Psychoanalysis and Psycho-oncology

Abstract

This chapter outlines the importance of a psychoanalytic perspective for a psychotherapist practicing in a cancer hospital. This perspective enhanced the author’s initial understanding of the psychological issues facing cancer patients and the emotional impact on the medical staff treating patients. These insights were an important part of the author’s initial contribution to the development of a psychotherapy for cancer patients and the development of the subspecialty of psycho-oncology. On the other hand, the psychotherapy experience with patients facing death, revealed the dearth of psychoanalytic literature on death anxiety. Freud’s legacy is that death anxiety is a secondary anxiety, derived from the anxieties of childhood and cannot exist in the unconscious. Clinical experience, case reports and case supervision revealed an avoidance of death discussion by the psychoanalytic psychotherapists, as this theory provided no useful guidelines for interventions for patients with death anxiety. Borrowing from Irvin Yalom (an existential psychoanalyst), Ernst Becker (Denial of Death) and experimental psychologist Sheldon Solomon, who empirically demonstrated the existence of unconscious defenses against death anxiety, called “Terror Management,” a new approach for managing death anxiety is described below. Psychoanalysis is enriched by a psychoanalytic psycho-oncologist.