Moving On After Cancer

"In three words I can sum up everything I've learned about life: it goes on." — Robert Frost

The question, “How do you move on?” was simple enough and six years into cancer survivorship I should have knocked it out of the park. It came from a cancer survivor, one year out of cancer surgery. I’ve thought, talked and written about this very topic for years, so I was stunned to hear myself sputtering out phrases like, “You just do,” and “Life is what moves you on.” Fortunately, the question came at the end of a counseling session so I punted with the phrase “that’s a good place to pick up the next time we meet.”

Conventional wisdom and training suggests that therapists should be wary of answering direct questions. It one of the things that, ironically, drives people crazy in therapy — their questions are always answered by another question. As a cancer-surviving therapist, it seemed like too much of a psychological two-step to answer a question about living with the fear of cancer’s return with something as banal as “tell me what you think.”

The trap I had unintentionally laid for myself, however, was thinking that there was some magic combination of words that could unlock this mystery or act as a healing balm. I know very well that my own sense of “moving on” had nothing to do with being given some positive affirmation or, even worse, a catchphrase. I understand deep in my core that there were countless variables involved in moving from surviving into thriving.

Later that evening, as I reflected on my attempt to put into words something ineffable, I became fixated on the very phrase “move on.” There are many ways that survivors are encouraged, prodded and cajoled toward the idea that in order to fully recover from cancer we need leave the role of cancer patient behind. In psychological circles this is often referred to as “closure,” but in the real world it’s better known as “get over it” or “let it go.”

Thirty-plus years into the practice of psychotherapy, I’ve learned that telling someone that their recovery depends on “moving on” is akin to telling a depressed person to just “be happy.” My approach these days is to talk about living with rather than living without, allowing over forcing and, most importantly, realizing that life moves on in wellness and illness, joy and suffering, pleasure and pain. I firmly believe that illness does not halt this process; it does not put the brakes on existence. Feeling stuck comes from a trick of the mind that sees suffering, of any kind, as an unnecessary detour and waste of time.

Once we allow our lives to unfold with cancer as part of our experience, we awaken to the literal meaning of the word survive which is “to live beyond.” This is the wisdom of being told that we become survivors on the day we receive our diagnosis. Thus, the need to discover the way ahead, to put psychological, emotional and spiritual distance between ourselves and the illness is already being met. Therefore, the work is often a matter of staying out of our own way as we move through this process.

That I momentarily lost my understanding that we can to live our down times with as much vigor, interest and compassion as our up times is no longer a surprise. Upon reflection, I understand that I was trying to help my client, not support her. I wanted to clear the road rather than walk it with her. I saw the hurdle of anxiety and wanted to knock it down — all of this despite my Zen understanding that the obstacle is the path.

I made a commitment to myself that I will not be caught off guard again. I’ve developed my, ever at the ready, response for the next time I’m asked some version of “How do you move on?” The answer is in three parts, and in true psychotherapist fashion in the form of questions.

1. Where do you want to go?
2. How will you know it when you get there?
3. How can I help you along the way?