Cognitive Behavioral Therapy (CBT) is a type of therapy that people can use to cope with a cancer diagnosis. Whether on your own or with the help of a trained clinician, you can apply CBT principles to many instances in your everyday life. CBT can help you manage your feelings, challenge some of your negative thoughts, and replace them with more helpful ones.
When you are diagnosed with cancer, whether for the first time or with a recurrence, you might not know how to cope with all the changes in your life. You might wonder, “How am I going to handle this, along with my everyday life? Now cancer is my life.”
Without a doubt, coping with cancer can be challenging. Cancer can change many things, including your lifestyle, quality of life, your plans for the future and your life goals and desires. But coping with cancer IS possible, and it doesn’t have to become your whole life.
Sometimes, the way we think about stressful events can leave us feeling even more worried and overwhelmed.1 For example, we might focus only on the negative parts of the situation, or the worst possible outcome. Or, we might expect ourselves to handle things completely on our own and never ask for help. We might even think that there is nothing we can do to feel better.
Here are some of the mental traps 2 we fall into:
Negative mental filters. Only taking the negative into account, despite the evidence (“My scan shows that the treatment is working, but I think the cancer is still growing.”)
Black-and-white thinking. Seeing things in extremes (“I’m either going to be cured or I’m going to die.”)
Mind-reading. Assuming that we know what others are thinking and why (“My friend hasn’t called me to see how I’m doing because she doesn’t care about me.”)
“Should” statements. Imposing unrealistic “shoulds” on ourselves (“I should not burden my friends and family or ask for help, no matter what.”)3
Instead of getting stuck in these traps, however, we can practice different ways of talking to ourselves that help us cope better.
Using CBT Techniques
Cognitive Behavioral Therapy (CBT) can teach us how to manage stressful experiences. Of course, it is normal to have negative thoughts and feelings about cancer. Although feelings seem automatic and uncontrollable, they are caused by thoughts and beliefs about the things that happen to us. The question to ask is: “are these thoughts helping me to cope with cancer or getting in the way of coping with it?” Thinking something different helps us do something different.
Here is a CBT skill that you can try at home, in the waiting room, or during treatment:
First, try to identify your distressing thoughts as they occur. Write them down.
When do you tend to have these thoughts? Are they triggered by certain events?
How do you feel when having these thoughts?
How does your body feel?
What do you usually do to cope with these thoughts and feelings? Is it helpful?
For example, if you think, “I absolutely can’t stand getting chemo anymore” the next time you go for treatment, you might feel anxious, fearful, or angry. You might get an upset stomach, snap at someone, or avoid getting treatment. Try asking yourself these questions:
What is the evidence for my thought or belief? “I get very upset whenever I enter the treatment room. My stomach is in knots when I see the chemo chair.”
What is the evidence contrary to my belief? “Even though I feel anxious, I usually show up for treatment. My stomach eventually relaxes and I can sit down.”
What would my friend think about my belief? “He would tell me that I can handle more than I think, that I’ve dealt with hard things in the past. I’ve gotten treatment before and I know the drill.”
What is a more helpful way to look at this? “Getting chemo is an unpleasant experience, but it’s not the end of the world. I have been dealing with it, and with support, I can continue to do so. Maybe next time I feel like skipping my treatment, I can call a friend or do some deep breathing.”
Acknowledge what is true about your negative beliefs, but then remember that few things in life are true in every instance all the time. You might not be able to control getting cancer, but you can control how you think about it. In what ways are you still able to live your life?
Remember, it is okay to have negative thoughts and feelings when faced with a cancer diagnosis. But have those thoughts become patterns? Are they overwhelming you? If so, talking to a counselor or therapist may help you break those patterns, look at all sides of your situation, and develop a better quality of life.
Edited by Maria Chi, LCSW-R