“Healing and Recovery” Phase of Cancer Treatment Going Gently …

" It is in the addressing the fear and grieving the loss I feel that I am able to move on with more con idence and even joy. I would call this “healing”." Pauline, LRCP patient.  Spiritual Counseling is available up to approximately 6 months after active treatment at LRCP. Contact Supportive Care at 519.685.8622 and ask to speak with the Spiritual Care Specialist.

Helen Butlin-Battler M.Div. Specialist in Spiritual Care London Regional Cancer Program

September 2012

790 Commissioners Road East London, Ontario N6A 4L6

519-685-8600 www.lhsc.on.ca/About_Us/LRCP/



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Contact Information Helen Battler, M.Div. Specialist in Spiritual Care, London Regional Cancer Program: Phone: 519-685-8500 Ext. 54037 Email: [email protected] Supportive Care, Social Worker Team, London Regional Cancer Program: Phone: 519-685-8500 Ext. 58622 Wellspring, London & Region: 519-438-7379 Offering a variety of cancer support programs at no charge. Yoga, art therapy, reiki, meditation, peer support. Call for current programs running. Hospice London: 519-438-2102 Weekly meditation group and other programs available. Daya Counseling Centre: 519-433-0077 A variety of counselors and subsidized counseling (usually have wait list for subsidy.) Family Service Thames Valley, London: 519-433-0183 A variety of counselors and subsidized counseling (usually have wait list for subsidy)

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A Time for Healing… It is helpful to frame the irst year post active treatment for cancer as your time for 'Healing and Recovery". It takes time to integrate the impact of the cancer diagnosis as well as the emotional and physical rollercoaster of active cancer treatment. There have been many changes that have taken place in your life and body. If you are discharged into surveillance for a cancer that is not curable, this may be the most challenging time of the process since diagnosis. If your cancer has been eradicated according to the inal tests after treatments you may still ind yourself in a highly fragile emotional state. It is important to give yourself lots of permission to take time to heal emotionally, spiritually and physically from the impact of your diagnosis and treatment this can take, for many, a good year. Post Treatment Emotions... You may ind after treatment that instead of feeling relieved and happy, you feel a range emotions such as sad, irritable, depressive, weepy, lonely, scared. These are very normal feelings. Many have said to me in this time, “I don’t know what’s wrong with me. I should be feeling happy because I’m supposed to be able to get back to my life now….but I don’t. I’m scared.” This post treatment experience has been described in this way, "I feel like I've been on a bus with my bags leaving my life that I can never go back to. Now, after my treatment is over, I am dropped off the bus with my bags and I have no idea where I'm going and I’m all alone." Often family and friends are ready to move on and are celebrating the end of

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your treatment process and yet you may ind yourself not ready to celebrate, nor feel that the trauma is over.

• Explain to your family what you’re feeling and that

this is normal.

• Gentle walks.

A Time for Grieving Much has changed since the cancer diagnosis. Your whole life, body and self may feel shattered and permanently altered by your experience. The changes to your body and therefore, your identity, can provoke a painful grief process. You may ind yourself grieving that your body is no longer what it was and having to ind a deep resilience to live with the daily symptoms and impact of this. These changes may be straining your relationships and your sense of vitality for living. Work with your doctors for optimal symptom management of the bodily changes you’ve undergone. It takes time to reconcile with these changes. Give yourself permission to feel whatever it is you feel and don’t try to put a brave face on when it’s not true. Grief is normal, very real and takes time and support to heal your heart. Healing can and will happen over time and with gentleness to yourself in this process. Beyond Survival Mode During treatment you can be in survival mode putting one foot in front of the other. Your life is illed with appointments, support and contact with many people from your health care team and your friends and family. With the absence of the treatment regime there is time to think and process. This is often when some ind themselves overwhelmed. After treatment many ind that the loss of contact with the health care team is just that, a loss even though it’s a relief not to be in active treatment. Sometimes

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• Talking through your fears with a wise listener

who does not try to ix them.

• Creative activities…try something new or do what

is familiar that you enjoy.

• Meditation – it’s easier in a group and there are

groups run by Wellspring, Hospice, yoga centres.

• Feeling your feelings rather than stuf ing them and

moving on.

• Seek help if you’re struggling.

Most importantly….be very gentle with yourself Give yourself permission to live the year after treatment as your 'Healing and Recovery" phase of living through or with cancer. You will ind slowly that a new way of living emerges. Take it slowly wherever possible and include nurturing of your heart and body in your day to day. Cancer and treatment can be traumatic yet you have come through it. Focus on one day at a time and give something nourishing to yourself each and every day. By doing this you may ind that a deeper inner strength is forming within you and your days are more often illed with greater meaning and purpose. You may ind you are stronger and focus on what is truly important to you in a different way than before your diagnosis. Give yourself credit for having come through the diagnosis and treatment no matter what the outcome...you’ve done it and you have today!

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your energy on what is nurturing, meaningful and purposeful in your day to day within the new limitations you are now living. It takes time but you will discover that even with a terminal diagnosis life can become richer and fuller if you are gentle with yourself and have the right supports for you and your family. Death is not simply an enemy. It is part of life and can push us into a ‘greening of life’ beyond what we could ever have imagined before the terminal diagnosis happened. This is what many people have discovered and shared from their own experiences. There are books that describe this beautifully and can offer a source of hope and strength as well as online groups and interpersonal support groups. Hope may have to be rede ined but authentic hope can be grounded in the real of today trusting that what you need for each day can ind you. This kind of grounded hope can source much inner strength despite the grief and struggle. Helpful Healing and Recovery Medicines • Lots of time in nature, the best healer. • Laughter .... watch comedies and feel good

movies.

• Keep fear out. Keep out media that feeds fear in

our minds. Challenge fear thoughts with a different, authentically hopeful story.

• Human connection. Time with friends that allow

you to just be where you are.

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the support that gathers around you in your community during diagnosis and treatment slows down once it’s over, yet you feel more in need of support than ever. Some feel a more acute fear than ever before because they are facing a 'new normal' with the possibility of recurrence in it. Some have described feeling paralyzed by this fear. You may bene it from counseling support during this time to assist you in processing the psychological trauma of having gone through cancer and the rigors of treatment. This can be a time where programs in the community such as Wellspring can help in you in this transition time. Spiritual Integration and Healing... Spiritual questions about mortality, meaning and purpose in your life may arise at this time after the busy time of active treatment is over. Some ind questions about life and death are in their minds far more than they used to be. Many feel they are reeling from the impact of confronting their mortality through the cancer and need support in integrating this painful awareness. Often this is the most fruitful time to bene it from spiritual counseling as the deeper questions about what you really want out of your life post treatment can now be focused on more actively. Examples of questions that have brought people to spiritual counseling after active cancer treatment are: • How do I want to live my life now because I

don’t to waste a second more of my precious time?

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• What is truly important to me in life … I’ve

Sessions support you to explore these questions and ind your own unique 'new way' of living your life with meaning, purpose and renewed trust and hope. You can learn to ‘put fear second’ and instead, put living irst and foremost one day at a time. Post treatment spiritual counseling sessions are available from Spiritual Care up to six months after treatment. Post Traumatic Stress... Post traumatic stress symptoms may also happen. These can include hypervigilance about personal safety or the safety of loved ones, dif iculty sleeping, racing thoughts, lashbacks to the most dif icult moments of the past few months since diagnosis, anxiety that controls you and makes you try to control everything around you. These are normal to some degree and will slowly lessen over time but if they intrude with your ability to function in the day to day, are impacting your relationships or continue over a few months you will bene it from talking with your family

doctor and also seek counseling with a trained therapist focusing on Post Traumatic Stress Disorder. There are highly effective interventions that can help these symptoms. Children and Recovery If you have children you may notice that they are manifesting some of these symptoms too. If you notice greater anxiety, withdrawal or signi icant changes in your children's personalities and behaviour, take them to a counselor specializing with children. You can contact Social Work in Supportive Care at LRCP for resources in this area. When Cure Is Not An Option If cure is not an option then living with this reality can be extremely dif icult. Ending active treatment yet without the hope of cure can be a time of great fear, sadness and loneliness even when surrounded by loved ones. If cure was a possibility at the beginning of your treatment but now you’ve been told it is not an option then your future has changed radically. As a result, you may ind yourself in the midst of all kinds of grief reactions including spiritual pain and struggle. This is a time when you will need to get support from others to gently care for you while you come to terms with this new reality. Your family and friends may also be struggling so sometimes they are not able to support you in the most helpful ways. They too may need support. Again, this can be a time when professional counseling from a therapist and/or spiritual counselor can guide and support you through the grief and assist you in refocusing

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lost my bearings?

• What do I want to teach my children about

living and dying?

• I’m no longer who I was … what do I want to

focus on in my life?

• I don’t really believe in my faith the way I

used to. It’s changed and I don’t know how to feel spiritually connected anymore.

• How do I live with this fear of recurrence and

not let fear rob me living my life?