In The Village of Care series we have the opportunity to hear from helping professions, who are not spiritual directors themselves but who can collaborate with spiritual directors to combine and expand resources for survivors. These voices come from medical, mental health, research, ministry, and public service. The goal in hearing these varying perspectives is to give us as spiritual directors some insight into the experiences that our directees may be having with other helpers in their lives, and language to talk about it with them. The expectation is that we are learning from our colleagues in other fields, and translating their advice where appropriate to the context of spiritual direction. We encourage you to make an effort to get to know care providers in your community now, so that you have relationships to lean on when greater context is needed.
The moment right before a patient’s consult with an Oncologist, where I know they will receive a cancer diagnosis, always makes me very anxious as a nurse coordinator. I usually wait outside the room and introduce myself only a few moments before the doctor comes in because I don’t want there to be any empty conversation space. I know that empty space means they will undoubtedly ask me about their results and I never want to lie (and what feels more mean than saying, “I’ve seen them. Wait a few more minutes for the doctor to come in...”). I know their life will never be the same and this is the first red letter day of a new chapter of their lives.
I sit with the patient and family after the doctor drops a bomb and explains in attempted-plain-medical-English, but I know most of what was said sounds like French and it’s hard for patients to move past the word “cancer.” A lot of patients feel that the ‘waiting and not knowing’ is the hardest part. Oftentimes, imaginations go a little wild and patients picture the worst, most painful treatments and a slow, long death. Whether someone finds out they have an incurable disease that will most likely lead to their death, or an early-stage cancer that will most likely be cured with treatment, the “cancer” word has a way of pulling someone’s life sharply into focus, and their mortality at the forefront of their minds. At the same time they are bombarded with practical issues such as who will pick up their kids from school, how will they pay their expenses if they aren’t working, who to share this news with, and when to tell close family and friends.
Being a support person such as a nurse, counselor, or spiritual director can certainly be a challenge. The training we have received has taught us to actively listen, but what if our client doesn’t know how to start talking about or processing their hurricane of many emotions that they may be feeling all at once? Using my experience as an oncology and hospice nurse for 10 years and speaking with Laurie Ostracher, LCSW, I’ve put together some basic tips for supporting your client with a cancer diagnosis. I’ve got some good news! You don’t need to be Ghandi or come up with inspirational or overly spiritual quotes! With some general prompts, focus on listening and let the client direct the conversation.
The training we have received has taught us to actively listen, but what if our client doesn’t know how to start talking about or processing their hurricane of many emotions that they may be feeling all at once?
Start by asking what would be the most helpful for them
You may think they would be concerned about death and dying, but they may surprise you and actually be preoccupied with a completely different issue! This sometimes can involve their hair falling out, or the fear of needing an ostomy bag.
Ask, “what kinds of thoughts are going through your head?” or say “It’s hard for me to imagine what you’re feeling like,” (even if you are a cancer survivor).
Be very empathetic and express how sorry you are that they are going through this.
Ask, “what kind of support do you have? Family? Friends?” Are their family and friends actually supportive?
If someone has pre-existing anxiety, support groups may not be the best environments. Classes may be a better fit, as they are more directional. You can ask what kinds of resources their clinic offers, or encourage them to get connected to the social worker at their clinic to find out about their resources.
Breaking the News to Children
Many parents become very concerned with what and when to tell their children. They should share what they know in age-appropriate terms with their children as they find information out themselves. Kids are very sharp and almost always sense that something is “off” before anything is said. Just like adults, their imaginations can go wild if they aren’t told the facts, so oftentimes the plain facts are less scary then what they had made-up in their minds. If your client is hesitant, they can wait until they have a treatment plan in place to tell their kids everything at once. Kids are very self-referential and mostly want to know how their lives will be affected. It can be helpful to make a visual calendar and include items like who will be picking them up from school, when visitors are coming (including relatives staying over). Be aware that telling your children information can come with a loss of control over your privacy. It’s only fair that they can discuss with their friends for support, as it is healthy for everyone touched by the diagnosis to have someone to talk to.
If others are approaching your client and wanting to discuss the diagnosis and your client doesn’t wish to, he/she can say something like “Thank you so much for your concern. Right now I’m really focusing on my kids. How are you? Tell me about what you’ve been up to!”
A cancer diagnosis is a huge blow to someone’s perceived control in their lives. It can really aggravate pre-existing anxiety conditions. You are in a unique position of privilege to come alongside someone in crisis. When I was a new nurse, these words brought me a lot of solace, “People will forget what you said, people will forget what you did, but people will never forget how you made them feel” (Maya Angelou).
TraciLyn Clark RN, BSN, PHN, OCN
Oncology Nurse Coordinator
SPIRITUAL DIRECTION BLOG
Expanding understanding and best practices for holistic health in the context of spiritual direction.