Few things are more life altering than a difficult diagnosis. Whatever your normal was, it may seem to have evaporated within minutes. When emotions around news of this magnitude set in, there can often be two main ways of reacting. The first is like an adrenaline rush that frenetically kicks everything into high gear, fueling a determination to gather and master every single possible piece of information out there (“I need to be in control!”). The second feels more like a paralysis of the mind and body, leaving us too overwhelmed to make sense of the unthinkable or too frightened to act on it (“I can’t handle this!”). Both are normal and to be expected, so our most important advice is, be gentle with yourself.
A Health Crisis Can Cloud Our Thinking
Whether you’re the one who’s been given a serious health diagnosis about yourself, or if you’re dealing with terminal illness of a family member, chances are it may be difficult to think clearly right away, when ideas of “solutions” spar with potentially hard realities. You may not know what to do next--or in what order. Should you tell your friends or hold back? Should you look up medical advice online, pre-plan funeral arrangements or stick your head in the sand? And why is this happening to you?
Yes, you tell yourself, people have been through similar situations before. Maybe you know someone who has had to figure out what to do for a family member diagnosed with terminal cancer or another illness. You may judge that there are surely more optimal ways of figuring things out than whatever occurs to you right now, but there are oh-so-many reasons why we aren’t able to step back and just take action immediately.
After a Difficult Diagnosis, Take Time to Regroup
For starters, when we’re emotionally overwhelmed, our bodies are wired to shut down the logical thinking parts of our brain. When a car is about to hit you, it simply doesn’t matter if you know what model it is. So the first step toward planning next steps would ideally be...taking some time to regroup. Whether that’s alone or in the company of loved ones, for a couple of hours or a couple of weeks, a concerted effort to engage in mindful or self-soothing activities can help revive our ability to think with more clarity.
Give Yourself Space to Open to the Idea of Planning
For many of us, years of avoiding conversations about illness and death have left us feeling that we simply don’t know where to start. Or worse, that speaking about it (or planning for it) would somehow hasten the inevitable outcome (not true, of course!). We may feel guilt at not wanting to plan, even if we honestly wish to help those who love us know what’s important, and what we’d like them to do if and when the time comes.
Putting off planning can offer a short-term reprieve. In not acknowledging next steps, we don't have to grant the rest that comes with it. But our bodies are often smarter than our minds, and avoidance can wreak its own physical and emotional havoc in the form of stress, pain, insomnia, even lethargy. The body knows when reality is being denied and has its own clever ways of communicating that to you, urging you to open yourself to embracing what is.
An Exercise Toward Opening
It may sound simplistic, but basic mindfulness can be really helpful, and can provide real relief. Try sitting in a quiet spot and focusing for even five minutes just on your breath. You can count breaths in and out, as in, inhale counting 1-2-3-4, then exhale 1-2-3-4. If you get distracted, that's okay. Just start again gently. Allowing yourself simply to be can help cultivate emotional space for the things you'll want to do. If after a time you find yourself ready, you could begin to pose the question, "What if I thought about making a plan?"
Whatever You Do, Don’t Judge Yourself
When you eventually find that moment to begin considering next steps, do your best to drop any judgment associated with how you’re approaching it. As with grief, there’s no right or wrong way to get started, and being hard on yourself will likely not help motivate you. Yes, there are considerations that are relatively important, and you’ll eventually get there, but for now, your initial efforts can feel more like a data dump of whatever thoughts are running through your mind. And simply taking those first steps can actually bring you relief and even comfort.
Consider Starting a List
Making a “Top of Mind” list might be a great way to start. No agenda, no order necessary. Just allow yourself the opportunity to jot things down--bullet points or journal-style--including treatment concerns, practical matters like healthcare proxies or getting a will together, or even choosing a music playlist or readings for an eventual farewelling in your honor. If your mind feels like it’s running in a thousand directions, let your pen flow freely without organizing anything. Just getting the thoughts down can feel empowering. As your list comes together, you’ll naturally start to cross-reference with planning advice you may have received from your care providers, your spiritual guides, your lawyer, your best friend, or others in your life.
It may be helpful to approach the beginning of a plan with a sense of your values and your legacy. What things are most important to you? How you want to communicate with those you love, and how you want to be remembered?
Those First Steps
As next steps come together, try to get a sense for which elements or topics feel more approachable. Take a look at a checklist if it might inspire you. What do you think you can handle and/or would be willing to do in terms of planning? Are there any elements that can help you establish a sense of comfort or assurance or gratitude? All of these first steps help ground you in the reality of what’s happening, but at your own pace. They also encourage a sense of acceptance and even openness for what’s to come. Know that everything will eventually get done, and it doesn’t have to happen all at once.
Be Kind to Yourself--Break Up Your Planning
Continue to work through the planning process in bite-sized chunks, and avoid bullying yourself or being overly ambitious. In dealing with a health crisis, whether for yourself or for a loved one, your energy--and your emotions--may not be consistent every day. Instead of self-talk that involves “shoulds” and “have-tos” which can actually be counterproductive, offer yourself manageable tasks to consider, and plenty of space to do them--or to wait a bit. Our best advice: create “mini-projects” or follow an organized checklist at a pace you feel is doable. Then forgive yourself if you don’t do them right on time.
Asking for Help Is a Badass Move
You may feel shy or sad or guilty or even angry about having to ask for help at a time when you are truly vulnerable. But this is absolutely the best time to give friends and loved ones a chance to do something for you. Whether it’s helping you to organize your home, helping you with emails or phone calls or meals, or sorting through documents--do not hesitate to ask for and accept assistance. Those who love you are likely eager to have something to do to show you how much they care for you, and to feel useful themselves in difficult circumstances. Nothing is more gratifying to someone than to be needed. So, need them. And tell them you need them.
If you find yourself in need of more help in dealing with the mental health issues around what to do after a difficult diagnosis, you may want to look for a qualified therapist who can support you through this part of your journey.