This article is based on a talk delivered by Dr. Colette Hirsch in conjunction with Keeping Abreast in October 2020. Dr Colette Hirsch is a Reader in Cognitive Clinical Psychology at King’s College London and a Consultant Clinical Psychologist at the Centre for Anxiety Disorders and Trauma. One of her current research projects is a trial of a new online intervention to build resilience in women who been treated for breast cancer.
For many women with breast cancer, going through treatment, whatever the outcome, comes along with a rollercoaster of emotions. Even after treatment has ended while there may be a sense of relief that treatment is over, low mood and worry often remain present, or even emerge for the first time. Despite feeling down or worried at times many women living with and beyond breast cancer find ways to focus on other areas of their life and adjust to a “new normal”. One of the factors that enables someone to focus aspects of life other than their cancer can be their level of resilience.
What is resilience?
Resilience is an ability to adjust and continue functioning OK after a traumatic life event, such as being diagnosed with and treated for cancer. Being resilient is not about hiding how you feel, or not feeling sad or anxious, but rather it is about being able to feel the full range of emotions when you need to and also focus on other parts of your life when you want to. So, resilience is linked to better quality of life.
Research shows that in women who have survived breast cancer, higher levels of resilience are linked to feeling less stressed, worried, anxious or low. Resilience is often accompanied by more positive emotions like joy and happiness, as well as people being optimistic, and flexible when dealing with changes.
Can we build resilience?
The good news is that resilience is not a trait, but a process within everyone that fluctuates.
Some people will be more resilient in certain contexts or situations, and everyone finds their resilience changes, even in relation to the same situation over time. That means that resilience can be developed at any stage!
Whilst there are some things that we can’t change, such as our genetic make-up, or previous negative life experiences, other factors associated with resilience can be developed, for example training resilient thinking strategies or developing new coping strategies. These skills are aimed to help people adapt and move on and not fall into the traps of extended low mood, persistent anxiety and unhelpful negativity.
How can we build resilience?
Experiencing a major life event like breast cancer and going back to day to day life after treatment has ended is not an easy task. However, by learning from people who are naturally more resilient and understanding what they do may help others become more resilient themselves. Many psychological and social factors help foster resilience. Everyone is unique and different things will help different people at different times. You might find the below helpful:
- Building a social support network
It’s always good to have friends or family members to could reach out to when things are difficult. This could involve building on relationships you already have and developing new ones. This could include, for example, childhood friends or new people you’ve met during treatment. There are lots of different organisations, both cancer-related and non-cancer related, online and in-person (covid-permitting) that provide great opportunities to build a network of people who you could reach out to for support. www.cancercaremap.org could be a great place to start.
- Keeping things in perspective
Perhaps easier said than done, especially since stressful situations make it difficult to keep things in perspective, but if you’re caught up in day-to-day worries or concerns trying to keep the bigger picture in mind, or thinking about what you would say to someone else in your position can help.
- Accepting change
Accepting and acknowledging the challenge that you experienced during your treatment can help you cope. Similarly, after treatment ends things may have changed for you; maybe your work, your body or your relationships with family or friends could have changed. It can be helpful to try and accept that some things might be different and try and find new ways of doing the things that matter the most to you, rather than dwelling on the past. How about spending some time writing a list of everything you’ve achieved in the last two weeks or month? The achievements don’t have to be big; they could be as simple as cooking a favourite meal or remembering to send a birthday message to someone.
- Having realistic goals
Post treatment one of the ways to bring structure in your life is by having realistic goals. It is nice to have something to look forward to once the weight and purpose of the treatment is lifted off your back. These goals can give you a sense of purpose, binding you to the present and now. Achieving these goals, brings about a sense of accomplishment and it’s important to celebrate every victory and step along the way (no matter how small it may seem!) You could try thinking about something you’ve always wanted to do, and then breaking this down into smaller, manageable and achievable goals that you could start to tick off as you work towards your big goal?
- Being kind to yourself.
It is very important to be kind and understanding to oneself. Trying to develop a compassionate, positive and warm way of speaking to ourselves can help us to feel secure and comfortable. We need to realise that we are only human and after going through such a difficult experience we deserve to take a break, slow down and be kind to ourselves and our bodies for carrying us through. If you notice self-critical thoughts creeping in try asking yourself “would I say the same thing to a friend that I’m saying to myself right now?” or “would anyone else reasonably expect of me what I’m expecting of myself?”
- Getting your basics right.
You have been through a really draining experience and it’s important to take a pause and think about what you need to do to care for yourself and your body. Self-care can support your mental and physical health. Self-care is a bit of a buzzword these days, but it’s important to recognize that it doesn’t need to mean fancy candles and spa days. It can be simple things that prioritise your well-being like:
- Eating regularly and choosing healthy food.
- Exercising regularly (to the best of your abilities).
- Making an extra effort to improve the quality of your sleep. For example by; not using screens close to bedtime, having a regular nighttime routine that helps you relax and fall asleep more easily and avoiding caffeine later in the day.
- Having a routine in your day to give you structure. Trying to keep a good balance between things that give you a sense of achievement or productivity, things that keep you connected to others, things that you enjoy and find fun and things that feel restful.
These factors could really help bolster resilience and put you back in touch with the things that matter to you the most.
We know some people may need more help to bolster their resilience. Our team have developed a new online programme to help foster resilience in women living beyond breast cancer. We plan to adapt this for those currently in treatment and those with recurrence in the future, once we know the approach can help women. We are currently looking for women living beyond breast cancer to help us work out how women find the treatment. If you might be interested in helping us with this please read more about it below.
Our research team is trialing a new online intervention to foster resilience to decrease low mood and anxiety in women who have completed their treatment for breast cancer.
The FRAME Project, short for Finding Resilient Answers More Effectively, allows participants to trial a fully online and easy intervention over a span of three weeks. It involves 10 half hour sessions of listening to scenarios and responding to questions.
We’re looking for women who are based in the UK, over 18 years of age, have completed their cancer treatment within the last 3 years and have not had, or do not currently have, secondary cancer.