The psychological impact of diagnosis and treatment for cancer. Dr Liz Chorlton (Clinical Psychologist)

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1 The psychological impact of diagnosis and treatment for cancer Dr Liz Chorlton (Clinical Psychologist)

2 Plan for this talk Emotional adjustment to changes in our health Challenges of moving forward with life after diagnosis and treatment for cancer Managing changes in our mood Managing fatigue and pain Living with uncertainty What can we do to help ourselves with this process

3 Emotional adjustment to physical illness Physical illness brings loss and change, such as: Loss of security in our health Body image (e.g. loss of hair, changes to body and how it works) Sense of identity Important roles (e.g. work, within the family, with friends) Financial security When we lose something important we typically grieve This is true of family members as much as the person who is ill

4 Grief A natural process that we usually work through over time Grief is commonly associated with a range of emotions Individuals differ in terms of the emotions they experience Often emotions come and go, but sometimes we get stuck with one main emotion We often feel worse before we feel better Over time, most people experience a lessening of the grief and a degree of acceptance of the situation

5 Grief cycle in response to loss shock disbelief acceptance reinvesting in life anger guilt anxiety hopeless helpless sadness

6 The Grief Cycle People typically move backwards and forwards through the grief cycle New changes in our health/new information affect our grieving We often lack support/awareness from others about the need to grieve for losses associated with our health Sudden changes in our health may leave us with little time to prepare and grieving may be delayed

7 What is the purpose of grief? Grief serves a purpose There are things we can do to help ourselves work through our grief Through doing this we can help work towards acceptance Acceptance of: what has happened the permanence of any losses/changes the implications for the future

8 How can we help ourselves? Recognise that we may be grieving and that this is a normal response to changes in our health/loss Give ourselves time to acknowledge and express our grief Plan an activity to do after we have been focusing on the grief Keep a balance between focusing on the grief and reinvesting in daily life Use support and opportunities to talk to others in a similar situation

9 Re-investing in life Gradually resuming valued activities of daily life Thinking about what is most important in our lives Choosing one or two activities to start with Setting small manageable targets/goals Pacing to manage fatigue/pain Over time this will help our mood Initially we may need to go through the motions even if we don t enjoy things

10 Grief vs depression Sometimes grief can slip in to depression With depression our mood remains low and does not generally change We lose the ability to enjoy anything We lack motivation and struggle to see the purpose to life Depression doesn t always resolve itself and it is worth visiting your GP/ speaking to your team about you mood

11 Managing uncertainty Most of us assume that we will stay fit and well until we are older When we are diagnosed with cancer we lose this sense of security in our health Initially we go from thinking there is a very low risk of something going wrong with our health to thinking that there is a very high risk of something else going wrong No risk 100% risk

12 Assessing risk Challenge is to form a realistic assessment of the likely risk e.g. Has the cancer gone away? Will the cancer come back? Will I get another cancer? No one can give us 100% guarantees Many things we do in life carry some risk However, we can collect evidence to help us decide how much we need to worry about the risk of being ill again

13 Managing stress Stress is an inevitable part of life Some stress actually helps us If stress levels get too high it can start to affect our performance and we show signs of not coping Stress management is about: Recognising the signs of stress Identifying the stresses in our life and seeing what we can do to reduce them or manage them better Reducing them if they start to build up Developing resources that help us cope

14 The Stress Bucket Resources Demands

15 Mindfulness meditation Mindfulness can help us accept the things we cannot change Mindfulness allows us to be truly present in the moment without worrying about past or future

16 Any Questions?