Written by Anna Papanikolaou-Koumbis, ΒSC. MSC., Clinical Psychologist and Health Psychologist
The need and the importance of the psychological treatment, as far as the cancer confrontation is concerned, has been proven based upon the biopsychosocial model. According to this model, the human being is considered as a whole which consists of body, soul and the surrounding social environment. As a result, the treatment of cancer has been established to be the collective work of a multidimensional therapeutic team, which comprises doctors, nurses, psychologists and other experts. Each and every of them takes over the respective job and all of them work together in order to achieve the best results.
The impact of the cancer disease on patients’ and their families’ psychosentimental balance
On hearing the word “cancer”, huge waves of stereotypes, emotions, hypotheses and scenarios emerge. A lot of worries about the potential psychological shock of patients and their families can emerge too. Τhe patients in particular, from the moment of the disease’s announcement, start being vibrated by a lot of different factors. They have to face the symptoms of the disease (prospective moving and mental changes, changes in appearance) as well as the disease’s side effects. Now, they are asked to discover themselves according to the new given facts of their life. They may experience intense emotions like stress/ anxiety, sadness, depression, guilt, fear and embarrassment. Abrupt mood changes, loss of control, autonomy and self-esteem often lead to social withdrawal. Sleep, sexual and role disorders can possibly make the everyday life difficult.
It is important to mention that similarly to the patients’ emotions, their families experience intense negative emotions until they accept and get used to the new reality of life. As carers, they feel this kind of special sentimental and psychological burden.
There is a specific phenomenon observed among the families, whose one member suffers from cancer. A remarkable effort is made by all the involved members in order to protect each other’s emotions. That’s why, most times, they stop discussing about the burning issue of the disease or they are obliged to pretend that everything is fine. This fact is psychologically tiring and makes matters worse since they postpone the adjustment to the new reality of life.
The benefits of psychological treatment for cancer patients and their families
A patient is narrating...
«The psychological treatment helped me to free myself from all the labels and stereotypes, related to the disease that initially crossed my mind. Not only did I treat I my body but also my mind because I managed to overcome my fears, accept the situation and focus on the positive aspect of life. »
The need of the psychological treatment of the patients, who suffer from cancer, and their families, arises when the disease is first announced. One of the main goals of the psychological treatment, this specific period, is the person’s guidance in order to be energetic and willing to fight. This means the person has to interpret the diagnosis as a challenge rather than a treat or a scenario of disaster. In this way, the desperation is avoided and the patients don’t give up. They also avoid stress and sadness and they positively deal with the situation. It is worth mentioning that the patients who are willing to fight develop less stress disorders, depression and other difficulties in psychological adjustment. Taking all the above into consideration, we can easily understand why an immediate psychological treatment is required.
The second goal of the psychological treatment is the support and the guidance of the patients and their families in order to handle and face their negative emotions such as stress, anger, panic, fear for future and depression. Obviously, these feelings derive from the first diagnosis and first announcement.
Last but not least, it is really important to encourage and support the person in setting goals and in readjustment of social, working and family roles.
In conclusion, we should highlight the fact that each and every person experiences the diagnosis, the treatment’s stages and his/her new life in a unique way. The psychological treatment works as an intervention, which is absolutely adapted to each person’s specific needs.
Some basic advice in order to face the negative emotions and thoughts
Dealing with negative emotions
Try to understand the emergence of your negative feelings which stem from your life’s conditions. It is really important for you to observe your emotions and thoughts without judging yourselves and without trying to send them away.
The key phrase you can say to yourselves or to one of your family members is the following: «It is absolutely natural, logical, understood the fact that I feel sadness, anger, desperation....». If you try to understand yourselves and your feelings, you will weaken and relief their negative influence.
Dealing with negative thoughts for the future
Take full advantage of the present- of course it is a challenge- by consciously (use your mind and sensations) being occupied with something during the day. For example, when you have a shower, you should focus on the sound of the water, the sensation of hot water on your body, the potential fragrance of the soap… . If it is difficult to control your thoughts, try not to get angry. Understand yourselves by saying…«Don’t worry. It’s natural. Thoughts come and go» and try to focus again on something else.
Other points that should be highlighted regarding the psychological treatment
The psychological treatment is dated in 1960 in U.S.A. It consists of different forms of individual and team treatment or even family support. Each treatment lasts one hour and it takes place in the doctor’s office or in patient’s home, if need be.
The sessions are organized through a discussion about subjects adapted to the needs and goals of the patients. As a result, both parts decide on them. In addition, some relaxation, mind and behavioral techniques are used.
The implementation of an effective treatment depends, on a large extent, on the psychologist’s education as well as on the quality of the therapeutic alliance. In other words, the strong bond between the patient and the psychologist is essential. On the one hand, the patient looks for help and guidance. On the other hand the psychologist, who is actually the patient’s choice, should be trustworthy and should strictly follow the code of conduct.
I feel that this decision- to visit a psychologist or to participate in a therapeutic team- requires courage and strength. Free yourselves from all the stereotypes and trust us. Our role is to support, to guide you to this effort that you make in order to face all your worries and negative feelings. With our help you can easily be adjusted to the given situation.
Written by Psychiatrist Kontoangelos Konstantinos, MD, PhD, 1. Α’ Psychiatric Clinic of National and Kapodistrian University of Athens, Aiginitio Hospital, 2. Research and University Institute of Psychiatric Health
Daily routine, quality of life
The treatments such as surgery, radiotherapy and chemotherapy are accompanied by serious implications on patient’s daily life, at times. For example, the patient’s ability to eat, to drink, to breathe and speak can be influenced. The pain and the intense cotton mouth don’t allow the person to enjoy a peaceful sleep. As a result, they feel tired and exhausted the following day.
Head and neck cancer may make patients’ life difficult, since a surgery can have a strong impact on visible body parts, on their appearance.
The long term implications of embarrassment in social, sexual and family relationships may lead to deterioration of patient’s personal relationships and communication with others, despite the improvement in physical functionality and in his general well-being.
The outward appearance affects the self-esteem, the depression and the social isolation. The person’s feelings of being stigmatized, as a result of his different appearance, are becoming gradually stronger and contribute to the general social implications of a persistent embarrassment.
The head and neck cancer patients fight to come to terms with the knowledge that their early life and their persistent past attitude could have contributed to the development of cancer.
Support of Psychological Health
During the daily clinical practice each patient with head and neck cancer needs psychiatric and psychological support. Unusual sadness with low or high intensity, death wishes and mood changes after a pleasant activity, may occur. How the patients perceive this kind of disease forms their behavior and what they believe regarding their ability to control and affect the reality.
The appropriate support of psychological health may help patients not only during their treatment but also after this. It is going to help the patients to change their beliefs through cognitive therapy or cognitive restoration. In this way, they can exert more control by having a new and functional perspective of the situation.
Written by Despina Floridou, Counselor of Psychological Health, Department of bone marrow transplantation , Department of children’s cancer Marianna Vardinogianni “ ELPIDA”, “Pedon” - “Agia Sofia” Hospital
«Our body is a part of our soul», Hippocrates, 460-370 BCE
A child with neoplastic disease
The psychological support of a child with neoplastic disease is really important during all stages. For example, it is important both at the beginning of the treatment and at the recovery period, if need be.
The child who is diagnosed with neoplastic disease should forget for a while his already known daily life and habits. The child is going to start a totally new life, which is going to include long-lasting hospitalization, body interventions as well as painful treatments.
Τhe expression of feelings that we expect to see depends on the developmental stage in which the child is. From infant’s phase until toddler’s phase the separation anxiety is a natural developmental phenomenon. As a result, the child’s hospitalization is going to cause remarkable inconvenience.
From ages five to ten the feelings of fear, anxiety and confusion about what will actually happen are really intense and we often observe intense stress during all the treatments. When a child diagnosed with neoplastic cancer becomes an adult, apart from all the above feelings, he feels anger, desperation for his appearance and fear for his life too.
A therapist of Psychological Health is going to solve all the above problems regarding the feelings. He should focus on the principle of individuality. In other words, he should focus on the unique way a child faces and experiences the disease. The therapist should also have a special and regular communication with doctors involved, from other specializations, in order to ensure his patient’s psychological readiness for facing the above feelings.
Common goal: Physical and Psychological Child’s Health
The therapist’s qualities should also include the following: respect for individuality, authenticity from therapist’s part, with unconditional acceptance of child, rather than a role of authority. Joining hands with children, with empathy and love, the therapist will light all the difficult pathways, which they are going to cross together.
Parents and other family members aren’t prepared for a cancer diagnosis no matter how many severe symptoms have already appeared. A feeling of “thunderbolt” is what exactly the family members experience outside the doctor’s office.
The emotional stress that parents experience will manifest according to parents’ social and educational level, the child’s age as well as the parents’ age. They are going to handle the diagnosis itself, the doubts of a successful treatment and the child’s physical strain.
A strong and consistent parent
The psychological support at this early stage is really important and is going to affect the parents’ and child’s emotional development. The first feelings are going to be interpreted and put in order by a therapist. In this way, he/she is going to turn them into functional feelings and their intensity is going to be reduced. As a result, the parents will be strong and consistent standing by their child with all their heart.
The therapist should facilitate the parents to be adjusted to the new reality and make them share their feelings, concerns and needs.
The initial contact isn’t easy. They frequently don’t want to talk to a “stranger”, although they know this kind of job. In the beginning, as a first approach, the therapist should show absolute respect to the time that the parents need in order to touch their feelings. It is really important to understand that the therapist isn’t going to show them what they should do for themselves and for their child. The therapist is going to help them with his/her knowledge and experience presenting them ways with which other parents managed to reach the end of this adventure.
We should always keep in mind the feelings of the child’s siblings. It is obvious that they have to fight as well, staying away from their parents and brother or sister. In some cases, they are forced to change house or stay at a relative’s house.
The communication with their own parents may be difficult and they may meet them after a long time. Most times, the presence of both parents at the hospital is essential. The siblings often feel guilty because they are healthy contrary to their brother’s or sister’s health.
A hand, an ear and a heart
Parents don’t always need advice. Above all, they need a helping hand, an ear to hear them and a heart to follow them. Those are the stepping stones for a therapist who works for cancer departments and has to do with children and their parents.