Brigitta Wössmer supports people with cancer. During her therapy sessions, she sometimes has to cry with a patient, or can but laugh about an astonished stonemason.In the mirror she sees only a shadow of her former self. The chemotherapy is making her hair fall out, and illness is making her extremely tired and robbing her of her vitality. When 28-year-old Anna Forster (not her real name) was diagnosed with breast cancer, her life was turned upside down. “It was as if I had been hit by an express train. Life was passing me by at high speed.” The young woman has to make important decisions within a short period of time because many cancer treatments increase the sufferer’s risk of becoming infertile. Which therapy should I choose? Do I want to have children later in life? She prefers to keep open the option of having a family, and chooses the corresponding treatment. This takes up valuable time however, and delays the start of the chemotherapy. Anna Forster: “I had to put up with what felt like a time bomb ticking away in my chest.”
16,000 people die of cancer in Switzerland every year. It is only cardiovascular diseases that are more fatal, although the Swiss Federal Statistical Office (FSO) expects that cancer will soon become the most frequent cause of death. A cancer diagnosis throws up a catalogue of existential questions for those affected: Will I get better again or am I going to die? And if the illness is incurable: What is my life all about? What will happen after I’ve gone?
Anna Forster was diagnosed with cancer when she started psychotherapy training, immediately after graduating as a psychologist. “The diagnosis came as a huge shock to me and was somewhat surreal; you don’t expect to get cancer at my age.” She had to interrupt her training and entrust herself to Brigitta Wössmer, a psycho-oncologist. “The therapy helps me to deal with my fears. Here I have a place where I can offload my worries.”
A cancer diagnosis causes an acute stress response in sufferers. How patients deal with the illness is however quite varied. “Some people respond to their illness in a very active way, while others try to continue their old life as much as possible”, reports Brigitta Wössmer from her many years of experience as a leading psychologist in the Psychosomatics unit at the University Hospital in Basel.
However, for all those affected it is important that “islands for everyday life” can be created as part of their therapy. “The illness is overwhelming and omnipresent. Which is why it is so important to find supportive moments where positive experiences are possible as well.” An “island” might be an excursion or a good conversation with a friend. Provided the treatment allows for this, work can also be an important part of the patient’s daily structure which maintains a certain degree of normality in these exceptional circumstances.
Although most of the patients at the tumour centre are going through a major crisis in their lives, they nevertheless remain in good mental health. As a psycho-oncologist, Brigitta Wössmer helps them to activate the resources available to them. These include their social environment, and confidence or trust in themselves and those treating them.
Humour is another important resource. One of the psycho-oncologist’s patients, a 40-year-old cancer sufferer, prepared for her death very consciously and went with her mother to see a stonemason in order to have her own gravestone made. The stonemason started by asking the name and date of birth. When he also enquired about the date of death to be engraved on the headstone, the patient responded, “I’m not sure yet, but it can’t be all that far off!” The stonemason was aghast and stared at his customer in astonishment. When the cancer patient told this story at her therapy session and imitated the stonemason’s peculiar facial expression, both women had to laugh. “It feels so good to render somebody else speechless once in a while!” the patient, who has since died, told her therapist.
If a person’s life is coming to an end, Brigitta Wössmer is at their side. “I feel very affected by many cases, and sometimes I take a piece of sorrow with me from the therapy session.” In order to stay healthy herself, the psycho-oncologist has to learn to accept her own limitations. “If something affects me, then I let it affect me. It doesn’t hurt to cry with our patients every now and again.” The fact that psycho-oncologists are often confronted with death in their work makes it particularly important for them to face up to their own fears about death to make sure that they do not avoid this important topic during therapy sessions.
People who have survived cancer often report that they have grown stronger as a result of the traumatising experience they have been through. Priorities change, and they learn to separate important things from unimportant things. Those affected become aware that they will not necessarily have a whole lifetime to live. They use their time in a more conscious way and tackle projects which they had always put off doing before. After successfully beating cancer, one of Brigitta Wössmer’s patients opted for a complete career change instead of remaining in an unsatisfying job for another five years until retirement as originally planned. And one patient took up playing the piano again, which considerably increased her quality of life and well-being.
Many cancer sufferers try not to talk to their family about their fear of dying because they feel they have to protect those close to them. “This means that they remain alone with their fears”, explains Brigitta Wössmer. The psycho-oncologist takes on the role of communicator and broaches the unspeakable when family members take part in a therapy session.
It is also very important that the illness is explained to children. Otherwise you run the risk that they will relate the changes in the family to themselves. “Children feel it if their parents are sad. If they aren’t aware of the illness, they will blame themselves for the changes, wondering if they are to blame for not behaving well enough.” Another very common misconception among children is that cancer is infectious. That’s because at primary school age they are kept off school if they have an contagious illness. “If children see that the mother has to stay at home on her own, they start worrying that they might get infected with cancer or that their classmates will become sick if they come to visit.”
Brigitta Wössmer opens the communication channels between cancer patients and their families. Sometimes she is the only person entrusted with a patient’s innermost fears, however. Her consulting room becomes a place where her patients can speak openly about everything. The bright room becomes an island where cancer loses some of its menace.
Profession: Pschyo-oncologist, FSP specialist psychologist in clinical psychology and psychotherapy
Professional experience: Leading psychologist at the Psychosomatics unit at the University Hospital in Basel, member of the Board of the Krebsliga Schweiz