Temps, identité, cancer

Abstract

The fruit of fifteen years of clinical experience with cancer patients, working in a specialty, where there is a climate made of an en bloc, homogeneous strategy, leads inexorably towards the question of time as being essential and central, when trying to analyze what constitutes the therapeutical reliationship with a patient who suffers from a cancer. This relationship is marked initially by the falling apart of an illusive identity, produced by the shock of the diagnosis that has been thrown upon the patient. Later, during remissions, there is another falling apart, this time, of another, superficial, and illusive, identity that had been provided by the containing, almost skeleton like, effect of long term treatments. All along this path, there are landmarks that point out to a need for a clinical renewal in cancerology On the one hand, there is a need for a theoretical work-up of the question of transference, particularly difficult with these patients. On the other hand, we must learn to conceptualize what is going in terms of the loss of the self, or better said, false self, rather than just the simple working through of a painful bereavement process.