The Middle Ground

The creative way to enriching your relationship.

A Family Copes with Cancer (Part 2 of 2)

Dealing with the stress of surgery

skilled physician

skilled physician

In the first part of this two-part article, Beth—mother of two grown children, Roger and Alana, and long-term wife of Chet—had undergone exploratory colon surgery. The results of the procedure were inconclusive and unsettling. A friend of the family recommended that Alana urge her brother and father to seek family therapy to help deal with the stresses.

When the family reported to their initial therapy session Roger and Chet, father and son, were not talking to one another and Alana, Roger’s sister, was furious with them both for focusing on each other rather than on Beth.

Each was so busy, in their own way, trying to hold themselves together, that they were neither able to offer Beth the full support they might have, nor could they be there for each other.

Instead of responding to that core reality they focused on issues they felt they could have some control over. Chet focused on his failed vacation, Roger on his disappointment in his dad, Alana in her disappointment in her brother and father.

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Kubler-Ross’ formulation about the grief process refers not only to actual loss but to the threat of loss as well. Denial is the expected first stage of response to a potentially cataclysmic loss.

No one acknowledged the obvious: That they were in a state of shock about Beth’s condition.

The sudden onset of Beth’s condition was shocking in itself. In addition to that, Beth was a person whose absence was difficult to tolerate.

My grandmother would have called Beth a ballaboosta. Such a person, can be recognized by these

grief cycle

grief cycle

signs: she is a consummate chef, whirling dervish of a duster, cleaner of all surfaces, arranger of all familial activities, hyper-aware of community activities and family functions, a caretaker par excellence. I use the female pronoun because traditionally the role belongs to a woman. That a man could likewise fit the description is not in dispute.

This seemingly selfless person takes up a large interpersonal space. And the unshakable dedication they devote to tasks at hand not only allows but invites others to lean on them. So, like a house with its main pillar missing, Beth’s absence caused the walls of family functionality to teeter and fall.

With her ever-accessible support for their efforts and emotions no longer available the family became aware of just how much they relied on her energies.

For the first time the family members were forced to contemplate what life might be like without Beth’s mothering presence.

My first task as a family therapist was to help Alana, Chet and Roger to come to terms with the enormity of this change—Beth’s absence—even if it was temporary.

That they were having trouble feeling good in their lives at this time made perfect sense.

Rather than allow the feeling that they lacked control of their situations each, in their own way, focused on an issue that might, from their point of view, give them a handle on some sense of control.

I suggested that this attempt was natural and normal but would have to result in frustration and disappointment because it was essentially a distraction.

There was no way of avoiding a profound feeling of discomfort in going through their situation. How we work with the-way-things-are involves choice, skill and attention. What-those-elements-are is not a matter of choice but circumstance.

Alana had hypothesized that it was understandably difficult for Chet to give up thinking about the trip that would never happen as planned. She reasoned: the trip represented his life before calamity. Thinking about the trip was a way for him to cling to the precious normality of life as it was before Beth’s health crisis was recognized.

Acknowledging that postponing or cancelling the trip was trivial compared to allowing a full awareness of the emotional implications of Beth’s illness came slowly to Chet. As Roger opened to this, more compassionate, perspective, he reconnected with how and why his relationship with his dad had in fact been good for so long preceding this crisis.

Chet was a doting grandfather and, though he certainly had a list of interests that kept him occupied, he reached out to Roger and kept abreast of what was important to him. He also shared his own thoughts and feelings with his son. Chet was a loving father. Alana’s affection and sympathy for him was a reflection of that dynamic.

As anger between Roger and Chet abated the sadness that lay underneath their anger was able to surface. Together, the three shed tears of pain, awareness and acceptance.

Meanwhile we strategized ways in which Beth could best feel supported by the threesome. There was a schedule for visits that Alana and Chet jointly coordinated. There were lists of questions and research into Beth’s condition that helped all concerned to feel more knowledgeable and less alarmed by what was going on medically.

There are times when a health crisis lays bare the lack of communication and mutual concern within a family. Years of deteriorated relationship make it hard for anyone to extend themselves towards others. In such cases, families are unable to help one another and the person who is suffering, the identified medical patient, bears the brunt through lack of coordinated care and support.

For this family, happily, there was a core of good will and a pattern of staying in touch with each others’ lives.

The dialogues that were conducted in the therapy office did not represent first time breakthroughs in sharing feelings, because those breakthroughs had occurred long before they came in for help. This made the help much easier to deliver. It contributed to the case being a relatively short-term treatment.

At the moment, Beth is recovering nicely from a condition that is being closely monitored.

She is being pampered by her family.

Chet especially has put his trip where it belongs—out of his mind for now—and is gratified to connect with Beth in keeping her stress level as low as possible.

hope
One of the key aspects of the work we did together featured talks about how stress slowed healing. Chet, Roger and Alana know they can return to see me when and if they would like. In the meantime, they seem to be doing well. By the way, the understanding is that, given how things have developed, if they do return, it will be with Beth.

Please feel free to respond with comments, questions or by sharing your own experience with this kind of situation if you would like.

Remember, love and good feelings are plentiful but elusive. I will help you locate and develop them in the Middle Ground.

(c) 2012

Marty Babits is Co-Director of Family and Couples Treatment Service, a division of the Institute for Contemporary Psychotherapy in New York City.

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