F-U Cancer Podcast - Grief and Cancer Care

Grief is a common emotion felt by individuals touched by cancer. It’s a complex response to significant loss, often involving sadness, shock, anger, denial and other feelings as a person attempts to cope with a cancer diagnosis, news of disease progression, an unwelcomed treatment side effect, or I think even the anticipation of missing milestones like graduations or weddings that are far in the future but already close to ones’ heart. Joining us today is licensed clinical social worker and cancer care expert, Paige Soleimani, here to talk with us about cancer related grief, how to cope and when to seek professional help.

The Podcast can also be found on YouTube, Spotify, and Apple.

Podcast Transcript:

Grief is a common emotion felt by individuals touched by cancer. It's a complex response to significant loss, often involving sadness, shock, anger, denial, and other feelings as a person attempts to cope with the cancer diagnosis, news of disease progression, an unwelcome treatment side effect, or, I think, even the anticipation of missing milestones like a loved one's graduation or a wedding that's far into the future but already very close to one's heart.

So, joining me today is licensed clinical social worker and cancer care expert, Paige Solamani, here to talk with us about cancer-related grief, how to cope, and when to seek professional help. Paige is an oncology social worker dedicated to supporting individuals navigating the complexities of a cancer diagnosis. She's based in Manhattan, New York, earned her Master of Social Work from New York University, where her passion for oncology began in her internship at NYU Langone Medical Center with the bone marrow transplant team. Following her graduate work, Paige joined Cancer Care, a leading national organization providing free support services to those facing the emotional, practical, and financial challenges of cancer. During her time there, she provided individual and group counseling, specializing in working with clients impacted by a cancer diagnosis and those bereaved due to cancer-related loss. Paige has also trained colleagues on the unique impact of blood and brain cancer diagnoses and led the only national telephone support group for individuals diagnosed with brain cancer, as well as an online support group for both blood and brain cancer patients and their caregivers. Paige currently works at Forge Health, where she was one of the first social workers brought on board to address the needs of clients impacted by cancer. She continues to provide compassionate care to this population. In addition to this work, Paige also maintains a private practice, Paige Solo Therapy, where she specializes in working with individuals affected by cancer, including patients, caregivers, and those experiencing bereavement. Paige feels honored to support her clients throughout their oncology journeys, and we're so very fortunate to welcome her today on the FU Cancer podcast.

Thanks for listening to the FU Cancer podcast. My name is Christina Rollins. I'm a dietitian, mom, and wife to a pretty awesome cancer survivor. We said FU to cancer nearly 25 years ago and are still going strong. I'm excited to share the FU Cancer movement, where we are a community of survivors, fighters, caregivers, and advocates connecting our shared experiences, passion, and determination to live a holistic and well-balanced life. Stay tuned because we've got a lot to talk about.

So, Paige, thank you so, so much for being here today. Thank you for having me.

So, what are the five stages of grief?

The five stages of grief are denial, anger, bargaining, depression, and acceptance. These offer a helpful framework for understanding the emotional journey after a loss. It's important to remember that grief is complex and a personal process, and these stages aren't rigid or go through a linear progression. Not everyone experiences every stage, and they also can occur in different orders or even simultaneously. Denial is often the initial reaction, a way to buffer the shock and pain. It allows you to process the loss at your own pace. Anger can arise as the reality of the loss sets in. It's a natural response to feeling helpless and unfairly treated. Bargaining might involve attempts to regain control, like wishing things could be different or trying to make sense of the loss by dwelling on the "what ifs." Depression reflects the deep sadness and weight of a loss. It's crucial to distinguish this from clinical depression, which requires professional help. Finally, acceptance doesn't mean that grief is gone, but rather a shift towards acknowledging the reality of the loss and learning to live with it. Grief can resurface in waves even after acceptance, triggered by reminders or anniversaries. Understanding these stages is valuable because it normalizes the grieving process. It helps you recognize your feelings, fosters self-compassion, and provides a language to talk about your personal experiences. Ultimately, there's no right or wrong way to grieve, and everyone's journey is unique. The most important thing is to allow yourself to feel, seek support when needed, and be patient with the process.

So, I've often heard, and you just mentioned this in your comment, but I've often heard grief described as really coming in waves, meaning that there are days or moments that are worse than others. So, how can an individual help manage that roller coaster of emotions they may experience, especially during periods of hope followed by setbacks?

Sure. When clients experience these resurfacing waves of grief, often triggered by specific places, dates, events, it's important to validate their feelings. It's crucial for them to understand that these triggers are a normal part of the grieving process, even long after the initial loss. Many are surprised to find grief resurfacing, so normalizing it can be a huge relief. From there, I explore strategies collaboratively. I might use the ball in a box analogy. It's a great visual for explaining how grief changes over time, not disappearing but becoming a smaller part of a larger life. In sessions, my clients and I discuss what might help them specifically. This could include honoring their loved one, such as visiting a favorite restaurant, spending time at their gravesite, or even creating a memorial. Expressive outlets, such as journaling, writing letters, or creating art, can provide a way to process emotions and communication with the memory of their loved one. Acts of remembrance: many find comfort in doing something in their loved one's honor, like volunteering or donating to a cause their loved one cared about. This is especially common around the holidays, as it provides a positive outlook, a positive outlet for grief. The key is to tailor the approach to the individual. There's no one-size-fits-all solution. So, each client I work with, I work with them personally to find what brings them comfort and help them navigate these triggering moments.

What are some of the physical signs and symptoms of grief?

Grief manifests in many ways, both emotionally and physically. It's not just about sadness. Physically, grief can take a real toll. A common experience is tightness or heaviness in the chest, often described as a "heavy heart." This isn't just a metaphor; it's a physical sensation. Beyond that, grief can lead to fatigue, changes in appetite, difficulty sleeping, headaches, and even a weakened immune system. The stress of loss impacts the entire body. And, of course, symbolically, the color of black is often associated with grief and mourning, representing the heaviness and darkness that can accompany a loss.

So, how are these symptoms of grief different from major depression?

Grief and depression, while both involving sadness and loss, are distinct experiences. Grief is natural and a healthy response to loss, typically of a loved one. It's characterized by intense sadness, longing, and a sense of emptiness, often coming in waves, like we just discussed before. Feelings of guilt, regret, and difficulty accepting a loss are common, but grief usually resolves gradually as the individual integrates the loss into their life. Think of the ball in the box analogy. The grief doesn't disappear but becomes a smaller part of the client's life. Depression, on the other hand, is considered a mental health condition. It can be triggered from grief, but also by other factors like stress or trauma, or even medical conditions such as cancer. These symptoms include persistent low mood, loss of interest in activities, reduced energy, changes in appetite and sleep, difficulty concentrating, and in severe cases, thoughts of self-harm or suicide. These are important differences in duration and intensity. Grief, while intense, typically fluctuates and lessens over time. Depression can be a chronic condition characterized by persistent and overwhelming sadness. Critically, while grief might involve guilt or regret, it doesn't usually include thoughts of self-harm, whereas suicidal ideation is a serious symptom of depression. Finally, grief is a normal human experience, not a mental illness. Depression, however, is a diagnosable condition requiring mental health professional support. It's important to remember that grief and depression can sometimes overlap. If somebody is experiencing intense sadness, loss of interest, or any other symptoms that interfere with daily life, seeking professional help from a therapist or healthcare provider is essential to determine the underlying cause and receive appropriate support and treatment.

So, what are some ways that an individual can sort of self-manage to cope with grief, and then at what point should they say, "Okay, I need to now go seek medical attention"?

That's a great question. So, initially, many clients find themselves overwhelmed by the practical tasks following a loss, such as closing accounts, updating wills, planning services. These tasks can be a necessary distraction, but once they're handled, the reality of the loss truly sets in. It can be jarring when the initial support system seems to return to their routines while the bereaved individual is left grappling with a complex range of emotions. Ceremonies or rituals marking the death can be incredibly helpful for some. In some cultures, there is a designated period of mourning with increased support from loved ones, which can be beneficial, especially in the earlier days. I also find that specific coping strategies can make a real difference. Gratitude exercises, even for the small things like a morning coffee, can provide temporary respite from grief. Journaling or simply talking aloud, as if continuing a conversation with the deceased, can also be super therapeutic. Sharing memories of a loved one with others can also be a way of keeping their presence alive. Self-care is absolutely essential. This includes basic things like maintaining hygiene, getting dressed, as well as venturing outside for short walks to break the isolation. I strongly encourage anyone experiencing loss to seek professional support. A therapist can provide guidance in developing healthy coping mechanisms, preventing the development of unhelpful or even harmful coping mechanisms. Therapy doesn't have to be a long-term commitment. Even a few sessions can offer a safe space to process grief and learn valuable coping skills.

So, how can an individual find meaning or purpose in their grief journey?

Finding meaning in grief is deeply personal and there's no single path. It's about rediscovering what helps you navigate the loss. One approach that resonates with many is focusing outward: volunteering or making a donation can be a powerful way to honor the memory of a loved one while making a positive impact. It shifts the focus, even temporarily, from the pain of the loss to something positive and constructive. Beyond that, there are several strategies to help find meaning: allow yourself to feel grief; grief is a complex emotion, and it's essential to acknowledge and even accept the full range of feelings: sadness, anger, confusion, guilt, even relief. Suppressing these emotions only prolongs the grieving process. It's okay to have good days and bad days; grief is not linear. Exploring the loss, reflecting on the relationship with the person who died, the positive aspects, the lessons learned, even cherished memories can be a source of comfort. Considering the impact of the loss and how it has changed your life can lead to self-discovery. Finding ways to honor their memory, whether through a memorial, sharing stories, or continuing traditions can be meaningful. Seeking support, talking to loved ones, joining a support group, or even seeking professional help from a therapist or counselor can provide invaluable support and guidance. Connecting with others who understand can lessen the feeling of isolation. Finding meaning and purpose might involve focusing on what you can control, identifying your values, exploring new possibilities, or, as we discussed earlier, helping others. Helping others who are grieving can be a particularly powerful way to find meaning in your own experience. Remember that healing takes time; grief is a process, it's not an event. Be patient with yourself, prioritize self-care, and be kind to yourself. It's okay to ask for help; you don't have to go through this alone. Finding meaning in grief is a journey, and it may not happen quickly, but by allowing yourself to feel, exploring your loss and seeking support and focusing on meaning and purpose, healing and growth are possible.

Well, Paige, thank you so much for sharing your expertise in this area. I really appreciate you taking time also out of your practice to talk with us today, so thank you for that. Anytime. It's been a pleasure being here today, Christina. And listeners, be sure to visit our website at fucancer.org. We've got a variety of information related to cancer care, nutrition, fitness, mental health, and also we encourage you to like and follow the FU Cancer podcast wherever you access your favorite content. Until next time, I'm Christina Rollins. Thanks for listening.