When Cancer Comes Calling
Gratitude as a Source of Meaning, Hope, & Strength
by Kerry Cox Irish, LCSW, OSW-C
May was in her early 30s when she was diagnosed with adĀvanced breast cancer. When we met, she was using a wheelchair, no longer able to walk due to spinal meĀtastases. May described herself as āan open book.ā And, indeed, she generĀously shared her lifeās story with me and with others in the weekly cancer support group I was leading.
May had experienced a difficult childĀhood in which sheād endured horrific physical and emotional abuse. She ran away from home at age 16 and spent the next few years living on the streets and in homeless shelters. She turned to prosĀtitution to support a drug habit in her early 20s. At age 28, she was hospitalĀized for a serious infection related to her intravenous drug use.
While in the hospital, she had an enĀcounter with a kindly nun that drastically changed her life. This meeting led her to enter rehab and then move into a home for women in recovery. By the time she was diagnosed with cancer, sheād been clean and sober for five years, had obĀtained an associateās degree in early childhood education, and was working as a teacherās aide in a preschool for chilĀdren with developmental disabilities.
One thing Iāve learned time and again from people living with cancer is that gratitude is not contingent upon external circumstances.
May freely expressed grief about her terminal illness, but she also disĀplayed a deep sense of gratitude every time I saw her. She kept a gratitude journal, writing down both the profound and small blessings sheād experienced each day. Her stories and reflections in our counseling and support group sessions were always peppered with the phrase, āIām just so grateful that ā¦.ā She expressed gratitude for the care she had received, her ongoing sobriety, the cards her former students sent her, the view from her apartment window. She never left our group meetings withĀout hugging each member, thanking them for teaching her and giving her strength through sharing their own struggles.
Choosing Gratitude in Any Circumstance
As an oncology social worker, one thing Iāve learned time and again from people living with cancer is that gratiĀtude is not contingent upon external circumstances. Some of the most grateĀful people I know are, much like May, dealing with situations that appear anyĀthing but fortunate. They live in poverty, are disabled or are seriously or terminally ill, have histories of abuse or abandonĀment. Yet it seems they look out at the world with grateful eyes regardless of their circumstances. They meet each day with a recognition of its abundance and not its lack.
There is nothing Pollyannaish about their attitudes, as some cynics might claim. Nor are they in denial about the challenges they face. Rather, they seem both deeply rooted in reality and deeply rooted in awareness that life still has gifts to offer, sometimes because of, and not just in spite of, these challenges.
A growing body of scientific research indicates that cultivating an attitude of gratitude has measurable effects on both physical and mental health. The benefits include improved sleep, reduced pain, greater resilience, and fewer symptoms of depression.
Take, for example, Shawnda, a 49-year-old stage III ovarian cancer surviĀvor. She says, āYes, cancer sucks and I never would have asked for it, but I canāt deny that it has brought blessĀings into my life too. The friends Iāve made in support group, the love and care Iāve been shown by my family, the awareness that my life is a precious gift, something I never really knew, at least not deep in my bones, before ā¦ these are blessings, and for these, I am thankful.ā
Cultivating an Attitude of Gratitude
In addition to the common-sense knowledge that gratitude is a key ingreĀdient in the experience of joy, a growing body of scientific research indicates that cultivating an attitude of gratitude has measurable effects on both physical and mental health. The benefits include improved sleep, reduced pain, greater resilience, and fewer symptoms of depression.
It is natural in times of fear, pain, or uncertainty to have difficulty tapping into feelings of gratitude. During these times, reconnecting with gratitude may require intentionality and practice. Some people find it benĀeficial to pray, asking for help in removing any barĀriers to feeling gratitude so that they are able to perceive and apĀpreciate their blessings. Others may find it helpful to write a statement of intention. For example: May I reĀmain open and willing to perceive my blessings today. May my heart overflow with gratitude.
Brother David Steindl-Rast, a BeneĀdictine monk who is the founder and senior advisor for A Network for GrateĀful Living, suggests following a very simple method of āstop, look, goā to deepen oneās sense of gratefulness. He explains that most of the time, weāre so caught up in the daily rush of life, with our attention ever attuned to the future, striving to manage busy schedules and deadlines, that we donāt take the time to practice gratitude.
Brother Steindl-Rast explains, ā[T]he first thing is that we have to stop, beĀcause otherwise we are not really coming into this present moment at all. And we canāt even appreciate the opportunity that is given to us because we rush by and it rushes by. So, stopping is the first thing. But that doesnāt have to be long ā¦ a split second is enough to stop. And then you look. What is, now, the opporĀtunity of this given moment? Only this moment, the unique opportunity this moment gives? And that is where beholding comes in.ā
Beholding means to look deeply, to truly see something. This often gives rise to an experience of awe and appreciation. Much of the time, when someone has been diagnosed with a serious illness, the conditions for being able to āstop and lookā ā or to behold ā ripen. Many matters that previously occupied your attenĀtion fall away, as does the ability and the desire to rush. Beholding becomes more possible.
John, a 66-year-old man living with multiple myeloma, reflects, āI used to be a runner, and one of my favorite running routes was the Marginal Way [an Oceanside path in Ogunquit, ME]. I ran it so often that, over time, I failed to see my stunning surroundings. I was more tuned in to my sports watch, moniĀtoring my pace and feeling annoyed with the āpokeyā tourists who were slowing me down. When I walk the path now, itās slowly. Slow is all I can do, and Iām coming to appreciate what a gift slow can be. I am literally āstopĀping to smell the rosesā (wild beach roses line the path). Iām hearing the surf, and the gulls, and the sound of my own shuffling feet. Iām awed by the sights of the cliffs and the ocean in a way that I never was before.ā
The last step is to go, to make use of the way in which youāve been moved or touched, to allow it to flow through you. Some might call this āpaying it forward,ā or contributing to the happiĀness of another without any expectation of return. This doesnāt have to be a grand gesture; it can be as simple as offering a warm smile and sincere compliment to a stranger.
If youāve ever been the recipient of a ārandom act of kindnessā ā such as having the person ahead of you pay for your coffee ā you know that these seemingly insignificant acts have a way of lifting your spirits and renewing your sense of joy and connection to others. But these acts of kindness donāt just bring joy to the recipient. In offerĀing kindness (or being a blessing, as Brother Steindl-Rast calls it), we renew our own spirits as well.
When you practice intentional gratiĀtude ā whether through āstop, look, goā or another method ā you may just find the strength, hope, and resolution you need to live a joyful life, no matter your circumstances.
Kerry Irish has worked in oncology and hospice-care settings since 1995, and was intimately involved in the creation and deĀvelopment of the Dempsey Center (a cancer support center in Lewiston, ME, that proĀmotes hope and healing to anyone affected by cancer). She serves as a psychotherapist and the psychosocial services manager for the Center. An active member of the AssoĀciation of Oncology Social Work, Kerry specializes in working with people coping with advanced cancer (either as survivors or caregivers). She is writing a book about finding meaning and hope when illness is advanced.
In addition to āstop, look, go,ā many other practices can help you cultivate an attitude of gratitude. One gratitude practice that seems to work well for many cancer survivors is keeping a daily gratitude journal. Your gratitude journal is a place where you can list what you are grateful for each day. All you need to get started is paper and a pen (or a screen and keyboard if youāre the digital type). Why not give it a try?
This article was published in CopingĀ® with Cancer magazine, May/June 2017.