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He lost his big brother to brain cancer. Now play therapy helps him process his grief

White Coat Black Art26:30Grief is child’s play

Zach Bulger goes into the play room at Canuck Place Children’s Hospice in Vancouver, and picks from an assortment of toys.

There are knights, dragons, polar bears and much more to choose from. He decides to play with a toy ambulance, airplane and police car.

“They’re all getting ready for their next mission. They just came back from a fire,” says Zach, 9, as he sits down to play with his counsellor. He’s wearing a hat that says, “How Great is our God,” and a Black Panther necklace that belonged to his older brother, Cameron. 

Cameron died three years ago from aggressive brain cancer, and since then, Zach has been taking part in play therapy. It’s an approach that lets children work through difficult emotions through play, with the help of a counsellor. 

And Zach’s mother, Sharon Bulger, says it has made a big difference for her son.

“Over time, you could find that he started to develop a language. He started to develop words that would express actual feelings,” Bulger told White Coat Black Art host Dr. Brian Goldman.

Zach picks through the toys he’s going to play with as his therapist Emily Watson watches at Canuck Place Children’s Hospice in Vancouver. (Brian Goldman/CBC)

According to Kevin St. Louis, president of the Canadian Association for Play Therapy, children don’t have the tools to express themselves verbally the way adults do. 

Play therapy instead lets children communicate through how they play. It can take the form of art, music, and just playing with toys. The counsellor sits and plays with the child, observing what they’re going through. 

St. Louis says he used to only be able to treat children who were ages nine and up with talk therapy. But play therapy has allowed him to work with younger children, including kids as young as two, all the way to 16. It’s even effective with adults, he said.

‘What lemonade are we going to make today?’

Sharon Bulger says her eldest son loved hockey, playing with Beyblades and watching Marvel movies. 

“He was the lover of life. That kid was funny — and I mean downright hilarious, actually,” said Bulger. “He loved his people, like his heart was huge.”

And he loved his brother, Zach. Every night, Cameron would beg his little brother for a kiss goodnight. Bulger says Zach would pretend he didn’t want to, but he would always relent. 

“Zach always went in and obliged and gave him a big squeeze and they would giggle. And that was Cameron. He loved his brother,” said Bulger. 

A woman sits with her son on her lap.
Sharon Bulger, at her home in Surrey, B.C., says she didn’t know how to help Zach as he grieved the death of his brother, but play therapy made a big difference. (Brian Goldman/CBC)

In 2017, when Cameron was six years old, he had vocal seizures in class, and became unresponsive. He was rushed to the hospital, where they discovered a mass in his brain. 

“I was handed a bowl of lemons, and I had to figure out how to navigate that and to do that in a way that was going to bring him the best days no matter what,” said Bulger. 

“We had a saying that we kind of embrace as a family. ‘What lemonade are we going to make today from whatever lemons we are handed?’ And we really lived in that because if we didn’t, then what are we living in? Fear? Despair? That’s not a life. We can’t, we couldn’t do that.”

He lived two-and-a-half years past his diagnosis. 

Play therapy

At Canuck Place, Zach has assembled a group of first responder toys to go with all the vehicles he picked out. Zach was four when his brother was diagnosed, and six when Cameron died. 

During that time in between, Zach didn’t get to see his brother much. Bringing Zach to the hospital would’ve put Cameron’s depleted immune system at further risk.

“When Cameron died, Zachariah asked us probably for about six months, almost every day, ‘Please tell me today he’s coming back. Why can’t he come back? Please, can we go to the gravesite and dig him up? We need to bring him back,'” said Bulger. 

“He didn’t get it. And we relived that grief with him day in and day out … because he didn’t understand.”

A boy plays with a toy helicopter and toy plane.
Zach wears a necklace from the film Black Panther that belonged to his brother, Cameron, at Canuck Place Children’s Hospice. (Brian Goldman/CBC)

But play therapy helped Zach realize the permanence of death. Even before Cameron died, Zach received counselling at Canuck Place, in the form of play therapy. 

Zach’s counsellor, Emily Watson, says this could look like a kid playing with a toy dog they say is really sad, which gives Watson the opportunity to reflect on those feelings.

“I might reflect, ‘Wow, the dog is so sad and he feels like nobody can help him, even though so many people are trying to help him.’ And I might just reflect what I’m noticing about the dog’s experience,” said Watson. 

Bulger said that as Zach developed ways of communicating his feelings, his anger lessened. She says he’s been able to tell people what he needs. 

Growing practice

It’s an option St. Louis says more people are turning to. He’s been working as a therapist for more than 20 years, and he says for the first half of his career he was using adult methods while working with children. 

But when he saw play therapy at work, he knew he needed to make a change. 

“I’ve seen it work. I’ve seen some tremendously positive outcomes come out of the playroom and I’ve seen the ways that it can impact families in positive ways,” said St. Louis. 

St. Louis says using play therapy helped him reach more children, at younger ages. According to The National Child Traumatic Stress Network, a grieving child can often be more angry and irritable, develop new fears, and withdraw socially. But St. Louis says play therapy allows therapists to actually help children, not just treat behaviour problems. 

He says play therapy is becoming more accessible across Canada. The Canadian Association for Play Therapy has about 500 registered play therapist now, and he hopes that number will continue to go up. 

A woman stands in front of a toy shelf holding a toy polar bear.
Zach’s counsellor, Emily Watson, says children can communicate their feelings through how they play. She works at the Canuck Place Children’s Hospice. (Brian Goldman/CBC)

Meanwhile, Zach will continue to receive care at Canuck Place as he grows up. When he decides he is done with play, he will be given other forms of counselling. 

For now, the process is slow, but steady, and Watson says, it is making a difference. 

“As he’s gotten older he’s had new questions and new opportunities to explore those questions. And I’ve seen him gain confidence in his ability to make sense of all that has happened and all that he experiences in his head and his heart,” said Watson. 

“[Grief is] not something to be fixed, it’s not something to make go away. It’s something to tend to. It’s something to learn how to be with and adapt to at different stages of life.”

WATCH | How painting can help with processing grief: 

Painting helped her process her emotions. Now, she’s passing the brush to others

On Sunday, Dorothé Kanku will be hosting her first art exhibition. She found her passion for painting after experiencing anxiety and depression. Now she hosts paint nights to help others express their grief.

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