Guilt reactions in patients with cancer

The personality and eniotional difficulties confronting patients with cancer are appraised to appraise the attitudes of both patients and doctors toward cancer and on the special factors that characterize the doctor-patient relation in cancer.

Abstract

STUDY OF THE ATTITUDES of patients withA cancer has been in progress at the Massachusetts General Hospital.T h e purpose of this survey was to appraise the personality and eniotional difficulties confronting patients with cancer.We hoped that this study would throw light on the attitudes of both patients and doctors toward cancer and on the special factors that characterize the doctor-patient relation in cancer.l ' h e practical value of this study would be to indicate methods for.alleviating tensions so that optimum rehabilitation might be achieved.Many patients have preconceived ideas abou.t the nature of their illness.Each individual patient also is reacting to the inipact oE the illness and the specific diagnosis in the light of his own particular personality pattern.I t is generally conceded that c;tncer is dreaded as a fatal disease of unknown etiology.Each patient has his own ideas of what cancer means to him-not only do they involve phantasies of dying and death, but also thoughts of sid- fering, pain, gruesome wasting away, and helplessness.T o add to the insecurity created by this illness, about which so little is known, is the fact that more frequently than i n any other disease the doctor hesitates to tell the patient his diagnosis.All this unfamiliarity with the disease and secretiveness about the diagnosis may magnify the patient's fears.This may also account for the restraint of the family and oE the professional personnel in dealing directly with the patient.Therefore the actual handling of some of the problems of patients with cancer requires special understanding and skill.Unlike tuberculosis, heart disease, and other chronic illnesses, there is relatively little in the literature about the attitudes of patients, their families, and professional persons toward the Froin the Department of Neurology and Psychiatry,