When considering the social context for working psychotherapeutically with clients who have cancer, by which I mean the facility, opportunity and availability to be able to share feelings, and experience a social network that is both supportive and empathic. This is obviously important throughout treatment, which can be frequently aggressive and mutilating; but equally important, are the various social setbacks brought about by having cancer. *Weisman & Sobel (1979) state that 50% of the psychological problems reactive to cancer may be improved by non-medical means. They continue by saying: “ Patients indeed seem to live longer if they can keep active and retain enriching affective relationships…”

Psychotherapeutic work with individuals (and groups), who have cancer, is different in many ways to general counselling and psychotherapy, and this is where I believe the entire psychosocial approach comes into being. In order for the client to have their full ‘voice’ heard, and express their entire existential reality, the therapist may well find that they choose to become much more ‘active’ in their therapeutic approach; sometimes needing to become more flexible with the timing of sessions…also with the clients’ permission, it may be appropriate to discuss treatment with their Oncologist, in order to clarify possible confusion and anxiety. Again, this kind of approach can help clients by knowing that the professionals looking after him/her are, in fact, working together for the ultimate good of their complete wellbeing.
When working with a client on an individual basis, again with greater flexibility, it can sometimes be useful to have some sessions involving friends and /or family; with this kind of systemic involvement, the effect of the illness upon all of these people may be explored – if it seems appropriate. Very often the person who is ill becomes anxious about the effect their illness is having on others who are close.

To have the facility to speak freely about the myriad of emotion when going through a cancer experience that has the potential to completely take one’s life away – in every respect, can be enormously powerful and constantly changing; for example whilst there might be periods of remission of the disease, there may also be recurrences.
“ When his health is under attack, the human being has need of affection, approval and security. He must feel that he is a member of a group where exchanges are fruitful and where there is trust. People who maintain significant social and emotional relationships seem to be better able to bear the physical and emotional shock of disease. They are able to share their feelings and their anxieties, and correspondingly appreciate the help that is offered. “
Patrice Guex (1989) Introduction to Psycho-Oncology

*Weisman, A.D. and Sobel,H.J. (1979) ‘Coping with cancerthrough self-instruction: a hypothesis, Journal of Human Stress, 3-8
Article written by Marion Leslie who is due to runs a workshop on Stress and health at The Albany Centre.