Cancer and Psychology

In difficult times, people tend to lean on their family and friends for support, care, and love. Receiving a cancer diagnosis is certainly a time when the support of loved ones is especially important. However, what if, instead of support, a patient received a narcissistic attitude from a loved one? Instead of care, a loved one retreated from the patient’s life? How should someone in a situation like this react to their loved one’s attention-seeking and negative attitudes and what explains the behavior?

Stress, Sickness and Relationships

“I have very little contact with [my mother],” says Rebecca Cagel, whose cancer diagnosis caused an extremely negative attitude from her mother and, ultimately, the end of their relationship. “Since my diagnosis my mother continuously insults me and tells me I am going to be a "bag lady" because I am unable to work a forty hour week.”

Extreme negativity, especially from parents, can be hardest to deal with and can only be partially explained by stress.

“When stress levels are lower, people can cover up their fears, think more rationally,” says Elizabeth Lombardo, Ph.D., Physical Therapist, Psychiatrist, and author of ‘A Happy You: Your Ultimate Prescription for Happiness’. “But when the imminent death of a loved one is thrown at them, calling to mind their own mortality and helplessness regarding death, stress levels can skyrocket.”

According to Lombardo, extreme stress can lead to feelings of anger, fear, and anxiety, all of which can manifest into negative behaviors and feelings towards the patient. In the case of Rebecca Cagel, her mother’s fear for her daughter’s life may have led to this negative behavior. This negativity is not healthy for a cancer patient, however, and can be cause for the severing of the relationship.

“It is sad but I have to distance myself from her because it would be too frustrating and depressing to be around her,” says Cagel. “I have to take care of myself and get her negativity out of my life.”

Can a Relationship be Salvaged?

There is a way, however, to potentially save a relationship that has been hurt by extreme negativity-- empathy might be the key.

“You might say something like, I know my cancer is tough on all of us, and it is not uncommon to feel scared, sad or even angry about it,” says Lombardo. “When you empathize, then the person will be more likely to be able to hear the rest of what you have to say.”

Expressing your concerns in an understanding, non-threatening way will help alleviate tension and could play a big part in maintaining relationships through tragedy.

Negativity By Any Other Name

Negativity can appear in a less obvious way than outright insult and rude commentary. Some people begin to seek attention or behave selfishly in response to a loved one’s diagnosis. In these instances, ego is most likely to blame.

“Those who utilize narcissistic traits...are usually those with poor egos,” says John Lops, an adult, child, and adolescent psychiatrist from Brooklyn, NY. “Events such as tragedies can be a platform to display how important they can be, as well as a wonderful opportunity to fulfill their narcissistic urges.”

Many times these people will go over the top in their attempts to support and care for the patient, defining their doing as how special they are and showing others how appreciative they should be of him or her. But according to Lops, a poor ego is injured further when the acknowledgment of these “nice gestures” from other family and friends moves to the past. Then these narcissistic traits reveal themselves as selfish and attention-seeking.

Carla Ulbrich, who suffered from a severe and chronic, but not terminal, illness was faced with these behaviors when a close relative made a comment about needing to get sick in order to get any attention from the family. Ulbrich remembers her next thought: “You can think that, and I suppose you can even whisper it to somebody, but do you really have to shout it to the person who is already suffering kidney failure?”

There is a way to deal with this type of behavior while still keeping this person’s fragile ego in mind.

“Due to the fragility of folks who displays these behaviors, confronting, for the most part, will not be helpful,” says Lops. “I would probably thank them and make them aware to what extent I appreciate their efforts.”

It is important for a patient to, in some cases, completely remove this person and their negative behavior for some time, and Lops suggests expressing appreciation, but also telling him or her that they need not take further responsibility of aiding in getting through whatever tragedy occurred.

Radical Reactions

Other radical behavior, such as denial or withdrawal, can also be caused by stress. Loved ones may gradually withdraw from a recently diagnosed friend out of discomfort or fear. Avoidance is the only way they can deal with such serious news.

“They can't let in or accept that their loved one is sick or dying. Instead they focus on themselves and deny that extreme changes such as a difficult treatment or even death is in their friend and family's future,” says Nerina Garcia-Arcement, Ph.D. Licensed Clinical Psychologist, Clinical Assistant Professor, Dept. of Psychiatry, NYU School of Medicine.

Avoiding the patient and denial of the situation can increase as the patient’s health deteriorates. Walter Meyers of San Diego, CA remembers how a friendship ended before a terminal diagnosis took a close friend’s life.

“Suzy, Scott and I all...worked together for years. When Suzy was diagnosed with cancer, I tried to be there for her, visiting her often in the hospital, even donating blood platelets for an [experimental treatment],” recalls Meyers. “As Suzy got sicker, Scott drifted further away...and when things got to the point that it was apparent nothing more could be done, Suzy called Scott to tell him goodbye. He said: “You think you’ve got problems? I went bowling last night and couldn’t break 100!”

Scott never made it to see Suzy and did not attend the memorial service. Meyers says he has not spoken to him since.

In all cases and at all levels of severity, negative behavior and attitudes in light of a loved one’s tragedy is serious and personal. However, it is important for both the patient and his or her loved ones to remember that a severe illness can affect everyone involved, both negatively and positively. By remembering this, it is easier to react empathetically and rationally in the face of such a life-changing event.