It is impossible to talk about children’s behavior without discussing parental behavior. A child’s development does not occur in a vacuum; it occurs within the context of the family, and parents set the tone for their home’s atmosphere. At different times during their child’s treatment, parents may be under enormous physical, emotional, financial, and existential stress. The crisis can cause parents to act in ways that reflect their own fear and lack of control—ways they would not behave under normal circumstances. Some of the common problem behaviors mentioned by parents follow.

Dishonesty

As stated earlier, children feel safe when their parents are honest with them. If parents start to keep secrets from a child to protect her from distressing news, she may feel isolated and fearful. She might think, “If Mom and Dad won’t tell me, it must be really bad,” or, “Mom won’t talk about it. I guess there’s nobody I can talk with about how scared I am.”

Denial is a type of unconscious dishonesty. This occurs when parents say things to children such as, “Everything will be just fine,” or, “It won’t hurt a bit.” This type of pretending just increases the distance between child and parent, leaving the child with no support. However horrible the truth, it seldom is as terrifying to a child as what he imagines if he doesn’t know the truth.

I try so hard to be honest with my 5-year-old son, but blood draws, which he thinks of as “shots,” are just so hard for him. Every doctor’s visit, that’s his first question, “Am I going to get a shot?” and I just want to say no. My husband’s the one who started saying, “It’ll be fine,” but the anxiety that came up later at the appointment was so much worse that I put an end to that pretty quickly. Now I say, “Yes, but just once,” because if I say, “I don’t know,” it just makes him worry.

Depression and anxiety

Parents of children with cancer often feel sad, depressed, or overwhelmingly anxious. Responses to stress can include changes in sleeping patterns, appetite, and sex drive as well as racing thoughts, poor concentration, suicidal thoughts, or drug/alcohol abuse. If you are consistently experiencing any of those symptoms, it may help to speak with a counselor or psychologist.

Find a counselor you click with. Stick with that person until you truly feel some peace about your experiences and strength for dealing with the ongoing stress of treatment or whatever else might come up. I regret that I toughed it out and didn’t recognize the depression I was experiencing for such a long time. I think finding sources of support in a variety of ways at the earliest moment possible can greatly mitigate long-term difficulties in coping.

If you have an underlying tendency toward anxiety or depression, having a child diagnosed with cancer can cause more symptoms. Depression and anxiety are extremely common and very treatable, and they should be dealt with early on.

It was two years after my son finished treatment that my depression became severe enough that I recognized it. I actually had a lot of suicidal thoughts and my husband urged me to see a doctor. He started me on Zoloft® and it has helped me tremendously.

Losing your temper excessively

All parents lose their tempers sometimes. They lose their tempers with spouses, healthy children, pets, and even strangers. When you are living with the chronic stress of having a child with cancer, you may find that you lose your temper much quicker than in the past and over situations that normally wouldn’t upset you. In part, this is because chronic stress leads to prolonged, higher cortisol levels—a hormone that is released as part of our “flight or fight” response.

There are many ways to naturally lower your cortisol levels, such as exercise, yoga, meditation, eating a healthy diet, watching a funny movie, and listening to music. Also, if you start to notice when you are close to losing your temper, get away from the situation until you can respond more calmly—take a walk, listen to music, do breathing exercises, find a private place to cry or yell, pet the family dog or cat, or ask another adult to step in and give you a break. Self-care is vital to preserving healthy relationships and avoiding saying or doing things you will later regret.

I had my share of temper tantrums. The worst was when my son was having his radiation. I tried to make him eat because it would be so many hours before he could have any more food. He always threw up all over himself and me, several times, every morning. It seemed like we changed clothing at least three times before we even got out of the house each day. I remember one day just screaming at him, “Can’t you even learn how to throw up? Can’t you just bend over to barf?” I really flunked mother of the year that day. I can’t believe that I was screaming at this sick little kid, who I love so much.

Emotional and/or physical abuse of children and spouses may begin, or increase, when either or both spouses feel incompetent and powerless, and when there is chronic stress in their lives. If you find yourself unable to manage your temper, seek professional counseling immediately. Counseling can help you prevent or repair any damage your outbursts may have caused to your family relationships. It takes courage and strength to seek help. But asking for help is a sign that you care deeply about your family and want your home atmosphere to be healthier and happier.

I had always taught my children that feeling anger was okay, but we had to make good choices about what to do with it. Hitting other people or breaking things was a bad choice; running around outside, or punching pillows were good choices. But, as with everything else, they learned the most from watching how I handled my anger, and during the hard months of treatment my temper was short. When I found myself thinking of hitting them, I’d say, in a very loud voice, “I’m afraid I’m going to hurt somebody so I’m going in my room for a time-out.” If my husband was home, I’d take a warm shower to calm down; if he wasn’t, I’d just sit on the bed, cry, and take as many deep breaths as it took to calm down.

Unequal application of household rules

You will guarantee family problems if the ill child gets a pass while the siblings are asked to step up and do extra chores. Granted, it is hard to know the right time to insist that your ill child resume making his bed or setting the table, but it must be done. Siblings need to know from the beginning that any child in the family, if sick, will be excused from chores, but that she will have do them again as soon as she is physically able.

I spoiled my sick daughter and tried to enforce the rules for my son. That didn’t work, so I gave up on him and spoiled them both. He was really acting out at school. What he needed was structure and more attention, but what he got was more and more things. They both ended up thinking the whole world revolved around them, and it was my fault.

Overindulgence of the ill child

Overindulgence is a very common behavior of parents of children with cancer. There are a variety of reasons for this: parents are trying to make up for the suffering their child is enduring or they are trying to make other parts of the child’s life more enjoyable. In some cases, parents overindulge their sick child because it makes the parents feel better.

I bought my daughter everything I saw that was pretty and lovely. I kept thinking that if she died she would die happy because she’d be surrounded by all these beautiful things. Even when I couldn’t really afford it, I kept buying. I realize now that I was doing it to make me feel better, not her. She needed cuddling and loving, not clothes and dolls.

• • • • •

Four days into Selah’s diagnosis, we were doing anything to keep her happy. Our sweet little 4 year old had turned into a demon child in that short time. Luckily, my very dear friend took me outside into the hallway, pushed me against the wall, and demanded to know exactly what I was doing. I just looked at her and said, “I have no idea.” I just didn’t want my daughter to die and that was my only focus. She then told me I was giving my daughter no boundaries, no behavior expectations, and she had no respect for anyone who walked into the room. Through my tears and our hugs, she assured me that the way we were going, if she didn’t die from cancer, we were going to want to kill her because of the monster we were creating. I am still so grateful that she wasn’t afraid to tell me what I needed to hear.

Not spending enough time with the sibling(s)

While acknowledging that there are only so many hours in a day, parents interviewed for this book felt the most guilt about the effect that diagnosis and treatment had on the siblings. They wished they had asked family and friends to stay with the sick child more often, allowing them to spend more of their precious time with the siblings. Many expressed pain that they didn’t know how severely affected the siblings had been.

I try to find some time in each holiday, weekend, or whenever that is just for Christopher and me. No matter how ill Michael is, someone else can cope with it for an hour or two, and nothing is allowed to interfere with that. We still go out, even if it is only Christopher and me at McDonald’s®. Bottom line is that all mothers have to accept that along with the baby is delivered a large package of guilt, and whatever we do for one we will wish we had done for the other. But I don’t think you can put one child on hold for the duration of the other’s illness, because the year that Christopher has lost while Michael has been ill won’t ever come again. He’ll only be 11 once, just as surely as Michael will only be 14 once (or possibly forever), and we owe it to our healthy kids to allow them to be just that.

Using substances to cope

Some parents find themselves turning to alcohol or drugs to help them cope. Some parents use illegal drugs for stress relief and escape, while others overuse over-the-counter and prescription drugs. If you find yourself drinking so much that your behavior is affected, or using drugs to get through the day or night, seek professional help.

Coping

Many parents find unexpected reserves of strength and are able to ask for help from friends and family when they need it. They realize that different needs arise when there is a great stress to the family, and they alter their expectations and parenting accordingly. Parents and families that had strong and effective communication prior to the illness most often pull together as a unit to deal with it. Most families, however, have periods of calm alternating with times when nerves are frayed and tempers are short. In the end, most families survive intact and are often strengthened by the years of dealing with cancer.