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Your Emotions

103060407_8Similar to other times of emotional crisis during your cancer journey, finding out that you need surgery that will result in visible scars of disfigurement can trigger a new storm of emotions. Emotions are a natural and integral part of being human. Most of the time, your emotions are probably fairly manageable, but dealing with potentially dramatic changes to one’s appearance, sense of self and ability to function can challenge even the calmest person.

It is important, as always, to be aware of your own emotions and regularly work on active coping strategies to help you manage them. Visible disfigurements can have a profound impact on your body image, quality of life and self-esteem.1 Arunachalam D, Thirumoorthy A, Devi S and Thennarasu. Quality of life in cancer patients with disfigurement due to cancer and its treatments. Indian J Palliat Care.2011 Sep-Dec;17(3):184-190. Psychological distress, including anxiety, fear and depression, can develop into mental disorders that may require treatment. All cancer patients have these emotions at some point, but those with facial disfigurements are even more at risk of developing severe psychological distress.1 Arunachalam D, Thirumoorthy A, Devi S and Thennarasu. Quality of life in cancer patients with disfigurement due to cancer and its treatments. Indian J Palliat Care.2011 Sep-Dec;17(3):184-190.

Steps to help you adjust emotionally

These steps will help you to cope with and positively adjust to your disfigurement:

  • Let yourself grieve for your loss. Whether you feel you have lost your good looks, a favorite facial feature, your sex appeal or your ability to feel confident, it is healthy to acknowledge the loss and mourn.
  • Confront your loss. Once you have allowed yourself to mourn a bit, you will need to deal with the issue straight-on. Continuing to wallow in grief or trying to deny that you look or function differently now will just cause the adjustment process to take longer. Looking at yourself in the mirror and accepting what you see, plus acknowledging changes in how you function now, will help you to believe that others can accept what they see in you as well. This is the first step to rebuilding your confidence and feeling empowered.
  • Find ways to think positively about your experience. By focusing on your feelings of pride and accomplishment in your ability to cope with your changed appearance and function, you will continue to build your confidence and sense of empowerment.
  • Reestablish your sense of self. You can do this by weaving your new appearance and experiences into who you are and what you value. Allow your disfigurement to become a positive part of your identity and not just something you have become accustomed to. This step is the most difficult to accomplish and will probably take some time.2 Callahan C. Facial disfigurement and sense of self in head and neck cancer. Soc Work Health Care. 2004;40(2):73-87.

Finding and maintaining social support

Greater social support is associated with less emotional distress and improved well-being in cancer patients.3 Deno M, Tashiro M, Miyashita M, Asakage T, Takahashi K, Saito K, Busujima Y, Mori Y, Saito H, Ichikawa Y. The mediating effects of social support and self-efficacy on the relationship between social distress and emotional distress in head and neck cancer outpatients with facial disfigurement. Psycho-Oncology. 2010 Dec 20. However, social withdrawal is one of the most common emotional responses of people with facial disfigurements.2 Callahan C. Facial disfigurement and sense of self in head and neck cancer. Soc Work Health Care. 2004;40(2):73-87. Consequently, finding and maintaining social support may be particularly challenging for you at this time. You may have to push yourself far out of your comfort zone to accomplish it.

Note that support from your family members, while positive and helpful in general, is unlikely to help you feel more confident about interacting with new people. It’s just not the same. However, support from your existing friends and acquaintances may help you to feel more comfortable socially and more emotionally ready to meet new people with confidence.3 Deno M, Tashiro M, Miyashita M, Asakage T, Takahashi K, Saito K, Busujima Y, Mori Y, Saito H, Ichikawa Y. The mediating effects of social support and self-efficacy on the relationship between social distress and emotional distress in head and neck cancer outpatients with facial disfigurement. Psycho-Oncology. 2010 Dec 20. You might also consider meeting with a support group of people experiencing similar issues to yours. They can be encouraging and offer suggestions for confronting your emotions and dealing with them effectively.3 Deno M, Tashiro M, Miyashita M, Asakage T, Takahashi K, Saito K, Busujima Y, Mori Y, Saito H, Ichikawa Y. The mediating effects of social support and self-efficacy on the relationship between social distress and emotional distress in head and neck cancer outpatients with facial disfigurement. Psycho-Oncology. 2010 Dec 20. You might also work with a counselor or therapist to build up your confidence, coping strategies and courage.

Though it doesn’t seem fair, the burden will usually be on you to reach out to others, reassure them and educate them. By doing so, you will show them your personality and help them see past your scars to who you really are.2 Callahan C. Facial disfigurement and sense of self in head and neck cancer. Soc Work Health Care. 2004;40(2):73-87.<

I think you have to know what the new normal is for yourself. “Am I happy with what I look like now in comparison?” No. But it is my new normal. I did not choose it. It did not choose me. It is a hump you have to get over. Heather P. (orbital tumor survivor)

Handling the emotions of living with a disfigurement

This website contains several pages about dealing with the specific emotions of living with a disfigurement. You may find these pages to be helpful.

Your Identity

Your sense of identity and your self-esteem are tied up with your self-image. Whether you liked how you looked before or not, it was the face you had seen in the mirror for your entire life. You may find that you struggle with your confidence and sense of self-worth. This is a crisis, but there are ways to reconnect your sense of self with your changed appearance and regain your confidence and joy in life. Learn about this crisis in this section.

Handling Negative Emotions

Almost every person who experiences significant changes in the function and appearance of their head and neck struggles with negative emotions. You may experience anxiety, depression, embarrassment, self-consciousness, anger, frustration or other emotions as you adjust to the changes. The good news is that most people do successfully adjust and go on to lead satisfying lives. Learn how to get through these challenges in this section.

Feeling Positive and Empowered

One of the most effective ways to adjust to your disfigurement, and help others adjust to it as well, is feeling positive and empowered. There are ways to think and talk about your scars that remind you and others what a tremendous battle you have fought and won. You can make your scars into badges of honor that demonstrate your strength and determination. Learn how others have done this here.


References

1 Arunachalam D, Thirumoorthy A, Devi S and Thennarasu. Quality of life in cancer patients with disfigurement due to cancer and its treatments. Indian J Palliat Care.2011 Sep-Dec;17(3):184-190.

2 Callahan C. Facial disfigurement and sense of self in head and neck cancer. Soc Work Health Care. 2004;40(2):73-87.

3 Deno M, Tashiro M, Miyashita M, Asakage T, Takahashi K, Saito K, Busujima Y, Mori Y, Saito H, Ichikawa Y. The mediating effects of social support and self-efficacy on the relationship between social distress and emotional distress in head and neck cancer outpatients with facial disfigurement. Psycho-Oncology. 2010 Dec 20.