Mark Kelly at the side of wife Gabrielle Giffords in the University Medical Center/ U.S. …In an interview for The New York Times on January 18th a woman faced with metastatic breast cancer made the following comment: "You always hear stories about women who 'battled it' and how 'courageous' they were. Cancer doesn't care if you're courageous. It's an injustice to all of us who have this. There are women who are no less strong and no less determined to be here, and they'll be dead in two years." You might wonder what that has to do with what has been reported to be the exceptional recovery of Representative Gabriell Giffords following a gunshot that traveled through her brain. The fact is that there is an important connection.
The woman who made this comment is herself someone who was diagnosed with breast cancer of a metastatic form, meaning it had already spread to other parts of her body-in her case, her spine. It is not hard to imagine how such a diagnosis can be emotionally and cognitively overwhelming. In comparison to other diagnoses-Stage 1 or Stage 2 cancer-it can seem like a virtual death sentence. Yet the irony is that the author of the above comments is herself a mother whose initial diagnosis took place six years ago. Perhaps she is the exception that proves the rule; alternatively, perhaps she is living proof of the conventional wisdom that fighting is better than surrendering.
saying-goodbye-bookIn the course of writing our book, Saying Goodbye: How Families Can Find Renewal Through Loss, Barbara Okun and I interviewed many individuals whose families endured what we call "the new grief," meaning the prolonged process that patients and their families alike go through beginning when a terminal diagnosis is given. Surely a diagnosis of cancer that had metastasized is about the worst possible scenario. Yet the question remains: Why can someone survive four (or ten) years after such a diagnosis? Why is Gabrielle Giffords' recovery moving along as well as it is? Is the answer purely medical? Do psychological factors play no role at all?
Based on interviews with many individuals and families faced with terminal illness, we believe that medical factors alone cannot account for survivability. This is true for the woman confronted with breast cancer as surely as it is true for Ms. Giffords. In other words, there is value in the idea of fighting a "courageous battle" against cancer (or a traumatic brain injury). At the core of that battle are certain personal beliefs about the nature of life and life's crises. The more deeply an individual embraces these beliefs, the better they are able to either survive or else fend off the debilitating effects of trauma or terminal illness. Psychologists have found the following beliefs to be associated with what we call psychological "resilience", or the ability to survive crises and emerge stronger as a result.
Ask yourself how strongly you embrace the following beliefs:
• I was put here for a purpose-my life has meaning.
• Crises are a normal part of life and I should expect them to happen.
• When it comes to a crisis I have not been singled out any more than anyone else.
• The best way to overcome a crisis is to mobilize my resources and confront it.
• It is possible for me to emerge from a crisis even stronger than I was before.
The more you are able to embrace the above set of beliefs, research tells us, the better you will fare in the face of a crisis, be it a terminal illness, an accident, or a trauma such as that which Ms. Giffords is facing.
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About the author: Joseph Nowinski, Ph.D. is a clinical psychologist with the University of Connecticut Health Center. He also has his own practice and is the coauthor (along with Dr. Barbara Okun) of Saying Goodbye: How Families Can Find Renewal Through Loss (Penguin/Harvard Health Publications). Connect with him and learn more at www.newgrief.com.
Photo: Mark Kelly at the side of wife Gabrielle Giffords in the University Medical Center/ U.S. Rep. Gabrielle Giffords' Office