FAMILY COPING BY TALKING AND LISTENING YAREN AGUSTIN, CANCER SURVIVOR DR. EPHRAIM GOCHANGCO, CLINICAL PSYCHOLOGIST

KARMINA CONSTANTINO (KC): Today’s series of lectures will serve as an eye opener in fighting the long battle against breast cancer. Ang pangalan ko po ay Karmina Constantino it’s a privilege and honor to be here to serve I can serve.

I’ll be your moderator for the next 60 minutes. First topic po natin this morning is centered on communication with the family of cancer patients. Family coping by talking and listening, yun po ang topic natin today.

YAREN AGUSTIN (YA): Ako po si Yaren Agustin, nung ako ay 13 years old, na-diagnos ako ng Non-Hodgkins Lymphoma. Lagi akong masungit nun, parang grouchy ako lagi. Pagkinakausap ako, hindi ako namamansin or pagkinakamusta ako, lalo na pagtinatanong nila kung “Okay ka lang?”, “Are you okay?” Ngayon pagtinatanong ka “Are you okay?” Of course not. ngayon pagtinatanong kayo, “Okay ka lang?”, tapos masama pakiramdam niyo, “Ok lang!” Pero iba talaga yung feeling… di mo laging masasabi na maiintindihan mo yung isang tao sa pinagdadaanan nya. You can never always say that you understand kasi magkaiba kayo ng experiences, magkaiba kayo ng pinagdadaanan. So nung nagkasakit ako, wala akong masyadong nakakausap dahil nga parang binablack-out ko lahat ng tao, kasi lahat ng tanong nila, lahat ng sinasabi nila laging “Kaya mo yan…” eh, hindi ko na kaya… Tapos, malakas ka naman eh… eh hindi ako malakas. Parang ang sarap kontrahin lahat ng sinasabi nila… kasi iba nga yung nararamdaman ko sa nararamdaman nila… “Bakit may cancer ka ba?” Parang ang sarap sabihin na “Paano mo nasabing kaya ko? Eh parang nagka-cancer ka ba dati?”

So ginawa ng Mommy ko pinakausap nya ako sa ibang patients na may cancer, tapos dun mo lang malalaman kung gaano ka kaswerte. Pag nakakita ka ng ibang tao na mas malala yung kalagayan sa iyo parang that’s when we realize how lucky we are kapag nakakita tayo ng tao na kailangan ng putulin yung paa bukas, tapos naglalakad sila na para ma-feel lang nila na may paa sila for the last time. Meron pang nagtatanong sa amin dati kung magpapa-putol ba ako kung mamamatay na rin naman ako. So, tinatanong nila kung magpapaputol pa ako ng paa kung mamamatay na din ako eh. So iniisip nya kung magpapaputol pa ng paa. Ang hirap sagutin yng mga ganung tanong, syempre dahil desisyon nila dapat yun. Anyway, yung madalas kausap ko lang lagi ang mommy ko, kasi sa family naming kaming dalawa lang… wala akong kapatid, separated sila ng biological father ko, tapos meron akong yaya, si Ate Aileen… Hi! Nasa likod sya, yan yaya ko sya since birth. So kaming tatlo lang sa family. So, di talaga ako sanay mag open-up lalo na feeling ko ako yung man of the family, syempre kahit bata pa lang, feeling mo na ako yung responsible kasi nga lalaki ka. So ang nakakausap ko lang dun yung mommy ko syempre, no choice ako… alangan naming kausapin ko yung kapatid ko, eh wala naman akong kapatid.

Tapos mga 3rd cycle na ng chemotherapy, that’s when I started to cry. Ang sarap pala ng feeling ng umiiyak ka, dapat di ako na pinigil yung first time pa lang kasi parang pinipigil ko yung nasa loob lang. Gusto ko sya iiyak pero wala akong kilalang pwedeng iyakan. Alangan naming iyakan ko yung mga friends kong 12 years old din, di naman nila maiintindihan yun na nahirapan ako. Alam lang naming nun maglaro. Nung kinakausap ko yung mommy ko lagi, nakakatulong siya in a way na kahit wala siyang sabihin, the fact na may nakikinig sa iyo at may nakakaalam ng nararamdaman mo kahit manlang hindi nila naiintindihan basta alam niya kung ano ang pinagdadaanan mo, mas makakatulong sya sa kalagayan mo.

Nung 6th cycle ko na, medyo okay na, regular na yung pagiyak ko, siguro mga twice a week ata. May schedule na yata yun, “Iyak na ko…3, 2, 1. Ahhh…” Nakatulong nga siya naging mas open ako sa lahat, para siyang tatay, nanay.. lahat na, tatay, kuya. Kunwari may itatanong ako, siyempre minsan binibigyan nya ako ng advice, syempre matanda na ko… sabi nya mag-condom ka, ganun… ganun… na minsan hindi nagagawa ng nanay, kasi awkward itanong sa nanay, parang trabaho ng daddy yun. Pero the fact na nag-start yun na yung communication naming yung may cancer pa ko, ang laking naitulong nung nag-bond kami, yung nagka-cancer ako, kasi yung iban tao, yung ibang cancer patient sa na-experienced ko, gusto lang nila malaman na di sila nag-iisa, na meron ding ibang tao na tinutusok sa likod, meron ding napuputulan ng paa, na wala yung mata, na wala ng kamay, di sila nag-iisa dun sa laban nilang yun… marami silang pwedeng makausap, matanong kung ano yung magandang panoorin tuwing Sunday pagka 8 hours kang nakahiga… sabi ko SOP, maganda. Malaking tulong yung positive outlook, kaya makipag-usap kayo.. if you feel like talking, talk, if you feel like crying, cry. Do what you want to do, as long as you don’t’ kill yourself. Maraming Salamat Po.

(KC): Our second speaker is a Clinical Psychologist at the Asian Hospital and Medical Center. He specializes in Psychotherapy for anxiety disorders and depression using hypnotherapy and (inaudible) therapy. May I please introduce to everyone to Dr. Ephraim Gochangco, or si Doc Epi.

DR. EPHRAIM GOCHANGCO (EG): Like Yaren I’ll be talking about communication. Of course when we talk about communication, it has something to do with other people. Commonly that’s how we see it, that when we communicate, we communicate with others, therefore, what I’ll be talking more about now is communicating with family and friends.

However, there’s also another form of communication. Do you know what that is? Alam nyo kaya kung anong klaseng communication nay an? Communication between you and yourself di ba? We communicate with others, family, pero do we really communicate with ourselves? Although on the side na lang yung sasabihin. I’m just saying to you, like for example, kunwari, what did Yaren say? He said, “Kung nalaman ko lang na masarap pa lang umiyak, noon ko pa ginawa.” Alam mo bakit? Kasi di nya kinausap ang sarili nya. Hindi lahat ng taong kumakausap sa sarili nila sya ang sira-ulo. We can talk to ourselves, and we make the better person out of ourselves, by talking to ourselves, okay! So that’s what I needed for you remember, that we can also talk to ourselves, it is also important.

Let us go to the family. As Filipinos, we give much importance to family. If we compare ourselves to westerners or Americans in particular, iba sila. Parang they get a partner and that’s what’s important, and the children they have is considered their family. Sometimes kung wala, dalawa lang yung tao. Pero sa atin, family for us it’s not only family of procreations, hindi lang yung nagkaroon tayo ng asawa, may anak, hindi lang yun… pati yung nanay at tatay, kapatid considered pa din yun…direct family, di lang yun may tiya, may tiyo, may lolo, may lola, lahat yun kasama. Pero alam nyo that encourages help. That’s what’s nice about that culture. In fact not only the Filipino culture, but Asians as a whole…particularly Asians are moreclosely knit. How can I say that our culture is much healthier emotionally and physically than the western culture. Well, basically, on the Western culture study itself, aa California Department of Mental Health, people with strong relationship with others, whether friends or family, tend to live longer and suffer from fewer diseases. Mas marami kang ka-relasyon, mas konti ang sakit mo, at mas mahaba ang buhay mo. People lacking in strong realationship have 2 to 3 times the risk of early death, regardless of whether they smoke, drink alcoholic beverages or exercise regularly. So maski na mag-exercise ka the whole day, kung wala ka naming kausap… In fact, di ba, maski na pets, study shows that if you have pets, importante talaga yung interaction.

Terminal cancer strikes socially isolated people more often than those who have close personal relationships. Ibig ba sabihin nun, na kapag ikaw ay isang daan ang relatives mo at dalawang daan ang friends mo, ibig sabihin hindi ka na susceptible sa maski anong sakit? Or even cancer? Yun ba ang ibig sabihin nun? Marami gumaganon, bakit kaya? Kasi ikaw lang ang maysakit, hindi… hindi naman necessary yun. Kung marami ka naming ngang kamag-anak, marami ka ngang kaibigan pero lagi kang (inaudible) at ayaw mong kumausap ng tao eh di ganun din, mag-isa ka lang. For example yung nangyari kay Yaren, naging masungit daw sya, so who would like to approach kung masungit? That’s why I specify strong relationships or close personal relationships. At one point Yaren started to reach out. Maski na hindi sya naiintindihan ng iba, “Wala akong pakialam, iiyak ako!” Iiyak sya kung gusto nya sa harap ng marami, “I don’t care!” He reached out, he started talking to his mother. That’s what’s very important. I think in the beginning pa lang he started talking na.

Now let’s go to the characteristics of a family. Anung characteristics ba ng pamilya? Para magkaroon tayo ng komunikasyon? We have what you call inter-dependence. Ano ang ibig sabihin ng inter-dependence? The members of the family are connected together so that each person is affected by another. Alam nyo yung mobile? Yung mga babies, meron kayong nilalagay na laruan sa ibabaw, di ba merong ganun yun? Tapos merong nakasabit… anong ginawa nyo pag ginawa nyo tong mga ganito sa isang arm? lahat gumagalaw. Ganyan ang pamilya, lahat gumagalaw. Kunwari dun sa isang pamilya may bumagsak na isang bata, anong mangyayari? Lahat magkakagulo na. Obvious ba na magkakagulo? Hindi. Ang gagawin lang ng nanay, gagawa ng paraan para turuan yung bata. Dahil duon ang mangyayari, nawawala ang atensyon dun sa isa pang bata. So paano ngayon yun, tapos yung tatay naman maiinis dahil nagiging masungit naman yung isang bata. So pagagalitan naman yung ibang bata. So lahat gumagalaw dahil sa isang event, maski na kasiyahan, negative or positive, hindi yun ang importante. What is important is, whatever happens to one member of the family, the whole family changes.

For some, at one point in their life they decided to move out from their houses because they could not stand their families, buwisit na buwisit na sya sa nanay at tatay nya dahil walang ginawa kundi insultuhin sya. Ibig bang sabihin nun hindi nya dala-dala ang kanyang pamilya pag lumipat siya sa isang bagong bahay o kung lumipat sya sa ibang bayan? Hindi, dala-dala pa din nya. Even if you physically remove yourself from other family members, iyong matatandaan ang memories at saka yung mga habits nyo sa pamilya, developed over the years and you connect to them. Kaya minsan nag wo-wonder kayo that even if you leave far away from family there will always be someone who will respond to you the way your father, mother, brother and sister responds to you. Kunwari sa trabaho, pansin nyo isa dun parang tatay nyo… yung isa dun parang kapatid mong masungit …hindi bale kung ganun eh. The point is, yung response mo dun sa masungit na taong yan parang din yung response mo dun sa masungit mong ate. Bakit hindi naiba? Bakit hindi mo palitan? Bakit pareho? Kasi dala-dala nyo yun, hindi porket umalis ka ibig sabihin hindi mo dala-dala ang pamilya mo, dala mo, kaya importante talaga ang pamilya gawan ng paraan para hindi nasasabi na gawing mabuti ang pamilya. Ang nasasabi ay ikaw paano mo isipin ang pamiya ay mag-iba para maski gaano kasungit si ate, gaano kadaldal ang nanay at gaano kalokohin ang tatay, parang dapat isipin na ito ang pamilya ko. The way you see it, maganda. So that is what is inter-dependence, hindi matatangal sa atin.

Isa pang characteristic about family is wholeness. Imposible malaman ko kung ano yung pamilya nyo kung ang kakausapin ko lang ang dalawang miyembro, lalo na pag sila ang magkakampi, ang istorya nila, magkapareho. Pero pag kinausap mo yung iba, iba na ang litratong nakikita sa pamilya. Kaya kailangan talaga kapag kinausap mo ang isang tao alamin mo sa ibang… tingnan mo sila dun sa pamilya pag naguusap-usap sila. Observe them, iba… iba doon sa kinukwento nya. “Bakit sabi nya ganun? Bakit ngayon pagkasama nya yung pamilya nya iba sya?” Iba talaga. You have to see the family as a whole. That’s the other characteristic of family, which is wholeness.

Another is, family state have patterns, ano ang ibig sabihin? Meron kayong way of relating. Sa phsychologists tinatawag dun, may dynamics kayo, kung paano kayo nagri-relate sa isa’t-isa.

Families tend to maintain homeostasis. Ano ang ibig sabihin nun? A kind of equilibrium that keeps the family following it’s standard of behavior, ibig sabihin, kunwari yung nanay medyo (illustrate) gumanun na yung mata, may ibig sabihin na yun, magkaka-giyera ba yan, hindi ba? Hindi mawawala yun, medyo tumaas lang ‘tong ganito (illustrate) pero pag kaliwa, hindi. Medyo sinisinghalan lang, pero pag eto (illustrate) giyera na. Meron yun hindi nyo mapapansin, ang nakakakita lang nun ibang tao, specially therapist. So nakikita nila yung mga little nuances sa behavior na kapag ang tatay nila (illustrate) yung sigarilyo, iba na rin, kapag (illustrate), ganyan iba na rin noh. That’s how it is. When something brings the family of you from the norm, pag may nangyari na, ibahin na yung behavior na yun ang mangyayari, meron isang member of the family that will behave in such a way that will behave in such a way na ang lalabas, babalik din sila dun sa ganun klasing interaction. For example, may isang pamilya…they are very dependent on each other… ibig sabihin nun pag huminga yung isa, susunod-sunod lahat, ganung klaseng hinga. Pero ang tendency, they depend on each other, ang problema lang dun sa dependence kung sino, sila-sila rin nagaaway-away noh. But the point is may dependency. May nangyari ngayon dun sa nanay, yung nanay nagka-problema, pumunta sa akin. So yung nagpunta sa akin, gumaling na sya. Ang problemang ito, not that this is a problem, actually it’s good noh, na dahil sa therapy natuto siyang naging independent. Alam nyo nangyari? Yung tatay naging depressed, pumunta naman yung tatay sa akin, gumaling na naman. Yung anak nagka-problema. So ang mangyayari no way but the family to become dependent on each other, kasi magsasaluhan na naman ng magsasaluhan nya. It’s good to help people, but to rescue is a different story. Do you know what rescue means? Yung maski na hindi naman kailangan ng tulong, tutulungan mo, yun ang rescue. Hindi importante sa pamilya yun, so yun lang ang ibig kong sabihin ano… binabalik natin…pag alam nyong magkaka-ganyan na…dapat ibahin nyo na noh.

So anong mangyayari dito sa family? After nung all this characteristic, napapansin nyo na kaya nangyayari ito ay dahil sa communication.

Alam nyo ba na maski na hindi kayo mag-usap lahat sa pamilya may communication pa rin kayo? Ano ang ibig sabihin pag hindi kayo nag-uusap? Ibig sabihin galit kayo sa isa’t-isa. Puwede bang ang ibig sabihin nun eh gusto ko lang magdasal araw-araw? Hindi noh. Parang masakit yun pag walang kumakausap sa iyo. Nagtitinginan lang kayo. Pag magdadabog may communication pa din yun… parang merong kang ginawa na ayaw ko, ibig sabihin nun noh. Whatever you do, you communicate. Of course, some people not like to be called that we are mammals or animals, pero sa lahat ng animals, tayo yung meron pinaka-sophisticated form of communication. Pero ang nakaka-lungkot nito, what’s sad about this, is that animals use their communication skills to the fullest, samantalang tayo hindi. Kapag galit tayo, galit… Galit ka ba?

AUDIENCE (A): Hindi

(EG): Sigurado ka hindi ka galit?

(A): Oo, sigurado

(EG): Hindi ba! Pero ang aso, yung mga aggressive animals, pagnag-away na sila, yung isa biglang gaganun (illustrate) tapos nakangangang malaking-malaki, hanggang pati bituka nila nakikita. Tapos yung nasa ibabaw, nakaganyan (illustrate) tapos gaganyan (illustrate.) Ang ibig sabihin nun, yung isa talo na, tapos makikita mo bigla silang maghihiwalay. Alam nila. Narinig nyo ba silang magsalita? Hindi, pero bakit naghiwalay? Bakit alam nung isa talo sya, alam nung isa panalo sya. And it’s an agreement na kapag alam kong talo o tapos na, walang patayan. Pero tayo hindi. We don’t do that. We have to enhance our communication skills.

For example, etong isang lalake na 40 years old, yung nanay dinala sa akin, Sabi ko sa kanya, “Alam mo ba tungkol lahat sa nanay mo?” And he says, “Of course, I know everything. She tells me everything”. So sabi ko, “Really?” Do you also know that your mother likes you to know that she likes to solve her own problems with you, instead of you solving it for her. Alam mo tumingin sya sa nanay nya, tapos yung nanay nya sabi (illustrate). She just smiled a sheepish smile, kasi under siya dun sa anak nya. Obvious ba, hindi alam talaga lahat ng anak, bakit? Yung nanay takot magsabi sa anak. Faulty ang kanilang communication system.

Kaya lang hindi lang naman sila yung may problema, tayong lahat naman may problema tungkok sa communication. One way or another we will hold information that can actually help others understand us. As a result, we isolate ourselves and prevent others from approaching us or becoming close to us. Dahil hindi tayo nagko-communicate, ina-isolate natin ang sarili natin, ibig sabihin nagiging mag-isa nalang tayo okay.

So, communication can be the tool that imprves the quality of interaction and it can also be the means for causing problems. When a family member is discovered to have breast cancer, the immediate response of other family members is to deny. How is that manifested? paano ipinakikita yung deny?

We shield and protect that patient from any emotional pain… “Wag tayong magsasabi ng problema dyan… kawawa naman, kasi ano, dapat hindi binibigyan ng problema yan.” Alam mo, may nangyaring isang ganun, so ang akala ngayon nung survivor, ayaw syang kausapin. Syempre, bumababa ang self-esteem pag lahat ng sakit na nasa katawan mo, tapos hindi mo pa makwentohan. Biglang itong survivor na lamang ito nalaman nalang nya na, kasi away sabihin sa kanya n yung pinakamamahal nyang pinsan, namatay. Ang tagal nya bago nya nalaman at alam mo paano nya nalaman dun sa kaibigan ng kaibigan ng kaibigan ng kaibigan ng pinsan nya… nagalit tuloy sya, eh di lalong na-isolate.

See what happens?

On top of that, other members islate themselves also. Hindi lang yung may sakit ang nagi-isolate, mismo ang mga members dahil nalulungkot sya, dahil yung kanyang kamag-anak may sakit, maski ano pang sakit yun, maski na TB lang, nalungkot sya dahil maysakit yung kamag-anak nya, tatahimik na lang sya dahil ayaw nyang kaalam, dahil nga kapag pinaalam nya lalong lumala pa ang sitwasyon. Pero baliktad, diba? Baliktad. Kaya ang pinalalabas nila, “Wala naming problema…” Meron nga eh? Ano ba yung problema? Dahil may sakit? Hindi, hindi yun ang problema. Ang problema, nakatahi yung bibig mo, hindi ka nagsasalita, yun ang problema.

The patient themselves feel oblige to be silent about their experiences, (inaudible) Breast Cancer: A Family Survival Guide. In Chapter 9, they cited an example of cancer survivor with breast cancer. She said, “Cancer is not something that people want to talk about. We who have it don’t want others to know it because they are afraid of catching it. They think it’s a disease or measles or chicken pox.” Di ba alam naman natin na hindi naman nakakahawa yun? Alam nating lahat yun, diba? And yet bakit sya ganito mag-isip? One explanation is dahil pino-project nya yung sarili nyang isip tungkol sa isip ng ibang tao. Alam nyo ibig sabihin ng project? Akala mong iniisip mo tungkol sa ibang tao, sinasabi mong kanila pero actually isip mo yun.

Pero guess what… just recently I found out na it’s two-way, hindi lang yung survivor ang nag-iisip ng ganun. Meron akong nakausap na isang babae sabi nya sa akin. “Takot na takot ako lumapit sa cancer survivor.” Bakit? “Alam ko naman na hindi nakakahawa yun eh, pero tingin ko baka magkaroon ako kapag katabi ko siya.” You see, the mind and the heart, hindi magkatugma. Anong dapat gawin dun? Di pag-usapan. Pag-uusap ang mabuti. Ang totoo nyan natatakot lang sya sa sarili nyang kamatayan.

Ultimately, the cancer survivor becomes isolated socially because she’s stops herself from communicating her fears and carries the burden of sadness all by herself.

Others also stop communication because of different forms of fears. One fear is the fear that they maybe infected, and another fear is that when they talk about it with the patient, they feel that they might upset them. As a result, the isolation of the patient increases her stress levels, lalong tumataas, therefore, making her more susceptible to illness, iba pang sakit pa. People don’t realize that by being quiet they have actually limited their ability to cope about the situation. For those who have a family member with breast cancer and chose to be open about the cancer, they were able to adjust well, and learned that commuinicating with friends, relatives and other people with the same experienced were important in helping them cope. Just to talk about it, nakakatulong, napakalaki. Maski anong problema eh, hindi lang sa sakit, maski anong problema kaya may tao dyan daldal ng daldal, daldal ng daldal kasi nasira lang yung kanilang anu, parang nagiging masaya na siya dahil naikwento nya sa kaibigan nya, lahat. Kung from that to sickness, anything, just talk about it. Talking with others will help the patient and family members realize that one is not alone, as Mr. Agustin said earlier. In this experience, there are others going the same fears. Knowing that others don’t do the same experience, it helps one to realize that it is normal to be scared, okay. In time the feeling of fear gradually appears. You know, what struck me in what Mr. Agustin said earlier was, yung acknowledgment of fear, of the feelings. Yung pinaka-importante, na, “Dapat pala umiyak ako, na nararamdaman ko na dapat umiyak. Nararamdaman ko pa ba ngayong araw na ito, hindi ko alam.” Now, the moment you acknowledge that, don’t you know it’s not only the survivor who has to acknowledge it, also the family members need to acknowledge the act.

Now, beforer I end, I’m going to share something with you: The personality trait determine the sickness. Pwede kaya yun, na kapag ganito ang personality mo, ito ang sakit mo, yan ang sakit mo, yan ang sakit mo? Ang Psychologist kasi, palibhasa di naman sila MD, kaya gumagawa sila ng paraan para kunwari bida sila, so binibida ko yung binibida nila sa atin. Ang sinasabi nila na kapag type A ka, alam mo yung type A? Yung laging nagmamadali, yung tingin ng tingin sa relo tapos di malaman ang gagawin, yung mga goal getters, mga achievers. Anong mga sakit nyan? Heart, high-blood. Others say that diabetes, and so forth pero specifically heart. Meron naman yung Type B, alam nyo yung Type B? Yung magkakabit, laging “Okay lang, relax lang!” Y,un walang sakit yun, because they are so relaxed. Pero alam nyo ba na merong Type C?” C means a combination of A and B, pero mukha syang B kasi hindi sya naaapektuhan ng maski sino. Ang diperensya lang is inside the person is a lot of emotions na hindi pinalalabas, yun lang ang diperensiya nila sa Type B. Supposedly, Type C people are the one’s with cancer, but it doesn’t mean that they are. Psychologists are just like that. I just got wanted to give that information. So ibig sabihin nun, mukhag very calm pero actually inside maraming pain, hinanakit, yung mga nanay na pag nakangiti ng ganyan (illustrate) pinagpapasensyahan lang yung asawa na lahat na ata ng babae dinala na sa bahay, yung anak nyang adik, pero nakangiti pa rin sya… You ask them, “Okay lang ho ba kayo?” and they answer, “Very much okay.” Tapos may cancer na siya. Why? Do you know that cancer cells are our own cells na nagmumutate? So that’s the way psychologist would like to explain it. But of course there’s no 100% truth in it because the medical doctors have to be the one to have to determine, dahal katawan yan, hindi talaga isip.

So, thank you very much.

(KC): Sinabi ng importante to communicate with yourself, so if you keep on repreating, parang is that a form of therapy na rin at parang a way to communicate na rin with yourself?

(EG): Yes, it’s a form of desensitization, because you keep on feeling it while talking about it. The book says that at one point you don’t feel it anymore because your used to it na, just like people in the warzone. Children are so used to war that if somebody’s killed in front of them they’re used to it. But of course, we are not into that. The point is, because we go over it again and again and again, it’s stops at one point. Ganito yun eh, even if therapy, meron kayong makakausap na isang tao…this is how it is: yung fear natin, we call that intrusive thoughts. Alam nyo ibig sabihin ng intrusive thoughts? Yung nananahimik kayo, nakapiket ka lang tapos biglang may sakit ako. That’s an intrusive thought. It comes back again and again and again and again, and you talk about it again and again and again and again. Yun ang purpose naming therapist; when you say it, ang mangyayari kino-connect naming yung isip yo duon sa damdamin niyo, pero dito sa mundong ito, meron isang tao na makakausap kayo, nyo, na ididikit ang isip nyo at dibdib nyo maski na hindi sila therapist. Who knows.. but in one of those support rules, may insights siya na sinabi nya sa iyo habang umiiyak ka, tapos nakaganyan ka (illustrate.) It’s whenthat happens na biglang mawawala ang fears nyo, ang subject nyo bigla na lang nawala.

(Q1): You mentioned yung interaction nyo with others. I am a person na napakarami kong friends. I go out, and I’m a very active person. In short, I spend time, so everytime maisa ito, the more kong naiisip.

(EG): The more intense your feelings are.. so mas lalong dumadating yung mga thoughts, so yun ang intrusive thoughts. Ano yung nasa isip mo?

(Q1): It’s fear or… marami… nalulungkot ako. I feel alone, I feel sad. So alam kong the more that I don’t want to be alone, so I go with friends. How do I cope with that?

(EG): The question is, what makes you think you are alone?

(Q1): I’m alone in the sense that I feel sad… nalulungkot ako. I was diagnosed 2003, nag-chemo ako apto March 2004. Parang yung feeling ko, I’m not questioning God. Ang feeling ko talaga, “totoo ba ito?” I was asking myself. Sabi ko “Totoo ba itong sa akin?” I only asked myself. I communicate with everybody, I’m an active person but I never question anybody. I only asked myself “totoo ba ito?” So the feeling is para bang, “ito ba ay totoong nangyayari sa akin?” Or there are times iniisip ko naman being affected because I’m alone here in Manila, my family is not here.

(EG): Okay, the second one, you can do something about it. The first one, you can also do something about it. It’s either you to accept it or not, it’s really up to you. The point here is, it’s not a matter of just being sad because your alone. There are two things. Kausapin ang sarili mo, ask yourself “tatanggapin ko ba talaga ‘to?” Kasi ang tanong mo eh, “totoo bang nangyayari ito?” Translate it into, “tatanggapin ko ba ito?” Parang binigay sa inyong regalo, “tatanggapin ko ba yan o hindi?”

One thing I’d like to point out, any form of experience, wether negative or positive can be perceived by you as negative or positive. For example, merong pumunta sa akin na nasasakal na daw sya ng asawa nya, nasasakal na daw sya ng anak nya, lagi daw gusto sa bahay lang siya, ayaw syang palabasin kasi dun sa lugar nila dangerous. Inis na inis na daw siya sa pamilya nya. Kakaulit nya, pangatlong beses nadinig ko sabi ko, “Miss alam ko na… pinoprotektahan ka lang ng asawa mo at anak mo.” Nagulat sya. ‘Oh my god, I can’t see it that way, I felt sinasakal ako nila, sakal na sakal na ako, hindi ko na alam ang gagawin ko.” Ang akala nya hindi sya mahal ng asawa nya at anak nya. So, something that was negative was transformed into something positive. My advice lang is to look for something positive in everything. That might help.

(KC): Paano mo ibabalanse yung projecting na yun at saka yung communicating with yourself?

(EG): You have to own your own thoughts. Kunwari ito, meron akong mahal sa buhay tapos sasabihin ko, “hindi nya ako siguro mahal.” That is a projection. Sabihin mo sa sarili mo, “ano ba ang tungkol sa akin nasa tingin ko na ang ibang tao ay ayaw sa akin? Kunwari kasi hindi ako guwapo, kaya ayaw sa akin…” Hindi… hindi mo alam yun eh, hindi mo alam baka yung type yung pagmumukha ko eh. Maski ano pa ang pagmumukha ko. Ako yung may mababang self-esteem, ang baba pala ng tingin ko sa sarili ko, hindi yung tungkol sa hindi nya ako mahal, hindi ganun. Mababa pala ang tingin ko sa sarili ko. That’s how you talk to yourself.

(KC): Kung yung pamilya ng survivor ang nagsasabi na ayaw pang makipag-usap o hindi pa handang makipag-usap yung survivor, ano po ang gagawin nila, being volunteers, kasi volunteer po si Ma’am eh, nagpa-facilitate ng communication sa pamilya.

(EG): Of course, the most important thing here is respect. Respect the loses of the person and wait till the person is ready. Until that time the only thing you can do is send little notes.

(Q2): St. Peregrine is the Patron of Cancer Patients. I have a different question, kasi I told my sister not to tell our mom that she has a cancer, is it okay?

(YA): Nung sinabi sa akin ng mommy ko na may cancer ako, pagkagaling ko after the operation na… “Yaren, you have cancer”. My first reaction was “wow sikat”, syempre kasi pag sa movies lagi na pag may cancer ka parang special ka, na dadalhan ka pa ng grapes araw-araw, pero I was a kid then, na syempre sa akin “naku, bitin ako sa buhay parang kulang pa yung na-experienced ko.” So, baka different din yung kwento nyo na baka iba rin ang maging reaksyon mo. May sakit ba sa puso yung…?

(Q2): Wala naman siyang sakit sa puso, actually ang alam kong sakit nya is only yung gout nya noh, but….

(KC): What is your motivation for deciding that you should not tell your mom?

(Q2): My mother is already 78. Ang sabi ko, baka hindi nya ma-accept nung mother na meron syang cancer. Sabi ko sa sister ko ang sabihin mo na lang yung sakit nyang gout, pero kasi only one week pa lang nyang nalaman na may cancer sya eh… hindi pala nya alam noh… kami palang ng sister ko. So, ang bilin ko not to tell our mother.

(EG): Okay, you know that’s a very difficult question to answer . In the US madali lang sabihin. Here, for methe point is still respect the person. A very good example is the following: my sister is a cancer survivor herself. My mom, when we went to States, we didn’t know that she was going to go through a biopsy and we didn’t know that. Pagbaba namin dun, she had a very sad face. Then yung next day she was going to have a biopsy. So kami nagulat ng ganyan, and it was just by chance that we wanted to go. My mother felt very bad because she says “She’s my daughter, she should have told me. I have the right to know as a mother.” Lalo na kung ikaw sarili mo, sarili mong sakit. I have the right to know what is going to happened to me. I would just saying to Carmina kanina, “alam mo, me, I would rather know na may cancer ako, you know why? Alam ko na kung ano and gapat kong gawin, lahat ng litson kakainin ko, lahat ng roasted calf kaiinin ko, lahat nt steak kakainin ko.” Kung ganun din ang mother mo paano yan… but then again, baka because you tell her, she’s might be very sad, and because she might very sad, the more she… we don’t know that but for me let’s just respect the person, she has the right to know.

(Q3): I would only like to add this information, give the patient a chance to adjust to the diagnosis that he/she has cancer. Wala po akong nakitang tao na nasabihan ng cancer na lumukso at sumaya. Bigyan mo sya ng pagkakataon mag-adjust at saka sabihin sa kanya, give one or two weeks. It is a normal grieving, when you received this news… but yung coping skill ng pasyente yun ang magpapaikli o magpapahaba nung kanyang anxiety, nakuha nyo na ba po?

Second lady, to answer your question, yes, you have to inform your mother. Why? First, let this assumption cross your mind: at 78 years old she knows she’s already about to go, you know it already. You think there is something wrong but if you will not tell the lady, the old woman, how will tell your mom, “may utang ba sa inyo? (laughs) Baka may mangyari sa inyo. Meron palang nakautang sa inyo hindi pa namin alam. Second, meron ba kayong pinagkakautangan? Third, ito pong naiwan na mga ari-arian para hindi ho kami mag-aaway na magkakapatid (laughs).

These are things that are laughable, but I will tell you, if she passes away, she will create a lot of trouble to each. Because you’re a human being, see to it, that the people you leave on this earth will not quarrel because of your negligence. So please tell your mother.

(EG): Thank you!

(KC): Im interested in your psychotherapy or hypnotherapy, could you please explain to us the procedure or is there a program for those who are interested tot try that kind of therapy.

(EG): In my clinic what happens is when the first one comes to me, there are many ways of going to therapy. One way is hypnosis, I call it imagery exercises. My form of imagery is what you call the modern hypnosis. I just ask you to close your eyes and then make you imagine things in your head, things that you remember when you were a child, things that are happening right now. Before you know it there is a theme that’s going on there and then I make you talk about it and then later on you will resolve that. That is hypnosis for me. Hindi na siya yung makakatulog ka.

I have what you call (inaudible) therapy. It’s a conversation, but it’s not just talking. An example is what I did to her kanina noh… that’s was very small example lang, pero what I do is, person talks and talks and talks, 15 minutes to 20 minutes and I just say a one word and then they think, and then I tell them to elaborate. That’s the form of therapy.