A child hospitalized at Sheba Hospital (Photo: Flash 90, Chen Leopold)
Cancer is notorious in general and when it comes to children, even more. Although the vast majority of children recover, still (despite wonderful progress) it is a serious, complex and prolonged disease.
The intensive treatments usually require a long stay in the hospital, and the coping includes various elements that have a sweeping effect on the sick child and his family. Reality, the routine that used to be, is reversed in an instant. There is no familiar and ordinary. And it is not easy to adapt to the new situation, which is also characterized by uncertainty, many changes and disruption of routine.
It may sound strange, but many of the children love the ward and even enjoy being there to some extent and sometimes miss it after recovery. The children are constantly with at least one of the parents, enjoy frequent visits from family members, wrapped in a warm and loving staff, and a host of children's stars who often come to celebrate.
So far, it sounds like our heroes, the patients, can get through the period well, but unfortunately sometimes other heroes are left behind, also beloved and important children, whom we call "the transparent heroes" – the brothers.
In an instant, everything changes
When parents need to be with the sick child, siblings are with other adults, uncles, grandmothers, friends.
The parents must invest all their energy and attention and work together with all their strength to heal and support the sick child, when their lives have changed beyond recognition and they are surviving on all fronts. It is reasonable to assume that from the eyes of the brothers the story is very complex. The siblings are used to, for example, Dad taking them to school, Mom showering them, telling a bedtime story. There is a goodnight hug from the parents and the most delicious schnitzels that Dad prepares, on Shabbat we go to Mom and Dad's bed and then to the beach, and there is Friday dinner at Grandma's. On the way you can sing and fake in the car with your mother loudly, sometimes get angry, laugh and cry. All together. And after school tell everything that was, and watch TV together. And suddenly in one moment everything changes. Parents, even when they are at home, are not entirely present.
The invisible heroes, sometimes called "the forgotten children" in literature, are very influenced by the period of illness, an objectively long period, and very, very long, in terms of child time. In addition to daily coping, complex and deceptive emotional coping is added. On the one hand, the healthy child is lucky, since he is not sick, and on the other hand, he is very jealous of his sick brother, so much so that sometimes, secretly in his heart, he would like to change with the sick brother. These legitimate feelings do not fit in with the message from the environment.
Little siblings hugging (Photo: ShutterStock)
When a child expresses jealousy about the gifts or attention that his sick sibling receives, they will usually tell him, "You have nothing to be jealous of, your brother is tormented." The child may feel ashamed for being jealous, sometimes even hatred towards his siblings. Jealousy and shame lead to a sense of guilt: how he dares to hate and envy his brother, and be troubled by a test, quarrel with friends or fear a Scout trip, how dare he complain, resent, ask, complain to his parents, when his brother has cancer.
I, too, grew up as the "sister of," with all that implies – a "transparent heroine" not by choice. Over the years, I found myself attracted to the therapeutic world and discovered that, like me, many therapists come to the profession from a place where pain is woven into resilience and vulnerability ripens into empathy.
In the Oncology Department at Schneider, we help parents provide an emotional response to siblings both by providing care in the community and through joint observation and mapping their needs. Without a doubt, the most common topic that comes up in the weekly support group we hold in the department is the issue of siblings. The parents share the pain and distress of the siblings. We reflect to them that the very pain they experience shows that they do manage to see them, to keep them in their minds and hearts. Sometimes, we offer small tips that can cause great relief.
In addition to the teams responsible for the physical care of the children, there is an entire army that is responsible for the soul. Social workers, expression therapists, psychiatrists and psychologists. When we work with a child and his parents, we try very hard to take into account the siblings as well. Naturally, and logically, one might think that first, all resources should be evacuated and invested in the sick child, and after he recovers, collect the fragments and rehabilitate the family, help the siblings overcome the ongoing event he experienced.
From the experience we have accumulated and from studies conducted mainly in the United States, it emerges unequivocally that it is crucial to treat and treat siblings from the moment of diagnosis. A study conducted in the United States found that sibling meetings of sick children are very effective. It was found that the mental well-being of the siblings improves, they report a reduction in stress, an improvement in self-image, a desire for company, an improvement in mood. The parents of the children who participated in the meeting described significant improvements in their mental well-being, level of communication and even empathy indices. They feel understood and empowered.
Today, it is widely accepted that difficult and complex life events can increase the resilience of a person, of a child. Usually, validating the event and processing it allows growth even out of pain and difficulty.
As part of our attempt to preserve and even empower the "invisible heroes," we organized a conference for siblings of patients we called "My Brother." The conference will take place on May 24, 2023 at 16:30
Michal Adiri Alush is a psychologist in charge of the Hemato-Oncology Division at Schneider Children's Medical Center of the Clalit Group
- health
- Parenting
Tags
- psychology
- Children
- Brothers
- cancer