Living with, or having lived with a diagnosis of cancer, and the impact of cancer treatments can lead to feeling low and having worrying thoughts. Having an occasional worrying thought is normal. However, if we get trapped in a cycle of having lots of worrying thoughts, and we are unable to calm them, it can make us feel very anxious. And it can lead to physical signs of our psychological symptoms, such as an unsettled stomach, feeling a heaviness in your heart and tightening of the chest.
It's important to highlight that it is normal to feel worried, concerned or sad when you meet a life-changing situation, such as living with cancer. There's evidence of a clear relationship between our thoughts, feelings and behaviour. So it can be helpful to know about common thinking patterns to help us to recognise when we are beginning to get trapped into an unhelpful way of thinking, and when we become short-sighted by our worries and concerns.
All or nothing thinking
When we view situations in binary terms such as; black or white, right or wrong, viewing cancer treatment as curable or death.
Illustration
Mr Smith is going through treatment, and views his cancer as untreatable, he is more likely to adopt the belief of “I might as well give up if this can’t be cured”.
Effect
This pattern of thinking might make you less likely to take your medication on time and keep your appointments. And therefore it may delay you getting better, whether that is months or years of remission.
Catastrophising
When we assume the worst outcome will happen, and that the outcome is out of our control.
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Wendy often thinks about what if’s – She finds herself thinking “What if the cancer returns?” “What if I only have weeks to live?” “What if I do something that progresses the Cancer?”
Effect
This pattern of thinking often includes what-if’s, and you can find yourself in a spiral of questions that makes you anxious.
Filtering
When we only select parts of information that matches our current beliefs and mood.
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Shelley is anxious about discussing her treatment options with her clinical nurse specialist. She is feeling anxious about the treatment, she therefore focuses on how painful the treatment could be, and does not pay attention to the success rates of the treatment.
Effect
Your mood and beliefs can influence what information you take in.
Jumping to conclusions
When we make assumptions about the future.
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Sheila found her first chemotherapy session very tiring. She tells herself that this is how it’s going to be for the rest of her treatment.
John is sitting opposite a healthcare professional and is waiting for his result. He believes that the test results are bad simply by looking at the healthcare professional.
Effect
The conclusions you can jump to can be quite distressing, therefore it is good to pause and take a moment and try to pace your thoughts.
Personalisation
When we start blaming ourselves for our circumstances – in this case for having cancer.
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Katya thinks 'I am being punished because of all the bad things I have done' or 'I have cancer because I am a smoker / drinker'.
Effect
Blaming yourself for your diagnosis. This way of thinking is unhelpful as you might beat yourself up over it. And it may lead to low self-esteem and stopping from doing things you enjoyed before.
Shoulds, Coulds, Woulds
When we tell ourselves that we could have done, or might be able to do things differently.
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Mohammad often finds himself thinking ‘I would have been able to look after my family if I didn’t have cancer’. And ‘I could have done something to reduce the chances of me getting cancer’.
Jonah finds himself thinking 'I should be able to go back to work after treatment'.
Effect
This pattern of thinking can lead to a cycle of blaming yourself, lower self-esteem and feeling helpless.
Do any of these resonate with you?
There is no right or wrong way to feel, and everyone will have different reactions at different times. It is normal to have these thoughts at times throughout your cancer journey. It can be difficult to get away from these unhelpful thoughts and ways of thinking, as they can often pop into our minds, can easily spiral out of control, and can seem believable. It is helpful to our mood, psychological and physical health, and to those around us, if we are able to manage our unhelpful thoughts.
Managing Unhelpful Thoughts
Our brains are wired to problem solve; to understand the “what”, “why” and “how”, and to predict the worst. Trying to control our negative thoughts by pushing them away or avoiding them, can actually make it worse. A thought can grow the more you try to push it away. But sometimes, simply being aware that you are engaging in unhelpful thinking patterns can help you switch to more helpful ways of thinking.
Being mindful of our unhelpful thoughts may allow us to make a skilful decision about how to best manage those thoughts in that moment. For example, when you notice that you are having a negative thought (e.g. 'the cancer might come back'), you can create a distance from the thought to help you to manage it. Some strategies that may help are:
- Writing your thoughts down on paper can help you see the bigger picture, and view your thoughts in a way that is less emotionally intense and overwhelming
- Noticing the thought and saying it out loud; 'I am having the thought that …'.
This can help you calm the thought. - Looking at the thought from a different perspective. Think about:
What advice you would give to a friend who was having this thought?
What is the evidence that this thought is true?
Is it helpful for me to think in this way? - Using mindfulness exercises to observe your thoughts and notice the feelings that they give rise to in your body.
It's important to note that not one of the above strategies is better that the others. You can pick and choose what works best for you. What might work for someone else, may not work for you. Being mindful of your negative thoughts, and being aware of the fact that you have a choice for managing them, can in itself help you to start to feel back in control.