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The Fear of Recurrence
Julie Larson, LCSW
www.julielarsonlcsw.com
“This just isn’t like me”
• Fear
• Sadness
• Guilt
• Anger
• Emotional numbness
• Uncertainty
• Worry
• Pressure
Totally NORMAL
And at the same time…
• Acknowledge personal strengths
• Deepened relationships
• Excitement about the future
• New desire to set personal goals
• Gratitude and appreciation for life
Fear of
Recurrence
Will cancer come back?
Will I get a secondary cancer related to my treatments?
Will I recognize symptoms?
What do I pay attention to? What do I dismiss?
Am I doing enough?
Am I overdoing it?
Why? Why?
Why? Why?
Taking Action #1:
Worry = Unanswered Questions
When is my cancer
most likely to recur?
What are the doctors
looking at during
follow up visits?
When should I contact
my medical team?
Did treatment put me
at risk for any future
health issues? How will
those be monitored?
What are the questions driving your worry and fear?
Strategy #1: Redirect
your Thinking
“What If?” to… “What Is.”
Take inventory of your present. What you
know for sure.
“What If?” to…. “What Else.”
Are there other possible truths?
“What If?” to… “Then What.”
Create a concrete plan for your worst-
case scenarios.
“What If?” to… “What’s Left.”
Turn the lights on in the rest of the room.
What is available to you now?
Desperatly
Seeking
Control
Control is your best effort to
get rid of or problem solve
something that is distressing
to you.
• Rested
• Nourished
• Hydrated
• Connected
• Acknowledged
• Tired
• Hungry
• Sick
• Overwhelmed
• Emotional
Paying Attention with Purpose
STRESS RESILIENT
STRESS VULNERABLE
“Well hello Worry…”
 Greet your feelings like a visitor.
 Resist judging or struggling to “fix” them.
 Allow them some space to just be with you.
 Struggling with the uncontrollable feelings often makes the
feeling more intense.
 Watch how it is you learn to live
despite their presence?
“Oh! Anger. It’s
you.”
“Ah,
Restlessness.
Yes, I know
you.”
“Fear, you’ve
returned I see.”
“Oh jealousy,
hello.”
Taking Action #3:
Multiple Feelings at once
Do you have
more than one
feeling at a time?
Are these
feelings
contradictory?
How do you
attend to these
feelings?
What do you
need?
Increasing Self Awareness
TRIGGERS
Prevents you from being present
Catastrophizing
Personalizing
All or Nothing
Fortune
Telling
Should
Must
Ought
Negative
Comparisons
“The Voice” inside your head
The Anger Sadness Alliance
SADNESS:
• Sadness is vulnerable.
• Sadness accepts the situation for what it is.
• What helps you feel safe enough to be really sad?
• Pay very close attention to what makes you stop crying?
• Why does THAT matter?
ANGER:
• Anger is active energy.
• Anger gets you fired up and ready to defend yourself, jump into action!
• Anger rallies you to do something to change the situation.
• What can you do with that energy?
• Do you know your triggers?
Mindfully
consider: Which
emotion tends to
be your default?
“He lived
some distance
from his
body”
Worry and Fear can be very “head heavy”
How can you reconnect with your body?
Breathe
Change location (sit/stand; inside/outside; lay
down/get up)
Feel your body – touch
Ground yourself into the…ground. 
Change the pace with breath
A Support “Who’s Who”
•Health Care Professionals
•Peers (other who “get it!”)
•Friends and Family: “F.D.R.”
YOU
FEELING
Friends
DOING
Friends
RESPITE
Friends
Stay
in
Your
Lane
• Your emotions are influenced by the people around you.
• Hearing variances in treatment plans or follow up care can
cause you to second guess your treatment.
• Learning about someone else’s recurrence is a trigger.
• The set-backs (or successes) of survivor friends can trigger
concerns about doing cancer “well”.
• MAKE YOUR CANCER PERSONAL.
This is your diagnosis. Your survivorship. Your story.
Let's Talk About It: Ovarian Cancer - Fear of Recurrence

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Let's Talk About It: Ovarian Cancer - Fear of Recurrence

  • 1. The Fear of Recurrence Julie Larson, LCSW www.julielarsonlcsw.com
  • 2. “This just isn’t like me” • Fear • Sadness • Guilt • Anger • Emotional numbness • Uncertainty • Worry • Pressure Totally NORMAL
  • 3. And at the same time… • Acknowledge personal strengths • Deepened relationships • Excitement about the future • New desire to set personal goals • Gratitude and appreciation for life
  • 4. Fear of Recurrence Will cancer come back? Will I get a secondary cancer related to my treatments? Will I recognize symptoms? What do I pay attention to? What do I dismiss? Am I doing enough? Am I overdoing it?
  • 6. Taking Action #1: Worry = Unanswered Questions When is my cancer most likely to recur? What are the doctors looking at during follow up visits? When should I contact my medical team? Did treatment put me at risk for any future health issues? How will those be monitored? What are the questions driving your worry and fear?
  • 7. Strategy #1: Redirect your Thinking “What If?” to… “What Is.” Take inventory of your present. What you know for sure. “What If?” to…. “What Else.” Are there other possible truths? “What If?” to… “Then What.” Create a concrete plan for your worst- case scenarios. “What If?” to… “What’s Left.” Turn the lights on in the rest of the room. What is available to you now?
  • 8. Desperatly Seeking Control Control is your best effort to get rid of or problem solve something that is distressing to you.
  • 9. • Rested • Nourished • Hydrated • Connected • Acknowledged • Tired • Hungry • Sick • Overwhelmed • Emotional Paying Attention with Purpose STRESS RESILIENT STRESS VULNERABLE
  • 10. “Well hello Worry…”  Greet your feelings like a visitor.  Resist judging or struggling to “fix” them.  Allow them some space to just be with you.  Struggling with the uncontrollable feelings often makes the feeling more intense.  Watch how it is you learn to live despite their presence? “Oh! Anger. It’s you.” “Ah, Restlessness. Yes, I know you.” “Fear, you’ve returned I see.” “Oh jealousy, hello.”
  • 11. Taking Action #3: Multiple Feelings at once Do you have more than one feeling at a time? Are these feelings contradictory? How do you attend to these feelings? What do you need?
  • 13. Prevents you from being present Catastrophizing Personalizing All or Nothing Fortune Telling Should Must Ought Negative Comparisons “The Voice” inside your head
  • 14. The Anger Sadness Alliance SADNESS: • Sadness is vulnerable. • Sadness accepts the situation for what it is. • What helps you feel safe enough to be really sad? • Pay very close attention to what makes you stop crying? • Why does THAT matter? ANGER: • Anger is active energy. • Anger gets you fired up and ready to defend yourself, jump into action! • Anger rallies you to do something to change the situation. • What can you do with that energy? • Do you know your triggers? Mindfully consider: Which emotion tends to be your default?
  • 15. “He lived some distance from his body” Worry and Fear can be very “head heavy” How can you reconnect with your body? Breathe Change location (sit/stand; inside/outside; lay down/get up) Feel your body – touch Ground yourself into the…ground.  Change the pace with breath
  • 16. A Support “Who’s Who” •Health Care Professionals •Peers (other who “get it!”) •Friends and Family: “F.D.R.” YOU FEELING Friends DOING Friends RESPITE Friends
  • 17. Stay in Your Lane • Your emotions are influenced by the people around you. • Hearing variances in treatment plans or follow up care can cause you to second guess your treatment. • Learning about someone else’s recurrence is a trigger. • The set-backs (or successes) of survivor friends can trigger concerns about doing cancer “well”. • MAKE YOUR CANCER PERSONAL. This is your diagnosis. Your survivorship. Your story.