Talking to Children About Illness — and Other Difficult Truths

Why our attempts to shield children from hardship so often achieve the opposite, and how compassionate honesty can help

In a recent Wall Street Journal essay, writer Sundas Hashmi shared how she told her children about her diagnosis of terminal cancer. It’s an incredibly hard subject — but Hashmi’s choice to be direct and compassionate highlights something universal: children benefit when we’re honest with them, even about life’s hardest truths.

Why Openness Matters

Children are more perceptive than we realize. Even when adults try to protect them, kids notice changes in mood, routines, and conversations. When they sense something is wrong but aren’t given words for it, they often fill in the gaps themselves, sometimes imagining scenarios that are scarier than reality.

Whether the topic is illness, divorce, financial strain, or grief, openness builds trust. It reassures children that the adults they depend on will give them real information, even when it’s painful.

The Risk of Keeping Secrets

When parents keep difficult news from kids, even with the best intentions, it can:

  • Heighten anxiety (“something is wrong but I don’t know what”)

  • Leave children feeling excluded or mistrusted

  • Make the eventual truth feel like a betrayal

Openness doesn’t erase the pain, but it provides a sense of safety: “I can handle hard truths, and my family will face them with me.”

How to Share Hard News With Children

  • Be age-appropriate: Tailor details to what a child can understand at their stage.

  • Be honest, but gentle: Clarity matters more than overexplaining.

  • Acknowledge feelings: It’s okay to say, “This makes me sad.” Modeling emotional expression helps kids do the same.

  • Keep the door open: Children process in layers. Encourage questions and expect them to revisit the topic over time.

Why This Matters in Therapy

At Rachel Liles Psychotherapy, we see the relief children feel when they’re included in the truth. It doesn’t mean sharing every detail — but it does mean helping kids feel trusted, safe, and supported. These conversations may be painful, but they also build resilience, empathy, and stronger family bonds.

Illness is just one example. Whether the challenge is medical, relational, or emotional, honesty delivered with care can turn fear into connection.

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The Human Element of Therapy: Why Friction Matters More Than Perfection