Continued from Part I

“She and her Grandpa were snuggle bunnies until he was diagnosed with cancer.  Now she won’t go near him?  Her Pop-pop is devastated. ”

From my days working as a children’s grief counselor in hospice care, less the exception and more the rule, before I even had one foot in their doors, families would immediately raise concerns just like this.  Desperate to understand what they perceived as sudden, strange, inexplicable changes in their child (rens') behavior following the heartbreaking terminal diagnosis of a loved one, the issue of avoidance regularly took front and center.  How could it be that the child, who now understood (as best they could) time with their Mommy, Daddy, Pop-pop, Mom-Mom, Aunt, whomever -now irrefutably limited, would avoid the very person with whom they shared such a tender relationship?   

Remember the Three Biggies?

Time for a review.

Children generally worry about these three big issues when a loved one is diagnosed with a terminal illness and dies:

1. The belief that the death was their fault-otherwise referred to as magical thinking-the irrational belief that the death of a loved one was the direct result of something they did or said.

2. The disease is contagious (whatever it is…cancer, heart attack, stroke, etc.).

3. Whose going to take care of them if both parents/or guardians die?

Last time I addressed magical thinking (we all do it!) this time let’s take a look at the belief the disease is contagious.  

Can I catch it??

As adults, we have a clear understanding terminal disease, like cancer, ALS, liver disease, etc.  are not something you can contract from hugging or caring for someone who is ill.  Children generally do not know this.  Keep in mind we teach children to wash their hands and cover their mouths to avoid getting sick.  From that perspective, doesn’t it make sense they would think all disease and sickness is contagious?

Given their orientation to illness, it’s not uncommon then for children to privately harbor panic, anxiety and significant worry “keeping company” (as my Dad likes to say) with their sick loved one puts them at colossal risk to “catch” the disease.  In spite of being rather ego-centric at this stage of their development, it is not lost on them this puts their loved ones caring for the patient at risk too.  Translated- exponential worry the entire family could die.  

Often small children don’t have the ability to articulate this core concern, without proper prompting.  When I work with children who have a terminally ill loved one -without fail I go after this sucker with both barrels!  Deliberately getting right down at their eye level I gently say, “You know, lots of children worry (the disease) is something they can catch just by hanging out with the person who has it.”  Using a tone more like a concerned investigator than a therapist, I follow up, “Hmmm, I wonder if you have ever worried about this.”

R E L I E F!

Visible and palpable, upon learning terminal disease is not something they can catch (with very few exceptions), is their relief. This is not only a relief for the child (ren) but for the adults who now have a better understanding of the logic behind why the child avoided their loved one in the first place.  In one instance, having gotten the “good news,” a little girl with whom I was visiting immediately bounded off, climbed into the hospital bed where her Grandpa rested and snuggled up against him.  He smiled and I, being the human I am, fought back tears, downright certain the lump in my throat was so gigantic the local news would shortly show up to cover it!  

To flush out the logic behind children’s behavior -think like a child.  Often this is where understanding is hiding out.    

Next time, I’ll tackle number 3. 

Hugs and kisses until then.