Emotional support is a must for a cancer patient; after all death is a must for all
The doctor called my uncle into his office and said: “I don’t know how to tell you this, but you have cancer.” Within a few minutes, my uncle experienced a number of emotions.
He thought about his family, friends, job, money, land, property. Questions like who is going to take care of my children, what about my wife? How is she going to handle all the property matters alone? What about my parents? I am the only earning member. How am I going to break this news to my family? That’s just the tip of the iceberg.
The emotional trauma that a person immediately goes through following a bad news is certainly difficult. However, worse still is the fact that very few of us have been able to understand the repercussions of such an ordeal, thus making us incapable of helping a patient in his bad times. Mental health professionals believe that there are a few emotional stages a person goes through when he finds about the bad news and uses several defence mechanisms in order to feel secure. A number of these are detailed below.
DENIAL: “No, that can’t be right, may be I should get a second opinion. I was fine, how can I have cancer?” “May be the lab reports are all wrong, labs here do not give accurate results.” “I am leaving for London, may be a new treatment there will save my life.”
These are some of the feelings a person goes through. It is very difficult for one to accept the fact that he has cancer. One feels psychologically safe by using the defense mechanism of denial.
The families go through the stage of denial as well, when they discover the bad news. Usually their prayers are: “God, please let the diagnoses be a mistake and the lab results be wrong.” This may last for a few hours, or days.
ANGER: “Why me.” “I never did wrong to any one, I have always helped people.”
“How could you do this to me, God? That’s not fair.” “Life is so cruel.”
These or similar questions come to mind when one starts accepting the fact that he/she has cancer. Such a person is emotionally disturbed, is very sensitive and touchy. A documentary on TV about breast cancer screening might be good enough reason for the breast cancer patient to start crying. The patient may displace anger on family members or friends e.g. may start yelling at spouse, children or servants for very minor or on reason at all. This anger is a mixture of several other emotions including frustration, resentment, hope, desperation and above all a feeling of helplessness. Families go through similar feelings as well, but usually there is less hopelessness. This is when the families try to console the patient and instill hope and determination in the patient.
The patient may express his anger at the medical staff for not explaining everything precisely or for not treating him/her right. This might or might not be true.
Anger can be self-directed which may lead to guilt like, “I wish I had not smoked so much”, “Oh, how I rationalized my drinking.”
BARGAINING: This is another strategy usually used by patients and their families in which they make promises with God and sometimes people.
“God, please make the cancer go away, I will donate money to the cancer hospital, or go for Haj, help the poor and needy.” “I will never fight with my husband again.”
At times the affected person sets self-imposed deadlines e.g. “God let me live till my daughter get married.”
DEPRESSION: At this point instead of talking aloud and bargaining, the person gives in and accepts to go through treatment, surgery, radiation, and/or chemotherapy. The usual attitude of the patient is of giving up, “OK, I’ll do whatever the doctors says. I am helpless!”
Here again the depression may be followed by, or lead to guilt especially when the several important events e.g. vacations, marriages are cancelled or postponed because of the patient.
“Why should others have to suffer because of me? Maybe I am standing in the way of my family’s happiness?”
“All the money that I saved for my son’s education is being spent on me.”
A lot of emotional support needs to be given to the patient, and the family friends need to reassure the patient that he/she is very important for them.
ACCEPTANCE: Gradually the person accepts the fact that he has the disease called cancer, whether he likes it or not. The treatment may instill hope and courage in him. On the other hand he may feel dejected and refuse the treatment after having to go through the side effects of the treatment process.
Every human being is different from the other and may take the whole event in different way. Mental health professionals agree that a person usually goes through these stages when he or she comes across and unpleasant shock, e.g. serious disease, injury, amputation, loss of a precious thing or person.
A person’s role may change when affected by a serious or long term disease e.g. father taking leave from job because of the illness; a student not being able to attend school or college.
This change can be psychologically detrimental and may result in reduced self-esteem as the person might feel that he/she is not worthwhile or productive anymore.
Here are some tips that might make one feel better. Jennifer Barraclough in her book Cancer and Emotion suggests to fit the treatment in ones life, rather than fitting life into treatment. The purpose is that you are still alive and instead of revolving your life around treatment process, try to adjust treatment in your life; try to make adjustments with your activities, instead of missing them altogether e.g. if full time work is too much for you, try to work part time, if possible, instead of just quitting.
FAMILY NEEDS ADJUSTMENT: Since the entire family gets affected by the member’s illness, therefore it is essential to make some adjustments, e.g. wife, or children taking extra responsibilities if husband is sick. Children are generally overwhelmed by the illness and are very sensitive to the change in the home atmosphere. They need to be told in a special way about the problem which can be easily understood by them. At this time they need special attention, reassurance and affection.
SHARE YOUR FEELING: Stuffing your feelings within and not sharing it with others can cause emotional harm leading to depression which may be followed by an outburst of emotions. It is very important for the person to share his thoughts, anxieties, concerns, sorrows and joys with at least one other person he/she feels comfortable with, a close friend, family member or a professional counsellor.
Talking about how you feel provides an outlet to your emotions and can be done by expressing your anger, resentment or appreciation towards the relevant person.
At times the individual and/or family therapy is helpful in order to get adjusted and learn ways to cope with the stressful situation in a better and more effective way.
ASK QUESTIONS: Make sure you ask all the questions you have in your mind from your doctor. Some times making a list before your visit to the doctor helps. Remember, it is your right to ask about your disease. Don’t feel shy or hesitant.
SPIRITUAL COUNSELLING: If you get satisfaction and contentment by discussing your apprehensions and problems with a religious or spiritual scholar then continue dong it. Spiritual counselling is the greatest source of relief and strength for many people.
Try to focus on what you still have i.e. blessing and not on what you don’t have.
Make the most out of every day. Try to focus on the present. Yesterday is gone, tomorrow has not yet arrived, what you have in your hands is today. Don’t spoil it by worrying about what is going to happen tomorrow. Hilary Seott, a breast cancer patient, said: “Illness may be terminal, is life not?” Death is one ultimate reality that no one can deny, rich or poor, sick or healthy.
