Overcome Toxic Positivity When You Have Metastatic Breast Cancer


If you’ve been diagnosed with metastatic HR-positive/HER2-negative breast cancer, there’s no right way to feel. “You are sitting with an enormous amount of uncertainty, and it’s normal to have waves of being terrified, anxious, worried, fearful, and exhausted,” says Helen Coons, PhD, a board-certified clinical health psychologist who specializes in working with women who have cancer.

But, when friends, family, and coworkers put pressure on you to “Stay positive!” and “Be strong!” their toxic positivity can take a toll on your mental health. You may feel like you have to constantly put on a brave face, which can be exhausting.

Toxic positivity, or the relentless pursuit of maintaining a positive outlook, can also be self-imposed. Facing the reality of having metastatic cancer is difficult, so you may choose to avoid it, Dr. Coons explains.

While it’s good to be cautiously optimistic that you’ll respond well to treatment, forcing yourself into a positive mindset doesn’t leave room for the range of normal and healthy emotions you’re experiencing.

It’s important to let those feelings out. Keep reading to learn healthy ways to express yourself — and how to avoid the toxic positivity trap.

1. Let Yourself Have a Good Cry

Don’t underestimate the cathartic power of crying. A study published in July 2020 found that crying therapy — using crying to supplement other therapeutic treatments — resulted in positive emotional changes in female breast cancer survivors. Their stress levels and mood significantly improved, and even their immunoglobulin G (an antibody that is critical for fighting off infections) levels increased.

Letting yourself be vulnerable isn’t a sign of weakness. It’s a healthy outlet for overwhelming emotions like sadness and frustration, which are completely appropriate when you have metastatic HR-positive/HER2-negative metastatic breast cancer, says Coons.

2. Talk Things Out With a Supportive Loved One

One of the things Coons often hears from people with cancer is that they avoid being honest with their loved ones, because they don’t want to burden them or take them to a dark place. But, chances are, your loved ones are experiencing the same emotions. “When you give voice to your feelings, it not only lets everybody else understand where you are; it also gives permission for them to have their feelings, too,” she explains.

Engaging in open and honest conversations with a trusted friend, family member, or partner can be very therapeutic. It’s important to connect with someone who listens without judgment and offers support without dismissing your concerns or pressuring you to look on the bright side. You’re also allowed to tell them when something they say isn’t helpful or if you just want them to listen without offering advice.

3. Start Journaling

When you’re overwhelmed and don’t feel like talking to a loved one, journaling provides a safe space to articulate your thoughts without feeling judged or worrying about someone else’s feelings. Start by setting aside a few minutes every day to write freely.

4. Get Creative

Using art can help you express anxiety, frustration, and sadness when words can’t quite capture your feelings. Don’t worry: You don’t need to be a professional artist. Try doodling, making a collage, or scrapbooking. If you’re into music, blast some of your favorite songs and have a solo karaoke session. Anything that helps you let your feelings out will work.

5. Stay Active

Physical activity is not only beneficial for your body, but also a great way to blow off steam. Coons recommends working with your medical oncologist to find the right exercise plan for you.

“What you want is regular exercise that isn’t going to hurt bones and will make you feel more energized, not more fatigued,” she says. Her recommendations are low-impact activities, such as seated yoga, tai chi, and — if your body can tolerate it — walking and hiking.

6. Connect With Nature

Getting outside is a great way to connect with yourself and how you’re feeling. The quieting aspect of being in nature can be beneficial for your physical and mental well-being, says Coons.

Take some time for yourself to be alone with your thoughts, or go on a hike with friends and have a venting session. If you want to be in nature with other women who understand what you’re going through, Coons recommends programs like Casting for Recovery, which offers free fly-fishing retreats for women with breast cancer.

7. Talk to Someone Who Understands What You’re Going Through

Coons emphasizes the importance of having a support network, so you’re not always alone with your thoughts and feelings. She recommends talking to a therapist who specializes in treating people with breast cancer, such as a cancer social worker or cancer psychologist. Ask about counseling services in the hospital or clinic where you get treatment.

She also recommends joining a support group, which may be offered in person or online. Just know that it might take some trial and error to find the right community for you. To get started, check out the National Breast Cancer Foundation’s list of support groups.


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