Coping With a Cancer Diagnosis

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By Danielle Bellina, LCSW

Being diagnosed with cancer — or any other severe, life-threatening illness — is a traumatic experience.

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For many people, it can lead to anxiety and depression that can make an already tough journey even more difficult.

Often, however, mental health therapy can help.

Penn Medicine Princeton House Behavioral Health offers evidence-based practices, including dialectal behavioral therapy (DBT), to help individuals cope with life’s challenges, including the mental and emotional impact of cancer.

About DBT

Dialectical behavioral therapy is a structured type of psychotherapy that is useful for a variety of different mental health conditions.

It helps individuals validate and accept their emotions and experiences and teaches them skills to help tolerate distress, regulate emotions and interact effectively with others.

Put another way, DBT can help people develop a “wise mind” versus letting their emotions lead the way.  

While everyone has a different cancer journey, DBT skills can help patients navigate their way through one of the most difficult times in their lives.

Distress Tolerance Skills

Just as they sound, distress tolerance skills are normally used to help you get through crisis moments and distressing situations, like learning you have cancer or undergoing surgery.

An example is a tool called STOP — short for stop, take a breath, observe and proceed mindfully. Here’s how it works:

  • When feeling overwhelmed or unable to cope, it can help to stop what you are doing and take a deep breath.
  • Then observe and pay attention to what’s going on around you. You may be feeling fear as you’re being wheeled in for surgery, for instance. But if you look at the doctors, nurses and staff around you, they’re likely calm and confident.
  • Recognizing you’re in good hands can then help you proceed mindfully.

Another distress tolerance skill is radical acceptance. While no one wants to get sick, accepting the reality of the situation can help free you to make decisions about your health and your life that are less rooted in anxiety and fear.

Accepting the situation does not mean that you like it or that you’re giving up. Instead, it means that you are recognizing that this is the way things are right now. 

Emotion Regulation Skills

It can be difficult to be in charge of your emotions when facing a cancer diagnosis, and it is understandable that you may feel sad, nervous, even angry.

Moreover, it’s important to give yourself time and space to feel those feelings. 

However, to protect your mental health, it can be helpful to put the scary, sad and distressing thoughts on a shelf every now and then and force yourself to find moments of joy.

How?

Try to get outside and take a walk. Watch a TV show you love. Call a friend to talk.

And though it may seem counterintuitive, start building a plan for the future. Will you have a celebration after your last round of chemotherapy? Will you take a trip when your treatment is over? Do you want to start a new hobby or learn a new skill?

Having hope for the future can help you see beyond your diagnosis.

Additionally, devising a cope-ahead plan for stressful situations like chemotherapy or another medical procedure can assist in managing emotions and keeping fear and anxiety at bay.

Everyone’s cope-ahead plan will be different, but it could include creating playlist of your favorite songs to listen to during treatment; enjoying a cookie or other goodie prior to your appointment; and/or treating yourself afterward by doing something you enjoy.

It could also mean getting enough sleep before your treatment and making sure the refrigerator is stocked with your favorite foods beforehand.

Whatever it is, your cope-ahead plan should make you feel good.

Mindfulness Skills

Mindfulness is a common thread throughout DBT. Mindfulness skills can help train your brain to be present in the here-and-now and can help minimize the tendency for catastrophizing, which can be common with serious illness.  

Learning how to be mindful and present in the moment takes practice, but here are some techniques. 

  • Focus on and observe your breath. Take full, slow inhales and even fuller, slower exhales.
  • Consciously observe your surroundings. Notice sounds, scents, and physical sensations, such as your feet on the ground or your fingers typing.
  • Note thoughts and worries as they enter your mind, but then return to the present moment.
  • Practice yoga and meditation.

Interpersonal Effectiveness Skills

Interpersonal effectiveness skills can help individuals communicate their thoughts, feelings and emotions to others and empower them to ask for help and support when they need it.

Examples of interpersonal effectiveness skills include:

  • Describing situations objectively.
  • Expressing your feelings clearly.
  • Asserting yourself and not beating around the bush. If you want a friend or loved one at an appointment, say so.
  • Not apologizing for how you’re feeling or for what you want.

These skills can also help you build a strong relationship with your cancer treatment team and can help you establish boundaries when it comes to disclosing and discussing your diagnosis with family, friends and colleagues.

A major health issue like cancer can cause significant mental and emotional distress. Help, however, is available so you can work through your emotions in a healthy way and find hope and comfort even when living with disease. 

For more information about Penn Medicine Princeton House Behavioral Health, call (888) 437-1610 or visit www.princetonhouse.org.

Danielle Bellina, LSCW, is a licensed clinical social worker and a senior primary therapist with Penn Medicine Princeton House Behavioral Health. In the past few years, she has used DBT skills during her own experience with cancer.

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