How can you prepare yourself emotionally for treatment?

Preparing yourself emotionally for treatment

A key part of psychological preparation for treatment involves preparing yourself emotionally for the demands of treatment. It may be difficult to anticipate what will be challenging for you emotionally. It is not possible to predict or know what difficult feelings might show up for you and the uncertainty around this may be a source of stress in itself.

While you cannot control how you might think or feel during treatment, there are things you can do to prepare yourself emotionally for treatment.

The following information may help you understand and manage difficult feelings that might show up for you during treatment. It may also help you feel proactive in managing and improving your psychological wellbeing.

It is normal to experience a range of different feelings following a diagnosis of cancer.  You may be experiencing feelings such as disbelief, fear, worry, anger, sadness and loneliness, or you may be finding it difficult to feel anything at all. You will have a lot of information and feelings to process and make sense of. The range and intensity of your feelings is likely to continue fluctuating during treatment.

It’s okay to not feel okay.

Treatment can take a long time. There may be periods of waiting and uncertainty. It can be physically and emotionally demanding. There are no right or wrong ways to feel. It is normal to experience a range of emotions at different points during treatment. You may find some intense feelings pass with time while others stay for longer. Some people describe the process as like an emotional rollercoaster. It is important to remember that your feelings are a response to the situation you find yourself in. There are many different ways to manage difficult feelings and you do not have to suffer alone.

It is important to be able recognise when you are experiencing difficult feelings. This enables you to choose how to manage those feelings.

Think about a time in your life when you experienced a difficult feeling such as stress, worry, fear, anger or low mood. Reflect back on whether there were any changes in your thinking or worries you may have had. There might have been changes in your body (e.g. increased heart rate, tension, sleep issues). Think about how you would recognise this feeling if it showed up for you again.

You may find that changes in your behaviour such as withdrawing or keeping busy are a sign you are experiencing difficult feelings. Sometimes family members or friends notice changes in us and our behaviour that we do not always see ourselves. It can be helpful to involve them in thinking about how to recognise when difficult feelings show up for you and influence how you manage.

One of the easiest ways to manage difficult feelings is to do a little bit more of what you know already helps. It can be difficult to change habits and learn new ways to manage during times of stress.

Think about what you already do to manage your wellbeing and try to do a little bit more of it. For example, if walking helps, think about other places or times you could walk too. You may want to think about ways to enhance strategies you already use.

You may be using strategies to manage difficult feelings and improve your wellbeing without realising. It might be helpful to ask family members or friends whether they have noticed you doing anything to help manage your feelings. Often family or friends notice changes in our behaviour that we do not always notice. Research suggests that if you consciously choose to do something to improve your wellbeing, you are more likely to perceive it as helpful.

You may notice that you engage in less helpful strategies to manage difficult feelings. It is important to avoid using strategies such as tobacco, alcohol and other substances to manage difficult feelings. Support is available if you find yourself engaging in these coping strategies.

When preparing for treatment, you may experience periods of intense, overwhelming feelings such as disbelief, fear, sadness, anxiety or anger. You may feel frightened about facing treatment and it may be difficult to tolerate the uncertainty regarding the potential effectiveness and side effects of treatment.

Following a diagnosis of cancer, it is common to experience a rollercoaster of emotion for some time. It is difficult to know what changes a cancer diagnosis may bring to your life. You may be experiencing a profound sense of grief for all you have lost due to the cancer and this requires a process of psychological adjustment over time.

Periods of intense, overwhelming feelings can be a common emotional response to a diagnosis of cancer. However, if you find that these feelings become increasingly present and feel unmanageable it is important to seek support. Use the Wellbeing Self-Evaluation Tool to help you understand your feelings and when to seek support.

Be proactive in managing your feelings. Consider whether there are situations or triggers that may lead to you feeling overwhelmed. Think about what changes other people might notice in you if you began to feel overwhelmed. There may be things you could do differently to help you better tolerate and manage these feelings. It might be helpful to let your care team know if you have a history of experiencing mental health or psychological difficulties. This would help your care team support you more effectively.

You may experience waves of distress or intense feelings. The waves are likely to continue during treatment. You cannot control or stop these waves of feelings but you can learn how to surf them. Finding a way to surf these waves of feelings allows you to ride each wave of feelings as it comes and goes.

Self-compassion involves recognising that suffering and disappointment are a part of being human. We are not perfect and we will not always manage situations as we expect. Nothing can prepare you for a diagnosis of cancer and it is okay to not feel okay about it. It can be a difficult realisation that life is not perfect and that part of living involves experiencing pain, loss and suffering.

We share a common humanity and nobody is immune from suffering. Becoming open to our suffering and pain without trying to suppress or avoid how we are feeling allows us to be more accepting of ourselves. This helps us practice self-compassion. Research suggests that self-compassion increases the likelihood of engaging in self-care and looking after ourselves emotionally.

Think about how you would treat a close friend or family member if they were going through a difficult time. Would you treat yourself with the same compassion that you would show them?

Some people talk about feeling under pressure to be positive or to engage in the ‘fight’ with cancer. It is important to be hopeful but that does not mean you have to deny the reality that cancer can feel frightening. It is okay to not feel okay about it.

Allow yourself to tune into how you are feeling and give yourself permission to be kind to yourself.

Understand your feelings and when to seek support.

Packing your ‘emotional care kit’ for treatment

When your emotional and psychological needs are met, you are in a better position to manage the demands of treatment.

It might be helpful to think about what you could pack in your ‘emotional care kit’ for treatment. Thinking about how you will manage your wellbeing during treatment may help you feel more prepared for treatment.

You may find it helpful to hold your ‘emotional care kit’ in mind. Or, you may prefer to use a physical space or object such as a bag or a box to hold reminders of what you can do to look after yourself emotionally during treatment.

You may find it helpful to talk to others about how they are feeling. If you find it difficult to talk about how you feel, it can be helpful to keep a journal of your experiences. You may prefer to express yourself via music, art or your hobbies.

Think about the people in your life who matter to you and how you can stay connected in a way that feels comfortable for you. You may find it helpful to have regular contact with family or friends. It is important to let them know what you need and what you want to talk about or do together. You may want to include photographs of people who mean a lot to you in your ‘emotional care kit’.

Think about what you value in life and what matters most to you. Try to stay connected with some of this if possible. You may have interests or hobbies which give you meaning that you can continue engaging with in some form during treatment. You may want to put something that symbolises this value or interest in your ‘emotional care kit’.

Although it may feel difficult to tune into aspects of your treatment, it is important to stay connected. Notice if there is anything you are concerned or worried about. You may find it helpful to write things down. It is okay to ask those who look after you any questions you may have.

If you are struggling with difficult feelings, it may be difficult to learn new psychological strategies to manage your wellbeing whilst also managing the demands of treatment. You may find it helpful to use helpful strategies you know already work.

If you are finding it difficult to manage intense waves of emotion, try using the ‘dropping anchor’ technique.

It is important to stay connected with how you are feeling and notice when you become overwhelmed. Try to be kind to yourself and practice self-compassion when you experience difficult feelings.

Think about how you are kind to yourself already. There may be additional ways you could show yourself kindness and compassion.

Sometimes overwhelming feelings can creep up on us. Overwhelming feelings can leave us feeling out of control. Give yourself choices if you find yourself beginning to feel overwhelmed. The dropping anchor technique may be helpful. Finding ways to
self-soothe may also help you look after yourself emotionally.

An easily accessible self-soothing box that contains ways to help you self-soothe may be helpful. It is important to start small and choose items that you find helpful.
This will vary for each individual.

You might want to include some of the following in your self-soothing box:

  • Meaningful objects that you know will help you (e.g. photograph, compassionate image, memorable object)
  • Visual items (e.g. photo album, book, funny video)
  • Audio (e.g. music, voice recordings, meditation)
  • Smell (e.g. favourite perfume, comforting scents)
  • Taste (e.g. comforting taste or treat)
  • Touch (e.g. grounding object, hand cream, soft comforting objects)

Our daily routines provide us with comfort and familiarity. Treatment can be demanding and disrupt our daily routines. It is important to acknowledge that treatment will likely disrupt aspects of your daily routine and you may feel like your life begins to revolve around treatment.

It might be helpful to think about the aspects of your daily routine that you find most useful. Consider how you could incorporate these aspect of your routine into your daily life during treatment. This will help you experience a sense of familiarity and grounding during treatment.

You may find it helpful to talk to family and friends about your treatment and how you are feeling about it. If you are likely to find this difficult, tiring or uncomfortable, you may want to think about ways to share information with others that feel comfortable for you.

Some people find it helpful to identify one family member or friend as a main point of contact who can link in with wider networks of family and friends. You may find there are other ways to share updates with family and friends via text message, email or secure social media platforms. It is important that you feel in control of the information you share with others about your treatment.

Dropping anchor technique

The aim of this technique is to help you ‘drop anchor’ in the midst of an emotional storm when your thoughts and feelings may feel overwhelming. The anchor should help steady you until the storm passes.

How to drop anchor:

  • Acknowledge what difficult feelings might be showing up for you in a
    non-judgemental way.
  • Notice what you can see, hear, touch, taste and smell.
  • Increase your awareness of your body.
  • Allow yourself to come into your body.
  • Notice how you are breathing. Try stretching, pushing your feet into the floor or changing your posture.
  • Refocus your attention on what you are doing now.
  • Notice five things you can see.

Understand your feelings and when to seek support.

Further support and help:

The advice on these pages is designed to help you prepare for the treatment ahead and support you through to recovery.

If you need further advice and support please discuss this with your key worker or healthcare professional.

  • Cardiff and Vale University Health Board Cancer support line:
    02920 745655  (9:00am to 12:30pm and 1:30pm to 4:00pm)
  • Macmillan Cancer Support:
    0808 808 00 00
  • Maggie’s Cardiff:
    029 2240 8024
  • Tenovus Cancer Care:
    0808 808 1010
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