Every woman with breast cancer will experience a different journey, and all of us survivors carry some level of physical and emotional trauma from the experience. But while there’s so much emphasis on managing the physical aspects of cancer, not many resources are offered for the emotional and mental scars. The most under-treated part of a breast cancer journey is often grief.
As a psychotherapist and resilience coach who specializes in chronic pain/illness, grief and trauma—and who has also had breast cancer—I know through personal and professional experience how hard it is to emotionally thrive during and after cancer treatment. The good news is that post-traumatic growth is possible; leveraging your experience and strengths for a better and more resilient life. And finding your way there means recognizing and healing the grief that comes at every stage of the process.
Grief is part of the mental and emotional toll that comes with cancer
Getting a cancer diagnosis is catastrophic and traumatic; you go through a wide range of emotional and mental turmoil. We are “built” to survive and endure difficult things. From the moment of diagnosis, we put our heads down and charge through treatment and fight for our life. Your whole goal and purpose is to survive. However, when treatment ends, the mindset and skill set to thrive is different than what’s needed to survive.
Our medical system is built around our physical survival: helping remove disease from the body. But it’s not set up to give us coping skills or even check in on our emotional or mental state. We’re expected to “handle it” and manage on our own.
The whole process is focused on the physical part. But there’s not enough support and guidance for the mental and emotional toll that comes during a cancer journey. It’s not fair and doesn’t set up breast cancer patients for success. They are not seeing or treating us as a whole person; they’re focused on the body, but not the mind and spirit. We need help that works in an integrated manner to heal all parts of us.
Since ancient times there has always been a guide, a healer; and we still need that aspect for our wellbeing. From the moment of the life-altering diagnosis, through treatment, and managing the after effects of cancer, we need a safe place to help us move from a constricted state of fear towards thriving. We need help to navigate this new territory through grief and all the emotions along the cancer journey.
Grief during breast cancer treatment
Cancer treatment is a grueling and exhausting journey. When our bodies are so overwhelmed with pain, we can enter a very dark place in our minds. We wrestle with fear and our mortality. During treatment, we grieve how our bodies used to be, the dreams we had for our future, the energy we used to have, and the things we are missing out on.
Praying or hoping the suffering will end
For most of us, it’s the lowest we’ve ever been, physically, emotionally and mentally. This is not an uncommon feeling for cancer patients. Sometimes you may even want to give up the battle or pray for it to end. I know I reached that level at one point. But I’ve learned hanging onto the last glimmer of hope can keep you going.
A stark difference exists between wanting the suffering to end versus wanting to end your life. Wanting the suffering to end is very normal. This is a perfect example of why we need to have mental and emotional support throughout our cancer journey. Please know that if you are ever feeling suicidal, contact the emergency number listed at the end of this article. Or, visit your nearest emergency room. It’s okay to need and seek help.
Grieving how cancer affects our relationships
Another traumatic aspect during cancer treatment is how it affects all of our relationships. Whether it’s family or friends, your cancer impacts how others interact with you. Oftentimes, people who you expect to support and be there for you, disappoint or ghost you completely. But, then, there are other people–acquaintances and others–who show up for you in amazing ways you never anticipated.
Allowing yourself to be angry and sad over lost relationships and disappointments is part of the grieving process. Try not to take it personally. (I know: easier said than done). It helps to know and understand that those peoples’ response is not about you at all. It’s about their own issues and fears: thinking about and confronting illness and mortality. Do focus on the people who are showing up and want to be a positive support for you during this time.
Mourning self-image and identity with breast cancer
We also mourn our self image and identity. Our appearance is altered during treatment, from surgery scars to losing hair, and everything else that changes. It’s very normal to grieve these different parts of ourselves and to feel like we don’t even recognize the person in the mirror.
Reconstruction of your breasts, or lack thereof (staying flat), is a big part of the breast cancer journey. The process of making the decision, regardless of which route you choose, can feel overwhelming. Working with a counselor can help you grieve, confront ideas about body image and expectations, and discover what it is you actually want or feel most comfortable with.
Grieving loss of sensation
One issue that seems that doesn’t get talked about as much as it needs to be in the breast cancer world is that of loss of sensation and stimulation in our breast area after treatment. For most women, even though you may go through breast reconstruction, there is a significant loss of sensation and you are left feeling numb where your breasts used to be. It’s completely normal, and should be expected, to mourn your breasts and all the joy and stimulation that they used to provide.
These changes can represent the loss of control that cancer brings. But it can also represent the birth of a new, stronger warrior emerging.
Breast cancer, grief, and growth after treatment
For me, personally, and many of my clients, grief really hit the hardest after breast cancer treatment ended. During treatment, life gets busy with doctor appointments and checkups, family and friends checking in on you, and you’re busy focusing on doing everything possible to survive.
Despite the support in place during treatment, when all the surgeries, chemo and radiation is done there’s often nothing but silence… a very loud silence.
Everyone assumes you’re “done with cancer” and much of the support and check-ins slow way down or vanish completely. The journey itself changes us. Without all the “busy-ness” or the need to use all your energy for survival, you’re left thinking: I miss the “old” me. Who am I now? What do I do now?
That’s where post-traumatic growth can become a factor
With cancer or any type of trauma, working through grief helps you accept a new way of living. Simply returning to “baseline” (how things used to be) is an unrealistic expectation. However, you can learn to leverage your strengths and experience and develop a new way of living that is more authentic and fulfilling. Many survivors, including myself, state that they cherish the small, simple things more. We take less for granted, are focused on enjoying the present moment, and are feeling very grateful to be alive. No longer do we take any part of life for granted. Instead, we cherish every second.
Overcoming the trauma response state
During treatment, it’s common to spend a lot of time in a contracted, or “trauma response” state. However if we stay in that contracted state, we can’t really live our best lives. Learning new mindsets and supporting skills are critically important to thriving after treatment.
I’ve studied neuroscience extensively, and we’re gifted with neuroplasticity (our brain can change). We can learn to change our mindset and the skills we use to deal with thoughts and emotions. Combined, these tools can empower us to be, what I call, “fiercely resilient.”
There’s no shame in seeking help and guidance for grief
I believe we are rarely just one feeling. More accurately, we live with mixed feelings. For example, after a traumatic experience, life continues on. You may be at an event or have a day when you are really happy, but at the same time you are desperately grieving what used to be. We can be both: happy and sad at the same time, and we need to recognize that that’s okay and allow ourselves to have this spectrum of thoughts and emotions.
In every journey that deals with trauma, we have to recognize that friends and family are loving and they’re good at what they do. But they’re not a therapist. As a result, they may be ill-equipped to handle the intensity of your feelings and easily get overwhelmed.
Why you need a healing team for your cancer journey
For every cancer journey, it’s important to create what I call a “healing team” and to include a trained specialist who can help you with your emotional and mental health along your entire journey.
Find a therapist or coach who is clinically trained in grief, trauma, and chronic health issues. Not every therapist or coach is equipped in holding dark places regarding mortality and health. The key is finding someone who can hold that space with you and be there with you.
The reality is that we don’t come automatically equipped to handle the type of life-altering experience of cancer, let alone do it alone. It’s normal to want and need help for your mental and emotional health. It’s possible to move from grief to growth through your journey, but you’ll need proper help and support. I wish it was an automatic part of the experience (and will continue to advocate to make this a reality). Until then, it falls on the patient to make the decision for themselves to enlist the help of a professional. Just know it’s worth it.
Finding immediate help for life-threatening situations
If you, or a loved one is feeling suicidal, please contact: National Suicide Prevention Lifeline at 1-800-273-8255. They are available 24 hours a day. For more information, visit suicidepreventionlifeline.org.
- Breast cancer mental health support + a personal journey - October 30, 2020
- Breast cancer grief to growth, with a psychotherapist - October 28, 2020