The Cancer Experience: Pastoral Considerations Chaplain Peter Jupin October 23, 2013

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1 The Cancer Experience: Pastoral Considerations Chaplain Peter Jupin October 23, 2013

2 Introduction Cancer cells seek immortality. (Siddhartha Mukherjee, The Emperor of All Maladies, 2010) Cancer : The defining plague of our generation Powerless, alienation, malaise, disconnection The Zombie Phenomenon: the walking dead Why Reality TV? Cancer is an awakening to self and to life.

3 Cancer as Paradox We are simultaneously living and dying. Good health is the slowest form of dying. We are simultaneously certain and uncertain about our future. We are simultaneously autonomous individuals and interdependent members of a family or community. We re born alone, we die alone.

4 Cancer as Metaphor Illness as Metaphor, Susan Sontag, Leprosy, venereal disease, cholera, TB, AIDS When I became a cancer patient, what particularly enraged me - and distracted me from my own terror and despair at my doctors gloomy prognosis was seeing how much the very reputation of this illness added to the suffering of those who had it. (p. 100)

5 Cancer as Metaphor... the most truthful way of regarding illness and the healthiest way of being ill is the one most purified, most resistant to metaphoric thinking. (Sontag, 1991, p.3) All illnesses are inseparable from the meanings ascribed to them within their specific cultural location. (Digiacomo, Metaphor As Illness: Postmodern Dilemmas in the Representation of the Body, Mind, and Disorder, 1992 and Stacey, Teratologies: A Cultural Study of Cancer, 1997)

6 Metaphors Cancer: Greek and Latin for crab, Greek karkinos War, battle, enemy Journey Punishment, curse Test Weakness God s will; Divine Providence

7 Cancer as Spiritual Crisis Crisis of Faith and Meaning Pain and Suffering Crisis of Hope Crisis of Purpose Crisis of Identity (Who am I?) Images of God (Who is God?)

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9 The Cancer Experience Positive / Adaptive Responses Negative Responses Anger, sadness, anxiety Cynicism, bitterness Despair, darkness May be adaptive as well, in limited doses Avoid The Tyranny of Positive Thinking

10 Anticipatory Grief (Therese A. Rando, Clinical Dimensions of Anticipatory Mourning, 2000) 1. Attaching v. Distancing 2. Rehearsal is not the real thing: Pre-death mourning is not the same in character or substance as post-death mourning. 3. Death is not the only loss being grieved.

11 Cancer as Loss Loss of autonomy and control Loss of illusion of certainty and control Loss of income, health, mobility, body parts, job/livelihood, family I ve lost my faith.

12 Cancer treatment can be traumatic. Shock, denial, numbing Heightened anxiety, arousal Hyper-vigilance, irritability Sleep or appetite disturbance Flashback, re-experiencing the trauma Avoidance Dissociation Helplessness, powerlessness

13 Pastoral Interventions What questions or spiritual concerns about cancer do you hear in your ministry? Helpful responses (from you or others)? Not so helpful responses?

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15 The Power of Prayer I m praying for you. You re in my prayers. I m praying for a miracle.

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17 The Power of Prayer Maybe the fact that we pray at all is itself the answer to prayer. Maybe the deepest desire of our hearts is simply to turn toward God, whether or not we ever hear an answer. Heather King, Shirt of Flame: A Year with St. Therese of Lisieux

18 Pastoral Considerations 1. How to manage and move beyond fear, anxiety, emotional distress How do I cope with these painful feelings? Affirm and move on! 2. Guilt and Forgiveness 3. Grief Resolution : Acknowledge the loss, actively mourn, envision (hope) a future. 4. How to identify and suggest healing metaphors and a new narrative 5. Need to identify a spiritual legacy 6. The battle is not against cancer; the battle is to live a good life.

19 Pastoral Considerations Here is what you don t know. What do you know? Here is what you can t control. What do you control? Everything has changed. What hasn t changed? Here is your uncertainty, your doubt, your anxiety. Where is your certainty? Who or what is your truth? Where is your comfort and peace?

20 Pastoral Considerations What is God calling you to do now? Who is God calling you to be now? What kind of a person do you want and need to be now? What are your gifts? Where is your heart? What spiritual resources are available and meaningful? Scripture, prayer, fellowship, liturgy, worship, sacraments, charitable activity, service

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