Make sure that the family rules are clearly understood by all of the children.
Come up with acceptable ways for your child to physically release anger.
Treat the ill child as normally as possible.
Get professional help whenever you are concerned or run out of ideas on how to
handle emotional problems.
Have reasonable expectations.
Model the type of behavior you desire.
Improving Communication and Discipline
The following excerpt is taken from Chapter
24 of Childhood Cancer: A Parent's Guide to Solid Tumor Cancers
, 2nd Edition by Honna Janes-Hodder & Nancy Keene, copyright 2002 by
O'Reilly & Associates, Inc. For book orders/information, call
(800) 998-9938. Permission is granted to print and distribute this
excerpt for noncommercial use as long as the above source is
included. The information in this article is meant to educate and
should not be used as an alternative for professional medical care.
Parents suggest the following ways to keep the family on a more even
- Make sure that the family rules are clearly understood by all of the
children. Stressed children feel safe in homes that are very structured with
regular, predictable routines.
After yet another rage by my daughter with cancer, we held a family meeting to
clarify the rules and consequences for breaking them. We asked the kids ( both
preschoolers) to dictate a list of what they thought the rules were. The
following was the result, and we posted copies of the list all over the house
(which created much merriment among our friends):
If they broke a rule, we would gently lead them to the list and remind them of
the house rules. It really helped.
- No peeing on rug
- No jumping on bed
- No hitting or pinching
- No name calling
- No breaking things
- No writing on walls
- No being alone in room
- Have all caretakers consistently enforce the family rules.
We kept the same household rules. I was determined that we needed to start with
the expectation that Rachel was going to survive. I never wanted her to be
treated like a "poor little sick kid" because I was afraid she would
become one. We had to be careful about babysitters because we didn't want
anyone to feel sorry for her or treat her differently. I do feel that we
avoided many long-term behavior problems by adopting this attitude
- Give all the kids some power by offering choices and letting them
completely control some aspects of their lives, as appropriate.
For a few months we ignored Shawn's two brothers as we struggled to get a
handle on the situation. We just shuttled them around with no consideration for
their feelings. When we realized how unfair we were being, we made a list of
places to stay, and let them choose each time we had to go off to the hospital.
We worked it out together, and things went much smoother.
My bald, angry, four-year-old daughter asked me for some scissors one day. I
asked what she was going to do, and she said cut off all her Barbies' hair. I
told her those were her dolls and she could cut off their hair if she chose. I
asked her to consider leaving one or two with hair, because when she had long
hair again, she might want dolls that looked like her then, too. But I said it
was up to her. She cut most completely off, and left some intact. It really
seemed to make her feel better.
- Take control of the incoming gifts. Too many gifts make the ill child worry
excessively ("If I'm getting all of these great presents, things must be
really bad") and makes the siblings jealous. Be specific if you want
people not to bring gifts, or if you want gifts for each child, not just the
Paige has a sister, Chelsea, who was five at diagnosis, and a brother, Dan, who
was four months old. Chelsea had a very difficult time. She didn't like it that
Paige was getting so many presents and she often felt left out. When I would
try to do something special for her, she would get mad--she just wanted
- Recognize that some problems are caused solely by the drugs. It helps to
remember that these children are not naturally defiant or destructive. They are
feeling sick, powerless, and altered by massive doses of toxic drugs, and they
need both sympathy and clear limits. Remember, when they get off the drugs,
their real personalities will return.
- If your child likes to draw, paint, knit, or do collages or other artwork,
encourage it. Art is both soothing and therapeutic and it allows the child a
positive outlet for feelings and creativity. Making something beautiful really
helps raise children's spirits. If your child writes or does artwork, recognize that powerful emotions may surface for both child and parents.
At my daughter's preschool, once a week each child would tell the teacher a story, which the teacher wrote down for the child to take home. Most of my daughter's stories were like this: "There was a rhinoceros. He lived in the jungle. Then he went in the pool. Then he decided to take a walk. And then he ate some strawberries. Then he visited his friend." But the week before or after a painful procedure, she would dictate frightening stories (and this from a kid who wasn't allowed to watch TV). Two examples are: "Once there were some bees and they stung someone and this someone was allergic to them and then they got hurt by some monkey bars and the monkey bars had needles on them and the lightning came and hit the bees," and, "Once upon a time there were six stars and they twinkled at night and then the sun started to come up. And then they had a serious problem. They shot their heads and they had blood dripping down
- Allow your child to be totally in charge of his art. Do not make
suggestions or criticize (e.g., "stay inside the lines" or
"skies need to be blue not orange"). Rather, encourage them and
praise their efforts. Display the artwork in your home. Listen carefully if
your child offers an explanation of the art, but do not pry if it is private.
Above all, do not interpret it yourself or disagree with your child on what the
art represents. Being supportive will allow your child to explore ways to
soothe himself and clarify strong feelings.
Jody was continually making "projects." We kept him supplied with a
fishing box full of materials, and he glued and taped and constructed all sorts
of sculptures. He did beautiful drawings full of color, and every person he
drew always had hands shaped like hearts. If we asked him what he was making,
he always answered, "I'll show you when I'm done."
- Come up with acceptable ways for your child to physically release anger.
Some options are: ride a bike, run around the house, swing, play basketball or
soccer, pound nails into wood, mold clay, punch pillows, yell, take a shower or
bath, or draw angry pictures. In addition, teach your child to use words to
express his anger--for example, "It makes me furious when you do
that," or "I am so mad I feel like hitting you." Releasing anger
physically and expressing anger verbally are both valuable life skills to
Shawn was very, very angry many times. We had clear rules that it was okay to
be angry, but he couldn't hit people. We bought a punching bag which he really
pounded sometimes. Play dough helped, too. We had a machine to make play dough
shapes which took a lot of effort. He would hit it, pound it, push it, roll it.
Then he would press it through the machine and keep turning that handle. It
seemed to really help him with his aggression.
Our therapist recommended that we have our five-year-old daughter make an
"angry sheet." She should be encouraged to draw or write what she
felt like doing when she was angry, and encouraged to get it all out. It was
pretty scary, because she drew pictures of stamping people, gouging their eyes
out, shooting them, etc. It was amazing how much better she felt afterwards.
Then we went through the pictures together and discussed which ones she could
really do, and which ones she could only think about doing because really doing
it would hurt someone.
- Get professional help whenever you are concerned or run out of ideas on how
to handle emotional problems. Mental health care professionals have spent years
learning how to help resolve these kinds of problems, so let them help
My daughter and I both went to a wonderful therapist throughout most of her
treatment for cancer. My daughter was a very sensitive, easily overwhelmed
child, who withdrew more and more into a world of fantasy as cancer treatment
progressed. The therapist was skilled at drawing out her feelings through
artwork and play. She also helped me with very specific suggestions on
parenting. For instance, when I told the therapist that my daughter thought
that treatment would never end (a reasonable assumption for a preschooler), she
suggested that I put two jars on my daughter's desk. One was labeled "All
Done," and the other was labeled "To Do." We put a rock for
every procedure and treatment already completed in the all-done jar, and one
rock for every one yet to do in the to-do jar (only recommended if the child is
more than halfway through treatment). Then, each time that we came home, my
daughter would move a rock into the all-done jar. It gave her a concrete way to
visualize the approach of the end of treatment. She could see the dwindling
number of pebbles left. On the last day of treatment, when she moved the last
pebble over and the to-do jar was empty, I cried, but she
- Most emotional problems that children develop as a result of treatment for
cancer can be resolved by professional counseling. However, some children may
also need medications to get them through particularly rough times.
My daughter was doing really well throughout treatment until a combination of
events occurred that was more than she could handle. Her grandmother died from
cancer during the summer, one of her friends with cancer died on December 27,
then another friend relapsed for the second time. She was fine during the day,
but at night she constantly woke up stressed and upset. She had dreams about
trapdoors, witches brewing potions to give to little children, and saw people
coming into her room to take her away. She would wake up smelling smoke. She
was awake three or four hours in the middle of the night, every night. Her
doctor put her on sleeping pills and antianxiety medications, and the social
worker came out to the house twice a month.
- Teach children relaxation or visualization skills to help them cope better
with strong feelings.
- Have reasonable expectations. If you are expecting a sick four-year-old to
act like a healthy six-year-old, or a teenager to act like an adult, you are
setting your child up to fail.
- As often as possible, try to end the day on a positive note. If your child
is being disruptive, or if your feelings toward your child are very negative,
the following is an exercise that can end the day in a pleasant way. At
bedtime, parent and child each tell one another something they did that day
that made them proud of themselves, something they like about themselves, and
something they are looking forward to the next day. Then a hug and a sincere
"I love you" bring the day to a calm and loving close.
A group of veteran parents compiled the following checklist to help you
parent your stressed child:
- Model the type of behavior you desire. If you talk respectfully and take
time-outs when angry, you are teaching your children to do so. If you scream
and hit, that is how your children will handle their anger.
- Seek professional help for any behaviors that trouble you.
- Teach your children to talk about their feelings.
- Listen to your children with understanding and empathy.
- Be honest and admit your mistakes.
- Help your children to examine why they are behaving as they are.
- Distinguish between feelings (always okay) and acting on strong feelings in
destructive or hurtful ways (not okay).
- Have clear rules and consequences for violations.
- Teach children to recognize when they are losing control.
- Discuss acceptable outlets for anger.
- Give frequent reassurances of your love.
- Provide plenty of hugs and physical affection.
- Notice and compliment your child for good behavior.
- Recognize that the disturbing behaviors result from stress, pain, and
- Remember that with lots of structure, love, and time the problems will
become more manageable.
Our children look to us to learn how to handle adversity. They learn how to
cope from us. Although it is extremely difficult to live through your child's
diagnosis and treatment for cancer, it must be done. So we each need to reach
deep into our hearts and minds to help our children endure and grow.