Hearing the news
Hearing that you’ve been diagnosed with cancer, even if you previously suspected it, can come as a tremendous shock. It can’t be absorbed all at once. You go through a process in which, given the right kind of support, you gradually recover your sense of being able to make choices, as opposed to being overwhelmed by a tide of events over which you have no say or control.
Even though it may feel as though nothing has changed in your physical body, you are already in mental and emotional pain, needing to find comfort and hope. The first step, however, is to really “hear” what your doctor has told you as you let it sink in.
Although you may never have had to cope with this much bad news before, it’s likely that you already have relevant life experience. For example, the dead car battery: You’re rushing to work or an appointment, you get into the car, and turn the key. A muffled grinding sound results…What do you do? It may sound ridiculous, but you actually go through a process:
- Denial: let’s just turn the key a few more times, maybe it will work. The battery can’t be flat!
- Anger: Why must this happen now, of all times? This is unfair! Who wasted the battery?
- Bargaining: Please, car, just start this once and I’ll get you a new battery later.
- Depression: It’s no use. I’m not going to make it. My day is ruined. I’ll probably get the sack.
- Acceptance: OK, it’s dead. At least I’m still at home. I’ll call work and make excuses, then I’ll phone for help with this car.
So this is a familiar process for people who are faced with life-altering bad news – though the intensity of our reaction will depend on the extent of the loss we are facing. Even in the situation of the dead battery, there is a huge difference between being late for work, and failing to show up for an exam or our child’s special moment. Where real loss and grief are involved, that grief response is personal and individual: no one can tell you how you “should” react. We all have different personalities, life experiences and coping styles, and that’s OK!
The process of moving into acceptance of a changed situation has been given the shorthand T.E.A.R. This stands for:
- To accept the reality of the situation, allowing yourself to believe it
- Experience the pain, giving expression to your feelings
- Adjust to the new reality, re-organising your life and commitments to reflect the changes
- Re-invest in the new reality, identifying opportunities to live more deeply into your values
Your coping personality
The pattern of adjustment depends on personal coping style, which might be similar to one of the styles described below, or might include features of more than one style. In addition to being part of our natural personality, these styles evolve through experiences of hardship and adversity – our own, or that of our role models who have passed on their own hard-won skill and wisdom, sometimes down the generations of a family.
Some people are “cognitive copers”. If this is you, you will respond to a grievous loss by hunting down detailed information in books or online, consulting experts, and trying to learn everything you can about what’s happening. The cognitive coper can become a source of information, helping others to access knowledge. Knowledge increases our power – and mitigates the sense of life as a terrifying chaos in which anything could happen. At the very least, sound information offers an objective standpoint in the face of uncertainty and fear, giving you some confidence back – as long as your sources are trustworthy and reliable. Being ready to make peace with uncertainty when even the experts no longer have answers is also part of cognitive coping, especially in the face of cancer which still holds many mysteries despite the tremendous pace of research in recent decades.
Some people are “psychological copers”. If this is you, you’re known for being a positive thinker who seldom dwells on the negative; you’re always looking for the silver lining in the cloud and you usually find it. Psychological copers have tremendous resilience because you’ll usually take “one day at a time”, count your blessings, and challenge negative thoughts. It’s often said that “when times are hard, friends are few”, but your positive attitude inspires people and attracts support.
South Africa is a land of rich spiritual traditions, so it’s no surprise that many South Africans are “spiritual copers”, placing their trust in God or a higher power. If this is you, you’ll find comfort and hope in accepting that control is out of your hands, because you recognise that God is in control. A spiritual coper finds inner peace through spiritual direction, in prayer or meditation, in devotional studies, through inspirational stories of healing and strength, and through spending time in peaceful, beautiful places. Because the ultimate hope of spiritual copers is beyond this world, it is a powerful source of comfort: “all shall be well, and all manner of things shall be well”.
Some people are “support system copers”. If this is you, then “ubuntu” is a central value in your life. You’ll turn to others for words of encouragement, sharing your burdens with your close community. Knowing that others care about you makes all the difference. It will probably be a priority for you to continue seeing people during your treatment, and you may make heroic efforts to stay involved with others in familiar ways. Support system copers are often “family people” who are comforted and uplifted when family rally round. Whether or not friends and family are actively present, support system copers often benefit from focused support groups such as those run by Reach to Recovery, and they make wonderful group members, setting an example for others.
Then there are the “physical copers“. If you’re a physical coper, you can handle anything as long as you stay active; you’re probably already wondering how soon you can go back to work. Physical coping doesn’t have to involve intense exercise; cooking, baking, gardening, housework or handwork are also outlets for physical copers, who usually like a tidy, orderly environment and don’t mind being the one who clears up. Even when tired or unwell, you’ll probably want to keep moving, may prefer being outdoors, won’t easily lose interest in food or sleep, and might be content to be alone as long as there’s something to do. Physical copers love to laugh, and respond strongly to music. The physical coper, interestingly, is also likely to cry easily – when laughter or crying is intense, chemicals are released that give a feeling of relief, so both are therapeutic. Physical touch is also important, which is sometimes where animal companions come into their own – we should never underestimate their potential, as animals often seem to know just what we need.
Be kind to yourself
Just as you yourself are going through a grieving process in your own way and coping in your own way, your loved ones are going through their own process of adjustment and grief. Sometimes this leads to needless trouble. The cognitive coper can seem too detached, the psychological coper too unrealistic, the spiritual coper too fatalistic and the physical coper might appear to be withdrawing or going into denial. Support system copers can be seen as too outwardly focused, even dependent.
There may be grains of truth to these complaints, as each coping style has liabilities as well as strengths – but people are who they are, and if ever there was a time to be kind to yourself and others, accepting our diversity and acknowledging that we need one another despite our imperfections, this is the time for that kindness to find new and deeper expression.