- By Barbara Okun, Ph.D., and Joseph Nowinski, Ph.D.April 4, 2012
- By Barbara Okun, Ph.D., and Joseph Nowinski, Ph.D.
A loved one's terminal diagnosis today does not necessarily imply impending death, as it might have 40 years ago. Instead, it marks the start of a slow process of decline and grieving that could stretch for years and ensnare not only the patient, but also his or her entire family. Almost all of us are destined to have this experience, if we have not already. We call the emotional aspects of the process “the new grief” in our book, Saying Goodbye: A Guide to Coping with a Loved One’s Terminal Illness, because it stands in sharp contrast to the feelings associated with the sudden death of a loved one.
Crisis and Early Memories
It has been our observation that a personal crisis, like a terminal illness in a loved one, often stirs up early memories, whether in the form of conscious recollections or dreams.
These early memories are important. Early relationships shape us. Our earliest memories of these relationships can hold key insights into our identity, our sense of who we are and how we fit into the scheme of things. Early memories also offer important insights into our place and role in our family. Understanding them can be the first step in taking charge of that role as you and those close to you move into the new grief.
Here is an example:
Marjorie’s parents divorced when she was 6. After that she and her younger brother spent roughly 80 percent of their time with their mother. Their father took a new job and lived three hours away. Marjorie did well in school and never had behavioral problems. However, she was also an anxious child, rather shy and insecure despite being pretty, smart and artistic.
Marjorie missed her father terribly when her parents first divorced. She would maintain her composure when he visited, but would break down as soon as his car disappeared around the corner when he left. On those nights she would often cry herself to sleep.
Shortly after Marjorie turned 20, her father called and told her that he had received a diagnosis of prostate cancer. The news shocked and upset Marjorie, but what surprised her even more was how in the following days she felt periods of intense depression followed by periods of equally intense anger.
Marjorie’s mood swings continued as her father began treatment for his cancer. She wanted to be supportive, but felt that the emotional roller coaster she was on could get in the way of that. Marjorie started seeing a counselor to try to figure out what was going on. In therapy she was asked about her early memories of her father. A few in particular that stuck out in her mind:
- An image of being in her father’s arms, being rocked on a rocking chair, her head on his shoulder.
- Reading at night before bed. Her father would lie beside her and go through their regular ritual in which he would ask her what book she wanted him to read.
- Going to a park and being pushed by her father on the swings.
Marjorie could not figure out the significance of any of these early memories. She had not thought about them for many years; but after learning of her father’s diagnosis, they popped into her consciousness. The therapist suggested a couple of ways in which the memories might be relevant. The memories suggested, for example, that Marjorie’s father had been a major source of comfort, probably starting when she was a toddler as he rocked her in his arms. Later, he read bedtime stories to her, which is also comforting to young children. He was a source of fun (taking her to the swings) as well as security (being able to stop the swing when she got anxious). She was special to him, and she basked in his love. Then, after the divorce, he was gone. Viewed from the perspective of this young girl, she had been not only loved, but also abandoned by her father.
As they discussed these memories, their significance became clear to both the therapist and Marjorie. Her self-confidence was often punctured by bouts of self-doubt and anxiety, and she felt that she tended to be unassertive and overly accommodating. She had long ago covered up the intense grief and anger associated with being abruptly left behind when her father moved away, but these emotions were now re-emerging. Eventually, with the support of her counselor, Marjorie was able to have a conversation with her father about her feelings. Their dialogue went on intermittently for a year as he underwent treatment and was ultimately declared in remission. During this time, Marjorie found herself becoming more assertive — she had finally found her voice. She was better at asserting what she wanted and what she did not want, changes she believed would serve her well in the years ahead.
Mining Your Memories
Beginning with the crisis stage of the new grief, it can be very helpful to take time to pause and reflect. It is not unusual for people to report vivid dreams and the emergence of long-repressed memories soon after learning that a family member has received a diagnosis of a terminal illness. Some of these memories may be uncomfortable. We may be tempted to ignore or even suppress them. But often the insights hidden in these early memories reveal themselves only when we share them. That sharing can be with trusted loved ones, or with a therapist. As Marjorie discovered, such dreams and memories can hold the keys to better understanding family relationships. They can point to unresolved issues. And they can hold clues to ways in which we may want to alter some of our relationships as well as the role we play in our family’s structure.
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