This article is also available at Medium.
Sometimes a cancer patient has to start a war. Not because of what you need, but because of what others might. Every other month my insurance company threatens to cut my psychotherapy sessions. For many, therapy sessions during cancer treatment is an after-care, an after-thought. “Psychotherapy session?! That is not a priority when you are about to die”, some might think to themselves.
As cancer patients we get so overwhelmed with the diagnosis and treatment we easily overlook resources that are available to us. Psychotherapy is one of those resources only mentioned in softly-spoken, hush-hush, word-of-mouth, peer-to-peer talks that might take place when you are both at the radiation lobby, as you wait for your turn. It’s your 28th session of radiation during the Xmas holiday — It is cold inside and outside of you. Or you may hear about psychotherapy from a person walking out of the oncologist room beaming with health, as you are sitting there with no hair, no strength and you dare to ask: “How did you survive through this?” That is when you might hear the word: “psychotherapy” — “It was really helpful; It was a lifesaver; I can’t recommend it enough; Why don’t you try it?”
And I did. I did it from the beginning. I did as soon as I was diagnosed with breast cancer. Not because of a recommendation by a doctor. I never once heard from a doctor: you might want to consider psychotherapy. But a breast cancer survivor did. One of those heroines that have beaten the 5-year mark. The one you look up to, and makes you feel as a little girl that have just held hands with Wonder Woman. She gave me the name of her therapist. And suggested I get psychotherapy support alongside my cancer treatments. And psychotherapy sessions became my weekly routine. I chose the day after chemo to see my therapist. The hardest day of all. And he would help me to talk. And he would help me to breathe. I would see him on the following week when my body was a bit stronger, but when the fear of the next chemo session was already starting to build. I had sessions before surgery. And he helped me to deal with the trauma of having my breast removed more easily. I had therapy sessions as I was getting daily sessions of radiation. And he helped me to be patient. Because he knew it would take time for me to feel like myself again. He helped me to deal with the anxiety. It engulfed me as time came to walk out into the world and go back to work as if everything was normal. The weight of all you just went through following you like a ghost.
Right now, I am the one walking out of the oncologist room beaming with health. Right now, I am the one who gets to play Wonder Woman. I am the one daring to say the hush-hush word “psychotherapy” into a cancer patient’s ears. And I whisper: “Do it for yourself. Do it for your family. Do it for your sanity and that of those you love. It is a long battle, cancer. Longer than you can imagine. You will have to fight it for the rest of your life. It doesn’t end when treatment ends. It’s your everyday.” And the hardest battles are fought alone, in the dark. Because there are days you can tell someone you love: “I am afraid.” But there are days you cannot. There are decisions that you will have to make on your own. Because if you share it with your best friend, which happens to be your husband, it will shatter him to pieces. So you find someone else you can talk to. Someone else to help you to process, to understand, to believe in the impossible: that you can live with cancer and after it.
Those who do not have a voice because they are in the middle of the battle: in and out of chemo sessions, appointments, surgeries and radiation treatments; Those who have lost the battle already even though they tried everything to stay alive, and were alone in their process of departure; Those are the ones I am speaking for! I wished psychotherapy sessions were widely available for those who are undergoing cancer treatment, or those like me that are just trying to live after the fact.
That is why anger bubbles inside of me, every time United HealthCare requests a peer review to evaluate my need for frequent psychotherapy sessions. According to a representative only extreme cases are eligible for weekly sessions. May I ask, If having cancer is not an extreme case, what is, Maam?!
The insurance company requested a detailed description of the symptoms to justify my need for psychological support after cancer treatment. Call it PST. Call it fear. Call me a coward, if you want. But the waves of panic come. The waves of grief come. It comes out of nowhere. It catches you when you least expect it. Like, when you stop in traffic for a mother holding the hand of a 5-year-old on his first day of school. And all you can think about is how you would like a turtle backpack just like that to be sitting next to your purse as you drive your child to school. But you will not. Because just 6 months ago, 24 weeks ago, 182 days ago, 4380 hours ago it was confirmed you are infertile for life after chemotherapy treatment.
So do you still want to hear my symptoms, Maam? Do you want to understand how come I still need weekly psychotherapy sessions after having cancer? Are you sure you want to know about becoming instantly menopausal? Hot flashes are the least of your problems. Try having sex with only one breast. I keep looking for the missing piece all the time. My husband, too. (You can laugh about it. We do.) Do you want to talk about hormonal therapy effects and the cramps on your hands that wakes you up in the middle of the night, and the fatigue that makes you lay down in the middle of the day? What about the lack of strength on your left arm and swelling that limits you to carry the tool it took your whole life to master? Now you have to carry it less and less often. The camera is just too heavy. Photography might be no longer your profession, but just a hobby. Call it economic depression if you like!
Oh, but let us not talk about that. Let’s not talk about co-pays, deductibles, out-of-pocket fees and what is really behind all this. It is not a matter if I need psychotherapy, or not. Or the fact that psychological support to cancer patients help us heal faster, and keep us healthier longer. It is a matter of the insurance company not wanting to pay for this treatment anymore. But I won’t mention the word M-O-N-E-Y if you keep your promise which according to United HealthCare mission statement is:
“We believe: In order to achieve the full potential of our enterprise in its purpose, to Help People Live Healthier Lives, we must fully understand and align with their needs and realities.”
So understand and align with our needs and realities, please! Trust a patient when they ask for a treatment. Do you really think a cancer patient will ask for a drug it doesn’t need, a therapy session that is not necessary or a surgery out of vanity? That means you know nothing about having cancer. Which is even more disturbing. Because I don’t want people who don’t know about cancer to define if I fall into the category of cancer recurrence, cancer survivor or cancer casualty and determine if I will be graced by insurance blessings to have my health services covered, or not.
Not only presidents get to start a twitter war. Some days you dare to question openly, what no one wants you to say:
Sometimes, you start a war quietly in waiting rooms, at the hospital cafeteria or during a walk in the park and you meet a person that gives you a gift by trusting you with the words: “I have cancer.” And you reply back: “Me too.” And they look up to you and ask: “how did you survive through this?” And they hold your hand as if you are Wonder Woman and you whisper many secrets in their ears including the hush-hush word: psychotherapy.’
It’s a word of mouth rebellion, a peer-to-peer revolution. The more we demand, the more we ask, the longer we might be able to say” “psychotherapy is covered by insurance”. It is a real need, and it should be a right of every cancer patient. Not an after-care, an after-thought. Psychotherapy plays a key role in my ongoing cancer treatment and it might help other patients which are also dealing with the unimaginable reality of this disease. I never thought I would have cancer just like I never thought I would get to be Wonder Woman.
~ For Geoff White and every Psychotherapist fighting for the treatment of their patients to be covered by insurance. And to my first Wonder Woman, Robin.