The Blame Game

Emotional Care - January 31, 2014

When we got the devastating news that my husband's cancer had spread and was no longer considered curable, a lot of difficult thoughts and emotions began to surface. One of the more challenging and difficult thoughts was the idea that we could have or should have done something differently in his treatment that might have prevented this outcome. Shortly after we got the bad news I had a long conversation with a friend of mine who is also an oncologist. When I asked her how the outcome might have been affected if we had chosen a different treatment plan from the beginning she wouldn't answer. She simply said "It is a dangerous thing to play the 'what if' game." At the time her response annoyed me but now I can see the wisdom of it. This logic goes beyond questions of treatment choices but also to the cause of an illness.

Usually when we are dealing with a medical condition we focus on the cause of the condition. We immediately want to know why. This is of course a natural and normal thought. In some cases it can even be helpful to know the cause so that medical professionals can effectively treat the condition, to avoid reinfection, or to help the patient fully understand the condition. However, I believe that much of the time it is not useful and can even be detrimental to focus your attention on the cause or source of the condition.

Recently I had a conversation with a friend who asked me for help in researching the cause of a chronic condition she has. She has been successfully managing her condition for years. She has read a lot about it and asked her doctors several times and no one has been able to answer the question of why she has developed the condition when some people in similar situations do not. While I was happy to help her look for information about the disease I told her that I don't think it is useful to focus on why she has it.

For many patients there is not one specific thing that can be recognized as a single source or specific cause of a disease or condition. For example, there is a well established connection between smoking and lung cancer. However a little less than half of all lung cancer patients have never smoked and not all smokers get lung cancer. There are connections with genetics and lifestyle choices associated with many cancers, with heart disease, diabetes, and several other conditions; yet rarely can a specific cause for any one individual's condition be determined. Sadly, some conditions and diseases such as type II diabetes or lung cancer have a stigma associated with them because of the general perception that it is caused by choices made by the patient. While lifestyle choices may play a role in some cases there often is a combination of genetics, lifestyle choices, environmental factors, and countless unknowns that contribute to someone developing a disease or condition. And in some cases, such as my husband's cancer, there was absolutely no indication of any cause whatsoever.

It is generally not helpful to focus on the cause of health problem after you have been diagnosed with a condition. I believe it wastes energy that could be focused on getting well and achieving better treatment outcomes. Of course it is human nature to want to know why but I recommend you try to spend as little time as possible thinking about it. If you focus on blaming yourself for your choices or blaming a physician for not ordering a test earlier or blaming your family for bad genetics, it won't change your condition. In my husband's case there was no one and nothing to blame. He was a non-smoker, no one in his family had any kind of cancer, his occupation gave him no unusual exposure to carcinogens, his age and genetic heritage were not typical for gastric cancer. We were forced to simply accept that it happened, because there was nowhere to point a finger of blame. In a weird way I think this was a blessing. Without having someone or something to blame, all of our attention and energy had to be focused on dealing with the cancer.

No matter what, when you are facing illness or injury you are going to have moments of wondering why it happened. I recommend that you look for ways to shift your thoughts when it comes up. A simple phrase you can say to yourself to stop the thoughts can be effective. Also, when well meaning friends or family members ask you why or how you became ill, quickly explain that you don't know why and since knowing why won't change things you like to focus on healing instead. Spend your time researching treatments and supportive care rather than causes of the disease or condition. In my experience using techniques to push your natural tendency to blame away can have a huge positive impact on your treatment and recovery. Even if it doesn't improve your outcome, your experience of life is likely to be more pleasant when your focus is not on blame.