Sunday, 15 September 2019

The Mental Big Bad Wolf

For the past few weeks I’ve been feeling much more anxious and sleeping badly. I was waking in the small hours and obsessively turning over problems in my mind. But these were minor problems that had escalated in the night. I tried mindfulness relaxation and deep breathing exercises, they brought my heart-rate down but I still didn’t sleep. In the morning I would feel exhausted and chide myself for being so obsessed with such minor matters. And earlier this week I began to suffer from a cold as well. Yesterday I sat down with T (who is now a qualified therapist) and talked all this through. Last night I managed to sleep for six hours.  

Although T is newly qualified, after four years of study for a counselling degree, she possesses great emotional intelligence. She gently probed the concerns that I described to her and I ended up learning a great deal about what is troubling me. The relatively minor problems that were disturbing me at night were stand-ins for a bigger problem that was more difficult to expose and address.

The big problem was, of course, to do with cancer. But this time, it was not the fear of recurrence itself; although, that is always there. Especially when you’ve had a type of cancer that is known to recur up to 20 years after the initial tumour. The big problem was how to live well alongside the fear of recurrence and the pervasive sense of vulnerability that are your inevitable life companions when you are a cancer patient.

In the early days of cancer treatment you are like a soldier in the front-line. You are wounded, in pain and it feels that death could come easily at any moment. It seems to be quite arbitrary that you are still alive when others around you, family, friends, neighbours, have died.  As time goes on, you manage to move away from the front line; but despite it being out of sight, it is not out of mind. On the other side of the hill the grass is green and the sun is shining but you can still hear some explosions and know that you could be catapulted back into the horror of the front-line at a moment’s notice. How do I know? Because it has happened to me three times.

Living with this sort of PTSD seems to be the norm for cancer patients. My last return to the front-line was almost two years ago and after that I was walking wounded and on morphine for three months. Since then I have been steadily building up my strength. This has gone well and over the past few months I’ve been regularly cycling three or four times a week and have managed some long rides again. My longest ride has been 77 miles and I’ve regularly been cycling over 150 miles a week. Just two weeks ago, as described in my last post, I was discharged from the lung clinic with well above average lung health.

The source of the problem suddenly became clear. Alongside this rebuilding of my body I had also been creating expectations about the rebuilding of my mental health. That this physical rebuilding, which was intended to take me back to the level of physical health I had pre-cancer, would somehow be accompanied by a rebuilding of my mental health – enabling me to regain the sense of casual self-confidence and lack of vulnerability that I had pre-cancer. Despite my physical progress, I was still plagued by anxiety and fear. So, plainly, my mental health hadn't been able to be restored to where I was before. This loss and apparent failure left me feeling additionally disturbed.

However, such a return cannot happen. You can’t go back to who you were before you were catapulted into the front-line. You can only go on to be who you have become, having survived thus far. You can’t escape the PTSD, but you can learn to live well with it; with all the capabilities (endurance, patience and resilience, to name but a few) that you have gained.

It won’t be easy. But with a partner like T I know I will have healing love and huge support on the journey ahead. Thank you T for helping me to see the wood from the trees and to find where the wolf lay.