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Healing a Friend or Loved One's Grieving Heart After a Cancer Diagnosis
100 Practical Ideas for Providing Compassion, Comfort, and Care
By Alan D. Wolfelt, Kirby J. Duvall Center for Loss and Life Transition
Copyright © 2014 Companion Press
All rights reserved.
ISBN: 978-1-61722-203-0
CHAPTER 1
UNDERSTAND WHAT CANCER IS
"Growth for the sake of growth is the ideology of the cancer cell."
— Edward Abbey
• Our bodies make new cells all the time so that we can grow, heal ourselves when we've been hurt, and replace worn-out cells. Every day, our bodies make perfect cells as well as imperfect ones. Fortunately, imperfect cells usually either die or are unable to divide and multiply. Our bodies have cellular quality control built in.
• But sometimes, abnormal cells find ways to divide and multiply without control. The cells form colonies called tumors (except blood cancers, which act differently). Some of the abnormal cells can sneak into the bloodstream or the lymphatic system and migrate to other places in the body. This is called metastasis, and when it happens, tumors begin to form throughout the body.
• Tumors interfere with the necessary functions of our bodies' organs and blood vessels. As they invade and grow, they cut off oxygen, obstruct the GI system, and create openings there there aren't supposed to be openings.
• There are more than 100 kinds of cancer. We name cancers by the place where they start. Breast cancer begins in the breast, for example. If it spreads to the brain, it is still breast cancer. Pathologists can tell where a cancer originated by looking at the cells under a microscope.
• Cancers are said to have "stages." Staging describes the extent or severity of a person's cancer. Knowing the stage helps doctors and other caregivers choose the best treatment. It also conveys a probable prognosis. Cancer staging ranges from zero to IV (zero, I, II, III, and IV), with zero being the least serious and IV the most.
CARPE DIEM
Learn a little more about your friend's cancer today — not to scare you but to help you be more conversant and supportive. The National Cancer Institute's website,www.cancer.gov, is a good resource.
2.
UNDERSTAND HOW CANCER IS TREATED
"Chemotherapy is brutal. The goal is pretty much to kill everything in your body without killing you."
— Rashida Jones
• There are three main forms of cancer treatment:
1. Surgery — The tumor (or as much of it as possible) is removed. For operable tumors, this is usually the first step in treatment. Lymph nodes near the tumor may also be removed to see if they have been invaded by cancer cells. If the entire tumor can be removed and the lymph nodes are clear, surgery may be the only treatment required.
2. Chemotherapy — Drugs that destroy cancer cells are taken either by mouth or intravenously. They attack rapidly dividing cells in the body, which includes cancer cells as well as some healthy cells. It is the harming of healthy cells that makes some cancer patients feel sick and experience other unpleasant side effects (such as hair loss).
3. Radiation — Strong beams of energy are targeted directly at the tumor, killing or shrinking it. Patients may receive radiation therapy before, during, or after surgery. Often patients receive radiation in small doses every day for several weeks. Some patients receive only radiation therapy, while others receive radiation as well as chemotherapy.
• Your friend may need different kinds of help during and after different kinds of treatment. If he is receiving radiation therapy, for example, he may need someone to accompany him to the radiation oncologist's office every day for half an hour. During chemotherapy, he may prefer help with housework. Ask.
CARPE DIEM
During treatment, be on the watch for help your friend needs most. Offer. Be specific.
3.
UNDERSTAND THE DIFFERENCE BETWEEN GRIEF AND MOURNING
"What happens when people open their hearts? They get better."
— Haruki Murakami
• Grief is the constellation of internal thoughts and feelings we experience when we lose something or someone we care about — or when we are threatened with the possibility of such a loss. Grief is the weight in the chest, the churning in the gut, the unspeakable thoughts and feelings.
• Mourning is the outward expression of our grief. Mourning is crying, journaling, creating artwork, talking to others, telling the story, speaking the unspeakable.
• Here's a way to remember which is which: The "i" in grief stands for what I feel inside. The "u" in mourn reminds me to share my grief with you.
• Everyone grieves when they are affected by life's challenges, but if we are to heal emotionally and spiritually, we must also mourn. Over time, and with the support of others, to mourn is to heal.
• Many of the ideas in this book are intended to help you mourn the natural and necessary grief that is a result of caring about someone who has cancer. Others are directed at helping you become a more empathetic cancer companion — someone who supports the person with cancer as she expresses her own natural and necessary grief.
CARPE DIEM
Ask yourself this question: Have I been mourning my friend's cancer, or have I mostly been restricting myself to grieving?
4.
ALLOW FOR NUMBNESS
"There is a feeling of disbelief that comes over you, that takes over, and you kind of go through the motions. You do what you're supposed to do, but in fact you're not there at all."
— Frederick Barthelme
• Did you feel numb and in shock in the days and weeks right after your loved one's cancer diagnosis? It's very common to feel blindsided by the news that someone you care about has a life-threatening illness.
• Feelings of shock, numbness, and disbelief are nature's way of temporarily protecting us from the full force of a painful reality. Like anesthesia, these feelings help us survive the pain of our early grief. Be thankful for numbness.
• We often think, "I will wake up and this will not have happened." Early grief can feel like being in a dream. Your emotions need time to catch up with what your mind has been told.
• Soon you will come to understand the diagnosis and prognosis intellectually, with your head. Only over time will you come to understand them with your heart.
• Of course, your friend will also experience his own days and weeks of shock, numbness, and even denial. You can affirm that these feelings are normal. You can also help by stepping in to coordinate appointments, prescriptions, groceries, etc. when the person you care about is too numb or shocked to be thinking clearly.
CARPE DIEM
If you're feeling numb and distracted by news of your friend's cancer, take it easy for a few days. Cancel any commitments that aren't absolutely necessary.
5.
HELP YOUR FRIEND FOCUS ON FIRST THINGS FIRST
"What happens when my body breaks down happens not just to that body but also to my life, which is lived in that body. When the body breaks down, so does the life."
— Arthur Frank
• Have you ever seen the psychologist Abraham Maslow's famous "hierarchy of needs"? It's a pyramid that shows the natural and normal priority of human needs.
• The base of the pyramid is formed by our physiological needs — in other words, the needs of our bodies. If your friend is in the middle of treatment right now, his body is under attack and will likely demand all his attention for a while. He needs to get ample rest, eat as well as he can, stay hydrated, and get relief from any pain he might be experiencing.
• Until his needs for physical comfort and safety are met, he simply can't move up the pyramid to address his other needs.
• Help your friend focus on first things first. Make sure she is being taken good care of physically. Only if she is feeling well enough will she be able to engage emotionally and socially with the people who care about her and with her own spirit.
• Of course, Maslow's hierarchy of needs applies to you, too! You can't support your friend with cancer socially and emotionally unless you first take care of your own body's needs. Don't make the mistake of thinking you can ignore the bottom of your pyramid, because if you do, your own life may come crashing down.
CARPE DIEM
Ask yourself: How am I feeling physically right now, this very minute? Am I tired? Hungry? Stiff? In pain? Attend to your physical needs immediately
6.
DON'T SAY THIS
"Attempting to get at truth means rejecting stereotypes and clichés."
— Harold Evans
• Most of us are guilty of offering clichés and platitudes when talking to someone who is experiencing challenges and loss. But now that you're reading this book, it's time to stop.
• In a well-intentioned (but misguided) effort to talk to someone about her cancer, you might say ...
- I know how you feel.
- So-and-so had ___________ cancer, too.
- It's all part of God's plan.
- God works in mysterious ways.
- God only gives you what you can handle.
- But you look perfectly healthy!
- Why didn't you tell me sooner?
- You'll beat this. I know you will.
- Everything is going to be just fine.
- You just need to stay positive.
• Do you notice how none of these remarks are focused on the unique and particular experiences, thoughts, and feelings of the person with cancer? Instead, they are either about you or about providing impossibly simple answers to exceptionally complex problems.
• If you feel a cliché forming on your lips, bite your tongue. Say something from Idea 7 instead.
CARPE DIEM
Right now, commit several of the responses in Idea 7 to memory.
7.
DO SAY THIS
"Once someone said to me, 'I'll ride the waves with you till the storm calms," and that meant a lot to me because I knew they would be with me no matter what."
— Author Unknown
• I'm sorry you have to go through this.
• I want you to know I care about you.
• How can I help? I'm good at_________, _________, and_____________.
• How are you doing? I want to know.
• Would you like to talk about it? I would like to be someone you can talk to.
• I don't know what to say, but I feel love and concern for you.
• I'm going to the store today. What can I get for you?
• I don't know what that diagnosis means. Would you mind telling me what it means for you?
• What do you most need help with?
• I was thinking about you today, so I called (or stopped by).
• You are important to me.
• You are a very special person to me.
• I love you.
CARPE DIEM
Today, reach out to the person with cancer and tell her one of these things. Then listen.
8.
DEVELOP THE ART OF EMPATHY
"When we honestly ask ourselves which people in our lives mean the most to us, we often find it is those who, instead of giving advice, solutions, or cures, have chosen rather to share our pain and touch our wounds with a warm and tender hand."
— Henri Nouwen
• The words "sympathy" and "empathy" are often used interchangeably, yet there is an important difference between the two — a difference you can leverage to make yourself a better helper.
• When you are sympathetic to someone else, you are noticing and feeling concern for his circumstances, usually at a distance. You are "feeling sorry" for him. You are feeling "pity" for him. You are looking at his situation from the outside, and you are acknowledging the distress passively. You may be offering a simple solution, platitude, or distraction. Sometimes sympathy also includes a touch (or a heavy dose) of judgment or superiority. Sympathy is "feeling for" someone else.
• Empathy, on the other hand, is about making an emotional connection. It is a more active process — one in which you try to understand and feel the other person's experience from the inside out. You are not judging the person or the circumstances. You are not offering solutions. Instead, you are making yourself vulnerable to the person's thoughts, feelings, and circumstances by looking for connections to similar thoughts, feelings, and circumstances inside you. You are being present and allowing yourself to be taught by the other person. Empathy is "feeling with" someone else.
• If you feel sympathy for the person with cancer but want to do something about it, you are experiencing an urge to be more empathetic. Be brave and steadfast enough to follow this urge where it leads
CARPE DIEM
Today, convert your sympathy for someone into active empathy and see what happens.
9.
UNDERSTAND THE SIX NEEDS OF MOURNING
Need #1: Acknowledge the reality of your friend's diagnosis and prognosis
"You hear the word 'cancer' and you think it is a death sentence. In fact, the shock is the biggest thing about a diagnosis of cancer."
— Clare Balding
• Someone you care about has cancer. This may be a difficult reality for you to accept. Yet gently, slowly, and patiently, you must embrace this reality, bit by bit, day by day.
• Growing comfortable with speaking the words aloud may help you with this mourning need. Learning to say, "My friend has _________ cancer" to other friends and family members when the need arises will help you come to terms with the reality of his diagnosis and prognosis.
(Continues...)
Excerpted from Healing a Friend or Loved One's Grieving Heart After a Cancer Diagnosis by Alan D. Wolfelt, Kirby J. Duvall. Copyright © 2014 Companion Press. Excerpted by permission of Center for Loss and Life Transition.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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