Treatment of a breast cancer survivor experiencing fear of cancer recurrence (#300)
PURPOSE: This paper will outline the case of Linda, a 61-year-old breast cancer survivor who participated in a Fear of Cancer Recurrence (FCR) pilot intervention.
METHODS: Linda received supportive psychotherapy during her breast cancer treatment and self-referred two years later with complaints of tearfulness, feeling overwhelmed, and difficulties with multi-tasking. On assessment, Linda’s FCR concerns were evident. She met criteria to participate in a five-week FCR pilot intervention. Linda held guilt about delaying a mammogram prior to diagnosis, and anger associated with her perception of insufficient original medical action. She had experienced a prolonged grief reaction to her father’s death 10 years previous after four weeks of “coping well”, and held negative cognitions that engaging with negative emotions would result in this same significant reaction. Linda had well-developed avoidance and thought-suppression techniques in response to cognitions about cancer but low insight about these. When unavoidable triggers were present (e.g., her relative’s deterioration due to metastatic breast cancer to the brain) without access to these techniques, Linda’s anxiety increased. Linda’s main treatment goal was to be able to face these situations “without falling apart”. The metaphor exercise in Session 1, explaining the treatment model, was salient for Linda throughout treatment. Understanding vulnerability factors, using attention training, and living well components were equally highlights of the treatment. Given Linda’s well-honed cognitive avoidance and lack of perseveration, detached mindfulness was a challenging component of treatment.
CONCLUSIONS: Linda reported being satisfied with now having more tools to deal with living with cancer. As a therapist, it was satisfying to witness Linda develop insight into the paradoxical maintenance of her anxiety by the use of cognitive suppression and have new skills for coping over the long term.
This abstract could form part of Symposium proposal, "An international perspective on advances in the Fear of Cancer Recurrence".