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Section 1
Cancer Diagnosis Reactions (Part 1)

Question 1 | Test | Table of Contents | Introduction

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In this section, we will begin to discuss eleven common reactions that family members or loved ones have to the news that their loved one has cancer.  This section will cover the first three common reactions.  The first three common reactions that we will discuss are shock, anger, and fear.  As you listen to this section, consider your client.  Does someone he or she care for someone who has cancer?  What was the client’s reaction when they heard the new?  Could the techniques in this section benefit your client?

11 Common Family Member Reactions (#1 - #3)

♦ Reaction # 1 - Shock
First, let’s discuss shock.  Ned, age 42, described the impact of his wife’s cancer as an electric shock to his system.  Ned stated, "I just don’t understand how it can happen!  Theresa takes such good care of herself!"  As you know, upon the discovery of cancer some clients, like Ned, feel stunned or frozen as though they cannot move.  I found that the news of his wife’s cancer violated Ned’s beliefs of how the world is supposed to work.  Ned stated, "It’s just not fair.  It’s not right." 

♦ Reaction # 2 - Anger
In addition to shock, has your client experienced anger as a reaction to the diagnosis of a loved ones cancer?  In some cases, the anger may have existed prior to the diagnosis of cancer.  Even if the cause of that anger seems trivial compared to cancer, the anger may not disappear. 

Ned stated, "I’ve been fighting with Theresa over finances for two years.  Now she has cancer, but I can’t just forget how she acted before.  I’m still furious!"  How might you have responded to Ned?  I stated, "Acknowledging anger is good and has positive benefits.  Now that you know you are angry, you can use it as fuel to solve problems, to become assertive, and to get your needs met.  Ignoring your anger, however, can be non productive.  It’s like burying a volcano and hoping it won’t explode." 

Think of your Ned.  How might you help your client understand that anger is not bad, but the behavior accompanying it is often unacceptable?  What cognitive interventions might you implement to help your Ned?  START

♦ Technique:  Rational Emotive Therapy
I used Rational Emotive Therapy in order to help Ned become aware of his anger.  As you may know, Rational Emotive Therapy focuses on disputing irrational thoughts about a situation and replacing them with rational ones.  Rational Emotive Therapy requires thought before action in anger situations. 

1. To practice, I asked Ned to write down a recent example of something which caused him to display negative anger.  As you know, this example was Ned’s activating experience.  Ned wrote his activating experience as his and Theresa’s disagreements regarding finances. 
2. Second, I suggested Ned write his beliefs about the experience.  For example, Ned wrote that Theresa had no right to criticize him for his spending when he makes most of the money.  Ned stated, "I feel like crap writing this stuff.  She’s got cancer for crying out loud."  I stated, "That’s why we want to help you get rid of that anger." 
3. Third, I asked Ned to write down the consequences of taking action on those beliefs.  Ned easily saw how his passive aggressive approach to Theresa’s criticism prohibited any positive communication. 
4. The fourth step in the rational emotive therapy process, as you kow, is to have the client dispute their own belief.  Based on the negative consequences of Ned’s proposed action, it was easy for him to see the fallacy in his belief that Theresa had no right to criticize him. 
5. I asked Ned to write a second set of beliefs that may reflect positive consequences.  When he finished, Ned felt like he was able to face Theresa to discuss their issues.  In a later session, Ned stated, "It’s good to put that anger behind me.  Now I can focus on helping Theresa feel better." 

Think of your client.  Could Rational Emotive Therapy benefit your Ned regarding his loved one with cancer?

♦ Reaction # 3 - Fear
A third common reaction to the news of cancer is fear.  For example, even though Theresa had a relatively good prognosis, Ned worried about her survival.  Ned stated, "It’s scary.  And I’m not only facing her mortality, but my own as well.  Other times I feel as if my life were a car swerving in the rain, always about to collide with oncoming traffic.  My heart stops, I readjust, not quite sure what’s going to happen.  Sometimes I panic." 

I responded to Ned by stating, "It is natural to be afraid of the unknown.  The only thing that is certain is that a complex illness has struck and no one can predict the outcome.  This crisis would spark fear in almost everyone."

In this section, we began to discuss other common reactions that family members or loved ones have to the news that their loved one has cancer.  This section, covered the first three common reactions.  The first three common reactions that we discussed are shock, anger, and fear. 

In the next section, we will continue to discuss insurmountable burdens, loss of control, grief and guilt. 
Reviewed 2023

Peer-Reviewed Journal Article References:
Arch, J. J., Mitchell, J. L., Genung, S. R., Judd, C. M., Andorsky, D. J., Bricker, J. B., & Stanton, A. L. (2021). Randomized trial of acceptance and commitment therapy for anxious cancer survivors in community clinics: Outcomes and moderators. Journal of Consulting and Clinical Psychology, 89(4), 327–340.

Cervantes Camacho, V., Mancini, T., Zaccaria, C., & Fruggeri, L. (2020). Testing the use of the System for Observing Family Therapy Alliances (SOFTA) in audio-recorded therapeutic sessions. Couple and Family Psychology: Research and Practice, 9(2), 90–99.

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.

Dunn, M. J., Rodriguez, E. M., Barnwell, A. S., Grossenbacher, J. C., Vannatta, K., Gerhardt, C. A., & Compas, B. E. (2012). Posttraumatic stress symptoms in parents of children with cancer within six months of diagnosis.Health Psychology, 31(2), 176–185.

Infurna, F. J., Gerstorf, D., & Ram, N. (2013). The nature and correlates of change in depressive symptoms with cancer diagnosis: Reaction and adaptation. Psychology and Aging, 28(2), 386–401. 

Sohl, S. J., Levine, B., Case, L. D., Danhauer, S. C., & Avis, N. E. (2014). Trajectories of illness intrusiveness domains following a diagnosis of breast cancer. Health Psychology, 33(3), 232–241.

QUESTION 1
What are three common reactions your client may experience when learning that a loved one has cancer? To select and enter your answer go to Test.

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