Seductive symbolism: Psychoanalysis in the context of oncology.

Abstract

Beliefs about what caused their cancer are a central facet of patients' experience of illness. These beliefs make up the patient's theory of etiology, which derives from various sources, including conscious and unconscious fantasy. This paper highlights this dimension of patients' experience, and the possible interaction between patients' psychogenic theories of etiology and their therapists' potentially generated psychogenic theories regarding patients' disease. It is suggested that a countertransferential pull for therapists exists to generate psychogenic theory regarding patients' cancer in the face of the threat of impotency it presents. This is discussed as a seductive pull into symbolism-based understanding of patients' cancer etiology-a pull this paper aims to characterize. It is suggested that the seductive pull results from the influence of psychoanalytic psychosomatic theory in the context of the dynamic between the ill patient and the therapist. Some psychoanalytic psychosomatic theory posits symbolism-based linear psychogenesis and the possible correction of soma via psyche in a great variety of illnesses and conditions, including cancer, and the hypothetical effect of this literature on the clinician's mindset and clinical work is considered. Specifically, it is suggested that this portion of our literature might serve a psychological function for clinicians, as it can help to shore up an omnipotence defense against the undertow of chaos inherent in cancer-related bodily dysfunction. More generally, it is argued that the context of existing psychoanalytic psychosomatic theory characterized by a focus on symbolism-based linear psychogenesis is potentially influential, and that this influence needs to be examined.

When Cancer Enters the Therapy Room: The Lived Experience of Psychodynamic Therapists Working with Clients with a Recent Diagnosis of Cancer

“…References to clients' reactions link to childhood experiences and how it re‐evokes traumas previously split off, although present in some cancer memoirs, has not been explored in research studies. Bergner (2011) draws attention to how therapists may feel a seductive pull into symbolism‐based understanding to balance their own feelings of impotency while working with cancer patients however this is not supported by the experiences shared in this study.…”

“…A study of the public, patients and oncologists showed over 60% believe psychological factors affect cause, progression and cure (Lemon et al, 2008). Beliefs about what caused their cancer are a central facet of patients' experience (Bergner, 2011, p. 268).…”

“…Despite this potential and these case studies, psychodynamic therapy for cancer patients is not the norm. Existential and cognitive approaches are typically utilised in the oncology setting, even though it is psychodynamic approaches that engage with the unconscious fantasy and dynamics in patient's cancer experience (Bergner, 2011). The reason for this is unclear.…”