Friday, November 26, 2010

CANCER AND PTSD

Thanks to our interminable wars, we hear regularly about returned veterans suffering Post-Traumatic Stress Disorder. PTSD is characterized by hypervigilance, nightmares, mood swings, and inexplicable emotions, including emotional numbness. In sum, PTSD is a frightening derangement of feelings.

We’re beginning to realize, though, that PTSD isn’t limited to war veterans. It’s shared by people who, having been through any situation that threatens their sense of self and who didn’t consciously process their consequent feelings. For example, one study found the rate of PTSD in adults who were in foster care for one teenage year was higher than that of combat veterans.

Is it any surprise, then, that PTSD is common in people with cancer? If you haven’t been through cancer yourself, then imagine that your doctor just spoke the C word. Your hearing failed immediately after that, but later you remember the doctor saying you need some diagnostic studies, and the sooner the better, since cancer cells are anything but patient. You undergo a variety of mystifying scans and other tests, learn about the stage and intensity of your cancer, and are encouraged to begin treatment, chemotherapy, say, immediately. The treatment is no picnic. It fatigues and nauseates you, and changes your body image. Meanwhile, your relatives and friends conduct their own confusingly mixed choreography. A few separate from you, a few infantilize you, and conversely, many show you loved you’d never dreamed of.

In other words, your life as you knew it is utterly gone, and at this point there’s no reliable replacement. Is that a bit unsettling? Would that all these changes had occurred more leisurely, with enough time for you to emotionally digest each, but that’s a rarity. New cancer can demand an urgency that leaves emotional health in the dust. Yet as one member of a cancer support group advised, “Buried emotions are always buried alive.”

Sooner or later, like stones in a farm field, they surface, and can do so in distorted, baffling ways: PTSD. Part of my work in facilitating cancer support is to convey two items of hope to new patients and their families:
    1. The emotional roller coaster they’re riding does NOT mean they’ve gone nuts. It’s not abnormal. It’s a common, even expected aspect of cancer.
    2. It’s transient. The emotions patients had to stuff temporarily in order to survive are now finally accessible, and can be gently drained away.

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