Monday, April 11, 2011

at a loss

On Friday I worked with Magical after school. At the end of our session his mom mentioned that they had something they wanted to talk to me about. Magical's been angry, she explained, and when he gets angry he is very mean to his family. She wanted us all to talk about it so that we could help Magical work on using nice words and controlling his anger. She mentioned that the doctors call it "chemo brain" when he and other patients like him become unreasonably or illogically angry.  I've seen his outbursts myself and can only imagine what it would be like to watch a child struggle with chemo day in and day out while overflowing with anger. Anyone would be angry. Some days I look at Magical and get angry too- not at him but at the situation and the world. How it it fair?

Helping children manage their anger is something I do (or at least try to do) frequently. But I've never been in a situation quite like this before. I've worked with children who had very, very good reasons to be angry, but somehow even those situations seem different. Those children still had moments of childhood during their day. They had friends and could run on the playground, and their bodies were not being pumped full of chemicals. 

I'm also use to giving discipline advice to parents. Yet that's usually for strong willed active children or impulsive little ones. One, Two, Three Magic isn't quite what this situation calls for. I can think of ideas and suggestions, but are they even appropriate?  I have no idea what Magical and his family are going through. Part of me is scared to make assumptions. Tell them to give him choices? He gets a lot of choices during the day. Insist on him using  a gentle voice? I've seen him become some unreasonably angry I'm not sure how he'll respond to redirection when he's upset. He stops seeing logic at a certain point. Ignore it and not react? Can you ignore a cancer patient screaming for food? When I'm there he responds to my redirection or my reminders telling him to use a gentle voice. But I'm there for two hours a week. I'm a change in his day, a friend stopping by. I don't think it has to do with me, but simply that I am a break from the mundane. 

I've been thinking about the family all weekend, wracking my brain for resources and recommendations to bring over. Do any of you have any advice? Any experience working with children cancer patients and how they emotionally react to chemo? 


Anonymous said...

Is there any resource at the hospital where the child is being treated? It is common procedure to assign a hospital social worker to a child's case; can anyone in the family ask the treating physician's office how to access that help? If one hasn't been assigned, the family can ask for one with familiarity in chemo-induced psychosis. It's going to be easier for the family and impossible for you to directly help, considering HIPPA rules.

Molly said...

I've never left a comment before, but I've really been enjoying your blog and your enthusiasm for your job. (I also teach special ed.)I have no words of wisdom on this subject of Magic and his anger, but it certainly breaks my heart. Watching a child explode in anger and become more and more irrational, is so heartbreaking. Sending thoughts your way.

Rachel said...

I do not know of anything to help off the top of my head, but you might want to check out the Books That Heal Kids Blog
She has books for just about every topic - I hope you find something that helps!

M.H. Rossi said...

Why is a person - young, old, no matter - who is suffering from a really bad cancer ... why is that person even expected to control his anger, especially if it's chemically induced? I have never had chemo, but from what I understand it is terrible and something no one has an easy time with. Perhaps it would be more helpful for the family to consider that he is offering them a chance to express unconditional love, an opportunity to continue to put themselves aside and simply be there for him. I'm sure his cancer has already required more of them than they thought they had to give, but it seems to me that more is being asked, including their understanding that although he may not be able to use nice words or otherwise be sensitive to them, he is still the little boy they love - a little boy who really needs them to totally love him now.

Johanna said...

If your gentle redirections are helping, and if that's the intervention the family is suggesting, it may be that that is helping already. If it does, great, if not, look into some other options.

For example, it strikes me that family therapy might be a good recommendation, if it's available, especially through the hospital--to discuss the feelings and what to do when they come up, whether they are from organic feelings or the result of chemicals pounding his system. The primary goal here would be to provide understanding and unconditional love, and secondarily to work with Magical to see what he thinks will help him when he's feeling that way. Kids are often more articulate about these things than we give them credit for.

And it seems like his behavior is more typical of children with mood disorders; if there is a psychologist or special education teacher who has background in mood disorders (anxiety, bipolar, depression, oppositional defiant disorder, etc.), s/he is probably very experienced at dealing with kids who have uncontrollable emotions. Some options that come to mind might be allowing him a safe place/outlet to express those angry feelings (whether they are emotionally/situationally sourced or simply chemically generated), ways to keep him from hurting himself or others if he lashes out physically, and ways to redirect.

My heart goes out to him, to his family, and to you. Bright blessings as you continue your work.