"Breaking Bad" and Psychological Transformation After Cancer Diagnosis

In the very popular television series, Breaking Bad, the main character's personality begins to undergo a dramatic change after he receives a diagnosis of stage IV lung cancer.  Walter White is ostensibly a meek and mild high school chemistry teacher at the beginning of the series.  The cancer diagnosis seems to bring out parts of his character that were hitherto unexpressed and unknown either to Walter or to his wife. Slowly and shockingly over the course of the five seasons that the show aired, Walt's character displays increasingly ruthless and sociopathic thought patterns and behavior. By the end, Walt is finally able to admit to himself and his wife, that the reason he did all that he did (i.e. cooking extremely high quality methamphetamine and all of the murder and mayhem that ensued), was that it made him feel truly alive, in ways that he had never felt previously. We watch him sacrifice everything, including his relationships with his family and ultimately his life, in order to give expression to needs and feelings that had apparently been split off and dissociated, and which had as a consequence never been integrated into the other parts of his personality.  The cancer offered the excuse and the permission that Walt seemed to need, for his long held back frustration and rage to find a way out. It also seemed to free him to aggressively pursue his desire, something which he seemed unable to do before, resulting in his brilliance going largely unrecognized and unappreciated.

Although most cancer patients/survivors don't undergo the dramatic personality changes that happened to Walter White, they may begin to think and act differently as a result of their cancer experience.  With a new awareness of mortality and limits, a cancer survivor may begin doing things that she had always wanted to do but had been putting off, like a trip to an exotic destination, sky diving, painting, writing or some other creative pursuit. She may also reevaluate her friendships and decide to let go of the ones that pull her down more than they support her. Sometimes cancer survivors are also empowered to begin to address issues in their marriages or with their long time partners that have been simmering for a long time. I would never consider cancer a blessing, but it has the potential to bring matters into clearer focus. It sometimes gives us the permission we need to speak our minds, be more fully ourselves, and courageously follow our hearts desire.  

Breast Symbolism, Breast Cancer and Psychological Impact

In 2004 prominent psychoanalyst, Joyce McDougall, described how the mutilating breast cancer treatments women are subjected to, invariably arouse considerable psychological distress that can include the loss of the feeling of bodily integrity, disturbance in self-image and the sense of subjective identity, as well as changes in feelings of sexual identity. “With the loss of the breast, the essential symbol of femininity is felt to be destroyed,” McDougall wrote. (See McDougall, J. (2004), The Psychoanalytic Voyage of a Breast Cancer Patient in The Annals of Psychoanalysis: Psychoanalysis and Women, 32:9-28, Hillsdale, NJ, The Analytic Press.)

Due to the current lack of scientific knowledge about effective ways to both prevent and treat cancer, without putting patients through poisonous and assaulting treatments, a cancer diagnosis of any type has the potential to trigger a myriad of emotions and complex psychological trauma. Because the female breast is so symbolic and laden with conscious and unconscious meaning, it is especially important when thinking about breast cancer to consider what may be going on in patients', family members' and medical providers' minds.  Breasts universally symbolize femininity, nurture, sexual maturity and fertility. The idea of a toxic presence in the breast shakes the idea of life-giving sustenance right to its core.  In many cultures, the female breast is a defining characteristic of female attractiveness and sexual desirability, so when a woman is faced with losing a breast, she will often feel threatened and challenged in many different ways, in addition to having to cope with the idea of having a life-threatening disease.

It is particularly crucial for medical providers to be aware of not just how their patients are being physically and emotionally impacted, but also how they, themselves, are being affected. Medical providers need to be trained to be sensitive to their own emotional reactions and conflicts; they are in the unenviable position of having to offer and impose harsh and sickening treatments that permanently alter their patients physiology as well as external appearance. When physicians lack emotional self-awareness, they are at increased risk of causing unnecessary harm either to patients or to themselves. With patients, they may push for treatments that statistically only reduce the chances of cancer recurrence by a very small percentage, or they may fail to adequately inform patients about the extent of various treatment side effects, i.e. what life will likely be like, both while going through treatment and maybe for years afterward. With themselves, physicians may slide into problematic coping mechanisms such as alcohol abuse, gambling addictions, or abusive behavior directed at medical subordinates or their own family members.

Psychotherapists working with women who are being treated for breast cancer or who have undergone treatment in the past, also need to tune in to what psychological conflicts, emotions, attitudes and trauma are being activated in their own minds as they listen to their patients.  The more effectively the therapist does this, the more she will be able to help her client access her own unfelt emotional trauma, with the aim of containing it and working it through.