Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: TUESDAY, June 14, 1994 TAG: 9407120001
SECTION: EXTRA PAGE: 1 EDITION: METRO
SOURCE: Jane Brody
DATELINE: LENGTH: Medium
A chronic or potentially fatal illness or injury in a loved one can also substantially and permanently affect the life of everyone else in the family.
Far too often, the impact of these events is even more disruptive to the affected individual or the person's family than the actual medical problem warrants. Most people are ill-equipped to cope with the effects of chronic illness on their emotional and social well-being.
Some may hide their torment, only to have it take its toll in ugly, self-destructive or family disruptive ways.
Others may rage against their fate, wasting precious energy and pushing away those who could help them live more constructively.
Still others may try to struggle bravely through on their own, unaware of potential sources of assistance that could smooth their way and expand their opportunities.
When someone in the family develops a chronic, disabling, incurable or life-threatening disorder, everyone in the family is likely to get ``sick'' as well. Aspirations and plans of the spouse and children, as well as the affected person, must often be readjusted and roles within the family structure must be redefined.
Communication patterns change, and not always for the better, and the resulting emotional and physical and financial stresses can strain even the most stable of relationships.
But as one therapist learned through bitter personal experience, the damage of chronic illness can be mitigated and for some, a long-term disorder can even become a growth experience.
Irene Pollin, a social worker in Bethesda, Md., lost an infant son and a teen-age daughter to a congenital heart problem, and, as if that were not traumatic enough, both of her parents died within a year of her daughter's death.
When Pollin sought psychotherapy to help her understand and cope with the resulting emotional devastation, she was given tranquilizers and urged to explore her early relationship with her mother. After nine years of sedation, she was no better.
To Pollin, the need for a more appropriate, short-term, directed approach to dealing with irreversible medical problems was obvious.
In working with chronically ill patients and their families, she developed what she calls Medical Crisis Counseling: eight, maybe 10, sessions with a trained therapist who focuses on how the medical problem affects the person's life and how the resulting obstacles - emotional, professional, interpersonal - might be overcome.
She also established the Linda Pollin Foundation, named for her late daughter and administered by Children's Hospital in Boston, to teach mental health professionals how to deal with patients and families caught in the entangling web of a chronic medical crisis.
Recognizing that many patients and families do not have access to trained psychotherapists, Pollin also wrote a book, ``Taking Charge: Overcoming the Challenges of Long-Term Illness,'' with Susan Golant and published by Times Books, 1994, $22, which sensitively and graphically describes strategies to help patients and families cope on their own.
As one of her disciples, Gerald Koocher, chief psychologist at Children's Hospital in Boston, put it: ``When you're dealing with the emotional consequences of chronic illness, you need someone to help you cope with real-life problems triggered by the diagnosis of chronic illness. Lots of people are living and living longer with chronic illness, but the medical profession is ill-equipped to help them cope with it.''
Typically, he said, after the diagnosis of a chronic illness, ``self-image is permanently altered, people worry about being stigmatized, their angry feelings are buried so they can cope with day-to-day problems, they fear isolation and abandonment and they feel out of control, as if they were coming unglued.''
This reaction does not represent mental illness, he emphasized, but is ``a normal response'' when chronic illness strikes.
Pollin realized that the fears and feelings touched off by chronic illness need an appropriate release so they do not result in misplaced anger and depression.
``Rather than losing control when you release pent-up pressure, you'll find yourself back in charge, calm, organized, able to think clearly and make good decisions,'' she maintains.
Pollin cautions patients and families against making drastic decisions, like changing jobs or moving, soon after discovery of a chronic illness. ``Your medical condition may not be as bad as you anticipate,'' she tells patients.
As time goes on or illnesses progress, Pollin said, patients and families may need to return to counseling to help them readjust to changing circumstances. But regardless of what happens, she has found that with a little help, people can ``remain in control, even while their lives have been changed forever.''
by CNB