1. C OPING WITH YOUR LOSSES Julie Larson, LCSW www.julielarsonlcsw.com

2. When others are ready to celebrate the end of your treatment, cancer survivors often experience a mix of emotions/reactions after treatment ends. THE POSITIVE FEELINGS: Acknowledging personal strengths Deepened relationships with loved ones Excited about the future New desire to set personal goals A sense of gratitude and appreciation for life W HEN A CTIVE T REATMENT E NDS

3. WHY? WHY? W HY ? W HY ?

4. THE Not-so-Positive FEELINGS Fear of Recurrence: Worry about future unknowns Anxiety: Concern about not being in active treatment Concerns about physical appearance Sadness Depression Grief Anger about having had the life disruption of cancer Financial concerns Guilt or Regret Emotional numbness Spiritual uncertainty Learning new ways to care for yourself W HEN A CTIVE T REATMENT E NDS

5. G RIEF 101 Denial. Shock. Numbness. Anger. Irritation. Frustration. Bargaining. If I do this, then… Sadness. Isolation. Ache. Void. Empty. Acceptance. New perspective. Awareness. Insight.

6. A M I GRIEVING ? R ECOGNIZING S YMPTOMS Crying Lack of energy Uncertainty Changes in sleeping or eating habits Feeling withdrawn or unmotivated Irritable, demanding, underlying buzz of anger Hyperactivity, fear of slowing down Decreased productivity, trouble concentrating Avoidance of others or fear of being alone

7. T HROUGH THE MIDDLE OF GRIEF …

8. S ELF CARE : S ADNESS. A NGER. What helps you feel safe enough to be really sad? People? Location? Comforts? Pay very close attention to what it is (thought?) that makes you stop crying? Why…. Anger is energy. What can you do with that energy? Do you know your triggers? Have you taken the time to really understand those trigger thoughts?

9. T HE W ORK OF B EING A T W ORK : Realize when you are stressed. Why? Triggers? Certain people? External Events? Begin to learn your Warning Signs: The build up to an emotional moment. Know your people! Vital Steps to Caring for You

10. 1. Make a list of different ways you care for yourself 2. Consider your five senses 3. What can you do at work? Home? When you are out socially? In the middle of the night? 4. If being with people is part of your list, what are you doing together? Ground yourself: *Look up *Breathe *Feel your feet on the ground *Tune into your body Ground yourself: *Look up *Breathe *Feel your feet on the ground *Tune into your body

11. Remember your feelings about talking about your diagnosis will likely change day to day. Try not to ignore your need to share your worries, fears and questions. Often talking with others helps you work through concerns or uncertainties in a natural way. Try not to put on a happy face if you are not feeling that way. Your true feelings are more helpful to everyone. Remember when others have awkward or hurtful responses it likely has nothing to do with you but is more related to their own feelings or past experiences. Talking about cancer can be complicated. Most conversations are not a one shot deal, they are an ongoing dialogue. Keep being as open as you can.

12. Assumptions Shoulds/Musts/Oughts All or nothing thinking Over-generalizing Unfavorable comparisons Personalizing Dwelling on the negative www.thetherapyspacenyc.com T HE DIRTY LITTLE HABITS OF OUR THOUGHTS …

13. What is the event? What are your emotions? How intense are these emotions 1 – 10? Initial negative self-talk Gather evidence of other possibilities? Challenge the thought distortions Does this lead to a different feeling? www.thetherapyspacenyc.com C HALLENGING DISTORTED THINKING

14. Affirmations are healing, positive messages you give to yourself to counter your negative self- talk. Three Types of Affirmations: I am… (A statement about you) I can… (A statement of your potential) I will… (A statement of change in your life) A FFIRMATIONS

15. ACTIVITY: Writing Affirmations Write three (or more) affirmations HOMEWORK: Find Time for You Read this list to yourself daily ACTIVITY: W RITING A FFIRMATIONS CAUTION: Resist the Cheese Factor

16. The YOU INVENTORY What underlying qualities would you want others to know about you? Did you learn anything new about yourself since you were diagnosed with cancer? Would any of these qualities be important in your relationships with others? How would you share this information within your disclosure of your diagnosis? G ETTING TO K NOW YOU… Skills, Talents, Passions, Past successes

17. Y OUR B EST R ESOURCE : Y OU ! The STUFF Inside You Understanding your personal meaning Visualizing your individual hopes and dreams Every feeling matters Cancer has a way of educating you about YOU Think back Rename the experience Use some of those skills now for your benefit

18. Lets dish about your role models, the people you admire. 1.) Who comes to mind 2.) What qualities or characteristics about this person do you like? ACTIVITY: R OLE M ODEL S EARCH !

19. 1. Listen to yourself. Come to understand what you are feeling, thinking and needing. 2. Learn how to care for yourself. 3. Decide who the best audience is for you today related to what you need to express. 4. Prepare yourself for important conversations. 5. Know your emotional hot spots. 6. Reach out to good friends or a therapist to help you better understand your feelings and support you as you I N S UMMARY :