Resilience and Breast Cancer

Rocky Mountain Cancer Center.  April 17, 2014.  Photo by Ellen JaskolResearch shows resilience can ease stress and improve life satisfaction among people diagnosed with cancer, but what does it mean to be “resilient”? In anticipation of our November 18 community meeting in Denver, Colorado, Jill Mitchell, LCSW, PhD, OSW-C, of the Rocky Mountain Cancer Centers offers some insight and tips on being resilient.

In physics, “resilience” is defined as the ability of a material to absorb energy when it is deformed, and to release that energy (bounce back).  The limit of resilience, in turn, is the point at which the material can no longer absorb energy elastically without creating a permanent distortion.

But resilience in the cancer world, is not as much about bouncing “back” as it is about bouncing “forward” – creating a “new normal” or even growing through the process of survivorship.

Resilience goes beyond just coping or just being “elastic.” It often also involves (or sometimes demands) a “permanent distortion in one’s life” (such as a loss of a breast, or a job or an anticipated future, for example).  However, it is these “distortions,” or losses, that can provide the fodder for growth and transformation when we call upon our internal resources (self-esteem, optimism, hopefulness, problem solving) and our external resources (friends and family, social and community support).

I am often awed and humbled by the ways in which people come to cope with and grow through the struggles or suffering they endure due to cancer.  One of the most important things to know is that although some people may have a more natural tendency toward resilience, we all can strengthen our ability toward resilience through a few specific strategies:

Start with your strengths – what already works for you, or has worked for you in the past?  Perhaps you are someone who needs to gather a lot of information.  Perhaps you feel rejuvenated being surrounded by nature, or writing in a journal or meditating.  Remind yourself about the strategies you already know help you to cope, and make time for those!  Resilience is about developing realistic goals and moving toward them.  Start with what works for you.

Develop and use your network of support – Share what you’re going through with your trusted loved ones, friends, and peers.   Explore support groups or consult one-on-one with your oncology social worker or other healthcare professionals who can be a resource for support, processing and validation.  Asking for help and sharing your thoughts and feelings with someone you trust can feel challenging and uncomfortable for people who are used to being in control or self-dependent. And yet, social support is a critical cornerstone for resilience. 

Give expression to your thoughts, feelings and emotions in a safe or productive way. Resilience is NOT just putting a smile on your face and ignoring the suffering you may be experiencing in silence.  Quite the contrary, actually!  Resilience is usually only brought to light when we face a challenge or crisis.  Giving voice to and sharing your suffering, your grief, your vulnerability, and the range of emotions you are experiencing is a powerful launching point for resilience. Indeed the people who find the greatest growth are sometimes the people who face the most significant losses or challenges but then mobilize the resources within and around them to overcome and grow beyond.

Explore and express gratitude. Know that attending to what you feel grateful for in your experience does NOT mean you are “in denial”. Quite the contrary, when we can approach a challenge, crisis, or trauma from a position of “what benefit might I find or create out of this?” it can help us to be more active in how we approach our healing. It can help us to face our challenges, rather than avoid or isolate ourselves.  The interesting thing is the more we consciously attend to what we feel grateful for in life, the more we become attuned to naturally perceiving that for which we feel authentically grateful.

Exercise and nurture your body.  Exercise is critical for managing emotions, helping with sleep and fatigue, and re-strengthening self-esteem.  Many survivors feel a sense of a loss of trust in their body, or powerlessness, after cancer.  I encourage you to nurture your body anyway.  Reward yourself with healthy food, exercise, sleep, and self-care, but also have compassion for the changes that your body has been through.

Clarify what you most deeply value in your life.  It can be easy for many of your own personal values and desires to get pushed aside or minimized for the sake of getting through treatment or just coping with one crisis after another.  When your world is turned upside down, that can also be an opportunity to take a deep look at what is most meaningful to you.  What gives you your greatest sense of purpose or joy?  What makes you feel most vital? Set aside some time to evaluate and clarify what is most important to you in life. Once you have that clarity then . . .

Think of small and very doable actions you can take that are in alignment with those values. This can help you to continue living the life you want, even when you feel at your worst.  The key here is “small” and “doable” to start!  For example, if one of your values is to have fun with your family, perhaps committing to a weekly family movie night at home, or committing to a monthly outing to a favorite park could be a place to start. Given that illness can sometimes get in the way of best laid plans, the other important piece of this is to be compassionate with yourself if you don’t achieve all of your goals. Continue to warmly re-invite yourself to try again on another day.

Nurture flexibility in your perspective through humor, creating meaning out of your experience, allowing yourself to hope. For some this may come naturally. For others it can be helpful to surround yourself with people, or the stories of people, who have found humor, hope, or inspiration through the most challenging of circumstances.  Allow yourself to play with humor or take  different perspectives on your situation.  At times, we may only have limited control over the course of the disease, but we can have power in how we create and re-create meaning out of our losses or grief.

Reconnect spiritually, or with whatever it is that helps you to feel part of something greater than yourself. People find spiritual connection in various ways:  solo meditation or prayer, attending a church or synagogue, spending time in nature, volunteering in the community, or listening to soul-stirring music are just some examples of what you might explore to honor or re-invigorate your spiritual connection. Take some time to remind yourself what it is that rejuvenates your sense of connection with that which is greater than any one of us.

Dr. Mitchell is an oncology-certified, licensed clinical social worker with Rocky Mountain Cancer Centers in Colorado. She also has a doctorate in Medical Anthropology and has spent the past 10+ years counseling or doing research on people’s experiences living with cancer. Most recently, Dr. Mitchell has been piloting a post-treatment group intervention to help distressed survivors find greater peace and vitality in life. She also volunteers on the advisory council for MyLifeLine.org.

Denver, Colorado area residents: Are you interested in exploring more about resiliency after breast cancer? Attend our community meeting taking place on Tuesday, November 18, at the Rose Medical Center!

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