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In Defense of Sadness
Karen Ritchie, MD

Those who have cancer are expected to be positive. Positive thinking has become the standard, and those who do not, or cannot, think positive thoughts often feel guilty for not measuring up.

But a diagnosis of cancer is a sad event. The disease brings loss, even for those who are cured. People who have cancer lose parts of the body. The cancer or its treatment may make them ill. They lose not only their health, but also a sense of well-being and security about the future. Some even find that former friends disappear, unable themselves to face the losses.

Those who pretend to others and to themselves that everything is fine do so at a cost. False cheerfulness takes energy, at a time when they may have little to spare. Emotional dishonesty keeps others at a distance.

We live in a culture that does not acknowledge sadness as part of life, that considers it evidence of weakness or moral failing. Sadness is unwelcome, a social barrier that makes others uncomfortable. When people with cancer pretend to be cheerful they may make it easier on their family and friends, and health professionals, by not requiring them to face their own grief.

Sadness is not depression. Major depression can take the form of despair, a bleak outlook that colors everything. It can be obsessive rumination, paralyzing guilt, or an inability to face the day and accomplish what needs to be done. Depression is a legitimate disorder that deserves to be treated.

But sadness is part of living. We are sad because life does not match our dreams, because we lose what we love and we lose what we need, because others let us down. Because our own bodies let us down.

People with cancer usually try to return to the person they once were, but most will be changed in some way. Those who allow themselves to be sad can recognize the losses and grieve for them. When they can admit that the old life and the old self are gone and find the strength to let them go they can create a new self to respond to the new situation. Some gain a new perspective. They may see life differently than they saw it before.

Those who want to be supportive of someone with cancer can do so by allowing them to be real, to feel what they feel. Those with cancer need someone to cry with, someone who is comfortable with the sadness. When they can count the losses they can grieve for what is gone and can move on to the next chapter of their lives.

from the book Angels and Bolters: Women's Cancer Scripts
Copyright © 2000 Karen Ritchie M.D.

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