Susan Silberstein, PhD An Award-Winning Cancer Counselor
Over 25,000 Patients in 30 Years
“It is more important to know what kind of patient has a disease than to know what disease the patient has.”Sir William Osler, the Father of Modern Medicine
Personal Tragedy Leads to a Lifetime’s Work
Susan Silberstein, PhD founded The Center for Advancement in Cancer Education in 1977, following her young husband's death at age 31 from a rare form of spinal cord cancer. She did so out of her burning desire to make a difference so others would not have to experience the pain, confusion and frustration she went through in trying to find options for him. She did so “not because I had any score to settle with the cancer establishment or with his doctors, who were all terribly sincere…It was because I was already intellectually persuaded there had to be other approaches.” She continues to serve as the Center's Executive Director. Susan was also a member of the Education Advisory Committee at The National Foundation for Alternative Medicine in Washington, DC.
In addition to counseling over 25,000 cancer patients (over 10,000 of these were breast cancer patients) at the Center without ever charging a fee (they operate on a donation basis) , Susan lectures extensively around the country on cancer prevention as well as alternative and complementary therapies. She teaches and serves as a consultant for medical and nursing schools and has participated in numerous national and international symposia. She has created and coordinated hundreds of conferences on mind-body, immunological and nutritional topics for oncology patients, as well as 20 conferences and numerous “in services” on these topics for health professionals. Susan is the Editor of Immune Perspectives magazine and the creator and narrator of the excellent video, Breast Cancer: The Diet Connection. Over the years, she has also trained numerous healthcare professionals as volunteer cancer counselors at the Center. She has just written a recipe/nutrition book, Hungry for Health, for people with an illness.
During the course of her counseling work with many thousands of cancer patients, Susan has learned much. She told us, “I may not know everything about cancer treatments, but I do know cancer patients! “ Indeed, she probably knows cancer patients better than anyone else doing this work! In a one-on-one setting, Susan and her volunteer staff help clients recognize life issues and other impediments to healing, as well as offering individualized recommendations for treatments, facilities, physicians and/or other practitioners. She continues to personally handle the most challenging cases herself.
During an interview for the book: “Remarkable Recovery: What Extraordinary Healings Tell Us About Getting Well and Staying Well,” Susan described the process she employs with clients. She looks carefully at each patient’s physical, financial and geographic limitations. She and her volunteers analyze physiological status and nutritional habits, attitudes and beliefs, mental and emotional status, goals and social support systems.
“We look at their mental or emotional readiness for a certain treatment approach. We never tell patients what they should or shouldn’t do. We ask them what their doctors have told them, what the doctors are offering them, how they feel about the doctor, what they feel comfortable doing in the conventional or unconventional medical world. Then we start offering them resources. You can’t believe how intimately involved I can get with a patient at the end of an hour. I know stuff about them that they swore they never told anybody. It’s not because I’m a brilliant psychologist. I think it’s because I’ve learned so much from what the other thousands of patients have taught me.”
The Importance of Mind-Body Medicine or Psychoneuroimmunology
Susan described the available science and research on the mind-body aspects of cancer and the field of Psychoneuroimmunology (PNI refers to the field of science relating to how thoughts and emotions directly affect the immune system) as voluminous. When clients are open to hearing about this topic, Susan generally recommends that they start by reading “Cancer as a Turning Point” by psychotherapist Lawrence LeShan, PhD, who has worked with cancer patients for fifty years. Over the past thirty years, approximately half of Dr. LeShan’s cancer patients with poor prognosis have gone into remission and are still alive—an amazing statistic! (Note: there is a chapter on this website on the work of Dr. LeShan).
Susan can quote references from numerous books, studies, authors: “PNI is a field that is over a quarter of a century old—it’s been around as long as I’ve been involved in this field. There is research now from everywhere in the world about the emotional patterns that influence the etiology and the outcome of cancer. I could literally spend the next several hours just telling you the names of researchers and some of the things they’ve done. I don’t even know where to start. This is huge!”
She likes to discuss the topic of spontaneous remission because it gets clients excited about the possibilities for them. It helps if they know that there are literally thousands of cancer patients who have gotten better primarily because of an emotional change. Caryle Hirshberg’s book “Spontaneous Remission: An Annotated Bibliography” contains 1574 cases. A 1966 book by Everson and Cole on spontaneous remission contained information about 1900 validated cases through 1960 alone!
Susan described some quick scenarios she recalled from these works, such as a uterine cancer patient with 2 weeks to live who hated her husband but felt helpless to leave her marriage. He suddenly died and she got well. Also a testicular cancer patient who had sexuality problems relating to his mother. As soon as he worked through these enough to get married, his cancer disappeared.
How does Susan broach this very delicate subject of emotional causes that may contribute to the development of a client’s cancer? Very carefully. “I try never to pin something on people. Finger pointing can be very disturbing for people and there’s a lot of that out there. There is not any one ‘family’ of factors that cause cancer. It is a combination of factors: the mental/emotional, the genetic, the physical and the environmental. When you get several aspects together, that’s potentially deadly.”
Susan went on to explain how she brings up the mental and emotional aspects when she sees that they likely apply with a client: “For example, when I see a strong correlation with a probable emotional pattern I will say, ‘You know, a large number of my _______(fill in the type of cancer) clients seem to have similar types of stress in their lives. I wonder if this is an area you would like to look at? Is there anything in your situation that you would interpret as stressful?’ If they give me the go ahead, I’ll go as deep as they will follow. Once I get my foot in the door, I let experience tell me how hard I can push.” She added rather proudly that when appropriate, she has been a contributing factor to the end of quite a few destructive relationships, the moving of clients to entirely new and supportive living situations and locations, complete changes of careers and the instigation of many other life-affirming choices—positively influencing the course of their diseases.
In describing her counseling role with clients, Susan said that it was basically, “Elucidating the areas that are fertile for change, seeing which they choose to address and then coaching them to find the most economical ways to do so. Economical in terms of their financial, logistical and geographical limitations.” She only gets one or two hours with a client, but by listening closely, inevitably it only takes a short time to find out who they are, how they think and to get them to begin to open up. Those who are most willing to talk about their personal issues, about what’s missing in their lives, about why they think they got sick, will most likely do best with their illness. Susan went on, “They all come in with an agenda…which therapy is the best to treat my cancer? I say-- We have many therapies, who are you? Then we can begin to find the answers together.”
When she began counseling patients twenty-seven years ago, Susan thought that poor diet and nutritional factors were the most likely cause of cancer and that changing these was the most important action a patient could take. She has now come around nearly 180 degrees in her thinking and if possible, she will take the patient down a path that is based on what’s going on in their heads first. She noted that she finds it is much more important to talk to patients about what is eating them, rather than what they are actually eating. “If patients are willing to address both issues, then they have a strong formula for success,” she noted.
Susan related the story of one of the first patients she counseled who showed her where her theories might need to shift. A man with spinal cancer came to her and related a medical prognosis that would leave him a quadriplegic within 6 months. He decided to go on a cruise, where he met a “guru” who told him to begin meditating and that “the cancer began in your mind so that’s where you’ll have to go to get rid of it.” He began to practice meditation several times a day. When he returned home, he did some heavy psychological work, got a divorce, quit his job, and his cancer went into remission. Susan remembers being confused with this, since she knew he hadn’t changed his diet at all. It was an “aha” experience for her as well.
Who Gets Cancer—and Why?
Dealing with the mental and emotional factors surrounding the development of cancer is not just about studying coping styles and factors. It goes to the very essence of who these patients are. Susan states, “Why people get cancer is the most fascinating and pregnant field for the prevention of cancer that we have today.”
Susan has written about the “Psychological Aspects of Persons with Malignant Process” with John W. Rhinehart, MD. As with other individuals in this report, she has noticed a common pattern of traumatic loss within the 6-18 months immediately prior to the cancer’s manifestation. You will also notice many similarities with Douglas Brodie’s characteristics of the “cancer personality.”
“Researchers are beginning to recognize that emotional stress plays an enormous role in susceptibility to malignancy. The following characteristics of the “cancering person” are often manifest throughout lifelong patterns—with the exception of the first item. These constitute what might be called “the cancer personality.” Susan’s observations about these characteristics are summarized below:
- Despair after significant loss. This can be the loss of a person, a job or possession that was central to life—6 to 18 months before diagnosis.
- Selflessness. A limited awareness of one’s own needs and desires. This has also been described by Charles Renninger as PNS (Pathological Niceness Syndrome). It involves continual catering to other’s needs or expectations, guilt associated with fulfilling one’s own needs and lack of acceptance of self. These people are harmonizers, attempting to keep the peace at all costs.
- Repression of negative emotions such as anger, resentment, rage, hostility, etc. There is a sense of inappropriateness with the expression of these feelings in any manner.
- Inability to form deep emotional relationships or a preponderance of negative, toxic relationships, especially with family.
- A sense of an inability to change the conditions of one’s life. Feeling there are no options, a lack of control, hopelessness of the situation. Also a sense of victimization and passiveness. This leads to frustration and ultimately to depression.
- A conscious or unconscious feeling that one does not deserve happiness or success—or even life itself.
- A conscious or unconscious desire to gain, through the legitimate avenue of serious illness, the attention that one could not receive for other reasons. There is a vested interest in maintaining the disease for manipulative reasons. Cancer is a socially acceptable form of suicide.
When questioned about whether she had observed similar patterns between certain types of emotional stress and where cancer manifested, Susan said, “After talking to hundreds if not thousands of patients with a particular form of cancer, I’ve informally observed this—yes—I’ve seen some powerful connections between emotional patterns and where they the cancer showed up.”
Susan’s comments and some corresponding cases are summarized below; they are ideas you may want to consider for your type of cancer. Her astute and thought-provoking observations could make up an entire book on their own. Remember, these situations are much more complex than the short descriptions we are able to include in this report. There are generally many synergistic factors that influence the development or remission of cancer.
- Lymphoma: Almost all lymphoma patients live in some type of extremely stressful situation. This is usually job-related and they hate their work, or it could be that they hate the environment in which they are living. For example, a person may live in an apartment in a large city, while longing for the country. Many prison inmates develop lymphoma.
- Breast Cancer: Susan noted that she has counseled over 10,000 breast cancer patients! In 99% of the cases, she observed a pattern of lack of nurturing, many times from a male, but sometimes self-nurturing, often present since childhood and repeated later in life in a relationship.
- Prostate Cancer: Similar to breast cancer, a lifelong pattern of lack of nurturing, often from females.
- Colon Cancer: Relates, along with liver cancer, to repressed anger and resentment, usually since childhood, but generally over many years.
- Kidney Cancer: Involves a situation of very deep patterns of fear.
- Throat Cancers: Usually relates to a lack of self-expression, generally throughout the lifetime.
- Ovarian Cancer: The ovaries are the most creative organs of the woman’s body. This is generally about major creativity that is suppressed or repressed throughout life. It can also be about mothering issues; these women often had an unapproving or absent mother or they perceive themselves as failing at mothering somehow.
- Lung Cancer: This is related to self expression issues and is an outlet for all kinds of repressed emotions.
- Multiple Myeloma: This is cancer of the bone marrow, which is the deepest place one can go in the body. The Hebrew word for ‘bone’ is the same as the word for ‘self.’ Susan has never seen an exception, this cancer is related to issues of very deep unexpressed, unresolved grief that goes to the very essence of who a person is and how they define themselves. It may be related to a situation that the patient has spent his entire life grieving about in some way.
Susan also shared some stories about long-term exceptional cancer survivors she remembers who turned their cancers completely around by making some very basic changes in their stress levels, emotional states and life situations.
Betty was diagnosed in 1985 as a breast cancer patient. She was a victim of incest and had been abandoned by her entire family of alcoholics. She joined a 12 step program along with A Course in Miracles and did “a lot of personal work.” She is fully recovered.
Neal was diagnosed in 1999 with metastatic prostate cancer. He had a violent and abusive wife. After a lot of counseling and leaving his marriage, he is fully recovered. Of note is the fact that Neal refused all conventional treatment.
Catherine was diagnosed with inoperable kidney cancer in 1985, with 3 months to live. She was made to feel inadequate and unworthy her entire life by her parents. She did “heavy psychotherapy” and is fully recovered.
Harry was diagnosed in 1985 with metastatic colon cancer. He had long repressed anger at his father and later at his wife. He did personal therapy and A Course in Miracles and is fully recovered.
Doug, diagnosed in 1993 with malignant melanoma, metastasized to his lungs. He had carried strong resentment toward his parents his entire life. They tried to force him into the family business while he wanted to be a musician. Doug did psychotherapy, quit his job, went into the music field and is fully recovered.
Warren, an MD with colon cancer, metastases to lungs. He was a hospital president who was extremely angry, even furious about the challenges presented by the healthcare industry and how he was forced to interface between the industry, his staff, his board and his administration. When Susan asked Warren “Who are you and what are you doing when you feel totally alive,” he described a 40 acre property with gardens he owned in Wisconsin. He only visited once a year or so, but loved it. Although this was a highly unusual situation, five minutes into their very first conversation, Susan felt comfortable enough to suggest that Warren consider quitting his job and moving to Wisconsin. He went! He is now fully recovered and living a very different and happier life.
Emily was diagnosed in 1987 with breast cancer. She had a very controlling abusive husband. When Susan asked her “What would it take for you to walk away,” Emily responded “I think about it all the time, but I can’t do anything about it. I have nowhere to go and I need his insurance.” Susan observed that this type of situation is usually the kiss of death for cancer patients. Emily said, “When I get better, I’ll leave.” And Susan responded, “No, you don’t get it. That’s how you get well!” Emily eventually left her marriage and stayed with friends for awhile. She bartered at a co-op, eventually working there, slowly building a new life, living in a trailer, then an apartment, eventually buying a house. She is fully recovered.
Rebecca has been recovered from lymphoma for 20 years. She did some “heavy duty psychotherapy” and eventually was able to forgive her mother for abandoning her. Her last memory of her mother was being under the hospital bed, looking up from under while her mother was dying, and seeing the bars on the sides of her mother’s bed as prison bars. It was an image that stayed with her all her life when she thought of her mother. When she was finally able to forgive her mother for leaving, while standing at her grave, Rebecca's cancer immediately went into remission.
Susan observed that for many cancer survivors, the only change in their lives has been a dramatic emotional breakthrough. She has seen many cases of these “spontaneous remissions” over her 29 years of this work, but also many “hard work miracles.”
Who Survives Cancer—and Why?
Like Dr. Douglas Brodie, Susan has observed certain personality traits common to the overwhelming majority of exceptional cancer survivors. Those patients who are willing to be open and dialogue about their issues allow support people to be of most help. “And those patients who manage to achieve a balance between cognition, emotions and behavior are the most likely to outlive their prognosis with quality longevity.” She has outlined the following traits common to survivors:
- They accept the diagnosis and reject the prognosis. This type of positive attitude implies self-affirmation, being the most authentic person they can be, getting in touch with what is right about them.
- Participation/Initiative/Commitment: This may involve disagreeing with doctors or loved ones and choosing intuitively which treatment feels right according to their own understandings and beliefs. Susan related the story of a patient who needed to make a decision about which treatment to choose. She didn’t want chemotherapy but was being pressured about it. She told Susan about a dream she had with 2 pools of water. One was very crowded with women who called to her to join them. That pool looked murky. The other pool was empty but looked pristine, clean, sparkling. The patient decided to dive into the clean pool and it felt wonderful. She chose an alternative treatment, rejected chemotherapy and recovered.
- Introspection: They use their illness for personal learning and growth, resolving losses, completing grief work and self-actualizing.
- Transformation of personal relationships: This includes learning to receive, making oneself a priority, reconciling conflicts and purging toxic relationships.
- Lifestyle changes: Developing new supportive patterns of diet, exercise, job and/or living arrangements. Learning to play more and have more fun. In this, Susan often assigns homework and asks clients to begin making a “Fun List.” They are to add anything to the list that seems as though it would be fun to them, and family members are to help. These choices can be outrageous, illogical or impossible, as well as small and seemingly insignificant. Then every night the client is to choose one item to do the following day. Susan called this a “fabulous exercise for waking up the healing potential of the body.” She went on, “You see, the immune system doesn’t know the difference—whether you’re actually taking the action, planning it, or just thinking about doing it.”
- Expression of emotions: This relates to both positive and negative emotions that have been repressed, especially anger and resentment. She tries to get clients to reconnect with the joy of childhood. In the same way one can auto-intoxicate if he or she physically detoxifies too quickly, this can apply with emotional detox as well. Susan suggests that, “If one gets into heavy traumatic emotions, this needs to be handled in a rhythmic, balanced manner using gradual coping techniques.” Of course, this implies being under the professional care of a trained clinician. Susan described a three phase process: get the repressed emotions recognized, get them up and out of storage and then get what has been stirred up out of the body. This process can take many forms, including personal therapy, couples counseling, support groups, pastoral counseling, stress management, bodywork, energy work and others.
- Life Purpose: Understanding one’s place in the spiritual universe. In this, Susan described finding “the one thing that engages them in life, a feeling of purpose, self worth and meaning, something that is all their own and unique about them—something that they should be completely selfish about.” She noted that there are patients who don’t want to die, but aren’t really ready to live either. She tries to find ways to engage them in life--to motivate the life force within them.
If patients really don’t want to be here anymore, Susan attempts to clarify that with them as well. Sometimes they’re ready and just need a way to get out of their body. “Some patients just want to let go and be with a loved one who has passed…..we help them to die spiritually at peace because they have gotten in touch with where their spirit really is. Because sometimes it has already crossed over long before the body goes---and that’s ok.” Again, she observed that cancer is a socially accepted form of suicide.
Responsibility vs. Response Ability
Susan described the very delicate balance she constantly works with in showing clients they may have contributed to the development of their cancer, without creating guilt and additional stress for them. In this, she described two ways to spell and describe the word ‘responsibility.’
“There is the traditional way. If you tell patients they have a responsibility for creating their illness and their wellness, it implies some blame and leads to guilt. If you spell it the second way—Response Ability –you create an awareness that leads to power. This second way can lead to opportunities for the awareness of the many theories, research results, clinical observations relating to the emotions and behaviors that might control or reverse their illness….This process is patient-driven, there is nothing by protocol. We try to present a smorgasboard of options and give clients permission to choose. It is never about guilt and blame; it is always about empowerment! Some clients are ready to embrace certain aspects immediately and some later. It’s up to them.”
Susan finished her interview with a story about a cancer patient and her partner who had driven to Philadelphia from New England for a consultation. Susan quickly surmised there were problems in the relationship as they couldn’t agree on anything and the tension in the air was thick. She asked if this happened often and they agreed it was a regular pattern with them. Susan went on to tell them she was more than a little worried about each of them. Certainly this was an immediate problem for the cancer patient. Susan explained that based on extensive PNI clinical research on the direct relationship between chronic stress and depressed immune function, that with this much stress, it really wouldn’t matter which treatment they chose. There would not be a strong enough immune response. And all the stress couldn’t be good for the woman’s partner either.
Susan proposed that the couple spend the six-hour trip home talking about their relationship in terms of what was in both their best interests. Perhaps they should consider a hiatus in the relationship or couples counseling to remove the very stressful environment they were living in. The woman called Susan the very next day and told her, “Thank you, thank you, thank you! We realized we really weren’t happy living together. He moved out this morning and I feel free!” She got better.
Pioneering Excellence in Healthcare
Dr. Susan Silberstein is considered a pioneer and leader in the field of holistic health and was honored as such by The National Foundation for Alternative Medicine on November 16, 2002 at its “Celebrating Excellence” award ceremony in Washington DC. Her closing remarks were the following prayer: “May the Almighty deliver us from the stubbornness of mind that clings to preconceived ideas. And may He grant us the humility and courage to examine without prejudice new sources of information. Amen.” Amen!
Susan’s philosophy can be summed up in her statement: “Miracles happen beyond the mainstream of medicine!” And she has seen and played a part in many of them.
NOTE: The Center for Advancement in Cancer Education is available for phone or in-person consultations at 610-642-4810. A very reasonable donation for membership is requested.