The objective of cognitive therapy is to turn negative thoughts into positive ones that will aid your cancer recovery. Self-help treatments which encourage people to be less passive have been shown to help them cope better with the disease, and suffer less distress. Whether such treatments can help you to live longer as well remains highly controversial. However, for many people, feeling happier and more in control of their lives may be enough.
Facing up to cancer is particularly difficult and painful for people who blame themselves for everything that goes wrong in their lives. This type of negative-self talk, where people accuse themselves of being stupid, incompetent or generally worthless, is fairly common. This critical inner voice undermines our self-worth, and can make us feel helpless and hopeless – a dangerous frame of mind for a cancer patient.
Cognitive therapy teaches you to challenge the false beliefs and negative thoughts that are making you unhappy and delaying your recovery. You may find that you are naturally practicing some, of these techniques anyway – even if you have never heard of them.
Renee, 66, had no idea what visualization was, and said she had not tried any complementary therapies. She recounted: ‘It sounds silly, but every night, I lie in bed and imagine that any rotten cells which may be in my body are leaving by my feet – and they’re not coming back.’ In fact, Renee, who was treated for facial cancer, is practicing a form of visualization, in which the imagination is harnessed in the fight against disease.
Further conversation revealed that Renee also practices positive thinking and cognitive therapy as well: ‘The surgeon had to take my nose away, and I now have a prosthesis. I don’t worry about the disfigurement – if people look at me, then let them look. I don’t think they realize the nose is false, but my face is a little swollen at the sides, as if I’ve been in an accident.
‘When I remove my prosthesis, I don’t think about cancer – cleaning it is just another little chore, like cleaning your teeth. I believe very strongly that if you allow yourself to think negative thoughts, you can wish the cancer back on yourself. I get apprehensive before check-ups and those are the times when I just have to talk very sternly to myself, remind myself that I am feeling well, and that the surgeon says he thinks he got all the cancer when he operated.’
Some people cope with cancer by denying they have the disease, or by minimizing it – explaining they are only having a mastectomy, for instance, ‘in case there is a malignancy’. Denial of the seriousness of the situation may be a good survival approach, although this is seldom publicized because it fits less neatly into the various theories about how cancer patients should think or behave. Denial is one way of regaining control in what seems to be an impossible situation, and it protects you against thinking that every minor symptom is a recurrence of your disease. But neither complementary nor conventional therapists recommend it as a survival strategy.
When Jim, 68, was told his cancer of the esophagus was inoperable, he flatly denied it, telling the doctor: That’s just your opinion and not mine.’ Afterwards, Jim explained: ‘I would be lying if I said I was not concerned by what the doctor told me and I did immediately check my wife would be able to get my retirement pension. But I am not frightened because I am 100 per cent convinced I can beat this. I have accepted defeat in no other aspect of my life, and this is just another challenge which I have to meet. I think the main cure for cancer lies within yourself. The mind is very powerful. You can convince yourself of something and make it happen for good or bad. I am making long-term plans – planting bulbs to come up next spring.’
Jim is not relying solely on his own resources, however. He has had radiotherapy to relieve his symptoms, attends regular check-ups, and plans to have chemotherapy if necessary.
Both Renee and Jim have worked out their own forms of cognitive therapy, but their reaction is unusual. Many cane patients would benefit from techniques that help them deal with their diagnosis and communicate more easily with their friends and family.
Part of structured psychotherapy treatment
Cognitive therapy can be particularly helpful in dealing with problems such as a change in body shape, function or appearance sexual problems, intense anger or anticipatory nausea and vomiting (experienced by some people who have had chemotherapy, whenever they approach their hospital).
When cognitive therapy is given as part of structured psychotherapy treatment, it involves up to 12 weekly sessions an hour. You may be treated by a psychiatrist, a psychologist or another trained health professional.
During this time you will have the opportunity to: express your feelings to someone who encourages you to talk, and does not tell you what you should be thinking; learn to structure your day; deal with false beliefs; and challenge negative thoughts.
Some large cancer centers offer cognitive therapy, and many more offer psychological support. If you feel you need this type of help, you should ring the unit where your cancer has been treated. In the UK, the cancer charity BACUP can provide free counseling in its London and Edinburgh offices, and also advise you on how to find a therapist. In the US, the American Cancer Society can provide similar help- Another US agency, Cancer Care, provides a free counseling service.