Interventions for Clients Coping with Cancer

On the last track we discussed dealing with discovery.  We examined three issues regarding dealing with discovery.  They are denial, anger, and sense of loss.  We also discussed techniques for minimizing the sense of loss. 

On this track we will discuss awfulizing.  We will discuss the progression of awfulizing through panic cognitions, the importance of clear decision making, how panic turns to awfulizing, and the stop awfulizing technique.  The stop awfulizing technique works by allowing the client to avoid engaging the mind in battle, by simply letting go, and thereby quieting the client’s emotions.  As you listen to this track, you might consider playing it for client education in an upcoming session.  Could your client benefit from hearing how John coped with his panic cognitions?

The Progression of Awfulizing Through Panic Cognitions
John, age 51, was told that his exam revealed cancer.  First, John was in shock and filled with fear.  Next, John was angry but unsure of where to direct his anger.  John stated, "I’m not quite certain who I’m angry with."  Then John experienced the guilt and had thoughts such as, ‘Did I bring this on myself?’  Then came a flood of questions.  "Will I die?  How long do I have?  What will happen to my family?"  Think of your John.  Do you have a client who could benefit from finding ways to be calm?  Clearly, telling John not to panic would be easier said than done.  How might you have responded to John?

The Importance of Clear Decision Making
I stated, "Cancer is a serious illness, but it is not necessarily fatal.  You do have the luxury of time, unlike a heart attack or stroke patient.  But time is not a license for inaction.  Be aware that an immediate response, often based in fear and panic is not only not required, but can also be harmful.  Let’s stop and examine your thoughts for just a moment.  When do you think clear decision making is most important?"  John responded, "Probably throughout the whole treatment."  I agreed with John that, clear decision making was important throughout his cancer treatment.  I felt that John’s thought process may have been lead by panic. 

How Panic Turns to Awfulizing
Think of a client you have treated for panic.  Could your client’s panic, as a cognitive issue, be labeled as awfulizing?  Does your John take his current situation to its worst possible conclusion?  I asked John to observe his emotions objectively.  John stated, "It’s like I’m afraid of what might happen."  Clearly John’s panic was a cognition of projected fear.  I stated, "Panic is a projection that is not real.  We are not our fears.  Our fears do not necessarily determine our future."  John asked what he could do about it. 

Technique:  Stop Awfulizing
To help John avoid panic producing thought processes, I explained to him the "stop awfulizing" technique.  I stated, "When you start to feel anxious emotions or panic arising inside, try to witness them.  Just observe your panic.  Try to step back and focus on the panic thoughts.  What may have started them?  What are the real fears that have started your awfulizing?" 

John asked, "If I’m not supposed to panic, then why would I focus on those thoughts?"  How might you have responded to John?  I stated, "Instead of putting yourself in the role of a victim who is hopelessly caught in a web of despair, become the observer.  By not engaging the mind in battle, by simply letting go and focus in another direction, your emotions will soon become quiet."

"That other direction might be to imagine yourself as an effective problem solver, a person who is about to make some very important choices.  You see yourself weight all of the pros and cons of your treatment options."  John responded by asking, "What else can I do?"

I stated, "Sit down.  Take a deep breath.  Say out loud, ‘Many people live who have Cancer.’  Observe your emotions.  Detach by separating who you are as a person from the emotional panic you may be feeling.  You are not uncontrolled panic even though you may be experiencing panic.  The two are very different."  Think of your John.  How might your client benefit from the stop awfulizing technique? 

On this track we have discussed awfulizing.  We will discuss the progression of awfulizing through panic cognitions, the importance of clear decision making, how panic turns to awfulizing, and the stop awfulizing technique.  The stop awfulizing technique works by allowing the client to avoid engaging the mind in battle, by simply letting go, and thereby quieting the client’s emotions.

On the next track we will discuss how to beat cancer.  The information on this track is from the City of Hope, a clinical cancer research center.  I find that clients coping with cancer can benefit from the four steps to beating cancer.  The four steps are confront fears, take charge, know options, and fight back. 
Reviewed 2023