The Cancer Directory. Dr. Daniel Rosy
your dependants, who would care for them if you were unable to, and how you would like to be cared for if you become disabled and dependent. You can even go into the details of where you would like to die and what kind of funeral you would like to have. This will inevitably force you to face your feelings and beliefs about death, so you may also need the help of a spiritual advisor. This may sound extremely grim, but most people who have employed this head-on approach have found it tremendously liberating. Paradoxically, any step you take in the direction of both healing old wounds and preparing to let go of life will enable you to live all the more fully. This, in turn, will enhance your energy, vitality and health and, consequently, the chances of stabilizing your disease.
Healing Your Emotional Wounds
Another thing that might emerge from this process is the urge to complete unfinished emotional business with anyone against whom you are holding a grudge, or by whom you feel you have been aggrieved or hurt. It may not be necessary to go anywhere near these people to do this work – it may be quite possible to make your peace with others during your counselling sessions. This often has very surprising results, as the dynamics of these old and difficult situations and relationships can often change dramatically once you have shifted your position.
Attending to these background emotional issues will be part of your long-term Health Creation Programme (see Chapter 9) and be best addressed after you have been through your treatment.
Facing the Cancer Diagnosis: Understanding Your Reactions and Identifying Your Needs
Now that we have looked at the psychological foundation for recovery, let us take a look into the question of how you are feeling now. It is very possible that, having recently had a diagnosis, you are still in a state of shock. It is important to understand the effects of shock and how to deal with it.
Dealing with shock
The diagnosis (or re-diagnosis) of cancer can put you into severe emotional and physical shock. Extreme shock is an odd thing. You may feel that you are able to cope but, in fact, your thinking and reaction times may be severely impaired. If you do receive bad news when you are not expecting it, it is safer to wait at the hospital or surgery until someone can come and pick you up. It is certainly better not to attempt to drive or go out onto public transport while you are in such a state and feeling so vulnerable.
It is estimated that in a state of shock, less than one-tenth of what you are told is retained. Because of this, the most important thing to remember is to never make important decisions while you are in a state of shock! Yet, medical personnel may rush straight from telling you your diagnosis and prognosis to explaining your treatment options.
The sense of urgency created by doctors at the time of diagnosis is usually exaggerated. Yes, it is a good idea to move ahead with appropriate treatment for cancer as soon as possible after diagnosis, but the treatment will be far harder to cope with – and may even be less effective – if you are in a state of shock and fear, and feeling out of control. There is clear evidence that being well prepared psychologically, with a positive attitude towards treatment, conveys not only psychological and quality-of-life benefits, but also a distinct survival advantage.
It is therefore highly advisable to take the time you need to:
• go through your emotional reaction to the diagnosis
• think about what seems the best treatment option for you (and this may even be having no treatment)
• prepare yourself mentally, physically and practically for treatment, before it starts.
Possible emotional reactions to expect
Everyone is different. Initial reactions to a diagnosis of cancer can range from extremely strong emotions to total numbness, and any degree in between. Your state can also vary profoundly from one hour to the next, so that you may find yourself suddenly in a highly emotional state, unexpectedly feeling out of control.
If you need to withdraw, withdraw. If you need to scream, shout and rage, then scream, shout and rage. If you need to weep, please allow yourself to let go completely and grieve over your situation. There is no need to keep up a brave face. This will not ultimately serve you, and will definitely delay the process of your being able to get your feet back on the ground, able to make clearly thought-out decisions about the way forward. Take all the time you need to go through your reactions. Do not be afraid to cancel work and social engagements if you need to. You have effectively been bereaved, and everything will go much better if you allow yourself the proper space and time to begin to come to terms with what you are experiencing.
There is often a sense of intense disbelief and the recurring question of ‘Why me?’. Many people go straight into fear, or even terror, and this can be felt both mentally and physically. Such extreme fear can cause a racing heart, sweatiness, a feeling of weakness and sometimes diarrhoea. The mental anguish can make it impossible to concentrate, perform normal tasks, keep up a social front or sleep properly. Over time, this all-pervasive fear can become focused into more specific fears, such as fear of pain, disability, disfigurement, hospitals and doctors. But underneath it all, it is usually the having to come face to face with one’s fear of death and the deep uncertainty caused by the diagnosis that causes such a strong reaction.
Often, the next feeling experienced is grief. This may be grief at the thought that you might die and leave others behind, or grief for yourself and the loss of your sense of a certain future. Often, relatives, too, will go into anticipatory grief. This can sometimes be so extreme that you find people treating you as if you had gone already! Combined with the withdrawal of friends or colleagues who are too embarrassed to talk to you about what is happening, you may be left feeling abandoned and isolated – as if you have passed through an invisible glass wall and are no longer part of the ordinary world around you.
You may find yourself experiencing a mixture of feelings, such as jealousy, resentment or even anger, towards those who are still healthy. You may dread the thought of becoming dependent on people with whom you do not wish to have that degree of intimacy, or even feel guilt at the thought of not being able to fulfil your ordinary functions. Of course, this will be tempered by the enormous love, closeness and gratitude you will feel towards those who stick with you through this crisis, with whom your relationship will deepen and grow immeasurably.
There can then be the other side of the story. You may, as already mentioned, have been expecting something like this to come along. You may even welcome the illness, feeling that the whistle has finally been blown on what has been an unhappy or unproductive state of affairs in your life. You may even find yourself feeling excited by the challenge of cancer, experiencing it as a much-needed wake-up call. Some may even welcome the possible imminence of death.
Do not think it is odd if you feel this way. Many people feel this way, especially if life has been really tough.
You may have beliefs or even a deep ‘soul memory’ that dying is not so much an ending as a transition into a far freer state of being and, thus, actually look forward to making the transition. Or it may be that life has been so hard for you that dying seems like a blessed relief. But, on a more pragmatic level, it could be that the diagnosis and possibility of death make every moment of life seem extremely precious and exciting and that, in one fell swoop, any sense of boredom or depression with life evaporates.
There is also another phenomenon that people often experience – which is a sense of being almost unnaturally calm. It is as if you are at the still point, within the ‘eye’ of a hurricane. While relatives and friends are being thrown into chaos by the new development, you may find yourself strangely quiet and ‘present’ with the ultimate truth and reality of your situation. It is as if there is a spiritual acceptance of the truth of what is happening to you and, from somewhere deep inside, you are being given the inner strength