Finding Your Way Through Cancer consists of ten free-standing essays on topics that are relevant to most people with cancer. You can read the essays in any order you wish, focusing at first on those of special relevance to you, perhaps saving others for another time. In the Introduction to the book, I give a brief synopsis of what each essay is about, and these are reproduced below. These short synopses will help you determine whether the book could be helpful to you.
Cancer and Your Life Story
In our minds, we all construct the “story of our lives” based on our life experiences, both good and bad. When we think about the meaning of our lives, we are thinking about the meaning of this story. When cancer enters, this story is changed. A new chapter begins, and its meaning will stem partly from your life story up to that point and partly from how you respond to your illness. Whatever meaning your illness carries, it will have an effect on your emotions and behavior. Your perception of a negative meaning behind your cancer (such as punishment for things you felt guilty about) can make you pessimistic and depressed. I give two case examples to illustrate this point. In each case, once the person saw how his or her life story was creating a negative meaning, they were able to respond in more positive ways and thus create a more positive meaning. How do you see your illness? Is it consistent with a negative theme in your life story or does it offer an opportunity to change your story in positive ways? That’s what this essay is about.
Cancer is a family illness in the sense that it disrupts family life and causes emotional upset in each family member. Many families seem to conspire, in a way, to keep the lid on, protect each other emotionally, and carry on as before. Although well intended, this approach can get in the way of a deeper emotional closeness within a family. This essay takes up the fear, sorrow, and guilt that can occur for all family members, and how these emotions are often handled in families. I also discuss the difficult issue of what children should be told (or not told) about a grown-up’s illness and some principles that apply to the content and timing of these disclosures.
Learning from Your Emotions
Cancer has an emotional impact on everyone. Although it may seem that one person’s emotions are pretty much the same as another’s, emotional responses are actually unique to each individual. They are based on very personal thoughts and carry personal meanings that stem from each person’s past experience. There is much to be learned from your emotions—about yourself, what is important to you, your personal emotional history, and your appraisal of your situation and the significant people involved. In this essay I give three case examples to illustrate these points. This essay is about self-exploration and self-discovery, using your emotions as a starting point.
Everyone who has cancer has anxiety too, to varying degrees at various times. If you think about how you are dealing with anxiety, you’ll probably recognize certain approaches or strategies that have worked for you in the past and that are consistent with your personality. I know many people with cancer who have made a concerted effort to master their anxiety. They have developed many effective approaches and techniques, and I share those in this essay in hopes that these approaches can also help you.
Giving Attitude to Cancer
Right now, as you read this, you have a certain attitude or approach to your illness. It is probably not an attitude you deliberately chose after weighing the pros and cons of other options. It might be more accurate to say that you find yourself with an attitude or approach that seems right for you. But where did this attitude come from? What gave rise to it in this situation? What does it say about you, your strengths and weaknesses, your personal history, and how you relate to suffering? In this essay, I hope to help you reflect on these questions with an aim toward embracing all the ways your attitude serves you well while also considering possible pitfalls and whether another approach could actually be better for you. I do this by discussing five attitudes that commonly arise in people who have cancer.
Five Existential Dilemmas
This essay discusses five dilemmas that most people with cancer confront, in various ways and at various times. How do you balance, for example, being optimistic but also realistic? How do you give your illness the attention it deserves while not letting it take over your life? How do you allow yourself to be justifiably upset over your illness while also keeping in mind that many others are worse off? And finally, how do you allow yourself to feel rotten when you are hurting while not giving in to sickness too readily? Most people with cancer want to have the “right” emotional reaction, but it is not readily apparent what that reaction should be. I hope this essay will help you resolve these dilemmas in a way that is right for you.
God and Suffering
This essay is relevant to those of you who are searching for comfort and guidance from your religious faith or spirituality. This search invariably runs up against some troubling questions. Why, for example, does God allow innocent people to suffer? How does your illness fit into God’s plan or purpose? Why does God seem so distant, silent, and even indifferent as you suffer from cancer? If God can’t or won’t intervene, then what does it make sense to pray for? In the philosophy of religion, the deistic tradition provides a view of God’s relation to the world that can help with these questions. It points to the spirit of God in each person, a spirit that can be called upon to help when dealing with cancer. In this context, I discuss five things worth praying for.
On Coming to Terms with the Possibility of Death
One way to have a peaceful death is to come to terms with it before your illness advances to a terminal stage. Many people with cancer do that, especially if their prognosis is poor. In this essay I discuss how patients I know have come to feel a sense of acceptance about their eventual death. Most of this discussion is based on interviews I conducted, as part of a study, with patients who were relatively young and had a poor prognosis. Many thoughts and emotions helped them in this process. If you are struggling with this issue—wanting somehow to feel reconciled to dying, when the time comes, but not knowing how to get there—it may help to learn how other people with cancer have done that.
Cancer as a Gift?
Cancer, of course, is not a gift. But for many people, having cancer has actually enriched their lives in certain respects, and these patients often refer to it as a gift. In this essay I discuss five ways that cancer can be (in part) a positive experience, and I give many examples from people I know. Cancer can be a wake-up call to pay attention to what really matters and to live with greater appreciation and gratitude. It can help you to live more fully in the present moment. It can make you more aware of how much you are loved and valued. Often, in response to cancer, a person’s best self comes to the fore. Cancer can also lead to a deepening of a person’s faith or spirituality. If you have not yet encountered these positive aspects, perhaps my discussion and examples will help bring them to life in your own experience.
My Interrupted Life: Jenny’s Story
Each person’s experience with cancer is completely unique, and there is no one right way to go through it. This is one unique story: the story of Jenny, a remarkable forty-two-year-old woman with colon cancer. Her story is told in the first person, constructed from transcripts of our therapy sessions, her journal entries, and my notes from our sessions and the support group meetings she attended. If you read her story, you will see that she is remarkable in her ability to face hard realities head-on. I think you will be impressed by her ability to articulate the conflicts and dilemmas that bounced around in her mind and may be bouncing around in yours. Her story brings to life many of the themes addressed in these essays, and it also reflects the individual and personal nature of each person’s experience. (My wife said everyone should read this story first!)
I use patients’ names in the essays in this collection, but these names are fictitious and I have changed other identifying information to protect the privacy of those who have shared their experience with me. In all cases, this sharing has been deeply personal, and I have been honored to be on the receiving end of it. I have tried to honor these patients in turn by sharing with you what I have learned from them.
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