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.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Adler, G. (1985). Borderline psychopathology and its treatment. New York: Jason Aronson.
Berg, J. W. (1984). Clinical implications of risk factors for breast cancer. Cancer, 53, 589–591.
Black, W. C., Nease, R. F., and Tosteson, A. N. A. (1995). Perceptions of breast cancer and screening effectiveness in women younger than 50 years of age. Journal of the National Cancer Institute, 87 (10), 720–731.
Claus, B. E., Risch, N., and Thompson, W. D. (1990). Age at onset as an indicator of familial risk of breast cancer. American Journal of Epidemiology, 131, 961–972.
Claus, B. E., Risch, N., and Thompson, W. D. (1994). Autosomal dominant inheritance of early onset breast cancer. Cancer, 73, 643–651.
Compas, B. E., Worsham, N. L., Epping-Jordan, J. E., Grant, K. E., Mireault, G., Howell, D., and Molcarne, V. L. (1994). When Mom or Dad has cancer: Markers of psychological distress in cancer patients, spouses, and children. Health Psychology, 13, 507–515.
Dupont, W. D., and Page, D. L. (1987). Breast cancer risk associated with proliferative disease, age at first birth and a family history of breast cancer. American Journal of Epidemiology, 125, 769–777.
Fawzy, F. I., Cousins, N., Fawzy, N. W, Kemeny, M. E., Elashoff, R., and Morton, D. (1990). A structured psychiatric intervention for cancer patients. Archives of General Psychiatry, 47, 720–725.
Freud, S. (1915). Mourning and melancholia. In S. Freud (Ed.), Standardized Works of Sigmund Freud, Vol. XIV. London: Hogarth Press.
Futureal, A., Liu, Q., Shattuck-Eidens, D., Cochran, C., Harshman, K., and Tanigian, S. (1994). BRCA1 mutations in primary breast and ovarian carcinomas. Science, 266, 120–122.
Gabriel, S. E., O’Fallon, M., Kurland, L. T., Beard, C. M., Woods, M. D., and Melton, L. J. (1994). Risk of connective-tissue diseases and other disorders after breast implantation. New England Journal of Medicine, 330 (24), 1697–1699.
Gail, M. H., Brinton, L. A., Byar, D. P., Corle, D. K., Green, S. B., and Schairer, C. (1989). Projecting individualized probabilities of developing breast cancer for white females who are being examined annually. Journal of the National Cancer Institute, 81, 1879–1886.
Hirohita, T. Nomura, A., Hankin, J. H., Kolorel, L. N., and Lee, J. (1987). An epidemiologic study on the association between diet and breast cancer. Journal of the National Cancer Institute, 78, 595–600.
Hirschfeld, R. M. A., and Goodwin, E. K. (1988). Mood disorders. In J. A. Talbott, R. E. Holes, and S. C. Yudofsky (Eds.), Textbook of psychiatry (p. 437 ). Washington, DC: American Psychiatric Press.
Josten, D. M., Evans, A. M., and Love, R. R. (1985). The cancer prevention clinic: A service program for cancer prone families. Journal of Psychosocial Oncology, 3 (3), 5–20.
Kash, K. M., Holland, J. C., Halper, M. S., and Miller, D. G. (1992). Psychological distress and surveillance behaviors of women with a family history of breast cancer. Journal of the National Cancer Institute, 84, 24–30.
Kash, K. M., Holland, J. C., Osborne, M. P., and Miller, D. G. (1995). Psychological counseling strategies for women at risk for breast cancer. Journal of the National Cancer Institute Monographs, 17, 73–79.
Koocher, G. P., and O’Malley, J. F. (1981). The Damocles syndrome: Psychological consequences of surviving childhood cancer. New York: McGraw-Hill.
Lichtman, R. R., Taylor, S. E., and Wood, J. V., et al. (1985). Relations with children after breast cancer: The mother-daughter relationship at risk. Journal of Psychological Oncology, 2, 1–19.
Love, S. M. (1995). Dr. Susan Love’s breast book ( 2nd ed. ). New York: Addison-Wesley.
Rosen, P. P., Lieberman, P. H., and Braun, D. W. (1987). Lobular carcinoma of the breast. American Journal of Surgical Pathology, 2, 225–228.
Sattin, R. W., Rubin, G. L., Webster, L. A., Huezo, C. M., Wingo, P. A., Ory, H. W, and Layde, P. H. (1985). Family history and the risk of breast cancer. Journal of the American Medical Association, 253, 1908–1912.
Schwartz, M. D., Lerman, C., Miller, S. M., Daly, M., and Masny, A. (1995). Coping disposition, perceived risk, and psychological distress among women at increased risk for ovarian cancer. Health Psychology, 14 (3), 232–235.
Seidman, H., Mushinski, M. H., Gelb, S. K., and Silverberg, E. (1985). Probabilities of eventually developing cancerUnited States, 1985. CA: A Cancer Journal for Clinicians, 35, 36–56.
Shaw, W. W. (1995). Surgical reconstruction. In C. M. Haskell (Ed.), Cancer treatment (pp. 343–347 ). Philadelphia: Saunders.
Stern, D. N. (1989). The representation of relational patterns. In A. J. Sameroff and R. N. Emde (Eds.), Relationships and relationship disorders (pp. 52–69 ). New York: Basic Books.
Stomper, P C., Gelman, R. S., Meyer, J. G., and Gross, G. S. (1990). New England Mammographic Survey, 1988: Public misconceptions of breast cancer incidence. Breast Disease 3, 1–7.
Styra, R., Sakinofsky, I., Mahoney, L., et al. (1993). Coping styles in identifiers and non-identifiers of a breast lump or a problem. Psychosomatics, 34 (1), 53–60.
Wellisch, D. K. (1979). Adolescent acting out as a response to parental cancer. International Journal of Family Therapy, 3, 230–240.
Wellisch, D. K., Gritz, E. R., Schain, W., Wang, H., and Siau, J. (1991a). Psychological functioning of daughters of breast cancer patients: Part I. Daughters and comparison subjects. Psychosomatics, 32, 324–336.
Wellisch, D. K., Gritz, E. R., Schain, W., Wang, H., and Siau, J. (1991b). Psychological functioning of daughters of breast cancer patients: Part H. Characterizing the distressed daughter of the breast cancer patient. Psychosomatics, 33 (2), 171–179.
Wellisch, D. K., Hoffman, A., and Gritz, E. R. (1996). Psychological concerns and care of daughters of breast cancer patients. In L. Baider and C. Cooper (Eds.), Cancer and the family (pp. 289–304 ). Sussex, UK: Wiley.
Winnicott, D. W. (1965). The maturational processes and the facilitating environment. New York: International Unversities Press.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1998 Springer Science+Business Media New York
About this chapter
Cite this chapter
Wellisch, D.K., Hoffman, A. (1998). Daughters of Breast Cancer Patients. In: Danieli, Y. (eds) International Handbook of Multigenerational Legacies of Trauma. The Plenum Series on Stress and Coping. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-5567-1_36
Download citation
DOI: https://doi.org/10.1007/978-1-4757-5567-1_36
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4419-3287-7
Online ISBN: 978-1-4757-5567-1
eBook Packages: Springer Book Archive