Compassion Focused Therapy for Cancer
Dr Rebecca Lewis
I am a Clinical Psychologist and Associate with Balanced Minds. In my ‘day job’ I work in the NHS in a specialist psychology service for people with cancer. One of the reasons I am drawn to Compassion Focussed Therapy (CFT) for cancer is that I believe it provides a comprehensive understanding of why we as humans experience emotional distress, whilst also offering practical strategies to promote wellbeing and reduce distress. For this reason, I have found it an incredibly helpful approach to use with the very understandable emotional distress associated with a cancer diagnosis or treatment.
Normalising Emotional Response
An initial diagnosis of cancer, or a recurrence or progression of the disease can bring up a whole range of emotions. People may understandably worry about physical symptoms, how they will cope with treatment and what the future holds. There is also often a lot of uncertainty and a cancer diagnosis forces a confrontation with our own mortality. Common emotions that arise in the therapy room are fear, anxiety, anger, hopelessness and sadness. In combination, these can leave people feeling overwhelmed. This may be the first time that someone has experienced these emotions at such a high intensity, which can lead clients to fear that they are “going mad”, that there is something wrong with their mental health or that they are not coping “properly”.
In contrast, some people might not experience particularly strong emotions, but might feel numb or that it all feels surreal “like it’s happening to someone else”. This can also lead to worry that they are not experiencing emotions of a particularly high intensity and again, that they are not coping in the “right” way.
Drawing on CFT ideas to share the evolved function of different threat emotions, as well as the function of a numbing of emotion, can help people to normalise, understand and bring compassion to how they are feeling. Breaking down a feeling of being overwhelmed into its different emotional parts can help bring clarity and help people understand and calm their distress.
People also sometimes describe feeling a pressure to always be positive, perhaps from well-meaning family and friends who are trying to encourage optimism. Taking the perspective that a whole range of different emotions are normal and to be expected can greatly take the pressure off.
Prioritising Soothing and Self-Care
I believe that CFT offers a range of practical strategies to promote wellbeing and reduce emotional distress, which are very helpful to draw on in a cancer setting. Whilst we can help people to understand and normalise their emotions, we can also support people in finding ways to help settle and reduce their emotional distress.
I frequently discuss the concept of the soothing system with clients, and we think together about how to find more space for soothing; either drawing on strategies used to calm emotions previously or introducing new strategies, for example soothing rhythm breathing or imagery work. These techniques can be particularly helpful for people to use during the more challenging moments of their treatment to help them stay calm, for example during radiotherapy which requires staying still in one position for long periods of time.
Optimising sources of support
We also know from CFT that care and compassion from others and to ourselves is incredibly important for managing emotional distress. However, many of my clients tell me that they do not talk to their loved ones about how they feel, because they worry about being a burden.
Part of my work is about providing care, compassion and a safe non-judgemental place to help people to process and regulate their emotional distress.
We might also work on how people can optimise their existing sources of support, for example by communicating to their loved ones how they would like to be supported emotionally and what they need. People might vary in how much they want to talk or not talk about cancer. Sometimes the well-intentioned encouragement from family and friends to remain positive can be galling. People most often desire a safe, validating, supportive place, to share how difficult things are and can guide loved ones to provide this for them.
We also work on helping people to be more compassionate to themselves and their emotions during what is inevitably an incredibly difficult physical and emotional situation. Despite the challenges of the situation, I have seen the power of CFT in helping people to understand and regulate their emotions in this setting, and I know that the people I work with have gained greatly from the approach.
Looking after ourselves
As a therapist, this work can be incredibly rewarding but also intense and highly emotional. I draw on CFT practices like soothing rhythm breathing and mindfulness practice to help me to calm my threat response which can sometimes be activated by the stories I hear. I also draw on imagery work to help me to ‘step in’ to my compassionate mind to support me in being there to offer care and compassion to the patients I work with.
Dr Rebecca Lewis
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