Cancer, the Mind, and the Problem of Self-blame

Abstract

Why me?" This question of causal attribution is pervasive among cancer patients-so pervasive, in fact, that it is the basis for the name of the largest national breast cancer patient support network. As work in the field of psychooncology has advanced, the emotional aspects of cancer have been publicized and have entered the minds of lay audiences everywhere. A 2001 survey by Stewart and colleagues of Canadian breast cancer survivors, recurrence free for an average of nearly 9 years, found that 42% of them believed that stress caused breast cancer-a belief that is without scientific foundation-while only 27% felt that genetics and 15% felt that diet were involved in causing breast cancer. 1 Remarkably, 60% of the women attributed their lack of recurrence to having a positive attitude and only 4% to use of tamoxifen.While there has been much publicity on lifestyle factors that can cause cancer, from excessive sun exposure to smoking, there clearly is a substantial part of the public who are predisposed to believe that emotional factors are a cause of cancer. Integrative practitioners, who emphasize lifestyle adaptations in treatment of cancer, not to mention causation, are invariably familiar with patients who react to their awareness of cancer's lifestyle connections with paralyzing self-blame and guilt. "Blame the victim" scenarios, or statements that cancer has been caused or progressed because of emotional stress, frustration of significant needs in life, or negative thoughts or emotions, appear to have been prominent in interactions with some alternative practitioners working with cancer patients. In addition, research studies have raised the possibility that psychosocial interventions might improve cancer survival, suggesting to many that psychosocial factors might also cause cancer. To explore the role that both alternative psychologies and research on psychosocial oncology may play in such self-blame, we have asked 2 insightful researchers to participate in this Point-Counterpoint. The 2 respondents have different assessments of the question of whether psychosocial factors might influence cancer causation or survival. Roger Dafter, PhD, is

Self-blame, Self-forgiveness, and Spirituality in Breast Cancer Survivors in a Public Sector Setting

“…For example, self-blame is associated with poorer psychological adjustment in medically ill patients, including women with breast cancer [1,4,5,7]. Because it has been suggested that behavioral factors such as diet and exercise may be related to an increased risk of breast cancer, some women with breast cancer may blame themselves for developing this disease, resulting in mood disturbance and decreased quality of life (QoL) [3,6,[8][9][10][11]. Support for a relationship between self-blame and psychological adjustment has been inconsistent.…”

Examining the Burden of Self-Blame Attribution Among Women With Cervical Cancer

“…Feelings of deservedness related to one's perceived character flaws may be self-identified as the cause of a negative outcome. In women diagnosed with cervical cancer, the inability to control for one's self-perceived negative, nonmodifiable character traits has been correlated to depressive symptoms (Block et al, 2006; Breitenbecher, 2006; Janoff-Bulman, 1979).…”

“…Women with cervical cancer who associate past sexual activity with the diagnosis are more likely to associate self-blame (Marlow et al, 2010), placing them at risk for increased psychological (Block et al, 2006; O'Neill & King, 2000) and spiritual distress (Friedman et al, 2010; Laubmeier et al, 2004; Morgan et al, 2006; Visser et al, 2010; Wenzel et al, 2005). When past religious teachings are compared to past behaviors that may have contributed to the cervical cancer diagnosis, greater spiritual struggle may occur in women identifying with a variety of religious faiths (Abu-Raiya et al, 2015; Kebede & Kebede, 2017).…”

The Relationship Between Self‐Blame for the Onset of a Chronic Physical Health Condition and Emotional Distress: A Systematic Literature Review

“…Self-blame is one type of causal attribution that involves perceptions of personal control over the cause of an event and is often reported by people with chronic health conditions with reference to them becoming unwell (Arman, Rehnsfeldt, Carlsson, & Hamrin, 2001;Bennett, Laidlaw, Dwivedi, Naito, & Gruzelier, 2006;Block, Dafter, & Greenwald, 2006;Lehto, 2014;Refsgaard & Frederiksen, 2013). Self-blame involves an individual believing that an unwanted event is in some way their own fault and that they are personally responsible for its occurrence (Mantler, Schellenberg, & Page, 2003).…”