• How do I find the right therapist for me?

Not all therapists are knowledgeable in how to work with cancer-related distress or look for connections between current symptoms and a previous cancer experience, especially as some symptoms won't present until years later. So, don't be hesitant to shop around to find a therapist with which you feel most comfortable.

• My cancer experience was years ago, could I still be dealing with its effects?

Yes, these cancer-related trauma's take up residence in different parts of our minds and can lay dormant for years until we are ready to process them fully. Don't hesitate to talk about events that happened years ago as they often hold insight into the current distress. I find it essential to collaborate with my clients to ensure anything discussed in therapy happens when the client is ready and at their pace.

• Am I just going to be asked to take another pill?

Psychotherapists and social workers in cancer-focused counseling often work closely with psychiatrists that can prescribe medication. However, results can usually be achieved without medication and their use is more typically in extreme circumstances. Ask your therapist to be upfront about whether they think medication is appropriate for your unique case. Although there are psychiatrists I refer to and whom I trust and have good working relationships, I do not believe medication is right for everyone.

• Isn't it normal for me to be anxious and depressed going through or having gone through this?

Yes, it is normal to be experiencing distress during and after a cancer experience, however, how we cope with those symptoms is a factor in our emotional and psychological recovery from cancer. It is recommended that you connect with a therapist to periodically meet with during treatment and recovery to help monitor your symptoms and offer coping skills along the way when needed. I always discuss with my clients what their needs are at that time and we schedule accordingly.

• Does it make sense that I feel more distress now that my cancer experience is over?

Yes. As with most traumas we are unable to process the experience fully while still trying to survive, which results in the delay of the symptoms until months or years later. Furthermore, when the routine of treatment is complete individuals often find themselves discharged from their medical support team leading to feelings of isolation and the need for alternative sources of support. This is the period where many of my cancer-related referrals are received because patients are not taught how to cope with what they just went through.

• What if I just don't want to talk about this stuff? Am I wrong for thinking that way?

Therapists don't look at coping methods as being right or wrong as this is different for everyone. The focus is more on the product of your way of coping (e.g., does it have unintended consequences?, Does it lead to more distress later on?). Don't interpret suggested alternatives to mean your way is wrong, but rather as there just might be another way that avoids undue distress down the road. Cancer counseling is much more than just talking about cancer too. More often than not, clients arrive in therapy wanting to discuss seemingly unrelated issues that have just become more difficult due to their cancer experience.

• I don't like asking for help because I don't want to burden others with my problems.

Not asking for help during or after a cancer-related experience is like going white water rafting, falling overboard, and then not wanting to burden others with pulling you back in the boat. You need to ask for help, and doing so helps others in the process by allowing them the opportunity to help. I work with many clients that express the same sentiment. Knowing when it's time to ask for help is a strength, not a weakness.