The Fear Factor: Tips for Coping

If you’re a regular reader, the fact that this post is hitting on Monday instead of Friday may throw you for a loop.  This post is a companion piece to a guest moderator spot on the Monday night #bcsm (breast cancer and social media) Tweetchat.  I hope that it is helpful.

The Fear

Anyone who has faced a life-threatening health crisis, will know what I am talking about when I say, “the fear.”  The fear is that thing that lurks beneath the surface.  It bubbles up when you have a headache.  It spikes when you have a stitch in your side.  The fear makes it hard for you to smile when people say, “But you’re done with treatment.  Aren’t you glad?”  They can’t quite understand that, at least while you were in treatment, you were monitored all the time.  It felt like there was less of a chance of a recurrence sneaking in under the radar.

The fear stalks you as you try to reengage with your life.  It can make it hard to plan for the future.  It can turn routine follow-up appointments to a tortuous obstacle course of anticipation, anxiety, and impatient waiting.  The fear can sneak its way between you and people who love you.  So for today’s post, I want to focus on a few concrete things that you can do to shift the balance of power from the fear back to you.

Tips for Coping

  1. Breathe.  I’m going to start with the simplest–but sometimes most effective–coping tool.  When you get anxious, or frightened, it is normal for your breathing to get more rapid and shallow.  So, let’s focus first on a coping tip that you can use anywhere and anytime.  If you recognize that the fear is ramping up, say to yourself, “I am going to focus on my breathing.”  Then take an unforced breath in through your nose (try to breathe in for two counts), pause (for two counts), and exhale gently (for four counts).  This eight-count pattern naturally begins to deepen and slow your breath.  That causes a cascade of anxiety and tension release throughout your body.
  2. Name your fear.  So many times, you may be tempted not to think about what you are afraid of.  The problem with that strategy is that trying not to think about something just focuses your mental energy on that thing.  For example, in the next thirty seconds, I want you to try your hardest not to think about pink elephants.  What are you thinking about?  Sometimes, when you name your fear, you can limit the amount of energy you spend on it.
  3. Create a container for your fear.  What this looks like is entirely up to you.  You may choose to keep a fear journal, or use a blog space, or post in an online forum.  You may write your fears on scraps of paper and stuff them in a “fear jar.”  There is a lot of room for creativity when you think about a fear container.  The important thing is that you give yourself both permission to express your fear and boundaries so that you don’t have to worry that the fear will “take over.”
  4. Get support. If you have already faced a life-threatening health crisis, then fear is a perfectly appropriate response.  You need support and safe spaces to talk about your fear.  As with containers, safe spaces look different for everyone.  You may connect with friends and family who can set aside their fear in order to support you through yours.  Or you may reach out to support groups online or locally.  You may choose to speak with a spiritual leader or therapist.  You may do a combination of all of the above plus a few extras.
  5. Allow yourself to connect to life despite the fear.  This is another tool that has lots of room for customization.  For so many of us, fear disconnects us from family, friends, and the activities that we love.  It’s almost as though the fear whispers to you, “If you enjoy this family moment without remembering me, you’re jinxing yourself.”  Part of coping with fear is intentionally, mindfully choosing to be active.  To do the things that bring you joy.  To spend time with the people that make life worth living.  To enjoy your body’s capacity–even if you’re in a phase of recovery.

These tips are just a beginning.  I’d love to hear some of your favorite fear management tips as well.


Image Credit: Photo of graffiti by Jimme, Jackie, Tom & Asha via Flickr

17 thoughts on “The Fear Factor: Tips for Coping

  1. Ann,

    I think you saved the best for last. “Connect to life despite the fear,” is the great leap forward that we all must take after a diagnosis with cancer. It is an overwhelming yet affirming process. My first reaction to my diagnosis was to hoard it like a rare commodity. If I didn’t have to say, “I have cancer,” aloud then maybe I could simply wake up the next day and discover it had all been a bad dream. But I did have cancer, and a multitude of decisions faced me.

    The first time you have to tell someone it’s like the ceiling caves in. Yet people rally. I received love and support from totally unexpected people, and in unexpected ways. If I hadn’t opened myself to that possibility, I would have been denied the love and support that is so essential to heal.

    Thanks for a terrific post,

    1. Jody,

      I remember that phenomenon. In some ways, each time that I had to tell a new person, I was allowing the loss to be a bit more true, a bit more real. I had to really gear myself up to say it out loud again. Thank you so much for your thoughts and feedback. I so appreciate the reminder that, when we are brave, we open new pathways for good stuff to come in.


  2. Ann,

    These are great tips. It’s important to remember that the fear doesn’t go away after the treatment ends and that we shouldn’t feel guilty about feeling fear but rather be mindful about coping with it.


    1. Rachelle,

      “Shouldn’t feel guilty…but rather mindful about coping.” I really appreciate that frame. That’s definitely the idea that I was trying to convey. Thanks.


  3. Ann,
    These are great tips. Thank you. I especially like #2, naming your fear. Without acknowledging it, how can you cope? Timely topic for me as I approach two yrs out from diagnosis.

    Thanks for joining in the chat last night. You were great! I need to visit your blog more frequently…I’m going to share this later today.

    1. Nancy,

      Participating in the chat was an honor and was a ton of fun. The #bcsm community is just amazing. I’m so glad that you found the post helpful–I think that many of us skip the step of naming our feelings.


  4. Ann, this is a terrific post. Enjoyed #BCSM last night, but as I explained, I cannot participate as openly as I’d like. However, I would like to share a research study that is currently recruiting participants. I was fortunate to be a part of the pre-trial testing and am still utilizing the program. I sent you the link via DM, but here it is if anyone else is interested in learning more: Attention and Interpretation Modification (AIM) for Fear of Breast Cancer Recurrence: An Intervention Development Study |

    1. Thanks so much! I’ll pass this along to folks that might benefit. I think that tools like the one in this study are part of the future of good health care. I appreciated your contribution to the conversation so much. I hope that you find the avenues that allow you to share your voice and get the support you need while you protect your privacy.


    1. Kathy,

      Thanks for the linkage of breath back to fight or flight. That is one of those things that I know, and so sometimes I forget to include it in the text! 🙂

      “Relax the body and sometimes the mind follows!”–and even if it doesn’t, your body still feels better!


    1. Dawn,

      They are all a bit my favorite–that’s how they got on the list. I think that the last one is both the most fun and the hardest. When it feels as though you’re consumed by fear, that is when it is most important to take a break.


  5. Ann,
    This is such a useful blog. I think it is common for family and friends to assume that it’s over once the treatment is over, and yet I know from friends of mine that the fear is palpable and present. These are very useful tips, actually useful for anyone who has suffered a trauma, and cancer and cancer treatment certainly qualify.

    1. Carolyn,

      You got to the heart of this post. All traumatic experiences touch us (including illness), and the effects can be long-lasting. I think that our loved ones just want us to be “out of pain,” and that means they sometimes struggle to hear our pain.


  6. Anne, This is such a great post and wonderful suggestions for facing any overwhelming fear. I love that you are address the anxiety that can haunt us when we are past the most active phase of a crisis. Often this is when we can feel most alone and vulnerable. Best, Allison

    1. Allison,

      So many of my patients don’t get to me until after their crisis is technically “over.” The phase after treatment can be some of the hardest and loneliest for many folks. Thanks for sharing your thoughts.


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