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Section 10
Parental Functioning and Cancer

Question 10 | Test | Table of Contents

"My mom was diagnosed with breast cancer. She's taking it well, but my dad's in denial. What can we do?"

Your instinct to get your dad to "let it out" in many ways reflects the generational differences between younger and older people when it comes to feelings, mental health, and psychology. Our parents were raised--many during Depression--with their attentions on subsistence: putting food on the table, fleeing religious oppression Or similar injustices in other countries, and other life struggles that left little time for focusing on feelings (much less discussing them). In particular, many men of this generation had to grow up fast, and part of their feeling responsible included not discussing their fears.

These same men became parents who vowed that their children wouldn't experience such hardships, and they honored that vow by making sure we had access to conveniences and luxuries including, in many cases, a higher education. We were exposed to psychology and a popular culture rife experts who extolled the virtues of s expression. Consequently, many of us learned to cope with traumatic situations in a very different way than our elders did. Not necessarily better--but different.

In or Out of Character?
To help determine if you really should be worrying about your dad, ask yourself, is this how each of them would have reacted 20 years ago? The answer is probably yes. While expressing yourself is generally good, why would you assume that coping styles that have existed for years would simply disappear in later life? I suspect that your mom was always a "glass half full" person, and that your dad was probably a bit less expressive. What you need to do is understand your father's underlying emotions and determine if they are substantially different from his usual coping style an dif they are causing difficulties in his actual functioning and quality of life.

The Fear Factor
I suspect that the basic underlying and overwhelming emotion here is fear. Imagine what your dad is experiencing now--being married to the same person for decades and facing the possibility of losing her. The idea must be terrifying. And the mind protects itself from that pain through a variety of defense mechanisms. Denial can be a very effective one. And determining how much of your dad's tightlipped posture is from denial, and how much is actually the opposite--that he understands exactly what is happening, is acknowledging it, and is grappling silently--will go a long way toward helping him. Even if he can't go so far as to share his feelings with you, here are some techniques that might help you to help your dad.

• Talk to him, but mostly listen. If you can get him to speak about this, he should do most of the talking. Don't try to pry words out of him. The best way to broach this Subject is to share your own fears. Perhaps you feel you need to be strong for him, and he, in turn, reciprocates. Be honest: "Dad, I'm really frightened about mom" might be a better way of broaching the subject.

• Find the right confidant. Perhaps he wants to protect you from his sadness or fear. Don't be offended. Is there a friend who might help? Sometimes there is another sibling with whom dad can more easily share his feelings.

• What about support groups? Men are tough customers when it comes to these, but they exist for spouses of breast cancer patients, and it's a place where he could vent with more anonymity. Ask your mom's oncologist for a local referral.

• Consider the possibility of depression. A frequent topic in this column, depression may be part of the picture. It's entirely possible that he is depressed, and some of his refusal to communicate might be related to this. His physician might be a resource here. Do your mom and dad have the same doc? If not, you could ask their doctors to communicate with one another.

- Lachs, Mark & Pamela Boyer; How can I help?; Prevention; Jul 2003; Vol. 55; Issue 7.

Personal Reflection Exercise #3
The preceding section contained information about children dealing with denial related to breast cancer.  Write three case study examples regarding how you might use the content of this section in your practice.

Update
Parental Experiences of Adolescent
Cancer-Related Pain: A Qualitative Study

Clews, C., Davis, C., Loades, M., & Jordan, A. (2022). Parental Experiences of Adolescent Cancer-Related Pain: A Qualitative Study. Journal of pediatric psychology, 47(9), 1071–1080.

Peer-Reviewed Journal Article References:
Compas, B. E., Jaser, S. S., Bettis, A. H., Watson, K. H., Gruhn, M. A., Dunbar, J. P., Williams, E., & Thigpen, J. C. (2017). Coping, emotion regulation, and psychopathology in childhood and adolescence: A meta-analysis and narrative review. Psychological Bulletin, 143(9), 939–991.

Egberts, M. R., Verkaik, D., Spuij, M., Mooren, T. T. M., van Baar, A. L., & Boelen, P. A. (2021). Child adjustment to parental cancer: A latent profile analysis. Health Psychology.

Katz, L. F., Fladeboe, K., Lavi, I., King, K., Kawamura, J., Friedman, D., Compas, B., Breiger, D., Lengua, L., Gurtovenko, K., & Stettler, N. (2018). Trajectories of marital, parent-child, and sibling conflict during pediatric cancer treatment. Health Psychology, 37(8), 736–745.

Soriano, E. C., Otto, A. K., Siegel, S. D., & Laurenceau, J.-P. (2017). Partner social constraints and early-stage breast cancer: Longitudinal associations with psychosexual adjustment. Journal of Family Psychology, 31(5), 574–583.

Yopp, J. M., Deal, A. M., Nakamura, Z. M., Park, E. M., Edwards, T., Wilson, D. R., Biesecker, B., & Rosenstein, D. L. (2019). Psychological and parental functioning of widowed fathers: The first two years. Journal of Family Psychology, 33(5), 565–574.

QUESTION 10
What are four techniques to help the spouse of a breast cancer patient share his feelings with his children? To select and enter your answer go to Test.


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