“You have cancer”. These are words one in three Irish people will hear, causing inevitably distress both for the individual patient and the entire family system. A cancer diagnosis can feel like a crisis and a huge loss for all involved. For many, a feeling of hopelessness in a diagnosis situation is very common. In fact, both carers and patients can feel helpless and hopeless. For the carer it can be difficult to watch their loved one in pain. For the patient, they can feel like a burden and a hassle on their family and friends.
When a loved one develops a serious illness it’s normal to go through an emotional experience akin to grieving. In my work as a psychotherapist I often journey with clients with terminal illness and loss is a huge part of their process. This loss seems to be something they don’t realise at first – like it is something they ‘should’ not feel. However, when we hear bad news we react by defending ourselves. This process involves allowing the news to dawn on us gradually or in stages. As we let it in bit by bit, we allow ourselves to slowly adjust without becoming overwhelmed.
Elisabeth Kübler-Ross was a psychiatrist with a particular interest in end of life care and she named this process as the five stages of grief; denial, anger, bargaining, depression and acceptance. Often these stages do not follow in a neat order but they will give you a guideline in terms of the range of emotions you may experience.
For me, I would go one step further and add ‘gratitude’ to the process. This is not to say I wasn’t grateful before cancer but now I have a more mindful gratitude. I am grateful in the present moment even when that present moment is difficult. Let me say more because I realise it’s a strong statement to make. When my mother was diagnosed with cancer my whole life changed. The diagnosis was terrifying, the treatment was often horrific, her death nearly suffocated me. For a long time I felt like I was just surviving rather than living.
Then I started to remember how she lived, how she laughed, how she showered us with love. I remembered especially how she lived through cancer helping those around her deal with the diagnosis even smiling with nurses and joking with serious oncologists, while also suffering silently so as not to worry us. In personal therapy I worked through my sadness and loss and came to a place of compassion; a place where I could view myself as she would have viewed me in suffering. When I imagined my mother seeing me struggle through life without her, a warmth came over me; a complete sense of loving kindness enveloped me with a whisper saying “Go easy on yourself Nead”. A reassuring sentence she would often say to me when I pushed myself too hard or criticised myself for feeling a certain way.
What I have learned in my studies, and now as I research the emotional experience of cancer for my doctorate, is that we can be so hard on ourselves in the face of pain. We can condemn ourselves further in our suffering. We say things like “I should be dealing with this better” or “I should be able to cope”. Perhaps it is a very Irish thing to say “Get up outta that bed now, sure you’re grand” and other such amusing T-shirt slogans. We have a tendency to brush the pain aside and just get on with it. We’re only human, yet we struggle to allow ourselves to be human. As a therapist I’ve had the great privilege of sitting with men and women going through cancer and often the response to having self-compassion or self-kindness is “I can’t give up” or “You want me to give in?” But perhaps in the ‘fight’ against cancer we fight ourselves.
That is why cancer taught me compassion in suffering. Compassion is not pity. Compassion is that feeling we get when we encounter suffering combined with the urge to want to try and end that suffering. By going through the loss I had suffered I saw myself in a new light. I could witness my pain through the loving eyes of my mother. Paul Gilbert writes about cultivating compassion by taking a bird’s eye view of the situation we are in and looking, from this more removed perspective, with a loving lens on our suffering. I believe compassion is a key step on the journey toward acceptance or even allowance of the current situation. While cynics may dismiss compassion as touchy-feely or irrational, scientists have started to map the biological basis of compassion suggesting it reduces stress levels, fights the ageing process and makes us feel good by boosting our immune system.
My whole life changed after cancer. But through such loss came such life. I have had the privilege of working with cancer patients; I have walked the Camino with men and women who have lived through cancer and I have learned to love in a more grateful way because of my own cancer journey. I have listened to cancer patients in my research study and while walking ‘the way’ and all have remarked on how cancer can bring a gratitude for life like no other experience. In losing my mum to cancer and becoming more self-compassionate and more grateful especially when suffering, I have been given a new perspective on life. I could hold the hand of my dear friend dying from cancer and feel only love and gratitude for having known him and only love and gratitude toward myself for having been there for him, even in my own suffering. When we have the courage to face our own pain, to allow it without self-judgment or self-criticism, only then can we move past it to freely enjoy and be grateful for all that life has to offer. When I am going through a tough time, those I have loved and lost are closest. Their love has helped me love myself… and for that I am grateful.
In the end, we don’t want to see our loved ones suffer no matter how much pain it may cause to ourselves, so be compassionate with yourself also. You are doing your best.
Compassionate communication – how to talk about cancer
- Say how you feel and remain the same with your loved one. Just because they are sick, you don’t have to become a different person. Be honest and talk about your feelings and fears and ask them about their own fears.
- Find an opening to talk by gently asking “Is there anything you’d like to talk about? “How can I help?” Indicate you are ready to have a discussion.
- Enjoy the moment with your loved one. Say what you need to say and talk about the good times too. Reminisce on happy memories and laugh about the fun moments you shared.
- Sometimes dying people hold on to life because they sense that others are not ready to let them go. I certainly felt this was the case with my mother, who hung on longer than any doctor could believe! Telling her I was ready to let her go was one of the most painful experiences of my life, but a necessary one.
Sinéad co-produced a documentary with Birthe Tonseth and Roger Childs from RTÉ called ‘The Walk of Life’. This was in collaboration with the Marie Keating Foundation and Dr Paul D’Alton, Head of Psycho-oncology at St Vincent’s University Hospital. You can watch it on the RTE Player here.
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