Sunday, July 27, 2014

Breast Symbolism, Breast Cancer and Psychological Impact

In 2004 prominent psychoanalyst, Joyce McDougall, described how the mutilating breast cancer treatments women are subjected to, invariably arouse considerable psychological distress that can include the loss of the feeling of bodily integrity, disturbance in self-image and the sense of subjective identity, as well as changes in feelings of sexual identity. “With the loss of the breast, the essential symbol of femininity is felt to be destroyed,” McDougall wrote. (See McDougall, J. (2004), The Psychoanalytic Voyage of a Breast Cancer Patient in The Annals of Psychoanalysis: Psychoanalysis and Women, 32:9-28, Hillsdale, NJ, The Analytic Press.)

Due to the current lack of scientific knowledge about effective ways to both prevent and treat cancer, without putting patients through poisonous and assaulting treatments, a cancer diagnosis of any type has the potential to trigger a myriad of emotions and complex psychological trauma. Because the female breast is so symbolic and laden with conscious and unconscious meaning, it is especially important when thinking about breast cancer to consider what may be going on in patients', family members' and medical providers' minds.  Breasts universally symbolize femininity, nurture, sexual maturity and fertility. The idea of a toxic presence in the breast shakes the idea of life-giving sustenance right to its core.  In many cultures, the female breast is a defining characteristic of female attractiveness and sexual desirability, so when a woman is faced with losing a breast, she will often feel threatened and challenged in many different ways, in addition to having to cope with the idea of having a life-threatening disease.

It is particularly crucial for medical providers to be aware of not just how their patients are being physically and emotionally impacted, but also how they, themselves, are being affected. Medical providers need to be trained to be sensitive to their own emotional reactions and conflicts; they are in the unenviable position of having to offer and impose harsh and sickening treatments that permanently alter their patients physiology as well as external appearance. When physicians lack emotional self-awareness, they are at increased risk of causing unnecessary harm either to patients or to themselves. With patients, they may push for treatments that statistically only reduce the chances of cancer recurrence by a very small percentage, or they may fail to adequately inform patients about the extent of various treatment side effects, i.e. what life will likely be like, both while going through treatment and maybe for years afterward. With themselves, physicians may slide into problematic coping mechanisms such as alcohol abuse, gambling addictions, or abusive behavior directed at medical subordinates or their own family members.

Psychotherapists working with women who are being treated for breast cancer or who have undergone treatment in the past, also need to tune in to what psychological conflicts, emotions, attitudes and trauma are being activated in their own minds as they listen to their patients.  The more effectively the therapist does this, the more she will be able to help her client access her own unfelt emotional trauma, with the aim of containing it and working it through.

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