HomeStrategiesHandling anger, guilt and blame     Anger is a very common response to bad news, and is often linked to feelings of guilt and blame. Guilt is most common in situations where we cannot give a clear "cause and effect" for a diagnosis. Many of the cancers appear to be quite random in that we cannot predict who will be affected, and we cannot give a cause. This leads to a search for meaning to help make sense of an otherwise senseless situation. A common question is "Is it something I've done?" Following on from that is the question "Is this someone else's fault?" The target of blame is often the doctor - "I wasn't diagnosed early enough", "I wasn't offered the best treatment", or from the relative, "He was alright when I had him at home, but he died in here because of your neglect". These accusations are usually accompanied by anger, which is directed at the Health professional. Try the following steps to handle anger: •  Acknowledge the anger (say what you see) "I can see how angry you are about your father's death"   •  Legitimise the anger if relevant. "It must be hard for you that he went down hill so fast after admission"   •  Find the true focus of the anger "I can see that you are blaming us, but I wonder if we deserve all the blame?"   •  Encourage expression of feelings "Can you tell me how you are feeling just now"   In the case of the relative's anger about her father's death, the daughter had promised her father that he would die at home. She blamed herself for allowing his admission to the Hospice, but this feeling was so uncomfortable that she transferred the blame to the Hospice staff. By encouraging her to find the true focus of her anger, she realised that her main emotion was a feeling of guilt that she had not kept her father at home. Her thought processes had moved at an almost unconscious level, but by encouraging her to express her feelings, she was able to put the situation into perspective and to realise that no one was to blame for the timing of her father's death. It is tempting, when faced with an angry individual, to explain the situation in such a way as to imply that the anger is inappropriate. In fact, when emotions are involved, logic has no place and it is best to work with feelings. Where anger is focussed, is often seen as "wrong" by the angry person. For example it is possible for an individual to be angry with their God, or with a sick or dead person. Rather than bring these feelings into the open, it is more comfortable to blame the carers - a little like kicking the cat - and for this reason it is important not to take the anger personally, but to find the focus and encourage the expression of feelings. Only then can the individual work through those feelings and find some resolution.        Printer friendly version  Click here	Denial When a family member asks you not to tell (Collusion) Handling anger, guilt and blame Answering difficult questions Grief Encouraging hope