Hester Hill Schnipper Photo courtesy of Beth Israel Deaconess Medical Center

MANY CANCER SURVIVORS HAVE HEARD about the power of staying positive. However, the excessive pressure to focus on the bright side at the exclusion of negative feelings—called toxic positivity—can minimize a person’s real feelings about cancer. People who gloss over the challenges of cancer with an overly positive stance can diminish your experience, insult your authentic feelings and even fuel internal guilt about your very real concerns. In reality, many of us will struggle to stay positive during and after cancer treatment, making this expectation nearly impossible to achieve.

In fact, pretending that everything is just fine and denying the very real problems that accompany a cancer diagnosis is the opposite of good self-care. There are two lines of defense against this kind of relentless positivity: being honest and gentle with yourself and learning how to deflect when you receive advice.

Here are some points I stress with my patients who often find themselves on the receiving end of these unrealistic expectations:

1)  A positive or negative demeanor has no impact on cancer cells, although your outlook can certainly affect the quality of your days. Cancer is a complicated biological process, and treatment, not your mindset, will tackle those cells.

2)  Cancer is not retribution for wrongdoing or poor choices in your life.

3)  Avoid worrying that your negative thoughts can somehow interfere with healing, which can start a terrible cycle. You worry. You feel worse. You worry that feeling worse will somehow fuel the cancer. You feel even worse. Steer clear of this bottomless rabbit hole.

4)  Accept that some days are going to be better than others, especially during cancer treatment.

5)  If you feel frustrated when someone encourages you to stay positive or suggests that God has a plan, take some deep breaths before responding. I often encourage my patients to be direct in these moments. They might ask, “Why did you say that?” This question almost always stops the speaker who immediately sees how minimizing their statements can be.

6)  If someone consistently downplays your experiences, have a strong prepared response, such as, “Having cancer is very tough and scary. I am entitled to my feelings.”

7)  While it’s important to stand up for yourself, remember to give people grace as well. A friend or loved one’s relentless encouragement to stay positive may be their way of protecting themselves from their own fears about your diagnosis.

8)  If you’ve recently finished treatment, people may expect you to simply return to normal with cancer behind you. However, I often tell patients that it takes at least as long as the duration of their treatment to start feeling like themselves again. You can always remind people by saying you are still working on recovery.

9)  Being hopeful and optimistic may make other people feel better about your cancer, but you should never feel obligated to pretend to feel something you don’t or to be anything other than who you are.

Hester Hill Schnipper is a breast cancer survivor and a licensed independent clinical social worker in private practice. She previously served as the manager of oncology social work at Beth Israel Deaconess Medical Center in Boston.