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When I was told at 49 I needed a double mastectomy after a diagnosis of breast cancer, I dutifully wrote it down in my reporter’s notebook and asked the surgeon: “What time is the interview?” She looked at me quizzically. “Interview, Sian? I think you mean surgery.”
My diagnosis had come as a bolt from the blue and, with the huge rush of stress hormones that followed, my brain was on high alert and had quickly clicked into journalist’s mode; where do I need to be and when?
This week my colleague Julia Bradbury, the ITV and former BBC Countryfile presenter, revealed she too has been diagnosed with breast cancer and will undergo a mastectomy in October. She has gone public about it to encourage other women to get tested if they have any cause for concern.
I may know something of what she is feeling right now, but of course, I cannot know all of it. Each individual cancer story is different. There is no fixed or correct way to respond to your diagnosis and there is also no perfect way to respond to a friend’s. Like many others, I sent Julia a message letting her know I am thinking of her, and sending my love, strength and support.
Because, while we all manage this differently, one thing I do know is when dealing with this kind of diagnosis we need space to be able to process it. To do that properly we have to show ourselves some compassion.
There’s a range of emotions that can come with a diagnosis of cancer. Bewilderment, rage, pity, sadness, even blame and shame. You can hurtle from one extreme to another: feel glad you’re alive one minute and fear imminent death the next. You may feel all of this, or none of it. There may be a veritable storm of stuff bubbling up in you that you can’t identify, or a flat feeling of nothingness. There’s no ‘right’ way to process the news that you have a disease, no correct path to follow, no story that’s the same.
The problem is societally we’ve adopted a language around cancer that is very much about battling and fighting against it. As if it’s up to us what the outcome is, and that those who battle hard enough will succeed in defeating their illness.
I really struggled with this. I’d lost my mother to cancer and I knew it wasn’t remotely a fair fight. I knew you could just be unlucky and that was that.
Yet, because of the expectations placed upon us – to be battling, to be brave, to be coping marvellously – we get angry with ourselves if we think we have fallen short. We beat ourselves up for not recovering fast enough or coping well enough, perhaps even believing that we must somehow have invited cancer in. Was it the stress? Did I eat and drink the wrong things? Should I have visited the doctor sooner? Round and round the thoughts go, all questions with no answers. We attempt to control what we cannot because the alternative feels frightening and that uncertainty, doubt and fear can cause us to do weird things and behave in ways we don’t recognise. We may put aside our own feelings about cancer, while we try to manage other people’s, insisting that we’re ok. But sometimes we are not. We may be fragile and vulnerable and it’s fine to admit it. In fact, there’s a real strength in doing so.
Since my own illness seven years ago, I have been retraining as a counselling psychologist. I am about to qualify, and have spent two years providing psychological therapy to cancer patients both in NHS and charity settings. While the experiences varied, there was a common thread and one that I investigated in my final doctoral research: each person came with a different cancer, a different experience, but they all found it hard to show themselves compassion. The self-critical voice was loud, telling them they weren’t “fighting” hard enough, they “should” be coping better, they ought be back to “normal”. That voice was drowning out any self-kindness and preventing any real chance of recovery. Their thoughts were on a loop, going backwards to what they should have done and forwards to what they feared might happen. This rumination and lack of self-compassion meant they were running themselves into the ground, becoming physically and mentally exhausted.
One woman told me of the side-effects of the chemotherapy, which were so severe she couldn’t leave the house for more than two hours without needing the loo and when she went, it burned. Yet she was still trying to be what others expected of her, felt ashamed of her symptoms and had told no one. Another feared falling asleep in the afternoon when her body told her to rest because sleeping suggested she was old and incapable. The judgment drove out self-kindness and in therapy, we worked to notice that and bring some compassion back.
It’s not easy. The word ‘compassion’ suggests, to some, a weakness or self-indulgence. But it’s vital for emotional recovery. The researcher Kristen Neff suggests we call it “fierce compassion”. Self-kindness is active and powerful and important in our psychological survival.
As a mother of four, I know how difficult it can be to accept that you cannot be the person your children or family needs if you’re not looking after yourself. That means recognising, “I’m in this place at the moment and I’m feeling a little wobbly but that’s OK.”
To all those reeling from a diagnosis, or living with and beyond cancer, I’d say this: notice those painful feelings, all of them. Don’t try to push them away – because what you resist persists. Accept they are there and that they will pass.
Acknowledge when difficult thoughts spin off towards the future or drag you back to the past. Spot them, but be a bystander and watch them go like clouds or traffic, not engaging with the narrative.
Reach for the outstretched hands. People want to help but don’t know how. See it as offering them a gift by showing them what might be helpful.
Write it down. Even the ugly stuff. No-one has to read it, but the act of doing so will help to engage a different part of your brain, switching off the high-threat state by allowing some distance.
I was lucky my own cancer was caught early and treated quickly and successfully. Fortunately the disease had not spread.
But having the mastectomy and being back in hospital for the reconstruction was psychologically tough. The truth is whatever your cancer story, this can be a difficult voyage and there is no “best” way to travel.
When I asked a man with incurable cancer how he managed, he told me: “When I am feeling really low, I remind myself of the final lines from a poem by Mary Oliver and it is something like this: ‘What am I going to do with my one wild and precious life?’” I would add, be kind.
Be kind to yourself in this one wild and precious life.
Rise: A First Aid Kit for Getting Through Tough Times by Channel 5 newsreader Sian Williams is available from Telegraph Books for £3.99. To order, visit books.telegraph.co.uk or call 0844 871 1514
The Macmillan Cancer Support Coffee Morning is on September 24 – all proceeds from this article will go to Macmillan.