3 Tips to Move Past a Difficult Diagnosis

Debilitating health and devastating diagnoses need not rob you of a life filled with purpose

Getting a life changing diagnosis can make it hard to know how to move forward, but there are ways. (engagestock/Shutterstock)

There’s a large swath of healing that exists somewhere between complete denial of tragedy and allowing trauma to swallow your identity completely.

Jennifer Guttman, a clinical psychologist who specializes in giving people a sense of personal control, calls this space “assimilating into the narrative of your life.” The work, often involving cognitive behavioral tools, is something she frequently undergoes with clients who are dealing with difficult diseases such as cancer, Type 1 diabetes, and rheumatoid arthritis.

“First thing, it’s important to face it head on, because most people tend to avoid it,” she said of people newly diagnosed or facing new challenges. “Passivity leads to a lack of empowerment.”

It’s common for people to get stuck in the denial phase of grief when dealing with unexpected health issues, but there are techniques to help you move through even the worst situations. The benefits of doing so reach beyond a better emotional outlook and include a higher likelihood of getting the nutritional and medical care you need for your diagnosis, Guttman said.

Those who integrate their diagnosis into the story of their lives, in part by finding their purpose within it, tend to be those who take charge of their illness, she said. They ask more questions, take notes at appointments, use a support system, and find ways to get help at every phase.

Not everyone who gets a devastating or unexpected health diagnosis will suffer from emotional trauma. One 2020 study in the journal Annals of Burns and Fire Disasters found that while more than 90 percent of patients with burn injuries experienced stress symptoms, about one-third developed post-traumatic stress disorder (PTSD).

Trauma experts aren’t exactly sure why only some people in identical scenarios develop PTSD, but it can often lead to shame, despite evidence showing that actual changes occur in the brain of traumatized people, according to “The Body Keeps the Score,” a book on healing trauma by Dr. Bessel van der Kolk.

Stress symptoms are varied but can include headaches, rapid heartbeat, acid reflux, constipation or other gastrointestinal distresses, trouble sleeping, muscle contractions such as jaw clenching, and neck and back pain.

PTSD symptoms fall under the categories of reliving the event, avoiding feelings or thoughts about the event, having more negative thoughts than before the event, and feeling hyperaroused (on edge or keyed up).

It’s important for patients to be honest with themselves and allow themselves to feel emotions such as grief, sadness, and anger. But then they need to keep moving through the feeling and integrate the experience into their identity, being able to talk about it more factually without the crippling emotions.

“The more you talk about it openly, the more it’s going to become part of the story of your life,” Guttman said. “You don’t want it to be a scarlet letter or define you but just another part of your identity.”

This will help you be as in charge of an out-of-control situation as you can be. It’s a good idea, she said, to have a strong support system that includes a spouse, parents or children, clergy, a support group, and a mental health professional.

A healthy support system will come in handy when you implement these techniques to face your emotions.

Learn to Live in the Present

Perhaps the most courageous act of integrating a disease into your story is to learn how to live mindfully in the present.

“You think you’re escaping having to deal with the pain of it all. Your body knows it’s still happening,” Guttman said. “Part of denial is detachment from feelings. It’s extra painful to sit with what’s happening after the denial phase. People don’t like to sit with uncomfortable feelings.”

Mindfulness is important because it cues your body that the illness isn’t in control, she said. You can only control the present, and part of that is to avoid negative forecasting and making dark predictions about the future, which is a temptation with a lot of illnesses.

Center your future plans on your relationships, goals, and your purpose, Guttman said.

Embrace Gratitude

It’s easy when you’re sick to dismiss positive things and experiences due to what Guttman calls “foreboding joy,” a sense that everything is going to fall apart again or eventually.

Watch out for minimization, she said, by embracing experiences and people for all they’re worth.

“Rejoice in as much memory making as possible,” Guttman said. “Continuing to live life and not giving up on life is super, super critical.”

The findings in a study published in The Journal of Positive Psychology in January 2020 show that gratitude is a simple but effective intervention that improves health behaviors and leads to better outcomes for patients with cardiovascular disease.

Journal Your Way Out of Negative Thoughts

Logic is a powerful tool for any negative emotion, and one of the best ways to use logic is to visualize it.

“Journaling is a really good thing for people to get out of their heads,” Guttman said. “When you write something down, it’s easier to see errors in your thinking.”

The negative thought spiral begins to unwind faster on paper. According to a 2015 study published in the Journal of Contemporary Psychotherapy, narrative journaling is an effective and useful tool for PTSD patients, especially those who are struggling to discuss events.

Cling to Your Purpose

Assimilating your narrative into your life makes the experiences with your health part of your overall story and purpose. This contributes to your agency, a term used in psychology to refer to people who are able to remain in control of their own lives.

Gilda Radner is a great example of someone who created purpose within her diagnosis to empower herself. The iconic comedian died in 1989 after a battle with ovarian cancer, but she wrote and spoke about her illness often.

“She was able to stay in charge of her life and not let the cancer be in charge of her,” Guttman said. “Purpose is extra important when you’re ill.”

Continue to make goals, even if they can’t be as grandiose as previously, she said. Micro goals, such as getting out to have coffee with a friend or walking to the end of the block, help to propel you toward hope.

She added that it’s important for those who form support systems to also nourish themselves in similar ways.

Guttman noted that since the pandemic, more people are feeling stuck than ever. Some of them are been dealing with long-COVID, but many others are set back due to the psychological impact of the past few years.

“I do know there’s definitely more people who are depressed and anxious than ever,” she said. “Anxiety and depression cause brain fog in themselves.”

The good news is that not only are her long-COVID patients improving, but she’s been inspired by patients with grim diagnoses who continue to keep optimistic control over their lives in all manner of circumstances. She’s also seen plenty of patients who lived with agency and purpose until they passed away.

“There are people who have super-positive outlooks and are amazing and super inspiring,” Guttman said.

Those who still struggle should begin building a support system right away. And if you have feelings of hopelessness or suicidal thoughts, you should contact a mental health professional or the suicide hotline—988—right away.