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Information central for parenting with breast cancer.

Setting the Foundation

Managing Your Feelings

How It Helps Your Kids

Managing our own feelings helps us stay calm and feel in control. It allows our children to do the same. It also teaches our kids resilience when they see you feel bad, take action, and then recover.

Here are some tips that may help you take charge of your own feelings.

Tip #1: Fit Cancer into Your Identity

Each of us has a self-concept, or identity, that’s made up of many separate roles. Here are some examples:

Gloria, age 80, is . . .

Grandmother
Widow
Bridge-player
Community volunteer
Mother

Jake, age 16, is . . .

Soccer goalie
Son
Student
Trumpet player
Brother

When we’re diagnosed with breast cancer, the role of “breast cancer patient” may seem to take over our entire self-image. It’s helpful to remember that “breast cancer patient” is but one of our many roles at the time we’re diagnosed.

Think about the roles that make up your self-image. Which roles do you want to be most prominent? Where does breast cancer fit in? Click here for a worksheet that can help you with this exercise.

Tip #2: Examine Negative Thoughts

We don’t always think clearly when times are challenging. As a result, some of our thoughts, particularly our most distressing ones, are often distorted and inaccurate.

Here’s a list of 10 reasons why we develop distorted thoughts. Next time you find yourself ruminating over a disturbing thought, use this list to evaluate how accurate it is. You can find tremendous relief by breaking the hold these thoughts have on your mind.

  1. All-or-Nothing Thinking - Only considering the extremes and ignoring any gray areas. Example: When you learn that you have cancer, you think, “I’m going to die.”
  2. Overgeneralization - Concluding that everything will always be negative because of one negative experience. Example: You don’t click with the first doctor you meet, and you think, “I’m never going to find a doctor I like.”
  3. Mental Filter - Focusing on a single negative factor that colors everything else. Example: When the doctor says, “You have cancer, but the tumor is very small, your lymph nodes are clean, and your prognosis is excellent,” you only hear “You have cancer.” Period.
  4. Disqualifying the Positive - Finding a way to discount positive evidence so you can cling to something negative despite evidence to the contrary. Example: After your oncologist reviews all of the medications you can take to prevent nausea associated with chemotherapy, you think, “Chemo is still going to make me horribly sick.”
  5. Jumping to Conclusions - Filling information gaps with negative thoughts. Example: When the doctor says, “You should have a lumpectomy,” you think, “My breasts will never look normal again.”
  6. Magnification and Minimization - Exaggerating or minimizing facts that don’t support your position. Example: When you make it through the first round of chemo with no problems, you think, “It just hasn’t hit me yet.”
  7. Emotional Reasoning - Believing that feelings are the same as facts. Example: Armed with facts and figures to support his case, your doctor recommends that you have chemotherapy. You refuse saying, “I’m not going to have chemo because I know it won’t help.”
  8. Should” Statements - Telling yourself (or others) what you (or they) should do, thereby creating guilt, anger, and frustration. Example: Your sister-in-law can’t pick up your kids after school, and you think, “She should have found a way to pick them up. I always bend over backwards to help her.”
  9. Labeling and Mislabeling - Attaching a label to yourself or someone else when it doesn’t fit the facts. Example: Chemo has made you too weak to attend your son’s football game. You think, “I’m the worst parent in the world.”
  10. Personalizations - Incorrectly identifying yourself as the cause of a problem. Example: Your doctor suggests that you take extra antinausea medication with your next round of chemo. You think, “I can’t believe I need more medication. It’s because I’m such a weak person.”

From Feeling Good: The New Mood Therapy by David D. Burns, MD.

When you realize that a negative thought is inaccurate, you can replace it with a more realistic one. Click here for a tool that can help you with this exercise.

Tip #3: Break Free of Negative Thinking

When we’re seriously ill, we can become entranced by negative thoughts, finding ourselves stuck in a downward spiral of negativity. In his book, The Anxiety and Phobia Workbook, Edmund J. Bourne, Ph.D., says that “it takes a deliberate act of will” to break ourselves free of negative thinking.

Bourne offers several positive options for controlling our minds when we allow our thoughts to travel down a negative path:

  • Do physical exercise.
  • Do progressive muscle relaxation alone or in combination with abdominal breathing.
  • Use evocative music to release repressed feelings.
  • Talk to someone.
  • Use visual distractions (e.g. watching television, reading a book, looking at a rock garden).
  • Use sensory-motor distraction (e.g. arts and crafts, repairing something, gardening).
  • Find an alternate positive obsession (e.g. work on a crossword puzzle or a jigsaw puzzle).
  • Practice healthy rituals (e.g. yoga, meditation, self-affirmations).

Tip #4: Redefine Good Parenting

When you ask a child what makes his mother a good mom, he is likely to list physical activities. You might hear:

“She drives me to the mall.”

“She make good pancakes.”

“She lets my friends come over.”

“She always put dessert in my lunch.”

When you ask parenting experts the same question, they answer with intangible behaviors. In his book the Ten Basic Principles of Good Parenting, Laurence Steinberg, Ph.D., suggests that good parenting can be distilled into 10 behaviors, none of which is specifically active. His principles are:

  1. What you do matters (e.g. being mindful when you’re with your children, learning from your mistakes, etc.).
  2. You cannot be too loving.
  3. Be involved in your child’s life (e.g. taking an interest in your child’s interests, avoiding intrusive parenting, etc.).
  4. Adapt your parenting to fit your child.
  5. Establish rules and set limits.
  6. Help foster your child’s independence.
  7. Be consistent.
  8. Avoid harsh discipline.
  9. Explain your rules and decisions.
  10. Treat your child with respect.

Breast cancer treatment often leaves us temporarily unable to participate in many of the physical aspects of parenting: cooking meals, bathing the children, attending a school play, and going on a fieldtrip. We often think, I’m such a bad mother because I can’t take care of my kids.

These physical activities have very little to do with good parenting, particularly in the short term. Click here for a tool designed to help you re-examine your thoughts about being a good mom.

Besides the intangible aspects of parenting, you might want to consider physical activities you can do with your kids that require less physical strength:

  • Watch television together.
  • Read to your child. Or lie in bed with him while he reads to you.
  • Listen to your child play a musical instrument. Or listen to music together.
  • Sit outside to watch your children play in the back yard.
  • Draw together.
  • Talk about your child’s day.
  • Plan a fun activity to celebrate the end of your treatment.

Think about the physical activities that you’re currently unable to do with your children. Then consider what makes these activities rewarding. Are you having fun with your child? Are you showing interest in your children’s interests? Then identify alternative behaviors that might serve the same purpose. Click here for a tool that can help you with this exercise.

Tip #5: Managing Friends and Extended Family

Friends and extended family members can be our greatest supporters and cheerleaders when we have breast cancer. They can also create stress when we’re least able to manage it.

Here are some suggestions for keeping your relationships positive and healthy:

You can decide what, when, and how much to tell people about your illness.

After receiving a breast cancer diagnosis, many women feel as if they’ve lost all control over their lives, and most of their privacy, too. Our friends and family are concerned about our welfare and want to know exactly what’s happening with us. It’s helpful to remember that sharing information is not an obligation.

Here are some things you can say when you don’t feel like explaining what’s happening with your health:

“I’m not prepared to get into the details right now.”

“I’m sorry, but I’m just not comfortable talking about that.”

“Thank you for your concern, but I’d rather not share that information.”

“Everything is on track.”

Be prepared for insensitive comments.

Some of the things said by well-meaning friends and family can be insensitive and even hurtful. Instead of saying, “I’m so sorry to hear that you’re sick” or “How can I help?” some people will say…

“Just be glad you’re alive.”

“You have breast cancer? Did you know Susie Smith? She died of breast cancer!”

“Who will take care of your kids if you die?”

“You have breast cancer? I can’t believe it. I’m having the worst day, and now you tell me this!”

“I told you to lose weight. You got cancer because you’re fat.”

Remember that people who make insensitive comments are almost always well-intentioned. Their insensitivity is usually a reflection of their own anxiety about themselves.

If someone asks, “Aren’t you afraid your cancer will come back?” she’s likely expressing her own fears about cancer. If someone says, “I can’t believe you decided not to have reconstruction after your mastectomy,” they’re likely imagining having to make that decision themselves.

Insensitive comments can be hurtful, but it helps to understand that they truly are unintentional.

You are not responsible for your friends’ and extended family’s reaction to your illness.

It’s difficult to watch the reactions of those we love when we tell them we have cancer. We feel sad and even guilty when our mom silently weeps, when our father can’t look us in the eye, and when our best friend falls apart.

As a result, we can turn into the caretaker, trying to ensure the comfort of our loved ones. Yet while we may feel responsible, we’re not. The adults in our lives have to take care of themselves so that we can focus on our own health and the care of our children.

Avoid toxic people.

Toxic people leave you feeling drained and exhausted most times you see them. When we’re sick, we have less energy and less tolerance for people who are difficult in one way or another. Consider limiting (or eliminating) the time you spend with people like this while you’re battling breast cancer.

Don’t know how to do this? Here are some tips:

Let your calls go right into the answering machine. This allows you to decide if and when to return calls.

Communicate through e-mail. This also lets you control your communication. And just because someone calls you, there’s no reason that you can’t reply by e-mail if it’s easier for you.

Use a third party for communication. Ask a friend or family member to pick up the phone when they’re around. They can take a message or tell the caller that you’re not up to speaking with them. See “Working with Helpers.”

Be honest. It’s okay to tell friends and family that you don’t feel up to talking on the phone or visiting with them.

Don’t expect anything from people.

Having a serious illness creates many opportunities for us to be disappointed by others. To make matters worse, our feelings of helplessness and isolation can magnify these slights, whether they are real or imagined.

We might look around us and wonder, “Why didn’t Susan make a meal for me after my surgery? I always go out of my way for her” or “I can’t believe my aunt hasn’t called to see how I’m doing.”

Here are two things to keep in mind.

Discomfort with another’s illness can prevent people from taking any action.

Some people may wring their hands with worry over calling a sick person. They may be afraid of bothering the patient, and they might not know what to say. Others may be paralyzed with indecision as they try to find an appropriate card to send.

Just because someone doesn’t contact you doesn’t mean they don’t care. They may be thinking about you often but can’t take any action because they’re afraid or confused.

For every person that disappoints you, many more will surprise you with their kindness.

A neighbor that you don’t really know might drop off treats for your kids. Distant relatives might send a warm letter. A mom from your kids’ soccer team might make a meal for you. Try to focus on these unexpected kindnesses instead of speculating about others’ failure to act.

Remember that an individual’s reaction to your diagnosis is usually more about them than it is about you.

Why does a normally stoic friend burst into tears every time she sees you after your diagnosis? Why does your loving mother-in-law become chilly and non-communicative while you’re going through treatment? Why do your friends from church stop talking when you enter a room?

These reactions likely have nothing to do with you. They are probably expressions of people’s own concerns that are activated by your illness.

Your stoic friend may have lost an aunt from breast cancer and hasn’t gotten over it. Your mother-in-law might be distraught with anxiety about developing breast cancer herself. Perhaps the only way for her to manage this anxiety is to turn inward.

Others’ reactions to your experience are rooted in their own fears about and experience (or inexperience) with serious illness. It truly isn’t about you.

Maintain a sense of humor.

Humor is healing. Here are a few ways to tickle your funny bone while you’re sick.

  • Bring a joke book to chemo. It’s easy reading, and it will make you smile even when you don’t want to.
  • Don’t delete the silly e-mails people forward to you without reading them first. They might make you laugh.
  • Go to a comedy club.
  • Rent a comedy to watch at home. (See “Top 25 Comedies” at Netflix.com.)
  • Visit humor sites online.

The best way to keep a sense of humor is simply this: Try to see the humor and absurdity of what you’re going through.

Tip #6: Your Feelings Are Not Contagious

Moms who are struggling with breast cancer can easily forget that our feelings are just that-ours. You may feel anxious about starting chemo, but your children don’t have to. You might be afraid of surgery, but your kids don’t have to be.

One of the ways to ensure that your kids will not share your negative feelings is simply to realize that feelings don’t have to be contagious. Children are often a blank slate when it comes to cancer. They may know nothing about the disease, including the possibly that cancer can be fatal.

When you discuss your disease with your kids, don’t project your own fears. Be factual and neutral. Answer their questions in an age-appropriate manner, filtering emotions from the discussion. This will keep your own fears and anxiety from being contagious. (See “Communicating with Your Children“)

Tip #7: Restore Yourself: Mind, Body, and Spirit

Moms who take care of themselves have more energy for mothering. Breast cancer can be destructive to your mind, body, and spirit. That’s why it’s more important than ever to restore yourself, inside and out.

Physical Activity

Research shows that breast cancer patients who exercise are better able to manage the physical and mental effects of their illness. Some breast cancer patients find that treatment leaves them too weak for their regular exercise regimen. Consider walking, yoga, and swimming as gentle alternatives. (Check with your doctor before swimming if you are presently receiving therapy that suppresses your immune system. He may feel that swimming in a public pool puts you at risk for infection.)

Relaxation

Relaxation techniques help calm us from the inside out by reducing muscle tension and lowering our heart rate. Breathing, visualization, and progressive relaxation can be very effective. See Tips for Relaxation for detailed recommendations.

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