Each woman responds to the crisis that breast cancer brings to her out of a whole pattern, which is the design of who she is and how her life has been lived. …... our feelings need voice in order to be recognized, respected, and of use. I do not wish my anger and pain and fear about cancer to fossilize into yet another silence …... may these words underline the possibilities of self-healing and the rich-ness of living for all women…..and to integrate this crisis into useful strengths for change (Lorde, 1980, pp9-10).
Personal health crises can befall any one of us at any stage of our lives. During these times, we often turn to medicine. Its evidence base dictates what the diagnosis is, what treatment to give, what protocols to follow. This is helpful especially in life-threatening circumstances. However, listening only to the voice of reason and medicine is problematic, as there is another voice that needs to be heard in such trying times. The voice of the person on the surgery table, in the waiting room, or under the MRI, is also valuable. For it is their body/mind/spirit who hosts the ailment, must weather the treatments, take the medicines and pursue healing. Their voice is ever present in their suffering and the emotional experience of their journey.
Experiencing early breast cancer can evoke a wide range of intense emotions for individuals going through this challenging journey. Each person's emotional experience may be unique. The feelings and reactions I observed included the full gamut of shock, withdrawal, gripping fear, anger, sadness, blame, guilt, helplessness, hopelessness, depression, anxiety, optimism, joy, hope, curiosity, contentment, and compassion. Whilst courage and strength were needed in the days that followed my diagnosis, creating a safety net was first on my list. Much of what lay ahead in terms of healing would not only be the physical recovery from surgery and radiation but the psychological experience that accompanied these.
This diagnosis was significant, even if I recovered, studies showed breast cancer treatment with radiotherapy can be stressful with greater risk of anxiety, depression, suicide and a decrease in quality of life. Emerging research shows art therapy interventions could support anxiety, depression, tiredness and the uncertainty and emotional experience of cancer diagnosis. In particular, depression and anxiety in breast cancer patients greatly influence their quality of life and survival rate after treatment.
Upon my own breast cancer diagnosis. instinctively I turned towards the wisdom of other women I knew who had experienced breast cancer, along with my husband, daughter, family and dear friends and a talented team of professionals. But there was another, my spirit, that needed a voice in this process. As Ray & Baum assert “physical illness cannot be effectively treated other than in the context of the psychological factors with which it is associated. The body may have the disease, but it is the patient who is ill”. It was this concept that propelled me to see a psychologist alongside the surgeon and radiation oncologist and to turn inwards through the use of a visual journal to delve into my emotional experiences.
I had kept a written journal for many years earlier, practiced daily art and was aware of the physical and psychological benefits of expressive writing (e.g. lowering blood pressure, improving cardiovascular health and immune function, speeding up healing, strengthening memory, improving mood and easing symptoms of depression). However, I had never used a daily visual journal for a personal health crisis. Engaging in creative expression had afforded many benefits to my clients. I wondered how creative expression in a daily art journal could assist me in this time of personal need. Anne Day found that “the journal is an important tool because it works as a catalyst for self-discovery and self-reflection”. So, I began to sit and make an entry every day, no matter how small or how long. I would commit to the daily practice of giving voice to my feelings and emotions.
There is no doubt the myriad of feelings that emanated from the diagnosis and treatment of breast cancer were at times overwhelming. On the day of diagnosis, I sensed deep within this was not a ‘fight’ or ‘battle’ with cancer. Whatever was inside me was in fact part of me and fighting it sounded too hurtful. Working on a body scan in the journal revealed “peace was within and around you”. There were other times when no words could be found to make sense of the experience. In these times I found the art journaling provided the container I needed. There were big emotions and feelings that needed to be acknowledged, felt and expressed. For emotions often aren’t surrendered until they are felt. I worked on the concept that externalizing a feeling through art making can help to process and release it. Working in the journal supported this especially when the feelings seemed unbearable, such as the pain following surgery, or the disorientation after surgery surfaced or the days filled with tears. By expressing these feelings on paper, I was able to externalize them and release their hold on me. Moving through them felt less laborious. In her book the Cancer Journals, Audre Lorde says of women who are breast cancer patients “our feelings need voice in order to be recognized, respected and of use”. There were times when turning towards my suffering and being able to hold it seemed too much, but I knew the journal would take anything created in it. Whether it be bold and messy markers, splashes of paint thrown across it or delicate watercolors and pens, it bore them all. In seeing it from a distance on the page, I gained new perspectives and brought compassion to it.
Some transformations occurred outside the journal pages where the emotions were captured. I learned about being enough – with nowhere to go, nothing I could do, nothing to get done, nothing to change, I realised I did not need to grow more deserving to be loved and belong, that I am enough. For the first time, I turned down invitations to be with others that did not serve my recovery. The new sense of self- compassion seeped into my feelings towards others. If as research suggests healing “is a process of moving away from an undesired state to a state of renewal” then I was healing (Firth, et al., 2015).
Journeying through health crises merely as a ‘body’ within the medical system is not enough for the mind-body-spirit being that we truly are. Our emotions play a critical and integral role in the quality of our lives. Yet too often the difficult ones are dismissed or avoided as they seem to threaten our safety. Disconnections and disassociations from our emotional selves can come at a price. We need to find healthy ways to allow the expression and resolution of all emotions, in all their lines, shapes and colors. There is an intrinsic and gentle healing aspect to creative expression. Encouraging people to find creative expression tools and therapies to support their personal health crises is important to their healing journey. Art therapy in particular can be a powerful and effective tool in helping individuals process the emotional experience of early breast cancer.
I hope to publish the full version of this tale.
de Witte, M., Orkibi H., Zarate, R., Karkou, V., Sajnani, N., Malhotra, B., Ho RTH, Kaimal, G., Baker, FA., Koch, SC. (2021) Therapeutic factors to mechanisms of change in the creative arts therapies: A scoping review. Front Psychol. 12:678397. doi: 10.3389/fpsyg.2021.678397.
Firth, K., Smith, K., Sakallaris, B., Bellanti, D., Crawford, C., & Avant, K. (2015). Healing, a concept analysis. Global Advances in Health and Medicine Journal. 4. 44-50. 10.7453/gahmj.2015.056.
Lorde, A. (1980) Cancer Journals. San Francisco, Spinsters/ Aunt Lute.
Ray, C., & Baum, M. (1985). Psychological aspects of early breast cancer (1st ed.). Springer-Verlag.