When fear gets in the way of health

By Dr. Batya L. Ludman, Psy.D., FT · Published June 15, 2012

Several years ago I had a breast cancer scare. Five very long days and many specialists later, they decided that what they thought was a tumor was most likely nothing. "Most likely" and cancer don't go well together in the same sentence. In that instant I had become a vulnerable patient. For days, my life – my future, my everything-- seemed to be in suspension as a long holiday weekend passed and I waited anxiously for the answer from various specialists - did I or did I not have cancer? Was I or was I not okay? My mind played wonderful tricks on me as I imagined the worst case scenario. You see, when I went in for that exam, it never occurred to me that they could possibly find something. After all, it was just a screening, no one in my family had had breast cancer, I was young and breast fed all my children. Totally naïve, I was caught with my pants down - or more accurately with my shirt up! In the blink of an eye, all could and did change- forever.

Sitting recently again in the waiting room with a dozen women and a few men (because men get breast cancer too), religious and non-religious, Jew and Arab, waiting for my yearly mammography appointment, I am reminded that behind each person there is a story. With a husband who specializes in cancer genetics and having had both parents die from cancer, I know only too well how the entire family is impacted by this diagnosis. And as I sit there reading the newspaper, I find myself also praying far more meaningfully than usual and even engaging in a little "if you could just…then I will" bargaining session with G-d. I always go from the clinic directly to the Kotel to give my thanks!

So when my favorite receptionist took me out of my contemplation and said, "How are you?" my reflexive, "fine" bore no relationship how I was really feeling. You see, at that moment, what I really wanted to say was, ask me that in three hours after I have had my mammogram, ultrasound, and my wonderful doctor reassuringly assures me that all is okay. Then I will really know that I am fine. Until then, I find myself brought back to that traumatic period, several years ago, when I was reminded that life's directions don't always lie entirely in our hands.

Let's face it, having a mammogram is no treat. Check out the internet jokes depicting breasts caught in freezer doors or being driven over by a steam roller on a cement garage floor and you'll know what I mean. Standing in a cold room, half naked, with a stranger, and smushed into a machine is not everyone's idea of fun but given my history, I wouldn’t miss this appointment for the world. You see I would far rather have the information and then deal with it, then worry, wonder or bury my head in the sand. Having hit middle age where Mother Nature is less than kind some days, I prefer to check off one more anatomical part as being okay - for now.

Confessing full disclosure, years ago I helped design a study with an obstetrician colleague to evaluate the effect of delayed prenatal diagnostic test results on anxiety. Back then, we were talking days, not minutes for results! Thus, as I searched meaningfully into my doctor's eyes as he examined me, trying desperately to understand and make meaning of each gesture or silence, I was aware of the direct correlation between length of this physical exam and my own anxiety. Hmm I think, why is he pausing, what does he see or feel? Why is he scanning the same area again and is there a hint of concern or am I simply imagining it? A ten minute exam feels like hours.

So what can you do when a medical procedure is indicated?

Pick up the phone and make your appointment today. Delaying only increases anxiety. Anticipation is always so much worse than the actual event. Colonoscopy, prostate exams, mammograms, and other procedures, while not particularly pleasant, are very bearable.
Once you have made your appointment, forget about it until the day before the procedure. Be optimistic. Assume all will be fine and not that you are dying! Worrying about what you don't know doesn't help, wastes time, doesn't change the results and doesn't feel good. Choose your time to worry and allow yourself permission to worry only at this designated time. Remember, you can't worry about everything and function well. When intrusive thoughts enter your consciousness (and of course they will), say "not now" and remind yourself that you will deal with them at the designated time, distract yourself and move on! So pick a time - such as from 5:00 to 5:15, the day before your exam, and only then allow yourself to worry. Otherwise the topic is off limits. Practice being calm. Learn relaxation breathing and mindfulness techniques. They really do work. I have successfully taught them to both children and adults. It is easy and you can use them any time. Learn to listen to your body. It tells you constantly just what is going on. What impacts you physically will impact you emotionally and vice versa. Your mind and body work together and a simple action such as breathing properly helps diminish anxiety. Reduced anxiety means less pain, less medication and greater control. Accessing accurate information can reduce stress. Don't believe all that you read on the internet. Speak to your doctor and make sure your relationship is good or find someone else. Trust is essential. Take a loved one with you who can hear the information, take notes, and review it with you again later as necessary. Sometimes it is hard to absorb everything the first time around. Surround yourself with people you love and who make you feel good. Be grateful for the good things in your life and that you are practicing preventative medicine and early screening. It just might save your life. Recognize what issues make you feel scared and vulnerable and talk with a trusted professional to get accurate information and help you feel calm. You may not have control over just what comes your way but you sure can determine how you will deal with it.