5 Ways to Manage the Emotional Distress of Cancer

A new book provides useful guidance for how to deal with the emotional and social upheaval of cancer

a cancer diagnosis can prompt us to reconsider what is important, like our relationships or art, and focus our attention there. SeventyFour/Shutterstock

The National Cancer Institute states that nearly 40 percent of men and women in the United States will receive a cancer diagnosis in their lifetime. Even during the pandemic, cancer was the leading cause of death around the world.

That means many people are dealing with treatment for this worrisome disease—including many of my friends and family members. While new treatments are giving people hope for greater longevity and even full recovery, the social and emotional toll of cancer is still severe. Right when cancer patients need calm clarity and social support for getting through treatment, they can have trouble finding either, compounding their suffering.

While no person’s experience of cancer is exactly the same as another’s, there are reactions that are common to many, write Elizabeth Cohn Stuntz and Marsha Linehan in the new book “Coping with Cancer.” These include difficult feelings such as fear, sadness, anger, and guilt; concerns about how the disease will change one’s life, job, or family relationships; and physical symptoms such as fatigue, pain, and loss of sleep. A patient’s constantly changing experience can breed uncertainty, too, exacerbating many of these reactions.

Drawing upon decades of research, practice with helping patients, and stories from patients (including the authors themselves), the book gives wise guidance on how to reduce stress, make better decisions, protect important relationships, and increase overall well-being while fighting off the disease—all of which can support a better prognosis, too. Based largely on Linehan’s model of dialectical behavior therapy, the authors offer several keys to coping with the physical, emotional, and social strains that cancer patients face. Here are a few of their recommendations.

Be Mindful and Accepting of Your Experience

Though some people believe there’s an ideal way to feel or behave when faced with cancer—upbeat, stoic, or defiant, for example—trying to fit someone’s ideal of how you should react or denying your own feelings is likely to backfire, write the authors. Instead, you should try practicing mindfulness—paying attention to your experience without judgment. This is a more effective way to understand your experience and your needs in any given moment.

“Your emotions, thoughts, and physical sensations offer valuable information. They can tell you what’s wrong and needs to be addressed as well as what’s going right that should be pursued,” write Stuntz and Linehan.

At the same time, being mindful can keep you from wallowing in negative emotions or ruminating about catastrophic possibilities. When you increase awareness of the fleeting nature of your thoughts, emotions, and physical sensations, it can create a little distance from them, opening the door to noticing positive experiences (or less bad experiences) when they occur. Savoring happy moments and small victories can provide a good counterpoint to the hard times, helping you to ride the waves of experience without being overwhelmed.

Finding some distance also allows you to notice patterns, including habits that might not be serving you.

“When you pay careful attention to the interplay between your emotions, your thoughts, and your body, you have the chance to understand your response and see where effective coping may be short-circuited and bring yourself back into balance,” write the authors.

Try Self-Compassion

If you accept that all feelings are valid, you can start to recognize where they come from and how to soothe them without repressing them. One method for helping with emotional upset is the practice of self-compassion. Showing yourself kindness and understanding for what you are going through, while recognizing that you are not alone in your suffering, can be a boon to your recovery.

According to the authors, “The goal is to try to coach yourself with the same warm, patient, and sensitive understanding you would give to a cherished loved one who is in a distressing situation.” That means acknowledging whatever experience you are having (for example, I feel pain in my chest right now and it’s worrying me), sending yourself soothing messages (even though this pain is hard, I’ve been through it before, and I know it will pass), and reminding yourself that you are not alone in your suffering (others have been through this too and survived).

People who are more self-compassionate tend to have less depression, anxiety, and fatigue and better quality of life when facing cancer, and generally tend to cope better under stressful conditions. Self-compassion may be particularly beneficial for keeping us as well as possible in trying circumstances.

Check the Facts and Question Distorted Thinking

When we are worried, it can often cause rumination—repetitive thoughts that disturb us and keep us up at night. This can lead to depression and other problems that can interfere with recovery.

Coping with Cancer: DBT Skills to Manage Your Emotions—and Balance Uncertainty with Hope (The Guilford Press, 2021, 167 pages).

As the authors note, people with cancer can succumb to distorted thinking patterns, such as “black-and-white” thinking or thinking in absolutes—for example, only focusing on bad news and ignoring progress, or telling yourself that you’ll never be able to work again and you’ll always be sick.

To find a more balanced approach, the authors recommend that you question these types of thoughts by stepping back and examining them and, perhaps, challenging or reframing them. Recognizing the difference between facts and fear-based assumptions can help you interrupt distorted thinking and keep your mind from spinning out of control.

Questioning assumptions can be helpful when talking to doctors, too. For example, some people with cancer are afraid to confront their doctors with fears or doubts about treatment, worried they will offend their doctor and, possibly, lose an important ally in their care. But most doctors are trained to listen and educate patients about their options and expect questions. It’s important to express uncertainty while staying open to emerging information—even difficult facts about your care—to maintain a realistic view of your situation.

Ask for What You Want From Others ... in a Kind Way

Support from others is key to healing from cancer. But sometimes cancer patients may feel reluctant to ask for help, especially if they tend to be “go it alone” types. Or they may fear that medical doctors or caretakers will not listen to them, making them feel angry for having reached out.

It’s important to find a balance between requesting help and demanding it from someone—especially from a caregiver who is already burdened. Asking for what you want clearly and confidently, explaining why you need the help, and appreciating the help you receive are all useful strategies for getting what you need from others to help you heal, the authors write.

Given that protecting a relationship with a health provider is paramount to many cancer patients, the authors give special attention to communicating with doctors, including this advice (using the acronym FAST):

• Be Fair: Validate your feelings and wishes as well as the other person’s.
• Assert: Don’t apologize for making a request, having an opinion, or disagreeing.
• Stick to your values: Make sure you are acting in a morally sound way.
• Be Truthful: Don’t make excuses, lie, or act helpless when you’re not.

Keeping interactions with others kind, honest, and assertive is the best way to preserve relationships through a long treatment.

Connect to Meaning

While no one wants to suffer from cancer, it can be an opportunity to remember what is most important in life. Whether it’s your relationships with others, your work or creative endeavors, the beauty of the world around you, or your religious faith, you can take moments to appreciate the things of value to you and embrace opportunities to connect to them.

“Being clear about what sustains and matters to you can help you assess whether you’re living the way you want to or decide what if any changes you want to make to promote the more meaningful parts of life,” write Stuntz and Linehan.

Meaning in life is central to happiness, and finding meaning in the midst of suffering can help people stay more resilient as they go through trauma. Nurturing meaning in life could involve writing a gratitude letter to someone who made a difference to you, volunteering to help others suffering from cancer, or writing a song or poem. Whatever you do to find meaning, though, remember not to do it because you “should” or to fulfill someone else’s agenda, but because it truly helps sustain you.

While none of these strategies are foolproof, they can help people who are going through cancer manage, and that’s good to know. On the other hand, I would argue that this advice is useful for anyone going through difficult times, health-related or not. We could all be more mindful, offer ourselves more self-compassion, be better fact checkers, treat our support networks kindly, and search for meaning in life. The book, though geared to cancer survivors, really speaks to us all.

Jill Suttie, Psy.D., is Greater Good’s book review editor and a frequent contributor to the magazine. This article was originally published by the Greater Good online magazine.