In 1981 I received a shocking diagnosis: Due to an allergy to a medication, I was “burning from the inside out.” Unable to metabolize an antibiotic, my body forced it out through my skin. Almost overnight I became the equivalent of a full-body burn victim. Over a series of weeks in a quarantined hospital room, I lost 100% of my epidermis. By the time I was released I carried physical and emotional scars, plus an enormous fear of recurrence.
While we don’t often think about trauma in response to health-related issues, facing a life-threatening diagnosis, enduring treatment and living with the fear of recurrence can all be incredibly traumatic. In fact, in an article published in CURE Magazine (June, 2014) Lacey Marlow cites these facts relating to post-traumatic stress disorder (PTSD) in the cancer community:
- 3 to 4 percent of newly diagnosed, early-stage cancer patients
- up to 35 percent who have completed treatment
- those who experience some but not all of the symptoms range from 20 percent in people with early-stage cancer to 80 percent in those with recurrent cancer
Understanding the nature of trauma, its effects and treatment can play a huge role in how you access resilience both during and after cancer treatment.
How We Define Trauma
A universal base for defining trauma can be found in three experiences:
- Anything less than nourishing
- Overwhelms your ability to cope
- Changes your self-perception and place in the world
You are a unique individual, which means how you experience traumatic situations (and respond to them afterward) will be personal to you; the result of your history, personality, learned coping mechanisms, belief system and perspective. The director of an oncology center once told me, “Someone becomes a cancer survivor the minute they receive a diagnosis.” If that’s the case, then the trauma of cancer—how it depletes a body and soul, overwhelms a mind and emotion, and changes how you see yourself in the world at large—starts immediately.
How Trauma Changes You
The side effects of trauma can be swift and appear within a few days or weeks, or they can display in a delayed timeframe. They may present because of an ongoing traumatic situation or arise in response to a triggering event long after cancer treatment ends. Regardless of how or when symptoms reveal they happen in three areas that affect your physical, mental and emotional self.
Physiological response: Trauma activates your sympathetic nervous system responsible for survival. A flurry of chemical changes shift your body into “fight or flight”, a process that increases stress hormones that amp up your adrenal system and can lead to feelings of anxiety, fatigue, exhaustion, lack of concentration and muscle soreness.
Neurobiological response: The body’s survival response causes changes in brain structure and function. Most significantly, the amygdala (your brain’s threat detection center) becomes sensitized and overworked; the prefrontal cortex (responsible for executive decision-making) reduces functionality; and the hippocampus (responsible for memory consolidation) underfunctions which can lead to memory loss and disruption.
Psychological response: Even after the danger has passed your mind’s deep imprint of traumatic experiences can create emotional discomfort. Sensory information (what you see, feel, taste, smell and hear) may remind you of particularly traumatic moments or fears. Plus, lingering emotions including depression, grief, loss, confusion and anger are all normal post-trauma responses as is a feeling of disconnection from a sense of feeling good about what it means to be you.
Some survivors naturally process and release these changes over a period of time. For others symptoms become more long-term and can lead to a diagnosis of PTSD based on the presence of symptoms lasting longer than four weeks in the following categories:
- avoidance of all reminders of the trauma
- re-experiencing traumatic elements, i.e. intrusive thoughts, nightmares, flashbacks
- arousal, i.e. hyper-vigilance
- alterations in cognition and mood (especially related to exaggerated negative beliefs and reduced interaction in daily life)
(If you feel that you or someone you know may have symptoms of PTSD visit HealMyPTSD.com/symptoms for a self-test to begin your diagnostic process.)
Healing Comes From Action
Cancer quickly and radically changes who you are and how you envision yourself. This dramatic shift—the very essence of trauma—creates a broad variety of negative consequences that affect your professional and personal worlds. The key to reducing, reversing and eliminating these effects lies in designing a personalized program that feels comfortable in approach and process in three essential areas:
Professional help: Many survivors begin with traditional approaches, including talk therapy, cognitive behavior therapy, dialectical behavior therapy, acceptance and commitment therapy and psychoanalysis. Repetitive discussion about what happened in the past, however, can become triggering. Survivors often include alternative methods that can be more gentle, e.g. hypnosis, neuro-linguistic programming, Eye Movement Desensitization and Reprocessing, Emotional Freedom Technique, Somatic Experiencing and Thought Field Therapy.
Daily practices: Neurophysiological changes can be reversed through many processes designed to reduce stress hormones, engage the prefrontal cortex and increase a sense of calm, confidence, control and self-esteem (a major ingredient in resilience). Popular methods for this include breathwork, meditation, mindfulness and guided visualization.
Personal roadmap for success: Deliberately deciding what you value and the specific healing outcomes you desire sets the stage for success. Develop a process that allows you to clarify what you want, verify the importance of those outcomes, and strategize a recovery program that integrates who you are today with specific, identity-related qualities for whom you wish to become tomorrow.
Successful post-trauma recovery is about more than physical health. It’s about reconstructing what it means to be happy to be you in the body and life in which you’re engaged. You are not the person you used to be. You can’t go back to who you were “before.” However, you can move forward into The New You, a self who knows what it means to face fear, death and suffering and emerge with a desire not only for health but for a life worth living. Achieving that may mean that you redefine who you are today even while you love, honor and respect who you were yesterday.