By Kelsey Mora, CCLS, LCPC, Chief Clinical Officer at Pickles Group and Author of "The Dot Method: An Interactive Tool to Teach Kids About Cancer"
Receiving a cancer diagnosis is a profound and life-altering event for any individual. For parents, the weight of this news is compounded by the immediate concern for their children. Questions like, "How will my child react?" and "How can I possibly have these difficult conversations?" are likely at the forefront of their minds. The truth is, children’s responses to such news are as unique as they are, a testament to their individual development, personality, and understanding of the world. This article, drawing on the expertise of child life specialists and counselors, aims to demystify these varied reactions, offer insights into their potential meanings, and provide actionable strategies for parents to effectively support their children through this challenging journey.
The National Breast Cancer Foundation (NBCF) is committed to providing comprehensive support for families navigating the complexities of a cancer diagnosis. Additional free resources for parents can be found at nbcf.org/parents. For a printer-friendly version of this guide, click here.
Understanding the Spectrum of Childhood Responses
When parents share news of a cancer diagnosis, children do not respond with a single, predictable script. Instead, their reactions can manifest in a variety of ways, each offering a window into their internal processing. Understanding these common responses is the first step in providing tailored and effective support.
Curiosity: The Quest for Information
One of the most common and often reassuring responses is a surge of curiosity. Children may immediately bombard their parents with questions, signaling a readiness to absorb information and make sense of the situation. This inquisitiveness is a healthy sign, indicating that they are actively engaging with the news and seeking to understand its implications.
What it might mean: A child’s curiosity is a direct reflection of their desire to comprehend what is happening. They are trying to fit this new, significant piece of information into their existing understanding of the world. It signifies trust and a willingness to learn, which are invaluable in this context.
What you can do: Parents should endeavor to answer these questions with age-appropriate honesty. It is crucial to remember that admitting "I don’t know" is a perfectly valid and honest response. This can be an opportunity to foster a collaborative approach, saying, "I don’t know the answer to that right now, but let’s find out together," or "I’ll get back to you once I have more information." The critical element here is the commitment to follow through and provide the promised information. This builds trust and reinforces that their questions are valued and will be addressed. Consistency in providing updates, even small ones, can help children feel more secure.
Reflection: The Quiet Processing Period
Conversely, some children may react with a period of quiet reflection. They might become withdrawn, engage in solitary play, or appear to distance themselves from the immediate conversation. This does not necessarily indicate disinterest or a lack of concern.
What it might mean: This behavior is often a sign that the child needs time to process the information internally. They are absorbing the news at their own pace, a strategy that allows them to integrate complex emotions and facts without immediate external pressure. It is their way of creating mental space to grapple with the reality of the situation.
What you can do: Acknowledge and respect this need for space. Reassure your child that you are available to talk whenever they feel ready, without any pressure. Maintaining consistency in your presence and communication reinforces that you are a stable anchor during this uncertain time. With time and continued reassurance, they will likely re-engage with the conversation when they feel equipped to do so. Your consistent availability acts as a silent promise of support, encouraging them to reach out when they are ready.
Seemingly Unfazed: The Art of Maintaining Normalcy
Perhaps one of the most perplexing reactions for parents is when their child appears unfazed by the news, continuing with their daily activities as if nothing has changed. This can be particularly disorienting when parents are grappling with immense emotional turmoil.
What it might mean: This response often indicates that the parent has provided just enough information for the child’s current needs. They may not require extensive discussion at this moment, and their ability to maintain normalcy can be a coping mechanism, a way to preserve a sense of stability in their lives. It does not signify a lack of care or understanding.
What you can do: The key here is to maintain trust and continue offering updates as significant events or changes occur. Do not mistake their outward calm for indifference. Be present, be available, and respond to their cues. Your ongoing presence and willingness to revisit the topic without pressure will remind them that it is safe to express their feelings and ask questions when they are ready. This approach ensures that their needs are met without overwhelming them.
Emotive: Expressing Big Feelings
Children who exhibit strong emotional reactions, such as crying, running away, or having tantrums, may be difficult to witness. Parents might question if they made the right decision in sharing the news. However, these outward displays of emotion are often a sign of trust.
What it might mean: When children feel safe enough to express intense emotions, it signifies that they feel secure in their relationship with their parent. They are showing you their vulnerability, even if they lack the words to articulate their feelings. This is a powerful indication of their reliance on your emotional support.
What you can do: Your role is to be present, validate their emotions, and stay with them as they navigate these feelings. Naming your own emotions, such as sadness, fear, or frustration, can help normalize their experience and provide a model for healthy emotional expression and coping. By sharing your own feelings appropriately, you create an environment where they feel less alone in their emotional journey. This shared vulnerability can strengthen the parent-child bond.
Avoider: Setting Emotional Boundaries
Some children may actively change the subject or steer clear of conversations about cancer. This behavior is often a signal that they have reached their emotional limit for the time being.
What it might mean: This is a child’s way of setting a boundary, a skill many adults are still developing. Just as parents aim to protect their children, children also seek to protect themselves and, at times, their parents. They may feel that discussing the topic further is too overwhelming or that they need a respite.
What you can do: Acknowledge that the topic is difficult and reassure them that it’s okay to revisit it when they feel ready. Gently bring up the subject again, particularly around significant events like doctor’s appointments or changes in routine. Maintaining connection through their personal interests can foster trust and comfort, allowing them to feel secure and less pressured. Following their lead in terms of conversation topics builds resilience.
Fixer: The Drive for Control
Certain children will instinctively try to "fix" the situation or offer solutions. This problem-solving approach is often a manifestation of their need to regain a sense of control in a situation that feels overwhelming and unpredictable.
What it might mean: When children engage in "fixing" behaviors, they are seeking agency and attempting to exert influence over a situation where they have little direct control. It’s a natural response to feeling powerless.
What you can do: Guide them in distinguishing between what is within their control and what is not. Help them identify their role in supporting the family and the patient. Offering choices and preparing them for upcoming events can foster predictability and a sense of agency. Exploring age-appropriate ways they can contribute, such as helping with simple tasks or creating artwork for the patient, can be empowering and fulfilling. The NBCF offers resources on "Small Hands, Big Hearts" that can provide further guidance on this.
Preparing for Future Conversations and Evolving Needs
It is crucial to recognize that a child’s initial reaction is not a permanent state. Their emotional and informational needs will evolve throughout the cancer journey, influenced by their age, developmental stage, the progression of the illness, and their individual experiences.
The Importance of Ongoing Dialogue:
Regardless of how a child initially responds, it is essential to remember that their needs will change. What felt sufficient at one moment may become overwhelming or insufficient at another. Therefore, ongoing communication and a willingness to adapt are paramount.
Strategies for Future Conversations:
- Reference Past Reactions: Before initiating a new conversation about cancer, it can be beneficial to remind your child of their previous responses. For example, you might say, "Remember when we talked about my cancer before, you had a lot of questions. I have some new information now, and you might or might not have questions. I’m here for whatever you need." Alternatively, "I know you felt you had heard enough last time we spoke about my cancer, but there’s been a change, and I want to update you." Acknowledging their past reactions validates their experiences and helps them prepare for the current discussion.
- Break Down Information: For younger children, it is often recommended to break down complex information into smaller, digestible conversations. This approach, detailed in articles like "What to Expect When a Parent Has Breast Cancer," helps prevent overwhelm.
- Maintain Open Channels: Continue to foster an environment where open communication is encouraged. Let your child know that it is always okay to ask questions, express feelings, or simply take a break from discussing the topic.
When to Seek Professional Support:
While most childhood reactions to cancer news are a normal part of processing difficult information, there are instances when professional intervention may be beneficial. If your child’s reactions are prolonged, intensely distressing, seem disproportionate to the situation, or begin to significantly impact their daily routines, functioning, or well-being, it is advisable to seek support from mental health professionals specializing in childhood oncology. However, in many cases, children are simply being human, responding to overwhelming news in the ways their minds and bodies know how. When conversations are handled with honesty, sensitivity, and consistent support, children often feel included, connected, and empowered.
A Foundation of Support: Resources for Families
Navigating a cancer diagnosis is an immense undertaking, and no family should have to face it alone. The National Breast Cancer Foundation (NBCF) is dedicated to providing a robust network of support for parents and their children.
NBCF’s Comprehensive Resources:
The NBCF offers a wealth of free resources designed to guide children through the complexities of a parent’s cancer diagnosis. These resources aim to equip parents with the tools and knowledge necessary to foster resilience and understanding within their families. Explore these valuable resources at nbcf.org/parents.
Partnering Organizations for Emotional Well-being:
In addition to the NBCF, several other organizations are dedicated to supporting the emotional well-being of children and families impacted by a parent’s cancer diagnosis. Collaborating with these groups can provide additional layers of support and specialized care. These organizations include:
- CancerCare: Offers free professional support services, including counseling, education, and financial assistance, to anyone affected by cancer.
- Children’s Oncology Camping Association International (COCAI): Connects families with camps that provide specialized programs for children with cancer and their siblings.
- The National Alliance for Grieving Children: Provides resources and support for children and families experiencing grief and loss.
- The National Children’s Study: A long-term study on child development that can offer insights into the impact of various factors, including parental illness, on children’s well-being.
The National Breast Cancer Foundation stands with you and your family as you navigate a breast cancer diagnosis. Visit our website to learn about NBCF breast cancer support groups, access free educational resources, or find a patient navigator in your area. Through open communication, consistent support, and readily available resources, families can foster strength, resilience, and a profound sense of connection, even in the face of life’s most challenging circumstances.
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