Men, Healthcare and Prostate Cancer

By Robert D. Simmermon, Ed.D., and Bonnie Ulman

As men age, their vulnerability increases and their psychological defense structure adjusts to appropriate developmental and psychological situations and circumstances. The possibility of contracting a serious illness increases and the potential for life-changing events becomes a real possibility and ultimately a realistic probability.

Dealing with increased vulnerability is very difficult for most men from the World War II and Baby Boom generation. These men pride themselves upon their ability to handle life’s challenges rationally and logically. Most contemporary men proudly describe themselves as problem solvers and men of action.

The struggle for personal control in family-life, business, and in the world psychologically defines these men. The notion and concept of Personal Power is the cornerstone of identity for a generation of men who have been told that they can accomplish anything if they put their minds to it. This personal power is not about domination, although that may be a component. These men feel most secure when they can “make” something happen.

Once diagnosed with a serious illness, most men are faced with a profound sense of powerlessness or helplessness. They may look for information from trusted friends and colleagues or they deny or underplay the seriousness of an illness. Regardless of the individual strategies, these men are dealing with the unknown. It is the unknown plus a feeling or powerlessness that feeds anxiety, dread, and ultimately depression.

Traditionally, men have handled personal and private matters alone or maybe with a trusted friend. For a majority of men, their most trusted confidante is their wife. When they are faced with a diagnosis of prostate cancer, several factors converge to increase the feelings of fear and vulnerability. Although spouses can be very helpful, the prostate is one part of the body where woman cannot have a first hand perspective. The sensitivity of the issues of the prostate makes it extremely difficult for some men to discuss their condition with even their most trusted friends, at least upon the initial diagnosis. This openness may increase over time but initial responses tend to be guarded.

Issues of sexual performance, control of body functions, and the possibility of serious life-threatening circumstances combine to profoundly increase anxiety and stress. Most men go through a process whereby they deal with their anxiety by reviewing their lives and mentally making arrangements for the worst outcomes. This process may not be discussed at first. In fact, a man may stay “positive”, think “positive” and talk “positive” to reassure himself and his family. Friends and family start with the mantra of “stay positive” etc. in an attempt for them to deal with their own fears and anxiety. Being “positive” is important at the proper time. Trying to talk people out of being frightened is always more for the family than the patient. It is important for the patient to go through the process of dealing with the illness. If he is not allowed to progress through all the steps, he may become emotionally “stuck.”

In the privacy of their own keeping, these men worry, as well they should. They may come up with statements like “It doesn’t do any good to worry; that doesn’t help.” This notion should be challenged.

It is important to worry; these patients should be afraid, but not paralyzed. This is not to frighten them or increase their anxiety, quite the contrary. It is about the importance of “productive worry.”

“Productive worry” is defined as worry that is in proportion to the factual conditions of a particular case. There are some legitimate reasons to worry when one has been diagnosed with a serious disease. The key is being able to discern the difference between productive and non-productive worry. When a person worries a little at a time in the proper rate and the proper sequence, they inoculate themselves against overwhelming stress and anxiety. The more one appropriately worries and deals with that worry, the stronger and more resilient they become.

“Productive Worry” may be one of the most effective methods of dealing with serious illness. Worry, in manageable doses, may motivate and influence one to attend to matters, which may help or expedite the situation. With too much worry, an individual can become overwhelmed and ultimately paralyzed and helpless.

It is important that we teach men how to productively worry. They will be able to relate to the notion of “productive” and if we attach worry to the formula, they are in a therapeutic bind. If they can transform the worry that already exist into “Productive Worry” they have regained some control and are in a position to take steps that will increase their physical and psychological well-being.

Robert D. Simmermon, Ed.D., is a counseling psychologist in Atlanta, GA, and Bonnie Ulman is president of The Haystack Group, a research and marketing consulting firm in Atlanta, GA.