TIME OUT:The upset of illness can deprive families of true support
THE WORD cancer still strikes fear into the hearts of many. Once its diagnosis was whispered among family and friends. It was referred to as “the Big C” with hushed tones, lest “it” would “hear” and visit itself upon those who discussed it.
This kind of “magical” thinking in relation to cancer continues in different forms to the present day and can contribute to the emotional concerns experienced by those who receive a diagnosis of cancer and their families. Because cancer, like most illnesses, is more than a medical entity – it calls upon families to respond with all the complexity of family relationships, and family relationships are always complex.
At the extremes are two family approaches: those that are fatalistic and those that are unrealistic. Family members may take conflicting approaches and both responses may deprive the person with cancer from obtaining the kind of psychological support required.
The view that fate has dictated a swift and inevitable end may remove hope for someone with good chances of recovery, while the belief that prognosis depends upon mental attitude can silence those with terminal cancer from articulating their inner fears and impose feelings of guilt on them for any setbacks.
The vocabulary surrounding cancer can also inadvertently cause psychological distress – words defining cancer as the “enemy”, those who have cancer as “victims” and the approach to it as a “battle”.
The belief that it can be “overcome by mind over matter” and willpower alone, can imply that every cancer diagnosis means the same, rather than recognising its many forms, locations, staging, migrations, remissions or progressions and impact.
Family styles also differ, so responses to diagnosis are shaped according to that style. Boundary issues come to the fore. At the extremes so-called “enmeshed” families may demand that all members share and care to the exclusion of everything else in their lives from diagnosis through treatment and recovery.
Conversely, in the more detached style, “disengaged” families, family members may be lucky to learn that a family member has an illness.
Family members may have had friends who are living testament to how successful so many cancer treatments are, while others may have experienced the swift loss of friends who had aggressive forms.
Many families displace their love and anxiety into argument with each other about what is best for the diagnosed person rather than asking that person for guidance. Some family members can feel that the only approach is to be open, honest, direct and talk about death, while others believe the possibility of death must be denied to the end.
What can be forgotten in the distress of illness is that the cue and control should be that of the person who is ill and that simple questions can provide direction. Questions that ask what a person knows, if they are worried or not worried, what is their greatest fear and how they would like the family to support them during treatment is usually the best way to go. Because when we are ill, we want a calm and “secure base”, to take things at our own pace and to talk, or not, when we want to, about what we want to talk about.
What is sad about cancer is that despite the great love that families have for each other, the upset of family illness can deprive families of supporting each other, even while they each try intensely to do so.
Which is why the daffodil is such an appropriate symbol encompassing message and metaphor about how to deal with cancer.
Daffodils remind us of our lives’ fragility that “haste away” so soon. Their springtime brightness reassures us how cancer treatments have developed so well, and of our strength and societal unity through the “host” of people touched by cancer, connecting us to each other in radiant resolve to deal with it together.
Marie Murray is a clinical psychologist and director of psychology in UCD mmurray@irishtimes.com