A cancer
diagnosis is a devastating blow. Oftentimes, the trauma of the diagnosis
is further worsened by well-intentioned people who simply don’t know
how to respond to the news
The popular notion that “everything happens for a reason” can be particularly toxic when faced with a life-threatening illness
When speaking
to someone who is suffering, don’t try to relate to their suffering by
comparing it to something you’ve experienced. The way we experience
suffering is uniquely our own, so hearing stories about someone else’s
situation typically isn’t helpful
Don’t offer
solutions and treatment strategies unless asked; don’t tell them their
suffering is “part of God’s master plan” or has some greater purpose.
Instead, make yourself available, be present with them and let them
express how they feel about their diagnosis
In 2019, 1,762,450 Americans are expected to receive a diagnosis of cancer,1
and it doesn’t matter who you are, hearing “You have cancer” is a
devastating blow. Oftentimes, the trauma of the diagnosis is further
worsened by well-intentioned people who simply don’t know how to
respond to the news.
A July 2019 article2
in The Atlantic addresses this sensitive issue. Taylor Lorenz tells the
story of Kate Bowler, a 35-year-old historian and author of “Blessed,”
a book that deals with “the origins of the notion that good things
happen to good people.”
Bowler’s cancer diagnosis came like a lightning bolt from a
clear-blue sky. In 2015, she sought treatment for stomach pain. It
turned out to be Stage 4 colon cancer, and she was given less than a
year to live.
“Many people who receive her diagnosis begin to get
their affairs in order and spend their remaining time with family in
between treatments.
Bowler did all that, but also launched a podcast3 called ‘Everything Happens,’
on which she talks with people about what they learned in dark times.
She wrote another book. And she set about changing the way people view
and talk about suffering in America,” Lorenz writes.4
Everything happens for a reason — or does it?
As explained on the website5
for Bowler’s second book, “Everything Happens for a Reason: And Other
Lies I’ve Loved,” her career as a professor at Duke Divinity School had
centered around “the study of the prosperity gospel, a creed that
sees fortune as a blessing from God and misfortune as a mark of God’s
disapproval.”
Her cancer diagnosis forced her to face her own mortality, and in so
doing, made her realize she’d “been tacitly subscribing to the
prosperity gospel, living with the conviction that she can control the
shape of her life with ‘a surge of determination.’”
Like so many others, she had bought into the idea that illness (or
any other form of misfortune) is a sign of personal failure — somehow,
you didn’t work hard enough; you weren’t optimistic enough. Somehow you disappointed God and this is your punishment.
“What does it mean to die … in a society that insists everything happens for a reason?” Bowler asks.6 She was happily married, had a young son and a job she enjoyed. In her mind, her future was all planned out.
She intended to get her Ph.D. and become a tenured professor. Up
until the day she was told she had late-stage cancer, her life had
followed the script of someone on the fast-track to happiness and fulfillment — proof she’d done everything right.
“But Bowler’s commitment to the notion that everything happens for a reason went out the door once her diagnosis hit,” Lorenz writes.7“Now
she believes that idea is deeply problematic. ‘We live in this culture
that seems unable to allow people to suffer without trying to explain
things to them,’ she said.
It’s common for people to tell themselves or others that the best
is yet to come. But promoting that idea, Bowler argued, can be cruel to
those who might consider their best days far behind them.”
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How to speak to someone who is suffering
Despite a grim diagnosis, Bowler survived. Today, four years later,
her focus has shifted to educating people about how to support people in
the midst of their suffering. Her own experiences taught her a lot
about this, and many of the things people say turn out to be less than
helpful. For example, Bowler suggests that when speaking to someone who
is suffering:
Don’t try to relate to their suffering — While
this may sound odd, the way we experience suffering is uniquely our own,
so hearing stories about someone else’s situation typically isn’t
helpful. It also shifts the focus away from the patient, making it
instead about you.
Don’t offer solutions and treatment strategies unless asked.
Don’t tell them their suffering is “part of God’s master plan” or has some greater purpose —
Randomness happens. Sometimes it’s just bad luck. Sometimes, a tragic
story will have a happy ending, but it’s not guaranteed.
Make yourself available and just be present — Lorenz writes,8
“Bowler had friends who faded away from her life after her diagnosis
because they didn’t know how to confront her tragedy. But the type of
person she found most helpful when she was at her lowest, she said, was
someone who just ‘shows up, doesn’t ask for anything, and just knits in
front of you.”’
Take a cue from the one who is suffering
Karen Raymaakers has also written about what to say when someone you know is diagnosed with cancer.9
She points out that our reactions are almost always shaped by previous
experiences, hence the wide variety of reactions to something as
devastating as a cancer diagnosis.
“They may show unbelievable strength you never knew they had, or
be more vulnerable than you knew. They might show a number of
different emotions — sadness, anger, guilt, fear, ambivalence, avoidance
— and sometimes they may show all at once or change from moment to
moment,” she writes.10
Raymaakers suggests taking your cue directly from the person who got
the diagnosis. “How your loved one feels about their diagnosis will
help shape your response to it,” she says. If they’re in a stage where
they want to talk about their cancer, try to be present and just
listen. If they don’t want to talk about it, don’t force it.
Whatever you do, though, don’t avoid the issue altogether. As noted
by Raymaakers, it can be tempting to gloss it over and pretend like
nothing is wrong, thinking your friend or family member already knows
you care about them and support them no matter what.
“The truth is, cancer is the elephant in the room. To not acknowledge it is almost more hurtful than anything you could ever say,” Raymaaker writes.11
“The best advice in this situation is to say how you feel.
Are you thinking about them? Then say so. Do you care about them? Then
say so. Are you sorry that they are going through this? Then say so.
Don’t know what to say? Then say that. Here are a few more conversation starters:
I am here if you want to talk.
I would like to help in any way I can.
Are you up for having visitors?
Is there anyone else you would like me to contact?
This must be a hard thing to go through.”
What not to say
Like Bowler, Raymaakers warns against trying to relate to what your
friend is going through by comparing it to your own experience. She
also discourages people from trying to find the silver lining.
“There isn’t much of a silver lining to a blood cancer diagnosis, so avoid saying things like, ‘It could be worse,’or, ‘At least it isn’t ...’For the person with the disease, this probably is the worst-case scenario,” Raymaakers says.12
Other don’ts include making overly pessimistic remarks, or saying
things that minimize what your friend is going through. Keep pep talks
like “It’ll be OK” and “Cheer up” for less distressing and life
altering situations. Raymaakers adds:
“Don’t leave if things get tough. If the person gets angry, let
them vent. If they tell you they’re afraid, open up the conversation so
they can unload on you. ‘What are you most afraid of?’ ‘What can I do
to help with your fears?’ … [I]f you let the patient do the talking,
you don’t need to worry about what to say.”
In her article, Raymaakers also delves into “how to handle hospital
visits,” and how you can help the person suffering through caring and
thoughtful actions. Here are a few selections from her listings. For
more, see the original article.13
• If your loved one is in the hospital,
call ahead to make sure they can receive visitors, during what hours
and whether certain gifts (such as flowers) might be inappropriate for
health reasons.
Many cancer patients are fatigued and need lots of rest, so keep your
visits to a half-hour or less, unless they ask you to stay. Keep in
mind many cancer patients have weakened immune function, so do not
visit if you’re feeling ill. • Show you care by offering to care for
their children or pets, run errands or do household chores for them, or
deliver precooked meals that only require reheating. You can also
offer to drive them to doctors’ appointments, or prepare a “chemo care
package” with a few thoughtful items that might bring comfort or
entertainment during long treatments.
Optimism is a healing balm
While it would be inappropriate to tell a cancer patient to simply
“cheer up” or “think positive,” optimism does play an important role in
health and healing. In “Optimism and Hope in Chronic Disease: A
Systematic Review,”14
published in Frontiers in Psychology in 2016, the authors highlight
findings showing an optimistic outlook on life in general leads to
lower depression levels, improved physical health and increased longevity. According to the authors:
“In regards to optimism, Scheier and Carver … defined
it as an overall tendency to believe that vivid experiences will lead
to good results rather than bad ones. Carver et al. … explained that to
be optimistic is to maintain a generally favorable expectation about
the future.
Hart et al. … added that overall positive expectations are
considered one of the main determinants for knowing whether people will
continue to pursue their life objectives in a condition of chronic
disease …”
Hope, defined as “a state of positive motivation based on three
components: objectives (goals to be achieved), routes (planning to
achieve these goals), and agency (motivation directed toward these
objectives),” has similar benefits.
Interestingly, evidence suggests that while optimism is protective against short-term stress,
optimists facing prolonged stress may actually be at greater risk of
health complications, “as optimists are more immunologically vulnerable
under such circumstances.” Still, the authors concluded that:
“Some association between higher hope/optimism levels and a
healthier profile was observed in 27 of the 29 studies. In regard to
the results perceived by the study participants after intervention, only
two articles found no relationship between the constructs and relevant
results …
Regarding cancer, it was found that optimism predicted a year of
survival regardless of other socio-demographic and clinical variables
in patients with head and neck cancer … and more abilities to manage
stressors while less optimistic cancer patients experienced more
negative psychological changes …
The results of the studies presented in this analysis suggest
that there is a close relationship between the constructs of optimism
and hope and a reduction in the effects of chronic disease. However, it
is important to highlight that the association between optimism or hope
and physical health differs depending on the context of the disease
and the subjects.”
Managing emotions when faced with a devastating diagnosis
Staying optimistic in the face of debilitating and/or lethal disease
is easier said than done, no doubt. Yet it’s worth the effort, if not
only to protect your mental health and avoid spiraling into despair.
If you’re been diagnosed with an illness, be it cancer or something else, you may want to consider The Emotional Freedom Techniques (EFT) to help you move through any negative emotions that surface to prevent them from becoming permanent companions.
In the video above, EFT practitioner Julie Schiffman demonstrates
how to use EFT for the grieving process. When faced with your own
mortality, feeling grief is natural. But it can become a hindrance if
you cannot move through it. EFT may be helpful for that.
Also, check out Bowler’s podcast,15
“Everything Happens.” Bowler interviews a wide range of individuals,
talking to them about “what they’ve learned in dark times.” Some
discussions center around loss and grief, while others tackle living
with chronic illness.
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