The topic for this blog is coping skills for cancer patients and their loved ones to not necessarily reduce the stressors you are currently under (wouldn’t that be nice?), but to help you better live with stress. Stress doesn’t cause cancer; but it does feed the mechanisms that make cancer spread. So, please, let’s address it head-on, even if the other stuff going on for you as a cancer patient or you as a person who provides the primary support for that patient is a full-on press right now. Take a breath, and make the time to do this.
In the last Blog, I suggested you (the patient, and spouse/family members or primary support people who make up the patient’s “home team”) individually answer three questions, off the top of your head. They deal with listing the things that worry you the most, before the cancer diagnosis, at the time of the cancer diagnosis, and right now.
It should be no great revelation that you have all been coping, with varying degrees of success, in your BC (before cancer) lives, with stressful circumstances. Each of us have a threshold of what degree of pressure due to chronic stress we can comfortably cope with, before we just plain explode. And I can bet that whatever that level of pressure was, it has risen since you began living with cancer, but likely your threshold for dealing with the extra stress hasn’t! And, combined with the BC stresses, you and the members of your “home team” probably consider yourselves on “stress overload” now. And chronic stress strains even the best of relationships, at a time when those relationships are invaluable.
The following are techniques and a tool, that may help you, together, to deal with stress more effectively as you continue your cancer journey, and do it in such a way as to offer techniques your core home team can each use to strengthen your relationships, and understand more fully the stress “triggers” each of you find difficult to cope with. And it compels you to communicate in a focused discussion the things that “bug” each of you. Better communication is always a huge plus!!
The following steps can be kept in mind, as you develop stress management techniques and tools. The first one you already have begun to do a few minutes ago.
- List your stressors. Write down all the stressors in your life so you know, specifically, what issues you are facing. It will be easier to tackle your stress points individually, rather than feeling as though you need to take them all on at once.
- Involve your medical team and your home team. Each of you may believe that you can learn to cope with stress on your own. Wrong. It’s important to make your family, friends, coworkers, and medical team aware of what you’re going through. Compensate for the extra difficulty you have communicating when you attempt it under stressful conditions (even if you consider yourself a good communicator). When you talk about what specific pressures you are dealing with, it opens the lines of communication – always a positive thing. Plus, these people may help answer questions and help you find solutions for your stressor list.
- Make achievable goals. When you are trying to tackle stressors, the best technique is to make goals specific, realistic, and ones to which you can attach an actual time frame. Make sure you set yourself tasks you know you can complete. For example: aim to attend one support group or a yoga class at least once a week; or spend 15 minutes at the beginning and end of each day writing a stress diary; or schedule regular appointments with a personal counselor (clerical, therapeutic, or wellness).
- Take some “me” time. Many patients as well as caregivers are used to taking care of families, spouses, or tasks at work – all at the same time. Resist the thinking that taking time for yourself is selfish or means spending less quality time for the ones who need you. Ask yourself when the last time was that you truly had “me” time. Try leaving for an appointment an hour early or arriving home late, to give yourself time to make a stop at a favorite coffee shop, store, or park. If you take time to recharge your batteries, it isn’t a selfish indulgence – it is a way for you to be better able to deal with all that you must as a person living with cancer.
- Avoid negative coping behaviors. Some people turn to food, alcohol, caffeine, or tobacco to cope with stress. These behaviors only allow you to avoid dealing with your stress list in an unhealthy way.
These five things are techniques. Now let’s focus now on one tool from which many couples/families living with cancer have benefitted: starting and maintaining a stress diary. The idea behind Stress Diaries is that, on a regular basis, you record information about the stressors you’re experiencing, so that you can analyze these stresses and then learn to manage them more successfully. This is important because often, these stresses flit in and out of our minds without getting the attention and focus that they deserve.
Stress Diaries are important for (1) understanding the specific causes or stressors in your daily life, (2) offering insight into how you react to stress, (3) helping to identify the levels of pressure at which you operate most effectively, and (4) improving the way you manage stress.
Start by making thirty copies of the following page. If you are using My Notebook, put them in the back of the binder. Or just put them in a loose-leaf binder or file folder.
Begin each day with your cup of coffee or tea and write a few lines in your diary, and end each day by putting on paper what your day was like in terms of what caused you stress and how you reacted to it. (yes, if you want, have a glass of wine, while you do it.)
By the way, there are loads of sample templates for stress diaries for patients to be found on-line. This is a bare-bones one that may not best serve your needs. Also, there are plenty of sites that deal with journaling as a tool for stress management. If you like to write, and it is cathartic for you, try journaling.
STRESS DIARY Morning Entry
Date: ________________________
Is this going to be a typical day? Yes _ No
If it is not typical, what will you be doing? ___________________________________________________
Do you expect it to be stressful? __________________________________________________________
What level of stress do you anticipate feeling? (1-10)
If it is a typical day, what level of stress do you feel now? (1-10)
Can you identify the cause(s) of a low level of stress? _________________________________________
Can you identify the cause(s) of a high level of stress? _________________________________________
STRESS DIARY Evening Entry
Time of day when I experienced stressful event or experience__________________________________
Intensity of the stress (1-10)
What was the situation? _______________________________________________________________
____________________________________________________________________________________
What was the preceding event (cause)? ___________________________________________________
____________________________________________________________________________________
What were my feelings/behaviors? ______________________________________________________
____________________________________________________________________________________
How did I react/respond? ________________________________________________________________
_____________________________________________________________________________________
How effective was my response in lessening my level of stress? (1-10)
Rate my mood now (1–10)
Try writing your stress diary for one month, and then
- First, look at the different stresses you experienced during the time you kept your diary. Highlight (1) the most frequent stresses, and (2) the ones that were most unpleasant.
- Working through the stresses you’ve highlighted, look at your assessments of their underlying causes (or triggers), and your appraisal of how well you handled the stressful event. For these highlighted problems, can you think of ways to deal with those triggers in a way that you feel like you can react to them in the future within the level of pressure you can be comfortable with? If so, list these possible ways.
- Next, look through your diary at the situations that cause you stress. List ways in which you can change these situations for the better, if you cannot avoid them.
- Finally, look at how you felt when you were under pressure, and explore how it affected your happiness and your effectiveness. Was there a middle level of pressure at which you were happiest and performed best?
Having analyzed your diary, your reward should be a better understanding of what the most important and frequent sources of stress are in your life, and an appreciation of the levels of pressure at which you are happiest. You may even be able to identify the sort of situations that routinely cause you stress, so that you can prepare for them and manage them well.
Now then, using this tool, circle back to the five techniques and take a good, hard look at Number 2. The best nugget of having used a stress diary is the ability to sit down with the others who are part of the home team and medical team, and communicate your findings and your feelings. And discuss how you can each help each other to cope with living with cancer.