Realistic hope – and its role in keeping us resilient in times of crisis

From JHH 16.2 – Faith, Hope & Love in Healthcare – Summer 2019


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Working with people affected by cancer can be emotionally demanding, but it is also very rewarding. Helping people relate to the future in a way that enhances, rather than diminishes, their experience of the present is important, but this should not involve unrealistic hopes that could set them up for later shock, disappointment and regret.

We have come to call this helpful way of facing the future ‘realistic hope, and by discussing, exploring and understanding it better we believe that more people can be helped to find a way through the crisis of a life-limiting illness like cancer.

Article by Dr Catherine Zollman – GP; medical director Penny Brohn UK, with Jennie Evans – Advanced cancer patient and Penny Brohn UK client.

I first became interested in holistic approaches to health as a medical student lucky enough to join the BHMA in its early days. I trained initially in medical oncology and immediately saw the potential of an approach that combined lifestyle support, conventional treatment and complementary therapies, even though the term integrative oncology hadn’t yet been invented. I now work at Penny Brohn UK, the leading charitable provider of complementary and lifestyle support for people with cancer, as well as continuing my part-time NHS GP and university teaching work.

Catherine Zollman

I was diagnosed with Stage IV colorectal cancer on the 2 September 2015. On 21 September 2015 I walked through the doors of Penny Brohn UK for the first time, seeking to find out how I could help myself in the face of the cataclysmic life change I was experiencing. In the face of a now incurable diagnosis, I have learned to navigate as meaningful a path through the minefield of life with cancer as I can with the continued support of PB, and I now try to share my experience in the hope that it might help others.

Jennie Evans

‘What is the most helpful way to think about the future?’

This question may seem rather abstract and philosophical, but if you are dealing with a potentially life- limiting condition, it has a very practical and profound influence on everyday life.

In our work at Penny Brohn UK, a charity which provides free holistic support and education to people affected by cancer, we grapple with this question daily, whether we are staff or clients. Many people are now supporting someone or living with a cancer diagnosis themselves. We’re living at a time where more people are being diagnosed, and often at a younger age, than ever before, but more are also living longer with the disease. It’s an area where positive psychology messages abound, and the ‘breakthrough treatments’ that seem just around the corner are still not a reality for most people. The connections between what we think or feel and our physical health are scientifically ever more convincing, so it feels as if there has never been a time when the answer to this question has been more relevant. We have started talking about ‘realistic hope’ as a way of helping people to navigate the present in a way that is grounded in reality, while enabling them to feel positive about life and the future, whatever that may hold.

In this article, we explore aspects of realistic hope, and the factors that influence it, from two contrasting stakeholder perspectives: an integrative medical doctor working with people affected by cancer at Penny Brohn UK (CZ), and someone living with advanced cancer, who has used the services at Penny Brohn UK to help develop and foster realistic hopefulness (JE). We have based the thoughts that follow on a conversational exploration of Jennie’s lived experience and Catherine’s years of clinical work in this field. We have chosen this observational and experiential style, rather than a literature-based review, with the aim of highlighting some of the more complex and subtle attributes and nuances that may enable individuals to move forward and hold their balance on the delicate tightrope of realistic hopefulness.

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