Emotional wellbeing 

It’s normal to feel a range of emotions when you or a loved one are diagnosed with cancer.

What is emotional wellbeing (psychological) prehabilitation?

The aim is to enhance your resilience, coping strategies and overall well-being. This can improve your ability to tolerate and respond to the challenges associated with cancer treatment.

How can cancer affect my emotional wellbeing?

As well as the physical effects of cancer, a diagnosis can have an impact on many areas of your life, including:

  • relationships
  • employment
  • mood
  • sense of identity
  • plans for the future
  • body image
  • fertility and sexual health.

What areas can emotional wellbeing (psychological) prehabilitation help me?

Psychoeducation

Understanding the potential emotional and psychological aspects of cancer treatment and available support resources can help you feel more prepared to
manage your cancer treatment.

Neuroscience research has shown that we have 3 main emotional systems. These are the:

  • threat system
  • drive system
  • soothe system.

Each of these systems have evolved to keep us safe, react to challenges, and maintain a sense of overall wellbeing. They work best when there are short-term threats or goals to manage or achieve.

When we spend too much time in one or two of these systems, it can be more difficult to maintain a sense of psychological wellbeing.

What is the threat system?

It’s associated with our fight or flight reaction to unpleasant situations. But when a threat covers a longer period, like when we or a loved one has received a cancer diagnosis, it can be unhelpful and exhausting to spend too much time in the threat system.

This can lead us to feel burnt out, anxious, despairing, and can make it more difficult for our bodies to rest and heal. You’ll notice that you’re spending a lot of time in the threat system by the physical reaction it can cause. This includes an increased heart rate, loss of appetite, disrupted sleep, and generally feeling stressed.

What is the drive system?

The drive system is associated with focused and motivated pursuit of a specific goal.

This system most likely evolved to help our ancestors commit to pursuing goals such as tracking or hunting prey or securing a mate. In the context of a cancer diagnosis, the drive system may be most active when focusing on engaging with treatment and reaching a specific goal such as the end of a treatment cycle.

As with all three systems, the drive system can help us to achieve our goals. But spending too much time in the drive system can become exhausting and unhelpful. A diagnosis of cancer can get in the way of our goals and achievements.

The soothe system

It’s associated with our need for ‘rest and digest.’ In evolutionary terms, after we’ve tracked and hunted our prey (drive system) and defended ourselves from predators (threat system), we revert to our soothing system to allow our bodies and minds to recover.

The soothe system is also associated with feeling safe, relaxed, and connected to our support networks. It’s the most healing of the three emotional systems. But it’s the one that people generally find the most difficult to access.

One of the easiest ways of moving between the three emotional systems is to engage with activities that elicit feelings associated with each system. For example,
if you spend too much time in the threat system, find activities that help you to feel more focused (drive system) or calmer and more content (soothe system).

It might be helpful to think about the last time you felt calm and content and ask yourself how you can recreate that now. It can be difficult to move from one emotional system to another, especially when you or a loved one has been diagnosed with cancer. It may take some time and practice and for you to find what works best.

Strategies to engage your soothing system

When you or someone you care about gets a diagnosis of cancer, it’s understandably a very stressful time. It can cause us to spend a lot of time in the threat system.

Here are some ideas to engage your soothe system

Relaxation and mindfulness-based techniques

They can help manage stress, anxiety, negative thought patterns, and access the soothe system. This can help you to feel calmer, better able to face
challenges and make informed decisions.

Some people find it helpful to notice their senses when they’re feeling stressed and spending too much time in their threat system.

Try the exercise below. Take moment to notice things that you can see, touch, hear, smell, and taste around you. Notice how you feel before and after this exercise.

5-4-3-2-1 grounding technique

Acknowledge:

  • 5 things around you that you can see
  • 4 things around you that you can touch
  • 3 things around you that you can hear
  • 2 things around you that you can smell
  • 1 thing around you that you can taste.

For longer-term stress management, you might find guided mindfulness meditations helpful for managing stress and accessing your soothe system.

Connecting with your support network

We encourage you to build and strengthen your social support networks, which may include family, friends, and support groups. This may feel more difficult when you or a loved one gets a diagnosis of cancer. But finding ways to strengthen your support network can be helpful in accessing our soothe system, maintain wellbeing, and cultivate hope.

Many people find it helpful to connect to others who have also received a diagnosis of cancer through support groups. The Bucks Cancer Information and Wellbeing
Service can help you find groups locally.

Goal setting and fatigue management

We encourage you to set realistic goals and develop strategies for maintaining engagement in meaningful activities during and after treatment.

This can be helpful for managing wellbeing following a cancer diagnosis and during treatment. But it’s important to set realistic goals and understand that you may not be able to do as much as you’d like to or as much as you used to, especially during treatment. It’s common for people to overdo it and try to get back to ‘normal’ as quickly as possible.

This often leads to a ‘boom and bust/crash’ cycle which can make recovery more difficult.

Watch the video below about cancer related fatigue.

It might be helpful to think about what you find most meaningful about an activity. See if you can access that activity in a different way if you can’t engage in it as you want to. For example, for someone who enjoyed playing football but finds it too physically demanding whilst undergoing treatment might still enjoy the sport as a spectator.

Be kind to yourself

One of the most important things to keep in mind is to be kind to yourself, especially when you find it difficult to do as much as you want. It’s common to find
that many things that you did automatically become more difficult after a cancer diagnosis and during treatment. Don’t overdo it and allow yourself the necessary time to recover between activities.

In the same way as if you had a broken leg, you wouldn’t try to run a marathon until it healed.

Accessing further support

Knowing how to access further support can be helpful when you want to address specific concerns. This can include:

  • adjusting to your diagnosis
  • difficulties during treatment
  • fear of recurrence
  • body image issues
  • sexual health concerns
  • understanding the impact cancer has had on your life.

For psychological support about your diagnosis, ask a member of our healthcare team for more information.

You can also self-refer to Bucks Talking Therapies for those experiencing anxiety and depression in relation to their cancer.

Our Cancer Information Team can provide information on local support groups and activities for those affected by cancer.

Useful links

Guided mindfulness meditations

Insight timer (app available on Apple and Android)

Advice on how to talk to people about a cancer diagnosis

Book recommendations

  • Living your life through Cancer through Acceptance and Commitment Therapy: Flying over Thunderstorms (Anne Johnson, Claire Delduca & Reg Morris).
  • The Cancer Guide: How to nuture wellbeing through and beyond a cancer diagnosis (Professor Anne-Marie O’Dwyer).
  • Facing the Storm: Using CBT, mindfulness and acceptance to build resilience when your world’s falling apart (Ray Owen).
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