Key takeaways
- It’s common for people who have been diagnosed with cancer to try to avoid processing their feelings
- Post-traumatic stress disorder involves reliving traumatic experiences, with the same or similar thoughts, emotions and body experiences
- Eye Movement Desensitisation and Reprocessing (EMDR) can help activate the subconscious brain to reprocess painful memories and store them correctly
- The mindful pause technique is a manageable way to redirect thoughts away from trauma
A cancer diagnosis is a life-altering event and there is no right or wrong way to respond to it. Typical reactions might include repeated frightening thoughts, being distracted or overexcited, trouble sleeping and/or feeling detached from oneself or reality. There may also be feelings of shock, fear, helplessness or even horror. It’s common for people who have learned they have cancer to shift into coping mode: focusing on the next treatment or therapy, and doing their best to stay busy and avoid examining their thoughts and feelings about what’s going on. They may also feel a need to protect their friends and family by holding it all in.
Trauma is not what happens to you, it’s what happens inside you as a result of what happens to you.
Dr Gabor Mate
Perci Health’s meditation and mindfulness practitioner Laura Ashurst explains that, ‘When active treatment comes to an end, many people who have been on that treadmill of coping often experience burnout. The more intervention they access from the point of diagnosis and through treatment, the less likely they are to feel like they’ve hit a wall at the end, with feelings of being unable to cope.’ In this article, Laura and Psychosexual therapist Lynn Buckley present two approaches to processing trauma around a cancer diagnosis.
When you’re given the news that you have cancer, it’s a very intense kind of shock. You realise that your body is fighting against you and the enormity of that reality is hard to accept. You’re processing so many emotions about what it means for you and for those around you, and you can’t control that. In the UK, there is a very well worn path of cancer procedure. It can be difficult to deal with because it quickly puts you on this ‘conveyor belt’ of activity, even before you’ve got to grips with the news itself.
The first time I was diagnosed, my reaction was probably quite typical. It had come on the back of other circumstances, and it felt like everything in my life was deconstructing at once. I was devastated and felt like life was unfair. But I did what everybody does. I pulled up my boot straps and thought, ‘Let’s get on with it’. I talked about ‘the cancer’ as if it was separate from me, and decided I would fight it, and I did, but it didn’t really change me. Four-and-a-half years later, when I was told the cancer had recurred, I realised I had the opportunity to do things differently.
I decided I needed to listen to the cancer. There is a quote that says, ‘Praying is asking the question. Meditation is listening for the answer.’ I’d never been a great meditator, but used it as a tool to really connect with myself during my treatment, which I hadn’t done at all the first time. Through meditation, my mind can communicate what’s happening inside my body.
I feel like I have the tools to respond to cancer now. My job is to cooperate and co-create what I want, which is to get back to normal life.
Jacq, Perci member
Trauma, cancer and EDMR
Lynn Buckley, Psychosexual therapist
It goes without saying that cancer is stressful, both as a patient and a relative. It is normal (and expected) to feel distressed and frightened, even traumatised, because of a cancer diagnosis, treatments, and the demands of living with and beyond cancer. With time and support, most people find that they learn ways to cope or adapt to the psychological impact of cancer. For some, returning to ‘normal’ life is a time of post-traumatic growth, in which a person may experience an increase in personal strength, closer relationships, greater appreciation for life, new possibilities and/or spiritual development. However, for others, the fear, stress and distress continue, lasting months or years. This could indicate Post-traumatic stress disorder (PTSD).
What are the symptoms of PTSD?
In PTSD, events from the past feel like they are happening now. You might find yourself reliving an experience or feeling like you are back in a particular moment, with the same or similar thoughts, emotions and body experiences. This can trigger the fight-flight-freeze response.
There are a range of symptoms associated with PTSD which can present physically, mentally and emotionally. These include:
- Re-experiencing event(s) through flashbacks and nightmares
- Avoidance of trauma-related reminders, such as places, events, people or things that bring up memories
- Hyperarousal, seen as hypervigilance, irritability, anger and fear
- Panic attacks
- Dissociation
- Inability to control emotions
- Difficulties/problems in relationships
- Loss of interest in enjoyable activities
- Negative self-perception, feeling diminished, defeated or worthless
What is EMDR?
Unresolved trauma memories are stored in the brain incorrectly. They get stuck in the brain’s limbic system – which is responsible for safety and the fight-flight-freeze stress response – and are not processed. In contrast, memories that have been processed are stored in the prefrontal cortex, which is responsible for emotional and body regulation. In this case, when something triggers the memory, it may be upsetting but you know the events occurred in the past and the stress response is not triggered.
EMDR helps someone to process and recover from past events that continue to affect them by helping the brain to process these incorrectly stored memories, so that normal healing can occur.
Lynn Buckley, Psychosexual therapist
EMDR (Eye Movement Desensitisation and Reprocessing) is one of the approaches recommended by National Institute of Clinical Excellence (NICE) to treat PTSD as well as many other mental health difficulties. It helps someone to process and recover from past events that continue to affect them by helping the brain to process these incorrectly stored memories, so that normal healing can occur. EMDR has been shown to be a powerful and effective approach to treat PTSD and can deliver results in just a few sessions.
How does EMDR work?
EMDR uses techniques called bilateral stimulation (BLS) which involves eye movements, taps, or tones that alternate from side to side. The BLS helps to activate the subconscious brain to make connections so that information can be processed and stuck memories can be stored correctly.
There are eight phases to EMDR, which a therapist will guide someone through. Safety is the most important aspect of this process, and the first two phases focus on history, treatment planning and preparation. This ensures the person is fully prepared and has techniques to help with distress during and between sessions.
A mindful approach to trauma
Laura Ashurst, Meditation and Mindfulness practitioner
It’s unhelpful to ask people not to think about their cancer diagnosis; traumatic thoughts naturally seep into day-to-day activities. While the situation cannot be changed or reversed, truly accepting it might not feel realistic in the beginning, so at this stage we work on embedding two core principles of mindfulness: self-compassion and self-kindness with self-awareness. The message is that it’s okay not to feel okay. Staying busy to distract yourself from your trauma is a shortcut to fatigue, burnout and overwhelm. A simple but helpful approach is to create time to incorporate little chunks of mindfulness into the day.
It’s okay not to feel okay. Staying busy to distract yourself from your trauma is a shortcut to fatigue, burnout and overwhelm.
Laura Ashurst, Meditation and Mindfulness practitioner
What does a mindfulness practice for trauma look like?
One of the basics of mindfulness is asking people to pay attention to what is happening physically and emotionally. However, when processing trauma, it’s not always helpful to direct a person to thoughts associated with that trauma. Nor is it always effective to ask a person to focus on the breath. The early days after a cancer diagnosis often feel very anxiety-inducing and overwhelming, and focusing on the breath can make this worse for some people. This is why working with someone on a one-to-one basis is important. Together we can find an approach that suits them.
A helpful mindfulness practice for trauma focuses not on the breath but the senses. Depending on what the person is experiencing, and at what intensity. In my practice, I ask the person that I am working with to take a small chunk of time to tune in mindfully to the world around them, paying attention to things in their physical environment that aren’t associated with the trauma.
Laura’s Mindful Pause
The mindful pause allows someone to slow down; to simply be present with one activity. This could be mindfully engaging with a warm or cold drink or a snack, for example. Often after a diagnosis of cancer, meals get skipped, or a person simply doesn’t feel like eating full meals, so this practice is beneficial and also manageable. The person would focus their attention on what they can see, feel, smell and hear. This might include the colour of the cup, the warmth of the cup in the hand, the taste of the drink and what they hear while drinking.
I would prompt them or teach them to notice whether there is any tension in the body. Are they gripping the cup or holding utensils in a tense way? I encourage them to notice this, and to give themselves permission to soften the grip. If I, or they, notice tension in facial muscles, I ask if they can focus their attention on softening the muscles in the face, including the area between the eyebrows, and the muscles around the eyes and jaw. If there is tension in the hands – which is often unrealised and can be very draining – can they gently release the tension and let go of that, too?
Traumatic thoughts may still trickle in but instead of dwelling on them and becoming distracted by them, they can be gently acknowledged and the thoughts redirected back to the mindful pause.
Why is this practice effective after treatment?
When I was diagnosed with secondary breast cancer, if someone had asked me to do anything complicated, I just wouldn’t have been able to. Being encouraged to show myself kindness and compassion during those moments when I was doing something essential, like eating or drinking, would have been so helpful.
When the person starts to feel a little stronger, we’ll work through looking at where their thoughts are taking them, for instance, worrying about what chemotherapy will be like and how they will cope with side-effects. A mindful pause may be all that is needed to acknowledge these worries and redirect their thoughts.
What is the value of working with a professional?
I would highly recommend getting professional guidance from a mindfulness practitioner to access these practices. They are simple in their approach but the skills need to be practised and it takes time to become proficient. If practised regularly, with guidance, incorporating them into your day, they are skills that are transferable to anything happening in life.
Everyone will have their own way of responding to and processing the trauma experienced as part of a cancer diagnosis. Engaging support from a professional can help you process trauma safely. Find out more about Psychosexual therapist Lynn Buckley and Meditation and mindfulness practitioner Laura Ashurst, including their availability.
While we have ensured that every article is medically reviewed and approved, information presented here is not intended to be a substitute for professional medical advice, diagnosis, or treatment. If you have any questions or concerns, please talk to one of our healthcare professionals or your primary healthcare team.