BRiC's Collective Voice: Breast Cancer and Femininity, Sept. 15, 2019.

Our Sunday discussion focused on how our members manage to look and feel feminine during treatment, we shared tips on what works for us and discussed whether it is important to feel feminine during treatment.

For many of our members the first hit to their femininity is hair loss through chemotherapy. A sudden and complete hair-loss affects the way we view ourselves and how we perceive that others see us. Add to that, the probability that surgery will leave us disfigured to a greater or lesser extent, then it is not surprising that we feel less feminine, less attractive and less confident.

Many members said they feel glamorous in their wigs, wearing styles that they would not have contemplated before, others hate their wigs and prefer hats, scarves and buffs, others choose the bald-and-beautiful look, embracing the liberating feeling it brings. But for every member who finds joy and confidence in their wig or hat, there are many more who feel the loss of hair affects them deeply and their confidence has taken a huge hit.

Lots of our members shared tips around using make-up, bright colours, lovely lipsticks and jewellery to boost confidence during treatment. Those who had attended a Look Good Feel Better course, or similar events, said they enjoyed the tips, such as how to draw on eyebrows. Others suggested using positive affirmations, looking in the mirror and seeing your own beauty; remembering to smile was a popular tip. One member said her method was to simply put her head down and power through, there is time enough to worry about our femininity after treatment.

Our private group has members with both primary and secondary breast cancer and for those with a secondary diagnosis the effects of ongoing treatment can mean their sense of femininity is hit even harder. They may be facing a constant battle with side effects: hair loss or thinning, weight gain, pain and bloating, were just some of those mentioned. For all our members the general tiredness adds to the struggle. Lots of us want to feel “normal” more than to feel feminine; something made difficult by the side effects of the drugs. Weight gain, premature menopause, loss of libido and loss of confidence affect almost all of us to some degree. For those of us in a relationship, having a supportive partner can be a boost to our confidence, although some members confessed to a feeling of disbelief when their partner tells them they are beautiful. Those who are single often worry about how potential partners might see us in our new, less feminine state.

Some of us who weren’t “girly girls” before cancer found the urge to enjoy what was left of their femininity, things that weren’t important before became a high priority, our hairdresser often became our new best friend. Keeping up with our routine helped many members, having a manicure, wearing make-up, buying nice clothes and getting dressed up helped to maintain that sense of self. For others it was a relief to be able to let those things slide and enjoy just being ourselves with no concern about how we looked.

We wondered if the pressure to feel feminine could be counterproductive. Side effects can be a long-term thing, is it feasible to keep on putting that pressure on ourselves to look and feel feminine when we are exhausted from the effort? One solution might be to find a way to be kind to ourselves rather than concentrating on how feminine we feel. Others thought that focusing on our femininity helps us to tolerate the treatment and its effects.

If you are a woman in the UK with a breast cancer diagnosis and would like to join our private group, please add your name into the comments or send us a private message and we will get in touch with you.

BRiC's Collective Voice: Coping with Grief and Loss; Sept. 6, 2019

This week, our Sunday discussion focused on our personal experiences of grief and loss. Our members dug deep and gave us some heartbreaking personal stories. How resilient we all are, and how supportive we all are of each other in our sorrow.

If you are a woman living in the UK with a breast cancer diagnosis and you would like to join our private group, please leave your name in the comments or send us a private message.

BRiC's Collective Voice: Complementary Therapies and Resilience; Aug. 28, 2019.

'It’s not necessarily about being pampered, although this can feel good, it’s more about the support and kindness of another human being.'

Our discussion topic focussed on complementary therapies and their effectiveness in helping us to build our resilience following a breast cancer diagnosis. Our members have tried counselling, mindfulness, CBT, acupuncture, meditation, reflexology, Reiki, tai chi, hypnotherapy and so on. A good therapist will listen to how we feel and offer appropriate therapies to suit our needs. Some therapies offer a quick fix, perhaps feeling more relaxed or targetting something specific like acupuncture for hot flushes. Others may take time to be effective, such as counselling, and things may get worse before a positive effect is seen.

Getting the timing right when trying a longer term therapy such as counselling is key, as acting too soon after diagnosis may result in a negative experience which may be off-putting for later when the talking therapy may be more useful. The trauma of a breast cancer diagnosis may take some time to process, and trying to crystalise our feelings may be harmful if taken on at a time when numbness is a useful self-protection mechanism. A good therapist will help us to make the right judgement at the right time.

Self-awareness can be profoundly liberating when achieved via counselling, CBT, psychotherapy or other kind of talking therapy, but it can also be very challenging work. We have to be ready to face our fears, to dig deep inside and look at what we have been through, what it means to us, now and in the future.

Our members have all had a primary diagnosis of breast cancer and many are living with a secondary diagnosis. Many reported finding the relaxation therapies very helpful both during and just after treatment, Reiki and reflexology proving very popular. Many cancer hospitals and centres offer these types of therapies to cancer patients free of charge and many of our members took advantage of this. Massage is also very relaxing, but many beauty salons and spas won’t offer massage to people who’ve had cancer without a letter from a GP or other medical professional, so it’s worth being aware of this when inquiring.

Sound therapy has been tried by a few of us and has helped considerably with fatigue. Herbal remedies have been used alongside our traditional medication to enhance healing and wellbeing and to counteract the side effects of our post-cancer medicines.

Some of us have shied away from complementary therapies, perhaps seeing themselves as someone who ‘just wants to get on with it.’ Personal wellbeing practices such as meditation and journalling are helpful. Others have taken a ‘bury my head in the sand’ approach, believing they don’t need or wouldn’t benefit from additional help. Calming meditative activities such as crochet, knitting and sewing are popular, providing both focus and distraction. Some of us feel that exercise is our therapy, we run or practice yoga or walk in nature.

Some of us are unclear on what therapies might be available and whether we have access to them as cancer patients. Many centres continue to support patients for up to 5 years after diagnosis, and those with a secondary diagnosis may find they have open access to their local centre. However some centres only actively offer complementary therapies during and just after treatment and this may not suit us, particularly if we are working as much as we can through treatment. Therapies offered vary considerably by region, and sometimes we may decide to find our own private therapists. It is key to trust the therapist and believe in the treatments undertaken. For some of us, we want to go to therapists who have been through cancer themselves, and/or have had specialist training in working with cancer patients.

Counselling is generally offered as a series of six sessions which may not be long enough to be fully effective, and as private counselling is expensive this can be a problem. Scratching the surface and opening up deep wounds but not following them through may leave issues unresolved once the counselling stops. Some of us have had unpleasant experiences with therapies, and it’s worth taking the time to find the right one at the right time, and to check qualifications of the therapist.

As a group we believe that psychological help should be part of the package of treatment following a cancer diagnosis, with much better information about how to access complementary therapies and what they can do for us. Counselling can be helpful even many years after diagnosis, and relaxation therapies provide an ongoing support for wellbeing whatever stage we are at. Self-care is so important following a cancer diagnosis and many of the relaxing therapies give us time and space to focus on our wellbeing, to feel cared for. It’s not necessarily about being pampered, although this can feel good, it’s more about the support and kindness of another human being.

If you are a woman living in the UK with a breast cancer diagnosis and you would like to join our private group, please leave your name in the comments or send us a private message.

Why some emotions are harder to experience after Breast cancer Diagnosis

'The uncertainty we are left with, the ambiguity we are trying to process, the side effects we have to deal with and the positivity we need to live up to. There is so much going on.'

Why are some emotions harder to experience after a breast cancer diagnosis, and others easier? Does it have something to do with protecting us from emotional distress?

As you might expect from a group of women who have all had a breast cancer diagnosis, some primary and some secondary, we all find intense emotion triggered by hearing about cancer, reading about cancer, talking about cancer, even adverts about cancer on tv. What surprises us, sometimes, is the unexpected rush of head-on emotion that we are confronted with, often when we are in situations which make it difficult to deal with. Some of us described having to withdraw from situations or conversations in order to take a few deep breaths to stabilise ourselves, to manage the threatening panic that wells up inside us. Our post-cancer brain is on high alert and wants us to run away from anything cancer related, flight being preferable to fight in social situations where we need to maintain our decorum.

The trauma that is caused by a breast cancer diagnosis weighs heavily on the brain. We want to make sense of what we’ve been through, we want to come to terms with it and its impact, but sometimes our need to process what’s happened is just too much for us to cope with in the moment. At these times, our brains will simply shut off the experience and we find ourselves numb and dissociated, distanced from our own suffering in order to allow our broken brain to deal with whatever is in front of us. Our fear is so intense that the brain builds a wall which is a barrier to our emotions. Sometimes we break through the wall, and as time goes on we may find emotions hit us like a train, causing upset that demands we plug the hole in the barrier and leave the emotions firmly shut away from view. As a result we may find ourselves living with conflict and contradictions in our own head, wanting to understand, accept and even make friends with our experience, yet being unable to face the fear which threatens to overwhelm us. Our feelings may become out of synch with our current experience, with sadness flowing over us when we are in beautiful surroundings or living with continuous low level anxiety.

Our members described a huge raft of different emotions which we struggle with, not least anger which sits alongside the cry of why me? Why can’t I move on? Guilt at surviving, guilt at the pain our cancer causes others. We are angry that we didn’t get the support we expected and needed during treatment, that we are not getting the support we need now. We are angry that our bodies let us down.

Self-awareness is strong for our members, many of us having worked with counsellors and psychotherapists in order to process our experience of breast cancer. However, self-awareness may not be enough as our brains will act to protect us without us knowing and this can cause confusion and can lead to depression. A downward spiral of feelings we can’t own or process that overtakes any rationality, with fear dominating our waking thoughts. Our fear may lead us to disengage from anything that forces us to feel strong emotion and we find ourselves living at arm’s length from our feelings and distancing ourselves from life rather than immersing ourselves. Some of us reported evaluating our emotional experience rather than allowing the emotion just to be there. Living in black and white rather than in colour.

There is an external pressure to put on a brave face, to be positive, all the time. However many of us don’t feel positive about our cancer, although we can be positive about the day to day of our lives. The uncertainty we are left with, the ambiguity we are trying to process, the side effects we have to deal with and the positivity we need to live up to. There is so much going on. On the outside, we are smiling, positive, in control. On the inside, we may be isolated, lonely, terrified, sad.

We may be at our most vulnerable at the end of treatment for primary breast cancer. The chemotherapy, surgery, radiotherapy is finished. We are sent away, possibly with a packet of pills depending on what type of cancer we have, to get on with it. The structure provided by appointments is gone. Now we have time to think, time to process what we’ve just been through. Our emotions are heightened, just as everyone around us is congratulating us for being brave, lucky, strong (and all the other platitudes) and aren’t we glad we can get back to normal life now? It’s very common for depression to hit us like a stone and we may feel totally bewildered. We may find it hard to sit and think about our cancer, as thinking about it makes it real, and while we were on the treatment rollercoaster we didn’t have to acknowledge it was happening to us, we were just doing as we were told, not feeling very much at all, we were too busy.

Many members commented on how useful it is to have the safe space that is our private group where we can tell it like it is with no fear of upsetting anyone. We all want to protect our loved ones from how we really feel, we don’t want them to be feeling our fear. In time, many of us are coming to terms with what has happened to our bodies and the mental scars left behind. As one member put it: we move on to find joy in the simpler things despite being quick to anger. The depth of our emotion means we can move from elation to sadness in a heartbeat, holding both together with our fragility.

We may be broken, but we are here. 

BRiC's Collective Voice: Crying: It's benefits; 28 Aug. 2019

'Perhaps crying is like a muscle, it needs to be exercised regularly in order that we can regulate it. Tears have a job to do, and serve a purpose.'

According to wikipedia, crying is the shedding of tears...in response to an emotional state, pain or a physical irritation in the eye. How often we refer to crying as having something in my eye, to explain it away, make light of it. Crying is as natural as laughing, but it’s seen as inappropriate to cry in many situations, and so we hold our tears in and put on our brave smiling face.

Our discussion on crying showed that within our group we have some women who cry at the drop of a hat, and others who never cry. Some of us would like to cry a little less easily, others would give anything for a good cry. For all of us, we worry that once we start to cry, we won’t be able to stop. Crying is a natural healthy way to release emotion, and can help us to get rid of emotion that we can’t label or talk about. A good cry can help us to feel lighter, relaxed and relieved.

Many of us have been brought up to hide our tears, believing it to be a sign of weakness. We save our tears for when we are alone.

Naz told us that there is some evidence that after a good cry we are better able to cope with stress. This indicates that it is good for us to cry when we feel overwhelmed. Many find that bottled up tears will escape at some point, perhaps when we at last have time to relax, away from our busy lives, or when our tears are triggered by something beautiful or poignant.

Our members, all of whom have a diagnosis of breast cancer, some primary and some secondary, reported many different experiences of crying. Some of us report feeling numb, unable to feel, unable to cry, perhaps because the pain of crying is too much to bear. Crying requires a letting go that feels impossible to face, but if we do, we may find that the very act of crying can bring us closer to our feelings, and by allowing ourselves to feel, we build the resilience we need to help us to move forward through ongoing difficulties.

Some of us noted that tears of joy and pride are frequent, perhaps because we become more appreciative and grateful after a breast cancer diagnosis. A bout of crying may start from something trivial - a tv advert, a newspaper article, something quite distant that resonates with us - but then our tears turn inwards and we find ourselves crying our hearts out, letting go of complicated emotions that we can’t even put names to.

Many of us push back tears, finding them intrusive and feeling that we don’t have time to cry. Some of us are afraid to cry, afraid to unleash our emotions. We may find crying depletes us of energy so we hold on to tears for fear of exhaustion. Some of us are ok with crying, but we don’t like it when tears catch us by surprise and we don’t know why we are crying. This can lead to a feeling of helplessness, that we are out of control and our tears are controlling us.

The shower is a common place for us to shed tears, getting rid of some of our emotion before we start our day. Our tears mix with the water as we cleanse our bodies and our feelings. Many of us find this a helpful way to start our day. Perhaps crying is like a muscle, it needs to be exercised regularly in order that we can regulate it. Tears have a job to do, and serve a purpose. And although many of us worry that once we start crying we won’t be able to stop, we do stop as our bodies have a way of ensuring we continue to breathe.

For those of us who can’t cry, Naz reassured us that it’s ok, it’s a normal reaction to trauma or grief. Learning to sit with our feelings is very hard, and can be helped by practising deep breathing, just sitting still and breathing in and out. Some of us did report a long period of not crying which ended with a surprising trigger and a good long cry.

Dry eyes can be a side effect of our medication and for those suffering, crying can actually hurt, which is a cruel contradiction for those seeking the relief that crying can bring.

We would like it to be ok to cry, for people to be able to sit with us while we cry and not be embarrassed or feel they have to put an arm around us. Counsellors are taught this and can be good at sitting with us while we cry. Lots of us keep our tears for when we are on our own, not wanting our loved ones to see us as weak.

Whether we love a good cry or find ourselves holding back the tears, our crying is part of our healing, part of our emotional release, part of our vulnerability and part of building our resilience.

If you are a woman living in the UK with a breast cancer diagnosis and you would like to join our private group, please leave your name in the comments or send us a private message.

BRiC's Collective Voice. Mindfulness: Its benefits and drawbacks. Aug. 2, 2019

‘Many reported finding mindfulness helpful during periods of relative calm in their lives, but found it too hard to do when very stressed or sad.’

This week we discussed mindfulness, its benefits and drawbacks.

So what is mindfulness? Here is one dictionary definition:

‘a mental state achieved by focusing one's awareness on the present moment, while calmly acknowledging and accepting one's feelings, thoughts, and bodily sensations, used as a therapeutic technique.’

Mindfulness has become a fashionable panacea for all trauma and distress, the modern antidote to frantic living. Courses are available in abundance, and it’s commonly taught in the workplace and even in schools. There is little research on how it actually works on the brain, and feedback is mixed on its efficacy, with some reports even finding it to be the opposite of helpful. Mindfulness is prevalent in the buddhist tradition and can include meditation and prayer. Some studies show it improves concentration, can help with a good night’s sleep, enhances quality of life.

Many of our women, all of whom have had a breast cancer diagnosis, some primary, some secondary, have found mindfulness very useful. It can be calming in stressful situations to breathe deeply and simply focus on the self or on our surroundings. However, focusing on our emotions can bring up all sorts of negativity and as a result, far from calming the mind, it can cause panic or upset. Accepting a flood of emotion in the moment, when what we are seeking is distraction from a difficult current situation, can be frightening. The idea that with practice we can actually control our thoughts and feelings is perhaps an attractive one, but it is difficult to master, and even more difficult to put into practice when most needed.

The link between body and mind is also the subject of much research, and it is undisputed that relaxing the body via breathing exercises can calm the mind. The vagus nerve is affected by controlled deep breathing and this has been shown to improve equilibrium. Acceptance is what mindfulness teaches, acceptance that the present moment is as it is, and that we are safe in that moment, despite what is going on inside us and outside us. It’s not resignation, a giving in type of acceptance, it’s an empowering peaceful way of keeping ourselves grounded. As one of our members put it, ‘(there are) subtle and not so subtle feelings that can emerge when we are focusing, and how in riding the waves of those feelings, we can drift safely back to shore.’

Visualising a calming scene when we’re feeling anxious can be a useful form of mindfulness - imagining being on a beach with the waves lapping against the shore can be helpful in counteracting the stress of a medical scan, for example.

Our women described many different ways of using mindfulness. Some of us have attended formal courses, some have used online apps, some have read books, some are self-taught. Some are using breathing techniques for relaxation without knowing much about mindfulness, others have taken elements of what we’ve learned, perhaps meditation or a body scan, and we use these to help them to calm our racing brains. Others have picked up on techniques of mindful eating and use these to address healthy eating issues. Yoga may be seen as a moving form of mindfulness, focusing as it does on proper breathing and fusing body and mind in relaxing movement.

Many of us probably practice a form of mindfulness unknowingly. Any focussed task that takes concentration can be done mindfully, and in a way that brings calm and relaxation. Crochet and knitting are a great example. This type of craft is both a distraction and a mindful activity, repetitive and calming.

For deep-seated trauma, such as may be caused by a breast cancer diagnosis, mindfulness may not be the right ‘therapy’ to address the issues. For some, mindfulness brings on sadness and panic, and this is a common reaction and often seen as failure. However this is perfectly normal and just means that mindfulness doesn’t suit everyone. It’s become so prevalent, everyone seems to be doing it. Mindfulness uses bodily sensations to connect to the present, through breathing or observing sensations in the body, and for those in pain or with scars and ‘broken bodies’ this means facing our trauma head on, which is just too much for many. Many reported finding mindfulness helpful during periods of relative calm in their lives, but found it too hard to do when very stressed or sad, for instance following a bereavement.

Perhaps instead of practising mindfulness we could consider slowing down our pace of life, so that we are naturally mindful of our own needs, the needs of others. For those with secondary breast cancer, this slowing down may be enforced by health needs, and for some it reveals a different way of living, a more mindful way of being. Would we actually be better off spending time with a good friend, really connecting, really listening to what’s going on in their lives, as opposed to taking time out alone to focus on ourselves? There is a lot to be said for mindful living.

Mindfulness has found a place in our world and its popularity speaks for its efficacy. However, it doesn’t take the place of talking therapies for deep issues and post traumatic stress disorder (PTSD.) Perhaps the best use of it is to find what works for you and practice that.

If you are a woman living in the UK with a breast cancer diagnosis and you would like to join our private group, please leave your name in the comments or send us a private message.

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BRiC's Collective Voice: Moving forward

'Most of all we want to spend time with the people we love.'

A breast cancer diagnosis can be traumatic and leave us at one extreme numb, or at the other, overwhelmed by our emotion. A diagnosis of secondary breast cancer even more so. This week our discussion focused on what we have found helpful in moving forward: things we have done, things we have changed.

Moving forward, for those of us with secondary breast cancer, means living with cancer on a day to day basis, knowing that treatment will be ongoing.  For those recovering from a primary diagnosis, it's about gaining physical and mental strength with which to live our best lives alongside the ever present fear that our cancer will spread or recur.  

Our women have found many things helpful, both practical and attitudinal.  After the shattered self-confidence which accompanies harsh treatment, learning self-respect, to value ourselves, damaged as we may be, is key. We find that practising self-compassion is vital, as we try to look after ourselves well, allowing ourselves little breaks, treats, gifts to ourselves. We give ourselves a symbolic hug regularly by spoiling ourselves, just a little bit. 

Exercise is very important for all of us. For some, this is a few stretches following surgery, a totter round the house, a gentle stroll up the road. For others, it's a run, a climb, a hike, a physical challenge that says to the world, here I am, look, I can still cut it! Despite cancer, despite extreme fatigue, medication side effects, I'm here, moving to the very best of my ability, even if it isn't as much as I could do before. 

We pay attention to our diet, drinking more water, eating well. This helps us physically and mentally with mood stability.

We are more accepting, less questioning. We see the bigger picture, we no longer sweat the small stuff, although it's the small stuff for which we are hugely grateful and our awareness of that increases. We notice more. We are open and determined and we do things our way, less affected by what others think. 

For some, setting personal goals and challenges is key to moving forward, this allows us to push forward, to help design our own futures. It's the challenge that is the triumph, not the outcome. If we make up our minds not to be limited, we can stretch ourselves a little further each day.  

For others, slowing down and being less busy is what helps us move towards an inner peace, using perhaps meditation or writing, making choices which allow us to experience life in a more reflective way.

We learn that stress may be self-imposed and we learn to say no, we learn not to worry about things we can't influence. We are more relaxed about what we can and can't do and can let go of getting it all done straight away, allowing things to wait and knowing that we've done our best, that it's good enough.

Some of us have tidied up our lives, de cluttering our homes alongside our lives. We want our surroundings to support us not hinder us. We tidy up our friends list too, seeing more of the people who support us and make us feel good. 

For those of us with secondary breast cancer, there may be an intense desire to re-prioritise and doing what we want to do with our lives becomes more urgent. These may be big things like travelling, getting married.  Most of all we want to spend time with the people we love. 

Others may say to us 'Live every day like it's your last' and some of us want to to tick off bucket list items and off we go, cramming it in and making as many memories as we can. For others, it's a gentler approach, perhaps involving living a life much the same as prior to diagnosis, thinking about careers, studying, always having a self improvement goal to reach for. We might change our jobs, reinvent ourselves in new careers which may be more challenging or perhaps less demanding. We might retire, go part-time. We might find a creative outlet or take up voluntary work. We might get a pet or take up a new hobby.   It's about finding a balance, really understanding what we want from life, and making it happen. It's about changing the things we can change rather than wasting energy on the things we can't change. 

Many women talked about how hard it it to make the adjustments needed to move on, whether that's after primary treatment or following a secondary diagnosis.  One thing is clear, with support our members are all making progress, and we are dedicated to helping one another build the resilience needed not only to cope, but to thrive.

If you are a woman living in the UK with a breast cancer diagnosis and you would like to join our private group, please send us a private message via the public Facebook page.