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Cancer as an Educator

Posted By Stephanie Trudeau-Hern, Tuesday, January 24, 2012

A familiar piano melody begins on the radio, then comes the guitar, and then the mellow voice of Garth Brooks sings to me about "The Dance” of life. I am somewhere on the interstate, half paying attention, but mostly crying. Not the attractive crying that you see in the movies, the "I can’t breathe, snot running down my face, need my inhaler” type of crying.

I pull off the interstate in order to compose myself. As I sit in the car I wish I could rewind the song, I don’t want to lose this feeling. An intense discharge of emotion washes over me, and wow, does it ever feel good. I wanted to drive back home; did I hug my kids long enough? Did I memorize their perfect little faces? Did I tell them they are going to be amazing human beings because they do so effortlessly what I struggle with - to love and to feel?

I chose oncology because it is what I know. I have lost an unusually high number of family members to cancer; I have experienced cancer as the unwelcome visitor, the family secret, and the disruptor of emotional and physical balance. I have been determined to figure out a way to help families stay connected and "healthy”. This is why I sought out my internship site; I wanted to be immersed with the families who are dealing with a diagnosis of cancer.

My internship site is a rural Minnesota oncology clinic and also the location where I conducted my master’s thesis. While researching caregivers of cancer patients, I recognized the need for integration of emotional support for family members. With the help of the director, we piloted a MedFT internship that provides therapy for patients and families who are coping with a diagnosis of cancer. What a better way to feed my research mind, to be privileged enough to hear first hand the struggles and the triumphs of these families. Another reason I chose oncology was my ability to disconnect, to be able to be around illness, and death, and to not have it affect me.

Or so I thought.

The emotional revelation I experienced in the car was after my second full day of patients and families. There were two patients weighing on my mind. They were young; both were mothers, and wives who were newly diagnosed. Much to my dismay there was transference and counter-transference all over the therapy room. I had prided myself in being able to theoretically conceptualize, to validate, and reflect feelings, all the things a novice therapist is taught. As I’m doing the mental dance, self-reflection of my physical responses while staying connected to their narratives, I begin to feel this burning in my throat. Are you serious?! I have tears in my eyes! I quickly shut it off, back to being emotionally available to them, the patients, the ones who needed me.

That night I cried for a myriad of reasons. Everything I knew about myself had been challenged. I felt energized by my patients’ determination and optimism, is this how "normal” people handle cancer? And why was I not able to be more stoic in the therapy room? Why did I cry? Have I not resolved the emotions of my past traumatic experiences? How am I going to be able to do this? Have I gotten in over my head?

I have decidedly begun another quest for knowledge, what does "self of the practitioner” look like? As the only therapist on-site, I began to ask the oncology staff, "how do you do this day in and day out without it affecting you”? The overwhelming response I have received is that you have to disconnect a little bit if you are going to deal with this setting, you will get used to it. I am immediately compelled to go into defense mode, I wanted to shout, but don’t you know I have to connect to my patients? In order to facilitate healing, I become part of their process! In trying to make sense of this I cannot help but to reflect on the perceptions of Maturana and Verela’s, "we do not see that we do not see”. It appears to me that I have made a quick judgment, could this simply be a gap in professional training?

In order to be an effective therapist, I am coming to terms with my new professional identity. I no longer have to stuff the emotions that are transparent during the therapeutic process. My outlets have become; crying in the bathroom between patients, journaling mad scribbles, listening to sappy love songs followed by angry heavy metal, and cursing the makers of Dove chocolates for personalizing their quotes to me. Feeling, connecting, and loving make me a better therapist. It is the dance that I choose to do, sometimes it may look like the "African Anteater Ritual”, while other times it may be an elegant ballet; but it is mine and I believe it is how I will be an agent of change within my clinical setting and most importantly for my families.

Stephanie Trudeau-Hern, MS is a doctoral candidate specializing in medical family therapy at the University of Minnesota. She is currently in a behavioral medicine internship with the Coborn Cancer Center in St. Cloud, MN in collaboration with the Department of Family Medicine and Community Health at the University of Minnesota.  She is a student member of CFHA, a collector of books, an enthusiast of John Hughes movies, and a sponge for knowledge with her most influential teachers being her 6 and 3-year-old children, and her patients.

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Randall Reitz says...
Posted Tuesday, January 31, 2012
Stephanie, what an inspirational piece. Cancer treatment is a tough, yet rewarding, focus for collaborative care. Outside of primary care, I believe oncology and psychiatry are the 2 specialties that can most benefit from collaboration. Psychiatry, because of the rich psychopathology and oncology because of the emotional support.

I blogged on my own family's trial with cancer here:

Thanks for contributing.
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