Making sense, making meaning after a breast cancer diagnosis

November 15, 2021

Watch time: 11 min 

What does “getting back to normal” look like after a breast cancer diagnosis? How do you make sense of what has happened and what does the way forward look like? These are common questions many women have after treatment is completed. Eucharia Borden, MSW, LCSW, OSW-C, senior director of health equity with the Cancer Support Community, will unpack these questions and provide you with tips on how to process the impact of your experience. She'll share how acknowledging what’s happened to you can create strength, growth, and purpose going forward. 

Presenter

Eucharia Borden, MSW, LCSW, OSW-C, FAOSW, is senior director of health equity at the Cancer Support Community. In this role, she is responsible for ensuring that CSC headquarters’ research, program, policy, and operations integrate relevant components of health equity, inclusion, and social determinants of health across all activities. She also works with the leadership of the Institute for Excellence in Psychosocial Care to inform the CSC Affiliate Network (including healthcare partners) on best practices in health equity. Read more.

Transcript

Shehzin (00:00):

For two years after my breast cancer diagnosis, I wanted nothing to do with anything related to breast cancer. I realized that while cancer changes everything, and while I wanted to live intentionally with my diagnosis, that breast cancer isn’t the only thing that defines me. I’m passionate about other things — o many other things. Finding a way to pay it forward helped me find meaning in my breast cancer diagnosis.

Keneene (00:30):

The time after ending active treatment was incredibly hard and eye-opening for me.

Lynn (00:34):

Sometimes people know right away what it is that they want to do. I was not one of those. I really needed time for it to percolate. And I think more importantly, I needed to take the time for me to heal myself so I could help others.

Eucharia Borden, MSW, LCSW, OSW-C, FAOSW (01:17):

Hi, I’m Eucharia Borden, as you’ve just heard, this can be a really difficult time. There’s so much going on. Have you noticed that right now, you may be feeling different after treatment than you felt when you were diagnosed or going through treatment? If you do have that feeling, you’re not alone, it’s absolutely possible to feel very different with your feelings and even your thoughts after treatment. So we’re here to talk a little bit about that.

What is it about after treatment that’s so different? I remember having a patient come to my office once on the day she finished her last chemotherapy treatment. She was so excited, and she kept saying, “I’m done with treatment. I’m done with treatment. I’m done with treatment.” And her excitement turned to tears, and her tears turned to sobs and she began apologizing saying, “I don’t know why I’m crying.

(02:22):

I’m so sorry this is happening.” Of course I told her it was OK, but we had a moment to sit down and really process in the moment what was happening for her. And this is important for you to do, as well. As human beings. We really do have that need to make sense of what’s happened to us, or what’s happening for us. It’s important to make sense of things first, before you ever get to that place of making meaning. It’s like acknowledging where you are in order to think about where you’re going. You may be asking questions of yourself, like, "Why don’t I feel normal? Why am I not happier? Why am I not better? Why do I feel so different?”

Let’s talk about that word “normal” for a second. “Why don’t I feel normal?” When you think about normal, well, it implies that things are as they should be.

(03:24):

It implies that things are good. Maybe even perfect. That might be how you use to define “normal.” So when you hear a term like “new normal,” those things may not feel like they belong in the same sentence. And that’s OK, because maybe they don’t. Some of you may be feeling really stuck right now. And while that may not be a comfortable feeling to have, just understand that you are not alone in feeling that you’ve been through something traumatic. You’ve had a cancer diagnosis. You’ve been through treatment. And that means that you may have had some really hard days. But the word “traumatic” and your experience, if it was traumatic, that means something different to everyone. And let’s be honest. Some of you are struggling to meet basic needs every single day. So you already know what it felt like to go through something traumatic long before cancer ever showed up in your life.

(04:31):

In fact, breast cancer may not have been at the top of your list of problems that you need to deal with. Maybe you have 10 things at the top of your list, and they all have a number one next to them, including breast cancer. You are not alone. I can only imagine that having breast cancer during the pandemic, that’s got to be incredibly difficult. Maybe you’ve had to come to your appointments alone. Maybe you didn’t have your loved ones sitting with you during treatment to hold your hand when you were just feeling so scared. Maybe you weren’t able to connect with your relative across the country that’s your biggest supporter. This looks different to everyone.

(05:21):

What you really want to do is give yourself permission to make meaning from your new story when it’s appropriate, because remember, you might be in that place of making sense out of what’s happened for a longer period of time than you thought initially. We don’t get to that place of making meaning immediately. It’s not necessarily a destination. It doesn’t mean that one day you wake up and you’ve already made meaning out of your experience, and now you move forward. You might be in that process of making meaning for a while. Why do we even need to make meaning? Quite simply, it’s how we’re built. We do want to make meaning. We do that whether or not we think about it consciously, but it’s happening all the time.

When I say “make meaning,” this could be big things or small things, big things could be like, you know what?

(06:19):

Now that I’m done with treatment, I’m going to launch a new company. I’m going to move across country. I’m going to sell my home and backpack across the United States. I’ve always wanted to see the national parks. I mean, those are big things that someone could do, but there are small ways to make meaning. And it’s not that they’re small. It’s just, when you think about things in comparison, which is something that we also tend to do, they seem small, but they’re just as big. This could be, I want to eat healthier. And I’m really happy about the fact that I’m doing that. It could mean I have better relationships now, after treatment, than I ever had in my life. It could mean that I’m setting boundaries in a different and healthier way, and I’m really proud of that. It could be that you now understand what self-care means for you.

(07:20):

It doesn’t mean you have an entire new self-care regimen or workout regimen that happens an hour, a day, five days a week. But maybe for once, you’re taking the time that you need 30 minutes out of a week to take care of yourself. And all of those are really, really important things.

There are so many opportunities right now for you to grow beyond that traumatic experience. It’s something that can feel hard to do. And it happens a little bit at a time. I think so often we hear people talk about one day at a time. Here’s another moment to be honest with yourself. Sometimes getting through one day can be difficult. So it may not be a day at a time. It could be an hour at a time. It could be moment to moment. And that’s OK, too. All of those are opportunities for growth after this traumatic experience.  Take the time that you need. Allow your process to unfold naturally.

(08:22):

Naturally, that can feel uncomfortable for some of you, right? I can say that even for myself, because we like to know, we want to know what’s next, but this is one of those times where we might not know that. And it’s getting comfortable with not knowing. It’s important to do, though, because it’s ever evolving. The meaning that you assign to your experience today may not be the same two months from now. It’s OK. And in fact, I would encourage you to expect that you may find a different meaning the farther out you are from treatment. So many times I would talk to patients who had already been through very difficult times in their lives, very difficult times. And yet they’re still here to tell me about it, which means that they coped well. You may not think about the fact that you’ve been through so much already because we don’t connect that to a cancer diagnosis. But in that other experience, you gained some very important coping skills. How did you get through that last experience or those last two experiences in your life that were very difficult? Because some of those ways that you coped, you can still use to cope right now.

(09:47):

So, what am I saying? I’m saying pause, make sense of what’s happened first. Don’t rush to making the meaning. It’s already unfolding. Give yourself time. Don’t “should” on yourself. What I mean is don’t say to yourself, “I should be farther along in this process. I should stop crying now that treatment is over. I should be feeling better.” Those kinds of statements put pressure on you and can actually make you feel worse. It’s like I’ve heard said before, don’t put a period in your life where there may be a comma. Just because treatment is over. It doesn’t mean that there won’t be other days where you don’t feel like yourself. In fact, that is actually what is normal. And there may be more to come as you continue along your path of making meaning and starting to feel like who you are now, which is just as great. Stay tuned.