Dealing with cancer involves more than worry and stress about the illness itself, the treatments, and the prognosis for the future. The very real and troubling physical symptoms of disease and side effects of treatment also cause great upset and suffering. Such disturbances range from the most obvious outward marker of cancer for many patients—hair loss—to inner changes, such as an altered self-image and problems with energy levels, including profound fatigue and difficulty sleeping that can turn into a vicious circle of sleepless nights, tired days, daytime napping, and more sleepless nights.
Cancer patients often also encounter many types of pain, from painful procedures like biopsies, blood draws, chemotherapy administration, and radiation therapy to post-surgical pain and lingering aches and pains from the illness itself. There are mindfulness practices that specifically apply to all of these problems, and can help reduce your stress and improve your overall quality of life. Being in distress initiates excitatory and inflammatory responses that can exacerbate many side effects, but good evidence shows that relaxation alone can reduce the intensity of such side effects.
Hair Loss and Changes in Self-Image and Identity
Often one of the most difficult side effects of many types of chemotherapy is hair loss. Many people see this as the official “badge” of the cancer patient. Hair loss makes it difficult to hide the illness from others or to deny that it’s really happening—even to yourself if you are the one with cancer. People in general are very attached to their hair. It’s part of what makes you recognizable as yourself. You might describe yourself as a redhead or blond, with characteristic short or long hair that’s straight or curly, and this may be a central part of your identity. You might not even realize the importance you place on your hair until it begins to fall right out in clumps, you have to clear the shower drain, or you don’t even recognize yourself in the mirror anymore. Who is this person staring back at you with the funny-looking bald head? As an indisputable symbol of loss, it can trigger a deep sense of grief. Friends and acquaintances may pass you by, failing to recognize you and making you start to wonder, Who am I anyway?
Women are sometimes mistaken for men, when this outward sign of femininity is taken away, and as sometimes occurs, your school-age children may feel uncomfortable being seen with you in public when you’re not wearing a wig or they may stop asking their friends to your home.
Women are sometimes mistaken for men, when this outward sign of femininity is taken away, and as sometimes occurs, your school-age children may feel uncomfortable being seen with you in public when you’re not wearing a wig or they may stop asking their friends to your home. Am I now just a generic “cancer patient” and that’s all anyone sees? This fundamental shift in appearance can make you question other aspects of your identity as well. Am I still the mother, father, carpenter, lawyer, or administrative assistant I used to be? What is it that really makes me me, and how can I get that back? The following meditation is a way for you to examine the fundamental questions of who you are that self-image challenges integral to the cancer experience may bring up.
Mindfulness Practice: Who Are You?
• Take a comfortable seat where you can sit balanced and upright, and breathe easily. Take a moment to tune in to your breath as it flows in and out of your body. Feel its rhythm. Begin to feel your body as a whole, pulsating with each breath in and out.
• After a few moments, when you feel settled into the rhythm of the breath, begin to pose a series of silent questions to yourself. These may begin with the most peripheral aspects of yourself, such as your possessions: Am I what I possess? Am I defined by my car, my house, my clothes, my shoes? Are these things what make me me?
• You may not have ready answers to any of these questions; what’s important is simply to pose them to yourself and allow yourself time to breathe and sit with each question. Then ask yourself, If I am not these things, then what am I? Again, there’s no ready answer to this question. Just try to sit and breathe with the question.
• Perhaps then move on to aspects of yourself that you may be more attached to: Am I what I do? Am I defined by the roles I play in life? Am I a mother, a daughter, a son, a sibling, my occupation, a cancer patient or survivor? If you didn’t have these roles to play, what or who would you be then?
Am I defined by my personal characteristics, such as my personality or my likes and dislikes? Do I define myself by my talents? Am I a singer, a dancer, a reader, a writer? A cheerful person, a cynic, a dog lover? Are these the things that make me me? What if all these things were lost too? Who would I be then? Am I this physical body? Is this body sitting here the same as the one I was born with? What makes me feel that it is, when nothing is the same as when I was born? What if my body radically changed? If I lost my sight, my hair, my ability to walk or run, would I still be me?
Am I my mind, my thoughts? Those never-ending thoughts that rise and fall constantly in my conscious mind—do those define who I am?
What if all of this were stripped away? What would I be? Would I still be me?
• Still sitting and breathing quietly, consider the possibility that you are none of these things. Is it possible that you could be more vast, that you could be something more than the body you now reside in, the thoughts you harbor, your likes or dislikes, your talents or roles in life? What might that feel like?
Can your identity really be known in isolation, disconnected from your friends, family, society, and environment?
Could it be that what’s essential about you transcends your ideas and beliefs about yourself and involves your connection to a larger web of being and becoming, a web that connects you with all beings coexisting in the vastness of time, the web of life?
• This might seem like a bit much to consider, but that’s okay. Just continue to sit for a few minutes more with the possibility that you are something beyond any material or personal characteristics you possess, things that change day to day and year to year; the possibility that you, your consciousness, is part of a more encompassing and enduring form of awareness.
The intent of this practice is to help you begin to see that the traditional things you may consider important in defining your place in the world are often transitory. There’s a more stable and enduring part of your being, and connecting with this possibility through your meditation practice may help soothe the pain of changes to your self-image and identity that cancer triggers.