Diagnosis: cancer. From denial to fighting and hoping

Cancer is one of the most widespread diseases, nowadays being considered a chronic disease. It is important to know that each person responds differently to this diagnosis, but receiving such a verdict is always difficult, both for the patient and for those close to him/her.

Learning you have cancer can be overwhelming. Patients may experience intense emotions that are very difficult to manage, such as despair, anger, helplessness, anxiety and deep sadness.

It may often seem like these emotions are stronger than they’ve ever been, that there’s no longer a purpose to life, and that anything that was ever positive is meaningless. The most surprising aspect for such people, however, is to learn that all these emotions are normal. A whole range of strong emotions is likely to arise during the course of diagnosis, but also during treatment and recovery. There can be shock, uncertainty, a sense of loss of control, fear, guilt, and sometimes they can also lead to anxiety or depression.

The main reason for these waves of emotions is the change

The main reason for these waves of emotions is the change as it comes with a number of possible losses. Each emotion is actually a reaction that comes as a natural response and it is very important to identify each emotion and fear, correlate and accept them, in order to move through each stage of the diagnosis process.

The emotional pain in this case is very similar to that felt in the case of the death of a loved one, after the loss of a loved one through divorce or a separation, so we can see five stages of coping with loss, mourning and grief. We may encounter denial, anger, bargaining, depression and acceptance. But these stages can sometimes appear simultaneously and not necessarily in this order, we may not go through some of them, and the way they feel can be very different from one person to another.

DENIAL

We may want to deny the disease, feel unable to accept it. It is possible to have thoughts like ,,This cannot happen to me”, ,,Impossible, it must be a nightmare”. And that’s exactly what it feels like… like a nightmare we can’t wake up from.

Confusion and fear are the first emotions felt when learning you have cancer, and in those moments it is almost impossible to be rational. This shock is normal and is actually a way our mind learns to protect itself and cope finding easier ways to accept reality. Statistically, people who went through this stage responded much better to treatment than people who skipped it.

Anger

With the acceptance of the denial stage, anger can arise with thoughts such as “Why me?”. It is important not to blame ourselves and to learn that it is perfectly normal to be angry when we feel emotional pain.

Anger arises because we realize that we are living a reality that we do not agree with, and it is possible to blame it on ourselves, on the doctors, on the disease itself, and it can be understood as a lack of control.

NEGOTIATION

The negotiation stage is the one where we start to ask ourselves, “What could I have done differently?”, “I should have done things differently”. This stage is actually the way to regain control and it is very important to know that some factors can be changed or controlled, but others cannot.

Focusing on what we can control is key to this stage. We can focus on what we have done well up to this point, what we want to bring back into our lives, what we want to keep from the present, and learn that such a diagnosis could not have been prevented.

DEPRESSION

Depression is a stage that sets in slowly, depending on how we process emotions and the context in which we find ourselves. There may be feelings of helplessness and loss of hope, sleep problems and loss of appetite, loss of energy and we can often feel the need to detach from those close to us. So it becomes necessary to remember that those close to us deserve to stay by our side, instead of putting up defensive walls and isolating ourselves from everyone around us.

It is important to know that you are heard, that you are entitled to feel disappointment and frustration, that it is normal to be angry or depressed, and we hope that – even though you often lose hope – you know that you are not alone.

ACCEPTANCE

There may be a fear of acceptance, this is perfectly normal as this stage can be very easily confused with letting go. By no means can we equate the two, however. Acceptance is actually the peace we feel when we are ready to put in the effort to fight the disease, while giving up is the lack of tenacity. When we give up, we will think, “There’s no point in fighting anymore”, while acceptance appears as “It’s normal to feel everything so intensely and I have every right to move forward”.

ASK FOR HELP!

Psychotherapy has the role of helping clarify these stages, to identify them and to argue the feelings. Each patient has a unique way of feeling and interpreting, defending and dealing with loss, change and pain. The thing to remember is that there is no right or wrong way to deal with cancer, and each person brings with them a unique set of resources that deserve, first and foremost, to be understood and helped.

Author: Psych. Cătălina-Antonia Hausner – Clinical Psychologist, Psychotherapist

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