ABSTRACT

The study set out to study the experienced distress of clients with breast cancer who also meet criteria for comorbid anxiety and depression (CAD) from the perspective of emotion-focused case conceptualization. A theoretically informed qualitative case analysis of 15 recorded psychotherapy sessions across three women was conducted using an emotion-focused case conceptualization as domains of inquiry and an interpretative framework. Experiences of mastectomy-related shame appeared to be maintained by cancer side effects, whereas social identities relating to gender and class triggered self-blame for cancer and shame at not functioning as well as expected. Existential fear, worry, and hypervigilance were indicative of cancer as an ongoing trauma. Unmet needs for safety were related to unclear communication with the medical team during treatment, while triggers relating to childhood adversity and insecure attachments perpetuated present-day distress. The findings suggest that emotion-focused treatments in psycho-oncology include a trauma-informed lens that allows for greater processing and integration of past trauma. Future research should explore breast cancer distress in women across different social identities for a broader and more inclusive understanding of distress presentations.

摘要

该研究旨在从以情绪为中心的案例概念化的角度研究同时满足共病焦虑和抑郁 (CAD) 标准的乳腺癌患者的痛苦经历。使用以情绪为中心的案例概念化作为探究领域和解释框架，对三名女性的 15 次记录的心理治疗课程进行了理论上知情的定性案例分析。与乳房切除术相关的羞耻经历似乎由癌症副作用维持，而与性别和阶级相关的社会身份引发了对癌症的自责和对没有像预期的那样运作的羞耻。存在的恐惧、担忧和过度警觉表明癌症是一种持续的创伤。未满足的安全需求与治疗期间与医疗团队沟通不畅有关，而与童年逆境和不安全依恋相关的触发因素使当今的痛苦持续存在。研究结果表明，心理肿瘤学中以情绪为中心的治疗包括一个创伤知情镜头，可以更好地处理和整合过去的创伤。未来的研究应该探索不同社会身份的女性患乳腺癌的痛苦，以便对痛苦表现有更广泛和更具包容性的理解。