Dealing with a terminal illness, including cancer, can be physically draining, emotionally overwhelming, and a psychologically taxing process for both patients and their families. Simply receiving the news that one may be terminally ill is often devastating, and is for many individuals, paralyzing. And for good reason: we spend so much of our day-to-day lives just living that we seldom give thought to our mortality, or to a time when it may have to end. So while most people feel that time is on their side, for many dealing with terminal illness, time seems to be working against them. Having to face these issues all at once can be a heavy burden one that requires courage, mental preparation, and emotional support.
Making matters even more challenging is the fact that talking openly about death is in most cultures frowned upon or discouraged. Even family members can anxiously avoid the topic, preferring instead to discuss subjects that provide comfortable distraction, or matters directly related to practical or concrete medical issues, that somehow feel more within one?s control. In short, most of us are implicitly taught to avoid thinking about death. No wonder so many of us do not know what to say to the dying. However this can lead to even greater isolation for the individual who has little choice but to face their own mortality. It is important that they do not go through this process alone, or without persons who they can talk to.
Each person will cope differently at the end of life. Such differences may be based on personal values and beliefs, degree of religious or non-religious affiliation, level of psychological awareness and insight, ability to express and communicate thoughts and feelings, and so on. Many will cope in the ways that reflect our cultural attitude toward death: by distracting ourselves from its inevitability or repressing the feelings that lucid awareness brings. It is not for me to judge how someone lives, or how someone chooses to approach the end of their life, but I think that something beneficial can often come from examining one's own thoughts and feelings related to life and death and that it is never too late to do so. This process may involve a direct exploration of what meanings we give each, while learning to tame anxieties or fears that might be awoken by such an honest inquiry.
Some people think that existential therapy is only useful or appropriate for retired philosophers, or for those who have been self-reflective throughout their whole lives. I disagree. Plenty of research suggests that when confronted by their own mortality, many will begin to reflect on their lives, challenge old beliefs and values, and begin to consider and question meaning and purpose. I believe that it can often provide an opportunity for people to discover new meaning and new joys even at the end of life. Some people say that death is pointless and something to be avoided that we should distract ourselves from it, since it does nothing but take away from the process of living. I could not disagree more. I believe that confronting death allows us to live more fully in the moment and to relate to the people in our lives more meaningfully. I also believe there is such a thing as a 'good death' and that it comes in part by learning how to face it with courage, dignity, and without regret.
My therapy approach for those dealing with terminal illness often follows some aspect of existential therapy. This process may include exploring questions about life purpose and meaning, helping to address personal or relational issues that feel unfinished, or examining thoughts or feelings about dying. My approach will especially appeal to those who would choose to tame existential fears or anxieties, rather than simply manage or suppress them by use of distraction or psychotropic medication. My ultimate goal is to help individuals achieve the best possible quality of life, and the most dignified and psychologically comfortable end of life.
The above outlines a general approach that I am able to offer potential clients in need of support. I have certified participation in a Palliative Care Front-Line Education program and have education and experience working with those who are dying. Please be aware that my services are not covered by MSI, though they are generally reimbursable through most insurance providers. Since I work in private practice, and not within the Hospital or as part of Capital Health, my services are most appropriate for those just receiving a diagnosis, or for those who are well enough that they are able to begin meeting at my Halifax office. Upon establishing a therapeutic relationship with a client, I will commit myself to being flexible enough to visit clients whose situation becomes palliative.
Links: Cancer Care Nova Scotia