Armfuls of Time, The Psychological Experience of the Child with a Life-Threatening Illness

By Barbara M. Sourkes, Ph.D. University of Pittsburgh Press, 1999.

Reviewed by: Meg Wickes, Hospice Volunteer.

This book is a remarkably generous and painstaking account by a professional in her field. Dr Sourkes shares with her readers, professional and non-professional, her work with children in the throes of dealing with a life-threatening illness.

Her sensitivity to each child's anxiety and pain is at the root of her work. With the aid of a variety of stuffed animals, residents of her office or brought by the child, she elicits inner feelings which could only find expression through play-acting and projection. The author makes great use of color in drawings and mandalas and black and white projective sketches. /conversations with the child are detailed for the reader accompanied by clear, precise explanation of results.

Her role in the therapeutic team is to relieve the child's emotional suffering, a role in which she obviously excels. I found the final chapters, which, of necessity delve deeper into the meaning of the dying experience to the child and their caregivers, to be most compelling. In the Chapter titled, "Facets of Awareness," she says, "For the seriously ill child, it is only the present that can offer reassurance, a reliability that the future may not hold. Without actually knowing such credos as, 'one day at a time,' or 'make today count,' many children instinctively focus on the present in their adaptation to uncertainty."

Dr. Sourkes has found that young children in the last stages of dying often can be surprisingly matter of fact. She says, "A four-year-old boy incorporated 'dead' into much of his play. For example he rolled back the plastic eyes of one of his stuffed animals, so they looked closed and informed the therapist: 'He's dead.'

It is not, however as simple as that. The author gives accounts of innumerable twists and turns in the feelings and thoughts of the children she treats. I came away with the feeling that these children were fortunate, indeed, to have Dr. Sourkes as their therapist in these crucial moments of their life - and sometimes - death.