How to Cope with a Medical Diagnosis

Are you having a difficult time dealing with a medical diagnosis? Are you unsure on what you can do to cope with a medical diagnosis? To help understand what type of emotional impact a medical diagnosis can have on someone's overall life and what you can do to cope with a medical diagnosis, I have interviewed psychotherapist Gary R. McClain, PhD.

Tell me a little bit about yourself.
"I am a licensed counselor and life coach who specializes in working with individuals facing chronic and catastrophic medical conditions as well as their family members/caregivers. I work with them on issues that include getting beyond the initial shock; facing emotions like fear, anger, and sadness; evaluating treatment options; gathering information; communicating with healthcare professionals and negotiating the healthcare system; building (and rebuilding) family relationships; managing the challenges of medical treatment; making lifestyle changes, maintaining self-image, and creating a vision for the future.

I have a practice in NY and also do some coaching over the phone. I have a program that I take patients and caregivers through, 'Prepared for the Road Ahead,' which helps them become more empowered. I have written for publications that include Arthritis Self-Management, HIV Plus, and Fibromyalgia News. I recently wrote a supplementary textbook for nursing and allied health education , 'After the Diagnosis: How Patients React and How to Help Them Cope.'

What type of emotional impact can a medical diagnosis have on someone?
"Patients are left to deal with their emotions on their own, and they are often totally unprepared. Before I focused my practice in this direction, I often encountered newly-diagnosed patients and caregivers through consulting work that I was doing, as well as in my personal life. I was often both concerned and saddened by the experiences of individuals facing a recent medical diagnosis. Cancer patients who were given a diagnosis and then given the responsibility of almost immediately signing off on a treatment plan that might change the course of their lives, certainly for the foreseeable future, while they were still in shock over the news. Patients with chronic illnesses who were being told that they would have to make major changes to their daily lives, when they had no idea that had this condition, hypertension being a good example. And patients who had one vision for their future but as a result of their diagnosis, would have to completely revise that vision, and were even concerned if they might not have a future.

Patients initially experience shock. This shock may last a few seconds or minutes, a few hours, or days and weeks. The shock is followed by emotions that may include anger, fear, disappointment, sadness, guilt, depending on the patient's coping style, the severity of the diagnosis, whether or not they were expecting to be diagnosed, and past experiences with illness in themselves and others.

What I find that clients often experience is a sense of helplessness. Human beings like to be in control, they assume that they can fix or avoid unwanted occurrences in their lives, and that bad things don't happen to good people. A medical diagnosis challenges our sense of control. We are helpless to stop it from happening, and may, at least initially, feel helpless to know what to do about it. Helplessness can lead to denial, at least initially. And it contributes to emotions like anger, fear, and other emotions."

How can someone cope with a medical diagnosis?
"Clients who are newly diagnosed ask 'Why me?' I encourage them to ask this question. It is on their mind, after all. There isn't an answer, but asking it can help clients to open up emotionally, to get in touch with the feelings they are experiencing. In some ways, a medical diagnosis is related to a loss of innocence , the belief that bad things won't and can't happen. It can be the beginning of facing life on life's terms; it can lead us to find meaning in the diagnosis and meaning in our life. In this way, a medical diagnosis can lead to a spiritual awakening of some kind, not only from the perspective of traditional religion, but also an awakening of the sense that we are all connected to each other, that we all suffer in some way. Compassion for others and ourselves.

One of the ways I work with clients is to help them to develop a strategy for getting informed about their condition. Not to spend hours on the Internet scaring themselves, but to take manageable steps to better understand their condition. Knowledge is power. When we don't have real information, our minds fill in the gaps, and this contributes to the fear factor. In that way, real information is an antidote to fear. I tell my clients: drown the fear in facts.

But patients have trouble taking in and processing information when they are in a state of emotional distress . It is hard to listen and to think when you are upset and emotionally overwhelmed. When patients have had time to process their emotions, to talk about their feelings, their sense of helplessness, their fears about the future, they are better able to learn about their condition, and the treatment options, and to make informed medical decisions.

It is also important for newly-diagnosed patients to develop a support network. They need a safe place to talk about how they are feeling, people that can partner with them in some way on the road ahead. They need people who can listen without judging them, without telling them to 'think positive,' who can listen without trying to 'fix' them or tell them what to do. Talking to a friend or family member may be helpful, or a member of the clergy, or a counselor, or joining a support group with others who are dealing with similar challenges. Support is power!

Ironically, family members and other loved ones are not always the best support, at least not initially. Family members are dealing with their own emotional reaction to the diagnosis. They are worried about the patient, and what the diagnosis is going to mean, and they are worried about what it is going to mean to them. As a result they may be unwilling to discuss it, or may attempt to micro-manage the patient by taking charge of decisions and care, which is disempowering. Family members may encourage the patient in denial of the diagnosis because they are in denial themselves. They may make unkind or thoughtless comments out of their own fear, anger, and sadness. Lots of denial of feelings may be going on, and caregivers and loved ones also need to have a safe place to talk about their feelings. As I tell clients, when one person in the family is diagnosed with a medical condition, the whole family experiences the diagnosis.

Sometimes my work involves helping family members and the patient to talk about the 'elephant in the room,' their shared sense of hopelessness.

Newly-diagnosed patients are increasingly in the position of having to be empowered. They need to be informed so that they can communicate with their healthcare team. This means being informed, knowing their rights and responsibilities, asking questions and following up. Most physicians encourage their patients to partner with them. Everybody benefits from teamwork. Sometimes patients need some coaching around how to best communicate, how to help their healthcare team to communicate. I help clients to understand their own learning style and then, in turn, encourage them to help their healthcare team to communicate in a way that they can best understand. This is all a process.

A medical diagnosis can be a blow to a patient's self-esteem, their self-image. Patients may not look or feel the same, at least temporarily. They may need to make changes in their activity levels, the things they can do, their diet, etc. Nobody likes to feel different, and sometimes, intentionally or unintentionally, loved ones may do or say things that result in the patient feeling different. Patients may need some help in feeling better about themselves as well as in communicating their needs and expectations to the people around them.

As discussed before, making a spiritual connection of some kind, a sense of meaning, can also be helpful in coping with illness and treatment.

What I tell my clients is that you are not your diagnosis. You are still you. I help them to find their own 'new normal,' to make changes that accommodate the demands of their medical condition.

A medical diagnosis is a stressful, if not a traumatic, event. When someone is experiencing stress, they may find that their normal coping skills are insufficient, and they feel overwhelmed. Talking to a mental health professional is a good idea, to help gain perspective on the diagnosis, to sort out emotional reactions and to develop short-term coping strategies. If the mental health professional has experience in working with clients facing illness, then that is a plus. Support groups, through hospitals and clinics, can be really helpful. Organizations focused on specific conditions, like the American Cancer Society , can help to connect patients with resources, their websites or local offices can be useful."

Thank you Dr. McClain for doing the interview on how to cope with a medical diagnosis. For more information on Dr. McClain or his work you can check out his website on www.justgotdiagnosed.com .

Recommended Readings:
How to Recover from a Loss of a Loved One

Surviving Through the Grief Stages

Recovering from Divorce