How to Understand the Intricacies Of Anxiety and Overcome Self Doubt: Dr. Marianna Strongin Addresses These Topics and More In 'Strong In Cancer'

I am 51 years old, and I was diagnosed with stage 3 colon cancer. I had the fastest metabolism growing up, and I was able to eat whatever I want and not worry about gaining weight. As I got older, my metabolism started to slow down but my eating and exercise (lack thereof) habits did not change. It took me a long time to realize how bad my health was and, unfortunately, it clicked when I was diagnosed. I have this immense amount of hate for myself. I have a grueling treatment process I'm about to undergo, and I feel like I deserve it. I didn't take care of myself, so I should suffer the consequences. 

Dr. Strongin: When faced with difficult life scenarios we often resort to cause and effect thinking. Reasoning through cause and effect can provide a way to cope with feelings of powerlessness. However, when our cause and effect thinking is solely focused on the past it can create a confluence of negative feelings.  In your scenario, this perspective is only causing you to blame yourself and even further disconnect your mind from your body. Instead, I would like for you to use this thinking to only focus on the present and future. Therefore, it would sound like, “If I listen to my body throughout treatment, I will have a better outcome.” In directing these thoughts in a forward momentum, your thinking should lead you to feel motivated, connected and hopeful.

It sounds like the disconnect between your mind and body may have started when your body changed- you went from being able to eat anything you want to being impacted by your diet and lifestyle. Perhaps there was a part of you that instituted an avoidance tactic when navigating your physical health.  However, rather than blaming yourself for the past it's critical that you move away from such thinking in order to reconnect with your body now. This way, you can begin coaching yourself through the treatment process and focusing on the present.

I always advise my patients to navigate the past with the intention of change for the future. Since you seem to be focused on the past, let’s make sure that we explore the past with forgiveness and grace and change our tendencies, defenses and even blind spots to help us cope in the future. In your case it will be important that you notice tendencies to withdraw, disconnect or resent yourself. Instead I would like for you to create a relationship with yourself that honors your past, feels your present and always remains optimistic for the future.

*****

I'm 29 years old, and I am currently going through chemotherapy for my leukemia. I am expected to spend a lot of time in the hospital for the foreseeable future. This process is exhausting and really hard. Over the past couple of weeks my anxiety has been shooting through the roof. I am having trouble focusing on what the doctors and nurses are telling me, and I have to ask them to repeat themselves often — I feel like I’m wasting their time. I also have this awful voice in my head telling me that they are out to get me, and I don’t know why. I know they are here to help but I can’t keep myself from over analyzing everything.

Dr. Strongin: You are absolutely right, the process of chemotherapy is extraordinarily exhausting and emotionally overwhelming. Your elevated anxiety and focus on a perceived threat makes so much sense as you navigate this unpredictable chapter in your life.

Lets first understand the intricacies of anxiety and its direct impact on your attention span. Anxiety is a feeling of worry, nervousness, typically about an imminent event or something with an uncertain outcome. When anxious we may experience difficulty concentrating, anticipating the worst outcome, irrational fears and dread, mind going blank and/or obsessive uncontrollable thoughts. In summary, our mind is in overdrive trying to cope with the unknown throwing our body into a similar rhythm. Increasing evidence shows that anxiety impacts both working memory space and cognitive processes to varying degrees. Studies have repeatedly shown that people with anxiety automatically perceive threats over other stimuli at the expense of crucial ongoing tasks (Bar-Haim et al., 2007). For this exact reason, when you are presented with information by your doctors, your anxiety is causing your mind to solely pay attention to the threatening information rather than comprehending all of the information. Consequently, this level of threat perception is causing you to mistrust or feel paranoid about your physicians. I want to reassure you that your inability to concentrate, comprehend the treatment information and trust your doctors is all a product of the anxiety you are experiencing.

We must first calm your body and then calm your mind. I realize this is extremely hard to do in a medical setting while also receiving treatment. It is unlikely that you will be able to fully calm your body in that environment to optimally comprehend the information your doctor is presenting. Therefore, I suggest having family and friends nearby in order to also hear the information so that they can process it from a less anxious perspective. Finally, I suggest you record all of it on your phone so that when you come home and are in a more calm environment you can replay the information and take time to process and comprehend it.

Learn more about SurvivorNet's rigorous medical review process.

---