The need to cling

Today I had a session with a patient who suffering from breast cancer. It was our first meeting. She is under chemotherapy.

She told me sincerely: I tried to find a psychologist, I need to cling otherwise I lose myself. I am afraid I will disappear if I am not able to cling. My medical oncologist is busy. She is always busy, under press of business. Nurses are the same. My children are adults. I have to understand them. They do not know what I feel. My behaviour is normal. Too normal. I feel I am able to give her space and attention.

I use Szondi test frequently. The main result: the cancer patients under oncological treatment want to cling, to sit on the mother’s lap.


Psychoanalytical obeservations on the ward

I’ve heard on the radio: if somebody tells you something into your erars in a silent way, shout out standing on the roof. I think it is important task of experts to become an interpreter, share the important words, sentences of patients/relatives with others. If we do not do that, valuable, unique, beautiful words remain on the ward, locked into the patient. Cancer patients are in somatic and psychic crises frequently, they have to think, to arrange their thoughts, „to inventory”, but after all they sense. „The mind is the servant of emotion” – wrote Bion.

Patients talk about chemotherapeutical infusion in an emotional way. They sign up the written text about the potential side effects of infusion. But their real knowledge and attitude toward chemotherapy is emotional. They give names the test- tube rack  of infusion: my bride, my groom, my love. Patients want to be in relationship with us. You can heal, cure, recover only in relationship.
They give negative nick-names of infusion: poison, chemical, spray, or positive ones  as Bambi, Cola, coctail, badminton, breakfast, Manna, water of life, mothers’ milk.
Mothers’ milk…. I remember what told me a middle aged patient suffering from malignant lymphoma leaving my room: well, now I,m going to my mother. She will order me the following mothers’ milk! I was astonished. She discovered and understood one of the deepest meaning of this hospital situation, she knows what and how happens. She is the baby, the oncologist is the mother, the chemotherapeutical infusion is mothers’ milk. She teaches me what is important, what is helpful in hospital. How interesting, her oncologist told me once: all of my patients are my children. Their real ages has no importance in this respect. When a patient is teenager, you know, my son would be soon a teenager. When a patient is at the same age as me, or older … well, my son will be middle aged than old one day.”


Psychoanalytical observations

Yesterday I’ve decided myself to create a new topic. I would like to share my psychoanalytical observations, experiences in connection with my daily work at our Lymphoma Center in National Institut of Oncology in Budapest. I work as clinical psychologist, psychotherapist/psychoanalyst for 18 years here.
I feel I get a lot of important things, special “objects” from our patients, their relatives and collegues.
I began my work at 7.45 am. A patient came to begin our psychotherapeutical work after her psychodiagnostical examinations. She told me it is not enough for her to treat the body. When the target is the body it means that the only target is the “bad body-part”, the soul is splitted. I remember as Winnicott wrote: there is no infant. Mother and infant are the same, they are unseparable. I feel: there is no patient alone. Only patient, relatives and experts. We develop unconsciously a common body and soul because everybody influences everybody in a verbal and a nonverbal way. The question of borders between them is so complex.

After some years I continue to share some of my psychoanalytical observations gained my workplace at National Institute of Oncology in Budapest. In the last years I was very busy and had no enough energy to write about my experiences. I get a lot of kind messages from my visitors, so I began tor write again. “Ripeness is all.”


Alternative medicine – children

Alternative medicine common in children

In places as far apart as Wales and Australia, about half of the children seen at pediatric hospitals are using complementary and alternative medicine (CAM), investigators report.rnrnIn a second study, British researchers found that children with chronic diseases were three times more likely to use CAM than healthy children.rnrnIn both studies, reported in the Archives of Disease in Childhood, the researchers found that parents and their children were unlikely to discuss CAM use with their doctors.rnrnAlthough the number of people using complementary or alternative remedies has been increasing with time, there have been no studies of CAM use by youngsters, note Dr. Colin V. E. Powell, from University Hospital of Wales in Cardiff and his associates.rnrnTo find out more, the team interviewed approximately 500 children and their parents attending a major specialist hospital in Cardiff, Wales and in Melbourne, Australia.rnrnCAM was used by 41 percent of patients in Cardiff and 51 percent in Melbourne.rnrnPowell”s group observed that Cardiff patients were less likely to use specific medicinal CAM, such as vitamins and minerals, herbs, or naturopathy, as well as non-medicinal CAM, such as chiropractic and therapeutic massage.rnrnOnly about one third of patients or their parents reported CAM use to their doctors. “The poor communication highlights the importance of local policy development,” the authors say, to promote a dialogue about alternative medicine between patients and their health care providers.rnrnFor the second article, Dr. l. J. McCann from University College London and Dr. S. J. Newell from St. James”s University Hospital in Leeds interviewed parents of 25 children with cerebral palsy, 25 with inflammatory bowel disease, 25 with cancer, and 25 healthy “controls” regarding CAM use.rnrnThey found that children with chronic illnesses were significantly more likely to use CAM than their healthy counterparts — 40 percent versus 12 percent. The sick children were also more likely to use complementary medications (21 percent versus 4 percent) — primarily Echinacea, and herbal and Chinese remedies.rnrnThe investigators also observed that 55 percent of parents whose children were using CAM had not discussed the issue with their doctor.rnrnMcCann and Newell suggest that doctors gain a working knowledge of complementary and alternative medicine, so they can discuss it with their patients.rnrnEditorialist Dr. E. Ernst from the Universities of Exeter & Plymouth, UK, points out that although alternative therapy may be harmless, bad advise from a homeopath or naturopath, such as recommending against immunizations, “would almost inevitably cause serious harm.”rnrnErnst agrees that clinicians need up-to-date knowledge about which CAMs work, which do not and which may be harmful.rnrnSOURCE: Archives of Disease in Childhood, February 2006. rnrnrnrnrnrn’, ”, 2, ‘CAM use, children


General parctitioner and the cancer patient

When patients have cancer, they stop seeing me” – the role of the general practitioner in early follow-up of patients with cancer – a qualitative studyrnTor Anvik , Knut A Holtedahl and Hege Mikalsen rnrnBackgroundrnrnThe role of the general practitioner (GP) in cancer follow-up is poorly defined. We wanted to describe and analyse the role of the GP during initial follow-up of patients with recently treated cancer, from the perspective of patients, their relatives and their GPs.rnrnMethodsrnrnOne focus group interview with six GPs from the city of Bodo and individual interviews with 17 GPs from the city of Tromso in Northern Norway . Text analysis of the transcribed interviews and of free text comments in two questionnaires from ninety-one patients with cancer diagnosed between October 1999 and September 2000 and their relatives from Tromso.rnrnResultsrnrnThe role of the GP in follow-up of patients with recently treated cancer is discussed under five main headings: patient involvement, treating the cancer and treating the patient, time and accessibility, limits to competence, and the GP and the hospital should work together.rnrnConclusionsrnrnThe GP has a place in the follow-up of many patients with cancer, also in the inital phase after treatment. Patients trust their GP to provide competent care, especially when they have more complex health care needs on top of their cancer. GPs agree to take a more prominent role for cancer patients, provided there is good access to specialist advice. Plans for follow-up of individual patients could in many cases improve care and cooperation. Such plans could be made preferably before discharge from in-patient care by a team consisting of the patient, a carer, a hospital specialist and a general practitioner. Patients and GPs call on hospital doctors to initiate such collaboration. rnrnrn rnrn——————————————————————————–rn rnTerms and Conditions Privacy statement Information for advertisers Contact us rn© 1999-2006 BioMed Central Ltd unless otherwise stated rn’, ”, 2, ‘general practitoner as oncological team member


social relationships – cancer patients

Effects of psychosocial treatment in prolonging cancer survival may be mediated by neuroimmune pathways.

Spiegel D, Sephton SE, Terr AI, Stites DP.rnrnDepartment of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, California 94305-5544, USA.rnrnResearch has provided growing evidence of links between the social environment and cancer progression. Indeed, social support in the form of marriage, frequent daily contact with others, and the presence of a confidant may all have protective value against cancer progression. Furthermore, retrospective data suggest that major stressful life events are more prevalent in patients with relapse or malignancy, and thus may contribute to cancer morbidity. Initial studies of the effects of psychosocial intervention with cancer patients have provided some promising results. In three randomized prospective trials, protective effects of psychosocial interventions on cancer progression have been confirmed, while one matching and one randomized study showed no survival effect after psychosocial treatment. Though more research is clearly needed in this area, this body of evidence suggests that psychosocial factors have potentially powerful modulating effects on the course of disease. Here we review evidence of one possible mechanism whereby psychosocial factors may influence disease-resistance capabilities: the neuroimmune connection. Suppressive effects of stress on immune function are well documented, and these effects have been shown to be modulated by social support. Thus, it is reasonable to hypothesize that supportive social relationships may buffer the effects of cancer-related stress on immunity, and thereby facilitate the recovery of immune mechanisms that may be important for cancer resistance. Data addressing this hypothesis are reviewed. ‘, ”, 2, ‘angol nyelv? tudományos hír