Dr. Tarein, what are the feelings, through which a woman passes, when he hears the dreaded diagnosis of cancer?
Despite advances in medicine, cancer continues to be associated with hopelessness. The moment of learning the diagnosis is shocking. In a few minutes there is a feeling of complete devastation, as if the whole life is turned upside down - the feeling of security, self-confidence and life, expectations.
This unleashes a storm of painful emotions – pain, fear and insecurity, anger, despair and a sense of injustice.
A bunch of unanswered questions arise, relatives are scared, the usual daily routine, plans and dreams seem impossible. This is a moment, in which it is almost unattainable to maintain common sense and a sense of reality. Various fantasies and catastrophic assumptions are included, which at this stage are difficult to refute. Old fears intervene, prejudice, inadequate messages from others, confusing advice, etc..
This is suffering, which is expressed not only mentally, but often physically, social and spiritual level. Although it causes different, specific experiences for each person, the collision with the disease has one common manifestation - the threat of loss, real or perceived.
Denial - belief - can also appear here, that some mistake may have been made. Encouraged by this, one rushes to seek another opinion, decides, that its results are confused with those of another patient or that doctors are not competent enough; eager to get some other words, to refute the former. These are completely normal experiences, which at the next stage gradually begin to settle. Usually calmness begins to occur, when it is clear what will be done, contact the treatment team and start treatment. Then the frightening notions gradually begin to adapt to reality and one is able to think more soberly about what is happening.. It takes time, in which the patient and his family accept the change, to reorganize in relation to it and to feel more stable. The pace, thus achieving this, is different. Also, this is not a linear process. Fluctuations may occur in it, to have better and worse moments.
These are the moments of doubt, of discouragement, of fatigue. Moments of tears. It is important to know, that they are not a bad sign, on the contrary, they show a normal thing, healthy coping of the psyche with this, through which it passes. Tears are not scary. They come from our desire for life. It is scary only when a person does not want life and does not cry for it.
And what happens to a woman's femininity?
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How can this be achieved?
By daring to think beyond appearances, when we stand on the side of truth. When we do not limit and hurt ourselves unnecessarily with imaginary clichés, when we do not project our fears into the other, and we can be honest and sensitive to ourselves and him, when we really decide, that we want to be better. I deeply believe, that despite everything, it is a matter of decision.
The onset of the disease does so, that one can no longer avoid the truth, to underestimate, to bypass the essential things. It requires change, rethinking, and taking the path of treatment in every plan - and physical, and mental, and life. This time it can affect many other old problems, which have hitherto been left behind in the course of everyday life and the sense of the infinite future ahead, which the disease changes. This change is painful - it causes fear, sadness, regrets. But so is it, which brings us back to those values and priorities, who have retreated. Questions arise, which require attention. In other words, opportunities arise.
What is the place of psychological help here?
Psychological care must be a fully integrated part of medical treatment. To be successful one treatment, to have a really good quality of life, even in very advanced disease, the mental side of this process must also be taken into account. Maintaining a good quality of life does not only mean good control of the disease. It includes all other areas of human life - his emotional state, full-fledged relationships and following his aspirations, despite the disease. In medicine there is a tendency to ignore the mental, as with doctors, and in patients. It is as if the physical is too drastically present, to think about feelings and emotions. But they are no less important factors for good treatment. Psychological help can help a lot in dealing with the disease and resorting to it should not be seen as capitulation to it. (as often happens), and only as a form of adequate self-care and a sign of a high health culture.
How society stands in relation to these diseases and sick people?
The social context has a very strong effect on the passage of the disease. In degree, which we may not even realize. It includes prejudices against disease and treatment, equating people at a completely different stage and type of disease, instilled fears and various misconceptions of all kinds (nutrition, contraindications, treatment methods, etc.), which further inhibit the sick person. I would say, that in our century Google has replaced the figure of the doctor. These are very powerful sources of anxiety, which have a strong disruptive effect on the already fragile balance of the patient. Society presses us to be always in shape, to be sustainable, to recover quickly, not to procrastinate, and to move forward, to compete with each other, to achieve more and more. In the end, it seems that we are still insufficient, we are still catching up. We, as specialists and especially as close people, we must have the ingenuity and patience to provide more comfort to patients to go at their own pace and in a way that is best for them., what happens to them. As a society, we need to be able to open up a little more space for suffering.
Dr. Margarita Tarein holds a PhD in Clinical Psychology from the Analytical Psychosomatics of Cancer. He specializes in psychoanalysis and psychosomatics in Paris. From 2010 r. collaborates with the Association of Cancer Patients in various projects such as the development of standards for psychological care, trainings for medical specialists and patient forums. She teaches at Sofia University and the Institute for Integrative Psychotherapy and Psychosomatics in the field of psychooncology, psychosomatics and psychotherapy in patients with severe diseases. He is the founder and honorary member of the Bulgarian Association of Psychooncology.
Dr. Tarein heads the first-ever Hospital Center for Clinical Psychology, psychooncology and psychosomatics in two of the hospitals of Acibadem City Clinic - Tokuda Hospital and Mladost Hospital. A new approach has been introduced to cancer patients. Upon admission for treatment, each patient goes through a psycho-social screening to assess their individual needs in relation to their mental state, social and family environment. This makes it possible to provide personalized patient care and maximum assistance in the treatment process.
