The case of John Browning demonstrates how people participate both in the onset of—and recovery from—illness. This case is revealing because it suggests specific connections between emotional stresses and cancer.John is a brilliant scientist who works for a world-renowned research firm. At the time of the onset of his cancer (of the pancreas), he was fifty years old. He was given a life expectancy of six to nine months. Professionally, he had always been an overachiever, but as he approached fifty, he began to face the fact that many of his childhood dreams would not be reached. Although he had received considerable professional recognition, it had not been at the level he had hoped. In effect, he was experiencing mid-life crisis.In addition, in the months prior to the onset of his cancer, John’s son went off to college. Almost every weekend for many years, John had gone to athletic events with his son. John took great pride in his son’s aptitude for sports. After his son’s departure, however, John stopped attending sports events entirely. Clearly, an era had ended.The end of this period also raised new stresses between John and his wife. His wife had not recently enjoyed sports and had not participated in the family’s many athletic pursuits. Instead, she had become involved with club work, church work, and similar activities. Since John no longer spent every weekend with his son, he and his wife were thrown together as they had not been for a long time, and they had to develop new ways of communicating and creating interests in common.Another of John’s regrets was that some years earlier he had left a university post to go to work for his present employer. His motivation had been the extra money he would earn for his son’s college education. But while his salary was indeed substantially greater, he badly missed having people to guide and instruct.A great satisfaction in his present job was that he had been able to produce a number of significant research breakthroughs by putting together a collection of scientists and guiding them into an exceptionally creative team. His supervisors had been so impressed with his performance that they put him in charge of another major project as a reward. But to John the new project felt more like a punishment than a reward, for it meant he had to leave his team. Like many of our patients, however, John had extreme difficulty expressing his feelings and never told his superiors how badly he felt about the new assignment.This inability to speak up for his needs became clear after John entered into therapy with us. He told us he had always prayed regularly, but he soon informed us that he had never prayed for his own health. John believed it would be wrong to ask for anything for himself in his prayers. These attitudes traced back to his childhood. John’s mother was, he said, “a very pious and self-sacrificing person.” John saw his father, in contrast, as a “selfish person” who accumulated money and then spent most of it on himself. John took his mother’s self-sacrificing attitude yet always believed he had inherited a selfish streak from his father.But as John rejected his father’s apparently immature and selfish behavior, he overcompensated because of his fear of being selfish. This showed up in his difficulties in communicating his needs and feelings to others, in investing his life with meaning by making himself responsible for others, and in abandoning pleasurable activities when they were not shared with his son. In short, John felt obliged to place everyone else’s needs ahead of his own, and so when his son left for school, when John was removed from his work team, when his professional dreams were unfulfilled, his personal rules were such that he could see no way to meet his needs. He thus became extremely depressed.Changing BeliefsThe first step for John, or for anyone else trying to get well, is to identify those attitudes and beliefs that lock him into a pattern of hopeless victim. The psychological reality is that if John were to hang onto his beliefs that everyone else’s needs come first, he would indeed be powerless to meet his own emotional needs. Clearly, these beliefs need to change.We worked with John to help him recognize the facets of himself he was ignoring, and also to help him change his perception in other areas in his life. As a result of those efforts, he reexamined his work situation and finally came to the understanding that his superiors had, in fact, been trying to reward him by giving him the new job assignment and had no way of knowing of his disappointment. We urged him—as we urge everyone—to take his emotional responses to life more seriously.We also worked with John on his sense of failure because he had not realized his early dreams. Like many ambitious men, John had channeled his energy into developing primarily those parts of himself related to his work. Now, since the dreams were no longer attainable, we urged him to give himself permission to explore other interests or pursue other parts of himself that had been held in check. Finally, we worked with John on his sense of loss of his son, pointing out the degree to which he had vested so much of his personal happiness in someone else rather than himself, and helped him to see that he had an opportunity to renew his relationship with his wife.None of this is meant as a criticism of John; many of us have experienced similar events and reacted similarly. The difficulty is that the beliefs John had adopted as a child in response to the conflict between his mother and father were blocking his finding alternative ways of responding to life’s inevitable disappointments. The point is that there are alternatives. Whenever people feel boxed in and trapped, it is because they are limited by their own beliefs and habitual ways of responding.*31\347\2*