Cancer & Emotions: A Guide for Patients and Family Part II: Coping with Grief & “Why Me?”

Cancer & Emotions: A Guide for Patients and Family
Part II: Coping with Grief & “Why Me?”

Any article on grief when you’re coping with a cancer diagnosis and undergoing treatment would not be complete without the often-cited “Five Stages of Grief” by psychiatrist Elisabeth Kubler-Ross. Often cited is actually an understatement. The “Five Stages of Grief” model is discussed or mentioned in almost every article, blog post, book, or magazine publication on illness, death, loss, or any moment in life when things don’t go as we plan (i.e., the rug is pulled from under our feet or we fall smack down on our faces and don’t know what to do). It’s understandable, though, because Dr. Kubler-Ross definitely knew what she was talking about. Although the model was initially created to help people prior to death, it is now used to help people going through all sorts of issues, whether you’re dealing with an illness yourself or you’re supporting someone who is going through difficult times. Here I offer my spin on the “Five Stages of Grief”.


Stage One: Denial (“Who? Me?”)

When initially diagnosed with cancer, some people believe that it’s a mistake or that it can’t be happening to them. They might even put off beginning their treatment because of disbelief, but at a deeper level, they are really just overwhelmed with emotions, questions, concerns, and fear. When we’re stressed or scared, denial is our friend because denial is a survival instinct: It protects us from the potentially dangerous and damaging effects of stress. If you don’t believe that something is happening, then as far as your mind is concerned, it’s not happening. Denial kicks in when we need to process something new, unknown, and/or scary, but we need to process it slowly, at our own pace, so that it’s not so overwhelming.

Stage Two: Anger (“Why me?!”)

This stage is characterized by feelings of frustration, especially towards those closest to the grieving individual. Some people will enter the Anger stage immediately after diagnosis, while others will experience Anger after Denial. Feelings of Anger sometimes occur when the grieving person can no longer stay in the Denial stage (i.e., the diagnosis becomes too real). In this stage, a lot of blaming can occur. The grieving person wants to blame someone, anyone, for the illness. Some individuals feel they are being punished for some reason and will blame themselves.


Stage Three: Bargaining (“I’ll trade you.”)

Sometimes, people wish to try to avoid their illness and feel like they can still go back to the way things were before diagnosis. Individuals will promise themselves or others (or a sky-borne deity) that they will change their ways or sacrifice something in exchange for health. Bargaining involves a misplaced sense of responsibility or blame that the grieving person puts on themselves for the cause of their illness. They feel that if they become “a better person” then a miracle will occur or they will be given a second chance and they can be well again. This implies that the person feels as if they were “bad” before and the illness is their “punishment.”

Stage Four: Depression (“What’s the point…”)

Some individuals will enter a depression stage after they recognize that they can’t avoid their illness and that the illness is real. Just like in the Denial stage, they are overwhelmed with their circumstances, but unlike the Denial stage, they accept their illness (and feel like giving up). The thought of fighting the illness feels bigger than what they believe they can handle. Many individuals will withdraw from family and friends and demonstrate an “I don’t care” or “Leave me alone” attitude.

Stage Five: Acceptance (“Everything might be alright.”)

Many individuals come to the point where they accept their illness and even embrace it. They figure that there’s nothing they can do about it, so they may as well accept it and stop stressing. This stage involves the person having a more calm view of the illness and more stable emotions about their circumstances.

Research hasn’t supported Kubler-Ross’ model, but regardless, people like it and people can relate to it and I guess that’s important too. These stages can occur in any order and some people might skip some stages, repeat two or three of the same stage, or remain in only one stage. Grieving is a process that is so unique to every individual, but understanding the process makes us feel a sense of relatedness. A sense that we are not on this journey alone and that when we read things like this article or the numerous other self-help texts and advice on how to cope, we know that these things exist because others have gone through and felt what we are feeling. This is proof that we are not alone in our struggles.


Why Counseling for Cancer Patients and their Loved Ones?

Why Counseling for Cancer Patients and their Loved Ones?

A patient who is first diagnosed with cancer is usually overwhelmed and frightened. Feelings of sadness, confusion, worry, and anger are completely natural. The patient’s psychological and social well-being are impacted, and a patient’s relationship with family and friends can be affected by this as well. The physical/medical hurdles, adjusting relationships and changes in personal philosophy may lead to feelings of hopelessness and helplessness, and it is really important to find ways to address these feelings.

Counseling can help the patient to better cope with the side effects and the pain that evolves from treatment. It may also help the patient and his family better deal with and express these common feelings, as well as provide a safe place to discuss their concerns.

Most cancer patients have to grieve the loss of their previous lifestyle, learn to accept their new reality, and make the most of their new situation. Many will experience an evolution of their view on life and likely re-assess their priorities. The process of living with cancer is life-changing; for the patient and for those who love them. Facing cancer is an experience that often leads the patient to re-examine his core values and passions and can motivate them to pursue new goals of great personal importance.

Here are some of the ways counseling can help the person facing cancer and their loved ones too:

For Newly Diagnosed
1. A safe place to deal with the emotional impact, worry, and fear
2. Working on addressing feelings of depression, guilt and self-doubt
3. Openly discussing the effects and the impact of surgery, radiation, and chemotherapy
4. Developing skills to assist with the side effects of treatment
Strategies to manage the stress and pain

For Loved Ones / Caregivers
1. Dealing with feelings of lack of control, anxiety and stress
2. Addressing new obligations and loss of previous lifestyle
3. Helping to gain a new perspective and deal with the new challenges in a healthy manner

For Beyond Treatment
1. Going through the process of grieving the loss of the old self and accepting the new self
2. Living with the uncertainty of long term survival
3. Adapting to the physical changes and limitations
4. Addressing challenges related to intimacy, reproduction, and employment
5. Addressing feelings of low self-esteem, anxiety, depression, and mood fluctuations

Counseling for Cancer Patients and Loved Ones
Houston, Texas

How To Find Out If You Have Skin Cancer

How To Find Out If You Have Skin Cancer – part a

The process of detecting skin cancer, the most common form of cancer in the United States, can be practiced with a monthly self examination combined with a yearly visit to your doctor. Early detection is key because, if diagnosed soon enough, skin cancer is almost always curable.

There are three main types of skin cancer, all of which are visible if you know what to look for. Melanoma, one of the main forms of skin cancer, is the deadliest. This disease is the most difficult to stop after it has spread throughout the body, which is why early detection and treatment are crucial. Skin cancer, of any kind, can usually be treated with success in it’s early stages.

How To Find Out If You Have Skin Cancer – part b

As individuals, everyone has freckles, birthmarks and moles. These are a part of you and you are used to seeing them, but you may not notice slight changes right away and that’s what you need to be watching for. Any change in a mole’s shape, edges, size or color should be checked by a physician. If a mole becomes larger than that of a pencil eraser or if it’s color is multiple shades of brown rather than a solid color, these are both potential warning signs of skin cancer. A mole’s border should be well defined and, if that is no longer the case, notify your doctor. In addition, any sore that will not heal or a mole that grows larger at a rapid speed should be tested immediately.

Deciding to seek medical attention is difficult. For this reason, it’s best to choose a physician that you are comfortable with, such as a family doctor. He/she can examine your skin and refer you to a dermatologist if needed. The presence of skin cancer is determined by removing all, or part, of the questionable area and testing it with a microscope. Surgery is often utilized in the removal of ski cancer and, if done in the early stages, can be a very quick process. There will likely be a scar, but the physician may be able to completely remove all cancerous cells with only a very small incision.

How To Find Out If You Have Skin Cancer – part c

If the cancer has spread, or is very large in the defined area, additional surgery may be required. In that case, chemotherapy or radiation treatments may be ordered to ensure the cancer is completely removed. Your physician will be able to answer all questions that you may have and should do so without reserve. When meeting with a doctor, ask for an explanation of all treatment options, including their likelihood for success in your particular case. Deciding to seek medical attention is a big step and one that a patient must be mentally prepared for.

This article should not be construed as professional medical advice. If you, or someone that you know, is concerned about the possibility of cancer, you should seek medical attention immediately. A medical doctor can discuss various options, prevention and treatment possibilities should the presence of cancer be detected. A series of tests may be conducted in order to confirm, or rule out, any such diagnosis and can only be done by a medical doctor.

Live Better Live Now in Houston, Texas has seasoned, board-certified and licensed professional counselors who specialize in working with cancer patients and their partners, friends and families.

How To Find Out If You Have Skin Cancer

Live Better Live Now – philosophy-in-action!


Get out there and jump into living life fully and authentically today!

This picture is of Ben from Live Better Live Now central office team in Houston – celebrating his birthday and Mother’s Day with his family. We love to see a positive life-philosophy put into practice.

Happy Birthday, Ben!

AR & the crew

Live Better Live Now / philosophy-in-action!


Ben Carrettin, Board Certified and Licensed Professional Counselor. Ben is the owner of Texas Recovery Support and Practice Improvement Resources, LLC. He serves and has served on many local initiatives including as a founding board member of Greater Houston Area Treatment Providers (GHATP, the largest independent behavioral collaborative organization in Houston), a member of the Houston Group Psychotherapy Society (HGPS), an active volunteer with the Texas Society of Addiction Medicine (TSAM) and is the Founder and Lead Administrator of Greater Houston Wellness.

He has worked in a variety of settings including private practice, private and grant-funded intensive outpatient programs, partial hospitalization programs and full in-patient hospitalization. Ben is also a Certified Anger Resolution Therapist (CART) and has received intensive training in Critical Incident Stress Debriefing (CISM), the latter of which he provides services to local businesses, private clients and the oil and gas industry.

More recently Ben been has completed an intensive training program incorporating Positive Psychology with current best practice addiction treatment for professionals and an extensive training in pastoral/grief care of the terminally ill and their families as a COH, International, lay chaplain.

In addition to his work in the clinical arena Ben has also worked in the corporate sector. In the Texas arena, Ben provides training in Ethics and Social Media for clinical professionals, executive social intelligence training for business leaders (ESI), and consultative court services in Voir Dire processes.


More Than My Disease

More Than My Disease

I work with many people who are struggling in the face of great adversity and like many of us – I have my own history with survival as well. What frequently comes up whether I am working with a stage three cancer patient or a mother battling with addiction to opiates is a desperate need for a redefinition of how we see ourselves in the face of our disease. I find that at least initially, when people come to the point of accepting that they have a disease – they often see themselves as defined by it: “I am a guy with cancer”, “I am a mom who is an addict”, and so on. Rationally, they are aware that this is not the limit of who they are – but the emotive part of us is very powerful and not so rational.

At Live Better Live Now we have a saying, “Survival is science, living is art”. Doctors, hospitals, medicine, treatment, etc – these are all here for your survival. But life is more than that – more than just survival. Living, and I mean truly living is a way of being; the creative expression of our existence. In as much as survival is the biology part of the equation, living is the philosophy of it.

Now I know some folks will take issue with me discussing cancer and addiction in the same breath – so be it. I am a strong believer of the “disease model” of addiction and in my experience there is a great deal of similarity in the path that all of us travel when we face down a disease. Having cancer or addiction can arguably be said to be not up to choice.  Genetics, lifestyle, whatever plays into it – no one asks for the suffering disease brings. However, choice plays a very big role in what I do once I realize what I am faced with. A stage three cancer patient can opt for aggressive chemotherapy and radiation treatments, try a new experimental approach, make drastic changes to diet and health regimen, choose nothing and live out whatever time they may have and so on. They have choices. The mom in recovery from opiate addiction can get a jump start at a residential treatment facility, go to 12 Step meetings or other community support group, work with a physician / addictionologist and a therapist who specializes in addiction and so on. They have choices. In both cases and many others, we may not choose the disease we face – but how we address it is ultimately up to us; our choice. 12 step has a saying that fits well here; “You are not responsible for your disease, but you are responsible for your behavior.”

How I define myself is also my choice. I’m not just arguing for a paradigm shift in cognitive definition. The way I live is how I am defined in the world. If I see myself as the guy or gal with the disease – and live as such – then in many ways I am the limit of my ailment. I strongly encourage my clients to get out and get into the world – this is as important as many other aspects of their treatment. Beyond the community and support that is there for those faced with similar disease (cancer survivor groups, addiction recovery groups, etc) – it is so important to be actively engaged in positive communities that revolve around living life fully in – in this moment. There are so many options – the sky is the limit. Some of my clients are more physically challenged so they opt for joining book clubs, pairing up with others to go walking, setting up a weekly breakfast at a local diner. Those that have the physical capacity I encourage to join a gym with a friend, set up a group to bike rides, a weekly basketball game and so on. You can usually find local groups on the web. But let’s not forget one of the best options that anyone can find; volunteer. There is always someone out there who has it worse than we do and helping them to find joy for a moment ineveitably does the same for us. No matter how small your town or how limiting your physical health – there is surely a need you can fill.

Yes, sometimes is can feel like “pulling teeth”, like it takes everything you have to force yourself up and out – keep at it. Patterns become habits and that, in a simple sense is what you are creating; a positive habit. Remember, our personal integrity is the harmony between what we believe (thoughts) and how we behave (actions). There is a very powerful and freeing feeling that comes with living in integrity. You know you are not only your disease – so don’t live like you are. Life is not linear, but a path. “Survival is science, living is art.” Get going !

Thanks for visiting. I hope you come back again.

(PS – one of the best examples of living fully in each moment and not being limited by the mechanics of his survival is Reggie Bibbs. You can learn a lot about what it means to persevere and revel daily in what is most precious from his story. Check out his mission in action witht he foundation he created; JustAsk).

Ben Carrettin – More Than My Disease