Psych-oncologist Dr Toni Lindsay shares some words of advice on dealing with uncertainty
Uncertainty has arrived and it is scary.
In just a couple of weeks it feels like we have gone from lives that for the most part were stable and predictable to a world which is changing very rapidly. Fear is in the way we look at each other, and in the way we think about the world, and people’s thoughts race from the here and now to the uncertain future, trying to make sense of it in any way that they can. You might feel like you have shut down, or conversely are running at a million miles a minute. You might have someone in your world who is flippant about it or wanting to talk about it at every juncture.
For the past almost 14 years, uncertainty has been part of almost every conversation I and my colleagues have had with someone who has been diagnosed with cancer. Their worlds also felt normal, and boring and predictable until they didn’t.
And then, just like that, a test result, a lump, a symptom that won’t quit – their worlds get turned upside down. Alongside the symptoms and the treatment, there comes uncertainty.
As humans we have very little tolerance for uncertainty – we like things to feel safe and secure. This has evolved in us over a long period of time – imagine our great ancestors in a space where they were being chased by things – for them it would have been a very good idea to understand what the threats were, whether there was a tiger behind a tree or if they had enough food stored in the cave. It wasn’t helpful to be unsure about these things.
The way uncertainty comes to us now looks different – but right now, there doesn’t seem to be much to grab onto. We don’t know how life will look in six months’ time, or even next week. We have all shifted rapidly – from working in an office, to at home, or perhaps for some of us to realise that jobs have vanished overnight. We have had to challenge our relationships with the people closest to us, and we may have realised some things about ourselves and the way we think when faced with a crisis.
In talking with my patients over the past weeks, the parallels have been profound. In fact, many have taken comfort in being aware that suddenly much of the world can understand what they have been grappling with for some time and have not been able to articulate or put language to. In thinking about this, I thought that the experience of these patients might help guide us through this time, and so, I thought about some of the things I have learnt from my patients about managing uncertainty.
- There is no comfort in seeking answers where there are none. Our brains are hard wired to seek information, and at these times of uncertainty we can go into overdrive trying to find anything that will quell this. However, this usually means spending time projecting into the uncertain future which spins us out more. There is incredible power in acceptance of knowing that there isn’t an answer that you can find right now and that’s ok. In fact, it gives you permission to stop being on the constantly updating news, seeking answers everywhere, and letting it occupy all of your thoughts.
- Stay in the present.
The uncertainty lives in the future. For right now, almost constantly the world is telling us to worry about what happens next, but we don’t have any way of knowing for sure. All we know is what is happening in this moment – and we can do something in the moment. Notice what is happening in your body, what is happening in the world around you. Are there five things that you can hear or see? What is happening with your breathing – can you slow it down, or make every breath last five seconds? These small breaks mean that you can reset, and come back to the here and now.
- Do the things that are important.
Whenever someone gets a diagnosis of something, they tell me how quickly things come into focus for them. They know almost immediately what the really important stuff is, and what is the stuff that takes up lots of energy but maybe isn’t very good for us. In these times of uncertainty, you have agency to make some decisions about how you spend your time, and what you focus on. This will not only help keep you present, but it will also help a sense of being able to have some control when the world feels like it is spinning. Also, you will probably feel better if you can do things that you enjoy and that feel meaningful.
- Routine makes the world go round.
At this time of uncertainty, it’s likely that you have less structure in your day than you have had before. The thing that all of my patients describe is that following a diagnosis, or in the midst of uncertainty is that they all free fall for a while – all the structure slips away, and they just move from one thing to the next. But very quickly they realise the importance of structure in their days to help manage the time. I suspect this has already happened for many people in the context of changes that have happened in the past weeks. It helps to put some routine and activities into the day. These might be simple like having a shower and having food at regular intervals (and trying to fend off the boredom eating!) or they might be bigger things like going for a walk, doing some exercise in the lounge room or doing a virtual catch up with people.
- Thinking about things doesn’t make them happen.
It’s a bit of a design flaw that we take everything that our brains think to be truth. For my patients, they may convince themselves that their treatment won’t work, or that something terrible might happen. In this situation, you might find yourself projecting into the future, and spinning about something that hasn’t happened yet. You might have even convinced yourself that you are going to get sick, someone in your world will, you have spread it to other people etc… thinking these things doesn’t make them true. Take precautions, do what the doctors are telling us to do, and stay safe. And, I am willing to bet, that if something does happen, and you or someone in your world does get sick; firstly, your brain wouldn’t have been able to tell you how it would really go, and secondly, you would just get on and cope with it. That’s what humans generally do.
- It won’t always feel the way it does right now.
We don’t know how yet, but this will pass, just like other difficult things that have happened in your life. I don’t say this to be flippant, but to emphasise the importance of staying present and connected with what’s important, and you will continue to deal with whatever comes your way. For some people that might be slight disruption, and for others it might be considerably bigger, but you will find your way through whatever that is.
The recent uncertainty will remain in our lives for some time to come – that’s what we do know. In the meantime, though, hopefully the above ideas will help to keep you feeling as settled as you can as uncertainty knocks on the window and hollers at the door.