The German philosopher Friedrich Nietzsche said “That which does not kill us makes us stronger.” This is an idea which strongly resonates within our culture and in narratives about cancer. It’s tantalising to imagine that we might be able to gain strength from adversity but do we really become psychologically stronger as a result of cancer or do we become more vulnerable?
I’m a living miracle, or so I’m told. I’ve survived two diagnoses with a rare and aggressive form of breast cancer. I can’t, however, take any credit for this remarkable achievement. I survived cancer because I have the good fortune to live in a time and place where I received the best treatment that modern medicine has to offer. Had I been diagnosed with breast cancer fifty years ago, like my grandmother, I would have died at the age of forty. My survival is nothing more than a happy accident and it came at a price. Cancer left my body broken. The treatments were punishing and stripped away layers of my identity. Emotionally, I felt like a prisoner in an unfamiliar country and, with the threat of further recurrence ever present, I’ve struggled with deep fears that even now, five years later, I can’t seem to put into words.
I remember how, during chemotherapy, I would sit on a park bench watching my young daughter and partner playing football together and feel like a ghost in my own life. Getting upset by a late train during rush hour, a looming essay deadline or a disappointing hair-cut seemed completely futile to me. I was completely unmoved by what seemed like minor irritations. I regarded this new-found serenity with a kind of wonder. I thought I was calm. In reality, I’d most likely learned to cut-off from the intense emotions of fear and anxiety that were my constant companions. I didn’t know I had become numb. This, I think, is trauma. It’s a bleak emotional landscape - not a place to visit, let alone stay. There was no strength, only going on slowly and quietly when I felt like giving up.
I’d never say I’m grateful for the experience of cancer. I feel so angry when I read cancer described as a gift. Cancer is a life-threatening disease which kills around 450 people every day in the UK. How is it that so much attention is given to the so-called ‘positives’ of cancer, or, as I’ve described them myself, the ‘silver-linings’? Positivity, it seems, is a characteristic that is becoming strongly associated with strength in the experience of adversity. There is also an emerging body of research into the phenomenon of ‘post-traumatic growth’ which describes the process of growing in positive ways from the trauma we have endured, including; re-evaluating our priorities, our values and goals; perhaps feeling closer to our families; having a deeper appreciation of our strength and resilience. I would argue that there is a crucial difference between recognising that we can come through the crisis of cancer, resilient and strong, and, coming to the view that we are resilient and strong because we had cancer. I don’t give cancer credit for anything I’ve learned, or, for any positive changes I’ve made. The scars run too deep and the losses are too painful.
Underneath my cloak of positivity lies the painful and uncomfortable truths that I tried to bury deep within myself: the illogical feelings of envy towards the person I was before cancer; the sadness that I am no longer capable and energetic; the loss of my womanhood; the self-consciousness. I see, in this ‘new me’, characteristics which are commonly associated with weakness: I finish work early. I cancel plans at the last minute. I’m unreliable. I need to have a nap at the weekend. I worry that I might be viewed as a malingerer. Emotionally, I want to feel less sensitive. I want to be less easily hurt. I imagine my inner self as a fragile and vulnerable new-born infant. I want to nurture and protect her from all that is bad in this world.
My experience of cancer still haunts me – the feeling that something terrible will happen as I fall asleep; the sights and smells which ambush me and transport me back into a past, vivid and real. I wrestle with irrational beliefs – maybe writing the word ‘survival’ in this blog will activate another deviant cell into action – or a fleeting feeling that I have cancer again washes over me. Over time, and with more stability in my physical health, I’ve found myself tipped into an ocean of intense and complex emotions. Although I feel joy in the astonishing miracle that is my life, I must also learn to manage the Tsunami-like waves of fear, guilt, helplessness and loss which wash over me and threaten to carry me away.
I’m learning to use my experience of vulnerability to become more resilient. I’m learning to express my emotions again, to practice compassion, to forgive myself for my mistakes, to accept myself as I am now, this new broken self, born from the trauma of cancer. I’ve learned from my friend Naz, a cognitive and affective neuroscientist and Director of the BRiC Centre, that vulnerability is a core ingredient of resilience – that the capacity to translate vulnerability and fragility into strength and to do this when we are hurt, when we feel depleted, when we feel we can’t go on, counterintuitively enables us all to go forwards on a pathway to resilience. Strength and vulnerability, I’m beginning to see, are like light and darkness, they support and complement one another.
You can find Tamsin at the BRiC Centre (Building Resilience in Breast Cancer)