Been There, Done That

Tara Schapmire, an oncology social worker, tries to give women who have advanced breast cancer the tools they need to sustain their emotional strength by working with them in a group setting.

People who have faced their own mortality often see the world through “new glasses,” including their relationships and activities they once enjoyed, she says. They discover value in things they didn’t pay attention to before, and at that same time, they are challenged to find meaning in activities—or friends—they used to make time for. It can feel disturbing and disorienting. As one support group member explained, she no longer “suffers fools.”

“Group may be the only place where they can connect honestly with others and no longer feel emotionally isolated,” says Schapmire, who works in the interdisciplinary program for palliative care and chronic illness at the University of Louisville in Kentucky. “They can express the truths they are unable to express elsewhere.”

She uses group sessions year-round to help women connect with the only people who really understand what they are going through: other women who have advanced breast cancer. She encourages them to be more self-aware and explicit about their needs.

“If someone says, ‘What can I do for you?’ have a mental list of things they can do,” she advises. “Maybe it’s a phone call or lunch later this week. Express your needs explicitly, particularly to friends who often want to help but don’t know how,” she says. If you and your partner avoid difficult topics to protect each other from personal fears, try bringing up the subjects in the car or on the phone, rather than face to face, for example.

No single exercise guarantees that everyone will get the level of emotional support they need when they need it, but Schapmire is encouraged by a shifting tide toward “a whole-person approach to care,” that is, care that tries to address the patient’s—and the family’s—physical, emotional, social, cultural and spiritual needs. What Schapmire and many psycho-oncology researchers ultimately want to know is “what works for whom, for how long and when along the cancer trajectory,” she says.

But for now, she incorporates the latest evidence-based lessons into the support group experience. “We still have a lot of room for more research on ways to improve quality of life for all those affected by cancer.”