My wife suffers with health conditions and has been diagnosed with cancer. The chemotherapy is starting to become difficult for her and I am concerned about the impact this may have on my child’s learning at school. I am also concerned that my son doesn’t bottle things up and that we do all that we can to help him feel supported.

Thank you for your question. From the detail you supply in your email to me, it is crystal clear that this young man lives in a loving, warm and supportive family unit (perfect conditions to cultivate and sustain a child’s resilience). Your concern relates to the fact that your child is starting secondary school and that his mother’s treatment coincides with an important milestone in his life. I can understand why, at this particular time, you might worry a little more about this child than other children in the family.

First of all, I think it’s important to recognise how emotionally resilient your lovely son already is. When we reflect upon how resilient a child is, we can consider things such as how they respond to new challenges (how did he get on at the recent school induction day or first week back, for example?), their own ‘rootedness’ in family life and attachment to caregivers (this sounds rock solid!), and their ability to adapt to change over time. Like all children, your son has lived through a pandemic and will have rapidly honed many of his coping skills over the last two years.

That said, this is time to focus on the family’s emotional literacy and to highlight existing coping mechanisms. It might be a good idea to initiate conversations with your children about your family’s coping skills generally, and with a sense of pride. Recent changes like the return to school or work provide good reasons to talk about how we handle change and how we navigate life’s ‘ups and downs’.

Rather than talking to your son directly about his mother’s health, you could kick start a conversation about coping and concomitant emotions, by linking it back to his school induction day. “I really loved seeing you enjoy that first week at school. How did you feel it went?”, “I really admire the way you just get stuck into new experiences. How do you do that?” Nudging your son to reflect on how he managed to do something that was tricky or challenging can boost his self-esteem and sense of personal resilience.

Widen the conversation out within family life when you get the chance. “Which coping skills do we have and use as a family that we could list?” Use our ‘Tooled Up’ Coping Menu as inspiration for your own. Young children might enjoy creating a list of family coping skills that you can stick on the fridge or family noticeboard. If mum is present during these family chats, you might ask her what the family can do to support her if/when she is feeling poorly.

Mum might have nice ideas that the children can implement, giving them a sense of agency and purpose, rather than helplessness. This is a good way of bringing up the topic of her health without a big serious chat about it that could feel scary. It’s also an opportunity to remind the children that there are certain things that you (as Dad) will be able to help Mum with (that they don’t need to worry about).

Never be afraid to ask your children if they are worried about anything and encourage all questions. If there is a vacuum of knowledge, children can be prone to imagining answers, but it sounds like you know this already. In your email, you reference the fact that “there have been no questions to date that we have been unable to answer”. Good for you. Your children already know that you welcome their questions and curiosity. Saying that, I would add that it is optimal for children to receive age-appropriate advice and that, generally, we let them take the lead. This means not over-sharing, gently observing if they seem upset or quiet and, crucially, creating talking time within family life.

If you are particularly worried about your son, proactively create “truth walks” where you go out together and are allowed to talk to each other about anything (not necessarily his mum’s condition, but about “boys’ stuff”). This is special father-son time that he should enjoy greatly. It might just entail a walk around the block on a Sunday afternoon for 30 minutes or a chat over a milkshake in the local café. Once your son knows that this time is his and his alone, he may well open up, over time, about any specific worries.

I completely understand why you are worried that he might be ‘bottling stuff up’ but, truth be told, he might be processing what is going on and may not know how he feels, so you might need to be patient. All you can do is set up the structures within family life where conversations are possible. Just being with him, hanging out and having fun, making him laugh, and ensuring that he does more of what he loves in his spare time, are all great investments in his resilience and happiness.

You might wish to pay attention to emotions within life more generally so that you can create a family culture even more conducive to opening up; talk about your feelings and use expressive emotional language to explain that feeling. If you are feeling a little down, consult the family ‘coping menu’ and model choosing an activity that makes you feel better or shifts your mood. Children often take their cues from their parents, so if your son sees you happy and relaxed, it is likely he will emulate that.

As your wife’s treatment progresses, it is a good idea to pre-empt situations where she may feel poorly and not be able to participate in family activities. You might choose to talk through things like ‘side effects’. Most children know that medicine helps us to get better but that some treatments can make people feel unwell before they get better. You might choose to discuss nausea, fatigue or that mum might lose her hair (if this is the case). You can explain that this doesn’t mean the illness is getting worse and that these symptoms will eventually go away, and hair will grow back, etc. There are many age-appropriate videos available that help explain both cancer and treatment to younger children.

Over the course of your wife’s treatment, there may be times when she wants a little peace and quiet. Brainstorming ‘ways we can help Mummy during the treatment period’ can help your children to feel purposeful and proactive. When it comes to talking about treatment, it’s good to emphasise its role in minimising, reducing or eliminating an illness in the body. It might also entail reminding them and consistently referring back to family affirmations such as, “Mummy is in the best hands, with the best doctors”. “Mummy is getting all the medical help she needs with a doctor she has confidence in”. “This treatment regime only lasts for X weeks”. It is important that these affirmations are co-created by the family and are appropriate for the given situation. Having things to look forward to as a family will keep all of you moving forward in a positive direction too.

Your original question was mainly about your son’s learning. Let me reassure you that your son will thrive academically if he is steeped in a positive home learning environment; a home where learning is important, homework completed, teachers respected, reading valued and where ‘family talk’ about the day (what went well, what was tricky, what are we grateful for) is part and parcel of family life. My advice to all parents at this time of year when children start secondary school is to help children practise being organised, help them to evaluate their week, monitor their own moods and enjoy making new friends as time goes on. The journey ahead is a great one and you should have confidence in your son, his abilities, his resilience and his capacity to cope. Tell him you are proud of him, equip him with the practical things he needs for the term ahead and, as a family, think of yourselves as a team.

Make sure that you, as one of the ‘team leaders’, have time for yourself built into the family schedule. It is important for you to hang out with and have fun with friends. This ‘time out’ may well help you to feel energised and better able to support your wife and the whole family during what may be a challenging experience.

Here are a few booklets and links on the theme of breast cancer that you may find useful reference points over the coming months:

Talking with Your Children about Breast Cancer

Breast Cancer and Your Child’s School

Breast Cancer Now