This feature by Elizabeth Cohn Stuntz, LCSW and Ronda Oswalt Reitz, PhD is Part 1 of 2 in a piece about how the application of DBT Skills can help patients cope with cancer. In this first part, Ronda and Elizabeth examine the impact of balancing the challenges of dealing with cancer as well as the first two tools that may be of assistance to cancer patients.
The words, “You’ve got cancer” struck Maria like a lightning bolt out of the blue. “How could this happen to me? Did my whole world just change?” Feeling like she was on an emotional roller coaster, she first felt angry, then teary and sad. “Is it really possible that I might not live as long as I hoped?” In the middle of that night, she felt frightened and anxious. Dare she be hopeful? Next came the self-criticism. “What’s the matter with me? I should just be calmer, braver and more positive. I am so overwhelmed.” All the new medical information seemed so complicated. “I can’t even think clearly. How am I going to make so many big decisions?”
And then came more questions. Maria was unsure who to tell and in how much detail. She wondered who or what could she rely on for understanding or support. How would cancer affect her relationships? Could she spare her family the stress and worry? What if she couldn’t carry out the same responsibilities as usual? Would people at work be supportive? Did she trust her doctor? Should she get another opinion?
Patients and those around them (even providers) can be thrown off balance by the challenges of dealing with cancer. While Maria can’t change the cards she’s been dealt, DBT offers effective ways to play them.
Marsha Linehan, developer of DBT, collaborated with her Zen student, cancer survivor Elizabeth Cohn Stuntz, to offer skills for dealing with cancer. Coping with Cancer: DBT Skills to Manage Emotions and Balance Uncertainty with Hope shares effective ways to manage the strong emotions that can come with cancer, find the clarity to make constructive decisions, communicate in personal and professional relationships, and find ways to connect to sources of deeper meaning and comfort. Stories of people facing cancer exemplify ways to use the skills and let readers see they are not alone.
While everyone responds uniquely, others share many of Maria’s concerns. It is natural that fear and anxiety may come up if there is a threat to one’s life. It makes sense that someone might be sad if they believe they may not be able to continue to live in the same way. It is understandable to be frustrated or irritated if health compromises cherished activities or if one is in pain.
While Maria and others may try to avoid these emotions, doing so may only intensify the feelings that can also offer valuable messages. Fear and anxiety may signal a need to get medical help. Anger can motivate speaking up for what we need. Sadness may encourage her to reach out for support. Indeed, it’s possible to learn how to both allow these feelings and to dial them down when they are stronger than is useful.
Having tools to manage what is happening can help Maria and those around her feel less helpless and have more faith in their ability to cope. For instance, recognizing and accessing one’s own capacity for wise mind strengthens confidence in making decisions. Mindfulness skills help people to more fully take in what’s happened and inform effective decision making. People can feel more in control when they know strategies to physically promote calm with longer exhales, progressive muscle relaxation, and physical touch. It can be very valuable to know ways to regulate emotions that are more intense than is useful. “Name it to tame it” reflects the neuroscience finding that identifying emotions calms the central nervous system. Indeed, cancer patients who could understand, categorize and label their emotions showed improved coping as well as other health benefits.
Read here for part 2 of this piece, in which Ronda and Elizabeth share several more DBT skills that can support patients coping with cancer.
Ronda Oswalt Reitz, PhD is the Coordinator for Dialectical Behavior Therapy (DBT) services for the Missouri Department of Mental Health. In this role, she is charged with the implementation, support, and evaluation of DBT programming in public mental health settings statewide. Read her full bio here.
Elizabeth Cohn Stuntz, LCSW is a cancer survivor and a student of Zen. She is also a psychotherapist practicing from contemporary psychoanalytic and Dialectical Behavior Therapy (DBT) perspectives. She serves on the faculty of Westchester Center for Psychoanalysis and Psychotherapy. After many years of providing social and emotional services for people with cancer and their loved ones, Stuntz partnered with Marsha Linehan (developer of DBT) to create a program of coping skills. They are the co-authors of Coping with Cancer: DBT Skills to Manage Your Emotions and Balance Uncertainty with Hope. Read more of her bio here.