When the Body Says No: The Cost of Hidden Stress (12 page)
Read When the Body Says No: The Cost of Hidden Stress Online
Authors: Gabor Maté
Tags: #Non-Fiction, #Health, #Psychology, #Science, #Spirituality, #Self Help
“My father is probably the only person who doesn’t know I’ve had my breasts removed because I’ve never told him. I don’t think anyone else is going to. He knows I had an operation that was cancer related. He asked Steve (Anna’s second husband), ‘Is this something to do with the breast?’ and Steve said, ‘Yes, it’s a continuation of the previous thing.’ Dad has never said anything to me. Through my chemo he was so ignorant and shitty to me. He’d come in the front door and say, ‘Go put your wig on. You don’t look pretty.’ I’d say, ‘You know what, I’m really, really sick and I just rolled out of bed to answer this door.’ Only I wouldn’t say it calmly like that—I’d get hysterical.
“I was driving him home recently, and he said, ‘I’ve got to speak to you about something. I know you’re not the person I should tell, but I have no one else.’ Then he launches into this thing—he’s eighty-two years old—about how his girlfriend doesn’t want to have sex with him. ‘Men have needs.’ That’s something he taught me early. A wife must—he told me straight up—never say no to her husband when he wants sex because if she does, he has the right to get it somewhere else. It’s your duty to provide sex. Here he is telling me that he wants to have sex and his girlfriend won’t and he has needs and what is he supposed to do. I’m sitting there thinking, This is so inappropriate—you should not be talking to your daughter about this.”
“Mind you … you could also say, ‘Dad, I don’t want to hear this.’”
“But then he’d be embarrassed. He’d feel ashamed and think he’d done something. It’s my job to not let him feel ashamed.
“At what point do I get to say, ‘I don’t want to.’ These are strange words for me, in any situation. I’ll lie to people, I won’t answer the phone, I’ll say ‘I’m moving to Tibet so I can’t take part in that’—I’ll do anything but say ‘I don’t want to.’ And when there’s no lie that comes to mind, I just take it all on.”
The straightforward connection between childhood experience and adult stress has been missed by so many researchers over so many years that one almost begins to wonder if the oversight is deliberate. Adults with a history of troubled childhoods may not encounter more serious
losses than others do, but their ability to cope will have been impaired by their upbringing. Stress does not occur in a vacuum. The same external event will have greatly varied physiological impact, depending on who is experiencing it. The death of a family member will be processed in a markedly different way by someone who is emotionally well integrated and in a supportive relationship than it will be by a person who is alone or—like Anna prior to her therapy—tormented by chronic guilt due to childhood conditioning.
One person whose true childhood history would likely be missed on self-administered questionnaires of breast cancer patients is former U.S. first lady Betty Ford. Mrs. Ford has written courageously in her autobiography,
The Times of My Life
, about her alcoholism and her efforts at healing after a family intervention by her husband, her children and others. She has been equally forthright in revealing her diagnosis and treatment for breast cancer, but—it appears from her published accounts—when it comes to her childhood she is still wearing rose-coloured glasses. She is typical of the person who represses her own feelings in order to preserve a sense of idyllic relationship with the parent.
Betty Ford, married to a decent but ambitious politician whose career dominated her life, was emotionally deprived in her spousal relationship. “I probably encouraged my husband to drink. He was such a reserved man it was difficult for him even to tell me he loved me—he had proposed by saying, ‘I’d like to marry you.’” For many years she suffered from what were clearly stress-related low-back pains, diagnosed as “osteoarthritis” and treated with painkillers and tranquilizers. She also drank heavily to soothe physical and emotional pain. Ford describes herself as filled with self-doubt and unable to assert herself:
I was convinced that the more important Jerry became, the less important I became. And the more I allowed myself to become a doormat—I knew I was a doormat to the kids—the more self-pity overwhelmed me. Hadn’t I once been somebody in this world?
Underneath, I guess I didn’t really believe I had been somebody. My career with Martha Graham hadn’t been a huge success—I had talent as a dancer, but I wasn’t a great dancer—and my confidence had always been shaky.
I couldn’t accept that people liked me for myself. And I was self-conscious that I didn’t have a college degree….
Uneducated. No Pavlova. And not half the woman my mother had been. I was measuring myself against impossible ideals—Martha or my mother—and coming up short. That’s a good recipe for alcoholism.
My mother was a wonderful woman, strong and kind and principled, and she never let me down. She was also a perfectionist, and tried to program us children for perfection. My mother never came to us with her problems, she just shouldered them. And she was my strongest role model, so when I couldn’t shoulder my problems, I lost respect for myself. No matter how hard I tried, I couldn’t measure up to my own expectations.
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The former first lady seems blind to her own disclosures here—about the way she experienced her childhood, about how her relationship with her mother and, no doubt, with her father, of whom she says very little—shaped her personality and coping style. She does not see that surrendering herself to her husband’s needs and expectations—becoming a “doormat”—resulted from childhood conditioning. The emotional repression, the harsh self-judgment and the perfectionism Betty Ford acquired as a child, through no fault of her own, are more than a “good recipe for alcoholism.” They are also a “good recipe” for cancer of the breast.
*
Mr. Crew has already gone public with news of his breast cancer. Unlike the women interviewed, he does not need his identity protected
.
You Are Part of This Too, Mom
I
n
Lock Me Up or Let Me Go
, her second book of memoirs, Betty Krawczyk writes about the death from breast cancer of her twenty-seven-year-old daughter, Barbara Ellen:
The last migraine I had was in the palliative care unit, almost three years ago, when the doctor in charge told me that I should tell Barbara Ellen it was okay for her to die.
“She wants your permission to die,” he said gently. We were in a private room reserved especially for people like me. The most wretched people of the earth.
“To hell with that!” I flung at him, shocked and horrified at the very suggestion. “She doesn’t have my permission to die! I forbid it….”
I had broken down at that point and was sobbing wildly. The doctor waited patiently. He was used to this reaction. That was his job.
“Mrs. Krawczyk, I think you understand that Barbara Ellen’s suffering will simply increase now, by the hour.”
“She is not suffering! She has the butterfly in her arm. She talked to her sisters and her father this morning, she saw friends just yesterday, she was talking to her little boy, and hugging him….”
“That was a gift. A gift she gave loved ones. To tell everybody good-bye. You’re the only one she hasn’t told good-bye. She wants to do this now. She wants your permission to leave….”
“Oh, please, don’t! Who do you think you are, God? How do you know this is the hour of her death?”
And then I was reduced to begging. “Give me a few more days, please. Please put the IV back in….”
“She doesn’t want it. You have to be strong enough to give your daughter what she needs right now. She needs you to help her, to let her go; that’s the only way you can help her now, to let her go”
The headache was so bad I thought I might expire before Barbara Ellen did. But I didn’t…. By the following evening I … had recuperated enough to tell my daughter that if she was tired of being sick and wanted to go, I would no longer try to keep her. She held my hand and told me she would wait for me wherever it was that she was going, and she died that morning, in my arms, her sister Marian holding her, too, her father also by her side.
1
I was the palliative physician in that scene. I well recall Barbara Ellen, huddled in her hospital bed under the window, in the first room on the right of the hall as you entered the ward from the elevator. Slight to begin with, she had been reduced to waif-like size by her terminal cancer. She said very little, and she seemed sad. I had no knowledge of her history, except for the essential details of her disease. She had been diagnosed with inflammatory breast cancer, a type that strikes young women and has a dismally poor prognosis. She had elected to refuse all conventional medical treatment—not an entirely unreasonable decision, considering her diagnosis, but highly unusual. Such decisions always involve more than the bare medical facts, and my sense was that this young woman felt quite isolated—had felt that way all her life. At times I just wanted to cradle and comfort her in my arms, as one would an infant or small child.
I had talked with Barbara Ellen after morning rounds on the day Betty depicts in her memoir. “How much longer do I have?” she asked.
“Not long. How does it feel to you?”
“I’ve had enough. Are you giving me anything to keep me alive?”
“Only the IV. Without the fluids you would die in a day or two. Would you like us to stop it?”
“My mother couldn’t handle that.”
“I get the feeling you always took care of her in some ways, so it may be difficult for you to do what you want now. But you don’t need
to take care of her any more. What would you do if you just took care of yourself?”
“I would take out the IV.”
“I respect your mother’s feelings. This is extremely hard on a parent—I can only imagine how unbearably difficult. But you are my patient here, and my primary responsibility is to you. If you wish, I will speak with her.”
Recently Betty Krawczyk and I met again to talk about her daughter’s life and death. We had conversed briefly after Barbara Ellen died, when Betty was grieving and attempting to comprehend why her daughter had died so much before her time. I had recounted for her my understanding about the possible connection between a stressful early childhood and an increased risk for the later development of cancer. Soon afterwards, I received in the mail a copy of her first volume of memoirs:
Clayoquot: The Sound of My Heart
. Inside the cover was this inscription: “Herewith my book. It explains something of my relationship with my daughter who died of breast cancer April 30 in your unit.” Having read that book, I hoped Betty would agree to be interviewed for
When the Body Says No
. As it turned out, Betty had been thinking of me, having just written the passage quoted above. She was interested in learning more about my perspective and hoped I might help her understand better some of the things Barbara Ellen had said in the last six months of her life.
It was no ordinary discussion Betty and I had, but Betty is no ordinary woman. She is well known in British Columbia and beyond for her activism in environmental causes. The title of her first book refers to an internationally renowned rain-forest preserve on the West Coast, Clayoquot Sound, threatened some years ago by logging interests. In September 2001 seventy-three-year-old Betty was incarcerated four and a half months for criminal contempt of court, following another logging protest.
Although
Clayoquot
is mostly about Betty’s experiences as an environmental crusader, she also gives a vivid and honest history of her personal life. With four husbands and eight children, she’s had an eventful life. Now Betty acts as surrogate mother to Barbara Ellen’s son, Julian, who was only two when his mother passed away.
Barbara Ellen gave vent to frequent expressions of deep anger at her mother in the final six months before she died. It is that anger Betty was still struggling to understand.
Betty Krawczyk was born in southern Lousiana, which, at that time, she says, was “mostly one big swamp.” “I wasn’t raised to be a protestor,” she writes in
Clayoquot
. “I was raised a poor, country, southern white woman.”
Memory is so selective, so subjective. At a sibling confab several years ago we were tickled and somewhat amazed to learn that we each, my brother and sister and I, had felt the others to be favored in the family. I know I felt the other two to have been favored. Actually, I still do. My brother was the older, and the only boy, so he got most of the attention. What was left went to my sister because she was the baby and delicate to boot. I was a big, healthy girl who could amuse herself, so nobody took any special notice of me. Which was just fine as far as I was concerned.
You really didn’t want my father to notice you. If he did, you were in trouble. Not that he beat any of us ever, but the threat was always there. We were there to be seen not heard, and seen as little as possible. My mother was different. She was warm and loving. Although I always knew she favored my brother and sister, she was so full of love some of it slopped over on me, too. After I grew up I once confronted my mother with my secret knowledge, and she was hurt and astonished and insisted that if she paid more attention to the other two, it was because they needed her more than I did, that I was always more emotionally independent.
2
Despite this apparent emotional independence, the young Betty suffered “wild nightmares and nervous imaginings in the dark.” She left home early, marrying “the first grown man who came to court who could actually prove he was financially solvent.” In short order, she left her husband, but not before bearing three children. “He was a bit of a compulsive collector of intact hymens. He couldn’t seem to stop after we got married. He finally collected one too many.”
Three more marriages and five more children followed in the next two decades. Barbara Ellen was the seventh among them, born just before Betty moved to Canada in 1966, “six kids in tow,” and her third marriage on the verge of breaking up. They lived in Kirkland Lake, Ontario. Her husband, a college instructor, was an emotionally distant
workaholic who also drank. “I didn’t like John when he drank,” she writes. “He had a tendency to get impossibly self-righteous and accusatory. So I found myself avoiding the same social situations I had originally reached out for. And my depression deepened…. I began to look at John and wonder who he actually was…. I thought that first winter in Kirkland Lake would never end and that spring would never come. Actually, spring never did come…. I think the two most frustrated people in that non-existent spring were me and the baby, Barbara Ellen.”
