Coping with and adjusting to mastectomy and widowhood : a comparative study : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University

Abstract

A comparison of two cross-sectional surveys of thirty women who had undergone mastectomy with thirty widows established that both losses were met with a similar initial grief reaction which moved through the stages of denial, alarm reaction, realisation and resolution, and manifesting most of the features of the normal acute grief reaction as outlined by Lindemann (1944). Significant differences between the samples in the duration of the reaction were established however. Fantasies of rejection and stigmatisation on the part of the women who had had mastectomies were not realised. Women in supportive primary relationships who regained and maintained physical health reported that they quickly re-established a normal outward lifestyle. Breast loss was not found to affect all other aspects of the woman's life in the same way as the loss of a husband does. Many women reported combinations of complex feelings in their intimate relationships, and attributed their being able to manage these emotions and confine them mainly to the physical realm, to the acceptance and support of their husbands. Most of the mastectomy sample reported that the threat of a recurrence of cancer and its possible consequences was sufficient to be the focus of long periods of intense and painful preoccupation, and remained with them to some degree, but so long as they remained physically well they were usually able to employ a denial strategy and not dwell upon the matter. Widows and those in less supportive marriage situations within the mastectomy sample coped least well with their loss, were prone to prolonged invalidism, were less satisfied with their breast prostheses, seemed to be less motivated to resume a normal life-style and were less able to control their emotions. For widows mastectomy reactivated and intensified their reaction to the loss of their husband. Women confronting mastectomy appeared to be able to make some use of forewarning as indicated by a reported absence of emotional numbing at the time of the actual loss on the part of half of the sample. Widows did not appear to be able to similarly guard against initial emotional numbing. Forewarning could not be demonstrated to influence subsequent adjustment to loss in either circumstances.