July 13th 2020
I had an appointment at the LRI today to get feedback on the biopsy of the removed mole. I was taken to the LRI by Catherine, and I remember wondering what might come my way and what the consequences could be. I had no real idea what I would do if the feedback was negative.
Due to Covid, Catherine was not allowed into the hospital, so I sat in the waiting room, killing time and keeping my mind clear of any negative thoughts. On meeting the doctor, I was immediately aware of the solemn manner of his approach, but didn’t particularly connect how this might have something to do with his news for me.
He was to the point and told me I had a malignant melanoma, and that there could be serious consequences. In turn, further treatment would be required. This treatment could involve surgery or other procedures and could last for some time.
I remember walking to the car park across the road and seeing Catherine’s concerned look – coupled with a hopeful smile – as I knocked on the car window. At that point, I only had the information I had been given, which was obviously of concern, but not too stark or disturbing. It was all might-bes and could-bes, so a bit worrying but not overly so.
The next morning, I started to wonder a bit more about events, what might be involved, and how I could deal with them.
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In mid-2020, I was diagnosed with malignant melanoma. It would be the start of a long and ongoing treatment journey, further diagnoses, all-clears followed by the reappearance of cancer, and more.
It’s been quite a ride.
Early on, though, based on my background as an executive coach to business and sports people, I realised I was well-equipped to tackle my cancer head-on. I began to document the tools and techniques I used when facing my illness, and this programme developed into the book “Steer Into The Skid”.
My programme aimed not to cure the cancer, but to allow me to use resources, tools, and techniques that would help me deal with, and respond to, whatever came my way. Seven key points spell out my approach:
1. To give purpose to my life (however long that lasts), not let it drift.
2. To live in the moment, not dwell on the past or worry too much about the future.
3. To give myself skills that help me cope with my cancer diagnosis.
4. To become and stay positive; positivity can only help my chances of recovery.
5. To empower myself – I will not be a passenger on this journey.
6. To develop mental toughness.
7. To make a plan, and work the plan!
The book ultimately became an 8-stage program showing people – practically – how to use select techniques from mindfulness, meditation, tools from psychology, coaching, and counselling to help them beat their own cancers. It also includes interviews with people who have been through their own health journeys.
Where does the ability to be mentally tough come from? Can it be learnt?
Some people feel that mental toughness or resilience are natural gifts (you either have them or you don’t). In my experience, yes, some people are naturally more resilient. However, everyone has some degree of these qualities, and they can be developed further and learned.
Is a Mental Health Programme necessary to help deal with a health issue?
The obvious answer to this question is no. None of the book’s interviewees, for example, followed a structured, planned, step-by-step approach to their health issues, or had a title for how they did it. However, all of them, often without realising it, used psychological and other tools to help deal with their situations.
Examples of these are positive anchoring, reframing, realistic positivity, mental toughness, strategies for success, plus staying and dealing with the now. Each interviewee had their own approach, based upon the principles of the MHP,including their own experiences and self-knowledge.
Positive Thinking and Attitude
A constant theme of this book is that positive thinking should not be based on hype and self-delusion, hence the term realistic positivity. This means accepting a particular set of circumstances and then deciding how best to deal with them most purposefully.
In other words, it is not just giving up and ‘going with the flow’ but responding in an optimistic and realistic manner, being willing to try new things, and running the risk of something not working. This comes back to finding a purpose in all circumstances.
Indeed, from the interviews, one dominant area of agreement was that unrealistic positive thinking and attitudes were worse than just being negative. Many interviewees felt that ‘hype’ or ‘self-delusion’ or ‘positive thinking with no foundation’ were actually destructive to positive self-regard and having a positive attitude.
The key to developing positive thinking was seen as building on previous difficult situations (which had been dealt with or overcome) and recognising the qualities used to achieve this result. A big factor in this was that the previous situation didn’t have to be a health issue; it was more about the qualities developed and used. Indeed, past experiences will almost certainly be from a different context but still prove helpful and relevant and applicable to the current health situation (e.g., dealing with a difficulty at work, being dropped from a sports team, working under time pressure).
Lack of self-pity
Some interviewees (plus many other people I met while going through my illness) had dealt with astonishing difficulties, yet none of them showed an ounce of self-pity. There was no ‘poor me’ or ‘why has this happened to me’. In talking about their situations, people were not focused on why something had happened but rather on what they could do about it.
The role of partners, family and friends
This next point is hardly a surprise, but its value and strength cannot be overstated. All of the interviewees felt that platitudes from others intended to calm worries – such as “Don’t worry, I’m sure you will be fine” – actually made things worse. People want to be treated as adults but in a way that respects their intelligence and builds upon demonstrated qualities rather than offering vague words of support. On your journey, and assuming it is valid for you, gently make clear to others that this is how you want to be treated.
The other big point on this issue was that – no matter how difficult it had been or was being – people facing big health issues all feel their illnesses are harder for the people ‘close to them’. In some cases, this becomes a real issue and another problem to deal with.
Be honest with yourself
Both myself and the interviewees feel that self-honesty is the key to this health journey, and something that we are responsible for. In other words, self-indulgence and raising false hopes for ourselves – no matter how well intended – will not help in the end.
This is not a license to give oneself a hard time, though. It is more a case of staying focussed on what can be done and what is required mentally.
And, by the way, self-awareness is not self-indulgence!
Keep up with hobbies and interests
Maintaining one’s previous life is important. This often incorporates a partner (as well as family and friends) and is seen as a vital element because it allows an individual to be treated as a ‘normal’ person. The actual hobby or interestsdon’t really matter;it is more about having something purposeful to occupy the ‘downtime’. In this case, downtime is not when someone is feeling low; it’s when there is nothing medical going on, specifically.
This is important because there is normally a lot of ‘downtime’ to deal with!
Also, it is good to have a cause, whether raising money for a charity, working with a committee of peers, or something else purposeful.
The role of psychological tools
People often use psychological tools without realising or knowing what they are called. A lot of how people decide to deal with (and respond to) their situations is based upon self and what works for them. As explained in the book, I based my approach (which became my MHP) on Mindfulness, Cognitive Behaviour Therapy, and more,because I knew about them and had used them both on myself and others. In other words, use what you know, but be open to adding new tools along the way.
Engage with the medics
It’s very easy to become passive when dealing with the medical people you encounter; after all, they are the experts and you are the patient. However, I would strongly suggest becoming more upfront in terms of any information they provide or that you may require. Help them to help you; tell them the truth, seek clarification about anything you don’t understand, and share any concerns you have.
The medics are human too, and their preference – as stated to me on a number of occasions – is to develop a quality relationship with the patient. Key workers are a classic example of this. A quality relationship is not an excuse for self-indulgence or weakness; tough, direct conversations will still happen but will work better when based on a deeper understanding between patient and medic.
Information overload
Every interviewee had strong opinions on this. Most felt that the information provided by the medics (from whatever source) was helpful and about right. Most had also followed up by using ‘Dr Google’, which most people – subsequently – saw as a step too far. It resulted in them getting bogged down by the volume of information available and useless detail. This could be complicated by partners, friends and familybecoming ‘helpful experts’, once again based on Dr Google.
Managing self over a long period of time
Having a serious health issue is not a sprint; it is likely to be spread out over a period of time. Within the long timeframe, there is likely to be a series of sprints based on treatments and appointments. Be prepared for the long haul.
Where I am now
At this point, I am still dealing with cancer but cannot have any more treatments and can’t have any more immunotherapy. So, it is a ‘watch this space’ period as I wait for the results of check-ups and monitoring. I feel entirely comfortable with this as I still am able to lead a normal life, including working, exercise, and socialising. The MHP approach has helped me get to this point and I intend to carry on with it and – if required – add in more stages and more tools/techniques/activities and skills.
Get on with it – the dominant message
One theme that I hope has come through, across the book, is the need for action. Indeed, every interviewee had their own version of this, and it was a clear and consistent theme. As one person said, ‘There are always loads of reasons not to do things; ignore them and get on with doing something. Sometimes it doesn’t matter too much what that might be.’
Good luck, steer into the skid, and safe travels!