Be kind to your fear following a cancer diagnosis. Laura Hewitt

Laura Hewitt Bsc (Hons), PG Dip Humanistic Counselling, MBACP

“There is nothing to fear but fear itself”


I consider the above statement by Franklin. D. Roosevelt tells us that fear can be all consuming. The fear of something is usually much worse than the event, we can allow that fear to grow and persuade ourselves to be more afraid. However it is said when we turn towards our fear in an accepting way, it will become less debilitating, will not last as long, and we can then apply the courage to face what it is we are fearful of. I have explored this subject through both my personal and professional experiences. I also interviewed Vivienne the creator of Victory with Style to discuss her fears following a breast cancer diagnosis.

I aim to gently guide you through some of the thoughts and hopefully without patronising you, look at caring for your emotional wellbeing and let you know you are not alone. I understand we are resourceful human beings and we are more than capable to attend to the principles below, however shock caused by diagnosis of can- cer can be a powerful phenomena and can initially close down our vital thought processes. I will highlight, to normalise some of the feelings and considerations you may be going through, after hearing probably one of the most shocking pieces of information about your- self that you will probably receive, and ways of coping with your emotional health during this time.

I watched my beautiful mother almost engulfed by the diagnosis of Cancer, she handed over her power of the early and necessary decision-making to her adult children. The love of this family network however, gave her the courage to face the challenges to come. It is these experiences amongst others that led me on the path of becoming a counsellor, believing in your entitlement to a safe and confidential space to explore and be heard in your subjective reality.

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Feelings are the portal to your inner world: the key to your deepest yearnings and desires and the compass that guides you through life.

Feelings should not be ignored or denied. After diagnosis and during your treatment plan It is normal to have an array of feelings, although everyone is unique, you may feel anger, frustration, sadness, confusion, helplessness, isolation, scared, uncertainty, and anxious, to name but a few.

Vivienne  “My fears were of no longer being in control, my normal daily life was shattered. I am no longer the same person, I have cancer! Despite that mornings appointment, I had regarded it as routine, my suitcase was packed ready for a working trip to Las Vegas that afternoon. Instead I was phoning in sick. I feel fine but I have cancer!!! Then  phoning friends and family with bomb shell news completely out of the blue. Telling my mother one hour after diagnosis that “yes everything is fine” in reply to her “How are you?”  question was tough. She had rapid onset of dementia so I decided I did not want her to know”…

..”My fears initially were that I was going to descend into ill health as a result of the treatment, and yet right now I felt fine. My hair would fall out, I would rapidly turn into a pale, weak, bald, cancer victim, pushing a drip around a hospital ward and throwing up violently as I fought for my life! I had fear of job loss, financial concerns and early death. I also felt disbelief, denial, shock and a feeling that I no longer belonged to normality. I was entering into unchartered territory and I am not necessarily someone that likes to hand over control of my destiny. I wrongly in an attempt to take control insisted on knowing ALL of the possibilities within 24 hours of diagnosis. It was too much. My brain could not cope. Yes, if it was an abstract thing, this is how I would “manage it” because I am solution orientated. However a cancer diagnosis has many possibilities. NHS and health care providers tend to deliver worse case scenarios, I guess to avoid giving false hope and also they often operate form scripts as a one size fits all. It is impossible in the first few days to absorb what it happening and indeed it is probably unknown as further information is not yet known. My advice is  slow your brain down – death is unlikely to be imminent – you are simply succumbing to the fear factor which is not helpful”…

Self-care


Considering the thoughts from Vivienne, it is important to find the right emotional support for yourself as soon as possible, to process everything that will be going on for you and to work through the information overload, with as clear a mind as possible. Vivienne  ..” A few select calls to trusted friends and my sister helped immensely. It is important that the first few people that you tell don’t plunge you further into helplessness and sympathy but rather a more balanced calm and rationality. Of course they are extremely shocked and stressed but they knew that their role  for the next few days was to diffuse and silence the fear and panic. My best friend said. “ We will get through this!” … “How?, I ask in shocked disbelief”…. “ We will because we have to and we will do it step by step.”. The “ we” I think was the powerful message I was no longer on my own in free fall. I hadn’t been rejected or swallowed up in more sympathy and shock that right now was not what I needed.”…

The above are wise words, as it is essential you find the space to accept your feelings and reflect on what is going on for you emotionally and physically. The time spent in each feeling space is individual, these conflicting emotions will be ongoing from diagnosis and probably spill over into the recovery period. There will be many times during treatment that this reflection will not be possible because of feeling unwell, therefore make time for your- self in this space.John Donne said – ‘No Man is an Island’, being isolated at any point in life is never help- ful, make a list of friends who are able to offer the kind of support you need, and contract with them for an offer of support and connection. We can have an array of friends who bring different perspectives and can fulfil different needs for us as we do for them. What may you need from the people in your life? Direction? Kindness? Fun? You may need sympathy and empathy? Or someone who can put aside, the fact you have cancer, and be with you for who you are? Again what you will need is individual , do not be afraid to ask for, and tell others what you need. Write your friends names down, their numbers and the type of support they can offer you.  1)………….      2)………….    3)………….

What does Self care mean to you Vivienne? …. ‘I rather quickly started to come out of the “shock” state as if I had been slapped. I knew I had initially to be practical. I need to sleep, eat and make a plan. My first port of call, that same day of diagnosis was to my GP.  I knew I would need sleeping tablets to quieten my mind and anaesthetise my brain so I could start to think straight. She obliged and I was glad I had my first night of post diagnosis not lying awake. I also gained perspective, relief and therapeutic benefit  by writing my thoughts and downloading the chaos onto paper. This was like tipping out the jumbled storage box onto the floor, where it would now be visible and could be put into some sort of order and organisation before being put back in the box (or brain).”..In the days that followed I did what I know a lot of people do after diagnosis they rush out and  buy a juicer from Argos! I also went to an expert homeopath. Both have their benefits but I recognise this was also a knee jerk reaction, and attempt to regain some control!”…

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Essential self-care guidelines:


  • Taking care of your body – Now more than ever there may be a need for some necessary lifestyle changes through diet and exercise. Guidelines are readily available, but again make it work for you, anything in life that becomes an endurance will be more difficult to maintain.
  • Pay attention to your thoughts and emotions – As previously mentioned these are the compasses that guide you through life. As a counsellor I pay close attention to your thoughts and feelings and how they manifest themselves, to find out what is actually im- portant for you.
  • Plan for distraction – Finding a sense of Fun, spending time with friends, watching a good movie are all beneficial when the realisation becomes too much.
  • Relaxation and Meditation.
  • Taking care of the practicalities in your life – There may be a few aspects of your life that you are temporarily unable to complete. Farming these out to capable and trusted others, will add to your own healing process – aspects such as Dog walking, some child care, shopping, financial organisation.

There will be plenty guidance from whoever organises your treatment plan and an array of information available on the internet and through hospital leaflets on what may happen next, but remember that this information may also be initially overwhelming. Read Finding Light in a Dark Place and Reclaiming my body through yoga by Ella Kate Reeves-Cullen for further advice and inspiration.

An Existential Process


I have added this section, not to get lost in the depth of philosophical discussion, but to explore the simple awareness of the value of life and choice, so please bear with me for just a few sentences. Existential therapy looks at the four givens of life which are death, freedom and its responsibility, isolation and meaninglessness. This therapy starts with the belief that although humans are essentially alone in the world, they long to be connected to others. People want to have meaning in one another’s lives, but ultimately they must come to realise that they cannot depend on others for validation, and with that realisation they finally acknowledge and understand that they are fundamentally alone (Yalom, 1980). The result of this revelation is anxiety in the knowledge that our validation must come from within and not from others. Irving Yalom also researched through his work, that we are never more aware of the value of life than when we are faced with a serious or terminal illness. I was made aware of an article recently, which although talks about ‘regrets of the dying’ (Ware, B 2009) is more about advice on the way to truly live life and are five principles that I find of value.

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  • I wish I’d had the courage to live a life true to myself, not the life others expected of me. Health brings a freedom very few realise, until they no longer have it.”
  • I wish I hadn’t worked so hard. People had missed out on their children’s youth and their partner’s companionship.
  • I wish I’d had the courage to express my feelings. “Many people suppressed their feelings in order to keep peace with others. As a result, they settled for a mediocre existence and never became who they were truly capable of becoming. Many developed illnesses relating to the bitterness and resentment they carried as a result.”
  • I wish I had stayed in touch with my friends. Becoming caught up in work life and one’s own life, may contribute to your most valued friendship passing by and not giving them the time and effort they deserved is said to be a deep regret.“
  • I wish that I had let myself be happier.  The realisation that happiness is a choice and that they had stayed stuck in old patterns and habits. The so-called ‘comfort’ of familiarity overflowed into their emotions, as well as their physical lives. Fear of change had them pretending to others, and to their selves, that they were content, when deep within, they longed to laugh properly and have silliness in their life again.” (Ware, B, 2009)

This is really truthful and beautiful advice, even though it’s a bit hard to think about and as said in the article ‘everyone could use a reminder from time to time’.

As well as being overwhelmed by all the necessary decision making to combat your illness, you may also feel swamped by well meaning advice from friends and family. It is possible that their fears and emotions about cancer may conflict with your unexplored territory. It is all important that you have available to you the best support to work through your experience, therefore seeking professional help may be of benefit with the above.

Finding a Counsellor


The Counselling Directory is an easy to navigate online system that has rigorous checks to ensure that every therapist is thoroughly vetted. Many counsellors offer free introductory sessions and I advise you meet several to choose the right person to work with for you. Feeling comfortable and the knowing that you can work with a counsellor may take priority over their expertise in the field of cancer, this may appear counter-intuitive, but the thera- peutic relationship is all essential. Do your research; look at counsellor’s websites, to find out who they are and whether they would be suitable for you.

I work with patients at my Brighton practice.  Contact Laura for further information.

References

The Dana Farber Cancer Institute

The Food & Feelings Workbook

The Top 5 Regrets of the Dying

Existential Psychotherapy

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