“My Mind Feels Heavy”…
was expressed to this therapist by a teen in an art therapy session. This was her attempt to describe the intense depression and stress experienced from chronic illness in her home environment.
Physician and author Doty (2016) has indicated that children can be wise and expressive beyond their young years. When given time and patient attention, children will talk about fears, what they like and don’t like–as well as the details of happy experiences.
This therapist/writer has provided young mental health clients with creative art therapy, basic journal writing, and music relaxation sessions. Many of these young clients have indicated difficulties in families, to include chronic emotional and physical illness, often including cancer.
On a recent visit to a cancer center of a large California medical center, this writer explored support services for clients and families.
Exercise sessions were offered; yoga and tai chi were featured. Lectures on adult cancer education and research were available weekly. Acupuncture was described and demonstrated. Brochures described adult group and individual therapy sessions for patients with various forms of cancer.
All of these exercise, education, demonstration, and therapy sessions seemed focused on adults with cancer and their mature family members.
This therapist and writer, with concern, wondered about children living and coping with family illness and cancer. How are children adapting and finding support to increase coping with the intense experience of family illness/cancer?
Child and Teen Experiences With Family Illness/Cancer
Many young family members experience a sense of guilt, according to clinical psychologist Rando (1991). Guilt can develop from conflicts during the family illness, such as frustration, anxiety, and irritation. Guilt may be stimulated by resentment of the time and resources spent on the ill family member. The needs of a child or teen may be neglected with family illness.
Relationships are also not perfect for adults–and children/teens. Guilt can occur for things one has done or failed to do. Adults and children/teens can always remember a time when they were, “not good.”
Level of maturity seems to be related to coping with the possibility of death. Children and teens usually have not had years or experiences to attain these skills. Other factors influencing a child or teen’s coping are availability of social supports and the role of religion, to better understand the support from a higher being or spiritual belief.
Children and teens can suffer from the reality that with the possible death of a parent that no one will ever love or be as concerned in this same, caring way.
Helping Children and Teens Cope
The American Cancer Society (cancer.org., 2018) explains that how children react to a cancer diagnosis often depends on how their parents handle a crisis. Parents often experience fear and uncertainty.
In explaining cancer, the Cancer Society suggests that young children (up to 8 years) will not need detailed information. Teens, with need for independence, may have different concerns for illness and cancer information.
All children/teens need: location and name of cancer; how it will be treated; and how it may affect their lives. The Cancer Society recommends the selection of a quiet place and to try to remain calm when sharing information with children or teens. Let children know there is time for additional discussions–for concerns, needs, and fears.
Children and teens may worry that cancer is contagious. They need to realize it is okay to hug and kiss a person with cancer.
Assure all young family members that they will continue to be loved and cared for while a parent or family member is sick.
Because children do best with routine and predictability, it is essential to keep lives the same, as possible. Teens need to know that parents recognize the need for their own time and space, although there is family illness.
Some children want to feel useful by helping more around the house or by caring for an ill parent. The Cancer Society recommends not to over-burden and to be specific regarding needed tasks to help.
Be aware of common signs of depression in children. These can include poor grades; loss of friends; excessive crying; easy anger; and talking about wanting to die. Professional help may be needed from a school counselor, pediatrician, or psychiatrist.
Rando has explained that children may not always have the words to describe feelings and thoughts. Because of young age, they have little-to-no control over their lives. They may feel stuck with emotional pain. Children communicate through play. They can express selves with art activities, physical activities, and games. For teens, creative writing can be helpful.
Rando has added that the presence of others, with their genuine care and compassion, is important to all ages of individuals dealing with illness and possible loss.
Support Groups for Children and Teens with Family Illness/Cancer
Select medical centers and support centers have special group and individual services for children and teens with the experience of family illness/cancer.
Sharp Medical Center, San Diego, California (sharp.com, 2018), offers a family cancer support group. Free of cost, the group sessions provide time for children, teens, and parents to meet both together–and apart, so younger people can express themselves in ways that may be difficult to do in front of parents. Children and teens are also given coping skills to help them manage both at home and at school. These family support groups meet one time each week, for one-and-one-half hours.
Kids Konnected (kidskonnected.org, 2018), was developed on the premise that when a parent gets cancer, the entire family is affected. The needs of the children/teens must be addressed. Programs started in California and are now available nationwide.
Kids Konnected was established in 1993 by eleven-year old Jon Wagner-Holtz. After his mother was diagnosed with breast cancer, and with a small donation, he started a phone support line in his home. Feeling alone, he wanted to talk with kids his age with the same experience. Jon has said, “Because of our ‘Konnection’, you don’t have to be alone anymore.”
Additional current offerings at Kids Konnected are summer camps, support groups, and other events.
Gilda’s Club, now called Cancer Partners (cancerpartners.org, 2018), was named for entertainer Gilda Radner, as she wished that no one face cancer alone. After her death from ovarian cancer in 1989, her husband actor Gene Wilder and an associate, Joanna Bull, began the first Gilda’s Club in New York City.
Gilda’s/Cancer Partners in Palm Desert, California, offers events and support groups, to include weekly sessions: creative expression, mindfulness/meditation, and a special teen group for those 13-17 years.
Gilda’s/Cancer Partners website also features a “Just for Teens” information page. Rachel Phillips, a writer, self-described as a teen writing for other teens, developed this resource page because of her experiences with a close friend with cancer. Writer Phillips explains definitions of cancer(s); typical cancer treatments; and common medications and side effects. She includes suggestions for how to gently talk to a friend with cancer. A suggested message/communication: “I’m thinking of you. Don’t feel you have to call me back.”
The Cancer Support Community, Los Angeles, California (cancersupportla.org., 2018)) offers child, teen, and family programs for the psychological and social needs of children and teens that have a parent or family member with cancer. There are group opportunities at CSCLA to engage in discussions about what they are experiencing and feeling. This community center offers coping skills and family communication education.
MD Anderson Medical Center, Houston, Texas (mdanderson.org., 2018), offers the Children’s Lives Include Moments of Bravery (CLIMB). This is a special program developed by the Children’s Treehouse Foundation, a non-profit foundation dedicated to the emotional support of children who have parents with cancer. Facilitators have been specialty trained to provide this program. There are six week sessions, two hours each week. Children are also given workbooks to record notes.
At MD Anderson, Teen CLIMB is a special support program to help teens (13-17 years) with a parent’s cancer diagnosis.
MD Anderson patients and patients from the community, as well, are invited for fee-free support groups. There are also groups to help parents describe cancer and coping methods to children and teens.
Mindfulness, Wisdom, and Empathy to Support Child and Teen Coping
The peace of mind and body, according to Doty, can be learned at any stage in life, with all ages, and in all situations. A wise, caring person taught a young Doty to cope with his traumatic, chaotic family health situations.
The active and passive forms of mindfulness techniques were learned by an eighth grade Doty–as well as presently practiced by him, as a physician and surgeon.
Find a quiet time and place.
Sit and just relax.
Take deep breaths.
Focus on toes and feet/relax muscles.
Once able to relax toes/feet, extend exercise upward–
And as able to extend entire body muscle relaxation, just sit and notice the calmness.
As therapists and human beings, consider the possibilities of teaching Doty’s self-talk to a stressed child or teen. With gentle voice and compassion, we can instruct to focus/relax with the phrases:
“I calm my mind…and
“I relax my body.”
Doty has thoroughly explored the relationship of emotions (“secrets of the heart”) and the brain. He has expressed, “The brain is one of the most beautiful things I have seen. To explore its mysteries and find ways to heal is a privilege.”
Doty, James R., M.D. (2016). Into The Magic Shop. A Neurosurgeon’s Quest to Discover the Mysteries of the Brain and the Secrets of the Heart. Avery/Penguin Random House, N.Y.
Rando, Therese A., Ph.D. (1991). How to Go On Living When Someone You Love Dies. Bantam Books, N.Y.
The American Cancer Society. (2018). In https://www.cancer.org/treatment/children-and-cancer/when-a-family-member-has-cancer.html
Sharp Medical Center. (2018). In https://www.sharp.com/health-classes/children-and-family-cancer-support-group-2113
Kids Konnected. (2018). In https://www.kidskonnected.org/about-us
Gilda’s Club/Cancer Partners. (2018). In https://cancerpartners.org/healthy-living-programs
Phillips, Rachel/Gilda’s Club/Cancer Partners. (2018). In https://cancerpartners.org/just-for-teens/
The Cancer Support Community, Los Angeles (CSCLA). (2018). In https://www.cancersupportla.org/events/category/family-programs/
MD Anderson Medical Center. (2018). In https://www.mdanderson.org/patients-family/diagnosis-treatment/patient-support/climb-support-program.html
Writer’s Note: Client quote, “My Mind Feels Heavy”, was modified from the original for the purpose of client confidentiality.