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Section 13
Cancer Treatment and Depression

Question 13 | Test | Table of Contents

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In the last section, we discussed hospital strategies.

In this section, we will discuss if the illness is not progressing as planned.

There is the possibility that some cancer patients who try everything they can may not recover as quickly as they think they should or recover at all.  Vince, age 42, had testicular cancer.  Vince had lived his entire life with only one testicle.  At an early age, doctors suspected it simply had not descended.  They x-rayed him and found nothing.  However, years later at the age of 41, Vince began having severe abdominal pains. 

♦ Case Study: Vince's Setbacks
It turned out Vince’s undescended testicle had been there and had grown to the size of a grapefruit.  Doctors removed the tissue, but the cancer had spread to Vince’s lungs.  When Vince’s wellness had not progressed the way he thought it should have, he stated, "Maybe it’s my fault.  If I had been better at the medication, or done a better job partnering with my treatment team maybe I could have recovered by now."

How might you have responded to Vince?  I stated, "Recovery is not in your complete control.  Biology can overcome psychology.  While there are many ways you can participate in your fight for recovery, and there is the distinct possibility that your activity may have a positive effect on the course of the illness, you don’t have the power to ensure recovery." 

Think of your Vince.  If your client believes that recovery is guaranteed if done ‘right,’ won’t any setback be perceived as proof of inadequacy?  I stated to Vince, "No matter what happens, you are not inadequate.  What you have been doing is right for you.  And you are doing it as well as anyone in the this situation can do it.  And just because there is no assurance of winning, you need not stop trying." 

Vince then asked, "Who wants to fight a losing battle?  I mean there’s just no way to know if I’ll win or lose at this point."  To help Vince understand the importance of trying, I stated, "If you refused to enter a race you weren’t sure of winning, you’d enter few races.  If you never took a job unless you would be guaranteed that it would be a great success, most people would be out of work.  Almost nothing in life is certain, and there are very few situations in which anyone has complete control.  In that respect, the fight for recovery from cancer is not much different from most other efforts in life."

♦ Technique:  Take the Opposite Track 
To help Vince avoid giving in to the idea of losing his battle with cancer, I implemented the take the opposite track technique.  I stated to Vince, "Take the opposite track.  If you find it too strange to love your painful experience, then do the opposite.  Develop obstinacy.  Actively hate the bad experience.  Refuse to accept your feelings.  Exaggerate your need to change your feelings.  Go way beyond your normal resistance.  Forbid yourself to accept the situation.  Say to yourself, "I’ll never accept this no matter what." 

I find that this strategy works because the mind is like a child and often does the opposite of what you tell it to do.  Think of your Vince.  Could a similar application of reverse psychology work for your client who is beginning to give in to the idea that he or she may not recover from cancer?

In this section, we have discussed talking to clients if the illness is not progressing as planned.  This included a description of the take the opposite track technique.

In the next section, we will discuss rebounding and rebuilding.  The first step to recovery after remission is to reconcile with the idea of being healthy again.
Reviewed 2023

Peer-Reviewed Journal Article References:

Craske, M. G., Meuret, A. E., Ritz, T., Treanor, M., Dour, H., & Rosenfield, D. (2019). Positive affect treatment for depression and anxiety: A randomized clinical trial for a core feature of anhedonia. Journal of Consulting and Clinical Psychology, 87(5), 457–471

Desautels, C., Savard, J., Ivers, H., Savard, M.-H., & Caplette-Gingras, A. (2018). Treatment of depressive symptoms in patients with breast cancer: A randomized controlled trial comparing cognitive therapy and bright light therapy. Health Psychology, 37(1), 1–13. 

Hopko, D. R., Cannity, K., McIndoo, C. C., File, A. A., Ryba, M. M., Clark, C. G., & Bell, J. L. (2015). Behavior therapy for depressed breast cancer patients: Predictors of treatment outcome. Journal of Consulting and Clinical Psychology, 83(1), 225–231. 

Hopko, D. R., Clark, C. G., Cannity, K., & Bell, J. L. (2016). Pretreatment depression severity in breast cancer patients and its relation to treatment response to behavior therapy. Health Psychology, 35(1), 10–18.

Kuba, K., Esser, P., Mehnert, A., Hinz, A., Johansen, C., Lordick, F., & Götze, H. (2019). Risk for depression and anxiety in long-term survivors of hematologic cancer. Health Psychology, 38(3), 187–195.

QUESTION 13
What is a useful technique for clients who are beginning to give in to the idea that he or she may not recover from cancer? To select and enter your answer go to Test.

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