“Scary”, “hard”, and “difficult” are words that youngsters frequently use to describe the feelings they have about cancer treatment of a sibling. Watching a sibling lose weight, lose his hair, be hospitalized, etc. engenders fears of death that children left to their own devices are ill equipped to work through. Siblings also often feel guilt, powerless, loneliness, anxiety, depression, anger, and jealousy. Unable to understand what “cancer” even means—they know their sibling is sick, but they may not be able to understand why their brother or sister is getting so much extra attention, gifts, and invited to special events focused on them meanwhile their own feelings may be unintentionally discounted.
If these feelings are left unattended the sibling without cancer may end up with issues of their own. They may stumble in their academic achievement or suddenly show misbehaviors. Some siblings after the death of a sister or brother may suddenly also get “sick” often and need to stay home close to Mom or Dad—perhaps unconsciously wanting to be cared for and safe. Siblings may also have trouble at school or in social settings when adults or other children express kind sympathies (adults) or awkward questions (children) that the sibling has no idea how to respond appropriately.
During cancer treatment, or in a time of bereavement, a sibling may become super responsible and take on the role of caring for their distressed and often overwhelmed parent—a role that may be dearly appreciated during a crisis but shouldn’t be left in place for a long time afterward—as children need to be parented versus having this role reversed.
Children also want to believe that their parents are powerful versus powerless in the face of challenges and they may suddenly move into crisis finding their parents cannot prevent the suffering or death of their sibling. These feelings of fear that a parent isn’t as strong as the child hoped may lead to inexplicable outbursts of anger or blame—words that a bereaved parent may not be equipped to hear in their time of grief.
Childhood cancer, treatment, and sometimes the death of a sister or brother, are extremely challenging events for a sibling to face. When cancer strikes a child, a lot of things happen and fail to happen for the siblings at home—despite the best wishes of their parents who want all their children to thrive.
As parents support their sick child and literally engage in a life and death medical battle to save the child with cancer they may unintentionally overlook the emotional and even physical needs of their other children. Healthy children may witness the physical and emotional pain of their loved one as well as the distress of their parents—often all without a good support system around them.
Good and loving parents may be too overwhelmed to explain things properly and children who are too young to understand concepts like “cancer” and “death” may find themselves floundering in a sea of anxiety for which there are not adequate supports in or outside of the family. If the cancerous child is hospitalized out of town, parents may literally not be present to help the siblings work through their own adjustments to this very difficult challenge.
Children with cancer clearly suffer and may even die, but the overlooked siblings also suffer—from anxiety and sometimes even posttraumatic stress—with these issues displaying as nervousness, intrusive thoughts, nightmares, and avoidance which all need to be addressed—lovingly in the family or also with professional help depending on the need.
While the challenges of cancer, death, and bereavement, if the battle is lost are substantial, parents should recognize that their other children are also going to be deeply affected. They can take steps to mitigate their other children’s suffering by turning to other family members, teachers, clergy, and even professionals to ask them to offer much needed support. Siblings will need opportunities to sensitively talk with their parents and perhaps even with a grief counselor about what death means, if the cancerous child is likely to die, what the suffering is about and how to deal with a grieving and overwhelmed parents. While it isn’t easy they will ultimately need to find healthy ways to grow through and beyond this difficult time in their lives.
Anne Speckhard, Ph.D. is Adjunct Associate Professor of Psychiatry at Georgetown University Medical School. This is the second in a series of blogs for Donna Speckhard’s initiative My Truth in 365 – A Virtual Journal Project on Pediatric Cancer. Check out her site at and please donate to the cause…. http://mytruthin365.wix.com/mytruthin365#!Finding-Courage-Healing-in-Story-Telling/cke9/B75436BB-E716-4D13-BF7A-447C9F84E58B
Anne Speckhard, Ph.D. 