Wednesday, December 28, 2005

An Unwanted Journey: Day 0034 - Arguing With Yourself

Ken Wilber uses the phrase “condemned to meaning.” By this, he means simply that we have no choice; when cancer is diagnosed, we will look to the medical experts to treat the illness, but to our culture to provide the scripts by which we attach meaning to the sickness which has invaded our life. Like his wife Treya did when she was diagnosed with breast cancer, I find myself alternating, sometimes at the speed of light, between the various scripts provided by Christian, New Age, Medical, Psychological, Gnostic, Existential, Magical, Buddhist, and Scientific approaches to the meaning of cancer (see yesterday’s blog for more about the idea of scripts).

If you’ve glanced through the brief summaries of these different approaches, you will probably find, like me, that not a single one is sufficient, although it is safe to say that some resonate more than others. Perhaps you find that it’s something like combination chemotherapy; if you mix a few together you can find a cocktail that is more appealing than any of the single approaches. For me, that mix would probably be a blend of scientific, medical, existential, and Buddhist approaches.

The point is simple: the meaning of cancer is a human creation, something which necessarily involves both the individual and the community in dialogue. This conversation between the personal and the communal is a non-stop process even when the voices we hear are not spoken aloud but inaudibly spoken in our minds as we think about cancer.

“What did I do to deserve this?”

“You were a shit disturber, weren’t you? That’s why you’ve got colorectal cancer now.”

“If I think positively, will that extend my life?”

“Only if you’re an idiot who thinks wishing for things will make it so.”

“If cancer has no meaning, can’t I just make it up? If it works for me, what difference would it make for anyone else?”

“Yeah, stupid. You have a family, right? Don’t you have an obligation to at least come up with a meaning that works for them too?”

We all have these conversations with ourselves, sometimes endlessly so. If somebody else were to offer questions or opinions to us, we would feel justified in disputing their assumptions or their logic. But sometimes when the voice arises within, we feel that it must be true, it must be our authentic self. The truth is, the nonsense we use in our internal dialogues is often just as nonsensical as what we hear other people saying.

Martin Seligman, in his book Authentic Happiness, offers advice on how to argue with yourself. What I find fascinating about his advice is that he recommends we do whatever is necessary to find an optimistic meaning. In the context of coping with cancer, this means that we need to develop facility in recognizing when our internal voices are offering pessimistic interpretations. Then, once recognized, we need to learn to dispute those voices. We do so through four approaches: evidence, alternatives, implications, and usefulness.

Evidence means that often the best way to dispute the pessimistic view of cancer which is voiced internally is to show that it is factually incorrect. For example, even thought Stage III rectal cancer prognosis statistics state that 55-60% will survive after five years from diagnosis, a pessimistic view suggests that means I have a 40-45% chance of dying in the next few years. Evidence suggests that the statistics are skewed. Most involve all age groups, not guys in the early 50s with an otherwise good state of health and no prior hospitalization, with an absolutely top-notch medical team using the most current surgical, systemic, and radiation therapy approach. The evidence clearly suggests that my Stage III rectal cancer has better survival prognosis.

Alternatives means that there are other ways to talk about and look at the circumstances facing us than the often most pessimistic view we take. If we focus on the elements that are changeable (I can exercise and eat well and develop my enduring happiness levels), specific (yes, the tumour has penetrated through the rectal wall, but all the distant organs look normal), and nonpersonal (this cancer isn’t about me failing in some way; it’s just an unfortunate series of events; and, after all, we’ve caught it before any evidence of metastasis), then those alternatives become life-enhancing and productive.

Implications means that even if the evidence is stacked against you, even if reality looks grim, we can still decatastrophize. What are the implications of Stage III rectal cancer? Well, we simply choose those that are life-affirming and ignore the worst-case scenario.

Usefulness means that sometimes the only smart thing to do is evaluate whether holding a belief about your prognosis is destructive or not. Whether it is accurate or not may matter far less than how it helps you. No, the world may not be fair, but the smart person will not think about that. If you concentrate instead on what you can do to make things better, things will be better.

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