A cancer diagnosis has the potential to throw your entire life into disarray, impacting both your physical and mental wellbeing. At SurvivorNet, we believe treating the whole person is imperative, so we've teamed up with Dr. Marianna Strongin to leverage her expertise as a licensed clinical psychologist. Dr. Strongin will answer SurvivorNet reader questions on topics ranging from navigating a partner’s mourning to learning ways to improve sleep and everything in between. (You can submit your questions here.)
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My husband and I just got married and moved into our dream house. We have been riding this high where we feel really in control of our lives. We have been looking forward to moving in together to start having babies. We went to the doctor to get checkups and the most devastating news was shared– I was diagnosed with ovarian cancer. Not only was I diagnosed, but also was told that I can't have kids. Of course my heart, my husband’s heart, is broken. In the past, my husband has been very supportive and comforting when something bad happens, but now he feels cold and removed. I feel like I'm in mourning, and I'm getting angry that I can't even talk to my husband about it. What should I do? Dr. Strongin: When our future dreams are shattered by difficult news, we are forced to reimagine a new one. However, in order to have the will and hope to do that, we must first confront the difficult news by processing and mourning it. I am so sorry about this difficult diagnosis and its impact on fertility- having a child can be a conscious and unconscious part of our adulthood fantasy and having to mourn this can impact many facets of adulthood including your relationship with your husband.Mourning is experienced differently by everyone. Feelings can range from disbelief to sadness to anger. Some can even experience all of this at once. I urge couples to take their own lane while mourning, deciding their own speed and path, and yet always finding ways to merge and join each other throughout their emotional travels. In your case this means allowing your husband to have the range of feelings he's having while also checking in with your own emotions and the impact his feelings have on you. Rather than pressurizing one another to be feeling certain things or reimagining the same future, I urge both of you to create room for the difference in emotion and the room to heal.
Research has found that cancer can have a significant impact on marriages. Similarly, research has also indicated that infertility can impact a partnership in a variety of significant ways. In both cases (cancer and infertility), studies have found that strong relationships can become stronger while previously unsatisfactory relationships are more likely to be negatively impacted. This means that couples who are sturdy before traumatic events are more likely to utilize the skills that foster that closeness (communication, mutual respect etc.) in order to weather the storm together.
In your case, you are both experiencing the impact of cancer and the inability to conceive all at once. Therefore, it will be critical to communicate often and find compassion for one another throughout this demanding chapter. Dr. John Gottman, a famous researcher on relationships, states that “all conflict is an opportunity to learn how to love each other better over time.” I hope you and your partner can do the same during this difficult time.
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I am 57 -years-old, and I have been battling blood cancer. At the beginning of my diagnosis I always had a very positive attitude. I am currently going through my fourth round of chemotherapy, and I am really struggling. I've always had trouble sleeping but now, even when my body is begging itself to sleep, I have these nightmares about my treatment and it is causing a lot of anxiety. I feel scared all the time. On the one hand, being awake and facing chemo terrifies me. On the other hand, the anxiety around sleeping is debilitating. How do I get over this fear of sleep?
Dr. Strongin: Sleep disturbance can be all encompassing and incredibly debilitating. It sounds like your treatments have been physically and emotionally painful, causing you tremendous amounts of stress throughout the day, which has seeped into your dreams and is preventing you from resting. Anxiety, depression and post traumatic stress disorder (PTSD) can cause adult nightmares. In your case, the nightmares are causing you to have insomnia which is repeated difficulty with the initiation, maintenance, consolidation and/or quality of sleep.
It’s helpful to address sleep disturbance from a cognitive and behavioral lens because sleep is both cognitive and behavioral. Cognitive Behavioral Therapy has a specific way of treating Insomnia called (CBT-I). This evidence-based treatment focuses on three interventions for sleep – cognitive, behavioral and psychoeducational.
From the cognitive side it’s important to focus on how you think about sleep. In your case, your worry about possible nightmares and the nightmares themselves causes the sleep disturbance. Consequently, it’s important to identify, challenge and alter the thoughts that cause you to fear sleep.
From a behavioral perspective it will be important to address the routine of sleep. For example, how do you signal to your body that it’s winding down for rest? I recommend having a consistent nightly routine that behaviorally signals to your body that it’s moving into rest and is, therefore, no longer in a threat state.
I also suggest associating the bed with rest. So when you are awakened by a nightmare it will be important to leave the bed, do a calming exercise outside of your bedroom and only return when tired enough to fall asleep. Psychoeducation is also critical because the nightmares are evidence that emotions such as fear or anger experienced throughout the day may not be fully processed or acknowledged in the conscious state. As a result, they are experienced consistently in the night. Sleep is multidimensional and treating it requires interventions from multiple angles.
If your sleep disturbance continues, I strongly suggest you share this with your oncologist and also consider working with a therapist. Psychotherapy can be extremely helpful allowing you to process your emotions through the day and making room for peace and rest in the night.
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