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Expressing Empathy: Part 2

Expressing Empathy: Part 2

Empathy in Patient/Doctor Relationships

*Names have been changed to protect privacy.*

Carl Patterson was with his elderly stepfather when he died from acute lymphatic leukemia. Tom had been a laid-back, easy going man who made friends easily and preferred to have a glass of wine than worry about small details. Carl, on the other hand, was detail-oriented and had been looking after his stepfather’s affairs for years.

Tom wanted to donate his body to a local university for medical research. In most cases, if a body is not received promptly after death, research organizations will refuse the donation. Carl knew this. So he grew impatient when hours passed after his stepfather died and the doctor, who needed to process the paperwork to release Tom’s body, didn’t appear. Carl repeatedly questioned the nurses. The nurses repeatedly paged the doctor. When she arrived, the doctor told Carl, “I have more important things to do with the living than with the dead.” Carl was stunned. “He had just died,” he said. “Her bedside manner didn’t exist.”

Numerous studies have found that empathy is often missing in doctor-patient communication. Expressing empathy can be even more difficult in situations involving conflict, anger, sadness or fear. These feelings are common on a cancer journey.  When medical professionals show empathy, patients feel more satisfied with the relationship. They also have more trust in their doctor, are less anxious about their condition, and are more likely to follow the doctor’s recommendations. Doctors feel better about their work too. Empathy is a learnable skill being taught more frequently in medical schools to help improve patient-doctor communication. …

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Expressing Empathy: Part 1

Expressing Empathy: Part 1

“Empathy is really the opposite of spiritual meanness. It’s the capacity to understand that every war is both won and lost. And that someone else’s pain is as meaningful as your own.” – Barbara Kingsolver, author.

Katrine Bellamy thinks this story is funny. It’s the story of how people sometimes react when they hear about cancer. Katrine and her neighbor took turns walking the kids to and from school. But, on the day she learned her 9-year-old son had a brain tumor, she asked her neighbor to pick up the children. When Katrine arrived home, she saw her neighbor standing in the driveway, waiting for her. “She literally collapsed in my arms,” said Katrine. The distraught women cried as Katrine reassured her that everything would be alright. Katrine needed a friend who would listen. She ended up helping her friends cope with the news instead.

This is an article about empathy. It is easy to misunderstand the difference between sympathy and empathy. When you have sympathy you have compassion for another person and acknowledge their hardship. Empathy is when you understand and feel another person’s feelings for yourself; it is a mutual experience of feeling. With empathy you “put yourself in their shoes.” …

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Conflict Management: Part 2

Conflict Management: Part 2

Strategies for Resolving Conflict

Coping with cancer, either as a patient, family member, friend, or medical provider can be very difficult. Stress levels are higher. Everyone involved can have less patience and be more sensitive to problems and issues. Common situations that might normally blow over can explode into a major argument instead. If you experience a conflict with another person, experts suggest using the following strategies:

  1. Identify the cause of the conflict. Get to the root of the problem, and then deal with the cause. Sometimes small conflicts are really about larger issues.
  2. Listen attentively and speak in a way that you can be clearly understood. Consider how you express yourself and disagree with others. Does the tone of your voice become accusing, snide, rude? Do you cross your arms, roll your eyes? Do you get defensive? What kind of pronouns do you use? Experts recommend using “I” instead of “you” during a conflict. For example, you might say, “When this happens, I feel unloved” instead of “When you do this, you cause problems.”
  3. Try to understand the other person’s position or perspective. Be open-minded so that everyone involved can talk openly about their different views. Consider the issue from the other person’s point of view.
  4. Take responsibility. Do you always blame others for problems? Conflict is two-sided. What common ground can you find?
  5. Set goals on which everyone can agree. Try not to dwell too much on what’s passed. Instead, focus on how to best move forward and what can be accomplished in the future.

Experts also recommend developing a plan for handling conflict in situations where disagreements might surface. For example, family gatherings during the holidays can be stressful. Think about how you might handle issues that come up. Or perhaps your hair has started falling out. People are bound to stare, ask questions, or make insensitive comments. How will you respond? Or, on the flip side, you know someone with cancer who is losing their hair. What should you say?

Settling conflicts requires communication that is respectful and empathetic. It helps if there is trust in the relationship. Also, a certain amount of self-disclosure might be necessary.

Communicating About Cancer Series

This research project was funded by a grant from the National Cancer Institute (CA144235; Dr. Wayne Beach, San Diego State University, Principal Investigator). Co-investigators included Dr. David Dozier from San Diego State University, and Mary Buller, Dr. Valerie Myers, and Dr. David Buller from Klein Buendel, Inc.

Conflict Management: Part 1

Conflict Management: Part 1

Managing Conflict

*Names have been changed to protect privacy.*

Just three days after his ninth birthday, Steven Bellamy’s mother, Katrine Bellamy, learned what she’d already strongly suspected. Earlier she’d called her son’s physician insisting she be told the results of Steven’s MRI. Not tomorrow. Not in three hours. Now. Instead, the doctor told her to immediately take Steven to the hospital. In tremendous pain, he was admitted to a room where he quickly fell asleep. Katrine spotted an envelope containing MRI images. She couldn’t help herself. She had to open it. Her husband, Dan, who thought she’d spent the past three weeks being overly paranoid about their son’s vomiting spells and headaches, told her to wait for the doctor. I can’t, she told him. I need to know now. Dan left the room, and Katrine pulled out the slides. The baseball-sized mass on Steven’s brain was impossible to miss. Katrine didn’t need a neurosurgeon to explain that she was looking at a brain tumor.

For the Bellamy’s, a long and difficult cancer journey had begun. Their story, like that of many others, includes episodes of conflict between themselves, other family members, friends and medical staff. This article is about conflict and how to manage it. If cancer is “The Big C,” conflict is the “Not-so-little C” that is almost always part of a cancer journey.

What is Conflict?

To put it simply, conflict is a disagreement. For anyone dealing with cancer, conflict can occur over something mundane like deciding what’s for dinner to more difficult decisions involving care. For example, Katrine and Dan had very different ideas about letting their nine-year-old son have a say in treatment decisions. All options sounded terrifying – some could mentally impair their son, others could kill him. When Katrine was pregnant, Dan said he didn’t think he could handle having a child with Down Syndrome. Now he had a child with cancer and was terrified. Dan wanted to present Steven with his options. Katrine said that it would be too much of a burden on their child. After much discussion, Katrine and Dan concluded that “This is our cross to bear. “ Steven would not participate in the decision-making process. As parents, the burden was theirs. They would make the decision and “live with the consequences.”

An equally agonizing conflict occurred with the care of George Janosik, who had been diagnosed with terminal cancer. Janosik’s siblings and in-laws shared caregiving responsibilities which included giving him morphine to ease his excruciating pain. Janosik pleaded for a lethal dose. The caregivers were torn. Some felt it was cruel to let him suffer. For others, self-assisted suicide violated their religious beliefs. It was also against the law. No decision was ever made. Soon after, Janosik died.

These examples highlight how conflicts can emerge due to differences of opinion, beliefs, and communication style. In addition, personal values, stress, distrust, misunderstandings, personality clashes, and power struggles are common sources of disagreements. …

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Managing Emotions: Part 1

Managing Emotions: Part 1

Riding Cancer’s Emotional Roller Coaster

*Names have been changed to protect privacy.*

Anyone who begins a cancer journey is likely to step onto a rollercoaster of strong emotions that can vary dramatically from point to point along the way.  Patients, family members, and friends will experience many different feelings ranging from frustration and powerlessness to joy and affection after a cancer diagnosis.

Emotion can be thought of as the “bedrock” of the communication skills. How a person feels and how they control those feelings will affect how they deal with conflict, what they disclose and their level of respect, trust, and empathy for others. This article looks at the role of emotions and provides tips on how to manage feelings to better cope with cancer.

Emotions on a Cancer Journey

San Diego resident Tim Hayes had a lot on his plate when he received his testicular cancer diagnosis.  A 37-year-old college professor with a full work schedule, he had custody of his two young children, and a summer teaching session planned in Africa over the summer.

However, near the end of spring semester, strong abdominal pains made him visit his doctor, who gave him several medical tests.  Before the results came back, Tim traveled to Canada for a professional conference. But he felt miserable. He couldn’t eat. He was exhausted. He spent much of the conference sleeping in his hotel room, which is where his doctor tracked him down.

“My doctor told me one long Latin word, then another,” he said. Decoded, the Latin words meant cancer.

Tim asked if the diagnosis would interfere with his summer teaching plans. It would. He was told he needed immediate surgery, followed by chemotherapy and radiation treatment.

This kind of news would completely devastate some people. Others might be paralyzed by fear. Tim, however, immediately began planning for the future – a future he believed would be cancer free. He tied up loose ends, spent more time with his kids, and was determined to be healthy enough to teach again in the fall.

“It was symbolic of beating the cancer – that’s how I spent my summer vacation, but I’d be back to work in the fall,” Tim said.

Tim took a very practical approach to dealing with his cancer and maintained a positive attitude.  Not everyone would react this way. Emotions play a significant role in how individuals interpret a situation and resolve it. Emotions also influence a person’s attitude and behavior. …

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The Art of Self-Disclosure: Part 3

The Art of Self-Disclosure: Part 3

The Art of Disclosing Online

Social media has added another layer of complexity to self-disclosure.  Many cancer patients and caregivers seek support online. Others use email, texting, and social media channels like Twitter and Facebook as tools to keep large numbers of people informed about their progress. However, navigating these environments can be tricky and not always as emotionally supportive as it seems.

At age 29, Caitlyn Green considered her life to be perfect. She had strong family ties, a large circle of friends, was almost seven months pregnant, and had just received a job promotion. Then she felt a lump in her breast. It had better not be cancer she remembered her husband saying, half joking. But it was.

The radiologist casually dropped the news while Caitlyn was alone in the ultrasound room. Devastated, Caitlyn asked for her husband but was told he had to stay in the waiting room. In the past, that might have been the end of the conversation. Not anymore. Caitlyn texted her husband: “Come back here now!”

Like many people today, Caitlyn has spoken about her cancer face-to-face and online. She has used texts and her blog to inform her large circle of friends, family, and coworkers about her diagnosis, chemotherapy, the loss of her hair, the birth of her daughter, her double mastectomy, and her radiation treatment.  Talking about cancer online can connect people in similar situations and help them share information. It can raise public awareness and reduce stigmas associated with certain cancers and treatment. It can help people feel like they aren’t alone. Through strong online social networks, individuals can hear words of encouragement during tough times, something Caitlyn has experienced.

Katrine Bellamy has also seen the benefits of online communication. After her son was diagnosed with cancer, Katrine started a blog to share her feelings and received positive feedback from readers. “I was pretty blunt about how I was feeling. I couldn’t say these things to people, but I could write about them.” …

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The Art of Self-Disclosure: Part 2

The Art of Self-Disclosure: Part 2

The Pearls and Perils of Self-Disclosure

*Names have been changed to protect privacy.*

To self-disclose is to reveal something private about yourself. Disclosing information can help individuals feel understood and accepted, but can also be hurtful if the person listening is critical, minimizes, or magnifies what is said or withdraws.

Individuals typically weigh the risks and benefits before sharing intimate details about themselves to others. What you choose to say will probably be based on how comfortable you are disclosing information, the person with whom you’re talking, and the immediate situation. Some people have nothing to share, although others may expect an outpouring of emotion or personal details. Tim Hayes said he didn’t avoid talking about his testicular cancer, but other than updates about doctor appointments or treatment, he didn’t have much to say. “I didn’t think it was very interesting when you got past the update. What else are you going to talk about?” He also didn’t talk about end-of-life issues. He believed he would survive.

The Risks of Self-Disclosure

Texas resident Michelle Rasmussen knows the risks of self-disclosure. Her father’s diagnosis of terminal liver cancer came out of nowhere during a difficult time in Michelle’s life.  Frequent battles with her soon-to-be ex-husband over money and property had drained her energy and time. She became the primary caregiver for her father and her mother, who had recently suffered numerous health issues and needed considerable care. Her friends said she had written a country and western song because of the many problems in her life, but they also said she was tough and would get through this difficult period. However, they didn’t see Michelle crying alone at night, pushing aside meal after meal, wondering when she was going to snap. When she asked her sister for help, her sister told her she had her hands full taking care of her children. …

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The Art of Self-Disclosure – Part 1

The Art of Self-Disclosure – Part 1

Revealing, Relating and Risk-taking to Improve Communication

*Names have been changed to protect privacy.*

Jeannette Patterson likes to talk. She’ll talk to the person standing in front of her at the checkout line just as easily as she would talk to her doctor.  From corns to cancer to her granddaughter’s most recent accomplishments, Jeannette will share details about her life that other people would never disclose. Her husband Carl, for example, would never talk about these things publicly. You won’t find him talking about personal or emotional issues with family members either. If pushed, he’ll write a note. However, after his wife was diagnosed with colon cancer, Carl and his wife talked.

They talked about her medications and doctor’s visits. However, conversations about emotions were not so easy. She didn’t want to upset him, but he kept seeing her cry. He cried when she wasn’t looking.

Then, there were the accidents after part of her large intestine was removed in surgery. Without warning, she’d defecate on herself. Eventually, she got over the embarrassment of this happening in front of her husband. Carl reminded her to take care when eating and pack extra clothes and towels before going out. But for three years, her body repeatedly betrayed her in public, drawing people’s attention. She “rolled with the punches” and started talking.

“I needed to talk about it, to spread information and convince people to get colonoscopies in case this happened to them,” Jeannette said.

The Patterson family story illustrates the reality of talking about cancer. Some people want to talk about it. Others do not. Sometimes you can plan for conversations. Other times the conversation comes to you, ready or not. Talking about your thoughts and feelings with a partner or close friend is considered an important part of intimate relationships and can make you feel better. This article provides insights to help those who have been touched by cancer understand why some people share and others withdraw. It also offers guidance to help facilitate conversations about cancer. …

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Trust – Part 3 of 3

Trust – Part 3 of 3

Building Trust through Action

Trust is earned and built up over time. It comes from being straightforward, responsible, consistent and reliable. It’s keeping someone’s secrets when asked. It’s keeping certain things private even when not asked. It’s offering to help and following through on what you say you’re going to do. It’s being there for the long haul.

Building trust involves being present and supportive for people you care about – and allowing people that care about you to be present and supportive for you. Different people show care and concern in different ways. One person may show care through tough love while another person may do someone’s errands or chores.

For this activity, you will prepare to either ask for help or offer help. In both instances, it’s good to consider how this can be done. Mostly, it doesn’t matter if you’re a patient, a caregiver, or a family advocate. Patients can offer help while caregivers can ask for help. It is a multi-way exchange. …

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Trust – Part 2 of 3

Trust – Part 2 of 3

Strategies to Build and Repair Trust

Trust is essential for intimate relationships, but it doesn’t function alone. It is reciprocal. For trust to grow and thrive, all parties have to work at it. Conflicts often occur over trust-related issues or a belief that someone acted in a way that betrayed a person’s trust.

On a cancer journey, a patient might wonder if a particular person will be around when they are sick and need help. Can the person be relied upon to pick up their prescription from the pharmacy? Can he or she be trusted to be sensitive to the patient’s feelings?  Will he or she consider and respect the patient’s needs and desires when discussing treatment options?

From a caregiver’s perspective, a caregiver may ask if the cancer patient will trust him or her to look out for their needs. Will the patient be honest and straightforward about how they are feeling? Will the patient be supportive or empathetic when the caregiver feels overwhelmed or needs a break?

Trust is usually built over time and through small actions that add up to a collective whole.  Being dependable, honest, empathic, and having integrity are essential ingredients for trust to exist in a relationship. Self-sacrifice is also seen as a demonstration of commitment and trustworthiness.

If you want to establish a more trusting relationship with someone consider the following strategies: …

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