It’s a Thursday night at the Child and Family Center in Santa Clarita, a surprisingly cheerful place considering the serious troubles that are worked through in small comfortable conference rooms here. Participants in a support group, Talk, Learn and Cope, have come to finish some paperwork with Malibu Psychologist Jeffrey Titcher, who for the past 12 Thursdays has guided families of cancer patients through some deep emotional discussions.
Unlike support groups for patients, this new research-based program focuses on children whose parent is going through cancer therapy.
“Our goal is to lift the burden off the patient,” Titcher says. “We set up parallel groups of children 12 and under, teenagers and non-ill spouses. The patient is not involved at all.”
The joint project of the center and Henry Mayo Newhall Memorial Hospital, funded by a grant from the Betty Ferguson Foundation, helps adults share resources and care-taking strategies. Some veterans of treatment share with the newly diagnosed. They discuss role changes in the family, “parentification” and the role shifts that occur.
“Like fathers not being able to make breakfast the way mothers do, and they aren’t there to talk to after school,” Titcher says. “Although there are common issues to either parent being in treatment, the most difficulty is when the mother is stricken and her role as nurturer is averted. The family changes.”
True even for healthy families who ordinarily talk and share feelings.
“When there’s stress from within the family the dynamics change. They close ranks and stop communicating with each other,” Titcher says. “Everyone’s afraid of hurting the others’ feelings by talking about it.”
Though some children seem to cope, they wind up years later with problems.
“There’s this huge hole that was cemented over, that was never addressed,” Titcher says. “We see depression and many things later on. This is a means of inoculating them against post traumatic stress syndrome.”
The children are separated by age because teens cope with this trauma much differently from those under 12. Teenagers go to their peer groups and get involved in everything they can to keep from thinking about it. The young ones stay closer to home. “Sometimes they’re afraid to go out and play,” Titcher says. “They think if they’re having a good time they’re betraying their mother.”
The children share all these things with each other, so the therapists learn a great deal they might otherwise miss.
Kevin’s mother was diagnosed a year ago. At 10, he was having a tough time with his feelings. Even so, he seems more open than Sam, who is a year younger. His mother has been in treatment for five years. His sister Rebecca is only six and doesn’t remember when their mother was well.
The boys met in the group and have become friends even though their backgrounds are different. They agree to talk with a visitor.
Kevin says, “I feel kind of bothered but I couldn’t tell my mom that because it would either make me upset or my mom. It’s hard to talk about it because I’m worried that I’ll never stop crying.”
Sam says, “Sometimes when I cry, I can stop after about five minutes.”
Cari Savino, an intern who assists Titcher, has the younger children draw pictures about it, what they think it looks like and how to get rid of it, how to deal with it.
“It helped us to learn that Rebecca was angry,” Savino says. “We also focus on body tension, relaxation, coping strategies, tools to deal with something. It’s a time and a place that’s safe where they can explore the hard stuff. Then they put it away for the rest of the week.”
During the holidays they were able to help the children through Christmas and Hanukkah, and talk over how things might be different or the same.
“The Christmas after my mom had cancer, Santa gave us a lot more presents,” Kevin says.
“My mom doesn’t rest all the time,” Sam says. “She comes downstairs and celebrates our tradition with us every night.”
The boys’ fathers have finished their paperwork and join the discussion. Kevin’s dad, Mark, says the first big benefit he saw was “I got input on what the child was thinking that wouldn’t come out at home. They’re afraid of upsetting Mother and themselves. Working with Cari and Dr. Titcher, Kevin talked to them and then we could learn how to react. If you make the wrong reaction you make things worse.
“In the beginning, when we got the diagnosis, it seemed there was just a dead end. Kevin couldn’t sleep at night. Now they talk about the future.”
Titcher says trauma and attachment go hand in hand. The fear of loss can start a process of loss. We allow them to feel angry at Mom so they don’t also feel guilt. The point is to be positive no matter what the circumstance, always look forward to the future and be hopeful, to have another opportunity, to have a good experience. We teach this to both parents and children.”
“It’s easier to do that now. We’re going fishing again soon. Sam’s coming too,” Kevin says. “I’m more hopeful now, but I learned it’s okay to cry.”
A new group set to begin March 1 already has some referrals by oncologists. The results are to be published in an academic journal. For more information, contact the center at 661.259.9439.