Cancer Healing, Groups and Gaslighting

Judith Edwards*

*Tavistock Clinic NHS Trust, London, United Kingdom


This short paper’s aim is to link the term ‘gaslighting’ with the idea of functioning in a ‘work group.’ and the way forward for an individual after the trauma of cancer diagnosis. This article does not address the question of whether such work group functioning constitutes ‘scientific’ research, which is a term both used and abused in many circles. There is much debate on this subject which is beyond the remit of this article. However, the more research into cancer healing, where the experiences of individuals joins with research into psychoanalytic research into groups and group functioning, pioneered by the great psychoanalyst Wilfred Bion, (for other writers on the subject a web-search will be helpful) the more knowledge will be accumulated, which is surely the way forward for anyone diagnosed with cancer. As Bion advised, it is good to ‘keep your questions in good repair’ rather than feel there is any one answer to many of these vexed questions – vexed is a good word as it sums up how adherents of different schools of thought can become2.

But perhaps if we accept that fighting is not the best option, then this piece may be approached with ‘an open mind’. It is perhaps also useful to ponder how ideas become ideals and then morph into ‘idealisations’. As the philosopher Appiah insists: ‘we should not allow the plurality of useful thoughts to undermine our belief in the existence of the truth, leaving us with nothing but a disparate collection of stories’. (2018, p.35)1. He quotes the 19th century philosopher Hans Vaihinger who said that we can often learn a great deal by treating a subject as if it conformed to a certain theory, even though we know that this is a simplification. He says that such fictions ‘provide an instrument for finding our way about more easily in the world’. (Op cit, p 14)

For anyone, possibly without exception, the three words ‘you have cancer’ strike fear and dread into the heart, however much that same individual might have been struggling to turn a blind eye to ‘the truth’. As John Bowlby said in 1979, there is the conflict between “Knowing what you are not supposed {or not wanting- JE} to know and feeling what you are not supposed to feel”8. As Bowlby says, ‘Pressure exerted on children to conform to their parents' wishes can be crude or subtle, but its effectiveness depends always on the child's insistent desire to be loved and protected’. We can of course all have conflicting ideas and thoughts inside our minds, (knowing what we are not wanting to know as Bowlby suggested)- and we can exert pressure on ourselves as well as feeling it from concerned people around us...So what is the way forward here? IS there a way forward? Does life end here and now? These ideas may swamp the individual and in themselves prevent further constructive thought. ‘Blind eyes’ are not helpful in the task of seeing and of thinking. These symptoms are of course also classic indications of Post-Traumatic Stress Disorder.

There will be many conflicting ideas in one’s own mind, as mentioned above, and in the minds of concerned others. Does the term ‘gaslighting’ help here? As with most terms that quickly become popular, a lot of people don’t know what it really means. Does it just mean deceiving people? Or oneself? Or is it something more specific and can it usefully be employed when thinking about cancer diagnosis and its aftermath? George Cukor’s 1944 film ‘Gaslight’ portrays a young girl (Ingrid Bergman) who begins to doubt her sanity as her husband starts to play with her sense of reality: one thing that he does is to turn the gaslights down and tells her she is imagining this. The girl is fragile and disoriented (classic states after a cancer diagnosis) and her health gradually gets worse, although she of course does not have a cancer diagnosis. Since then, there has been a revival of the use of the term “gas-lighting”, which is used to describe emotional abuse as a way of controlling and denying the victim’s sense of reality to the point that it becomes distorted. This film was a psychologically accurate portrayal of ‘living with uncertainty’ (Bion) to the point where is feels like madness. What I suggest here is that this can happen inside one’s own mind, where one plays with hope and despair, turning one down and the other up. Is it possible to return from this point as an individual or does one then give up personal responsibility?

Now I stray into the personal in order to illustrate a universal situation. Having worked as a psychoanalytic psychotherapist for over thirty years, when I was diagnosed with cancer and prey to these emotions which threaten to destroy all sense of self, I had to revisit this state of mind. When the first shock had subsided, I founded a site www.cansurviving.com to offer a way forward not only to myself but to others faced with similar circumstances. This international group built site, now accessed in 48 countries worldwide, has forums dealing with various aspects of the body (and diet) the mind and the spirit. People can come back and back again, browse different forums, and take away what they feel is good for their own forward development. This free site is not advocating any one path, and explores both complementary and alternative ways of healing after diagnosis. It has variously been called by our growing group of members ‘a life-jacket’, ‘a kick starter’ and ‘the best site on the web for healing cancer’. This is quite a compliment since there are over 5 and a half million of them at last count. I suggest that one could acceptably describe it as ‘a work group’ (see below), in that its task remains constant even though sometimes the individual may be beset by doubt and fear.

So how to deal with all these conflicting thoughts inside the mind, tuning the wavebands of hope and despair up and down like conflicting radio stations, so you feel quite enraged and maddened by the chaos? Let alone the conflicting advice from other well-meaning people who only have your best interests at heart, but may come on so strong with their point of view that your own light of curiosity goes out completely.

The great psychoanalyst Bion talked of the ‘basic assumption’ (Bion 1967 :173)5 group: The basic assumption group describes the tacit underlying assumptions (you could call these unconscious) on which the behaviour of the group is based. Bion specifically identified three basic assumptions: dependency, fight-flight, and pairing. In the co-created free international group cooperatively built site www.cansurviving.com we try to operate as a work group, as I indicated above, avoiding dependency on one source, either orthodox or alternative, splits (pairing) and exaggerated positions of ‘right’ and ‘wrong’ (fight-flight).‘Work-group mentality’ (Bion, 1970: 173)7 describes the disposition and dynamics that characterize the life of an adequately functioning group Its members are able on the whole to manage their shared tensions, anxieties and relationships, in order to function effectively; the outcome is a ‘capacity for realistic hard work’ (p. 157). ‘Basic-assumption mentality’ (p. 173), by contrast, as indicated above, describes the state of a group that is taken over by strong emotions – anxiety, fear, hate, love, hope, anger, guilt, depression (p. 166) – and has, as a result, lost touch with its purpose, and become caught up in an ‘unconscious group collusion’ (Eisold, 2005b: 359)9; the outcome is ‘stagnation’ (Bion, 1962: 128)6.

And reeling back to factors which help to create cancer in the body, stagnation and resultant inflammation come high on the list. But is important to note that the two groups in themselves do not function in a split modality. There is basic-assumption dependence, where it seems as if people do indeed depend on the leader to provide ‘nourishment, material and spiritual, and protection … a kind of group deity … one who [knows] the answers without need to resort to work’ (Bion, 1961: 147-8)4. But there are occasions where dependence on a leader can lead not to ‘stagnation’ or to ‘platitudinous, dogmatic, and painless’ thinking, but to productive work. In such cases, dependence does not seem to be experienced as a distraction from the group’s purpose but rather the opposite: leader and group members together maintain a focus on their purpose, and the leader is authorised by the group to lead. While I did indeed found this site, I downplay fantasies of ‘infallibility’ by not giving personal advice. Even the ‘Personal Stories’ was a late comer onto the site for this reason. While this sort of leadership still may be considered to represent a form of dependence, it is dependence in the service of, not in conflict with, the group’s purpose, and the Cansurviving core team also help hugely in this regard. As we say on the site: “This is both for use on its own if you don't go down the chemo route, or as a complementary path which can help with the orthodox side effects and also encourage the body to be a less receptive place for cancer cells to grow…This of course gives no guarantees, is not a panacea, and is merely offering possibilities which you might like to consider. This is your road and yours alone. Others may walk it with you, but only you can walk it for you.”

Bion’s theory of groups can help to further our understanding of group, organizational and societal dynamics. All of these will of course come into play for anyone faced with cancer diagnosis. What are society's main ‘answers’ to the question of diagnosis? How do individual practitioners relate to what they do as well as other ways that might be available to effect the same job? And how does any individual manage to carry on in the face of the strong emotions raised by diagnosis? Although Bion’s ideas have been adopted and developed within the field of group relations, there is limited awareness, let alone use made, of these ideas in mainstream fields of organization studies and of group and organisational development. In terms of cancer awareness and healing modalities, there is for example however a group called ‘Yes to Life’ in the Uk which is starting the conversation across apparent divides. ‘Yes to Life’ empowers people with cancer as they say to make informed decisions about their cancer care options. For more than a decade they have provided evidence based information for those who need it, giving information to guide people through the often very confusing options available. Their helpline is supported by highly trained volunteers, all whom have personal experience of cancer or another chronic condition, or have supported a close relative or friend. These volunteers often provide a lifeline to those whose voices have not been heard, or who are otherwise isolated.

The positive effect of a reliable and timely response to someone's frame of mind is invaluable, especially when so much of their experience can be stressful, spent in limbo and often waiting endlessly for the next appointment or result. Importantly they also provide financial support in the form of grants for therapies, consultations, nutritional therapy and equipment, all of which help people to manage their condition.

But sadly, these ideas remain the preserve of a relatively small number of specialist consultants and academics and, except in isolated instances, (as with ‘Yes to Life’) have not made the transition they deserve to a wider practitioner group. The Cansurviving team and the work group which has derived from it hope in some small way to be contributing to the widening of perspectives in the field of cancer healing.

Placing the focus of attention on work-group mentality and on forms of interaction, rather than on the basic assumptions, is in greater accord with mainstream theories of group behaviour and so likely to be more accessible to a wider audience (as we are finding on Cansurviving). While Bion’s own attention turned towards psychoanalysis, he nevertheless left us some fruitful ideas to consider.

Again, personal experience may be used as an example here. When I was first diagnosed with breast cancer I dreamed that I was driving my car into a very dark cloud, with my husband at my side. I could see that the clouds were getting lighter later – but how much later? Yes, a storm was brewing. I can now look back, and I really resonated with something Haruki Murakami said in his novel Kafka on the Shore (2005):

"Once the storm is over you won't remember how you made it through, how you managed to survive. You won't even be sure, in fact, whether the storm is really over. But one thing is certain. When you come out of the storm you won't be the same person who walked in. That's what this storm's all about"

One of our members told the story of how a teacher told his teenage class that while cows ran away from a storm (which would catch them up anyway) buffalo would walk right into it. Now this site exists nearly seven years later, for other ‘buffaloes’ who walk into the storm. Take heed of your dreams, we suggest, and give back when you too emerge from the black clouds (we have a forum on Depression which can help on the dark days). As Atul Gawande said in his Reith lecture (on the site) ‘if talking were a drug it would cost thousands of pounds’. As he said: ‘We’ve had I think an about 50 year experiment with medicalising mortality and the ends of lives, with casting it as just another problem for us to treat like any other, and I think that experiment is failing. But we have an alternative emerging. It’s one where we learn and elicit what matters most to people in their lives besides just surviving, and then we use our capabilities not to sacrifice it but to protect, to protect it –to protect those priorities that people have. And I think that is our opportunity.’ This author has also written an article ‘Survivorship and Sailing On’ (Edwards 2018) which attempts to illustrate Atul Gawande’s deeply relevant point.

So, to return to the title of this piece: Can cancer healing be helped with group activity, and can we all be beset, both inside our minds as well as from those ‘outside’ with threats of ‘gaslighting’? What I hope to have suggested here is that we can indeed help one another in what is called in cliché terms ‘the journey’-by taking it day by day and relying on our own intuitions to counteract our own gaslighting fears, as well as those derived from well-meaning outside advice. As another great psychoanalyst D.W.Winnicott said in a review of Jung’s Memories, Dreams and Reflections: ‘The search for the Self and a way of feeling real, living from the True as opposed to the False self is a task that belongs not only to those who are mentally unstable, but to a large proportion of the human race...generally the problems of life are about this search for a Self.’ Those beset with anxiety following cancer diagnosis might do well to look at the www.cansurviving.com site and see where it leads them. Of course, those whose bent does not include psychological thinking may not find themselves happy with this approach, but as the great philosopher Schopenhauer said ‘All truth passes through three stages: First it is ridiculed, then it is violently opposed, then thirdly it is accepted as self-evident.’ And as Samuel Johnson said in the 18th century: ‘Nothing will ever be attempted if all objections must first be overcome’10.

Dr Judith Edwards PdD MACP has been a psychoanalytic psychotherapist since the 80s, working at the Tavistock Clinic and elsewhere, and is internationally published. Her Selected Works ‘Love the Wild Swan’ were published last year in Routledge’s World Mental Health Series, and she has published a memoir called Pieces of Molly (Karnac)

  1. Appiah KA. As If: Idealisation and Ideals, Harvard University Press. 2018.
  2. Bion WR. Group dynamics: A re-view. International Journal of Psycho-Analysis. 1952; 33: 235-47.
  3. Bion WR. Group dynamics: A re-view. In M. Klein, P. Heimann, & R. Money-Kyrle (Eds.), New directions in psychoanalysis, London: Tavistock Publications. 1955; 440-77.
  4. Bion WR. Experiences in groups and other papers. London: Tavistock Publications, 1961. [Reprinted London: Routledge, 1989; London: Brunner-Routledge, 2001.]
  5. Bion WR. Second Thoughts, London Karnac. 1967.
  6. Bion WR. Learning from Experience, London, Karnac. 1962.
  7. Bion WR. Attention and Interpretation, London, Karnac. 1970.
  8. Bowlby J. ‘On Knowing what you are not supposed to know’ Canadian Journal of Psychiatry. 1979 August; pp.403-8
  9. Eisold K. Psychoanalysis and psychotherapy: a long and troubled relationship. International Journal of Psychoanalysis. 2005a; 86: 1175-95.
  10. Johnson S. The History of Rasselas, Prince of Abyssinia. 1759.
 

Article Info

Article Notes

  • Published on: April 13, 2018

Keywords

  • Gaslighting

  • Psychoanalytic
  • Psychoanalyst Wilfred Bion

*Correspondence:

Dr. Judith Edwards
Tavistock Clinic NHS Trust, London, United Kingdom
Email: judith@judithedwards.co.uk
Copyright: ©2018 Edwards J. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License.
Citation: Edwards J. Cancer Healing, Groups and Gaslighting. J Mental Health & Clin Psychology (2018) 2(2): 25-28