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Surviving the psychological strain of serious illness

by Ross Gray PhD, now retired

Psychological challenges accompanying major physical Illness

I spent more than 20 years as a psychologist at a Toronto teaching hospital, working with clients struggling with serious physical illness. While people came to me to discuss a wide variety of problems, in this article I want to focus on the most commonly appearing problems … and what helps to cope.

1.Fear of the future: Ill people get caught up in cycles of hoping for things to go well and fearing that they won’t. There are worries about test results, treatment effectiveness, possible recurrence or worsening of disease, dying, and losing family and friends. Skills to release from the terrorizing effects of this fear are a great help. Practicing activities that you find relaxing, such as yoga or exercise, or participating in relaxation and meditation programs can make a big difference.

2.Dealing with the intensity of feeling: Ill people and their caregivers often go through months of strong emotional reaction and sleep problems following the diagnosis of a serious illness. It can feel like you’re going crazy, even though it’s a normal reaction to difficult circumstances. Talking with other people who’ve had similar experiences can help. Group programs and peer counseling provide vehicles for such sharing.

3.The tyranny of positive thinking
: Ever get tired of people telling you that you need to have a positive attitude? Over many years of working with ill people I’ve never met one who could manage to be positive all the time. Nor would it be helpful even if it were possible. There are times for being positive, times for looking at difficult realities, times for joy, times for sadness. In a world often resistant to the acknowledgement of suffering, it is important to identify for yourself a safe environment to explore how things really are.

4. Isolation and loneliness: Dealing with illness is lonely business, even for those who have staunch friends and loving families. They can’t fully understand what you’re going through. Nor do they really want to hear all those difficult thoughts and feelings because it’s upsetting to them. Similarly, it can be lonely to be a caregiver, absorbed with the needs of your loved one and less able to do what you need for yourself. Contact with others who know what it’s like can be a primary healing opportunity.

5.Loss of identity: A woman who always took the lead in child care doesn’t have the energy to do it any longer and is drowning in guilt. A man who had an active sex life with his partner has lost interest because of the impact of treatment and feels like a failure. Our usual ways of being in the world get compromised or destroyed by illness, and it is no easy task to roll with the punches. Deciding to engage in programs that foster personal growth (like music, art, writing, or exercise) is a healthy sign of a person’s willingness to make changes that need to be made.

6.Caring for the self: Many people have never seen it as a priority to take care of themselves. They push their bodies like machines, always serving productivity regardless of the cost on their health. Or they always put the needs of others ahead of their own. Illness forces a new look. If you don’t take care of yourself now, who will?

7.Exhaustion of body and mind: Illness and treatment can be grueling and break down even the most resilient people over time. When you feel that possibility of collapse and depression, don’t hesitate to reach out. Psychotherapy can be very useful, as can activities that help rejuvenate tired and worn out bodies.

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For someone who is ill or is caring for an ill person, it can be difficult to get to a counsellor's office. For information about IM and video counselling, see

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Copyright © 2007 Mike Mares. All rights reserved. The copyright of contributions belongs to the contributors, and all other material is the property of Mike Mares