When Cancer Strikes: Emotions Stirred by Physical Illness

Oct 4

Sarah contacted me soon after her breast cancer diagnosis. When we met for the first therapy session, she was emotional about her illness and cried bitterly. Sarah kept asking, “How could this happen to me? I don’t understand. Why would I get cancer?”

I empathized with her pain and fear. I acknowledged the daunting feelings about the cancer treatment process. Over our next few meetings, she discussed with me all she was being told by her doctors. Fortunately, a routine mammogram detected the cancer at an early stage, and her prognosis was excellent.

This did not seem to make Sarah feel better, as I had thought it would. She did not feel relieved and grateful about this turn of events. Instead, she continued to experience the malignancy as an affront. She reiterated, “I don’t understand. How could this happen to me?”

After some time, I said gently, “You seem to think that you and perhaps some others should be immune to certain illnesses or other tragedies in life, or somehow you have failed in some way, because something has happened to you that you actually don’t have much control over. I wonder what these thoughts and feelings are all about, and could we work together to understand them?”

Sarah seemed taken aback by my comments. To her credit, she then mused, “I’ve always felt I had a handle on my life, my health, and my body. I work out. I eat well. I am very careful about everything. I was doing regular breast exams. How could I have missed this? But even more so, how could this have happened to me, and why?”

I was struck by Sarah’s omnipotent thinking. I thought this could be a residue from her childhood. Had this way of thinking been developed to ward off feelings of intense helplessness and lack of control about earlier life events, I wondered to myself. I was also intrigued by her repetitive question of why this happened to her. That question suggested an underlying fantasy. In reality, any one of us can get ill with almost anything.

As the immediate crisis started settling down a bit, I was able to gather more of Sarah’s life history. It turned out that she had been the only and adored child of parents who often spoiled her with material goods, but not enough emotional nurturance. The family was deeply focused on external appearances (lavish home, designer clothes, expensive vacations, etc.). Beneath the glamorous facade, her parents’ marriage was a farce. Both parents were involved in extra marital affairs. When Sarah was about nine, the marriage collapsed, which is when it also became clear the family had been living mostly on borrowed money.

In therapy sessions with me, Sarah gradually recalled the tremendous shame she felt in life after her parents’ divorce. What had seemed intact and perfect, had proven to be rotten and defective. Just like a hidden malignancy in a seemingly normal looking breast. She could then also approach memories of thinking at that young age (as children often do) that the divorce was somehow her fault. She should have been able to prevent it and keep her parents together. This was very similar to what she imagined about the cancer in her body. She thought she should have been able to prevent it from occurring.

Working with these issues in therapy and connecting her past experiences with her feelings about her current situation, helped Sarah tremendously. Over time, she was able to view the cancer that had developed in her body as something that was not her fault and not necessarily preventable. She was instead able to deal with cancer as simply an illness she needed to fight with all the resources she could muster and with the best possible help she could get. Her self-blame, self-reproach, and outrage decreased, all while her compassion increased for what she had experienced as a child.

Several years after ending therapy, Sarah contacted me to let me know that she remains cancer free and is enjoying her life.