What if you can’t find the silver lining in your illness?
Five years after my cancer diagnosis, I’m struggling to feel grateful for the experience.
At the beginning of November, I celebrated the five-year anniversary of my breast cancer diagnosis. Theoretically, this should have been a joyous occasion. The last five years have brought me a host of gifts: Mercifully clear scans, the salve of distance, more precious time to watch my children grow. None of these things I take for granted.
But on the day itself, I felt a surprising mix of sadness and anger. Studies have repeatedly shown that gratitude is good for us, and yet, five years out from my illness, I still struggle to find the silver lining in it. Am I thankful to be alive? Unquestionably. Can I proclaim, like Lance Armstrong back when he was still a role model, that cancer “was the best thing that ever happened to me?” Not a chance.
It’s common for people who’ve been affected by serious illness to feel conflicted, said Meghan Beier, a psychologist who specialises in chronic illness at the Johns Hopkins University School of Medicine. “There can be this sense of, ‘I feel grateful that there’s treatment, but also I’m upset about how this has changed the trajectory of my life,’” she said. “Even if it brought some positive things, that change can still cause grief, frustration and sadness.”
While it’s a year-round sentiment, this maelstrom of emotions can be magnified around a holiday that focuses on giving thanks. Maybe it’s that cousin who asks over turkey what you’re grateful for or the tenth Instagram post from someone feeling “#blessed.” Maybe it’s that you can’t walk into Target without being bombarded with pillows, dish towels and paper plates emblazoned with messages of gratitude (and I walk into Target a lot).
It can be complicated to embrace thankfulness, but there are ways to do it on your own terms.
DON’T FORCE IT ON YOURSELF
Since being diagnosed with ovarian cancer in 2017, Deanna Corbin, 42, has tried to keep a gratitude journal, something research has shown can increase well-being. “But I feel like I’m just going through the motions,” said Corbin, an executive assistant in Pleasant Hill, Calif.
For people who have endured serious health issues, “count your blessings” can feel like part of the hospital discharge plan. “There is this sense that there’s a mandatory gratefulness that is supposed to come with illness,” said Meghan O’Rourke, 46, a writer in New Haven, Conn, whose book, the Invisible Kingdom, recounts her struggle with chronic illness.
But convincing yourself that you should feel grateful – or beating yourself up because you don’t – can make you feel worse.
“The most authentic thing you can do is to tell yourself, ‘I know this is a time for giving thanks, but I’m just not feeling it,’” said Ranak B Trivedi, a clinical health psychologist and health services researcher at Stanford University. “‘It doesn’t mean that I’m a flawed character. It just means that, right now, I’m grappling with a lot emotionally.’”
Convincing yourself that you should feel grateful – or beating yourself up because you don’t – can make you feel worse.
It’s just as crucial to acknowledge what you are feeling, whether it’s sadness, guilt or jealousy. (And that last one can be a doozy. The year I was diagnosed, I threw away every cheery holiday card the minute it arrived.) Research has shown that naming an emotion, then spending a few minutes thinking or writing down what triggered it, can have a positive impact on well being.
Sitting with that uncomfortable feeling may help you practice what O’Rourke calls “ugly gratitude” – the idea that even painful emotions can be a conduit for thankfulness. Recently, she watched a movie that made her sad, but also “gave me an outlet for this grief I was feeling that I couldn’t find one for. So there was gratitude that I could just sit and nurse that for a bit.”
Remember too that feelings can coexist. “A lot of times, people expect it to be one or the other – that you can only be grateful or feel grief,” Dr Beier said. But actually, “we can live with two truths that are seemingly opposed. We don’t have to dismiss the uncomfortable emotion.”
Now that she’s done with cancer treatment, Corbin said that people often expect her to have experienced some momentous epiphany. “They’ll say, ‘Wow, you must just look at life completely differently now.’” The fact that she mostly doesn’t, she said, “makes me feel almost guilty sometimes.”
In her book, O’Rourke examines “the wisdom narrative” – or as she puts it, society’s expectation that “if you must be ill, at least be improved by your illness.” People need to hear that someone has emerged from sickness with renewed perspective because sickness “is scary and terrifying, and so we want to find something redemptive in it.” But for those of us tasked with this emotional buttressing, it can feel contrived. “I sometimes feel I’m supposed to perform aspects of my illness, and one of the performances is gratitude,” she said.
There is evidence linking a positive attitude with health benefits like lower blood pressure, decreased heart disease and better weight control. But the relentless external pressure to find the bright side “can be quite alienating to some folks,” said Barry J Jacobs, a psychologist in Philadelphia who specialises in chronic illness and family caregiving. “If they don’t want to participate in it, they can feel judged, or that their point of view is not supported by the culture.”
While it’s imperative to admit your true feelings to yourself, Dr Trivedi stressed, it’s fine to deflect a little in front of someone else.
“If people say, ‘Oh, you must be so grateful for this or that,’ you can just say, ‘It’s definitely a season for giving thanks, isn’t it?’” she said.
Remember that positive and negative emotions don’t exist on a continuum.
LOOK ELSEWHERE FOR HINTS OF THE POSITIVE
Even if you’ve recovered, lingering side effects can make it difficult to do things that once brought you joy, so the list of things you’re grateful for can feel diminished. Dr Beier asks her patients to think about what was “meaningful and valuable to them before illness, then try to bring the core pieces of that back into their lives.”
If you miss running, for example, think about what you enjoyed about running – maybe it was being outside in nature, or being around other people who enjoy the same thing – and come up with activities you can still do that contain those elements.
Volunteering with an organisation connected to the illness you experienced can be rewarding; research has shown that donating time, energy and money can have a positive effect on well-being. But, said Dr Beier, there’s a caveat: “If our entire life becomes about the illness, that can be overwhelming. It’s great to get involved, but it’s also important to figure out what else is meaningful in your life that you can devote time and attention to.”
Remember that positive and negative emotions don’t exist on a continuum. “There’s this idea that if you get rid of a negative emotion, a positive one will automatically follow, but that’s not how it works,” said Dr Trivedi. “You have to intentionally work on increasing the positive.” And you can increase it in tiny ways that have nothing to do with your illness. “You don’t have to feel grateful for modern medicine if you don’t feel like it. But maybe you feel grateful because you looked outside and saw some amazing fall colors,” she said.
And so recently I’ve been trying to harness the peace that comes from doing that. I succumbed to Target’s seasonal merchandising and bought a small reusable whiteboard that says “today we are thankful for ____,” which I hung in the kitchen for anyone to fill out. I think I will frequently just write “my kids” and I think my kids will frequently just write “ice cream sandwiches.” But I also think that’s all right.
By Holly Burns © The New York Times Company
The article originally appeared in The New York Times.