Not actually an osprey nest (sorry)

Coping

I’ve noticed a lot of people – myself included – experiencing heightened stress as a result of ‘the situation’.

The following is the ‘Coping’ chapter of my book ‘Caring for a Partner with Breast Cancer in the UK’. While it’s written in the context of a partner having breast cancer, it still translates across usefully, I think. I’m sorry I’m too lazy to edit it, but I hope it helps someone, even if a little.

COPING

At a glance
Have coping strategies in place.
Don’t think about ‘what ifs’ – keep your mind in the present.
Deal with one thing at a time.
Prioritise what’s directly in front of you.
Don’t be afraid to ask for help.

I’ve put this as a separate special chapter because I think it’s an extremely important component in treatment and recovery to have coping mechanisms. Jen and I used them to get through the ordeal. You will need coping mechanisms too.
I’ve put this chapter near the beginning of the book because, well, how do you cope with the news of cancer? How do you cope with the treatment?

The following chapters hopefully go some way to helping you on the path of taking effective action, getting organised and what- not, but this chapter is for when you’re in those…moments…when you don’t know what to think.

It’s difficult to overstate the levels of profound, persistent stress and anguish you and your partner are likely to feel both in the immediacy of receiving such shitty news, but also through the near constant demands of treatment and recovery interwoven through your day-to-day activities. You may feel as though you’ve lost control of your lives. To a certain extent you have. Strangely, the wake up call: ‘that you don’t truly have any control over your life’ can be a stressor in its own right.

So part of the puzzle is to recognise when you’re feeling stress and having effective mechanisms in place to help you relieve the levels of stress you feel. As with so many things in life, there are clearly good and bad approaches to stress alleviation and, even with the good methods, different degrees of success for different people.

To help you get a structure of your own in place, consider one or some of the following approaches:

Take a deep breath…and relax….
There’s a lot to be said for breathing. In this context, controlled deep breathing. Couple it with incremental muscle relaxation – where you start by relaxing each part of your body from, say, the feet, all the way up to your face – you have a recipe that makes things just a little more bearable. Best to do this laying down in a darkened room, preferably on a soft surface like a bed or sofa.

Meditate
You can progress your relaxation to meditation. My personal favourite is Zen meditation – look it up, there’s loads of literature on it and no you don’t have to become a Buddhist or be in any way religious. That said, it can be a deeply ‘spiritual’ experience even for the agnostic (me and Jen) and dare I say the atheist.

Get (or stay) physical
Exercise is another great way to clear the mind and give yourself a break from the trials of daily life. It doesn’t have to be a sport – yoga, Thai chi or even simply walking around the block or, better still, in the countryside, is extremely beneficial and is proven to improve mindset as well as physical fitness. Personally I use the treadmill at the gym, put my headphones on and read an e-book.

Hobbies
If you don’t have a hobby, now can be a good time to start. What interests you? Jen found those colouring books for adults to be very therapeutic. OK, it’s not so much a hobby as a time killer. Then again, I guess that’s what a hobby is. She used to like cross stitch, though hasn’t done any for a while. I like messing around with computers – especially content management frameworks. Yeah, I know.

Look at how you think
It’s worth looking into Cognitive Behavioural Therapy and/or mindfulness as these disciplines can be very useful tools in the fight against negative thought streams (as I call them) as well as depression, anxiety and dark moods. It can be particularly effective in helping you identify negative, circular thought patterns while giving you the ability to deconstruct, analyse and reconsider thoughts that are pulling you down or holding you back.

Music
Chilling out to some tunes (perhaps even having a mad boogie in the living room) can be very therapeutic.

Films
Watching a dumb movie that you don’t have to think about too much (guilty confession, I once spent an entire day watching animated films because they had simple stories, lots of fun and bright colours) can be a great way to take your mind somewhere else, giving your sub- conscious vital time to process stuff.

Games
Console, phone, handheld and/or board games can be great to keep the mind active on something challenging, enjoyable and, perhaps most importantly, distracting.

Reduce your load
Don’t take on too much and be comfortable politely declining when someone asks you to do something (unless it’s your partner, of course!).

See it, list it
Keep tabs on the things you feel are beyond your control or you’re struggling to manage. Ideally a running list. This means when the fleeting negativity comes about, you can later take positive action against whatever it was when you’re feeling stronger…or when you can get help.

Get help
Don’t be afraid to ask for help. No-one in their right mind would expect you to handle everything on your own. That includes asking help from professionals who deal with this shit on a daily basis.

Sleep
Make sure you get plenty of ‘healthy’ sleep. Ideally try to go to bed and wake up at the same times and aim to get between seven and eight hours of sleep a night. A scheduled sleep pattern is essential for mental hygiene. Keep an eye on sleep at other times as it may be a sign of something more sinister going on – think depression or exhaustion.

Laugh
Don’t feel guilty for having fun when you can. It’s OK to laugh and joke. In fact, I’d go so far as to say it’s essential to get through this in one piece. Laughter really is a great healer. So if you can spend some time with your partner watching a rom com, a stand up comedian or whatever, it will have a positive impact on you both.

Ideally these things should be, as best as you can with the somewhat unpredictable nature of cancer treatment and care, at set times of the day. Of course you can’t do them all at once, and it’s a question of finding out what works best for you. But it’s vitally important that you have at least one of them in your arsenal of coping strategies, so make sure you keep a slice of time carved out just for you each day to work on and practise your coping mechanisms. Ideally you should try them all until you find a good fit. And do it before you find yourself in a dark place as by then you may be too overwhelmed physically or mentally.
All of this is useless, of course, unless you’re able to identify the things that are causing you stress – particularly the things that cause stress ‘spikes’. By recognising when they occur, you’re better armed to defend against them and ward them off – especially if you have coping mechanisms in place.

A good example of this is when you’re thinking about ‘what ifs’. JUST DON’T! OKAY!? Other indicators of negative reactions to stress may include one, some or all of the following:

Increases in drinking (caffeine and/or alcohol), smoking, eating, gambling or similar vices (such as illicit drug use or risk taking).
Sleeping to avoid reality or general lethargy.
Ignoring problems in the hope they go away.
Dwelling on negative possibilities or outcomes.
Violent outbursts, either emotional or physical.
Anxiety, dread and or general feelings of fear (adrenaline, in- creased heart rate, butterflies in the stomach).
Lack of emotion.

If you experience any of the above, don’t ignore it and don’t normalise it. Recognise it for what it is, try to identify what happened to trigger it and deploy a coping mechanism. Even if it’s just a ‘time out’ from the day. Make sure you’re keeping an eye on yourself.

From my experience, the human mind has a knack of taking information and extrapolating different scenarios. It’s also alarmingly good at filling blanks with utter rubbish. A good example of this is superstition. (Thanks, Mum, for that whole ‘Mr Magpie’ bullshit….)

You will almost certainly start wondering ‘what if’. Like, ‘what if’ the operation goes wrong, or the therapy doesn’t work, or I’m not strong enough to do this or the cancer spreads…or has already spread. It’s scary stuff to think about. But also consider that ‘what if’ we die in a car crash on the way to the hospital? Probably because you weren’t concentrating on the road worrying about what ifs….

My point is, this line of thinking does NOT help. It may have been useful when we were nomadic hunter gatherers trying to stay alive in a hostile environment, but in the scenario we now find ourselves it has almost zero utility. Over time, these questions WILL wear you down. Even break you. It takes some mental agility and a strong will, but try to catch yourself in the act of having these thoughts – because you most assuredly will – and stop yourself. Pull yourself back to the present. The here and now. Focus solely on the FACTS. On what you KNOW. The things you can directly influence. Things you can do to aid a successful outcome. Focus on planning, allowing yourself to rest, giving yourself and your partner time and space to think, on collecting yourselves.

Statistics don’t help either and they certainly can’t tell you how your situation is going to turn out. Nor should you seek out horror stories – they exist on the internet aplenty. None of these stories will be the same as your partner’s. Breast cancer treatments are as individual as the people receiving them – no two are EVER alike. They’re like fingerprints. DNA signatures. One offs. Just because someone’s Auntie once had a bad reaction to the same medication your partner’s going to have, it doesn’t automatically follow that your partner is going to encounter the same difficulties. It’s a meaningless anecdote. There are so many variables involved that you simply cannot know, so there is no benefit to holding the story up for comparison. Case history, physiology, age, stamina and any number of thousands of other factors in combination means you simply CANNOT compare stories. Clear? Good.

Try to keep your mind in a neutral state. Saying ‘you’re going to be OK’ is just as speculative as ‘you’re going to die’. So, the only logical recourse is to focus on logic and reason. Deal with what’s directly in front of you, step by step, until you’re past it and on to the next step. That can be as simple as being prepared for a hospital visit for a scan. Don’t think about the results because you simply can’t know them. If it were possible to know the test results before the test there’d be no need to take the test, would there?

That’s not to say you shouldn’t think and talk about worst case scenarios – like death – because they’re very real possibilities – indeed, they’re actually inevitabilities. After all, we’re all going to die, it’s just a question of when and how. But wallowing in misery because you’re going to die one day would defeat the point of being alive, wouldn’t it? So you mustn’t dwell on them. Nor should you let these thought pat- terns spoil the precious, precious time you have together.

Consider the following statements:
You can live your life, be miserable and afraid, then die; You can live your life, be happy and brave, then die.

Both statements are entirely possible. Therefore, if you were given a choice between the two, which would you think to be the better choice?

Of course, life is rarely so black and white, and sometimes it’s difficult to see a way through the dark thoughts. It takes considerable mental discipline and maybe even a little desperation, but whenever you catch your mind wandering down a dark rabbit hole, pull back. Focus on the present, what you know to be facts.

Consider hobbies and healthy stress outlets like martial arts or other forms of physical activities. That said, you may need to reduce regular activities that take you away from your partner when she is most vulnerable.

Plan ahead! Making yourself aware there are hardships in front of you actually reduces stress in the long run. They’ve done tests with rats that prove this. Understanding what’s in front of you gives you a far greater chance of overcoming it. A great deal of fear is born of ignorance – fear of the unknown.

A note on fear and bravery – bravery cannot exist without fear. Bravery isn’t the absence of fear, it’s the overcoming of fear. It’s doing what needs to be done despite what appear to be overwhelming odds. When your stupid monkey brain is telling you to run and hide, but you step up and get it done no matter what.

I can’t tell you not to be afraid because it’s not possible to switch that shit off. But you can have quiet resolve. Deal with each step of the process. Don’t look too far ahead. Be mindful. Face the facts. Then act.

Irrespective of whether you believe in a god or not, you need to make peace with the powers that be if you’re to move forward. I can’t say how you should approach this because everyone is different. Personally, Jen and I are agnostic, believing it’s no more correct to say there’s a higher power than it is to say there isn’t. So, we seek meaning through the beauty of life, the universe…and everything (apologies to Douglas Adams fans). It’s a philosophical approach, with just a hint of ‘Pascal’s Wager’.
In truth, I’m somewhat envious of those who have faith in a greater power – particularly those who believe something better than this life happens afterwards. It must be a great comfort thinking that way.

Suffice to say, we find comfort in closeness, shared experiences and helping others less fortunate. A sunset. A flower. There’s plenty of food for spirituality if you look in the right places, be it marvelling at the myriad spirals found throughout nature or praying to the sun god, Ra. Whatever your poison, take solace in it, drink it deep. Just being alive in the universe is a wondrous, terrifying, awe-inspiring thing. Even if you’re cooped up, the imagination can take you to places and experiences that are even beyond the bounds of possibility.

Embrace and cherish each moment, no matter how terrible it seems, because it’s all temporary. It’s all fleeting. No matter how unbearable it seems, no matter how much it pains you to see the love…the shining star…of your life suffer, you can get through this. You can help her get through this!

Talking to people – either those who have already ‘lived the dream’, so to speak, or people who are trained to help in these scenarios can be extremely useful, both as a means of letting the feelings out but also to gain some much needed perspective. I would thoroughly recommend forums for talking to people in a similar boat – you may even find some solace in helping other people nearer the beginning of the journey.

If you’re really struggling with life and your outlook, consider speaking to your doctor who can refer you to counselling or prescribe appropriate medication.

If that seems too extreme do consider calling one of the numerous support charities. You’d be surprised how useful it is to talk to someone who’s ‘outside the problem’.

These lessons are ones I’ve had to learn myself. The hard way. Take what I’ve said to heart – these aren’t just glib, page filling platitudes, they’re very real lessons that have been proven to work because I’ve lived them.

Try to take a philosophical approach to life, because you don’t know what’s round the corner – it could be good or bad, though chances are it’s a mixture of both.

Finally, take each step of the journey one at a time. Don’t try to look too far ahead, besides basic scheduling, and don’t, don’t, DON’T think about what ifs.

I’ll say that one more time – DO NOT THINK ABOUT WHAT IFS!