The "cancer conversation" can be a focal point of stress for me, personally. It is not that I don't or won't converse. When specific, non-judgmental inquiry is initiated I do not have any qualms about answering. The open-ended "how are you feeling"? Or the blatant, expectation for me to "dish" - I can feel my emotional protective wall envelope me. Not because I am protecting myself from the inquiring person, but because I am protecting myself, from myself. More so when family "expects" me to be the one to initiate the discussion. I also, selfishly, (and I do use that description quite a bit when trying to express how I am dealing with my chronic illness. Not because I am being self-deprecating, but because cancer is a "selfish" state of being) squirm at the thought of having to deal with the inquiring persons reactions.
Then there is the discomfort of the unknown. When presented with the open-ended query of: "how are you feeling [or doing]"; I am not sure just how much the inquisitor really wants to know. We live in a society where the perfunctory start to every conversation, whether it be with the SB Barrista, a client, an adversary, or a BFF, starts with "how are you"
In short, its complicated
The below synopsis, of a study conducted by The University of Texas' study on cancer communication, delves into the complexity of this "conversation."
Reprinted from "Navigating Cancer" - October 12, 2011
Some people choose to discuss their health concerns with those who are closest to them. Others prefer professional counselors, support group members, other survivors, or acquaintances made through the Internet. Not everyone finds the connection they need from the same source, and the depth of the conversation will vary as well.
Erin Donovan-Kicken, assistant professor of communication, led the research to examine the strategies people with cancer use to communicate with family, friends, and colleagues. Donovan-Kicken and her team interviewed cancer survivors on how they approached the topic of their diagnosis with various audiences. The team gathered data regarding the advice patients received, the challenges they faced, and the recommendations they would make when talking about a disease. The participants were also asked to evaluate existing patient literature and how they managed information about their illness.
The study results indicate that asserting control over communication is an important factor for patients coping with the stress of cancer. Yet despite best efforts to control that communication, patients can’t control other people’s reaction. Patients will benefit from setting boundaries with family and friends when they need space to be ill or feel emotional in private. They should be allowed to focus on themselves without needing to support others, and to avoid people who are overly solicitous. Choosing not to engage in social discussions about an illness can prove to be an empowering decision for some patients.
Ultimately Donovan-Kicken’s research defined the difference between asking –
“Are you opening up to people?” and
“Do you have people you can talk to if you want to open up?”
The distinction is note-worthy for oncologists and survivor advocacy groups who counsel and provide support to patients. Patient literature could also be refined to emphasize what is meaningful about communication from patients’ perspectives. It could include suggestions on how to manage or withhold from personal health discussions, and establish boundaries allowing patients to experience their illness in a way that best suits them.