Becoming Your Own Advocate

How to Define Your Needs: Getting Support from Family and Friends

Research over the past three decades has shown that when women with breast cancer receive wanted emotional support from close family members or friends, they are able to better adjust to their diagnosis and experience lower levels of stress.

Research over the past three decades has shown that when women with breast cancer receive wanted emotional support from close family members or friends, they are able to better adjust to their diagnosis and experience lower levels of stress. 1, 2

A new study from Oregon Health & Science University in Portland has examined the important assumptions that emotional and social support is always helpful to people with cancer.4 The study authors investigated the health implications of a mismatch between the intentions of a support giver and how that support is perceived by the person with an illness. This new study produced findings that can be helpful in understanding and improving the relationships between people with an illness and their family and friends.

Researchers asked women with breast cancer to describe what kind of social support they had or had not received following their diagnosis. They were also asked what type of support they did or did not want to receive.

Women participating in the study were then asked questions about the sort of problems they had faced at home or at work in coping with their diagnosis and treatment and what kind of psychological distress these problems caused.The goal of this study was to understand whether a match or mismatch between the type of support women received and the type of support that they wanted to receive had any effect on their ability to cope with their illness.

The study found that when the support women received was unwanted, it could cause unnecessary stress, and that an increase in the amount of unwanted support received led to an increase in the amount of stress experienced.

Previous research on this topic usually focused primarily on the person with an illness and assumed that any support received was always wanted. This study places an emphasis on both those receiving the support as well as those giving it and acknowledges that whether the support received is actually wanted is important.

This study is also significant because it directly compared the effects of both wanted and unwanted support on women’s psychological health. Researchers found that negative interactions between giver and receiver left a more memorable impression. Negative support, defined as either unwanted support that was received or wanted support that was not received, significantly hampered the participants’ psychological adjustment to their illness.

This study highlights the importance of breast cancer patients letting their family and friends know what kind of support they need. The authors write that “the match between the type of support a woman wants and what she receives” can determine how well that support helps her to cope with her illness. They also suggest a framework for how a person with breast cancer can gain perspective on how they are coping with their illness.

This study suggests that this may not always be the case. Examples of unwanted support can very widely. For example, a person whose coping style includes seeking as much information as possible in order to help make treatment decisions might not respond very well to friends and family members encouraging them not to read so much about health. Similarly, the person who has difficulty interpreting medical literature and is looking to their medical practitioners to help them make treatment decisions might object to unsolicited offerings of medical books, articles, and web sites.

Because it is difficult to predict what kind of support a person would like and need, it can be very helpful for the person with an illness to make clear what they want from those around them in terms of support and assistance. Similarly, it can be helpful for people who want to provide support to ask about what type of support is actually wanted.

In this study, women were asked questions about the behavior of the people giving them support. For example, does the person providing support:

» Ask if I want to go out?
» Distract my attention?
» Encourage me to use religion?
» Encourage me talk with others?
» Give me facts about cancer?
» Give me advice?
» Give me a philosophical perspective?
» Help me take my mind off cancer?
» Identify with how I feel?
» Try not to say the “wrong thing”?
» Provide relevant information?
» Remind me that things could be worse?
» Say time will make a difference?
» Share stories about others?
» Suggest I go on as before?
» Tell me about their own experience?
» Treat me normally?
» Try not to talk about cancer?
» Try to focus on the next steps?
» Try to minimize the impact?
» Try to understand the situation?

The women in the study were then asked whether these behaviors were wanted or not. These answers were then tallied according to the following criteria:

Support Is Wanted Not Wanted
Received Positive Support Match Unwanted Support
Not Received Support Omission Neutral

There were 79 women with an average age of 55 who, within the last two years, had received treatment for breast cancer in both early and late stages of disease. They had a wide variety in the type of support they wanted: women either told themselves things would turn out well, wanted to act normal, wanted to learn as much information and advice as they could, or wanted to talk about cancer but didn’t specifically want advice from others.

None of these four different coping styles was generally more helpful than any other.What had the strongest effect on a woman’s ability to cope was whether the support she received was the type of support she wanted.

According to this research, defining for your family and friends what kind of personal support you need can make a big difference on how well you are able to cope with and adjust to your diagnosis and treatment. Using the specific questions used in the study can serve as a good starting point for discussion as they can clearly define specific support actions and make it easier to articulate your needs.

This can, however, sometimes be difficult to do on your own. In an interview about the study, one of the authors suggested that this discussion can be facilitated by a third person, such as your healthcare provider. 3 In the end, this sort of honest discussion can help a person coping with any illness more clearly define his or her needs, perhaps leading to the kind of support that is most beneficial.

1. Dunkel-Schetter, C. A. (1984). “Social support and cancer: Findings based on patient interviews and their
implications.” Journal of Social Issues 40: 77-98.
2. Moyer, A. and P. Salovey (1999). “Predictors of social support and psychological distress in women with
breast cancer.” Journal of Health Psychology 4: 177-191.
3. Norton, A. (2004). “Unwanted support in breast cancer may be harmful.” Reuters Health.
4. Reynolds, J. S. and N. A. Perrin (2004). “Mismatches in social support and psychosocial adjustment to breast
cancer.” Health Psychol 23(4): 425-30.

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