‘Strong in Cancer’: How To Combat Financial Anxiety, Plus Tips For Making Difficult Treatment Decisions

My family was poor when I was growing up. In college I studied hard, graduated with honors and got a good job. I am very proud of myself. I was able to save money after 15 years into my career. I felt confident and in control of my life until I was diagnosed with stage 4 breast cancer at the age of 37. Although I did save money, these treatments are so expensive and I will have to take out loans. I am drowning in anxiety over my finances. In some sense, it feels like my freedom is slipping away. I feel trapped by my finances and soon to be my physical limitations. 

Some of the most typical emotions that individuals feel in relation to money are fear, guilt, shame and envy. It sounds like before cancer you saved money, like most of us, to ensure security and more freedom in your future. However, your recent diagnosis and the financial burdens of treatment have created fear for your future well being and your future financial security. Cancer seems to have pulled the security of the future from you in more ways than one, and it’s important that we reframe your relationship with money so that it doesn’t stand in the way of your cancer treatment and mental health.

Often, our relationship with money is filled with cognitive distortions. Cognitive distortions are biased perspectives we make about ourselves and the world around us. They are irrational thoughts and beliefs that we reinforce over time which can cause us to have intense emotions such as fear. In your case this may have formed in the context of growing up poor. A common cognitive distortion that people form around money is called  “All or Nothing or Black and White thinking, ” which causes a person to see things in extremes.

In your case, you might be feeling as though not having savings and taking out loans means you have no security or freedom. Just like the name- it makes one feel like they have all or nothing with almost no in between scenarios. If this resonates, then it will be very important that we reframe your thinking and create a “grey” thought like, “Just because I am taking a loan or using some of my saved money, does not  mean that I will run out of money.” Another "grey" thought might be, "If money is for security then using it on my health is exactly what it's for."  Simply restating it away from such extremes allows us to better accept our reality.

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I am a 49 year old who has stage 4 liver cancer. I was diagnosed really late and it feels like I am running out of time. I live with my wife and two daughters in New York City, we are all very close. I'm lucky that my hospital is 20 minutes away so my family can go back and forth fairly easily. Since my cancer is very advanced, I was recently accepted into a clinical trial in Europe. My doctor is encouraging me to go as this opportunity may add many years to my life, but not guaranteed. I am extremely conflicted about whether or not I should stay in NY to continue receiving treatment here with my family constantly by my side, or if I should fly to Europe, not be with my family and MAYBE add years back to my life. I have to decide now and I’m not sure what to do.

This is a difficult decision, and I urge you to think about it collaboratively with your family as it will impact all of you. When we are confronted with very difficult decisions such as this one it is important to consider the factors that go into decision making.

Dialectical Behavioral Therapy (DBT) explains that we have three states of mind- EMOTIONAL MIND, REASONABLE MIND AND WISE MIND. Our EMOTIONAL MIND is characterized by our strong emotions such as fear, anger, sadness etc. Our REASONABLE MIND draws on logic, reason, statistics and history. Finally, our WISE MIND is the state we would like to optimally make a decision in because it attempts to negotiate between EMOTIONAL and REASONABLE MIND, and therefore is more intuitive and mindful.

When we are in a more acute stress state, which you might find yourself in as you navigate this decision, it will be really important to create space for REASONABLE MIND. In doing so,  you may want to better understand all the information regarding the clinical trials and what that will entail. Therefore, EMOTIONAL MIND, which may feel stuck, sad and angry will try to understand the facts and together these two states can begin negotiating and collaborating in order to make a WISE decision. Notice that we are ultimately attempting to make a WISE and optimal decision rather than right/wrong or good/bad decision. By staying away from such dichotomous thinking we can learn to emotionally negotiate with ourselves and to make the most appropriate decision for right now.

 

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