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The Tibetan medical system holds that the origins of illness are rooted in Ignorance, Desire or Hatred… provided these are kept in a state of equilibrium the body remains healthy.
I have been interested for a number of years in the role of the psychosoma in the psychoanalytic situation, and I should like to explore the role that psychoanalysts may play in studying the conscious anxieties and the unconscious fantasies of breast-cancer patients. I would like to discuss, as well, the extent to which psychological treatment may augment the success of the medical and physiological care of the cancer patient.
My experience in this area has been with a number of breast-cancer patients who came to me for psychotherapy, including three who were in full analysis for a number of years. It is notable that, considering the number of people in the population who suffer from cancer, relativly few cancer patients seek the aid of psychoanalysis or psychiatry. This may suggest a reluctance on the part of cancer patients to undertake psychotherapeutic treatment. Those who came to me for treatment were usually motivated by having read books or papers of mine on psychosomatic issues (though not specifically on cancer; this is, in fact, the first paper I ever wrote on cancer in the psychotherapeutic situation).
The mutilating treatments imposed by breast cancer (radiation, chemotherapy, mastectomy, breast reconstruction) will invariably arouse considerable psychological distress in the affected woman. She may feel the loss of her feeling of bodily integrity, disturbance in her self-image and her sense of subjective identity, as well as perturbation in her feeling of sexual identity. With the loss of the breast, the essential symbol of femininity is felt to be destroyed. As one of