Experts suggest writing about your breast cancer journey
Following a breast cancer diagnosis, most patients will have a wide array of emotions to sort through.
For some, they will avoid talking about the anger, fear or second-guesses with loved ones in an effort not to worry them.
Instead, write it down and get it out, say health experts.
By keeping a journal, if only for your own reading, you have a way to manage your feelings and make sense of what's going on, says Nancy Morgan, the former (she retired in 2014) arts and humanities program director, Georgetown Lombardi Comprehensive Cancer Center, Washington, D.C.
Expressive writing, not a to-do list, is what's most emotionally beneficial, say health experts, citing several studies.
"From my experience with patients, telling the story is the most important thing," says Melissa Craft, assistant professor, director Clinical Nurse Specialist Program, University of Oklahoma College of Nursing, Oklahoma City.
Your story starts with discovering your cancer. By writing about your experience, describing who you are and what you're going through, you're saying, "I'm unique. This happened to me," Craft says.
When Craft worked with women in her research, she used the word "story," not "expressive writing," to encourage participation.
"When I say expressive writing, I see eyes glaze over. When I say story, everyone is engaged," Craft says.
Her study showed writing personal stories about breast cancer improved the quality of life for those women who did it.
However, women are encouraged to go beyond the cancer story.
Write about what you'd like others to know about you, what you're impassioned about, says Morgan, a writing clinician.
You may discover that as you write you find some meaning in your story, and that may be the most rewarding outcome, Craft believes.
"The ultimate thing that happens when you tell the story is that you take something that seems to have no meaning and you find meaning," she says.
Experts caution that you may find writing painful.
"You can be angry; tearful. That doesn't mean it's bad, but cathartic," Craft says.
In Morgan's experience, when people do get upset during the writing process, it's temporary.
"The calm comes from releasing worries and fears," she says.
You may also be concerned you're showing weakness. You're supposed to be the core of the family and your journal entries reveal cracks.
Although that's a common concern, your frank writing can provide an opportunity to rehearse what you'd like to share, and that can valuable for you and your loved ones.
"I tell patients, 'Just think how sad you'd be if this was your mom and you found out 10 years later how sad she was. You didn't have a chance to help her. To cry with her,' " Craft says.
Nancy Morgan remembers being rebuffed when she encouraged one patient to keep a journal.
"The woman said she only writes happy things in a journal and 'I'm not feeling happy,' " Morgan says.
Instead of offering the woman a journal in a cheery color, Morgan's response was to offer the color black, which was accepted.
"She started writing about interns who came in the middle of the night waking her up."
Like the woman who vented about not getting a good night's sleep, you aren't limited in what you can write about.
"Lose the teacher. Lose the judge. Have it as your goal to be as honest as you can," Morgan says.
You may be a regular diary keeper, but you don't have to write for the long term to reap a positive outcome, Craft says.
In fact, in her research on potential quality-of-life benefits of expressive writing for early breast cancer survivors, Craft asked women to write for 20 minutes a day for four consecutive days.
That allowed enough time for patients to deal with the issue of cancer, but not so long that they'd feel drained, Craft says.