Tuesday, July 7, 2009

Emotional Honesty

I had an interesting night at work last night. I took care of a Lithuanian patient who had had a stroke affecting her ability to speak. Though she had immigrated to this country decades ago and spoke fluent English, the speech centers of her brain were affected. She could only speak her native language. I had a CNA working with me; she was also from Lithuania and served as a translator for me. I know nothing about Lithuania, so talked for awhile about that country and its culture with my CNA, who immigrated here at age 46. Turns out that in Lithuania she'd been an economist, with a Master's Degree in economy. I am very interested in other cultures, so talked with her for awhile.

In her younger years, Lithuania had been under communist control; leaving the country had been illegal, and attending church had been forbidden. But under communist socialist control, she said their needs had been met, that her education had been free, she had made a good living as a single parent and she paid no taxes. She'd also lived in Lithuania after independence had been achieved. She said there were good and bad things about living under both regimes. In some ways her life was harder after independence was achieved and the communist government overthrown.

I asked her what about American culture had been most difficult for her to get used to, and I was surprised by her answer. She said Americans were always smiling. That they felt they had to put on a happy face even when they were depressed, even when they were experiencing times of despair, even when they were in pain. She said an American would smile at you and act friendly even when they didn't like you. She almost felt like we were emotionally dishonest. She said that in her country people were more honest and open about what they were feeling, so it was much easier to be supportive of other people as you knew what they were feeling and what they needed. They felt no need to conceal negative emotions.

I think after listening to her, that she was right. In America, we always feel a need to "keep a stiff upper lip", to "think positive", to "look at the bright side". Maybe that's not a good thing.

I know in my cancer world many struggle with depression, anger, fear and grief. Many of the 600 cancer patients I've communicated with to date have shared those feelings with me. But most are unable to share those feelings with those around them, those who love them. Depression and fear are seen as "giving up", anger is misunderstood, grief is minimized. Many are told they have to "stay positive" to beat cancer, though studies have shown that is not true. Their emotional struggles are minimized.

I heard a saying years ago that always stuck with me. It was that joy is doubled and despair is halved when shared. The negative feelings associated with a cancer diagnosis need to be shared and understood by those surrounding the person diagnosed. They are a normal part of the cancer experience and need to be acknowledged and expressed. I wonder if in our country there would be less of a need to take antidepressants and to see therapists if we felt we could be more open with our feeling, if we could more easily share what we felt with those around us. Sometimes I think in this digital age especially, we communicate with more people, but the quality and depth of our comunication suffers.


When someone asks me how they can best help a cancer patient, I tell them to listen without offering advice. To allow the cancer patient to freely express the negative emotions that surface. To just listen and not advise sometimes, to allow the patient express the normal emotions that they feel.

We all need to learn to accept and ride the storms in our lives and to seek help when the going gets rough. Maybe we all need to be a bit more Lithuanian. Rainbows only happen after the storm, not before. We need support those during their rainy seasons, to acknowledge and help them ride out their storms.

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