Research has shown that there is a clear relationship between our thoughts, our feelings and our behaviour. We all have worrying or depressing thoughts - it is a normal part of having a human brain. Sometimes these thoughts can be useful, for example, if you had a job interview, it would be useful for your brain to have the worrying thought of “I might not get the job if I don’t prepare for it”. This would potentially lead you to spend some time reading about requirements of the job, which could be helpful. However, if we get trapped in a cycle of having lots of these worrying or depressing thoughts, and we are unable to take action to calm them, it can make us feel very depressed or anxious.
It is normal to feel worried or sad when confronted with a life-changing situation such as living with cancer. Research has shown that once we feel unhappy, we tend to view ourselves, others and the world in a more negative way.
It can be helpful to know about common patterns of thinking so that you are better able to recognise when you are beginning to get entangled in a downward spiral of worry and/or sadness. Some of the common thought patterns experienced by people with cancer include:
All or nothing thinking:
Viewing situations or events as either black or white. For example, having cancer that cannot be treated may result in beliefs of “I might as well give up if this can’t be cured”. In this case, the cancer is being viewed as either “curable or death”, whereas the reality might be months or years of remission.
You might select only parts of information which match your current beliefs or mood. For example, you might feel anxious when speaking to a member of your medical team about treatment. You might focus on information about how painful the treatment could be and pay less attention to the success rates.
Jumping to conclusions:
This involves making assumptions about the future e.g. “my first chemotherapy session was so tiring, this is how it is going to be for the rest of my treatment”. You might also try to mind-read what others are thinking (based upon their actions) to manage feelings of uncertainty. For example, you might infer that “the test results are bad” by a look from your nurse or consultant.
Some people may blame themselves for having cancer. For example, “I am being punished because of all the bad things I have done” or “I have cancer because I am a smoker/drinker”.
Assuming the worst outcome will happen and that it is out of your control. This pattern of thinking often includes thoughts of “what if?” e.g. “what if the cancer returns”, “what if I only have weeks to live?”.
The ‘shoulds’, ‘woulds’ and ‘coulds’:
This might include thoughts of “I should be able to go back to work after having treatment”, “I would have been able to look after my family if I didn’t have cancer” and “I could have done something to reduce the chances of me getting cancer”.
Unhelpful thoughts are tricky in the sense that they are often:
- Require little effort to pop into our head
- Can spiral out of control especially if we have few distractions
- Difficult to control
Managing Unhelpful Thoughts
Sometimes being aware that you are engaging in unhelpful thinking patterns can aid the process of adopting more helpful ways of thinking. Have another read of the common unhelpful thinking styles provided above – did any of them resonate with you?
We know that our brains are designed to make sense of problems, to understand the “why”, “what” and “how”, and to predict the worst. Trying to control negative thoughts or avoid them can sometimes strengthen this negative experience rather than diminish it. In other words, a thought can almost grow, the more you try to push it away.
Being mindful of your negative thoughts may allow you to make a skilful decision about how best to manage them in that moment. For example, when you notice that you are having a negative thought e.g. “the cancer might come back”, you can create a distance from the thought to help you to manage it. Strategies to help you do this may include:
- Writing your thoughts down on paper to help you view them in a way that is less emotionally intense and overwhelming.
- Telling yourself “I am having the thought that…” as a way to defuse from the thought.
- Look at the thought from a different perspective by asking yourself questions such as “what advice would I give a friend who was having this thought?”, “what is the evidence that this thought is true?”, “is it helpful for me to think in this way?”.
- Using mindfulness exercises to observe your thoughts and notice the feelings that they give rise to in your body. Click here
Neither of the strategies above is better than the other. Being mindful of your negative thoughts and aware of the fact that you have a choice for managing them, can in itself help you start to feel back in control.