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Does the attitude of a cancer patient influence treatment success? What attitudes and masks do cancer patients adopt? How to react when a cancer patient rejects help? These questions were answered by psycho-oncologist Adrianna Sobol - therapist, author of the book "Tame the cancer", member of the Board of the OnkoCafe Foundation - Better Together!
- Marcelina Dzięciołowska: Does the patient's attitude affect the treatment progress?
Mgr Adrianna Sobol:There are studies that prove that they have a "better attitude" - generally speaking, he althy thinking about their disease and treatment, coping skills with various difficulties translates into the fact that patients are better able to cope with the treatment process and sometimes it even eliminates the side effects of the therapy.
- M.D .: How does it work in practice?
A.S.:The patient is then cared for, the task of which is to ensure that his emotional state does not develop into various emotional disorders or diseases, such as depression, which very often accompanies patients during the treatment process.
A.S.:I prepare patients and try to help them build a real picture of treatment and cancer, not the one heard from outside.
- M.D .: What is the patient's task in all of this?
A.S.:This path and cooperation with the patient develops with each step of the treatment and it is this kind of skilful accompaniment to the patient at various stages of treatment, when at each of these stages there is something else.
The first thing for the patient is to accept the information about the treatment, assume the role of the patient and become the patient. Then you need to prepare yourself and enter the therapeutic path.
- M.D .: What emotions accompany the patient in therapy?
A.S.:At various stages, the patient faces various emotional states: from shock to anger, a certain willingness to bargain with fate, patients often struggle with depression.
- M.D .: What's the hardest part of all of this?
A.S.:Please note that every person who measuresdealing with such a situation, he deals primarily with his mortality, which - as research shows - many Poles think that it is something that can happen, but not necessarily, because we try to push this knowledge away as much as possible. In the case of cancer patients, such a situation suddenly becomes a real situation that confronts fears.
- M.D .: What is this fear about?
A.S.:For telling our loved ones about their illness that we would like to protect. In such a situation, a kind of dance begins between the sick and the family, because everyone is trying to protect each other, and in fact they cannot be with each other, because they do not know how, because they feel embarrassed, because they are afraid, they do not want to hurt anyone.
- M.D .: How can the therapist react then?
A.S.:This is where the topic of patient support in the ability to provide information about the disease to his relatives, people at work and from the environment appears. The families of patients who wonder what it means to be good support also need such support.
- M.D .: What other difficulties do cancer patients face?
A.S.:Patients suffering from oncology also mourn their he althy ones, because no matter how wonderfully the therapeutic process would go (I am a fan of oncology and progress in this field), after all, no patient will ever think of himself as he althy again, which also requires dealing with the loss and building a new identity.
- M.D .: What if the patient's condition worsens?
A.S.:When the disease has recurrences, metastases, the disease takes the form of an advanced disease - at each of these stages a psycho-oncologist is needed to help the patient deal with these extreme emotions that none of us will ever be prepared for.
I am glad that patients are fighting for a psycho-oncologist to be present in oncology wards, and according to the regulations, every psycho-oncologist should be in a clinical oncology ward.
- M.D .: What are the attitudes of patients towards cancer?
A.S.:Patients have different attitudes towards the disease, depending on the patient's personality type and other non-disease experiences in the life of the patient.
- M.D .: What to do when the patient does not know how to cope? How to help him?
A.S.:In such a situation, it is worth remembering how I de alt with the difficult situation withthe past, who helped me and who didn't - it is worth reminding my patients.
Each of us has been in a crisis situation at some point, therefore the patient should be directed and made to remember how he coped with the difficulties back then. This will help to establish a plan of action together.
- M.D .: Is this topic related to the fact that patients identify with the disease, because, inter alia, face a kind of relieved treatment from the environment?
A.S.:Attitudes are different, there is a patient who will say that it is an obstacle to be overcome, there is a patient who will say that it is an insurmountable obstacle and all efforts go towards Poor, there are patients who will treat disease as a punishment and that it must be so, and there are patients who are little talked about as it sounds quite controversial because such patients "like" to be sick.
- M.D .: How do they like to get sick?
A.S.:This is an attitude in which the disease fulfills a kind of function, where patients feel relieved, because the disease takes a lot, but can also give a lot - you can, for example, hide behind it . More than once I have had patients who said "I'm so good here, I don't want to leave the hospital". Behind this attitude is often masked depression.
- M.D .: Why is this happening?
A.S.:Because the disease gives the status of uniqueness, everyone around them focuses attention around the patient and cares for him - I know it from my daily practice in the ward.
- M.D .: Are these attitudes true, in line with what the patient experiences inside?
A.S.:All attitudes come from something and it is very important to notice it, catch it and work on it. Most often, the patient behind these various attitudes (even the one who claims that he likes to get sick - this is, of course, a mask), he actually calls and shouts in very different forms: "Take care of me, I'm afraid" - for each of these attitudes there is tremendous fear.
- M.D .: How to get in touch with such a patient hidden behind a mask?
A.S.:Sometimes I come to my patients uninvited, introduce myself and often hear: “Nooo, why do I need a psycho-oncologist, I'm doing great, I don't care about anything - it's great ”then I joke to myself“ Aha! we will meet, but a bit later "- I say it half jokingly, half seriously, because I do not think that every patient has to use therapeutic help, but there is something about it that putting on a strongman's mask means that the patient will be able to cope with everything generally not alwayschecks.
- M.D .: Are patients finally taking off their masks?
A.S.:It often happens that patients throughout the diagnosis and treatment process have a mask of a strongman and do not allow themselves to be weak, express their true emotions.
When the treatment ends, the patient is given the password “you are well, your disease is in remission” - then the story begins.
- M.D .: What is the patient's reaction?
A.S.:Everything lets go … Fears and fears come back with redoubled strength, and the patient begs for help, because the whole process of emotions that accompanies at particular stages had no chance to find an outlet.
Therefore, the question “Who am I now? A patient, am I he althy already? How should I cope? " This is a very difficult situation.
- M.D .: What to do when someone doesn't want help?
A.S.:This is a very difficult question with no clear answer. There is no formula that will save all patients. There is no key sentence that will prove itself in every difficult situation.
- M.D .: What is the meaning then?
A.S.:In this support, it is important to be attentive, authentic, present, alert to the patient's signals. If the patient does not want something very much, it is very difficult to convince him. Nevertheless, it is worth pointing out and showing.
Even when the patient says "no" to it, it is often the case that he or she wants to be taken by the hand and led to someone to help him. This is also a topic that needs to be tamed.
- M.D .: For what reasons do patients most often refuse to support?
A.S.:I often see patients think that if they benefit from support, they will be considered weak. And yet, when ill, everyone wants to be strong and brave. What's more, families say to them "who if not you?", "You have to fight" - I hate this nomenclature anyway, these words are, contrary to appearances, very burdensome.
- M.D .: So going for help is a shame?
A.S.:Poles associate going to a psychologist with the fact that something is wrong with me, and in fact the greatest strength of a human being is admitting his own weaknesses, after all it is it doesn't take anything away.
- M.D .: What is important for the effectiveness of therapy from the point of view of a psycho-oncologist?
A.S.:The psychooncologist is to support, show and develop a joint action plan. In cancer, it is very important to be task-oriented in order not to feelhelpless. At least in those situations where the patient can do something, something to influence. It is a matter of taming, showing that there are no weaknesses in it.
- M.D .: This first step to tame the patient is …?
A.S.:When I enter the room with patients, I often talk to them about the weather, for example, to show that I am not scary, patients find out that I do not start immediately confront them with their fears and they gradually begin to feel that they are ready to talk to me.
- M.D .: What about the patient who is at home, not in the hospital?
A.S.:It is very important to speak out loud what the patient needs. Sometimes it is necessary to face the situation, take the patient by the hand and lead them to an interview. If the patient does not want to speak, he will not, but in such situations this element of support is the key.
- M.D .: Well, yes, not only the patient suffers, but also his relatives …
A.S.:If the family sees difficulties arising from the entire treatment process, it is important for them to announce: "If you do not want to go, then I will reach for support, because I being with you, accompanying you in this process, I also suffer, it is also hard for me. I do not know how to behave, so I openly say that I am going to use the help ”.
- M.D .: This gives the patient a clear signal that he is not alone in this situation, what else?
A.S.:In this way, we build awareness in small steps, tame it and learn what a great and important task in the entire therapeutic process, i.e. naming your needs, the ability to ask for help, as well as the ability to receive this help.
- M.D .: What is the most difficult part of it for the patient?
A.S.:I accompany patients very often in this great lesson in receiving help, because they were always so brave, they looked after others, they always looked after others, and now they need help themselves and it's something we can't, we have to learn, it's a lot of hard work.
Expert
Adrianna Sobol, psycho-oncologist, lecturer at the Medical University of Warsaw Psycho-oncologist and lecturer at the Medical University of Warsaw at the Department of Oncological Prevention. He works at the LuxMed Oncology Cancer Hospital in Warsaw. She is a member of the Board of the OnkoCafe Foundation - Together Better, a psychotherapist and founder of the Ineo Psychological Support Center. Has created an online training platform He alth Begins In The Head. Author of numerouspublications in the field of psycho-oncology and he alth psychology. Co-author of the book "Tame cancer. Inspirational stories and a guide to emotions" (Znak, 2022). She acts as an expert in television programs, co-creates campaigns and social campaigns. He conducts numerous trainings and workshops in the field of psychology and personal development.
Psychooncologist and lecturer at the Medical University of Warsaw at the Department of Oncological Prevention. He works at the LuxMed Oncology Cancer Hospital in Warsaw. She is a member of the Board of the OnkoCafe Foundation - Together Better, a psychotherapist and founder of the Ineo Psychological Support Center. Has created an online training platform He alth Begins In The Head. Author of numerous publications in the field of psycho-oncology and he alth psychology. Co-author of the book "Tame cancer. Inspirational stories and a guide to emotions" (Znak, 2022). She acts as an expert in television programs, co-creates campaigns and social campaigns. He conducts numerous trainings and workshops in the field of psychology and personal development.