As well as offering emotional support, counselling can also improve the outlook for women going through treatment, including the mortality rates of those who are severely depressed, according to statistical analysis in the United States. "The better someone's emotional health, the better the quality of their life," says experienced specialist counsellor Juliet Ireland.
Breast Cancer Foundation chief executive Evangelia Henderson says the campaign aims to raise $500,000 to get the free professional counselling under way from April, using referrals by doctors. It will be offered nationwide, face-to-face in bigger centres and by telephone in more remote areas to ensure all women are given the opportunity to access it. "Absolutely it's a need," says Henderson. The public sector does not offer it and private counselling is beyond the financial reach of many.
"Counselling isn't just a 'nice to have' if you really want to make a difference. The anxiety that people feel, the stresses, are outside our normal experiences," says Henderson. "Well-adjusted strong women can find, when they get diagnosed, that goes out the window."
There is the fear of getting through it, the worry about families and husbands and potential relationship problems to deal with. People at the end of treatment can also fall into a black hole, when they need to get back on with their lives. "It doesn't matter what part of the journey they are on."
Often women suppress these anxieties. "They can't talk to their doctor or oncologist."
All cases differ, but typically there is initial shock, followed by a long, arduous treatment process with the accompanying fears of potentially losing hair, a breast and their sense of femininity.
"Their self-confidence is hugely battered. "Women wonder, 'How am I going to cope with everything this disease throws at me on top of everything that life throws at me'?" says Henderson. "Most women who've had breast cancer, it's very difficult to forget about it. They live with fear it may come back, or it may be back."
Recovery prospects are much better than many realise, however: the five-year survival rate is now at 86 per cent.
Henderson says individual counselling would complement the foundation's existing support services, which include one-on-one and group physical rehabilitation, online and printed materials and a free breast-care nurse advice line as well as breast cancer support groups around the country.
The fundraising T-shirts, numbered one to 1000, will be available to buy for the dollar value of their individual number, with extra donations most welcome - especially, jokes Henderson, for those snaffling the lower-number Ts.
She says a foundation supporter suggested the numbers approach and the Ts were designed to be an eye-catching tribute to those diagnosed. By limiting each T-shirt to an edition of one, it signified the individual and personal journey each woman undergoes.
The numbers are in a bespoke font, originally designed for Wallpaper magazine and donated by New York-based company Commercial Type.
• To buy a T-shirt and support the foundation, go to 1000women.co.nz. For more about the foundation's work see nzbcf.org.nz.
THE COUNSELLOR
Just about every cancer patient counsellor Juliet Ireland sees has been told: "None of us knows when we're going to die. We could be hit by a bus tomorrow."
Such observations don't help, she says. Friends and family need to let their loved one talk. They need to learn to listen, not to give unsolicited advice. Being told: "You'll be fine", can come across as dismissive. Often, such well-intentioned comments are more about the speaker trying to reassure themselves.
"It's okay not to have all the answers."
Helping someone feel less alone by just being there or offering practical support is better than trying to "solve" everything.
Ireland's professional counsel, gained from working in the public and private sector, is:
• Asking for help is a sign of strength, not weakness.
• Gaining expert advice should help provide coping tools.
• Inexpert advice or "jolly ups" often doesn't help.
• Doing practical, helpful chores unasked will be appreciated.
Just as people rally around when someone first has a baby, community support when someone is confronting an illness is invaluable. Ireland advises moving from saying "let me know when you need help" to helping out unbidden with things such as folding the washing, leaving a meal, picking up children, or arranging a trip to the movies. "When someone has health issues to focus on, doing things like the vacuuming is the last thing on their minds."
Empowering those suffering understandable fear to seek professional help is a step to helping them function better. "The campaign is one of the first times that attention has been paid to this area."
Ireland believes treating psychological stress should be as important as medical care.
Dealing with fear and anxiety can empower some people to make healthy changes in their lives that can help with recovery. Individual responses vary widely, from those who are able to make the best of a bad situation to those who cannot. Crunch times come at change points in treatment or health status, says Ireland.
"It's the uncertainty. We like to feel we are in control of our lives. A diagnosis of cancer strips away that certainty."
After the usual year of intensive treatment people often need help readjusting their focus away from their health. "Their question is, 'So what does my life look like now?'." Finding a "new normal" and regaining their energy levels may stir up tensions put on hold by the initial diagnosis.
"They may feel like they've had a second chance of life and stop trying to please everyone."
Others may feel guilty at doing okay, or even robbed of attention as they confront an uncertain future. "The more benefits that people are able to find from the experience of their diagnosis the better the quality of their life," says Ireland.
- VIVA
