Can I Stay Emotionally Healthy During Cancer Treatment?


In this informative and fascinating article, our director of education, Martha McCormick, explains how positive psychology can help patients stay emotionally healthy during cancer treatment. Using research from the University of Pennsylvania, Martha helps identify specific characteristics that are found in people who are "thriving," and how these characteristics can help us to stay positive in the face of great trial.

According to researchers at the University of Pennsylvania, Positive Psychology is the scientific study of the strengths that enable individuals and communities to thrive. It is founded on the belief that people want to lead meaningful and fulfilling lives, to cultivate what is best within themselves, and to enhance their experiences of love, work, and play. One outcome from this is a model of resilience based on the assumption that these same strengths which help us to thrive can also make us resilient during difficult times such as breast cancer treatment, when reserves of endurance and confidence can be severely taxed.

This is taking a “strength-based” approach to resilience. Rather than having to learn new behaviors and attitudes, a strength-based approach highlights existing strengths and capabilities that may become personal assets during hard times. You could list many strengths that help us to live good lives. But research identifies five characteristics likely found in people who are “thriving” in life. With initials that create an acronym “PERMA,” the characteristics are: Positive emotion, Engagement, Relationships, Meaning and Accomplishment. Positive Emotion can be linked to two other terms – optimism and enjoyment. Optimism means viewing life overall in a positive way. It means recognizing that usually both good and bad things may happen in life but believing overall that things trend toward the positive. It doesn’t mean that you have to feel good about bad things or feel happy all the time. Enjoyment usually comes from some sort of focused activity, intellectual stimulation or creativity. Engagement means having activities in your life that pull you in so that when you are involved in that activity, you are entirely absorbed in what you are doing. Most likely, whatever you are doing is challenging enough that you have to pay attention. Mindless activities such as zoning out in front of the TV, surfing the internet or taking a stroll aren’t usually ways to be engaged. But trying to learn something new, figure something out, or challenge yourself in some capacity are all ways to be absorbed in something. Relationships concern people in your life whom you look forward to seeing; who add to your life in a good way. Time spent with others who stimulate you, make you laugh, make you think and make you feel connected is time that enhances your sense of well being. Meaning pertains to things that feel more important than just yourself and your own happiness. Religious observance, or other faith-related activities can add meaning to life and give a structure of values that makes sense of life. Other kinds of meaning-based activities might include community organizations, volunteering or specific work-related meaning. Some people structure their lives around meaning while others seek it outside of daily activities.
Accomplishment is about doing things, and knowing that you can. The dictionary may imply that accomplishment and achievement mean the same thing but that’s not usually the case here. Achievement usually implies some sort of judgement or contest. Accomplishment might or might not be that and often it implies things that might not be trophy material. “I grew enough tomatoes last year to make sauce for two dinners.” That’s not a lot of tomatoes but may be quite an accomplishment. Or, “I got the lawn mowed this weekend.” That’s in spite of the rain and the soccer tournament. Yes, an accomplishment!

What can watching our PERMA do for us? First, just being aware of the components means that we start to notice and value them. Most of us have PERMA to some degree, but maybe not in balance. It can be easy to cultivate in good times – great family and friends, community involvement, interesting work, time for hobbies, etc. But life events, like serious illness, moving, changing jobs, losing a family member, can let us loose sight of PERMA.

Some may have PERMA all tied up in the same package. It might be a job or parenting or a great neighborhood. But if something disrupts that package, much can be lost. Having cancer may be all-consuming. Many speak of breast cancer treatment as a part-time, if not a full-time job, that also affects the lives of family members. If activities that provided meaning and relationships are cut off, this can add insult to the injury of treatment. Inability to participate in athletics or schooling, feeling “out of the loop” socially, or experiencing anxiety and uncertainty due to health worries are all common side effects of cancer treatment.

Keeping PERMA in mind can support a sense of wholeness through treatment and survivor issues. Much is written about “life balance” for women who usually have many roles as employee, mother, caregiver, etc. But, it is almost impossible to balance anything consistently over time. The PERMA model better lends itself to the idea of good nutrition where each food group has its place on the plate; varying from day to day or week to week, but all represented.
In the case of breast cancer, we know that many women add to their sense of meaning and their relationships through the treatment process. Prevailing through a challenging course of treatment can be life-changing and add to the sense of mastery and accomplishment. Many find sustained meaning in spirituality as a result of that experience.

Like Breast Cancer, one’s sense of thriving is an individual matter. We all get to decide what defines positive emotions, relationships, engagement, meaning and accomplishment for ourselves. Still we can be confident from the evidence that a good mix of positive emotion, engaging activities, good relationships, sense of meaning in life and personal accomplishments all contribute to resilience and ability to thrive, regardless of health concerns.

Martha McCormick MS, EdS
Director of Education, To Life!

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