vendredi 14 décembre 2012


Lazarus syndrome?

I wanted to share with you in this illustration about little-known text of great depth because it has to draw its truth closer to the disease and its collateral damage.

We are here at the heart of a phenomenon little or no perceived especially by relatives of cancer patients, because here it is good that he is.

Lazarus syndrome, as its name suggests does refer to this companion of Jesus back from the dead.

Text from Dhomont Theresa'' Healing: end of the fight? '' Lazarus Syndrome and other difficulties in PatrickBen Soussan, Cancer: psychodynamic approach in adults.
ERES'' The Body'' Moreover, 2004 P 187-195.

Healing: end of the fight?

Lazarus syndrome and other difficulties

LAZARUS SYNDROME

The word healing is used with caution about cancer.
He prefers the remission, although this remission can last twenty
years.
However some, and they are more numerous, heal.
Complete rehabilitation to severe depression, they may live
"As before", better than before, but sometimes worse.

This is the last I want to mention.

Rescued from certain death, they can no longer feel quite alive.
To have grazed too close to the border between life and death,
they no longer recognize homeland.
And their lives dragged painfully in an extraordinary dimension that we hardly suspect.
But this place, they pose critical questions
in which any human being can recognize, as we resemble them,
forgotten shipwrecked between birth and death unknown.

These key issues, the author of Lazarus or the big sleep,
Alain Absire (1985) poses the quite original.
He imagines the life of Lazarus after he was resurrected by Jesus.
But it is Lazarus undead.

Jesus resurrected in the state where it is after four days at
kingdom of shadows. Alain Absire follow us step back to life
Lazarus, his difficulties, his rebellion, his errors.
Jesus performed many miracles when Mary, sister of Lazarus, come
ask him to heal his brother.
But Jesus said, "This sickness is not fatal, it is for the glory of God. '

Several days later, the death of Lazarus Jesus is announced.
He was reproached for not having saved. Jesus, however, will open the tomb
four days after the death.

Another miracle happened. Lazarus demonstrates the divine power.
Reflects the glory of God on him. Many are curious, the faithful who
come visit the miracle.
But Lazarus feels death, he bears the traces of its passage into the other world. He is thin, very weak, his senses are assaulted by the earthly life: seeing, hearing, breathing, walking, everything gives him unbearable pain.
But he still want this? A he still thirsty?

No, not yet, Lazarus is recovering.

But gradually Lazare will find that this state, he thought through,
will be its new state.
Marks the death fade more.
It will mourn everything that made his life a good life: his job
carpenter, his physical strength, the desire to work, his wife, the love and
his desire for her.

Gradually disappear faithful and curious, frightened by the little glory
emanating from Lazarus, terrified by the image of death hovering around him.
His entourage, happy to find the moment of his resurrection,
begin to resent the other Lazarus, different in every way
the one they loved, the one that once they cried.

Lazarus, feeling the fear and loathing he inspires even his wife, in
go on the road in search of Christ, believing that he alone can
answer his questions: "Why have risen?
Why am I alive? What is the meaning of my life? '

Professor J. Holland, cancer, proposed the term
"Lazarus syndrome" to describe the difficulties that are
faced by people in remission from cancer, mainly the difficulty
the resumption of relations with an entourage that had begun to
grief at the news of the disease.

Let's see how these situations are similar, why this name would be justified.

The first comparison that can be established regarding the place of
physician, often associated with the place of God. It is less sensitive since the
1990 and for future generations, but older people
frequently use the term "savior" miracle, some
more direct way of talking about God that their averted death.



Others speak of the need to trust the doctor, even the faith necessary to treatments.

The doctor in our society has a prominent place.
It is supposed to know how the human body and is involved in this secret of the gods.

Today we are more confident to know that the doctor
our good fortune, or God, to prolong our lives.
And even to put an end, our trust in God is blunt
because we need laws to make sure the doctor is not going to extend unreasonably. Despite regulations that limit the power of
physician, the mere mortal will still put his fate in the
hands of the medical profession.

The oncologist has even more this place, at present,
cancer is still strongly marked by the symbol of the death and the healing
seems like a miracle. Some patients follow with the same devotion
their hospital visit and pilgrimage to Lourdes.

Like Lazarus demonstrates the divine power in healing cancer
testament to the power of medicine. As for Lazarus, unfortunately,
all the cures of the disease are not exactly
to heal the sick.

The best formulation was given to me by MB, comparing his situation to that of Job.
Suffering from Hodgkin's disease this gentleman had lost his job, his
house, his animals. He was now alone, without any attachment hardware.
It seemed to be going after the cessation of things
down here. So maybe he had the right to a full recovery since
continued to trust his doctor he called "man of science
and magic. " Her cancer was cured. The joy of forgiveness as it was brief
did not erase the general physical deterioration occurred during the disease:
important paralysis, pain painful and disruption of its total
social life. Mr. B. began to consider themselves as poor as Job!


QUEST FOR MEANING OF HEALING


The quest for the meaning of illness is an attitude often encountered
the affected person or in his entourage.
We can find the same searching for meaning in society through philosophical, religious, psychoanalytic science.
In cases of epidemics, the search for meaning can fuel conflict between social classes.
It seems that when healing occurs, the same search for meaning
appears.

When cancer occurs, it gradually takes effect in the history
a person, as some diseases have made sense in the history of
humanity. The end of tuberculosis has probably fueled the tremendous faith
in science and in a modern world where we could ignore death.

His return also takes effect in the collapse of the idealized image of
modern world.

Some people need to question the meaning of their healing
and the date of the biological healing corresponds to nothing in the calendar
their personal history.

As cancer announced not take direction only from the awareness of what might make sense for the person, healing will make sense after a process of maturation and development of the idea of ​​healing .

Perhaps it is more difficult to find a way to cure if the quest for meaning of illness was unable to find an expression?

Given the mythical aspect of cancer and the guilt
feel very sick (guilt of having created their cancer), we
can assume that the "cure me" to the Medical exceeds
far beyond the mere application of somatic healing.

After healing somatic reveal issues another order,
addressed to the doctor supposed to know everything.

Lazarus complains that God had restored to life, because it is not in this life
where he wanted. Mr. B. complains his cancer, he has never seen! It is said
Now that he is gone, that cancer is cured. These are just words
that do not match anything. This is a story that does not belong to him. He did
decided anything of it. His vision of her cancer were the vicissitudes of
life, it was the treatment of pain.

Everything in this life, but also past was symbolized pain
live.
Cancer is also embarrassed to make plans, exclusion, its absence in the projects of others.

"Why am I alive? Because nowadays, it treats the Hodgkin
because the chemo is. If I had been born earlier, I do not be asking these
questions, I'd be dead. My father died of this disease. He had
at a time when we did not even cared.

All this does not make sense.
My life is due to chance! "The time after the disease is another time. Struggling
against his cancer, Mr. B. somehow came to exceed the age of the
father had died. He thought that from there he could not die. He could
reborn.

But with less fear of death, new life seemed very bland
and gradually the joy of being alive died.

"I guess he said, trying to know what I'm talking about. I
I wonder what I can pass on what I saw in a fashion
that borders yours but has nothing to do. No more than one link with
the other, if it is this attempt, I say, you hear.

Everything I say friends, I can not say. I must make them believe that I belong to the same world they do not run away. '
The world after, even if they have grazed it doth not least its
mystery. But there is more fear.
The physical and moral suffering was such that the fear of death has been relegated far behind.
Death is the last step, it is a haven of peace.
The scary part is the way to achieve it.
The fear of death helped to fight against the discomfort of treatment,
pain.
Overcome this fear now, what will be the engine if they need
fight again?

Mrs. T. with cancer of the stomach is in complete remission
two years.
A state of fatigue and multiple pain could not allow him to return to work. Domestic chores and child rearing are minimized.

Three members of his family died of the same disease.
Mrs. T. feels equidistant from these three people and their families present, its
husband and children, not knowing which way switch.
She feels her status as an extreme solitude, neither with the dead or the living. Only in a parallel world.


EARLY MOURNING


Projects fled, unable to imagine tomorrow mark the difficulty
investment faced by people healed.
This lack of investment is not unrelated to the dynamics
grief triggered by this particular illness. These
grieving process appear to the patient with regard to the outside world
and to the environment, with respect to the patient.

Freud describes the grieving process as a work (Freud, 1915).
This indicates the current position of the subject. Lethargy that characterizes a person in mourning is a sign of mobilizing all its forces for this mourning.
"Grief is a reaction to the loss of a loved one or an abstraction put in place (home, ideology). '

The reality is that the object of love is gone and it becomes absolutely
necessary to remove all libidinal investments that could bind to this
object. The divestment does not willingly, but do not
can be done quickly, it creates a feeling of revolt.

This revolt result of the conflict between the imperative of divestment and commitment to these links. The purpose of mourning is that reality takes over, that investments are removed.
Thus the individual will find free and available to reinvest in another object.

Pending such release, the lost continues to exist as a
in the psychic life of the bereaved.
It is a compromise that takes place: to be so exalted be lost
in order to be detached.

The announcement of a serious illness, treatment not without risk, a
prognosis for survival, while it confronts a possibility of death, a
real existence of his death.
This generator can cause anxiety patients in two opposing reactions:

- The emphasis may be on the denial of death;
- Or instead focused on the likelihood of death.

In the latter case, the grieving process begins towards the outside world.

This work divestment of the world requires a long
effort and it will not be easy for an individual to re healed all the way
in opposite direction.
This is even more difficult than the threat of relapse is high.
Also for the entourage, the emphasis may be on the probability
of death. In this case, the announcement of the disease comes to replace the ad
of death. The work of mourning sounds with even more
rebellion, guilt, he anticipates the actual death.

Mrs. O. Her husband was diagnosed with leukemia.

Married for ten years, the couple lived in disharmony and was accommodated.
The patient's husband helped Mrs. O. to imagine an end to their relationship.

After a period of turmoil at the idea of ​​being alone, Mrs. O.
began to find their dreams and youth projects.
They were told that in this disease, the moral plays to 50%. Her husband had not the moral.




Depression for many years, it was not called a leaf.
Husband's death became certain. Mourning began with the announcement
of the disease.
The length of hospitalization was left to the wife the time
to reorganize her life as if she was alone, but the husband, in remission
complete, returned home one day.
She was already slumped after work, now it was all day. For her, it was a ghost. It was outrageous that no doctor could tell him exactly how long he could live.

She protested: why had they not aware that it was healing, living dead at home?

She wanted to take steps, work, divorce, children away,
but was it possible to leave someone sick? She hesitated sometimes
wondering if all these steps are not useless, if not panicked
not for nothing: all would perhaps go in order ...

R. is very depressed, life has no taste for it. She believes that
what is happening is normal: she lost her daughter.

For ten years, she saw a real ordeal. It can not, nor wants to forget his pain. Everything in his speech seems to indicate that his daughter died ten years ago.
It will take a request for clarification on my part to learn that the death dates
only four years. For this mother, the announcement of the disease was similar
the announcement of the death.

Relationships they have had the past six years with her daughter, she can not say much: they were difficult.
The essence of the relationship that she can speak is difficult to conceal the
suffering of the lost. I learned during the sessions that girl is
married and continued to work during this period.


TRAUMA


Many of these patients continue to consult for pain
or entity.
Depression or chronic pain, such decompensation
could they be understood as a state of post-traumatic stress?

Description of traumatic dissociation can not help us
remind patients: "At the moment of impact trauma, dissociation
allows the victim to escape the terror that results from the confrontation
to death.
Post-traumatic dissociation is clinically
by inhibiting anxiety, amnesia facts, denial, but also by symptoms
depersonalization (feeling of dispossession of integrity
physical or mental) or derealization (feelings of unreality and strangeness
the world, without altering the perception).

Depersonalization gives an impression of detachment, which transforms the actor made a sort of automaton or spectator "(Lopez and Sabouraud-Seguin, 1998).

The description of the state of post-traumatic stress also reminds us
complaints of some patients and their victims face positioning
violence care and pain ... "The victim relives the trauma
recurrent and intrusive memories, nightmares related to aggression,
nocturnal awakenings brutal.
She feels that the attack could be repeated especially after an external stimulus or ideational. It avoids situations that remind him of the attack.

All these disorders are aggravated after exposure to situations reminiscent of the circumstances or symbolizing the initial trauma.

Other clinical symptoms are reduced up external contacts and affects a state of permanent high alert, sleep disorders and cognitive disorders affecting memory and concentration, but misdirected legitimate anger against itself or against his family [...] "(Lopez and Sabouraud-Seguin, 1998).

Mr. S. said: "I come to see you because I said I have nothing where
I hurt. "He shows me his chest:" There, where I was operated on, hopefully I
'm cured but I can not believe it.
I have pain all the time, it's that I can not do anything, I think all the time
that I had, that I lived.
I do not know how I managed to get out, it was terrible, terrible.

What was terrible?

Treatments. The last chemo, I drank.
I would not have supported me once again that inflicts pain.
I preferred drink. I was warned that it did not taste good.
Besides the taste, I was left in the mouth. "Mr. S. bursts into tears.
He cries sobs, saying he did not know it existed
places like this, diseases like that. At night he wakes up with a start,
He has nightmares, he is still in the hospital. Sometimes it can no longer fall asleep
and he thinks that he has lived.

Number of patients we also relate avoidance behavior.
Important detours to avoid board near the hospital, nausea
returning just by seeing the hospital.
The avoidance of TV because in
many films scenes take place in the hospital.
Reading a simple article about a testimony of former patient can destabilize mood and revive states of distress or anger at the heaviness of care.
Many show a kind of cleavage.

Socialeadaptée attitude with an inability to deal with anything that has a link with the disease and, in parallel, an inner attitude obsessed by memories
care, fear of relapse.

Ms. S. in remission for twenty years, waiting in a context of fear anxiety relapse, "You know, she said, these diseases, we can say
you want, it will not cure! '


CONCLUSION


The story of Lazarus in parallel with the history of some cancer
cured raises a number of questions. The particularity of this
lies in the long confrontation with death through disease and thus
Indeed, the difficulty to rejoice at the news of healing.
If healing may disappoint the patient is that it is primarily disappearance
disease of biologically.

As the disease is defined by medicine.
It expects that the patient may differ.

The interest of the physician is the subject of science, cancer, distinguished
to be wearing it, which it does not concern his art.

It is based on an assumption of similarity and continuity of operation of an anomaly is spotted body and the therapeutic action can be performed.
But the subject is presented in its entirety to the physician.

If the doctor can satisfy a biological healing in his practice, the patient, will remain unsatisfied until that healing will not affect the whole of his condition.

It remains true that the therapeutic action can save lives at the risk of encountering
this patient dissatisfaction healed.

If Lazarus realizes the power of God, the patient in remission
was it not witnessed the power of a body that surpasses?

There is no cure for himself but with the increased capabilities of medicine
During that suitson independently of him.

The return to life of Lazarus is not accompanied by any earthly mission.
Lazarus was not resurrected for himself or for his happiness on earth,
it participates in the fulfillment of a desire that transcends and left alone thereafter
to find meaning to his life.

This is perhaps one of the lessons that we need to withdraw from listening to these
patients heal without joy. This time of loneliness could be that of a
second healing, psychic time reconstruction of the patient
remission.

This reconstruction could be considered as a necessary step after biological healing. The disease takes place in a context that disrupts psychic.
Healing can not by itself erase all revisions that have occurred.

Can we therefore consider that it is our commitment to full
if we let the patient healthy although weakened in the rocky desert
mental decay?

If divine power has given life to Lazarus, he does not rest with the human guided paths that will bring him back among them?


This valuable text found on the internet has allowed me to finally put a name to what I suspected for years: far away completely cancer continues to affect life or loins with more force.

When the doctor is able to heal you he did not forget to warn you that you are forever a person at risk, at least for cancer and what touched you once can return to any place and at any time.

Even though the passing years make me believe that the threat tends to move away, he did not go a day without my thinking.

This is not necessarily negative and can crop the priorities quoidien.

It's part of me forever and even if the scar that crosses my abdomen is the only visible evidence, I remain sensitive evocation of the subject.

Guilt is also part of my syndrome: why am I still here and others are not so lucky? ...

The question remains unanswered forever but I claim my right to ask it,
this is part of my humanity and my ability to keep all my faculties intact resilient faculties that enabled me to cope emotionally difficult childhood and the loss of a mother left too early.

As if life had wanted to prepare myself for the worst and that the message sent on this occasion would enable me to take a direction different life from that which I was.

I'm working on the change from because I think you understand this message but it is not so simple and we must accept it to rub cancer that nearly destroy us and our loved us (never forget this occasion damage to close by this event, I will return at the time of a future article) and integrate this accident as a life stage.

I do not forget the turn taken by my life and for the sport that has become mine.

Today I reached a turning point in my life because I saw a period of equilibrium made of professional and personal passions meet and make me feel stronger.

I feel I have finally found the usefulness of this accident of life inspire all those who one day or another will face this situation startle, whatever form they may and also to the right to alternate phases of good and less good.

One thing is certain: I will continue to fight on the ground of my life and put all my strength into his service.


Aucun commentaire:

Enregistrer un commentaire