But I Don’t Need a Psychologist!

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Status report:
I’m just over half way through radiotherapy. I’ve got 14 daily sessions to go. So far my skin has become a bit pink by the end of the week but there’s no burning, blistering or peeling. I am greatly relieved.

I’ve managed to overcome the impersonal nature of the treatment by learning the names of the various technicians and engaging them in brief conversation each day. We share tiny bits of information. Be become more human to each other.

I’m also unplugging their iPod full of hits from the 80’s and plugging in my own music. It’s the same meditative selection that I used through chemotherapy. It’s a way of making the treatment room temporarily mine.

I’ve become very good at keeping very still. It makes treatment go faster. I’ve even memorised the marks on the table where the foam leg rest should be and I move it there each time. It means that when I lay back into the body mould they’ve made for me I need very little adjustment. Adjustment involves people with cold hands manually moving you to line up with laser generated markers so minimising this is a good idea. I know to keep still, to pretend I am a bag of wet sand, and to let other people move me into position. Helping isn’t helping.

Meanwhile my body continues the long recovery process. My hair now looks like a deliberate choice rather than a medical aftermath. It’s much thicker too. My eyelashes are fully restored and my new eyebrows are so well shaped that I don’t need to pluck them any more. On the flip side there’s the return of the chin hair. My pubic hair is just ridiculous and I may shave it and use it to make a wide brimmed felted hat! My fingernails are just days away from growing out the chemo damage and the line in my biggest toenails that marks my treatment is slowly moving upwards.

The chemotherapy induced menopause is a bonus from my perspective. I was well past my child-bearing years when cancer struck. The hot flushes and night sweats have become less frequent and less severe. They’re a welcome alternative to menstruating. The predicted mood swings haven’t happened. If I cry it’s with good reason and I don’t cry often. I don’t churn negative emotions into negative behaviour. I use my words.

I’m still in considerable pain. I don’t think this is related to the radiation treatment. The peripheral neuropathy caused by chemotherapy has left me with painful hands and feet. It’s much worse in the morning when I can’t form a fist with either hand. Sometimes the pain wakes me at night. I’ve also got pain in my elbows which seems to be related. My right elbow is particularly bad and I’m using my left hand for anything weight bearing. My lower back is sore and I think this is related to the difficulties I have with my feet. I try to make a conscious effort to stand straight and walk well but I find myself hobbling like a caricature of an old lady. My trusty Birkenstocks make the back pain worse. Way back at the beginning of all this when they scanned me for other cancer I was told I had arthritis. At the time I laughed it off, given the significance of the cancer diagnosis. Now I wondering if any of this pain is arthritic.

In spite of all this my mood continues to be great. I’m almost at the end of treatment and looking forward to declaring myself well. I know I’ve still got six months or more of recovering from side effects but I’d much rather recover from side effects than be killed by cancer. Daily I prove that it is possible to be happy in spite of chronic pain, in fact, it’s possibly the best way to cope with it. I now know that happiness is not a random mood that descends upon me from nowhere only to vanish of it’s own accord.

The biggest lesson from the whole of my treatment is that I really can choose to be happy, and using a few simple strategies I can achieve happiness most of the time. I had learned about all of this prior to my cancer diagnosis but some part of me didn’t believe it. I dismissed it as just so much new age psycho-babble. I believe there are times when I may have actually said “Try telling someone with a cancer diagnosis to choose happiness and see how far that gets you.” Turns out I can choose to be happy. Even with cancer. Even with pain.

Recently my happiness took one giant step forward. In spite of my reservations about some of the content in Jacqueline Helyer’s relationship workshops, I am pleased to report that it did serve as the catalyst for improving my relationship with Graham. We are much more intimate. I have fallen in love again.

So why did this week see me spending an hour and a half with a psychologist?

Well firstly, it was free. The Radiation Oncology Institute where I’m having treatment has a psychologist on staff for all patients. Gratis. This is worth knowing if you’re due to start radiation treatment, or any other form of cancer treatment. Private facilities in particular are increasingly offering free or cheap psychological support for patients. Some public hospitals are also introducing in house psychologists. Where they’re not available on site, it’s often possible to get a referral to a psychologist and your GP can refer you if your specialist can’t. It’s my opinion that everyone can benefit from spending some time with a psychologist. Here’s why:

We all have different filters that we use around friends and family. We are careful about how much information we share and what emotions we choose to express. Yes, you’ll sometimes meet someone dealing with cancer that behaves like a spoilt three year old and demands that everything be about them, but most people continue to be considerate of those around them. You don’t need a filter with a psychologist. They’re a professional, impartial listener trained to help you get back in touch with how you’re really feeling, without pressure from anyone else.

Prior to spending time with Kerrie, the resident psychologist, I was fairly sure that I was travelling along pretty well. A visit with Kerrie confirmed this. This doesn’t mean it was a waste of time. It was possible that I’d walk into her office and fall in a heap, finally able to let my guard down. Checking in with someone professional can be hugely beneficial either way.

I’ve heard people say that a psychologist is a waste of time because they won’t tell you anything that you don’t already know. My response is that sometimes it’s really helpful to be reminded of what you know. Sometimes we forget. A good psychologist will also reassure you that what you’re feeling is normal, expected, human and appropriate. Sometimes, when we are feeling overwhelmed, this is reason enough to see one.

Psychologists spend a lot of time just feeding what you say back to you. “What I’m hearing is………….” “So if I could just summarise, it seems you’re saying………….” “You seem to be having some emotion around X. Would you like to tell me more about that?” It can initially feel very contrived but this technique is great for helping people think out loud. It also respects our ability to come up with our own answers if we’re given the time and the safety to do it. I like it very much for that.

Friends tend to give us well meaning advice. Sometimes this is a bit like you telling me you’re having trouble seeing and me handing you my spectacles. I’m sure they’ll help you. They certainly help me! Psychologists don’t ‘solve’ our problems for us the way friends do. They provide us with a confidential, safe environment that supports our growth, but at our own pace and in our own time.

Of course, not everyone has the ability to unravel their own problems and knit them into a new way of being, or to do it consistently. Psychologists can offer us tools to help us change. Whether it’s something as simple as taking a couple of deep breaths to calm down or something as complex as a diary to record and rewrite destructive internal dialogue, psychologists know some great, proven strategies for helping us to improve the quality of our lives. They don’t have prescription medications to ‘cure’ us because the work they deal with can involve time and commitment. Change is always fuelled by effort and growth is often preceded by pain. A good psychologist helps us to understand that, no matter where we are, we walked there with our own two feet and we’ll need to walk out of there the same way. Nobody is going to carry us.

Perhaps that’s the reason that so many people avoid seeing a psychologist; it’s likely that they’ll call us on our denial. It’s possible they’ll see through our self delusion. It’s likely they’ll hold a mirror to our obfuscation.  That’s precisely why we should see them. They can help us to break out of unproductive or unhappy patterns. They can shift us closer to happiness. It’s true that we may get there on our own but I think a psychologist can provide a short cut, or at least a road map.

What they won’t do is make you lay down on a couch and talk about you childhood, or your past trauma, or something acutely humiliating……..unless that’s what you need to talk about. This Hollywood stereotype of ‘therapists’ is possibly also responsible for frightening some people off.

It’s worth knowing that a psychologist is not the same thing as a life coach. ‘Life Coach’ is a relatively new term and there are no specific qualifications required. I could have cards printed tomorrow calling myself a ‘Life Coach’ (or a counsellor for that matter) but I could not call myself a clinical psychologist without a degree, supervised practical experience and professional registration.

If you’re wondering how they’re different to psychiatrists, the practical difference is that a psychologist can’t prescribe medication. The therapeutic methods are very similar. Psychiatrists have all trained initially as doctors and then chosen to specialise in psychiatry. A psychologist does a degree in psychology followed by practical training in counselling. They’re both good, although in my experience some psychiatrists seem far too enthusiastic about medication. While I have no doubt that antidepressants and other therapeutic drugs have saved the lives of some people with mental illness I also think that it’s sometimes a case of ‘If you like using a hammer then everything looks like a nail’.

As a result of an hour and a half with Kerrie I know that I’m travelling well. I am mostly, genuinely happy. I am appropriately emotional about the possibility of an early death, particularly if I contemplate my unborn grandchildren and the possibility of never knowing them, let alone sitting down to celebrate their 21st birthdays. I can easily get teary over the thought of my husband on his own, my daughter coping with babies without her Mum to help her, my Mum burying her daughter. This is just life. All of us have reason to be sad about the things that we will miss when we die. Cancer just puts these things in sharp focus.

And my early death is far from certain. It’s possible. That’s all.

In the mean time I’m going to be as happy as I can be for most of the time and appropriately sad when I need to be. Life is wonderful. Precious. Joyful.

I’ve made another appointment to see Kerrie when I finish radiation therapy. The end of treatment can be a difficult time for a lot of people and it’s possible I might need some help. Even if I don’t, I know that having the opportunity to check on my mental health is as important as any of the regular checks I make on my physical health.

I probably don’t need a psychologist. I’m going to see one anyway.

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