Because of my interest in oncology social work and psychosocial oncology, I have done a good bit of reading about coping and resilience in cancer patients. Unfortunately, I don't have the time to cite my sources right now, but I wanted to share some thoughts that might be helpful for caregivers and patients.
As adults, we can be blown away by the strength and resilience of children. Sometimes this leads us to wonder why we aren't able to see things the way that they do. There are actually many reasons!
Our brains work in certain ways so that we can survive and thrive. We are all born to be very flexible and "open" as children. This is so that we can learn the many things that we need to learn in order to be functional adults later. This flexibility also serves another purpose when we are kids - it allows us to endure the blows that inevitably come our way as vulnerable and dependent creatures. Most of us are able to adjust to the wounds of childhood and go on to be healthy adults.
I recently learned that the resilience class offered in my MSW program only deals with childhood resilience. It is easy to study resiliency in kids, because it is a prominent part of a child's world. Much of the ability to be resilient fades, or gets complicated, as we get older. We develop certain "constructs" that help us function in a reliable and responsible way. We develop a healthy fear of death that keeps us from doing rash things. We develop an understanding of the importance of productivity, parenting, planning for the future, etc. When cancer enters our lives as adults, whether patients or caregivers, all of these constructs that we have developed are threatened. We cannot fall into Mom's lap and feel protected. Instead, we must keep going and caring for those around us. Often we end up with traumatic stress symptoms, anxiety disorders, depression and the like. These things happen to children, but to a lesser extent than one would expect, and children have that extra level of resiliency to bounce out of them, especially when they are in a loving and stable environment.
Here are some other interesting things that make a child's experience of disease different than an adult's.
First of all, while dealing with cancer and all of its effects, children are usually free from the adult responsibilities involved. They don't have to worry about filing insurance claims, keeping the house, paying the bills, making medical decisions, etc. As the parent of a patient, even though you are not the one going through the cancer, you are the one with all of the responsibility. Naturally, it may be harder for you to be positive and plow ahead at times. And if you are an adult patient, you go through the cancer AND handle the responsibility. So don't expect yourself to be able to see things as clearly or as beautifully simply as children do.
Second, a child's understanding of reality is much more malleable than an adult's. Children have yet to come to certain milestones in their lives. A child has never been independent, so she does not have to deal with the loss of independence while going through treatment. Childhood dreams are often more free-floating than adult dreams, so they may find it easier to change their dreams based on their medical condition, while adults may have a hard time making these adjustments. Children have experienced less years being physically well, so a serious illness at an early age may not feel as unnatural to them as we would expect.
Third, children under a certain age have not mentally developed to the point that they have a complete understanding of the threat of death or its implications. This is not to say that they don't have experience or insights, but their experience and insights are limited by their mental development. So the next time that you wish you thought like a child about cancer, remember that they may be NO WAY to go back to that kind of thinking, because your brain is fundamentally different now!
Of course, adolescents with cancer deal with a whole different situation. Teens may not have the responsibilities of adults yet, but they have a more complete understand of dreams, death and loss. Adolescence is already a rocky, identity-forming period. When cancer is thrown into the mix, some adolescents "revert" to feeling and behaving as children, and some seem to mature at a staggering rate. There is certainly no right or wrong way to cope. Many adolescents seem to have a knack for "moving on" and leaving the cancer experience behind them. With their whole adult lives still ahead of them, this is a good thing!
It is probably obvious that I focus on adults, so I have less information on what it is like to be the child in the situation. I can imagine that children's fears, especially, can be much more intense. I know mine were when I was young! But my point in writing this message is to remind us all that our perspectives of the same experience can be SO different, and this is especially true with children and adults. It is easy for us to project onto a child how WE would feel if it were happening to us. It is harder for us to imagine what it feels like to be that child, with that child's imagination and thinking processes, living in that child's world.
We should be careful in what we judge as "strength" or "weakness." The ability to "move on" after cancer involves many variables. I recently watched a video of a young child who had the same surgery that I did, along with a load of chemotherapy. He could move his arm in so many ways, he could jump around and land on his arm without wincing! It struck me that children's bodies have such ability to heal. No matter how much PT I did, my body just wasn't able to make that kind of progress. We can view mental resilience the same way: older minds, like older bodies, are often slower to heal. And that is okay!
What do you think?