“You’re gonna beat this!” is something well-meaning friends often say, intending to provide encouragement.   I truly appreciate the sentiment because it means my life has value.   However, an aggressive Inflammatory Breast Cancer that has now progressed to Stage 4 Metastatic Breast Cancer means the odds are not in my favor.   Although I have realistic hope for healthy-ish years ahead, the statistics are sobering.   If the day comes when treatments can no longer stop the disease, and it becomes clear that I will not “beat cancer,” I will feel that I have let everyone down.  Despite all the high-fives, prayers and entreaties to “keep fighting,” my life will conclude as a failure.  This is one example of how toxic positivity can become corrosive for those of us living with an advanced cancer. 

Toxic positivity overlays a rosy glow on mud by pretending that there is no mud.  It represents an extreme and twisted extension of the American can-do attitude.  In the face of overwhelming adversity, a shiny smile, flexed bicep and a mindset fixated only on what is favorable are all it takes to overcome.  There is no room for doubt or pessimism.  Within the cancer community, no one addresses this topic better than Kate Bowler, a survivor of Stage 4 colon cancer. 

I want to make clear that a generally upbeat attitude is not the same as toxic positivity.  People have often remarked at my positive attitude when faced with cancer but it is an extension of what comes naturally.  My baseline is sunny-side up and I genuinely love being alive.  At the same time, I am a realist and prefer to deal with facts, even the unpleasant ones. 

My approach to cancer has evolved to become “realistically optimistic.”  Its guiding principles include undertaking any treatment that can be reasonably expected to extend my life, becoming comfortable with uncertainty because the future isn’t under my control, extracting the juice from the present moment and making peace with what is.   Naturally, all of this is easier said than done, and every day remains a work in progress.  There is no requirement to like the facts but I prefer reality served up cold and clear, like water spilling from a mountain stream.    Sadness, frustration and despair are an inescapable part of the cancer experience, especially regarding my diminished physical capacity.   These emotions need to have their moment, albeit not always gracefully, but I choose not to loiter in despair or despondency.  I’ve trained my eye to recognize everyday miracles without waiting for the big, splashy ones.   This is how I intend to “beat” cancer.

Toxic positivity obtains its fuel by avoiding negative emotions. It says to not feel, and please don’t think except in a very narrowly defined way, which is a form of internal gaslighting.   Anxiety, its close cousin, thrives on avoidance, which makes it sprout like weeds after a heavy rain.  The two conspirators walk hand in hand, creating a barrier that seeks to protect from the pain that life can bring.   Isolating oneself from reality, no matter how brutal, results in numbness, a sense of disconnection and unease.  As a psychologist, I understand that anxiety dissipates once we stop running from it and face it, looking it right in the eye. The antidote is simple; make friends with reality and invite fear as a dance partner.  No relationship is perfect and this one won’t be either but it will remove anxiety from the driver’s seat.

In the wake of serious illness, we are sometimes so desperate for wellness that we generate our own false hope.  Forcing ourselves to focus only on the positive during grueling moments is a way of avoiding precarious emotional terrain.  Well-meaning friends and family may try to pull us out of a funk by advising us to “think positive.”  Sometimes, a patient suffers from cancer that has permeated the body in a way that is incompatible with life but is encouraged to “keep fighting.”  A more humane response would be to gracefully accept the reality of death, including the pain it will bring to those left behind.  Grief at the loss of a loved one is one of the hardest parts of human experience and it is no wonder that we seek to avoid it.  Still, it is worth the effort to be awake to the moment, instead of emotionally anesthetized. 

Cancer remains a cruel and heartless disease and treatments often fail.  Even with the best possible health-care, bodies will die.  We may not be able to find a cure, but we have the opportunity to live as best as possible each day.   One day, we will all reach the end of our lives and I hope mine will be full of the deep ruts that are the sign-posts of a life well-lived. 

Instead of saying, “You’re gonna beat this,” how about “good to hear you are doing well now and I hope it continues.”  And then, if you value my life and that of others in the same situation, donate to the IBC Network Foundation or another entity that supports research.  Maybe one day, with access to better treatments, it will be possible to legitimately say “you are gonna beat cancer.” 

Note:  If you are interested in more on this topic, check out books by Kate Bowler, including “Everything Happens for a Reason and Other Lies I’ve Loved,” and “No Cure for Being Human (and Other Truths I Need to Hear).”