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Challenged to Change: Leveraging a Breast Cancer Diagnosis for Personal Growth

Pink Sync presentation | Cydne Evans, EdD, MPAS, PA-C

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Learning objectives

Describe Post-Traumatic Growth (PTG) as both an outcome and a dynamic process

Explain research-based strategies for helping breast cancer patients cultivate PTG

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Frankl (1959)�

“We must never forget that we may also find meaning in life even when confronted with a hopeless situation, when facing a fate that cannot be changed. For what then matters is to bear witness to the uniquely human potential at its best, which is to transform a personal tragedy into a triumph, to turn one’s predicament into a human achievement. When we are no longer able to change a situation, we are challenged to change ourselves”

Frankl, 1959

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POST-TRAUMATIC GROWTH

Foundational frameworks originate from Tedeschi and Calhoun (1996)

Outcome: a positive psychological change resulting from struggle with highly challenging life crises

Process: ongoing cognitive and emotional work to reconstruct a shattered worldview

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PTG: Outcome

Greater appreciation of life

More intimate relationships with others

Greater personal strength

Recognition of new possibilities

Spiritual/existential development

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My study: young survivors, ages 25-39

Qualitative research with young female breast cancer survivors, ages 25-39

Core themes:

Personal cancer impacts

(psychological, physical, mothering and fertility)

Growth Manifestations
Process of Growth
Medical Provider role

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Interesting findings

Participants could not recognize growth during the process

Growth happened spontaneously, but continued because they engaged

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STRATEGIES

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Strategy 1: Framing your Environment

Normalize that "shattering” is a normal!

Growth is possible—but likely unnoticed

Avoid the "prison of positivity"

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Strategy 2: Behavioral factors

Engage in self-disclosure, sharing emotions, even negative ones (Henson et al., 2021)

Deliberate rumination (Szczesniak & Bielecka, 2022)

Written self-expression (Wu et al., 2019)

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Strategy 3: Personal factors

Positive reframing (Cordova, 2008)

Mindfulness practices (Pat-Horenczyk et al., 2015)

Identify new possibilities and reprioritize personal values

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Key Takeaways

It is okay to shatter--this sparks the search for meaning

(Frankl, 1959; Janoff-Bulman & Frantz, 1997)

Give meaning to the journey--meaning stimulated the will to live

(Joseph & Linley, 2005; Landmark, 2001)

Engage in behavioral activities that cultivate growth

(Bandura 2001; Cordova 2008; Tedeschi & Calhoun 2004)

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References

Bandura, A. (2001). Social cognitive theory: An agentic perspective. Annual Review of Psychology, 52(1), 1-26.

Cordova, M. J. (2008). Facilitating posttraumatic growth following cancer. In Trauma, recovery, and growth: Positive psychological perspectives on posttraumatic stress (pp. 183-205). Wiley. https://doi.org/10.1002/9781118269718

Frankl, V. E. (1959). Man's search for meaning. Beacon Press.

Henson, C., Truchot, D., & Canevello, A. (2021). What promotes post traumatic growth? A systematic review. European Journal of Trauma & Dissociation, 5(4), 100195. https://doi.org/10.1016/j.ejtd.2020.100195

Janoff-Bulman, R., & McPherson Frantz, C. (1997). The impact of trauma on meaning: From meaningless world to meaningful life. In M. J. Power & C. R. Brewin (Eds.), The transformation of meaning in psychological therapies: Integrating theory and practice (pp. 91-106). Wiley.

Joseph, S., & Linley, P. A. (2005). Positive adjustment to threatening events: An organismic valuing theory of growth through adversity. Review of General Psychology, 9(3), 262-280. https://doi.org/10.1037/1089-2680.9.3.262

Landmark, B. T., Strandmark, M., & Wahl, A. K. (2001). Living with newly diagnosed breast cancer: The meaning of existential issues. Cancer Nursing, 24(3), 220-226.

Pat-Horenczyk, R., Perry, S., Hamama-Raz, Y., Ziv, Y., Schramm-Yavin, S., & Stemmer, S. M. (2015). Posttraumatic growth in breast cancer survivors: Constructive and illusory aspects. Journal of Traumatic Stress, 28(3), 214-222. https://doi.org/10.1002/jts.22014

Szczesniak, M., Madej, D., & Bielecka, G. (2022). Relationship between world assumptions and post-traumatic growth among Polish cancer patients: Moderating effect of rumination. International Journal of Environmental Research and Public Health, 19(19), 12444. https://doi.org/10.3390/ijerph191912444

Tedeschi, R. G., & Calhoun, L. G. (1996). The Posttraumatic Growth Inventory: Measuring the positive legacy of trauma. Journal of Traumatic Stress, 9(1), 455-471. https://doi.org/10.1002/jts.24703

Tedeschi, R. G., & Calhoun, L. G. (2004). Posttraumatic growth: Conceptual foundations and empirical evidence. Psychological Inquiry, 15(1), 1-18.

Wu, X., Kaminga, A. C., Dai, W., Deng, J., Wang, Z., Pan, X., & Liu, A. (2019). The prevalence of moderate-to-high posttraumatic growth: A systematic review and meta-analysis. Journal of Affective Disorders, 243, 408-415. https://doi.org/10.1016/j.jad.2018.09.023

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