April 6, 2008
Hope: The Ultimate Energizer
Ernest H. Rosenbaum, MD and Isadora Rosenbaum, MA
Hope is not an abstract concept. It is a vital component of the will to live. As such, we need to understand its power as well as its mercurial nature. We need to develop strategies for cultivating it and for regaining it when we lose it - because we do lose it, often several times a day.
It is natural to lose and regain hope frequently because no one mood predominates in any of us, especially when we are dealing with cancer. We are variously despondent, exhilarated, troubled, optimistic - yet it is obviously only in a positive frame of mind that hope can work its magic. Hope can assuage fear. It propels us to laugh, to accomplish long-dormant tasks, to reach out to family and friends, to make plans for the future. Hope is energy.
Hope is also closely allied with belief. For example, doctors and medical researchers have long marveled at the mystery of the placebo effect wherein those in a control group are given a drug or treatment with no therapeutic value. Their subsequent improvement in health or imperviousness to pain is now thought to be mediated through the neurobiology of the brain - that is, when the brain anticipates relief, it releases endorphins, one of the body's natural painkillers.1
Sources of Hope
Most often, we can initiate a hopeful state of mind by taking action. We may find it when we seek knowledge about our medical condition by questioning our doctor. We may also find it by discussing our feelings with a family member or friend, by participating in a cancer support group, or simply by getting out of the house - going to a movie or a theater, or taking a walk. (How many of us have experienced a high from an unanticipated encounter, a chance remark, a moment of oneness with nature?) Others derive hope from religious or spiritual beliefs. But, again, because hope naturally waxes and wanes, we must fight to preserve it and continuously reseek it.
The Medical Team
Medical team members can be instrumental in engendering hope. But even though they are empathetic and experienced, it is helpful to them when people are able to communicate their worries and fears. It is important to ask them specific questions about your disease, your prognosis, and what to expect from medical procedures and therapies. Their attitude can make all the difference in the way any one of us approaches a medical problem.
I myself recently benefited from the support of my doctor following major surgery for esophageal cancer. For a few days I was devastated, but each time he came into my room, he announced: "You are on the pathway! Just hang in there! You're doing great! Things are going to be okay!" He was right.
Of course, the nature of our hope may vary according to our prognosis. If a cure is possible, we will naturally hope for that, and -if not a cure - then a remission, or a second remission. But even in the final stages of life, hope can play a role in our desire to see another day, to spend time with a loved one, to have a painless death.
Fellow Cancer Support Group Participants, Family Members, and Friends
The single, most valuable component of participation in a cancer support group is the opportunity to talk with others who have had - or are having - an experience similar to ours. They can help us understand the debilitating effects of fatigue or other side effects of therapy and reassure us that what we are experiencing is normal. Moreover, seeing that they have survived these tribulations encourages us to think that we can do so as well. For this reason, it is not unusual to see a person who is very upset walk into a support group meeting and later emerge feeling better. Such a person will probably wish to repeat the experience and may soon be in a position to offer hope to others. Hope is contagious.
Additionally, because dealing with cancer can cause stress in the best of relationships, group leaders often encourage people to bring a family member or a friend to their support sessions. In a responsibly-run group, there are no holds barred in terms of what participants can say or the grievances they can air. Such candor increases mutual understanding and lays the groundwork for future intimate conversations.
Hope for Tomorrow and Today
While researchers continue to study the biology of the placebo effect, we already know that the wellsprings of hope lie within each of us. We also understand that although it can be a daily struggle to harness and hold onto this healing force, we may just be surprised at our resilience.
1 To find out about current research on the placebo effect, see Dr. Jerome Groopman's recent book, The Anatomy of Hope: How People Prevail in the Face of Illness, Random House, New York, NY 2004.
Reprinted by Permission from CancerSupportiveCare