Ten years this month -- long

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Ten years this month -- long

Postby larryb » Thu Dec 07, 2017 8:12 am

A trauma therapist’s experience

In December 2007, my primary care physician noticed something on my back and sent me to his favorite dermatologist. As they say, “the rest is history”.

I am not sure why she said it but the dermatologist told me that there was a fifty-fifty chance that I would be dead in ten years. So began my journey with melanoma that continues to impact my life every day. Fortunately, there has been “no evidence of disease” and I am told that I am doing okay.

What followed was an SNLP, multiple scans and appointments, face peelings, etc. some of which I now know were likely not helpful and appropriate.

I am sure that my experiences are not all that different than yours…. the terror, anxiety, depression and everything else….. except for one thing.

I am a Ph.D. level psychotherapist and since 1978 have exclusively treated victims of combat exposure, crime, disaster and chronic illness. I have responded to terrorism, natural and manmade disasters in the US and elsewhere. There is quite a bit of irony there that I can only now begin to appreciate it.

I have been an active consumer of the support and information on this forum. I have found Catherine’s medical and psychological advice helpful and on target. But I have never been able to fully participate for reasons that any trauma therapist knows…. Avoidance seems more comfortable at least in the short run.

So, “in honor” of my ten years figuring out how to life with this, I decided to share with you what I have learned in hopes that it might be of help but knowing that it will probably help me more. Here goes.

Trauma is trauma. I say this to my patients all the time. A life-threatening experience is a life threatening experience and no one escapes unscathed or the same as they were before. Knowing that these changes are inevitable and can be managed is really important. One of the biggest lessons of my forty-year career in trauma has been that people will survive the very worst that humankind and nature has to offer or even imagine. Being told you might die is traumatic and changed everything for me.

The emotional impact of trauma is wide ranging and dramatic. I felt fear, hopelessness, crazy, depressed, immobile, numb and everything else. Sometimes, I felt them every few minutes, every hour or day. Often, I could think about nothing else and it was hard to focus on my work and family. I may have planned my funeral a few times. Trauma also can impact the way we relate others. There is a concept in trauma theory, “centrality of self” which just means people in life threatening situations are more worried about themselves than others and bad things can happen to relationships. A great partner made all the difference for me. She was there through all my ups and downs and did not waiver. All these feelings and reactions are normal.

Avoidance is normal too. I remember in the beginning I had to get help to research treatment options and outcomes. I could just not face it. I mentioned that I could not participate in this forum. Yet I was always reading about your experiences and could not stay away. Avoidance is our brain’s way of making sure we are not totally overwhelmed. It can get in the way but must be appreciated as adaptive as well.

Trauma changes “everything”. I was not ready for the changes in my life even though I should have known (avoidance?), I tell people that every day. My priorities changed, my relationships changed and I set a whole new course for my life. Trauma makes our lives look different and we respond accordingly.

“It’s not all bad.” In the past ten years, traumatology has embraced what is called, Post Trauma Growth”, the idea that almost universally trauma survivors feel as if their lives are improved and they are better off emotionally, spiritually and in their relationships. So the trick is to see the changes as opportunities, not losses, obviously not easy. In my case, I had wanted to be closer to the SC coast, travel less and not be the boss. Five years ago, we sold our mental health practice and moved here to the beach. In June I began seeing patients just four days a month. I can’t see how this would have happened without melanoma in my life.

Management is possible, there is no “cure”. Trauma is not a disease, the symptoms or feelings can only be understood and managed. It is possible to make good and bad decisions when faced with your own mortality. The idea is to make more good choices and avoid the catastrophic ones. I have seen way too many survivors run toward self-destruction and sometime succeed. It is very sad to heap the consequences of bad decisions on top of what is already a horrible situation.

“It is never over, not really.” Yes, I am less fearful on a daily basis. My emotions are more my own. But I am the most “covered up” fisherman and I still get anxious when I have derm appointments. I think about my life and mortality in a much different way and see how fragile everything really is. On anniversaries, like this month, I relive my experiences, the feelings and what happened. I know that while there may no evidence of the disease of melanoma, the lasting emotional impact is permanent and there will still be hard times.

And I guess I have to mention that it is okay to get some counseling. Just make sure you are really picky and the therapist has a lot of trauma experience and knowledge. Ask a lot of questions and don’t hesitate to move on if you get a bad feeling.

So my life is good. I owe much to my wife, family, friends, collegues and even the dermatologist who unnecessarily scared me so badly. And thanks to Catherine and all of you for the information and emotional support you never even thought you gave.

Onward to the next ten years …… hopefully.
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Re: Ten years this month -- long

Postby Catherine Poole » Fri Dec 08, 2017 8:26 am

Thank you for posting! I absolutely agree and I have found growth and strength after a terrible three years of caregiving a young and vibrant husband with Lewy Body Dementia. I agree. Also, I always think folks should know that being scared, crying, etc are all normal. Let it out! When I had my melanoma diagnosis I knew I had to help others face the anxiety and other feelings that happen. This might make a good blog...email me.
Catherine M. Poole, President/Founder
Melanoma International Foundation
Catherine Poole
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Re: Ten years this month -- long

Postby point30 » Fri Dec 08, 2017 11:16 am

Thank you for posting Larry.
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Re: Ten years this month -- long

Postby JennyMK0908 » Mon Dec 11, 2017 2:58 pm

Thank you for posting!

It's stories like yours that give me hope! I was diagnosed with stage 1A melanoma just 4 short months ago. Every day is a struggle. The diagnosis and all it entails fills my thoughts from the time I open my eyes in the morning, until the time my eyes close at night. I have sought help from a behavioral therapist. Although we have only met 4 times, she has been such a gift. My husband has been a great support, but this therapist gives me an outlet who doesn't judge, lets me cry, lets me be weak, encourages me to be strong, and gives me avenues to try when others seem pointless.

I have read so many "success stories" of people who have dealt with melanoma, and I truly hope my story follows suit. I try to focus on all the things I don't want to miss. My sons' wedding days, my grandchildren who I have yet to meet, my 50th wedding anniversary (we just celebrated 27 years of marital bliss!), vacations yet to be taken.

The best piece of advice I have gotten from this forum so far..."Don't let melanoma win by taking over your life happiness. Give it the respect it deserves by keeping derm appointments, practicing sun safety, and doing self exams, and go LIVE". Someday, I hope to be able to put this in my rearview mirror, at least just a little bit, until then, I hold on to stories such as yours!

Thank you again!
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Re: Ten years this month -- long

Postby larryb » Tue Dec 12, 2017 7:16 am

Jenny, feel free to be in touch any time. I will be thinking of you. bergmann.larry@gmail.com
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Re: Ten years this month -- long

Postby JennyMK0908 » Thu Dec 14, 2017 3:19 pm

Thank you for your offer!
I'm not sure why I'm having such a difficult time focusing on the positives of my diagnosis (it was caught early, .43mm stage 1A, excised completely, no mitoses, no ulceration, minute risk of recurrence or spread, small risk of finding another lesion) instead of dwelling on the negatives. I keep thinking...my body made cancer! That is a terrifying thought!
My therapist recommended that my primary doctor prescribe an anti-depressant for me. This week, he started me on Lexapro. I hate that this is what my life has become. I yell to myself "I just want my life back" on a daily basis. My husband tells me that is a choice only I can make. I try desperately to stay positive, but as time goes by, the news keeps getting more difficult to handle, not easier. My therapist says she sees progress in me, but I struggle to see that. Venting on this forum has helped, but again, I see it as "I am posting on a cancer forum". Terrifying!
I guess one day at a time.
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Re: Ten years this month -- long

Postby jeffb » Fri Dec 15, 2017 10:35 am

Thanks so much for your post Larry! I find much wisdom and comfort in your words for they apply to my roll as the caregiver as well, but in a much different way. Thank you for your post.

Jenny, yes, one day at a time. Sounds so simple so why can it be so hard to practice at times? For me the key has been just that, practice. It take me time to heal. I have to just keep at it as best I can.

If I may suggest one thing, a support group of cancer survivors. I have found for my issues, I really get a lot of comfort, support and fellowship talking with (or just listening to) a group of people who are in the same boat as me and who just "get it". They understand and I take comfort in that.

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Re: Ten years this month -- long

Postby Prd10 » Sat Dec 16, 2017 8:24 pm

Thanks for taking the time to do this Larry. It really hits home for me and is one of the most relatable articles I've read on cancer survivorship, and I've read a lot. I was diagnosed with stage 3 at the age of 28 with a six month old. I always include the fact that I'd just had a baby because I think that's a big enough life change! I became stage 4 two years ago at 34. Not at all how I thought I'd spend my 30's. To say that it's been traumatic would be accurate, but it's funny because until you said it I don't think I'd ever considered myself a trauma survivor. I guess I don't really consider myself a cancer survivor either because ya know I still have tumors and some fighting left to do. Or
maybe I'm just in denial. I can get on board with the idea of trauma though, and have accepted in some ways that it changes everything good and bad. I really struggle with the idea that the relationship changes are my fault, but feel like I'm coping as well as I can. I feel horrible for my son that cancer has affected him at such a young age. It's so horribly confusing for us, I can't even imagine how confusing it must be for him and getting him the right help hasn't been easy.

Anyway, wanted to say thank you. I found your knowledge and writing to be very powerful. You must be very good at your job because I think this is probably the most I've shared with anyone!

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