What can we do if we are told that a family member has cancer?

What can we do if we are told that a family member has cancer?

Receiving news as serious as the illness of a family member is often an event with enormous destabilizing potential. This fact becomes even worse if we talk about cancer, since this disease carries with it an enormous stigma as it is socially considered a fatal condition, although in practice it is not always the case.
Many people, once the initial shock of the news has passed, then to ask themselves if there is something they can do for their family member, but many times the question arises of how a person can be helped in this situation at all.

As we discussed earlier in posts on this topic, talking about cancer in general is misleading, since this disease, depending on the location, size and health status of the patient can be as harmless as to have practically no complications (in cases of rapid detection and intervention), or as terminal as being inoperable and deadly.

In any case, many of the things we can do for people who suffer from this disease are the same regardless of the degree of severity of their condition, so we are going to make certain points and then mention special cases.

1) Understand what kind of help our family member needs: We all have a way in which we like to be comforted, some people need physical contact, it calms them and makes them feel better, but other don’t stand it and may feel uncomfortable with it. In the same way, there are people who appreciate regular interaction and being checked on to see how they are doing, and there are those who prefer to have their own space and time alone to manage the wave of emotions that comes with this type of news. Since we cannot read the minds of the people we live with, there is a little trick that almost always works: Ask!
Giving space to our familiar, and asking questions like: “is there anything I can do to help you?”, “Would you rather we talk about this often, or do you think it would be better for you to deal with this on your own?” “Would it make you feel better if we made plans more often?” are great ways to empower the person we speak to. We allow them to manage the interactions they have in the way that is easiest for them, and we also have the certainty that we are helping.

2) Be attentive to intense emotional reactions: It is very normal that after receiving news of this caliber, emotions can overtake the person who listens to them. The emotions that someone may feel can be really varied; sadness, shame, guilt for not having acted before, anxiety, fear, anger and many more. Sharing the burden of these emotions (always at the pace the affected person sets, as mentioned before) always makes them easier to manage. In addition, normalizing these types of emotional reactions and accompanying the person who suffers them is never a bad option.

3) Pay attention to distorted thoughts: When we suffer waves of intense negative emotions, they often bias our way of thinking and we can end up having thoughts that are somewhat dramatic, illogical and somewhat extreme. It is not uncommon to meet people who think that what happens to them is a punishment for something they did wrong, that their life no longer has meaning, or that others cannot help them at all. Helping patients eliminate these thoughts is the job of a psychologist, but sometimes simply being aware that they exist and are negatively affecting us helps reduce the effect they have on us.

In some cases, unfortunately, cancer is terminal, and although the previously mentioned shows of support are just as important, these cases have a particularities to them.

It is worth mentioning that in the face of death many times people re-evaluate their life and consider how it has gone, what they could have done differently, etc. This is a natural and desirable process, in which the accompaniment of a professional will always help.
Even so, there is an element that usually gives meaning to the last moments of the life of a person in the terminal phase, and it is the opportunity to say goodbye to their loved ones. Many people who die naturally do not have the opportunity to say goodbye to family and friends, and sometimes this is something that takes its toll to the point of complicating the grief of those close to them. However, expressing emotions, desires and affections while still can help both the sick and their families to move on and face the end in a less painful way.
There are always last wishes and actions to take, and it is at these times that patients have the option to do so.

Cancer is an increasingly studied and understood disease, and there are already many professionals in both oncology and mental health (psycho-oncology) who dedicate their lives to helping people who suffer from it. Accompaniment in these moments by qualified personnel can always be a relief that allows to lighten the burden of such a difficult moment for those who need it.

Division of Psychology, Psychotherapy and Coaching
Fernando Pérez-Ullivarri
Psychologist
Adults and adolescents
Languages: English and Spanish
See Resumé

I have been diagnosed with cancer, now what?

I have been diagnosed with cancer, now what?

Being informed that we have cancer is usually a huge shock that can leave the person who receives such news in a state of emotional disturbance. It is true that there is no protocol on what to do or how to act when faced with this type of situation, but experience shows that there are certain things that can be done to soften the impact of the news and take care of our physical and psychological well-being. Here are four ideas that can help us deal with such a process.

1) Reduce uncertainty about what is happening to us: Cancer is a disease caused by an abnormal growth of cells that can present itself in many ways. The relative severity of a 1 cm mass versus a 3 cm mass is different, it is also different depending on the place in our body where it is located, our state of health, previous pathologies, if there is metastasis, the tumor margins (outer edges) and the state of the lymph nodes closest to the tumor mass among other factors.
Each case of cancer is unique, as there are so many variables that can affect the process, and only a specialist in the field can explain with accuracy the state in which we find ourselves. Understanding these details about the is crucial, if we do not do so, we may overestimate the severity of our tumor, or even underestimate it. The role of the oncologist in this step is fundamental, he is the professional who will help us see what is happening to us and reduce uncertainties regarding our future. It is therefore very important to ask our doctor everything that is relevant to us, so he can help us manage our doubts and fears.
Some of the most common questions that arise at this time are related to the severity of the problem (especially with regard to cancer mortality), the possible physical and health consequences, the options for intervention and possible consequences, and ways in which the diagnosis could change the patient's personal and work life (whether it will make him/her unable to work or carry out some of the activities that he/she usually does on his/her own, etc.). It is always good to remind ourselves that we have the right to ask about all these things, and no doctor will deny us this information if we ask for it. It is very advisable that we ask everything we want to know.

2) Keep an open line of contact: In line with what was mentioned above, many times the shock of the news does not make it easy for these doubts to during consultation, but rather they appear over time. It is also possible that as the treatment or the cancer progresses, new concerns arise that we did not have before. If we do not have a way of raising these doubts with our professional, it is very easy to fall into the temptation of ruminating on them (overthinking), catastrophizing about the possible answers to these questions, or looking for information on the Internet about what is happening to us (not a very advisable option, since we are not objective when we look for data about what is happening to us, we pay more attention to the most negative and extreme information due to our own biases.).
Insisting on the aforementioned, having a line of contact with our medical professional will help us avoid these strategies that will certainly increase our anxiety, as well as bringing a generally supportive figure during the course of the problem.
It is convenient to remember that doctors are professionals with a very heavy workload and the fact that they have not offered us a method of contact does not mean that they cannot give it to us if we require it, Even the best professional can forget to do so on a bad day!

3) Managing emotional discomfort: After a cancer diagnosis, it is normal to experience a wave of negative emotions, guilt, anger, sadness, anxiety, helplessness, and sometimes even embarrassment when it comes to telling others about it. All these emotions respond to a normal process of adaptation to a change of this magnitude.
The first thing to know is that we are not alone. Even if for some reason (such as living abroad) we cannot count on family and friends, there are always resources that we can turn to for support at times like this, and that will help us when we need it most. Support groups of health institutions, associations of cancer patients, but more importantly for this case we can always ask for the help of a mental health professional specialized in the subject. Managing this type of discomfort with help is always easier than suffering alone.
Often our initial instinct when suffering so many negative emotions is to avoid them by distracting ourselves and shutting down emotionally. Even if this is a strategy that can make us suffer less short term, it is not very advisable, since we only postpone the problem and when we eventually face it, it will hit us harder. Distancing ourselves from others and not doing the activities that we normally did due to apathy is something that sometimes happens in these situations but finding the strength to do these kinds of things is precisely the one thing what will help us to move forward with more energy. This is not a call to force yourself to do all kinds of activities and punish yourself if you do not manage, but rather it is an invitation to start understanding that if you feel low mobilizing is something that will always help you feel better.

4) Manage the anxiety of the process: Anxiety problems are attracted to uncertainty like a metal to a magnet, and unfortunately during the development of cancer there is a lot of uncertainty. The duration of the problem, of the treatment, the consequences they may have, and future relapses are unknowns that bring up mental scenarios that may or may not happen and that will surely take their toll on us. As a general attitude it is good to remember that what we think makes us feel certain things (for example, if I assume in the face of this uncertainty that my case will get inevitably worse, I will feel terribly distressed every time I think about it) and to remind ourselves that we do not know what is going to happen since I cannot see the future. The solution here is not to force ourselves to have positive thoughts, but to be pragmatic; we do not have a crystal ball to see what will happen, therefore it is better to face problems (e.g. possible relapses) if and when they occur, not before they appear.
Developing techniques to deal with negative thoughts and other manifestations of anxiety (panic attacks, apathy, fatigue, avoidance) may be a good idea. Techniques such as Mindfulness and meditation, relaxation, and cognitive exercises in which we learn to identify distorted thoughts are particularly useful for these situations. In this regard it is essential to highlight the figure of the psychologist as a resource that will help us achieve these goals and better manage the situation in general.

I have been diagnosed with cancer, now what?

Cancer is an extraordinarily complex problem in terms of how to deal with it, but the fact that it affects so many people has generated a highly specialized body of professionals who focus on treating its physical and psychological aspects. If you have been diagnosed with cancer, you are not alone, there are many people who can help you if you want and need it, lots of encouragement and we will be here if you decide to come to us.

Division of Psychology, Psychotherapy and Coaching
Fernando Pérez-Ullivarri
Psychologist
Adults and adolescents
Languages: English and Spanish
See Resumé

Pensamientos Obsesivos de Tipo Sexual

Pensamientos Obsesivos de Tipo Sexual

Question

Hola,

Hace aproximadamente tres meses, sufrí una crisis muy fuerte con pensamientos obsesivos y dudas acerca de mi orientación sexual (miedo a ser Gay), detonada por haberme masturbado viendo porno transexual y homosexual (cosa que muy ocasionalmente hacia y jamás me causó problemas). Decir que siempre he sido heterosexual, sin ningún tipo de duda. Los pensamientos me incapacitaron hasta el punto de estar en cama, estaban desde que me levantaba hasta que me acostaba (siendo peor por la mañana). Analizaba todos los síntomas físicos de mi cuerpo al ver hombres por la calle, por ver si me excitaba, entre otros «rituales».

Todo cedió, y estuve fantástico con una chica, con erecciones y placer como nunca, hasta ahora que volvieron los pensamientos por un detonante menor. Otra vez incapacitantes, con el día pasado en cama y analizando 24/7 mis respuestas y demás.

Decir que me habían bajado hace unos meses la dosis de paroxetina a 10mg. Yo la empecé a tomar hace cinco años por una crisis muy similar pero con pensamientos de otro tipo como que me estaba volviendo loco, o me estaba entrando una enfermedad neurológica (el detonante fue una prueba de Estimulación Magnética Trascraneal de la Facultad que me llevo a pensar lo anterior). Con la paroxetina todo mejoró, hasta esto de los pensamientos de homosexualidad.

¿Será la bajada de la medicación (aunque han pasado cinco meses o así) que ha hecho que vuelvan esos pensamientos obsesivos, por ser solamente 10mg?

¿Será un problema de sexualidad real?

Por favor, me gustaría saber la opinión de los expertos,

Gracias de antemano

Answer

Querido amigo.

Antes de nada, agradecerte que hayas compartido esta situación tan difícil con nosotros para que podamos ayudarte.

Cuando psicólogos y psiquiatras hablamos de los pensamientos obsesivos, decimos que son un tipo de pensamiento recurrente, involuntario, y que a veces tiende a generar mucho malestar en las personas que lo sufren. Este tipo de pensamiento tiene la mala costumbre de ser más recurrente y molesto cuanto más malestar genera su contenido (ya que muchas veces es el propio agobio que nos genera una idea el que nos deja ese “miedo” y hace que vuelva).

Por lo que comentas en la pregunta, las dudas y pensamientos obsesivos sobre tu sexualidad comenzaron hace tres meses, y desataron una oleada de conductas de comprobaciones físicas (prestar atención a los cambios en tu cuerpo) y psicológicas (ver tu nivel de excitación) que pretendían aclarar tus dudas respecto a tu sexualidad. Al parecer estos pensamientos obsesivos y las comprobaciones para lidiar con ellos empezaron años atrás en otro aspecto de tu vida (la salud) y ahora se reflejan en tu sexualidad, llegando hasta el punto de ser incapacitantes para ti.

Quisiera comentarte que el hábito de hacer comprobaciones es una reacción muy común cuando nos encontramos nerviosos o ansiosos, que pretende mantener las cosas bajo control y calmarnos, “entender” lo que nos está pasando. Aun así, lo único que se suele conseguir con este tipo de comprobaciones es que la ansiedad y las dudas se disparen más actuando como más gasolina para el fuego, no es de extrañar que esta situación haya llegado a donde ha llegado, por desgracia. Luchar contra el impulso de hacer comprobaciones y dejar que el malestar se vaya poco a poco y sin cuestionarlo continuamente suele ser una receta que trae mejores resultados.

En esa línea quisiera comentarte que, aunque puede que la bajada de la medicación haya podido contribuir al problema que comentas, intentar cuestionarte qué ha causado ese cambio puede ser un tipo de comprobación que alimente el problema. Es muy complicado afinar que porcentaje de causa tiene cada una de las cosas que ocurren en tu vida, y aunque fuésemos capaces de hacerlo, ¿no sería más útil aprender a gestionar estas situaciones que obtener una respuesta que no va a solucionar el problema?

Te animo como primer paso para enfrentarte a la situación a cambiar el foco de cual es causa de mi problema (tengo que controlar si es la medicación, o es mi sexualidad, o es que me siento mal…) a cómo te sientes en el momento actual respecto a ese “problema” (focalizarte más en el “aquí y el ahora, es decir, en el momento en que vivas tu sexualidad centrarte en las sensaciones que te genera, repetir lo que te guste y si no te gusta algo darte cuenta). Responder a esas dudas en momentos en los que “no toca” no suele ser de mucha ayuda.

Respecto a las dudas sobre la sexualidad, me gustaría tranquilizarte diciendo que ningún pensamiento obsesivo la va a determinar. Este tipo de pensamientos es un hábito que podemos alimentar (con las comprobaciones como te he contado antes) o hacer que vaya a menos, pero la sexualidad es algo mucho más complejo, y desde luego no determinado por la manera o el contenido de lo que pensamos.

Las fantasías sexuales o el material que utilizamos para disfrutar de nuestra sexualidad no tienen por qué ir en línea con lo que luego hacemos en la vida real, una persona puede fantasear con realizar prácticas fuera de lo común pero no querer hacerlas en su vida. Nuestra vida sexual y nuestras fantasías son dos cosas distintas.

Pese a ello, si aun sin esos pensamientos sigues teniendo dudas sobre tu sexualidad, consultar con un terapeuta puede ayudarte a aclararlas.

Espero sinceramente que esta respuesta te sea de ayuda y te mando un saludo afectuoso.

Division of Psychology, Psychotherapy and Coaching
Fernando Pérez-Ullivarri
Psychologist
Adults and adolescents
Languages: English and Spanish
See Resumé