Your Journey Beyond Breast Cancer: Tools for the Road

By Louise B. Lubin PhD

“You have breast cancer.” These words begin a life-altering journey to live with and beyond cancer. You’ve experienced a myriad of emotions and have ongoing questions and concerns. In Your Journey beyond Breast Cancer, author Dr. Louise B. Lubin offers an interactive, how-to guide for women at any milepost on their breast cancer journey.

She offers practical tools to manage uncertainty and loss, relationship changes, the importance of living in the present, and directly facing mortality, as well as how to find your inner strength and resiliency. Each of these challenges is addressed with specific tools to increase knowledge of your body and how to care for it, identify how the power of your mind and thoughts can work for you, and embrace the wisdom of your spirit to find balance and wholeness.

Dr. Lubin, a clinical psychologist with forty years of experience, presents these life skills recognizing that each woman is a unique individual and not just a statistic. This integrative whole-person approach is the necessary path to find a healing balance and wholeness for your life with and beyond cancer.

• Language: English
• Publisher: iUniverse
• Release date: Jul 19, 2021
• ISBN: 9781663201485

Louise B. Lubin PhD

Louise B. Lubin, PhD. is a licensed clinical psychologist in Norfolk, Virginia, who has practiced adult, marital, and family therapy for forty years. She developed programs and a website—“Many Paths to Healing”—for hospital systems and physician groups to provide patients the tools to cope and manage the challenges of illness. Dr. Lubin is a retired community faculty at the Eastern Virginia Medical School. Visit her online at www.manypathstohealing.com.

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Copyright © 2021 Louise B. Lubin, PhD

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ISBN: 978-1-6632-0147-8 (sc)

ISBN: 978-1-6632-0149-2 (hc)

ISBN: 978-1-6632-0148-5 (e)

Library of Congress Control Number: 2021909855

iUniverse rev. date:  07/15/2021

Contents

Preface

Introduction

1     The Uncertain Roundabout

2     The Rough and Lonely Road

3     You Are Not Traveling Alone

4     Focus on the Lane You Are In

5     Navigating the Exit Ramp

6     Finding Your Path Back Home

Tools for the Road

Resources

To the sisterhood of women who

have been my teachers

Preface

I n my forty years as a clinical psychologist, I’ve had the privilege of working with hundreds of women in individual and group settings as they’ve faced their journey through and beyond breast cancer. They’ve shared with me their knowledge, pain, and loss as they traveled on this road. Some were recently diagnosed, while others were in active and ongoing treatment, experiencing a reoccurrence, or managing end-of-life decisions. It has been my privilege to walk this journey with all of them. I have gathered over the years these resources and tools that I hope will be useful to you on your personal journey. This guide is not a substitute for professional counseling or medical consultation; rather, it is an interactive manual of important life skills.

We all seek to find wholeness and balance in our lives. Each of you is a unique woman who must find her individual path to healing. When breast cancer challenges you, I hope this guide will help you identify your own road map to move forward. The exercises, activities, and tools provided will increase your knowledge of your body, identify the power of your mind, and connect with the wisdom of your spirit.

I wish to thank my patients, workshop participants, friends, and other health professionals who have given their time, talent, and insights. They have all been my teachers. I also want to thank my husband, Barry, and my family who have always been an optimistic, encouraging force for growth and change.

Thank you for choosing to read this guide. My wish is that it will provide not only useful information and tools but also hope and strength to empower you to move forward on your journey beyond breast cancer.

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Introduction

Y our doctor just told you that you have cancer. I bet that moment, along with how numb, shocked, and afraid you felt, is frozen in your memory. Your immediate thought might have been, Am I going to die from this cancer? After the initial shock and trauma, maybe you thought, What will I have to go through to try to beat this? How will I ever manage all the physical and emotional changes? How will my family ever deal with this?

If you are like the many women I have seen as a psychologist over the past forty years, you gathered your resources, educated yourself on what the medical community recommended, and began the difficult first phase of treatment. You counted down your chemo, surgery dates, and radiation sessions and put one foot in front of the other. You pushed through the challenging physical and emotional demands in the hope of reclaiming your life. Your strength has been tested, and you have endured physical pain and many daily challenges. Hopefully the medical community was a source of support and information for you in these initial phases.

After the whirlwind of that first active treatment slows down and your contact with the medical community is less frequent, you probably feel more on your own. You now have the space to question, What just happened to me? What do I do now? These questions surface only after enough time has passed and your sense of trauma feels less acute.

In individual as well as group settings, I have been humbled by the resiliency and strength of these women as they faced this life-challenging disease. The word that best describes most of them is determined, and their fighting spirit has been a privilege to watch.

You will all be at different points on the time line of treatment. Perhaps you have finished the first phase, are continuing with some additional form of treatment, or are beginning treatment again after a reoccurrence. Because each of you is more than a statistic in a research protocol, your cancer journey will be different from anyone else’s. There is no exact right path to follow except the one that is right for you as you attempt to live your own unique life.

At each turn on the road, you will face many hard decisions. You certainly did not choose this challenge, but it is now in front of you. Deciding what is important to you and how you want to live and setting your priorities are some of the demands of this disease.

The challenge is how you want to move forward toward healing. Healing involves taking risks and choosing to take responsibility to find your unique wholeness and balance. The medical community works to achieve a cure, which is the absence of physical disease. Everyone hopes for a cure. Even if you do not achieve a cure, you can and must seek your definition of personal healing.

I have always been fascinated by how the mind, body, and spirit interact to enable healing of disease and illness. I have seen the strength of resolve and change that are possible when a woman commits to identify her needs and learns how to care for her physical, emotional, and spiritual needs. My patients have been my teachers. Many of the life lessons I have learned are included throughout this guide. When you become aware of how precious life is, priorities shift. You can see more clearly the truth of what really matters. You can redefine, rediscover, and reconnect with what is truly important to you.

I have seen how the challenges of cancer continue long after the diagnosis and initial treatment are over. These ongoing life challenges are the basis of this guide. Each chapter will provide you with guidance and information as well as specific tools to address the power of your mind, knowledge of your body, and wisdom of your spirit. You will learn how to physically take care of yourself and make choices each day to practice self-care. You will understand how the power of your thinking is central to your decisions, feelings, and behavior. My focus on spirit is to help you identify and connect to your inner essence, soul, or higher power. Your spirit can also be your sense of being part of a universe greater than yourself. The chapters are as follows:

• Chapter 1, The Uncertain Roundabout, focuses on how uncertainty and fear of the unknown and possible reoccurrence might cause you anxiety.

• Chapter 2, The Rough and Lonely Road, describes how cancer is an experience of grief and loss that must be acknowledged and managed.

• Chapter 3, You Are Not Traveling Alone, discusses cancer as a family affair for not only your immediate family but also significant others in your life.

• Chapter 4, Focus on the Lane You Are In, provides tools to focus on what you can control: the present moment.

• Chapter 5, Navigating the Exit Ramp, asks you to face the fear of death that can arise with cancer and how important it is to define your values and needs to others.

• Chapter 6, Finding Your Path Back Home, directs you to find your way home to the strength and resilience within you.

The road to healing is not one you can travel alone. We all need help whenever we are facing the unknown. Managing the uncertainty of cancer demands that you open yourself up to learning tools and strategies to move forward. There are many paths and roads to healing. The road you take can seem more like a maze than a straight path. There will be times when you hit a roadblock and feel stuck and unable to move forward. Perhaps your treatment is not going well and needs to change or halt for a period of time. You might need to circle back and start again in a different direction. The path might seem narrower when you are feeling alone or wider when you open up to the support from others. Although this guide is not a substitute for either medical or psychological consultation, it is a resource to help you cope and thrive to move forward.

My patients have expressed that cancer has changed their lives in profound ways. Please be aware that the identities and details of the women in the guide have been changed and combined to protect confidentiality. My greatest hope is that what I have learned by traveling with these amazing women will help make your journey more manageable.

This journey is more like a marathon than a sprint. You run a marathon by pacing yourself rather than trying to sprint as fast as you can. This guide should not be read quickly or in one sitting. You might want to have a journal in which to write additional thoughts as they occur to you. As you move through this guide, there will be opportunities to question yourself and commit to take some action. These questions are rest stops to pace yourself as you travel forward. Keep your focus and goals small and specific enough to be able to take a first step. Stretch enough to feel some movement forward, but don’t anticipate what might happen and not even begin. The challenges of cancer can reveal to you what is truly meaningful and important in your life. Pay attention not only to what you can change but also to your own inner ability to bring health and healing to your life now and in the future.

The natural healing force within each one of us

is the greatest force in getting well.

—Hippocrates

Wherever you are on your journey, I hope you will be able to use these tools and information to move forward to connect with the healing power within you. Let’s begin on this journey together.

1

The Uncertain Roundabout

Find Your Route Forward

• Learn how to calm your body.

• Challenge your thoughts to feel more control.

• Face your fears with acceptance and compassion.

How Uncertainty Affects Your Body

W hen you first received your cancer diagnosis, you were thrown into feelings of uncertainty about your future health and well-being. Questions about how, if, and when the cancer might reoccur accompany you long after diagnosis and treatment. Anxiety is always about the future. Your body reacts to your fear of the future as if you were in real physical danger. Your autonomic nervous system is designed to respond and react to real or imagined physical or emotional threat. This system is composed of two parts: the sympathetic (flight, fight, or freeze) and the parasympathetic (rest and digest and relaxation) nervous systems. They affect your body as follows:

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The next time you face some uncertainty, notice how your body reacts. Awareness is the first step to creating change. How does your body react to uncertainty?

Although your sympathetic system can be automatically triggered by many different factors, including heredity, medical conditions, medications, and stressors in your daily life, you do have some control over the parasympathetic (resting) system. One of the ways you can bring about the calming effects of the parasympathetic system is to learn some relaxation tools.

Relaxation is more than just watching TV or taking a bath. Although these activities can be enjoyable, the following tools focus on ways to regularly practice relaxation to bring about a calming of worry and anxiety. How do you slow down your body to feel calmer and safer? The quickest and easiest way to slow down your body and increase your sense of alertness and presence is to adjust your breathing. When you get anxious or fearful, your breath is shallower and more rapid. Try the following to help you relax.

Tool: Abdominal Breathing

1. Focus your attention on your abdomen.

2. Inhale slowly and deeply through your nose.

3. Imagine your chest and abdomen are like a balloon. Fill them with air to allow them to expand.

4. Pause for a moment, and slowly exhale through your nose or mouth. Be sure to exhale slowly and completely, and let your body go.

It is helpful to breathe in on a count of four. Pause and hold your breath for a count of five, and then slowly exhale to a count of seven through your nose or mouth. Try to repeat this for a total of three to five minutes. If you get light-headed, adjust your inhalation, pause, and exhale. Don’t push or force your breath, and try to keep your breathing smooth and regular.

I have heard it said there is little difference between how fear and excitement feel in your body. When you are anxious, slowing down your breathing is calming. Making an Ahh sound can help you to settle back into your body with more awareness. Plus, it just feels good to exhale some of that tension!

Tool: Mini Relaxations

Adjust your breathing anyplace and anytime. No one needs to know you are doing this. Your breath is with you every moment of every day. Try the following with your eyes open or closed, depending on what you are doing:

1. Count slowly from ten to zero, counting one number on each out breath.

2. While taking a breath, think, I am, and on the out breath, think, At peace.

3. As you breathe in, count slowly to four, and on the out breath, count back down to one.

4. The next time you face a difficult situation (e.g., going in for a procedure, making a treatment decision, or talking to someone when you feel upset), take three deep breaths before you begin.

The only time these tools won’t work is when you don’t use them!

Tool: Shifting Your Awareness

1. Close your eyes, and breathe. Notice your body, how the air feels when you breathe in, how your heart beats, and the sensations you have in your stomach and gut.

2. With your eyes still closed, purposefully shift your awareness away from your body to everything you can hear, see, smell, or feel through your skin.

3. Use your senses to shift your awareness outside yourself.

By shifting your awareness back and forth several times between what’s going on in your body and what’s going on around you, you learn in a physical way that you can control which aspects of your world—internal or external—you notice. You can gain a sense of control over how you react to physical sensations and become better able to manage anxiety. You can grow your ability to observe your thoughts and sensations. In a stressful situation, the goal is to respond, not just react.

Will you try this tool to shift your awareness the next time you feel anxious?

Try doing one of these breathing tools for three to five minutes, and notice if you feel any greater sense of calm in your body. Can you feel your body slowing down? Did your thinking also slow down, or were you focusing on any specific thought or upcoming situation? Did you feel any letting go of tension or tightness in your body or mind?

Carrying Tension in Your Body

Dr. Edmund Jacobson, in the 1930s, developed progressive muscle relaxation. He found that tensing and releasing various muscle groups can increase body awareness and help you create a state of relaxation. A muscle cannot be tense and relaxed at the same time. Knowing the difference between how a tensed muscle feels and how a relaxed muscle feels for you is the aim of this tool. Many of us carry our anxiety and fear in our body when we are stressed. Are you aware if there is a specific place in your body that tenses up when you are stressed? Try the following:

Tool: Jacobson’s Relaxation Technique

Find a quiet place where you will not be interrupted. Loosen any tight clothing, take off your shoes, and get comfortable. Give yourself fifteen to twenty minutes at a specific time to try this. Some prefer to do this before they go to sleep.

Don’t try too hard. Just let it happen, and don’t judge how well you are doing. Keep an open, passive, detached attitude. It does not need to be perfect.

When you tense a particular muscle group, do so with some strength but not strain. Hold it for seven to ten seconds. Concentrate on how the tension feels in your muscles. Release the tension abruptly, and then relax the muscle. Take fifteen to twenty seconds before going on to the next muscle group. You might tell yourself, I am letting go, or I am relaxing, between each muscle group.

Many people find it helpful to start at the top of the body and work down. Do the following:

• Clench