Hi, I'm Malory Lee, and I'm a senior social work counselor
here at MD Anderson.
Today I'm joined by Traci Newsom, who is a senior social
work counselor at MD Anderson League City.
And this is the Cancerwise Podcast.
Hi, Traci. Thanks for joining me today.
I'm looking forward to our conversation.
Today we'll be discussing navigating the holidays while
dealing with cancer.
And that can be going through active treatment, that can be
having completed active treatment, that can be having a
loved one going through cancer treatment.
So, this is a big topic, a lot to talk about.
So, let's get right into it.
Thanks for having me. It's good to be here with you,
Malory. I think that there's so much to unpack.
There are a lot of pressures that come with the holidays.
I think for anybody, what we feel, the pressure of
the holidays approaching and how to manage that.
And then when you throw a cancer diagnosis into
the mix, it becomes all the more overwhelming
and heavy in terms of the emotions.
Starting with the pressures, I think there's maybe
a pressure to continue on the usual family
traditions. Maybe you typically host the holidays
and you're thinking, how am I going to find the energy to
do that this year? Maybe you do all the cooking and,
and same. How will you do that?
Maybe you're just not in the best frame
of mind, after what you've been through, and you're
wondering how you find the just the emotional energy to
tackle the holidays.
So, I hear a lot around those pressures to begin with.
And then, of course, there's the emotions that bubble to
the surface for our patients and their families around the
holidays. What are the kinds of emotions that
you hear from families who are struggling?
I hear a lot of what you shared.
There's pressure that people put on themselves,
you know, especially if they held a certain role
in the family when it came to the holidays.
There's pressure from society comparing ourselves to
others.
I think we often think about the holidays as,
you know, time where we are expected to be very festive and
happy and participating in a lot of things at
all the time. And so, there's that pressure.
But on top of that, there's just,
and I think there's been more of a shift in attention on
these complex emotions that can come up with the holidays.
It's not just the festivity and the joy.
It's also a lot of the difficult feelings.
You know, there can be feelings of loneliness and isolation
for those who maybe have lost loved ones, or for
whom family might have difficult relationships
or dynamics for those who are grieving, and then also
those dealing with cancer, you know, there's always
experiences of grief, whether it's the losses
that come with cancer or if it's, you know, anticipated
loss that hasn't happened yet.
All of those emotions can bubble up during the holidays,
and it can be triggered by that.
Holidays are a milestone, so they are marker
of the passage of time.
So, they remind us of
kind of existential concerns.
One thing I do hear from patients with cancer sometimes
is kind of thinking about
their mortality, and the holidays can bring that up, too.
I think when cancer, when you deal with cancer, it's a
life-threatening illness. So, regardless of
your cancer type, your cancer stage, your prognosis,
it's natural to have feelings about mortality or
some fears or thoughts.
And so, sometimes I hear patients say, you know, I wonder
how many more holidays I'll be able to spend with my loved
ones. Or I wonder if this is my last holiday.
And that can be a really stressful thing to think about.
I think in working with patients, we often try to find
opportunities. Well, how can that be an opportunity to
to find meaning? You know, if this were your last holiday,
what would you want it to look like?
What are the things you'd want to do and how would you like
to spend your time?
So, there's, there's avenues to explore.
But as you said, just a lot of emotions and oftentimes
very complex emotions.
I hear a lot around that as well, particularly around
the themes of grief, where there's loss of either
people special in your life or someone not being able to be
there, or maybe the grief of just how you, cancer has
changed you as a person and has impacted your life.
But in addition to the kind of the grief and the loss and
sadness that's sometimes felt, I also have patients
talk to me a lot about the gratitude that they feel for
being here this year.
Maybe there was a time where they wondered if that was
going to be possible, and to be able to be here and spend
time with their family.
And so, those conflicting emotions
I often encourage patients
to consider that it's okay to have those
conflicting emotions. You can hold space for feeling grief
and feeling loss while you also acknowledge the gratitude
that you have for your life and to be able to spend this
time with your family, so it is heavy.
It's a lot that our patients face.
That's a great point to just the fact that we often have
seemingly contradictory emotions at the same time,
and that that's perfectly normal.
You know, there's a lot of complex emotions that they might
be struggling with at the same time.
And so, I think a big part of, I think we're transitioning
into talking about how we manage those emotions.
A big part of it is being aware that we
can experience a lot of emotions at the same time, being
open to them and also acknowledging
when they come up rather than kind of pushing them away or
trying not to feel a certain way.
So, can you speak more about ways that you've helped
patients manage these emotions, or ways that patients have
found helpful to manage emotions?
I think starting with acknowledgment is, is
the first step, I guess, to to working through the way that
you're feeling. There's a tendency to kind of stuff it
down. You want the holidays to be a certain kind of way for
your family and your friends and for it to be joyful
and special. And so, if you're feeling any sort of
difficult or possibly negative feelings,
there's a tendency to shove those down.
So, I think starting with acknowledging them and then
looking for ways to release those feelings
and emotions that you've got.
Whether that's talking to a trusted friend or
family member, sharing how you're feeling,
seeking counseling, even for a few sessions just
to process and work through the tremendous ways that cancer
has affected your life.
Reaching out to your social work counselor at MD Anderson
can fill that role for you as well.
And other ways may be journaling
or finding ways to write out how you're
feeling. That process of getting it out of your head and
onto paper can bring a lot of insight
and a needed release of that pent-up energy.
So, I think starting with acknowledging.
The next step maybe would be to think about how you can do
things differently and be open to asking
for help, open to communicating with your family.
I sometimes hear from families that, or patients, that
feeling of some resentment or frustration
with the loved ones around them who maybe don't necessarily
completely understand.
They're empathetic and they're loving, but they don't
completely understand what you've been through.
And sometimes patients will tell me, well, I don't.
I kind of expected them to understand that I've been
through a lot, and I don't have the energy to do these
things, but it doesn't feel like they're really
understanding. So, I think it's important to communicate
that to your loved ones and really let them know how you're
feeling and have a conversation with family about how can
we do things differently this year.
Can we modify some of these traditions?
Would somebody else like to host?
Can we do a potluck style?
And everybody brings their favorite meal so that
it eases the burden a little bit on you.
I hear that a lot, too.
I think that the piece about support, about reaching out.
That can be really hard when you're dealing with cancer.
A lot of times you hear people say, you know, I don't want
to burden my loved ones.
I don't want to have to talk about it with my family
who are also going through it.
And that's where your suggestions of maybe talking to a
counselor or joining a support group could be really
helpful. I know MD Anderson has a lot of opportunities
to connect with other patients, whether it's through a
support group or through a program like myCancerConnection,
where you can connect one-on-one with another cancer
survivor or patient.
But sometimes just having someone outside of
your natural support system to talk about this can ease
that feeling of, you know, not wanting to be a burden, but
also to your point, you know, letting people know what you
need is, is a huge part of the cancer
journey. I think it's impossible to do this without
support. So, being able to articulate what you need,
being able to express how you feel to others
and find support.
Like you said, just kind of delegating, you know,
letting people know what what tasks would be helpful
that can help in sharing the burden around the holidays and
just make things a little bit easier.
Definitely.
And I liked what you said about reaching out to a support
group or myCancerConnection.
There's a real power in connecting with people who truly
have walked through this.
So, I love that as a means of support.
I think holidays can be an isolating experience for
a lot of people, whether it's because you're not with your
loved ones or, you know, say, dealing with cancer
treatment, if you're unable to travel or be with the loved
ones that you would usually spend the holidays with.
That part can be isolating, but sometimes it can, we
can feel isolated or lonely, even when we're surrounded by
our whole family. Just having the experience of cancer
and feeling like maybe our our loved ones don't quite
understand what we're going through can be an isolating
experience. So, I'm just highlighting that because it can
be a big step in reducing that isolation by reaching
out, by just letting someone know how you feel or finding
an avenue of support that does feel good to you.
I think we've touched on this, but, you know, recognizing
holidays may look different than they have in the past,
especially when you're dealing with cancer treatment.
That's a big part, I think, of of coping with the holidays.
So, do you have any advice, or what advice do
you have for patients and their loved ones on how to
embrace this change?
I think really just being realistic
about what your limitations are and what you can manage
this year. I, a patient had shared with me at one point
that she thinks about after cancer, she only has
so much energy for each day.
And so, she thinks about her energy as like a water pitcher
full of energy for each day.
And she really had to sit down and think about what are the
things that take away from that energy
or that drain the energy, and versus what are the things
that really replenish them.
And so, she and I think this can apply to the holidays,
too, where you sit back and think, "What are the things
that I can do this year that may, even
if they're enjoyable, they may drain me a little bit, and
maybe I need to step back a little bit or minimize
some of these social activities" or whatever it may be
that's draining for you, versus what are the things that
are going to fill you with joy and really prioritize those
things. So, maybe you take a step back from
the hustle and bustle and the shopping and the grand
gestures, and you think a little bit more about what are
the tangible kind of things that we could do as a family
that are low cost, but would be kind of a treasure
that, you know, maybe you write letters, maybe you make
videos for your family members.
Maybe instead of buying cards this year, you make cards
something tangible again that your family can take
with them but doesn't take a lot of energy.
Yeah, those are great ideas.
And I like what you said about just kind of being aware of
your, your capacity, right. Your energy levels, the
pitcher. I think that goes into, kind of,
knowing our own needs.
And so, I often talk about kind of having a self-care plan
in general, but also if we know it's going to be a
stressful time, as we know the holidays often are, having a
self-care plan in advance can be helpful.
And what that looks like could just be first identifying
what your, your needs are, your physical needs, your
emotional needs, your spiritual needs, finding
ways that you can meet each of those things.
And so, that could be regarding food, that could be
physical activity and exercise, that could be sleep,
that could be making sure you're, you're taking your
medications and making sure you're taking care of your
health to the best of your ability.
So, keeping all these things in mind, especially because
the holidays can often throw those routines
out the door, right? We're often having big dinners.
We are often around things that might not be
our normal, you know, day-to-day structure that helps us
take care of ourselves and then identifying the things that
help with our emotional concerns.
You know, what are activities that help me feel
calm and centered and grounded?
Who are supports that I feel like I can trust and reach out
to in a time of need?
What are activities that just help me have a sense
of meaning if I'm struggling?
So, having kind of a plan and then being open to what comes
up, I think can be helpful when we're navigating all these
changes in the way holidays can look different.
Absolutely. I love the self-care plan.
All of those things that replenish that energy are huge,
and they do tend to fall by the wayside
around the holidays, because we get so caught up in all of
the hustle and bustle.
So, I love encouraging patients to make sure they
make that a priority.
And I also wanted to highlight, you said this, but kind
of letting go of expectations.
I think that's a huge part, just
easing our expectations of ourselves,
of others and remembering that there's
there's no one way the holiday needs to look or should
look. I often tell myself and patients,
you know, "Don't should on yourself" because a lot of times
the only thing that comes out of those thoughts are
feelings of shame or just
negative sentiments.
And so, letting go of expectations, thinking, out
of the box, there's no way this has to look.
I don't have to do certain things.
And I can create a new tradition that makes sense for me
and my family in this, this holiday season.
Yeah, absolutely.
I think that opportunity, the door is open to do some
things differently that maybe you haven't done, and maybe
it'll turn out to be something that your family really
loves, and you choose to carry on for years to come.
Yeah. I think we often also want to limit
how much we compare ourselves, whether to others or
even to ourselves, former versions of ourselves or former
holidays we've had. So, this might be setting limits also
with social media or limits on
certain activities.
So, just knowing your own boundaries, knowing as you said,
you know, what, what's going to, how much is in your
pitcher at any given point is helpful.
I think going back to thinking about traditions, how we
adopt those or maybe even start new ones, think
we can look at the holidays as an opportunity rather
than a stressor. So, here's a time when we might be
spending time with loved ones, or we might be seeing family
that we don't normally see, especially in light of cancer,
maybe this is an opportunity to record some memories,
whether it might be photos and scrapbooking,
making videos.
This all goes back into what you were saying about
tangible, low-cost ideas, ways that we can connect and find
meaning and build a legacy.
You know, what are things that you might want to leave for
your loved ones? For a lot of people, food is an important
part of the holidays. Whether it's food that's important to
your culture or to your family traditions.
So, one idea could also be coming up with recipes
and building a family cookbook together.
So, there's a lot of opportunities to create meaningful
traditions this holiday season, even when things
might look different.
I agree, and I'm just thinking about families, too,
while you're talking that families can play an important
role in all of this, and being open to
doing things differently and taking that step of reaching
out and saying to their loved one who's experienced cancer,
"I know you may not feel your best,
or you may still be dealing with some of the fallout of
what you've been through. How can I help?
How can we do things differently?
How can I make things easier for you?" And so, meeting
them where they are and being open to trying
something different. I think is important.
Absolutely.
Well, we know that the holidays not only impact
those who are in active treatment, but also survivors
who finished treatment.
In your work with survivors, what are some common questions
or concerns that have come up?
It goes back a little bit to what I mentioned earlier, that
sometimes there can be some feelings of frustration.
As a survivor, you've put treatment behind you.
Maybe outwardly you look like you're doing pretty well
and seem to be feeling pretty well, but maybe on the inside
you don't feel 100%.
Or maybe you're still struggling with the emotional effects
of all of this.
And so, I think being kind to yourself
and being willing to talk to your family about, "Hey,
I know I look like I'm doing fantastic, but here's
the way that I'm feeling, and here are some ways that
you can help me through this."
And it's very common, I think, for survivors to experience
a lot of emotional distress.
And part of that distress, I think, is caused by this idea
that, "Oh, I should be feeling better, right?
I'm done with treatment.
I want to be back to normal.
Why don't I feel back to normal?" They're comparing
themselves to how they felt before their cancer diagnosis,
and oftentimes how they feel now doesn't quite match
how they felt before.
And so, that's an area that people can be hard
on themselves. Some people might also describe, after
finishing treatment, that their support system isn't as
strong as it was maybe during treatment, because maybe
people think that things would be easier now that you're
done with treatment, or maybe you're cancer-free.
And so, that itself can be a really hard thing to deal with
when you're a survivor, and it can be very isolating.
Going back to kind of letting go of comparisons, letting go
of expectations and just being open to what we
experience and then knowing when
when we need more support and reaching out for that
when needed. But it's a very normal thing to feel.
And so, acknowledging that is, is, I think,
really valuable for for survivors.
I hear sometimes, too, from patients that
it's challenging to stay present in the moment.
Maybe you're feeling anxious.
You're getting ahead of yourself. You're thinking about,
"Will I be here next year?
Will my cancer come back?" All of those unknowns
that our patients face that cause a lot of anxiety,
that you can really get in your head over, and maybe it's
a struggle to stay present in the moment with
your family. Do you have advice for patients
who are struggling with how to stay present?
A lot of times we're caught up in worries
about the future. Or maybe we're ruminating about things
that have already happened, things from the past.
And that takes us away from the present moment, which is
really the most important time.
This is the time you can spend and that you have control
over. I think being present and being mindful
is something that can be very valuable.
It's not always easy because we can't always control
those thoughts, right, that come up.
It could be worries about something that's going
to happen, next week's treatment.
The effects of chemo.
What I'm going to do tomorrow for, for
this, this holiday event.
Or it can be thinking about things that have already
happened that you can't really change.
But all those things take you away from the present.
Sometimes we need to ground ourselves in that moment.
So, finding a way to find your breath.
It might just be paying attention to your breath.
Feeling that in your body.
That's a good way to ground us and just get present
and kind of set aside whatever might have been on our mind,
whether it was thoughts about the future, worries, thoughts
about the past, sometimes doing something active, doing
something really physical can help us get present and
take our attention away from the content of our mind
into what we're experiencing in this moment.
Yeah, finding activities that really engage you, that
maybe get you moving and get you active and that really
force you to be in that present moment.
I think those grounding exercises can be helpful where
you're really focusing on the senses.
What can I see? What can I feel?
What can I touch? What can I smell in these moments to sort
of bring you back to reality and get you out of your head a
little bit? Also, going back to gratitude.
I've had patients tell me it's really helpful to stay
in the present just by writing.
Each day they get they get up and write in a journal or on
a Post-it note. What are the 2 or 3 things that I'm
grateful for today?
They could be the big things of having time with family
and connecting in different ways, or it could just be the
simple things. The sun is shining, and I got to sit outside
on my back porch, or I got to pet my dog today.
Just those present day
gratitudes can help keep you grounded.
Yeah, that's a great idea.
I do want to bring up caregivers because that's a big part
of our work.
You know, working with caregivers. But also, it's a very
difficult thing to go through and something where
caregivers need a lot of support.
So, can you share a little bit about
what experiences caregivers might struggle with around
the holidays, and how you might support a caregiver,
or suggests, or offer suggestions to a caregiver?
You're right. I think caregivers also feel the pressure
and at times, the burden.
Many of the kinds of emotions that we've talked about with
patients our caregivers are feeling, too.
And they're they're wondering, how do I help?
How can I be there for my loved one who's been through so
much? Maybe they're feeling alone and feeling lost
about how to manage the feelings that they're having.
And so, I think encouraging them to tap into similar
resources that we've mentioned for our patients.
Seek counseling. Go and talk to someone where you
can really be open and free with how you're feeling, and
process your own emotions about watching someone you love
go through something so traumatic.
Reaching out to, we do have caregiver supports,
support groups. We do have myCancerConnection.
There's a portion of that that's for caregivers to connect
caregivers with other caregivers to help you not
feel so alone. And again, that power and connecting
with someone who can truly understand what
you're feeling in all of this.
I'm glad you brought that up, because just as patients can
feel really isolated dealing with a cancer diagnosis,
the experience of caregiving can be really isolating,
especially if you are the sole or primary caregiver for
a loved one. The holidays bring an opportunity.
Most of the time you might see you might have more people
visiting, or you might see loved ones that you normally
don't get to see.
So, finding opportunities to maybe delegate some of those
tasks can help ease some of the burden on, on
you if you are the primary caregiver.
So, seeing that as an opportunity.
Like you said, finding supports that are helpful
to you because it can be so isolating, you know.
Talking about your experience.
Some of the conversations we had earlier about letting go
of expectations can be really helpful
because a lot of times we we see caregivers deal with
feelings of guilt, maybe feeling like
they're not providing the care, the level of care that they
should be providing or that they want to provide for their
loved ones. So, letting go of expectations
and being kind and compassionate towards yourself, because
being a caregiver is a full-time job, it's emotionally
and physically taxing.
It takes a lot out of you.
So, being able to be kind
to yourself is, is really helpful when you're
coping with all of that.
As a caregiver and or a patient, it goes
back to communication. So, you just need to be talking to
each other. Acknowledge that you've both, you both
have your own experiences and your own feelings about
what's happened to your life and and talking about what
those feelings are and how can we do
things differently to to ease the burden for both of us
so that we can truly enjoy our time together.
To go off of that also is the idea that, you know, we
we are only responsible for our own feelings.
We can't be responsible for others' feelings.
We can't control what other people are experiencing.
We can do our best, right? We can offer support.
We can be kind and supportive and compassionate.
But in the end, that person's emotions are their own.
And I talk to a lot of caregivers who struggle with not
being able to take away their loved one's pain or not being
able to offer complete comfort, right?
And that, that can be one of the hardest things is that you
have to kind of sit with the fact that your loved one might
be in distress or in pain, or that you can't
get rid of all the symptoms or struggles that they're
dealing with. And that's really challenging.
Absolutely. And in those circumstances, I think it just
comes down to being present.
You don't have to have all the answers.
You don't have to have the right thing to say.
Just be in it with this person.
Listen, be a physical presence there
loving them through this.
Yeah. There's often not, not
the best thing to say, right?
We sometimes don't know what to say in those moments,
and that's okay. I think just being, like you said, being
present, you know, sometimes even acknowledging, you
know, I don't know what to say in this moment, but I'm, I'm
here to be with you through it, you know.
That, that means the world.
Absolutely.
Thank you, Traci, for being here today.
And thanks for a wonderful conversation.
Thanks so much for having me.
And thanks for tuning in today.
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