The Role of Mind-Body Medicine in a Cancer Survivor’s Experience

: This paper tells the personal story of a cancer survivor and her experience dealing with death. It analyzes Ernest Becker’s thesis, The Denial of Death , by examining the solutions, which he suggests humans use to cope with the fear of death by establishing a sense of purpose and control. The author identifies examples of Becker’s solutions by looking at the mechanisms she used to cope with the possibility of dying through out her journey with cancer. With a tendency toward secularization and a focus on psychology in present day, the solutions people use to deal with death are changing. The author looks at how self-help, in the form of mind-body medicine, is a new solution that is used to deal with the fear of death in the present-day socio-cultural landscape. While providing control, this way of dealing with the fear of death can be isolating and lead to self-blame.


Examining Earnest Becker's thesis
When I was diagnosed with cancer, I urgently wanted to gain control over my death and find meaning in my life. This experience fits with psychoanalytic anthropologist Earnest Becker's thesis that death is the ultimate human fear and therefore the ultimate human repression. In his book, The Denial of Death, Becker (1973) proposes that humans strive to be heroes to establish a sense of purpose and thereby reconcile the human condition that Becker called "individuality within finitude": being aware of one's specialness but also one's mortality.
Becker proposed that humans use various solutions to establish a sense of purpose and control by becoming heroes. These solutions, which include giving life meaning through religion and obtaining a sense of heroism and control by contributing to society, are belief systems and a form of self-deception, i.e. the illusion that one is a hero or has control. They are used to cope with our awareness of impermanence (Becker, 1973). Encounters with death can create holes in these belief systems and can threaten our sense of control.
In retrospect, it is apparent how I turned to Becker's solutions, by focusing on my career for example, as I faced mortality during my experience with cancer. However, Becker's solutions as described in The Denial of Death are nearly fifty years old and are not fully representative of the solutions humans use to deal with mortality today. With increasing secularization and a move away from religion as a central dogmatic structure, there are many people-including myselffor whom religious beliefs do not provide a solution. A movement toward individual spirituality could be seen as an adaptation of the religious solution, as it can serve the purpose of bringing meaning to life. Howarth (2007) looked at the how our changing social and cultural world has shifted the way we view and experience death and dying, and "how societies make meaning when confronted with mortality" (p. 15). The major evolutions that have taken place from the premodern era to the post-modern era include a shift from a focus on the collective to a focus on the individual, from religion to psychology, and from a focus on the soul, as a religious entity to a focus on the self as a psychological entity (Howarth, 2007).
When I was faced with death, Becker's solutions were not sufficient to give me a sense of control. I turned to mind-body medicine, the philosophy that the mind has the power to heal the body, to cope with the lack of control over my life and death. What I named "the mind versus body solution" can be seen as a new incarnation of Becker's solutions, which have morphed to fit the human experience in today's more secular and individually focused society.
Just like Becker's solutions, the mind versus body solution was successful in providing me with a sense of control by suggesting that I had the power to heal myself. However, especially when this method is delivered via self-help books, it can be isolating as it does not inherently provide a community that can offer social support. For me, it also led to self-blame for my illness as the conceptual separation of mind and body guided me to believe that my physical illness was manifested by my mind. If left as an unconscious coping mechanism, the mind versus body solution can lead to unwanted negative outcomes.

My Story of Cancer and Arthritis
I was eighteen, I had just graduated high school, and I was (as I now see retrospectively) finding meaning in my life through Becker's cultural solution. The cultural solution involves being successful in life, as judged by cultural values, to prove one's worth. I had dreamed of being a ballerina since I was three. I planned to prove my self-worth by achieving this dream, and then serve society as an artist by emotionally moving audiences with my performances. I was also excelling in my first term of parttime university, proving my intelligence as a backup solution, since excelling in the arts can be a fickle pursuit. Once the tumor was discovered, I was added to the surgeon's list for emergency surgery, and I was to get a call as soon as he had an opening in his surgical schedule. During the ten days I awaited the call, I continued my arduous schedule of attending university in the morning followed by professional ballet training in the afternoon and evening. People asked how I could focus on everyday things, but for me, the question was how could I not? I needed to hold onto my sense of control by maintaining normalcy.
The initial goal of the surgery was to perform an open biopsy to determine if it was safe to remove the tumor without spreading the potentially cancerous cells. The section they biopsied and tested while I was on the operating table was benign, so they proceeded with resection. When I woke from an eighthour surgery, the doctor's initial opinion was that my tumor was not cancerous; we were all flooded with relief. However, the lab analysis of the entire "grapefruit-sized" tumor showed that it was marbled with malignancy. This left an additional concern about whether the unaware surgeon had taken enough care to completely resect the cancerous tissue and avoid contamination of the healthy tissue during surgery.
Only two weeks after my major surgery, I returned to the dance studio. I still did not know if I was going to die, but I was determined to dance. I had a fresh six-inch scar running from my pubic bone to my belly button and was in no condition to be training. However, the possibility of death called for enforcement of my illusion. The only time I was not thinking about the possibility of dying was when I was working toward my goal.
The internal psychological discomfort was so immense that I tried to numb myself to reality when I was not dancing. Becker recognized partying and/or sexual indulgence as mechanisms to avoid pain. I will refer to this as the "numbing solution" since other activities, such as shopping and unhealthy engagement with media can serve the purpose of avoiding ones' pain. The numbing solution remains as a possible solution to engage with when a larger significance in life cannot be found and instead people narrow "their meanings down to the body and to this world alone" (Becker, 1973, p. 168). For months, I required sleeping pills to sleep each night, and I would watch happy, mindless television shows to keep my mind distracted and occupied.
My mother used Becker's religious solution to deal with what she refers to as "unbearable pain at the thought of losing my daughter" (personal communication, 2020). The religious solution is when people turn to God to find meaning in their lives. They identify as being heroes by devotedly following scriptures and acting in the will of God, for example. My mother did this by keeping a candle continuously burning for weeks and praying several times a day for me to heal.
I had a rare form of childhood cancer, called ganglioneuroblastoma, and the adult oncologists did not know how to treat it in a young adult. After much uncertainty about my future, I finally found a pediatric doctor who agreed to treat me despite my age. He confirmed that my survival at one year meant I had a 50% chance of no recurrence of cancer, and I would continue to be followed for five years, at which time I would have an 85% chance of no recurrence.
The unknown, since it included the possibility of dying, was very hard. As time passed, the chances of survival increased, and the immediate threat of death became more distant. After a few years, when I began to settle back into what felt like a normal life, I was diagnosed with rheumatoid arthritis. With modern medicine, this is no longer an immediately life-threatening disease, but it is still a serious autoimmune condition that requires taking drugs that are novel and untried. This threw me into the unknown again, with many doctor visits. Perhaps the worst part was the threat this disease placed on my ballet career. I immediately searched for something to give me control and a sense of cohesion.
For me, the medical system could not sufficiently reconcile why my cancer had a 15% chance of coming back or why my body was presenting another serious, potentially lifeshortening illness. As Harrington (2008) argues, the dissatisfaction with the medical system is not only due to its inability to always provide a cure, but also because it cannot provide an answer to the existential questions that illness, and the possibility of death, bring to the surface: "Why me, why now, what next?" (p. 12). Instead, it discourages making sense of the illness and attributes outcomes to luck and statistics. Leaving things up to luck offered me no control and left me, facing death, with little to hold onto, and no way to assign meaning to my life or my death.

The Mind Versus Body Solution
The new solution that I turned to next was partially predicted by Becker (1973) at the end of The Denial of Death. He wrote, "alternatively, he buries Himself in psychology, in the belief that awareness all by itself will be some kind of magical cure for his problems" (Becker, 1973, p. 284). This movement that Becker recognized nearly fifty years before my time, was the source of the solution that I found and named the mind versus body solution, but it had changed with the tendency toward self-focus, selfdevelopment, inner work and individuation found in today's society. Becker thought that for psychology to be a solution, there needed to be a therapist for one to follow as a guru of this healing belief system. Becker believed that it is necessary to outwardly project the meaning and blame for one's life (to a greater power, a loved one, or a guru), but as I discovered, this was no longer a requirement. In the 21st century, we have found a way to bypass this external requirement by recognizing components of ourselves and projecting meaning and blame from one part of ourselves to another: blaming the brain for the health of the body.
In her book The Cure Within, Harrington (2007) explores the history of what she broadly terms as mindbody medicine. Mind-body medicine has roots in the Christian Bible and other religious structures. For example, it can be traced back to the belief that sickness could be caused by demonic possession. With the dawn of classical medical theory in Ancient Greece, Hippocrates documented the effect of the mind on the body: "if the soul is burned up ... it consumes the body" (as quoted in Browne 1985, p. 42). Mind-body medicine is a very broad, inclusive field that incorporates its religious roots, with spirituality, science, and most importantly, individual stories of recovery that serve people better when explained as a miracle rather than chance (Harrington, 2007). I would argue that these stories of miraculous healing serve people better as a solution to the conundrum of mortality if it is believed that a person was able to facilitate their healing. Becker (1973) described the human construction of the ultimate hero as someone who can control death: "The hero was the man who could go into the spirit world, the world of the dead, and return alive" (p. 12). In Christianity, Jesus is an example of this ultimate hero. In the present day, with mindbody medicine, this quest to control death manifests in the belief that the health of the body can be controlled with the mind. This trend of psychologizing death or emphasizing the effects of the mind and reducing the focus on the biological activities of the body has been delivered to the public from a plethora of sources through the self-help industry (Northcott & Wilson, 2017). The ease and popularization of printing books allowed a multitude of miraculous stories and personal methods of healing to reach a wide audience (Harrington, 2007). These include books such as Heal Your Body: The Mental Cause for Physical Illness and the Metaphysical Way to Overcome Them (Hay, 1988) and Getting Well Again: A Step-by-Step Self Help Guide to Overcome Cancer (Simonton et al., 1992).
In my story, I desperately wanted control and needed an illusion to act as a solution to my fear of death. When I first heard the concept that the mind could heal the body, the idea that I had created my illness through my thoughts was revolting as it felt like I was being blamed for my illness. To subscribe to the concept of mind-body medicine, a further division beyond the mindbody separation was necessary: I had to become aware of the difference between my conscious and unconscious mind. For, it was not my conscious mind that was wishing for illness, but as suggested by the self-help books, my unconscious thoughts/beliefs or past unresolved psychological trauma might be responsible. For example, Hay (1998, p. 7) states, "...cancer comes from a pattern of deep resentment that is held for a long time until it literally eats away at the body".
The concept that I had control over my health and consequently my mortality began to be appealing. I looked inside, trying to find patterns and reasons for cancer and rheumatoid arthritis. Our minds are extremely creative and good at finding patterns. For example, I thought maybe I had manifested cancer in my abdomen because I had spent so many years being frustrated with my stomach. After all, I had trouble holding it in during ballet. Next, as instructed by the self-help books, I was meant to forgive myself and send love to my body to heal these unhealthy, disease-creating thoughts.
One of the striking differences in the mind versus body solution from the solutions Becker described is the individual and internal focus. The other solutions have an external object or figure onto which to projectpeople feel heroic in the eyes of God, society, or their loved ones. This inadvertently provides an opportunity for access to a community that can offer comfort and support. For example, the documentary The Boy Whose Skin Fell Off, tells the story of Jonny Kennedy, a man dying of complications from Dystrophic Epidermolysis Bullosa (Collerton, 2004). He uses both the cultural solution, by making it his life purpose to raise money to find a cure for the disease (with the hope of helping others with this condition), and also the religious solution, turning to God and his church. Both of these solutions surround him with a community that not only serves as a way for him to feel heroic but also as a form of support. With the mind versus body solution in the form of self-help books, the internal process of controlling one's beliefs and thoughts is internal and offers limited access to community or outer social support. Becker (1973) further described this need for outward projection, deeming it necessary not only for meaning but also as a place to assign blame for the human condition: "...projection is a necessary unburdening of the individual...He must project the meaning of his life outward, the reason for it, even the blame for it" (p. 158). Perhaps if the mindbody solution was paired with physical visits to a psychotherapist, and better yet, group therapy sessions, this solution could offer this important sense of community. However, what Becker referred to as "blame" still has nowhere to go but inside. This can be contrasted by looking at the religious solution and how it provides God as an outward being that can be projected onto. Gielen and Kashyap (2019) studied a palliative care hospital in India, and interviewed a person who said, "living and dying are in God's hands" (p. 33). Other patients, instead of using God to give their lives meaning, felt deserted by God. In either case, the meaning of life or blame for death was projected externally. Kainz (2003) studied mind-body control strategies and concluded, "the caution is to not make the leap from patient self-help to patient self-blame" (p. 48). I argue that within the context of this solution, the blame is extended further from the bereaved or society to the person who is dying if they are not successful in fighting the disease. It is infallibly set up so that the mind-body medicine does not fail, but rather the dying either fails or succeeds harnessing their mind to heal their body.

Concluding Discussion
By giving me a prescription or roadmap on how to heal, the mind versus body solution did provide me with a sense of control but I do not believe it was a sustainable or healthy solution. I was not able to recognise what function it was performing for me at the time, so in retrospect, I feel misled and like the energy I was putting towards healing was wasted on the hope that I could be successful in curing disease by changing my thinking.
Since I was so desperate to find a way to gain control and not die, it was easy to subscribe to certain amounts of self-deception. I found patterns to make events in my life fit with the ideas of mind-body medicine. For example, I cannot help but wonder if I had trouble holding in my stomach due to the physical space the tumour was occupying, making this frustration an outcome of my illness and not the cause.
The mind versus body solution was isolating for me because it required my focus to be on the information in books and the promise of healing offered by an unfamiliar author as the source. My focus went internally into my thoughts (which were polluted with worrying ideas about what would happen if the books were wrong), instead of outwards to friends and community for support. It also put all the responsibility for healing onto me; if I was not able to control my mind and heal, that was my fault. Overall, once I moved past the initial stage of hoping it would help and the relief it brought by giving me something to do to take control of my situation, it was lonely and scary. My experience with mind-body medicine left me with the feeling that I was somehow deceived. I wish I could have seen that I was using the mind versus body solution to maintain an illusion of control.
Self-help in the form of mind-body medicine is a relatively new incarnation of Becker's solutions that can be used to manage with the fear of death. Just like the other solutions outlined by Becker, the mind versus body solution can offer a sense of control, perhaps heightened by the self-sufficiency provided by self-help, which can be empowering. It is, however, still an illusion of control and it is valuable to examine this trend of internalization leading to lack of community and self-blame that comes with mind-body medicine, especially in the avenue of self-help.