Intruder in the Night: Cancer and the ‘I’ Within

Abstract

Little has been written about psychoanalytic psychotherapy with people who suffer from medical conditions such as cancer and as distinct from the well-established literature describing psychoanalytic theories and clinical work with those who have medical conditions which may be considered to have a psychologically-influenced causal basis.In this paper, I will explore the nature and experience of cancer, its psychological impact upon the patient and also the therapist, and the patient's relation to the disease inside. I think about cancer as an unboundaried invader within the body which may temporarily dislocate the patient's ego, resulting in the 'I' of the patient feeling overwhelmed or threatened. The subject of this paper is the 'I' which perceives and relates to the cancer within. The aim of the paper is to work towards describing the principles and practice of a model of ego-supportive psychotherapy with cancer patients, its goal being to help the patient to strengthen, relocate or reinstate his/her vulnerable ego.

Experiences of selves in isolation: A psychodynamic approach to the care of patients being treated in a specialized medical hospital unit 1

“…Some of the issues I have raised here relating to working within a psychodynamic framework in a medical setting, including the emotional impact of the patient's illness upon the counsellor, are explored in an earlier paper (Parkinson, 2003; see also Segal, 1996).…”

An exploration of psychotherapists’ experiences in medically driven cancer care settings

“…Two participants discussed how feelings of isolation decreased when they became more familiar with the cancer setting and the language in context. A certain degree of knowledge of medical language was considered helpful by two psychotherapists to understand the clients’ experiences of cancer, resonating with Conti's () and Parkinson's () perspective.…”

“…() suggest that although some knowledge of medical language may be useful when counselling people with cancer, attention should be given to the wide range of themes emerging from the clients’ distress and concerns rather than the disease itself. In this respect, clients’ experiences of cancer could be better understood by considering their emotional state, inner world (Parkinson, ) and the search for meanings in their illnesses (O'Connor et al., ). As the client's relationship with cancer is physical, emotional and existential (Heywood & Loewenthal, ), the counsellor should create a safe space in which clients can express their thoughts and feelings about their diagnosis, treatment and the likely prognosis (Lockett, ).…”

“…From existing literature, divergent opinions emerge about the skills and knowledge needed by psychotherapists working in cancer settings, such as hospitals or charity organisations. Some authors (Becker, 2000;Conti, 1989;Heppner et al, 2009;Iwamitsu et al, 2013;Krenz, Godel, Stagno, Stiefel & Ludwig, 2014;Myers, Stephens, Boyce & Hermann, 1991;O'Brien, 2014) believe psychotherapists should have knowledge of medical language and of cancer diseases, while others (Curran & Kobos, 1980;Heywood & Loewenthal, 2007;Keeling, 1976;LeMay & Wilson, 2008;Lockett, 2009;O'Connor, Wicker & Germino, 1990;Parkinson, 2003;Vos, 2014) emphasise an existential approach to counselling. Heppner et al (2009) suggest counsellors and other health professionals should have training in cancer symptoms and treatments.…”

“…Some authors suggest cancer training would enhance psychotherapists' understanding of the physical aspects of cancer, and the emotional impact of cancer diagnoses and treatments on the client (Becker, 2000;Conti, 1989;Iwamitsu et al, 2013;Parkinson, 2003). Myers et al (1991) highlight that cancer training is a priority for professionals working in cancer settings.…”