Navigating Post-Cancer Recovery

The final bell rings. The last chemotherapy session is done, the radiation beams have ceased, and the surgeon's scalpel has been put away. The battle against cancer is over, and the patient is declared 'cancer-free'. For many, this is the moment of triumph, a joyous culmination of a gruelling journey. I see what often follows—an unwritten chapter of recovery that is as complex and challenging as the medical treatment itself.

The common narrative of post-cancer life is one of unbridled joy and a return to 'normal'. Yet, for many survivors, this transition is fraught with emotional and psychological hurdles that can feel isolating and deeply disorienting. The medical team's focus shifts, friends and family may assume the ordeal is over, and the survivor is left to grapple with a new reality that is anything but 'normal'.

So, what are the psychological landscapes of post-cancer recovery, and why is it so crucial to acknowledge them?

1. The End of the 'Fight' and the Onset of 'What Now?'

During active treatment, the focus is singular: survival. Patients become warriors, their days structured around appointments, treatments, and managing side effects. This singular focus, while exhausting, can also provide a sense of purpose and structure. When treatment ends, that structure collapses. The 'fight' is over, but the question of 'what now?' looms large. Many survivors experience a sense of anticlimax, a sudden emptiness where the daily battle once was. This is not a sign of ingratitude, but a natural psychological response to a profound life change.

2. The Shadow of 'Scanxiety' and the Fear of Recurrence

The fear of cancer returning is a constant, unwelcome companion for many survivors. Every ache, every pain, every routine check-up can trigger what's known as 'scanxiety'. This is a valid and pervasive form of anxiety, where the mind is perpetually on high alert for signs of the disease's return. Learning to manage this fear is a critical part of recovery. It involves not just positive thinking, but developing practical coping strategies, such as mindfulness, grounding techniques, and open communication with one's medical team.

3. Body Image and the Grieving of a Former Self

Cancer treatment often leaves physical scars, both visible and invisible. Surgical procedures, weight loss or gain, hair loss, and the side effects of medication can fundamentally alter one's physical appearance. This can lead to body image issues and a profound sense of loss for the body they once had. Grieving this former self is a necessary part of the healing process. It requires self-compassion, patience, and a willingness to explore a new relationship with a body that has been through so much.

4. Identity Crisis: 'Who Am I Now?'

Cancer can act as a profound disruptor of identity. For many, their life was defined by their career, their hobbies, or their role within their family. After a cancer diagnosis, they may have become a 'patient' or a 'survivor'. As they move forward, they are faced with the challenge of reintegrating into their old life, or perhaps, building a new one. This often involves a deep reflection on values, priorities, and purpose. The person who emerges from the cancer experience is often changed, and finding a way to integrate this new self with the old can be a significant psychological task.

5. The Burden of 'Being Positive'

Society often places an immense pressure on cancer survivors to be eternally positive and grateful. While a positive outlook can be helpful, the expectation to be happy all the time can be a heavy burden. Survivors have a right to feel anger, sadness, fear, and frustration. These are valid emotions, and suppressing them can lead to further psychological distress. I encourage survivors to embrace the full spectrum of their emotions, allowing themselves to grieve, to be angry, and to be uncertain without guilt.

The Path Forward: A Call for Psychological Support

Post-cancer recovery is not just about physical healing; it is a journey of psychological and emotional reconstruction. It requires a different kind of support—one that acknowledges the complexities of this transition.

If you are a cancer survivor, please know that your feelings are valid. You are not 'doing recovery wrong' if you feel anxious, sad, or uncertain. Seeking out a therapist can provide a safe space to process these emotions and develop strategies for navigating this new chapter.

To friends and family of a survivor: Continue to be present. Ask about their feelings, and don't assume that a 'cancer-free' diagnosis means the end of the journey. Listen without judgement and offer support that goes beyond a celebratory 'you did it!'

The unwritten chapter of post-cancer recovery is a testament to the resilience of the human spirit. It is a time for healing, for reflection, and for building a life that is not just 'back to normal', but perhaps, even richer and more meaningful than before. It's a journey that deserves to be acknowledged, understood, and supported with as much care as the medical treatment that came before it.

Navigating Grief During the Holidays

The Empty Chair at the Table:

The holiday season is often portrayed as 'the most wonderful time of the year'. For many, the festive lights cast long shadows. When you are grieving a family member, Christmas can feel less like a celebration and more like a deadline for a joy you simply cannot manufacture.

I often see clients struggle with a specific type of holiday tension: the conflict between the world’s expectation of cheer and their internal reality of loss.

If you’re facing the holidays with an empty chair at the table, here is a psychological perspective on why it hurts so much—and how to mindfully navigate the season.

Why the Holidays Amplify Grief

In psychology, we often talk about 'anniversary reactions'. The brain is an incredible linking machine; it associates scents (pine, cinnamon), sounds (carols), and rituals with specific people. When those sensory cues trigger memories of someone who is no longer here, it creates a 'mismatch' in the brain that results in sharp emotional pain.

Furthermore, the holidays emphasise continuity and tradition. When a link in that chain is broken, the entire structure feels fragile. You aren’t just missing a person; you are missing the version of yourself that existed when they were alive.

Strategies for Coping

Grief isn't something you 'get over'; it’s something you learn to carry. Here are a few ways to manage the weight this season:

 * Practice 'Selective Participation': You are under no moral obligation to attend every party or maintain every tradition. Give yourself a 'social budget'. If a particular event feels like it will be too draining, give yourself permission to decline.

 * The 'Both/And' Mindset: One of the most helpful tools in therapy is embracing the idea that two seemingly opposite things can be true at once. You can feel both deep sadness for who is gone and genuine warmth for who is present. You don't have to choose one.

 * Create a 'Memory Minute': Trying to ignore the loss often makes the 'elephant in the room' feel larger. Instead, find a small, contained way to honour them. Light a specific candle, cook their favorite side dish, or share one specific story before dinner. By giving the grief a seat at the table, you often reduce its power to overwhelm the entire day.

 * Lower the Bar: This is the year for 'good enough'. If the cards don't get sent or the decorations stay in the attic, that is okay. Your primary aim is self care, not festive perfection.

A Note on 'The Firsts' and 'The Laters'

Whether this is your first Christmas without them or your fifteenth, the 'pangs' can be unpredictable. Grief isn't linear. If you find yourself crying over a specific ornament or a song playing in a shop, don't pathologise it. It’s simply your love for that person looking to be felt and acknowledged.

The Goal: The goal of the holiday season shouldn't be to 'get through it' without crying. The goal is to move through it with self-compassion.

​If you feel heavy while everyone else seems light, know that you are not failing at the holidays. You are being deeply human. Your worth this Christmas is not measured by your festivity, your productivity, or your ability to keep a smile on your face. You are enough exactly as you are: grieving, tired, or even occasionally joyful.

The 5 Stages of Grief

Grief is perhaps the most universal and profoundly personal human experience. When we suffer a significant loss—be it the death of a loved one, the end of a relationship, the loss of a job, or a major health diagnosis—our world shifts. For decades, the framework of the five stages of grief has offered a map for understanding this complex emotional terrain.

Developed by psychiatrist Elisabeth Kübler-Ross in her 1969 book, On Death and Dying, these stages were initially based on her work with terminally ill patients, not necessarily the bereaved. However, they have since been widely applied to the experience of mourning.

I view these stages not as a rigid, linear checklist, but as a set of fluid emotional responses. Understanding them can bring validation to your healing journey.

5 Stages of Grief: 

1. Denial and Isolation

 * What it looks like: 'This can't be happening'. In the initial shock of loss, denial acts as an emotional buffer, a defense mechanism that helps us survive the immediate pain. It allows us to pace the overwhelming flood of emotions. We might find ourselves going through the motions, feeling numb, or simply refusing to believe the reality of the loss.

 * The therapeutic view: This stage is crucial for managing the immediate trauma. It's not a sign of weakness, but a sign that your mind is protecting itself from being completely incapacitated. Therapy helps gently move the client from 'This isn't real' to 'This is real, and it hurts'.

2. Anger

 * What it looks like: As the initial numbness wears off, the pain is replaced by intense anger. This anger is often misdirected—at doctors, family members, God, the deceased for leaving, or even at oneself. It stems from a profound sense of helplessness and injustice. 'Why me?' or 'This isn't fair!' become the dominant thoughts.

 * The therapeutic view: Anger is pain with a voice. It is a necessary release of bottled-up emotion. The therapist's role is not to suppress this anger, but to provide a safe container for it. We explore the root of the anger, helping the client channel it in constructive ways, rather than letting it become destructive.

3. Bargaining

 * What it looks like: This stage involves a hope that we can somehow avoid the cause of grief or reverse the loss. We might dwell on 'If only...' statements: 'If only I had called that day', 'If only I had taken them to another doctor', or making a promise to a higher power in exchange for relief from the pain. It’s an attempt to regain control in a situation where we feel utterly powerless.

 * The therapeutic view: Bargaining is a temporary truce with reality. It is the negotiation phase, where the mind tries to rationalise and find a loophole. Therapeutically, we gently guide the client toward accepting the unchangeable reality, moving from magical thinking to grounded reality.

4. Depression

 * What it looks like: This is the quiet stage of sorrow, where we truly begin to process the magnitude of the loss. It’s marked by intense sadness, lack of energy, withdrawal from social interaction, and feelings of emptiness. This is not clinical depression (though that can co-occur), but a natural, appropriate response to a significant loss.

 * The therapeutic view: This is the most critical stage for healing. It requires sitting with the pain without judgement or trying to fix it. A therapist validates this pain as necessary work. We help the client distinguish between appropriate mourning and pathological isolation, ensuring they maintain self-care and a connection to their support system.

5. Acceptance

 * What it looks like: Acceptance is often misunderstood as being 'okay' with the loss, which is rarely the case. Rather, it means accepting the reality of the loss and learning how to live with it. The intense, raw pain begins to soften, and the focus shifts to reorganising life without the person, thing, or role that was lost. It means finding a way to integrate the loss into one's life story.

 * The therapeutic view: This stage is about meaning-making. It is where we explore the legacy of the loss and how it changes the client's future narrative. Grief doesn't disappear; it simply changes its form, moving from an active wound to a scar—a permanent part of who you are, but one that no longer dictates your life.

The Key Takeaway: It’s Not a Straight Line

The most important truth about the stages of grief, is that you will cycle through them. You may jump from Anger back to Denial, linger in Depression, or experience all five in a single day.

If you are navigating a loss, remember:

 * Your grief is unique. There is no 'right' way or timeline for mourning.

 * Be patient with yourself. Healing is not a linear process of improvement.

 * Seek support. Professional help can provide the non-judgemental space needed to navigate the turbulent waters of sorrow and eventually find acceptance.

If you are struggling to cope with a loss, please reach out to a therapist or a trusted support network. You don't have to carry this weight alone.

Navigating Disconnected Families During the Holidays

The air is thick with cinnamon and nostalgia, the stores are blasting carols, and our social media feeds are full of perfectly staged, happy families. For many, Christmas is a time of profound connection and joy. For countless others, the holidays can be a stark and painful reminder of a fundamental sorrow: family disconnection.

The pressure cooker of Christmas amplifies existing divisions, turning what should be a time of warmth into a period of acute stress and loneliness. If you are feeling this sting—whether you are estranged from a close relative, managing a strained relationship, or simply feel fundamentally misunderstood within your family unit—know that you are not alone, and your feelings are valid.

The Myth of the 'Perfect' Christmas

The first step in coping is to challenge the powerful, idealised narrative of the holiday. Society paints a picture of harmonious, multi-generational gatherings, but this image is often a carefully constructed illusion.

 * Amplified Expectations: We project our deepest longings for acceptance and unconditional love onto this one day. When reality inevitably falls short, the disappointment is magnified tenfold.

 * The Contrast Effect: Seeing others seemingly achieve this ideal—especially on social media—can trigger feelings of shame, failure, and isolation regarding our own family situation.

The therapeutic truth? Family is complicated. Disconnection is a natural, albeit painful, consequence of differing values, unresolved trauma, or necessary boundaries. Accepting this reality reduces the sting of the 'shoulds'.

The Different Faces of Disconnection

Family disconnection isn't a single experience. It shows up in several key ways, each requiring a different approach:

1. Estrangement (The Empty Chair)

This is the clear, painful absence. Someone has been consciously cut off, whether by your choice or theirs. Christmas highlights the physical and emotional space they once occupied.

 * Coping Strategy: Acknowledge and Create New Rituals

Allow yourself to grieve the loss of the relationship and the idea of what it could have been. Instead of focusing on the empty space, pour your energy into creating a new tradition that feels meaningful to you, whether it's volunteering, hosting a dinner with friends, or a quiet, self-care-focused day.

2. Emotional Distance (The Crowded, Lonely Room)

The family is physically present, perhaps even sharing a table, but the conversations are superficial, the arguments are cyclical, or you feel fundamentally unseen.

 * Coping Strategy: Set a Time Limit and Lower the Stakes. You don't need to fix decades of family dynamics in one day. Focus on micro-boundaries:

   * The Check-out Plan: Decide how long you will stay.

   * The Safe Topic List: Steer conversations toward neutral, low-stakes subjects (movies, food, holiday plans) and away from polarising ones (politics, money, past grievances).

   * The Ally: Identify a trusted person (partner, sibling) to share a knowing glance with or step away with for a quick break.

3. Managing Conflict and Boundaries (The Tightrope Walk)

This is the anxiety-ridden anticipation of a guaranteed argument or the need to enforce boundaries that others consistently disrespect.

 * Coping Strategy: Repeat Your Mantras and Practice Self-Regulation. Go into the day with three clear, non-negotiable boundaries. Practice your calm, neutral responses ahead of time:

   * 'I’m not discussing that, but thank you for your concern'.

   * 'I need to step away for a moment'.

   * 'That doesn't work for me, but I hope you enjoy it'.

   * If a boundary is crossed, follow through calmly, even if it means leaving. Your peace is your priority.

Shifting the Focus: Creating Your Own Warmth

If your family of origin isn't providing the warmth and connection you crave, it is not only permissible but essential to seek it elsewhere. This is the opportunity to embrace your Chosen Family.

 * Invest in Connection: Spend time with the people who replenish you—friends, neighbours, partners, or coworkers. These are the relationships based on mutual respect and shared values.

 * Give Back: Volunteering is a powerful antidote to loneliness. Shifting your focus to those in need can rewire your brain from sorrow to purpose.

 * Practice Self-Compassion: Treat yourself as you would a dear friend going through a difficult time. Acknowledge that this is hard, allow yourself to feel sad, and then offer yourself kindness.

Remember: The spirit of the holidays is about love, generosity, and light. If your family connection dims your light, it’s time to find a new source. You have the power to redefine what 'family' and 'Christmas' mean for you.

Growing Up with an Alcoholic Parent

A Home of Chaos and Silence:

The family, for most, is a sanctuary—a place of unconditional love, safety, and stable ground from which to launch into the world. For those who grew up in a home where a parent's life was affected by alcohol, this sanctuary becomes a battlefield. The emotional landscape is a minefield of unpredictability, secrecy, and profound loneliness. I've had the privilege of counselling many individuals who are grappling with the long-term echoes of this difficult childhood. Their stories, though unique, share common threads of pain, resilience, and the quiet struggle to build a sense of self in a world that never quite felt safe.

The Child's Experience: Navigating the Emotional Abyss

A child's developmental needs are simple and foundational: a sense of security, predictable routines, and emotional attunement from their caregivers. An alcoholic parent, however, is often emotionally unavailable, oscillating between moments of fleeting normalcy and alcohol-fuelled chaos. This creates a deeply confusing and often terrifying environment.

The child learns to become a hyper-vigilant observer, constantly scanning the environment for clues about the parent's mood. Is the bottle out? Are their movements slurred? Is the door closed? This hyper-awareness is a survival mechanism. They learn to anticipate conflict, to pre-emptively manage their parent's emotions, and to make themselves small and invisible to avoid becoming the target of an angry outburst. This vigilance, while adaptive in childhood, often manifests in adulthood as anxiety, difficulty with trust, and a constant feeling of being on high alert.

The Role of Secrecy and Shame

The family's unspoken rule is to never talk about the drinking. This culture of secrecy is a powerful shaper of a child's identity. They learn to hide the truth, to lie to friends and teachers, and to carry the weight of the family secret alone. This breeds a deep-seated sense of shame—the feeling that there is something inherently wrong or broken about their family, and by extension, about themselves. This shame can become a constant companion, leading to low self-esteem and a belief that they are not worthy of love or happiness.

The Three Unspoken Roles

In an attempt to bring order to the chaos, children in alcoholic homes often adopt specific roles, which were first described by Sharon Wegscheider-Cruse:

 * The Hero: This child takes on the role of the responsible adult. They overachieve, are perfectionists, and often become a caretaker for their younger siblings or even the parent. They seek validation through achievement, believing that if they are 'good enough', the family will be okay.

 * The Scapegoat: This child acts out, rebels, and often gets into trouble. They draw the attention away from the real problem (the drinking parent) and onto themselves. This role, while seemingly destructive, can be a desperate cry for help and attention.

 * The Lost Child: This child becomes invisible. They are quiet, withdrawn, and often spend their time alone in their room, lost in books or a world of their own creation. They learn to self-soothe and rely on themselves, which can lead to social isolation and difficulty with intimacy in adulthood.

 * The Mascot: This child uses humour and charm to diffuse tension and lighten the mood. They are the family clown, but beneath the laughter, they are often terrified and burdened by the responsibility of keeping everyone happy.

While these roles provide a sense of predictability, they prevent the child from developing a genuine, authentic sense of self. They are living a part, not living their truth.

The Adult Aftermath: Healing the Wounds

The impact of this childhood doesn't magically disappear in adulthood. Survivors often present with a complex constellation of issues:

 * Relationship Challenges: Difficulty with intimacy, a fear of abandonment, and a tendency to attract emotionally unavailable partners who replicate the familiar chaos of their childhood.

 * Emotional Dysregulation: A struggle to identify and express emotions in a healthy way. They may be prone to explosive anger, or conversely, be emotionally numb and detached.

 * Trust Issues: A deep-seated belief that others are unreliable and will eventually let them down.

 * Perfectionism and People-Pleasing: A need to be flawless and to constantly seek external validation, stemming from the childhood belief that they must earn their worth.

 * Chronic Anxiety and Depression: The constant state of hyper-vigilance and the weight of unresolved trauma can lead to mental health challenges.

The Path to Healing

Therapy offers a safe and confidential space to unravel these complex threads. Through a compassionate and non-judgemental relationship, survivors can:

 * Name the Pain: For many, this is the first time they have ever spoken the truth about their childhood. Simply naming the experience can be profoundly healing.

 * Process the Trauma: Attending therapy, they can reprocess the traumatic memories and learn new, healthier coping mechanisms.

 * Grieve the Lost Childhood: They can mourn the childhood they deserved but never had—the sense of safety, predictability, and unconditional love.

 * Reclaim Their Authentic Self: By letting go of the old survival roles, they can discover and embrace their true identity, separate from the chaos of their past.

Growing up with an alcoholic parent is an invisible struggle, one that leaves deep and lasting scars. The journey to healing is not easy, but with courage, self-compassion, and the right support, survivors can break the cycle of pain and build a life that is truly their own—one of stability, love, and emotional freedom.