Coping with Cancer: Feeling Right When Things Go Wrong: Beliefs I Use to Help Me to Stay Alive

Pat Fobair, L.C.S.W., M.Ph.

People can get by without outside reinforcement by reinforcing themselves with heavy doses of encouraging selftalk. “We can do it, I can do it!”


When it comes to the possibility of loss of one’s life, we have a sense of shock, with feelings of isolation and fear. We may notice feelings of being “out of control.” I found that it helped me to notice my feelings of sadness, fear, and anger as soon as possible, and give myself permission to feel disappointment directly. I feel less defensive sooner when I can do this. For example, I have fewer blaming thoughts and use less denial when I can acknowledge my emotional pain. Almost as soon as I get to naming the feeling, I am able to move on to constructive thinking and problem solving. Yet, a source of conflict may emerge within us between our values and beliefs about life and the more immediate reality emerging before us.


When our survival appears to be threatened, some of our basic beliefs in life seem out of line with the new reality. “How could God let this happen to me? I’ve lived a good, clean life. What is true? I feel deceived! The meaning in life seems to have shifted!” Albert Ellis, PhD, addresses this major issue with his rational emotive behavioral therapy (REBT).

Some ideas are comforting; others challenge us to shift our thoughts to more inclusive humanitarian viewpoints. Here are those that I found comforting:

  • Humans are by nature remarkably imperfect and are encouraged not to define themselves by their shortcomings. “If I can be imperfect, I can relax within.”
  • Humans are not only different from one another, but also differ within themselves by way of thoughts, feelings, and involuntary biochemical sensations. These differences frequently occur spontaneously, often for no special reason, and are best accepted rather than protested against. “You do not have to be like me!”
  • Humans do best when they do not try to be islands unto themselves. Nor would it be well to make themselves endlessly dependent on their social group. Rotation and balance between you, me, and us is the socially advisable ideal.
  • By putting yourself first and keeping others a close second, you may be able to promote the give and take that is compatible with harmonious social living.
  • The essence of good problem solving is to give yourself some emotional slack; to lighten up on yourself rather than tighten up. Permitting yourself an emotional breath of fresh air has value apart from outside changes that you may be able to accomplish.
  • Individuals are capable of emotional self-reliance with or without the support of their family or social system. “I can get along alone, should I need to do so!”
  • Un-damning acceptance of self, others, and life is a fundamental premise of rational living. “You are okay just the way you are, and so am I!”
  • Humans routinely don’t practice what they preach. Pledging to more consistently practice affirmed ideals, while not condemning oneself for not hitting the bull’s-eye, is suggested. “Thanks for forgiving my discrepancies!”
Here are philosophies that may challenge us to rethink our values and beliefs:
  • There is no law of the universe that says others have to do unto us as we do unto them. Although it is nice when others treat us like we kindly treat them, such returns on our emotional investments are not necessities. “I will have to tolerate my disappointments with others who ‘let me down.’ And, I can allow myself to feel less guilty when I disappoint others.”
  • The persistence factor is best not underestimated. Getting behind yourself and pushing is habit forming and has a life of its own. Consistently going to bat on behalf of yourself strengthens emotional stamina while increasing the chances of success.
  • Everyone is in this life together and no one person is any better than any other. There are no good or bad persons, only individuals who do good and bad things. “This is hard to accept when I feel hurt, angry, or disappointed, but blaming others only covers up my feelings and distances me from feeling them fully.”
  • Happiness is a fleeting thing. It comes and goes in large part by how well you are able to provide for your wants. Vital absorption in a selected project or cause that structures large amounts of your time can improve your sense of meaning in life. “Having projects and completing them gives me satisfaction.”
  • We all can benefit from a healthy perspective on discomfort in life. Accepting reality rather than intimidating ourselves about discomfort will promote an expanded lifestyle. Worshiping the avoidance of discomfort can lead to an avoidance lifestyle. Humans are in the world to experience the world, which includes a fair amount of discomfort. “It has been hard for me to give up my childhood view of entitlement to unlimited happiness.”
  • Convincing yourself that you can stand what you don’t like allows you to be well grounded in curtailing your frustrations. “The little child in me wants to run away and avoid discomforts and situations that I don’t like.”
  • To damn or condemn a human, including yourself, is immoral and encourages a continuation of problems. “Accepting and forgiving others reduces tension in my life.”
  • A cornerstone of emotional well-being is not dramatizing the significance of disappointment by “awfulizing” or “catastrophizing” the consequences. “When I am scared, I immediately think of the worst thing that might happen, then imagine that it has happened. Accepting that I am feeling scared, and that it’s just a feeling, helps me let go of the dramatization inside my head.”
  • Accepting the deficiencies of surety, certainty, and orderliness in this world permits less confusion about and more enjoyment of what it does offer. Uncertainty is part of our daily world. “Accepting this idea encourages me to make the most of each day, and to ‘stay in the moment.’”
  • Running from pain increases suffering. Taking the long, easy way rather than the short, hard way is central to rational thinking. “Every time I’ve avoided a problem, it has returned to be struggled with again!”
  • Humans are born with the ability to emotionally upset themselves. Rational emotive behavioral therapy takes a dim view of the idea that family of origin or other intrusive background factors are crucial in understanding how humans disturb themselves. “I can choose to upset myself, or to calm down and figure it out!”
  • Just because we experience feelings in a situation does not mean that the circumstances caused the feelings. Nor must we presume that if we have a problem we wish to solve, we must solve it. “Feelings do not equal facts! Feelings are just feelings, ‘physiological phenomena,’ i.e., subjective reactions that may be pleasant or unpleasant, brought about by external circumstances and one’s own thoughts and behaviors, and experienced as brief electrical surges in the body.”
  • People can get by without outside reinforcement by reinforcing themselves with heavy doses of encouraging selftalk. “We can do it, I can do it!”

This philosophy holds us responsible for our emotions. Accepting this higher level of responsibility puts us in the driver’s seat to be our own best problem-solving philosophers.

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Pat Fobair, L.C.S.W., M.P.H.

Pat Fobair is a California licensed clinical social worker who worked in San Francisco Bay area hospitals for over forty years.'. She initiated group therapy support for cancer patients at Mount Zion Hospital in San Francisco, January, 1970, (now part of the University of California in San Francisco). In the 1980's, she started multiple groups for breast, young people, and multiple cancer diagnoses at Stanford University Hospital's, Department of Radiation Oncology, (1980-2003).  More With her colleague, Susan Weisberg, LCSW and six patients treated for Hodgkin's disease, Fobair developed the "Surviving!"magazine which featured stories written by patients. They published four times a year, 1983-2003. At the behest of Dr. Ernest H. Rosenbaum, MD, she facilitated in the development of the Supportive Care Program at the center for Integrative Medicine at Stanford Hospital, in 1998-2003, led by David Spiegel MD in the Department of Psychiatry and Behavioral Medicine. From the 1980's through 2003, Fobair was active in psychosocial and medical research on patients' quality of life after treatment for Hodgkin's disease, and breast cancer. Her work has been published in over 40 journal articles and book chapters, 1975-2012, and presented throughout the United States, Europe and Asia. From 2007-2012, Fobair was a CIES Fulbright Specialist on the Social Work list with the United States State Department. During tours in Turkey (2008) and Vietnam (2012), she worked with professional colleague, Grace Mishler, MSW using the Coping Engine teaching tool. It was particularly popular in Vietnam at the University of Social Sciences and Humanities, Vietnam National University, and at the US Consulate in Ho Chi Minh City, where an audience of 250 people did not want the lecture to end until their questions had been answered. Fobair developed a system, the Coping Engine, as part of her work with cancer patients, 1990-2013 at Stanford University Hospital. Initially called, "Coping with Loss of Control" it was used with cancer patients treated in the Department of Radiation Oncology. It evolved into the "Coping Circles" and "," a web site and tool she continues to assist.