Psychology and cancer
Psychology and cancer
Massimiliano Mariani - Psychotherapist
In oncology the relationship between doctor and patient is of paramount importance, and it is also delicate. What is advisable? To show empathy with patients or to maintain emotional distance from them?
Going to either extreme is not good to build a good patient-doctor relationship and to help patient through the treatment. It is important that each doctor and health care professional can find a balance in order to be open to help the patient, and it is also necessary to be distant in order to work in the most free and effective way. Free especially from the emotional charge that may emerge when doctors meet a person immersed in a painful context, like cancer patients, who may be thinking about death.
The awareness of how all this affects patients and health care professional is the main tool to find one's own balance - which varies from person to person -, that helps to receive and put into words the emotions at stake. Such awareness reduces the risk of 'sucking in' in these feelings and take them home, outside the office or clinic.
CNAO has proved to be very aware of how important this is for the well-being of both health professional and patients. This is why in Padua, we are engaged in training courses for doctors and health care professionals. These courses provide health care professionals with a common space for reflection where they can acquire the necessary tools to diminish, as much as possible, the stress generated by their work so that thy can continuously improve their relationships with patients.
How can psychotherapy help people to face the disease from a mental point of view?
Being diagnosed with a disease, especially cancer, certainly generates a deep crisis in a person's life. The balance, routine and the behaviour mechanisms that until that moment have been taken for granted, start to collapse under pressure.
Psychological support in these situations can help not only patients but also their families to find their own balance, and to accept the difficulties and to try to be happy despite the new limits given by the relationship with the disease.
I think that when you find yourself at such a difficult situation that affects every inch of you, it is hard to find a space where you can try to be as well as you can despite the disease. This does not mean to stop feeling the pain and suffering that the disease brings with it, but to be able to take it on consciously so that these feelings do not affect any other part of your life that can be protected. The possibility to be happy, in the first place, to say a trivial thing that in true fact is not that trivial.
How do doctors and nurses react to psychotherapy? Are they willing to work together with the psychotherapist?
For many years medical training has been doctor-centred and disease-focused, in which a caring figure who knows about the situation takes care of the patient throughout the treatment. In the last years a new point of view was introduced. It was described as "patient-centred medicine" that has led to reflect upon several interesting aspects. Firstly, the possibility that the patient can be responsible for his own treatment path as a person suffering from a disease (and not just "sick") and deal with such disease as effectively as possible.
Very often I had the chance to discover a genuine desire on the part of healthcare professionals to get involved, to feel that awareness I mentioned before, reflecting upon themselves and their relationship with patients.
From this point of view, the CNAO team has proved incredibly attentive and open, able to alternate moments of great empathy and moments of relaxation and light conversations. In every situation, a great respect was shown among the different players, including the therapist, which has led to an effective exchange, in my opinion, so that each of the participants could grow from both professional and personal point of view.
In this sense, the possibility of creating a collaborative work between therapists and healthcare professionals, as well as among therapists, patients, and relatives, is a very important tool that in the past few years has proved to be extremely valuable to improve the experience of treatments and the results of such treatments, both in terms of the satisfaction perceived by patients and of preventing excessive stress for health care professionals.