Breast cancers differ! Treatments differ! Human responses to diagnoses, treatments and prognoses also differ! Even side effects of the same treatments differ! Families differ! Relationships differ! Husbands and partners differ! Histories differ!
The assumptions made by doctors, patients and their families tend to remain fairly standard, despite all the differences mentioned above, to remain fairly standard. Indeed, psychologists, medical researchers, doctors and behavioural scientists have spent over half a century trying to determine the patterns of behaviour and relational issues that are associated with cancer treatments. Careful examination of the literature leads me to believe that cancer patients are no different from any other patients faced with life-threatening diseases or even with sick patients who may not be so ill.
An assessment of the nature and dynamics associated with a patient’s unique medical, psychiatric, psychological, interpersonal and social circumstances tends to be by far the best indicator of how patients’, families and partners will respond to their own or their loved one’s diagnoses and treatment. Clearly, existing impoverished or damaged relationships do not always survive breast cancer. There are for example, patients who use the diagnosis and side effects as shackles with which to tie their partners down. These patients may emotionally blackmail their partners into tolerating their abusive behaviour under the guise of so-called side effects. Notably, they tended to be abusive well before ever being diagnosed with cancer.
There are also partners of cancer patients who consciously and/or unconsciously employ the patients’ symptoms as weapons against them. They mischievously use symptoms such as chronic fatigue and compromised sex drives as symbols of the patient’s selfishness, laziness, etc.
It is clear that a breast cancer diagnosis is very frightening. Partners and families often initially feel enormously overwhelmed and even traumatised. Importantly however, more often than not, the diagnosis creates the emotional disequilibrium that social systems require in order to reorganise themselves. In short, it may be because most breast cancer patients survive their disease that once treatment starts, mentally healthy patients and their families settle down to the reality of their current status and begin to address the needs associated with their new reality. Grudges and irritations often become irrelevant. Anger is better managed. Conflicts are often resolved. Triviality tends to be rejected and the meaning of relationships and family become paramount.
On a more practical level, a patient’s lack of appetite often leads to the creation of healthier food choices. Their lack of sex drive often results in fore-patience and greater sexual creativity. Rashes and skin irritations are often treated with good quality creams which pave the way for better self-care and grooming. Finances are often reconsidered and priorities identified.
As a former and highly experienced couple and family therapist, I never believed that I would be able to say – with conviction – that those of you who have been unlucky enough to be diagnosed with breast cancer, may not only survive for a very long time, but may also now have the opportunity to grow new and healthy marital relationships and partnerships.
Written by Karen Applebaum