Comments on: Ask Richard: Needing Secular Counseling After a Mastectomy

By: Richard Wade

Richard Wade — Wed, 15 Jul 2009 09:22:40 +0000

Beth,
Oops. Yes, I was responding to CatBallou. I have fixed that in my comment above. Your comment did not sound hostile at all, nor do Catballou’s. I value people’s feedback and their opinions. They often persuade me to think differently, especially when they are offered in a positive spirit.

By: Andrew Skegg

Andrew Skegg — Wed, 15 Jul 2009 04:23:27 +0000

I must say that I would not have been so forgiving. If the “patient advocate” cannot respect your beliefs, then why should you respect theirs? Tell them to take their silly superstitious garbage with them as they leave the room. I guess no one is more anti-smoking than an ex-smoker?

By: Beth

Beth — Wed, 15 Jul 2009 03:50:59 +0000

Richard,

I wanted to say thanks for your appreciation of my feedback in your first response. I hope it did not come off as hostile; it wasn’t meant that way.

Your second response, however, I think was meant to be addressed to CatBallou.

By: Robert

Robert — Wed, 15 Jul 2009 00:48:38 +0000

Richard, I want to say I was touched by your very thoughtful reply and advice. You took a good deal of time and covered all the issues in a very clear and even handed way. I was impressed. Well done. I suspect you have more empathy in your little finger than I have in my whole body!! Robert.

By: CybrgnX

CybrgnX — Tue, 14 Jul 2009 22:57:24 +0000

Although I was raised VERY catholic and LOVED my catholic Mom a lot. I have no patience with them. Praying is a cope out of a cope-out. They can’t help so we can continue wasting our time not helping even more!! Just asking how they can help in any small way is better then praying!!!

If some fool tried to pray for me, I would tell them that they can pray only if their prayers will return my ‘whatever’ to full health or they can say the lords prayer for me after they have shoved their head up their ass first!!!!
Of course it would be said with polite respect with a smile .

By: Richard Wade

Richard Wade — Tue, 14 Jul 2009 21:27:38 +0000

CatBallou, at this point I can only shrug my shoulders. I said “most” because that is the truth of my own experience. Most of the women whom I have counseled about this and similar issues were faced with those challenges, and most of the women who were counseled by my colleagues were too. There are exceptions, and I hope that e-patient is one of them, but I’ll risk saying the unnecessary warning over ignoring the elephant in the room, which is the most common mistake. Saying what might be a complication does not make it become real in the person if it is not in them to begin with, and not saying it does not make it go away if it is indeed, there.

I take your view with great import, however, and I agree that asking open-ended questions like “How do you feel about this?” is preferable to listing feelings to which the person might say yes or no. This is not a therapy session however, this is a discussion about therapy. If, for the sake of encouraging her to follow through, and others to take her first step, I have been too blunt or insensitive to e-patient, then I apologize to her. Only she can know her feelings.

I view people as much more than insoluble, sovereign individuals. They are also very much the ongoing process and product of all their relationships, especially those with their loved ones. People are not like pebbles, with no way in. They are more like sponges that soak up much of whatever is in those with whom they live. I have seen too many individuals keep their therapy private, and then go right back to their old behaviors and self images because they are living with others who, not understanding their interconnectedness and having no other model to go by, keep responding in the old ways.

If you write in with a question of your own, I will be honored, and I will respond to you with my most circumspect and sensitive effort.

By: CatBallou

CatBallou — Tue, 14 Jul 2009 20:19:09 +0000

I appreciate your response, Richard, but I still don’t agree with you. You didn’t say “some women experience some of these problems,” you said “for most women, it is an assault on [list].”
I recognize that you’re the counselor, but from personal experience, when I have a crisis or problem of some sort and people project their imagined responses onto me, it is not helpful. If I tell someone about a problem and that person says “Wow, you must be devastated” (or lonely, miserable, etc.), or “I’d be scared” (etc.), it makes me rethink my own reactions and wonder whether I’m failing to recognize the severity of my problem. I still think it’s better to let the person describe their own responses, rather than listing possibilities or “normal” responses.
And although you may be addressing a wider audience, this woman was asking a very specific question about counseling resources, not about coping with a mastectomy.
Now when I write in with a question, I’m going to have to change my alias!

By: Richard Wade

Richard Wade — Tue, 14 Jul 2009 18:20:59 +0000

Beth,
You are right that a combination of couple’s sessions and individual sessions would be the best, and that would even include individual sessions for the husband. I should have made that clear. I say that it is essential for the husband to be involved because e-patient spends far more time with him than her therapist, and even though she might make excellent changes within herself, her communication patterns with her husband might not automatically improve without guidance and encouragement. A newly healing individual living in a family system that still operates in old patterns will have a difficult time maintaining her progress.

Portland ME Skept,
You can find a bit about me on the “About the Contributors” button at the top of the page, just above Hemant’s handsome face, or you can click here. Thank you for your input and encouragement. I consider very seriously what people share in their comments.

By: Erp

Erp — Tue, 14 Jul 2009 15:33:04 +0000

Aside from the counseling advice, I would report the experience with the patient advocate back to the hospital. Their job is to help the patient not hurt them. If they are barging in on a conversation between a patient and family or offering prayer (especially to patients who have not described themselves as Christian and not straight off the bat even for those), that implies insufficient or bad training.

Doing a quick google search seems to indicate that the term ‘patient advocate’ covers a wide range of roles. However, I could not find a code of ethics for the type you seem to have encountered. In fact for some it might almost be an end run around a chaplaincy program (and hospital chaplains generally subscribe to a code of ethics that prohibits offering prayers to ‘nones’).

By: Portland ME Skept

Portland ME Skept — Tue, 14 Jul 2009 14:59:22 +0000

Richard,

I had the same response as CatBallou to the litany of possible responses to a mastectomy, and I hope you’re right that e-patient is not bothered by it. I’m not a woman, but I cringed a little when I read it.

That having been said, I enjoyed your article. I couldn’t find a platitude in the whole thing.

I can’t find more information on you. Can you post a link so we can see more about your background? You seem well-informed on a number of varying issues.

And to e-patient: I admire your generosity in dealing with the patient advocate. Thanks for opening up about your own battles.