An interview with Kamila Weigt, a clinical psychologist and family therapist, about how to face the news that loved ones have cancer, and why clear communication with one another, talking about one’s illness and nurturing close relationships with others are so important.
Grażyna Hanaf: My daughter comes to me and says: “Mum, I have breast cancer.” How should I react to support her?
Kamila Weigt: The first reaction is always shock, and that is a natural reaction. Our task is to listen to this person and support her emotionally. If she is someone close to us, we can begin by gathering as much information as possible about the disease. Is this definitely the final diagnosis? If it is, and all the tests confirm it, what steps can we take to cope with the disease? In addition, it is important to be close and provide emotional support.
GH: What attitude is best to adopt?
KW: It would be good to control your own emotions. Do not panic yourself. You should focus on treatment. If the diagnosis is certain and the patient is facing surgery, removal of the breast, you should support her so that she can make a good decision, although it is a very difficult one. In the case of breast cancer, surgery means not only mutilation of the body, but also an assault on one’s image of one’s sexuality and femininity. This is where our role lies: supporting the woman in the decision to undergo amputation.
GH: And what if the person shuts herself away? The daughter says: “This is my business. I don’t want to talk about it.” Should we leave her in peace, or should we do the opposite and fight, because thinking this way will make it harder for her to get through the illness?
KW: The relationship with the patient depends on what contact you had before. If your daughter was always a closed-off person and did not express her feelings clearly, the illness will not change her. She may shut herself away even more. Please remember then that our bond does not consist only of verbal contact. Previously, we met somehow and lived alongside each other. You need to show nonverbally that you are with her and try to establish contact.
GH: What specifically can be done?
KW: If you are an open person, you can ask: “How can I help you? You don’t want to talk to me now, but can I do something else for you?” You should also express your feelings clearly. Your need for help.
GH: My daughter will have different moods related to her illness. What will she go through, and how can I help her at each of these stages?
KW: The classic stages experienced by a person with a terminal illness are the denial mentioned above, as well as anger, depression and finally acceptance. When a patient feels anger, the most common mistake is to take it personally. This only deepens the patient’s anger and distrust.
GH: What should we do when our daughter shouts angrily that I cannot understand her because I am healthy?
KW: You should support her without taking the anger personally. Listening to your daughter, giving her hope and encouragement can help. A clear message: I am with you.
GH: And what about depression?
KW: Depression can take two forms. One is connected with the current situation and fear of losing one’s job and income—reactive depression—but it can also result from spiritually preparing oneself for departure. The patient knows exactly what is happening to them, even if they do not talk about it. What can we do? We can talk about death, illness and emotions. Patients often feel fear of separation and losing those closest to them. We should repeat that we are with this person. We can also provide material help, but nothing can replace building a bond and devoting time to the patient. This is especially important if it was not so important before and there was no room for it.
GH: You emphasize the importance of relationships with loved ones. Does our reaction to learning that someone we know has cancer depend on what kind of people we are and what bonds we form with others?
KW: It is a very delicate matter and depends on what relationship we have with that person. If we have always been open with her, she will not be surprised that we remain that way. It is important to reassess our lives and see that the most important things are feelings, closeness, friendship and showing love.
GH: When we learn that a female colleague has fallen ill, and we were not previously very close to her, how should we react?
KW: It should be stressed that we need to moderate what we say and what emotions we show so as not to hurt the patient. We must neither impose ourselves nor pretend that we know nothing. If we did not have close contact before, we should rather keep our distance.
GH: And what if, simply as human beings, we want to support someone we have learned has cancer? Even though she was not particularly close to us before and we did not have a closer relationship.
KW: You can always consider how you want to show her that you are with her in these difficult moments and that you are able to help her. If she needs this help, you can make a small gesture. You can observe the contact between you; if you work together and have known each other for some time, you can judge from her behaviour and appearance whether she needs such support. You can see it. Let us talk about it as much as we can. You must not approach a person you barely know and suddenly ask: “How is your cancer going?”
GH: In our society, terminal illnesses are taboo. It is difficult for us to talk about them. Does it make sense to say publicly that one has cancer, as Kamil Durczok, the journalist, did?
KW: It makes sense, because coping with the stress brought by a cancer diagnosis or any other chronic illness involves encouraging patients to name and express their feelings clearly. This allows emotions such as anxiety and fear to come out, so that the patient can move from the anger phase to the acceptance phase of the illness. Acceptance is necessary in order to direct all one’s energy towards treatment and recovery. Amazons’ clubs serve this purpose. In such a group, women support and help one another. When new people join, they can see for themselves what path their fellow members have travelled. By helping others, they help themselves. By talking about how they themselves coped with cancer, they give hope to others.
GH: Does such a public confession not carry a fear of pity, which people associate with the thought: “I am better off because he is worse off?”
KW: When you have cancer, you perceive reality differently and your system of values changes. I do not think that a sick person sees those around them in this way. They are trying to give meaning to what is happening to them—to pain, suffering and life.
GH: What can guide us, apart from sincere intentions to comfort someone with cancer?
KW: Most often, it is our fear of cancer and fear of death, which everyone carries within themselves. We do not reflect on the fact that death is the final stage of life; we are afraid of it. We do not talk about it because it is a taboo subject. Often, out of fear for our own lives, we wonder how a sick person copes with a situation involving such a great threat of death. In this way, we want to reduce our own fear.
GH: Does a patient need a therapist to help them during recovery and the fight against cancer?
KW: Yes, psychotherapy is needed. When we learn about the illness and what happens to us during it, we gain control over ourselves. This reduces our fear. We need to understand the meaning of suffering. Suffering accepted calmly becomes woven into human experience, increasing maturity, knowledge and wisdom, and driving personal development. We need to identify and name the emotions that accompany us. Patients often cannot cope on their own because the subjects they have to face are difficult, had not previously been discussed and are taboo subjects. The intervention of a psychologist or psychotherapist is certainly needed in three cases: when the patient learns they have cancer and experiences shock; when they are referred for surgery, especially when it is an operation that mutilates the body; and when the disease recurs. More and more psychologists are being employed in oncology wards and clinics, providing professional help.
GH: So what is most important for the patient?
KW: A sick person expects three things from us. First, that we do not abandon them; second, that we listen to them; and third, that we help them. People with cancer perceive time differently. While fighting cancer, they focus on what is important today, tomorrow, or at most a week from now. The threat to their life inspires them to take an active role in the treatment process, but also to live actively. For example, women who have taken up the fight against the disease are very active, have hobbies, participate in social life and meet socially.
GH: Is this a way of coping with the illness, and why?
KW: Living with a constant sense of the threat of death and continuously fighting the disease creates tension. This tension helps release hope and bring about changes in life. The patient’s attention is therefore directed towards the healthy aspect of their life; this helps in the fight against cancer and releases energy to overcome the disease. Focusing on negative emotions and a sense of hopelessness worsen the patient’s condition. Illness is overcome through activity, a fighting spirit and choosing life.
GH: Thank you for the interview.
What should you do when someone in your family develops cancer or when it happens to your friends?
- A sick person expects three things: be with me, listen to me, help me.
- Our reactions to news of illness affecting someone close to us or someone we know should reflect the relationship we previously had with them. If we were close, we can be open; if not, we should keep our distance.
- Let us observe the sick person so as not to hurt them. We can see whether they need help.
- Let us clearly express our emotions and willingness to help.
- Let us talk openly about cancer.
- Let us build close bonds every day, not only when illness occurs. By then, it is already too late.
- When we are not sure whether we can manage to provide support on our own, let us turn to a specialist psychologist or psychotherapist.