I would appreciate hearing thoughts on the pros and cons for getting psychological help for Breast C

HC2021

Spouse was diagnosed of Stage IA invasive breast cancer. Had lumpectomy and radiation therapy late last year. Recently been told to have Dilation and Curettage (D&C) diagnostic procedure as her doctor suspects malignant growths in uterus and ovaries. She’s been very strong in the midst of all these but I want to help her evaluate if professional psychological counseling may be beneficial.

ChicagoSandy

IMHO, there are no "cons." Many major cancer centers even have "onco-psychiatrists" on staff for precisely that reason. Caveat, of course, is that SHE must be the one to ask for help or bring up the subject.

po18guy

At times, we need to glance in the mirror first. Oftentimes, it is the caregiver who needs the consolation. From watching my wife, I know that it can be far more painful to watch suffering than to undergo suffering. Suffering is finite, but worry seems to have no bounds. Yet, we have a unifying faith which has sustained the two of us through all of this.

Is your wife good with both positive and negative outcomes?

Kylerem

I started counseling and then a support group right after I finished frontline treatment. My wonderful husband just didn’t know how to handle my ups and downs and I knew it wasn’t fair to him as he had his own worries. It was immensely helpful. I have recently been having a hard time coping with all the fear and unknown that cancer brings so I started one on one counseling again-I had continued with the support group. There is nothing like talking to someone outside of your friends and family to take some of the worry away. I would say a definite yes to trying some counseling. Possibly a support group as well as no one knows what you’re really going through like a fellow cancer warrior. Wishing her the best.
Pam

2943

Each person going thru this journey has their own worries, concerns, issues. If my husband had brought this up, I would have wondered what I was doing wrong and probably withdrawn. It was available at my cancer hospital but I did not need it during initial phase. Know what is available to each of you IF SHE WANTS IT. Hugs to you as you navigate this path.

lynn1950

There are no cons.

ChicagoSandy

Another resource is ImermanAngels.com. Your wife would be matched with a "mentor" who has/had the same or very similar diagnosis and can lend emotional support, including coping tips. I am mentoring two IDC patients and am being mentored by a fellow ocular melanoma patient. Until in-person support groups can get back up & running, it's a great tool. Also virtual groups via your local Gilda's Club.

Carool

I, too, think there are only pros. I started seeing a psychopharmacologist who worked with breast cancer patients at my cancer hospital. She recommended an antidepressant/anti-anxiety medication, and that medication helped me. She did not do therapy with me, only monitored my moods and saw how I was doing with the antidepressant. I recommend that your wife consider going to either a talk therapist (who might also prescribe meds or have her see a psychopharmacologist to get meds) or just a
psychopharmacologist, to get meds. I wish you and your wife all the best.

HC2021

Thanks everyone for the feedback. Truly valuable.
@ChicagoSandy - I will certainly look into ImermanAngels/Gilda and perhaps even get myself started first.
@po18 - negatives are certainly harder to deal with. What have you found to be most helpful if I may ask?

Bug

My oncologist recommended a therapist in my medical group that specializes in cancer issues. She helped me a lot. She really "got it" (past tense because, unfortunately, she left the area recently). Since she was in my medical group there was no charge for her services. I highly recommend someone to talk to if one is comfortable with it.

legaljen1969

I echo the thoughts of everyone else here when I say there are no "cons." I do agree with @ChicagoSandy that SHE must be the one to bring it up though, The only way I see to get around that is if her doctor or oncologist brings it up as something they offer and YOU are very supportive of the idea "if she wants to do that."
I wish I had started counseling right away after getting my diagnosis. My diagnosis and surgery came just before COVID came around and shut down the world, so I have been patiently waiting for someone willing to take new patients and someone I can see.
I knew our hospital had a social worker. I went to see him once at the beginning of my journey when I was trying to handle some conflict with my mother and how MY cancer affected HER. There was a lot of pressure on me to put on a happy face and smile and "keep it private" while she was telling all of her friends and getting advice on THEIR cancer which was often very different than mine.
You have to find the right fit (or your wife does). In all honesty, it may benefit each of you to have someone to counsel you as you navigate this journey. My husband has an amazing support system with friends who let him talk and vent. I became so withdrawn in the early days of my journey when my husband or my mother would cry or get worried. I felt like if I heard one more time "Don't worry" or "Don't cry." I wanted to say "I have freaking cancer, and I will cry if I want to." I just shut down because I didn't want to "worry" anyone or make them sad or scared. My mother wanted to attend all of my appointments with me, but that was my one safe space where I could worry or cry. My surgeon was amazing and started having her nurse call me in to get the vitals and start the exam and go over results, and then call my mother in to discuss planning and treatment.
It's not an easy conversation to have. If your wife seems interested, by all means support the idea of counseling. If you notice your wife seems like she is "guarding" or "protecting" you, that might a reasonable opportunity to ask if she would like to speak to someone who might feel a little more neutral who could help her weigh her options and get out the things she feels like she can't say to you.
Though seeing a therapist, counselor, social worker is much more common and accepted these days- there still seems to be a stigma attached to mental health issues. Believe me, the mental and emotional component of this journey can really take a toll on patient and caregiver.
@HC2021 I don't know your life circumstances but maybe a pastor is available.
To be honest, I almost wish a counselor or therapist was looped in to the care team from the very beginning of a cancer patient's journey- so it was just "part of it" when the process started and it was just "expected" that the patient knew they had support- instead of having to seek it out or have someone suggest it to them. Then, if the patient is already seeing someone- they could opt out or have their existing therapist looped in to the care team just as part of the treatment continuum.
When my father had open heart surgery several years ago, the hospital social worker came to talk to my mother on the day of surgery about options available to her as the caregiver and about options available to my father as the patient. My brother and I were there too, and the social worker just told my mother that since it was such a major surgery and such a vital surgery, they just made it part of the process to get people started and let them know where to go early on instead of waiting for a problem to develop and then trying to find someone to help. I thought the approach was a great one.
Anyhow, please encourage your wife to come to this forum. There is always lots of support here- for both patients and caregivers.

legaljen1969

@ChicagoSandy, what is Gilda's Club? I have never heard of that. I think a lot of people in big cities have a lot of resources that those of us in small podunk towns don't know about. I know sometimes all it takes is finding out such a thing exists and the will to get it moving in a new location.
And the Imerman's Angels? Is that a local thing where you live or is that supposed to be a nationwide thing?
I am still learning my friend.

HC2021

@legaljen1969 Thanks so much for sharing your journey and thoughts. Best of luck to you. I’m also just learning about the two organizations that @ChicagoSandy mentioned and would appreciate hearing others’ experience as well.

ChildOfGod4570

Oh, there are ***absolutely no*** cons to getting psychological help during cancer treatments! Not just for the patient but for the caregivers as well. Sadly, when I was going through my active treatment, I asked about a therapist, but no such person was mentioned; nor were support groups. Thank God my mother found What Next for me! My experiences and what I see here confirm what I have been saying for years. It's important to treat the physical cancer in a patient, but please give equal attention to the patient's emotional health! In our heads we know we're doing what we need to do to fight the cancer, but we also feel sick, ugly, different, etc. it's also important to have support for the family and friends caring for the patient, as watching their loved one go through the journey is a very heartbreaking and helpless feeling. HUGS and God bless.

MarcieB

As others here have pointed out - it must be HER idea. And I caution you to be very sensitive to her reactions if you bring up the subject. I had counseling for a time after my first husband died because I knew I needed it and there was no one at home for me to talk to anymore. it helped tremendously. But, sometimes all I really needed was someone to allow me to cry and reassure me my feelings were valid. I didn't want to pay someone the big bucks to comfort me, I wanted it to come from someone who loves me. When I was going through treatment, I might break down and tell my husband all my fears and if he would say, (and he sometimes DID), "Maybe we should call someone....?" it would sound, to me, like he didn't want to deal with it. Of course I know better now. It's easy to know better when you can look back on it. But, treatment affects our emotions too, and how we *hear* things might be very different than how they are intended.

I agree, it might be a good idea to alert her doctor and ask her to discuss it with your wife.

po18guy

@HC2021 An underlying faith strengthened us for any eventuality and has sustained us through 12 years of it. Seeking and receiving consolation in the supernatural realm indeed can provide that "peace which surpasses all understanding."

ChicagoSandy

Gilda's Club was founded in the early 1990s by Gilda Radner's widower Gene WIlder as a center for cancer patients (originally gynecological, but since expanded to all cancers) to gather for support, classes, social events, etc. First one was in L.A. & then NY--now there are branches in many major cities. Due to the pandemic, all activities moved online--so ANY English-speaking (some groups are offered in Spanish, too) cancer patient or caregiver with internet access ANYWHERE in the world can join FOR FREE.

Carool

I went to a Gilda’s Club in Manhattan soon after my breast cancer treatments ended (this was many years ago). I never went back, as I felt being there was a downer for me. People with many different cancers were in my group, and I wasn’t prepared to hear some scary and very sad stories. I’m not at all a Pollyanna type, but I preferred the early-stage-breast-cancer adjuvant treatment group my hospital offered that I went to during and somewhat after my treatments.

Of course, every group there is different. It wasn’t a closed group, and I assume that each week there might be different people along with the regulars. And Gilda’s Club offers many activities (I assume) in addition to groups. I’m saying my experience, in reply to HC2021’s request.

Fun fact: People with Gilda’s Club tried to change the name of the clubs, because, it was thought, young people don’t know who Gilda Radner was. I think the name was changed for awhile but then it reverted to its original name, because people protested. And each Club has a red door (at least that’s how it used to be).

fiddler

I agree with everyone, she has to ask.

Not everyone is extroverted - some introverts do not do well in groups barfing out our inner selves - in public!

The cancer clinic that treated my cancer (Swedish Hospital, Issaquah, WA, a few miles west of Seattle) did not have counseling in any form 8 years ago. (The hospital kitchen, though, had the best pastry chef I'm here to tell you, and the tasty morsels went far in lifting my spirits!)

You know your wife best so you'll know best how to approach the subject with her. If you think it's something she would benefit from, something that she would be amenable to doing, figure out a way to broach the subject with her.

Caretakers can suffer a great deal, too. The worry and stress can have an effect on the caretaker's health. A common thing is for a caretaker to die within a couple of years after a loved one goes through an ordeal. Find someone to talk to for YOU. You need to be there for her, but you also need to enact 'self care'. It's not being selfish, it's being pro-active.

Thanks for asking this group. We're all rooting for the two of you!

fiddler

OMG @ChicagoSandy! I thought you were a power couple, but Gilda Radner & Gene Wilder??? Holy moly, what a combo. I can only imagine what a party at their place was like. What fun it could have been.

cllinda

I saw a counselor during my journey. It really helped me. I could get out my feelings and not be judged about it.
I also had a really good friend who would pick me up for coffee and I could tell her anything. A close friend can be a blessing, too!

legaljen1969

@MarcieB, I was thinking about your husband's response "Maybe we should call somebody." I can imagine how you felt, even though, in retrospect (or in the logical world when not caught up in emotion), that he was trying to be helpful.

I was reviewing an old radio broadcast today with Bill and Pam Farrell, the authors of "Men Are Like Waffles, Women are Like Spaghetti." The basic premise is that men typically compartmentalize things and stay in one box at the time- dealing with one thing at the time. Women are like a plate of spaghetti- with noodles intertwining and overlapping and wiggling. I know that's a very accurate description, for the most part, of my husband and I. He is very logical- step by step, let's deal with one thing at the time. I am very spaghetti-like. Everything interacts.
Example- when I had to go for my first mammogram post surgery- the spin out started. All of the thoughts were racing. "What if it is back? What if I have a new cancer? I am going to be a burden on people. People are going back away from me. If all of our friends back away, who will help my husband cope? Does he need help coping? Does he know where to go to look at his insurance coverage? Does he remember where the keys to the safety deposit box are? If I die, How will he shut down my accounts? Accounts- does he know how to reach the accountant? Oh yeah, I need to ask the accountant about that restaurant. Oh great, my husband doesn't cook. Who will cook for him? Will he find a new wife? Will he look before or after I die? Will I die alone?" ALL of that spaghetti from a routine task. My husband's outlook "Okay, let's get you to the mammogram and see what it says. If we need more, we jump to the next thing."

So, all of that to say- sometimes we need a counselor to help us untangle our spaghetti so we can see what's going on OR to cut down the barriers of our waffles so the syrup can flow out of the boundaries.

legaljen1969

@cllinda, it's great to have a good friend who will listen and you know you can tell them anything- the good, the bad and the ugly.

ChicagoSandy

My beef with the Chicago Gilda's Club is that they don't have a regular bc support group--they have one each (or did before going virtual) for general cancers, metastatic, Black & Latina patients but not for bc in general. We had a great one at Evanston (IL) Hospital--but then the popular facilitator (a bc survivor herself) died soon after the sudden onset of an unrelated cancer, and attendance dropped off precipitously. A succession of facilitators just couldn't pick up the baton & run with it, so the group disbanded. We were going to meet anyway, rudderless, at a Panera (which had some kosher options for one observant group member), but then the pandemic hit before we could meet.

The closest support group for bc is all the way down in the SW suburbs, only once every few months. So here, BCO, and Imerman Angels it has to be.

And Fiddler, my husband did a rotation at the Issaquah branch of Swedish during his 3rd yr. of med school at UW. He also did one at the Hutch during 4th yr. My law office was in Robinswood, near the Factoria freeway interchange. I miss Seattle, even 43 yrs. later! (Definitely Boehm's Candies, which made me very popular with my Chicago office mates every time I'd return from a Seattle U. Law Alumni meeting).

legaljen1969

@ChicagoSandy, when you were still practicing- what sort of law was your specialty? I have never thought to ask before.

EileenS

EileenS - I had my first breast cancer at age 50 and joined a wonderful, positive support group at my cancer center. I also journaled, and let my husband know I was open to him reading my journal since he didn't want to talk about it. He never did. I journaled so I could read it later and see the progress I had made, physically and mentally, certainly NOT to relive those experiences. I got counseling off and on for a couple of years. I wish he had also gone to a counselor but he refused to talk about it. I experienced survivor grief when a 26-y/o gal in my support group died of her breast cancer. She and her husband had a 4-y/o. It was more than I could handle alone and the counselor helped me work through it. Spouses of cancer patients definitely should seek counseling of some sort--they have issues, too. We all experience a new normal after a cancer diagnosis and many of us need help.

ChicagoSandy

Jen, I started out in Seattle doing mostly family law (post-judgment custody & support modifications), personal injury & probate. When I moved here, I spent 4 years as an Asst. IL A.G., doing welfare litigation & Const. law for 2 years and then defending the state in the Ct. of Claims from personal injury, medical malpractice, & lapsed appropriation cases. When I went into private practice, I did mostly estates & trusts, probate, real estate closings and property tax appeals. Retired in 2012 when my boss had a stroke and I didn't want to take over the practice at my age. I still occasionally do pro bono work for my fellow musicians.

legaljen1969

@EileenS- I was diagnosed just before my 50th birthday. The first part of my 50th year was spent doing biopsies, lumpectomy, mastectomy, starting treatment and then COVID hit and the year went sideways in a hurry. My life in 2020 was the truest living example of "We make plans and God laughs." I was looking forward to "celebrating" my 50th year- my half century on this earth. Added to that, my husband and I had our 25th anniversary. I had been married for half of my life. Wow, 50 years of life, 25 years of marriage in 2020- the year I hoped I would see things more clearly (yea, see what I did there. LOL).
My husband never wanted to, and never wants to talk about it. As soon as my mastectomy was done and they told us they had gotten all of the cancer- it was "over" for my family. All just a neat little package to put away in a corner, something we can all remember but never have to re-live. Except, I live it every single day when I take my shower, when I get out my shower and see there is no breast there, when I put on my mastectomy bra and slip my FOOB into place.
I keep thinking I will finally get the "courage" to seek counseling, but that's just one more thing for my family to hold against me. One more example of my "weakness." One more thing "they" will feel "ashamed of " about me. I think I will try to be more diligent about journaling.

Now, the rest of this is just generic to anyone. Not specifically directed at anyone.
Please know that I respect caregivers. I respect the family members who travel with us along our journey, but when we expend all of our energy worrying about how it affects them and impacts them, we don't get time to process our own "stuff."
Please be supportive if your patient wants counseling. Please don't make them feel like they are "less than" if they request it, or need it, or want it. I would give anything to have someone to talk to that didn't expect me to have a happy face all the dang time and wouldn't judge me when I am angry with my body, sad that it will never look the same again, sad that I will never be pretty enough, sad that now I am "damaged goods." I am tired of being pitied, tired of being someone's "good deed" for putting up with me.
There is a way to come alongside a person who needs your help and support without making them feel so stinking unworthy of it. When you make your support about YOU, it ceases to be supportive.
Yes, I am having a bad night, a bad week, a bad.... well just everything right now.
Counseling could help. Mental health is important. Maybe you, or your patient, just need someone to reach out and say "I care" or "You matter." One of the things I try to practice now when I find out someone has cancer is to do something proactive- whether it is sending a card to say I am thinking about them, showing up to be with them as support during a appointment, offering (and following through) on a ride to an appointment. So many people say "I am here if you need me." That puts the burden on that person to call you, and to try not to burden you.
My first few weeks and the first couple of months, I had a very few times I really "needed" someone for something and I called upon the people who said they would be there when I "needed" them. Let me tell you that 100% of the time, those people were unavailable. One hundred percent of the time they flaked on me. 100% of the time they never followed up or asked me if things got worked out. I think people get embarrassed when they say "I will be there" and they flake on you. I was disappointed at times and I was frustrated at times, but not mad. I did get mad after awhile when I would follow up to let them know it worked out and they were still ghosting me.
I get it. People have lives and the world doesn't revolve around me, but it taught me a lot about being vague about what I was willing to do and the whole "I will be here if you need me." I have said it since then, and I have had to go back on my word or say "I can't help you right now, but maybe when I get off work or when I have off from work tomorrow." Sometimes that it is not helpful, but I always follow up to make sure they got that ride or their medicine or whatever.
Sometimes just a kind word is needed, or just the initiative to call back or text to say "I am still here. I still care."

EileenS

legaljen1969 - I am so sorry you've had such a difficult time with your family accepting your cancer--and your survival! Shame on them. However, I experienced something similar with my husband (who is now my wasband) when 7 years after first diagnosis my breast cancer returned in the same breast. The body can take only so much radiation so I needed a mastectomy. I asked my surgeon to do a bilateral and call in a plastic surgeon to do immediate reconstruction. I wasn't going to go through this for a third time--NO WAY! My husband asked if he could offer his opinion and I said he could, but it was my body and my decision. I had the bilateral and reconstruction, certainly not an easy task to complete. I have never doubted my decision. My husband apparently couldn't handle it and started avoiding me sexually and found it safer to be with men. When I found that out, my love for him flew out the window, never to return. I had made my decision and now he had made his. I didn't know who this person was. I filed for divorce after 39 years and have been very contented with my single life. At age 70, twenty years after my first breast cancer, I was diagnosed with lung cancer. A second lung cancer was found two years later. I have a wonderful healthcare team and support community, mainly my family and my church, and now six years later my lung cancer is in remission. I am walking proof of the power of prayer. I take each day, one at a time. We are not always responsible for what happens to us but we are responsible for how we react to life events. Pray every day. Get good medical help. Reach out to others and help them when you can. The best you can do for someone else is to pray for them. God bless you. I pray you will find answers that will help you continue to live well.