The Significance of Optimism in the Mastectomy Experience

Abstract

Cancer like any other stress strikes without warning and poses a serious threat to current and future wellbeing. Cancer is such a traumatic life event that potentially shatters one's perception of themselves, others and their belief in a just, meaningful and benign world (Janoff-Bulman, 1992). The very news that one has been diagnosed with cancer can be devastating. Even though medical advances can prolong life and in many patients may lead to remission or cure; nonetheless, most people perceive this diagnosis as tantamount to a death sentence. They often report feelings like 'being in a state of shock', 'feeling out of control' or being angry, fearful or helpless. Grief and loss are often key issues, and there may be powerful feelings of distress and fear that cancer could be fatal. However, diagnosis of breast cancer for a woman can be far more distressing. A woman's breast is part of her self that signifies her womanhood and sexuality and thus mastectomy has a devastating impact on a woman's feminity and sexuality. Having undergone mastectomy, women experience a range of emotional, psychological, physical and practical challenges like physical changes in body appearance and functioning; psychological difficulties ranging from concerns about body image and sexuality, changes in self-concept, to severe disorders such as anxiety and or depression and changes in social relationships with their spouse and other family members. Schover (1991) has reported that mastectomies have resulted in divorce and break-up of relationships. Machacek (1996) reported about attitude of patients towards disease and themselves. Fear and anxiety play was found to play an important role in seeing doctor too late. Image of an incurable disease, an idea of subsequent loss of an organ, symbols of woman-hood and sex appeal, physical and psychological degradation, subsequent fear of losing a partner, loss of social prestige and position at work were common themes reported. Irwig (1997) observed that women who had satisfactory sex life before surgery had developed serious sexual problems in year after mastectomy surgery. Kumar (2008) in a study on mastectomy patients reported that some of patients generally expressed their distressing feelings as: crave acceptance, but I feel worthless, incompetent, - a failure! I fear rejection! Inside me there's a terrible emptiness! Owing to adverse psychological impact of breast cancer on patient it is very common to see pessimism creeping in patient's attitude towards oneself, future, and illness. Most patients lose hope and will to live ahead and view their illness as end of world. However, it has been seen that patients who remain positive during cancer experience and post mastectomy report positive outcomes in spite of severe distress that is related to breast cancer and its treatment (mastectomy).Differences in individuals outlook towards illness and life in general, their expectancy about future events is seen to have important implications on degree to which individuals benefit from such adversities, their levels of experienced positive affect and negative affect and spiritual experiences of individuals. It is these individual differences among mastectomy patients in terms of optimism and pessimism and their effect on benefit-finding, positive affect, negative affect and spirituality that present study focuses on.OptimismScheier and Carver (1985) defined optimism as the generalized expectation of positive outcomes in important domains of life while pessimism refers to tendency to expect negative outcomes in future. According to this perspective it can be said that optimists are people who expect good things to happen to them while pessimists are people who expect bad things to happen to them. This difference among people is important in many aspects of living, especially in manner with which people deal with adversity. …