
When we work with children, we ask what has happened in their life so far and can adjust our kit to ensure that toys and materials representative of painful and positive experiences are in there. However, being a non-directive therapist means the children direct the play and so they may also never choose to use the specially selected materials. My hospital kit is quite well loved, though!
I recommend having a range of play materials and not influencing your child’s play as they process things; even if they’re saying something you believe is wildly and factually inaccurate.
So, who am I and what qualifies me to talk to you today?
I’m Louise, a Play Therapist and mum living and working in South Wales. Growing up, my first loss was of my beloved Grandad to lung cancer and I can still remember the race and scary drive to the hospice for my Dad’s final goodbye to him, taking my Po doll (Teletubbies!) to his funeral and missing him incredibly.
Later on as a teenager and very young adult, my grandmother and aunt from the same side of the family both died from breast cancer and pancreatic cancer, respectively. My pastor’s wife also died from lung cancer when I was 16 which taught me to wonder why bad things happened to good people as she had never smoked and my teenage brain didn’t understand.
Additionally, in my professional career, I have supported children and their families who are grieving due to divorce, imprisonment of a family member and bereavement of a loved one. Whilst completing training for a specialist placement with Cruse Bereavement Care, I realised I had been suspending grief from my marriage breakdown and took time off work for the first time in my life to heal a bit more from that. If only healing was a one-time thing though?! I often say if you want a perfect therapist to work with your children, don’t choose me!
I have worked with a children’s hospice as they supported siblings with play therapy and have been in private practice for the last 2 years. Doing this means there’s no postcode lottery and I don’t have any conditions like, we can only see you before a death, after a death or when x, y or z has happened and there’s no limit on the number of sessions.
Sometimes, with all the best intentions and good guidance, we can be just too close to a situation and need to ask for support. I am happy to point out any further resources for your situation and often work with other therapists to make sure that your family is being put first. You can find me at Voyage of Hope Therapy Services and on Twitter and Instagram.
Below I have chosen just three resources but there are many more out there - it can be just knowing where to look and when.
My amazing friend Debbie Murphy is a fellow single parent who parents her son so calmly and beautifully and had breast cancer when he was 2 years old. I really recommend her blog posts at: https://adventuresofasingleparentblogblog.wordpress.com/2017/10/26/where-is-the-emotional-support-after-treatment-for-people-affected-by-cancer/ I have peers who provide Play Therapy at Kids Cancer Charity: https://kidscancercharity.org/ They provide play therapy for children who have cancer, and their siblings. You may have seen them on Children in Need – they are fab! Lastly, I use this as a resource from MacMillan and recommend it – talking to children and teenagers when an adult has cancer: https://be.macmillan.org.uk/Downloads/CancerInformation/ChildrenAndYoungPeople/MAC5766TalkingtochildrenE2.pdf