Cancer is a disease with powerful psychological impact. The distress associated with this diagnosis is a factor from the first moment of shock when you discover you have cancer. It remains a constant variable during treatment when medical jargon and working through treatment alternatives have to be sifted through bewilderment and fear. Feeling helpless and overwhelmed may not end with the completion of surgery, radiation and/or chemotherapy. Living with the threat of recurrence is a lifelong challenge and means that, for many, long term disruption in their lives is a reality.
The experience of breast cancer depends not only on the medical prognosis and the extent of treatment, but also on one's prior conceptualizations of the disease, general emotional well-being and the availability of emotional support. For some women, deeply ingrained ideas about individual responsibility for health can add a layer of guilt at this difficult time. Some self-help books take a stance that can add to this misplaced extra burden of blame.
Other expectations can also be factors in an individual's emotional experience. For example, patients are often prepared for the physical side effects of chemotherapy, but not for the emotional experience of shame, embarrassment, dependency, panic and unattractiveness that many women encounter. Patients may not be prepared for the loss of trust in their own bodily experience and find their anxiety levels rising after treatment is completed and the protective umbrella of frequent contact with medical personnel is gone.
Cancer is a crisis for the family and for the network of people around the patient. Some families will deteriorate and some may actually improve in their functioning -- but most will experience considerable strain. Many women attempt to deny their own needs so that the family will not suffer and the family may maintain an attitude of forced cheerfulness avoiding discussion of anything that might be negative. Who is on the patient's side? With whom does she talk over choices? Cancer can become an isolating experience.
There is strong evidence that Individual and Group Psychotherapy can help. Having a place where one can talk about the psychological difficulties that emerge from the illness experience, without worrying about the impact on family/friends, is helpful. Group members often gain by learning and seeing other people in the group and may discover new ways to solve problems. The sense of isolation can be reduced. Research indicates that, cancer patients benefit at a feeling level from group psychotherapy, and their survival potential is also maximized.
What is the the difference between a peer support group and a professionally led therapy group? There are significant differences between support groups and professionally led groups.
Support groups are generally modeled after self-help groups and no individual interventions are attempted by the leaders. Participants take turns introducing themselves by name, giving a brief description of the history of their disease (e.g., when diagnosed, treatment status) and mentioning some current event or concern. Normally, interaction between members is reserved as a post-group activity. The size of the group is variable and limited only by room size. Attendance is open and individuals can come regularly or infrequently as they choose. Leaders usually provide a thoughtful introduction by reading or playing video-tapes but then allow the group to function in a self-help manner. While support groups may effect survival, there is no research to support this as yet.
Group psychotherapy is limited to size, usually 7 to 10 members only, and members are asked to commit to regular attendance for a fixed period of time (12 to 16 weeks). The small size and relatively fixed membership promotes trust and cohesiveness among members. The psychologist/leader provides information, and structure, encourages the examination of feelings and facilitates support among members. Close personal group experience has been shown to be a survival factor in many research studies.
The following are links to other web sites that I found helpful.
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