Q & A – General Life Threatening Illnesses Issues

General Life Threatening Illnesses Issues

Q. How can we possibly manage to cope with a diagnosis of a life-threatening illness?

Such a diagnosis is overwhelming! A person (and their carer) is flooded with feelings and thoughts of panic, loss-of-control, fear, guilt, anxiety, anger etc. etc. What can lie beyond that whirlpool of responses? A clue can be obtained from the work of an American psychologist Abraham Maslow.



Q. What is Maslow’s relevance to this issue?

Abraham Maslow developed his Hierarchy of Needs theory (starting in the 1950s). He believed that human beings are motivated by needs, and that certain lower needs have to be satisfied before higher needs can be.He defined these needs as physiological, safety, love and esteem. He believed, for example, that a person needs to feel safe before they can develop feelings of love. His conception of a hierarchy of needs is very relevant for the terminally ill and their loved ones.



Q. Is there a hierarchy of needs for the terminally ill (and their loved ones)?

Sure. I have developed a useful model together with my colleague Joel Nathan. We call it the Nathan Hierarchy Of Needs.

Our model incorporates five types of needs. The first are Control Needs – A person with a serious diagnosis feels a loss of control over their life, as they realise the reality of their situation and their need to hand over control to others. Such a person needs to establish some sense of control by reading, talking, doing, and feeling – whatever it takes. People come to work with me to start the process of feeling a sense of control, and to explore the rest of their hierarchy of needs.




Q. What about children? Shouldn’t we protect children from learning about a terminal diagnosis/death?

We need to deal with each loss as it happens. If not, when a major loss occurs, it naturally reconnects us with past losses and we can grieve intensely for many losses at once, without knowing it. So as a child experiences losses (of relationships, pets etc.) they need to experience these losses to develop the skills to deal with the inevitable human losses and deaths that they will eventually be exposed to. Hence, a child’s early losses can help prepare him/her for later losses. Then, when they have to deal with a death, they can be exposed to the facts and the emotions of others in a way that is appropriate for their personality and developmental stage.



Q. So what specifically do children and teenagers need:

Recognition that the grieving process starts with the diagnosis/initial news.

To be trusted with difficult information – accident/diagnosis/health deterioration/death.

To be able to discuss the difficult information.

These are also very appropriate for adults! Other individual needs can be explored during individual counselling sessions .



Q. So what specifically do the parents of a grieving child need to be aware of?

To expect the unexpected.

To be an advocate for the child at school.

To not expect child to grieve with you.

To not expect child to grieve in the same way as others.

Not to expect the child to be the comforter of the parent.

Other individual needs can be explored during individual counselling sessions .




Q. Are there any differences in the ways we can help adults or children better manage the life-hreatening illnesses of people they are close to?

In our dealings with people of all ages we need to be sensitive to the individuality of the person we are trying to support. We need to be with them without trying to lead them towards a direction of our choosing. We need to be able to manage our feelings so we are able to help others manage their own feelings.

For example, people who give the advice of “Just move on and get on with it” are usually very uncomfortable with how they themselves are feeling and so need the griever to “get on with it” to make things easier for the person giving the advice. The advice giver is trying to direct the griever in a direction which may be totally inappropriate for them!

We need to deal with our own feelings and be able to listen. Don’t just say something, sit there!

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