Facing Cancer and the Fear of Death: A Psychoanalytic Perspective on Treatment

(Paperback)

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In Facing Cancer and the Fear of Death: A Psychoanalytic Perspective on Treatment, Dr. Norman Straker proposes that death anxiety is responsible for the American societys failure to address costly futile care at the end of life; more specifically, doctors default on the appropriate prescription of palliative care because of this anxiety. This leads to unnecessary suffering for terminally-ill patients and their families and significant distress for physicians. To address these challenges in the culture of medical education, increased psychological support for physicians who treat dying patients is necessary. Additionally, physicians need to reach a consensus regarding the discontinuation of active treatments. Psychoanalysts have traditionally denied the importance of death anxiety and report relatively few treatment cases of dying patients in their literature. This book offers multiple treatment reports by psychoanalysts that illustrate the effectiveness and value of a flexible approach to patients facing death. The psychoanalytic reader is expected to gain a greater level of comfort with facing death and is encouraged to consider making themselves more available to the ever-increasing population of cancer survivors. Further, psychoanalysts are encouraged to be more useful partners to the oncologists that are burdened by the irrational feelings of all parties.

Reviews

In Facing Cancer and the Fear of Death, the psychoanalyst Norman Straker...enriches the work enormously by allowing us to look into the minds of cancer patients, some our own colleagues, as they face these difficult and painful times. . . .[T]he varying voices combine to create an emotionally meaningful, deeply intelligent work. I think everyone, and not just therapists, should read this book. We all face death, many of us in the specter of cancer, and the experiences, difficulties, and resolutions described here could help us navigate the challenging times. * Journal of the American Psychoanalytic Association *
In this compilation of essays, Norman Straker of Memorial Sloan-Kettering Cancer Center and his colleagues offers helpful perspectives into the widespread death anxiety that affects individual health care decisions as well as large-scale policy imperatives. ... The reader is provided with a unique opportunity to peer inside varying states of existential threat, guided by analysts of superior psychological insight. ... On the whole, the text is succinct, well written, and wide ranging in its sources of knowledge while staying grounded in psychiatric theory. Palliative care clinicians will likely find this book to be interesting and helpful. The issue of deciding the optimal use of the psychoanalytic frame (and which rules to break) has relevance for palliative care consultants who often navigate the difficult waters of end-oflife decision making. The psychiatric perspective featured in the book provides palliative care clinicians with a refreshing approach to understanding complex psychodynamics in various clinical settings. The personal essays as well as case presentations are bracing in their honesty and are invaluable sources of insight for all who care for seriously ill patients. * Palliative Medicine *
The issues dealt with in this book are topical and real. It was interesting to read about the psychological needs in end-of-life care from a slightly different angle (i.e. by psychoanalysts), and the potential benefits of palliative care as viewed from outside our specialty. * IAHPC Newsletter *
This is a much needed and remarkable book that is a must read for all therapists who treat cancer patients, and those therapists who unexpectedly may be facing the prospect of their own mortality. The elegiac and moving narratives of analysts treating cancer patients, and analysts who become cancer patients themselves, can profoundly inform and shape the readers appreciation of the need for flexibility of technique in these situations. The reader will also derive great benefit from Dr. Strakers summary conclusions and recommendations, distilled from these stories and from his thirty five years of experience as a psychoanalyst working in the field of psycho-oncology. -- Stephen M. Saravay M.D., American Academy of Psychosomatic Medicine
This book provides a deeply personal yet strongly academic perspective on the experience of cancer. Dr. Straker has assembled a group of professionals who openly share their knowledge and experience. The depth of Dr. Straker's scholarly understanding envelopes the other contributions and provides an informed psychoanalytic framework. The book will be valuable to those who work with cancer patients and will be extremely useful in the education of trainees. -- Philip Muskin M.D., Columbia University Medical Center
Anxiety over dealing with death and the dying process affects patients, their families, friends, and physicians, often leading to inadequate and unsatisfying management of this inevitable, natural life event. The results of not dealing with the elephant in the room can have long-term adverse consequences on the survivors, including the physicians caring for the patient. Posttraumatic stress disorder, depression, guilt, and alcohol abuse may be the unfortunate legacies of dealing with death anxiety poorly. Dr. Norman Straker, who has devoted much of his career to managing the psychological needs of patients with cancer, as well as their families and caregivers, has produced a superb book on defining the causes and management of death anxiety. Using a combination of psychiatric theory, research results, and in-depth case studies, he and his colleagues present practical, flexible approaches to dealing with death and death anxiety in cancer patients. It is a book that will be especially useful to oncologists, radiation therapists, internists, psychologists, psychiatrists, and others who deal with death and dying. -- Glen D. Braunstein M.D., Cedars-Sinai Medical Center

Author Bio

Norman Straker, MD, offers an approach for facing death and the treatment of cancer patients based on 35 years of clinical experience. One of the original faculty members of the very first psycho-oncology services under the leadership of Dr. Jimmie Holland at Memorial Sloan Kettering Cancer Center, Dr. Straker is still engaged in pedagogy and research at the center. He also teaches at Weill Cornell College of Medicine, Mt. Sinai Medical Center, and the New York Psychoanalytic Institute. A psychoanalyst by trade, Dr. Straker has chaired the discussion group, Psychoanalysis and Psychoanalytic Psychotherapy of Cancer Patients at the American Psychoanalytic Association for more than 25 years. He is in private practice in New York City.