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The following article is written by Dr Melissa Weinberg from Deakin University’s School of Psychology. This is the second article in a two-part series examining the psychology of cancer. You can read the first part, ‘How do our brains process a cancer diagnosis?’ here.
In the first of this two-part series, we explored the initial psychological reaction to a cancer diagnosis, and some of the ways treatment can affect emotions, thoughts, and behaviours. In this piece, we’ll look at the psychological factors associated with recovery and life after cancer.
Following the end of their treatment, or once the acute treatment phase is over, clients often present with a fear of recurrence.
While we all live each day knowing we will die at some point, we typically become very adept at not letting that disturb us day-to-day. It’s not the same for people who have had cancer. For them, the fear is very real, and very front of mind. Questions like ‘What if it comes back?’ or ‘How will I get through more chemo?’ keep my clients up at night, and can impede their ability to move forward with their lives.
Health-related anxiety is a common presentation, with psychological symptoms escalating in advance of a check-up or oncologist appointment. For these sessions, the patient usually returns to the hospital or even the exact room where they received their diagnosis, triggering physiological and psychological reminders of their illness.
While the fear of recurrence or even death can leave some hyper-vigilant to their health or acutely aware of even the subtlest bodily changes, and feel unable to make future plans in case their cancer returns, others may make drastic changes to their lifestyle, or respond with a newfound appreciation for life.
In literature, this can be referred to as ‘post-traumatic growth’, denoting the positive changes that can occur following a traumatic event.
The research on post-traumatic growth following cancer is curious, given that cancer does not meet the criteria for a traumatic event.
Nevertheless, it is not unusual for people to resolve their distress by finding meaning in their illness, or reporting positive outcomes that they attribute to having cancer. They might claim they now realise what’s important to them, or feel more appreciative of their loved ones as a result of their threatened loss.
'Health-related anxiety is a common presentation, with psychological symptoms escalating in advance of a check-up or oncologist appointment.'Dr Melissa Weinberg,
School of Psychology, Deakin University
Fundamentally, people change in response to life events. We are all products of our history, and the experiences that we have shape the way we respond to future events.
An appropriate resolution of grief is signalled by the ability to remember the person or the loss without the intensity of emotional distress that we feel at the onset.
When we evaluate the change as either positive (as the term post-traumatic growth implies) or negative, I think we’re committing a disservice by implying there’s a right or a wrong way to adjust to a significant life event. In my opinion, this detracts from the individual experience and suggests those who are not grateful or appreciative for what they have in their lives, have not effectively coped.
One of the reasons I enjoy working with cancer is that most of the time I find myself working with people who have little or no history of mental ill-health. My psycho-oncology clients are usually high-functioning, well-adjusted, well-supported people, who have a clinically diagnosed physical health condition.
I think it’s important to remember that they are not psychologically ill, they are physically ill. Their psychological reaction is often appropriate as a response to what they’re going through.
Social support, information, and being allowed the space and opportunity to effectively process your emotions (sometimes with support from a therapist if need be), can go a long way to alleviating the psychological distress associated with cancer.
Remember what works for one person may not work for another, and respecting the individual’s wishes and emotional needs during their time of distress is crucial.
When people are going through cancer, they typically don’t go through it alone. While there is one person who physically has the cancer, their partner, children, or other close family members can experience the psychological effects of cancer as well.
For further information and resources, the Cancer Council Victoria is a great place to start. Visit cancervic.org.au for more.
Honorary Fellow, School of Psychology, Deakin University
