Jan was thirty-four when she was diagnosed with breast cancer. She had two children from a previous marriage and had married a wonderful man, Jeff, less than a year earlier. How could she tell him that she might need a mastectomy when they were still honeymooners?
Her husband's first reaction was to try to fix the problem. "Don't worry, honey, we will get a second opinion."
The second opinion confirmed the diagnosis and recommendation: radical mastectomy with removal of the lymph nodes.
Jeff and Jan became distant, each in his and her own world. Jan felt a deep sense of shame and believed that Jeff would not love her after the surgery; Jeff felt helpless. They cut themselves off from the greatest heater of all: love.
After the initial shock, they turned back toward one another as a couple and looked for professional help. They found a nurse therapist who had seen many couples go through treatment and had been inspired by those she had seen triumph in the face of adversity. She helped Jan and Jeff practice the lessons courageous couples had taught her.
She started out by telling them that love is the defiance of despair. She assured them that if they maintained a strong connection through the cancer challenge, they would grow individually and together.
Jan and Jeff decided to redefine the problems they faced as gateways to growth. They decided to avoid attack thoughts as much as possible. They also agreed that peace could be found in the midst of turmoil if they had calm in their hearts. They decided that the decision of whether to have a mastectomy was Jan's. After treatment, she made the decision to exercise regularly and change her diet for health reasons. She joined a spa with a close friend.
Throughout her illness and healing process, Jan worked at noticing the difference between pain and suffering. Pain is a necessary part of life. Suffering is a choice. The pain of breast cancer treatment must be faced in order to heal. On the other hand, Jan realized that she brought on quite a bit of her own suffering by self-attacks. For example, she had thoughts like, "I am defective."
Euripides wrote, "Real friendship is shown in times of trouble." As Jan felt better about herself, she was able to seek support from others. A good friend from her church helped her when she reminded her, "God does not make any junk." As they laughed together, it gave Jan a new perspective on herself; she realized she was hindering her own growth by beating herself up. When those inner attack thoughts started creeping in, she made a conscious effort to replace them with thoughts of gratitude like, "I am grateful for my perfect healing." After a few weeks, she no longer had to work on her positive attitude; it came naturally.
That change in attitude led her toward positive actions like a better diet, regular exercise, and searching for support information on the Internet.
Mother Teresa once said that our best protection is a joyful heart. Jan found that she was drawn to those who could face adversity with a sense of humor like her friend from church. She learned to avoid people who were toxic. Emotions are contagious, and she didn't want to catch bad moods from others.
Although Jan's cancer was serious, it also provided Jan and Jeff an opportunity to deepen their marriage and strengthen their commitment.
How? They learned to banish the half-truths: no more whitewashing a bad day. They learned to be more authentic with one another and to tell the truth with love.
The nurse therapist shared the following ideas with Jan and Jeff to help them learn the secrets of effective communication when handling the life challenge of breast cancer.
1. Forget the Fix-it Approach
By nature, most guys have a common reaction when something is broken: fix it. They replace the broken window, change the flat tire, or get the lawn mower running. Their natural inclination is to stop in and find a way to fix the problem.
There is no easy fix for breast cancer recovery. Jeff had to listen to and learn from Jan and the medical staff before he could help Jan through the recovery. He found out that sometimes, it was something as simple as being there for, and listening to, Jan.
Henri Nouwen wrote, "When we honestly ask ourselves which person in our lives means the most to us, we often find that it is those who, instead of giving much advice, solutions, or cures, have chosen rather to share our pain and touch our wounds with a tender and gentle hand."
Jeff learned to be that tender and gentle hand. Jan also learned to seek out friends who were able to sit with her through the physical and emotional pain. She realized that although people meant well, she actually felt worse after nervous reassurances like, "Get well soon." Jan was already too hard on herself and felt she needed to "just get over it." The acknowledgment that her healing was a process was realistic and encouraging.
2. Accept Reality
Jan learned that love is based on acceptance and not performance. As she learned to accept herself and her cancer, she could open up to the caring of those around her. As long as she was mired in shame and felt bad about herself, she cannot see the looks compassion around her or allow others the opportunity to give from their hearts.
Jan and Jeff needed to work on accepting the situation rather than withdrawing into shame or inadequacy. They learned to talk openly about the cancer and to be gentle with themselves and to one another. They also learned to be open with family and friends, not try to hide behind a false smile.
When she realized that it was up to her to teach others how to treat her, she became more active in letting them know what she needed. Sometimes, she wanted help; and other times, she needed to be left alone.
Jeff realized his role was not that of a protector but that of supporter: he learned to stand behind Jan's decisions during and after the recovery process.
3. Pain Is Unavoidable; Suffering is a Choice
Although life brings pain, internal suffering is often self-imposed.
At first, Jan felt ashamed about her illness; she withdrew from others and suffered in silence. She cut herself off from the healing love of friends and family. She didn't choose to have the pain, but she did choose to suffer alone.
Jan found that it helped her to focus on caring about others. She decided to face her pain, but not give into pity parties. For example, she knew that the nurse who gave her radiation treatments was having a tough pregnancy, so she always asked about her and brought her articles and some things for the baby.
4. Refrain from Lame
Jan and Jeff both learned to avoid lame reassurances. Jeff quit trying to paint a rosy picture by saying things like, "Things are fine, dear," or "I'm sure tomorrow will be a better day." Jan learned to avoid saying she was "just fine" to Jeff when she needed support.
Instead, they told the truth with love and humor. Jan once returned from chemo and told Jeff she hoped that he liked plaid since her chest was marked up that way for radiation.
He laughed and told her, "Why, plaid happens to be my favorite now."
They used humor in defiance of despair.
Many times, friends have no idea of what to say to a woman with breast cancer. Jan learned how to help good friends refrain from the lame by bringing up her condition in an honest and straightforward way when she needed to talk and let them know she did not feel like discussing cancer. She simply told them, "I appreciate your concern, but it would not help me to talk about it right now." She then took the initiative to change the topic to avoid an awkward silence.
5. Don't Reduce a Woman to ABC
In one of her episodes of shame after the mastectomy, Jan exploded at Jeff and told him she would not be measured at an A, B, or C.
Jeff answered her that she was not his A-, B-, or C-cup girl; she was the same Jan that he knew and loved. More importantly, he showed his love and acceptance through involvement in her treatment, giving her a warm hug for no reason, humor, and lovemaking.
6. Change the Meaning of Sex
Jan and Jeff redefined sex as an exchange of affection and decided they both needed lots of that. They learned to talk openly about hormonal changes like lack of lubrication and a reduction of Jan's sex drive. Some positions were painful for them, so they made some adjustments.
7. Make a Bad Day Better
As a family, they developed a "best bad day" tradition. Jeff started this when Jan was having some bad days during chemo. He helped the children do special things for Jan on those days. One child made place mats, and another one decorated a card. They maintain this tradition to support one another through bad days. It is a powerful model for children to learn compassion and altruism.
8. Enough is Enough
Jan and Jeff taught friends and family when enough is enough. People often say nothing, or they overreact when they learn that their mother, sister, or other relative or friend has breast cancer. Jan knew when enough was enough.
When she was ill, Jeff became the gatekeeper. He encouraged the children to make creative items, initiating the "best bad day" activities for all of them. The children were encouraged to express feelings and fears.
9. Remember the Song in Your Heart
True friends and family know the song in your heart and can sing it back to you when you cannot recall the words. When she was down, Jan's friends and family reminded her of happy memories, the things she had to be thankful for and all the things they had to look forward to when she was better. Every evening, the family told each other things they appreciated to the other thus making positive deposits in the family's emotional bank account.
10. Celebrate Every Day
The biggest lesson Jan and Jeff learned was to be grateful for every day.
It has been eight years since Jan's cancer treatment, but they continue to live in the present as much as possible and share a celebration of life. They go on dates once a week to nurture their connection and romance. They now have a plaque in the kitchen that reads,
In the depth of winter I finally learned that
There was within me an invincible summer
-Camus
...check http://www.amoenalife.com for support material for women with breast cancer and their families.
Dr. Linda Miles is a highly regarded psychotherapist with over 30 years experience. Her book The New Marriage, Transcending the Happily Ever After Myth was a finalist for the Foreward Book of the Year Award. She has written many articles for professionals and published in national magazines such as Parents and Entrepreneur.
