Now for Part 2. Thank you for staying tuned! My hope and prayer is that the information I share can truly help you in your practice, both personally and as a therapist.
Today’s post will focus mainly on family struggles that come with cancer and illnesses as well as the difficulties associated when communicating/not communicating about illness. When I think of struggles that a family goes through during such a time, I immediately think of the guilt that I have for watching families in the past suffer through illness and the ignorance I had for not having a clue of what they were going through. This is where I hope to help you. The good news is I don’t think you have to go through a life threatening illness to be able to truly be there for those who are suffering.
Guilt & Grief
The amount of guilt I have for not empathizing with families in the past who have had a family member go through cancer is enormous. I always thought that the one diagnosed had been through hell, and once they were in cancer remission, everything was great! Yes, I felt sorry for their families, especially ones where an illness ended in death. But the ones who had family members survive? Oh, they must be so grateful and every day must begin in thankfulness! Oh how ignorant I was! I learned from literature and my own family research that the relatives who seem to have a more difficult adjustment to a cancer diagnosis are first-degree relatives. These are the family members who are faced with the diagnosis day in and day out, as many may actually live with the one diagnosed. Often times, life after cancer is the toughest. Family members can be called upon to provide support, both emotionally and physically (Strayer & Caple, 2012).
A huge weight was placed upon my family members during my cancer journey.
They wanted to help me physically and emotionally and just were not quite sure how to do that often times. They were grieving my diagnosis and struggling much themselves with emotions and relationships, which made attempting to care for me hard, if not impossible, at times. This was surprising to me. I always envisioned family members having the ability to give the one suffering all they want and need! Did my family go above and beyond to help me emotionally and physically? Yes. Did they do everything in their power to be there for me? Yes. But, could they—really? No.
As a therapist, would you suggest one with substance abuse issues to help another one with substance abuse issues? The answer might be yes after one is in recovery. But during? Absolutely not! The same is true with close family members and cancer. If they are grieving and struggling like my family was, they need help too. They cannot be everything that the cancer patient needs, as they are typically in a huge place of need themselves.
My Dissertation Research
During my dissertation study, I interviewed my 7 closest family members and asked them in-depth questions about my cancer journey and how it affected them personally. It was humbling, hard to hear, and scary to ask those questions. To be honest, during my treatment, so much focus was on ME. Afterall, I was fighting for my life. But my family was fighting wars as well- fears, shock, uncertainty, caring for me, unsure of what to do, unsure of what to say, going through grief themselves—the list goes on and on. My diagnosis was so severe- so bleak, that they were grieving at the thought of losing me, but couldn’t share that with me. Many of my relationships with family members became more distant during my cancer treatment. I didn’t want to put my fears on them and vice versa. I always assumed that families became closer during tragedy, especially with a happy ending, and that is not the case many times. We are closer now, but many relationships were strained during my actual cancer battle.
Communication in Families
Before this study, I think I would have said that my family communicated about my illness pretty often. Personally, I think there are many variations in communicating about an illness. My family was good at discussing the facts and making sure everyone was informed, but we skirted around several issues that the illness brought about, specifically my emotional health and my family’s emotional health. We were unsure how to communicate about my illness as many of my family members were apprehensive in that they would say the “wrong” thing, or something hurtful.
Many families just simply do not know how to communicate about illness in general, and that, in and of itself, can stunt the process of recovery and the life quality of the patient and family members. Those who learn how to effectively communicate have a much better relationship with their families and loved ones (Shields, Finley, Chawla & Meadors, 2012). I truly believe that my family did the best they knew how in communicating about my illness through my journey, but we could have done a much better job had we been more informed. Many of us had never experienced a devastating diagnosis like this, and we were clueless about how to communicate about my breast cancer. This is where a Marriage and Family Therapist could have helped our family greatly. They could have told us that the communication skills that are most essential in dealing with long-term health problems are to be direct, open, and sensitive. It is important to normalize difficult feelings, establish clear boundaries, and rebalance the relationship, and all of these things require effective communication (Baucom, et al., 2009).
When looking at the struggles that my family had, I think many of those struggles could have been less painful had we communicated more effectively, and learned what true communication looked like in the middle of such tragedy. Had we learned how to communicate more effectively, I believe our entire family would have grown together and grown as people. Thankfully, we have (almost 4 years later), but it’s been a journey where relationships were strained, lots of tears were shed, many needs not being met, and much of now knowing what to do. I pray that we as therapists, and if we encounter illness in our lifetime personally or that of a family member—that we focus on communication. Frank (1995) said, “To seize the opportunities offered by illness, we must live illness actively. We must think about it and talk about it” (p.3).
A Family Systems Perspective
I know I am just touching on literally hundreds of pages of my dissertation in just paragraphs, but I hope we can all learn that illness, much like any “problem” in a family, forces the homeostasis out of balance and we as therapists must be equipped to know “typical” patterns of what to expect and how to educate ourselves to best help families communicate and grow closer through an enormous trying time.
This is part two of a four part series. In Part 3, I will speak entirely on a significant other’s role when caring for a partner fighting or living with an illness. I will finally wrap up the series with practical steps and advice for Marriage and Family Therapists to use in therapy, as well as self-care tips if you encounter something like this yourself. Looking forward to sharing Part 3!
- Baucom, D. H., Kirby, J. S., Pukay-Martin, N. D., Porter, L. S., Fredman, S. J., Atkins, D., Keefe, F. J. (2009). Men’s psychological functioning in the context of women’s breast cancer. Journal of Marital and Family Therapy, 18(2), 317-329.
- Frank, A. W. (1995). The wounded storyteller: Body, illness, and ethics. Chicago University of Chicago Press.
- Strayer, D., & Caple, C. (2012). Breast Cancer in Women: the Effect on the Family