THE TYRANNY OF POSITIVE THINKING (continued)

For many years, whenever I spoke to groups of patients and their families about cancer and the mind, I would cite all the research data suggesting that we couldn't attribute cancer survival totally to personality or positive attitudes. Invariably, someone would come up to me after the talk and say, "Dr. Holland, I heard what you said about the research, and I respect your opinion. But, I don't care about what the research says. I believe in the mind-body connection, and I know I survived because of my attitude." I began to realize that people have strong ideas about these issues that aren't based as much on facts as on deeply held beliefs.

I have come to view beliefs about the mind-body-cancer connection as being similar to beliefs about religion. People who truly believe don't need (or look for) scientific proof of the connection. People who don't believe are equally adamant on the "no connection" side. I have learned from experience that trying to influence strongly held beliefs is exhausting and, more important, successful only once in a blue moon. You believe or you don't. "At probably matters most in the long run is that your view is consoling and comforting to you. We have a strong obligation to insist that families and medical staff respect each person's beliefs about cancer. People who have cancer should be supported, irrespective of their views, and without fear of criticism or ridicule from those around them.

Clearly, there is a broad spectrum of beliefs regarding the role of the mind and emotions in cancer. Some people believe that emotions are the key factor and that cancer is caused-and, therefore, can be controlled-by the proper emotional makeup and response. Others discard that idea as unscientific and untenable by current scientific standards. Others sit in the middle, believing that how we respond to cancer certainly affects the quality of our lives--and might have an impact on survival.

If you do hold a belief in a mind-body-cancer connection, it is important that you understand that your doctor may not share your view. However, most doctors today are willing to disagree respectfully and do not discourage complementary mind-body therapies that are potentially helpful and not harmful. (A complementary therapy is used in addition to, rather than instead of, standard medical treatment; see Chapter 10.) Most physicians today win say something like this: "I'm not aware of the proof for that. But I encourage you to do anything and everything that helps you feel better, so long as it doesn't interfere with your medical treatment."

Occasionally, a physician might completely discourage you from pursuing a therapy you believe is helping you. It is important to resolve the conflict with your doctor as best you can through open discussion. Even if your doctor does not agree with the approach you've embraced, it is important to be honest about it. For example, if a diet or nutritional regimen you've embarked on has caused you to lose a lot of weight, tell your doctor, because it could interfere with your medical treatment. Most diets suggested today are not extreme, but any that limit protein and calories can reduce your body's ability to tolerate chemotherapy.

Researchers in Toronto, Drs. Brian Doan and Ross Gray, suggest that at one extreme of a continuum of beliefs about the mind and cancer are the persons who see cancer as the enemy and see themselves as the warrior on the white horse who must fight the proverbial dragon, in this case, cancer, like St. George. These are the folks who confidently say, "I'm going to beat this." British researchers Drs. Steven Greer and Maggie Watson, at the Royal Marsden Cancer Institute, called this the "fighting spirit," which ensures that a person uses a head-on, direct approach to dealing with cancer. We know that this is a good way to cope. This active stance is carried a step further in a complementary cancer therapy in which one visualizes the immune system fighting cancer. This approach was developed by Dr. 0. Carl Simonton and Stephanie Simonton and popularized in their book Getting Well Again.

The Simonton approach encourages patients to visualize their healthy cells fighting the cancer cells. This method is appropriate and satisfying for many people with the fighting spirit. Patients with this personality type derive considerable comfort from visual imagery, relaxation exercises, and hypnosis. These are also people who confront their problems head-on when well, and they are likely to collaborate vigorously in their treatments when ill.

However, this approach is not for everyone. Many people tend to face a difficult situation by using an outwardly "nonfighting," stoic stance. They may view the role of the mind as less central in the treatment of cancer, except as it involves commitment to the medical treatment. In the past several years, these individuals have often been made to feel that they are failing because they cannot create a warriorlike fighting stance. They may be criticized by relatives for 66 not trying hard enough." Many people with cancer come to see me or other therapists for help with depressed feelings precisely because they don't fit today's popular model for coping with cancer. They assume that it must be their fault that they're out of step, that there must be something wrong with them. So they come to see me in the hope of getting fixed up and altered into a "healthy, normal" coper. Instead, they're often surprised to discover that I validate their feelings and their own natural way of coping. I learned early on that when a person is in the middle of a crisis related to illness, it is not the time to try to change his or her way of coping. When you are in the "trenches" of cancer treatment, it is best for you to call on the resources you already have. Immediate support is important in the crisis. Helping you find more appropriate and more effective ways to cope can come later (see Chapter 6).

If you wake up every morning and exclaim, "I'm going to beat this thing!" and you practice your imagery exercises, which help you feel powerful "in the face of this tough disease, I would never discourage you from following this "combat-style" approach to your cancer.