Daughters of Breast Cancer Patients

Abstract

One could fairly ask, does a chapter on daughters of breast cancer have a rightful place in a book on multigenerational legacies of trauma—especially given that most of the chapters of this volume deal with the psychosocial sequelae of war, repressive governments, and urban violence? After some soul searching, we decided that the chapter deservedly belongs in the book. The protagonists of this chapter, daughters who are often also sisters, nieces, and granddaughters (or all of the above) of breast cancer patients, bear a genetic legacy of trauma, past visions of suffering, and fears from the past carried forth into the future. Their traumas, fears, and psychic scars do not come from a political regime, but rather from the possible mutation of a gene. This gene, now identified as BRCA-1 and BRCA-2 (for Breast Cancer 1, or Breast Cancer 2) has been localized on the short arm (small part) of chromosome 17 (Futureal et al., 1994). Given this now-identified reality, these women must learn to live with several conflicts. On the one hand, the “perpetrator(s)” of their suffering (who has passed the increased risk and vulnerability for breast cancer on to them) is the same person (or often persons) with whom they empathize, or for whom they mourn and grieve. On the other hand, they have a vulnerability for which there is no definitive medical treatment at present. Thus, they must learn to cope with and adapt to a threat that has been termed the “Damocles Syndrome” (Koocher & O’Malley, 1981). The nature of these daughter’s trauma differs from that of victims of political oppression in two distinct ways that greatly complicate their adjustment. First, their aggressor is internal, invisible, and, until fairly recently, mysterious and unknowable. This contrasts with victims of political repression in which the persecutor is external and distinct. Second, although for the victims/survivors of political persecution the trauma reverberates psychologically, the distinct physical threat generally ends. The Holocaust ended, as did World War II and Stalinist Russia. For the survivors of their mother’s breast cancer, the physical threat will never end, the potential aggressor will never go away, die, be overthrown, or even be reduced in power or potential risk. In fact, the risk increases with age.