For most, the diagnosis of "cancer" still sounds like a sentence. Joanna Krupa talks to Dr. Elżbieta Zdankiewicz-Ścigała about what a person with such a diagnosis feels and what is the role of a psychologist in the therapeutic process of neoplastic diseases.
Why are cancer diseases treated as traumatic experiences?
The category of traumatic experiences has been distinguished in psychology because its essence is a direct threat to one's own or relatives' lives. Additionally, when we think of children as "traumatic", we consider an experience that threatens to disrupt the processes of psychological integration. Let's take an example. Divorcing adults themselves may treat divorce as a stressful experience, according to the definition given above, but for a small child up to the age of 12 or so, it is a traumatic experience. The diagnosisof cancerfor the person who is directly affected is also a fully traumatic experience. Also for his family. Let us pay attention to the fact that the diagnosis, first of all, lets you know about the existing threat to life, but at the same time it makes you realize how fragile life is and that no one has a patent for immortality. This is what the uniqueness of traumatic experiences is all about. Hence, they cause a very strong fear, terror - fully justified.
Is prostate cancer a special type of cancer?
Like any cancer disease, which I have already mentioned, it is life-threatening. The uniqueness lies in the fact that, although it affects only men, the whole family is indirectly affected. If breast cancer or ovarian cancer are a special type of cancer for women, because they relate to the attributes of femininity, then in this sense for mencancerprostate is a unique disease because it touches the attributes of their masculinity. The psychological effects ofprostate cancercan therefore affect self-esteem, mental well-being, and family relationships.
What are the most afraid of men diagnosed with prostate cancer. Death or loss of manhood?
Referring to the psychological attributes of masculinity, it is impossible not to mention the patient's dilemmas regarding his own sexuality. If the self-esteem of a relatively young man, because they can also get sick, is based on potency and sexual performance, it is known that the disease will cause a very strong anxiety. And this fear is notit will only concern the sexual contacts themselves, but also doubts that he will not be deprived of the opportunity to have sex. You can meet with this type of fear quite often. Fear of losing sexual performance can also cause real problems with potency, but their origin is in beliefs and fears, and not in objective realities.
To sum up: although cancer affects the body, its consequences are also felt on the mental level. This is because not only somatic he alth is at risk, but also mental balance on many levels. From the most basic one, concerning the possibility of fulfilling the role of a sexual partner, to questions about self-esteem ("what does it mean to be a man?") Or the meaning of your own life. Each traumatic experience causes a very strong fear and this is the most natural reaction.
Do emotions such as fear, terror and helplessness have to be released?
It is difficult to answer this question unambiguously, because it all depends on individual ways of dealing with such a confrontation. Depends on what the person does after diagnosis. The three most common strategies for dealing with anxiety are. The first is avoidance and denial. We pretend that nothing is happening, minimize the problem or "force" everything related to the diagnosis out of our consciousness. They are especially irritable when their loved ones ask them "embarrassing" questions. The second type of reaction is to avoid information about the state of he alth, and even to take actions and behaviors against it. The last, most he alth-promoting reaction manifests itself in the so-called task-oriented approach to the disease and a very realistic, sober assessment of the situation. Fear becomes the engine of changes in the current lifestyle, and often also the beginning of a change in the quality of life. Suddenly, we make a revolution in the system of personal values and see the charms of life that have been underestimated so far.
It is worth remembering, however, that these styles of confronting the threat to life are not constant and unchanging. This means that denial in the first phase of struggling with the diagnosis can turn into rebellion over time and bring a very positive attitude towards oneself, loved ones and the disease itself.
The diagnosis of "prostate cancer" is a challenge for the entire system, that is, close and extended family and friends. We psychologists in the so-called We perceive and seek resources for crisis intervention in the patient's close vicinity. They know the best ways to deal with the threat, moreover, loved ones are an important foundation on which to build relationships from scratch. Because you have to be aware that life before and after the diagnosis is not like thatitself. It is not only about being aware of our own mortality, but also about realizing that everything has an end, and it is up to us how we live our own lives. Full acceptance of disabilities (it causes anger, rebellion and fear) can turn into respect for your own life and for the lives of loved ones.
Does your perception of yourself change because of your illness?
Illness always changes the way we understand ourselves and the world around us. Suffering is a lesson in humility towards life, radically changing the system of values. We open up to our loved ones, we value the spiritual dimension of life. We become active community workers (in the case of patients with prostate cancer, it is, among others, the Gladiator Association). We appreciate the closeness. Suddenly it turns out that men want and can experience emotions. They stop being ashamed to show "unmanly" feelings such as fear or sadness. It also happens that we discover passions and talents that have not yet been realized. For many people, cancer is not a death sentence, but a recipe for a new life and a new quality. Not better and not worse, just different.
Does the state of the psyche influence the patients' recovery?
The higher the optimism, the greater the mobilization to fight the disease and the greater the belief in success. This attitude has a better effect on the immune system. One would like to say that faith works miracles and it is not about healing with faith, but about giving yourself encouragement and support, which undoubtedly mobilize healing processes. Depression, sadness and self-destruction have a very negative effect on both the psyche and the body. From many studies on people with other types of trauma, e.g. loss of a loved one, irreversible loss (paralysis or loss of limbs as a result of an accident), we know that the more patients are open to new challenges and the more they trust to overcome the crisis, the sooner they find in a new situation and look for other values that will give their lives meaning anew. Psychologists are looking for these subjective predispositions thanks to which it is possible to creatively recover from the worst trauma.
How can psychotherapy help in the fight against the disease and its consequences?
Crisis intervention, or perhaps psychotherapy, is necessary when, after the stage of diagnosis and confrontation with thoughts about life-threatening and a specific "incompleteness" or "handicap", the person is unable to find themselves in the new, crisis situation. The existing world has partially collapsed, and the new one has not yet been constituted. Such a state of chaos is a difficult time for the patient and his relatives. States of fear, anger, looking for guilty etc. This is a natural reaction, but if it lasts longer thanmonth, consult a specialist. We need to check what is the source of destructive emotions, because we already deal with such emotions, and look for such forms of help that will reduce anxiety and other negative feelings and lead to realistic adaptation mechanisms. The therapist's task is not only to help familiarize the disease, but also to show new dimensions of life.
Should the patient or his family always turn to a psychologist for help?
There is no tradition of using psychologists in Poland. Very often there is a belief that he is visited in an extreme situation, that mentally ill people use his help. This is a clear mistake of thought. My dream is to convince myself that you see a psychologist as a physical he alth specialist so that you can get help when a problem arises.
Are psychologists able to influence the quality of life of others?
I would like to say that the more psychology in life, the less pathology. The most puzzling for me as a psychologist is that we know so much about the world that surrounds us, and so little about ourselves and our emotions. How many times have destructive feelings poisoned our lives? And how many times have we pretended they just weren't there? Once I was tempted to say that emotional illiteracy is a syndrome of our time. The principle of "the less you feel, the less you suffer" unfortunately takes its toll. I think it's time to change your password - instead of "I think, therefore I am" to "I feel, therefore I am".