The psychological impact of mastectomy

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Perhaps one of the most distressing events that can happen to a woman is to be told she has breast cancer and needs to have a mastectomy. The psychological impact on a woman can be devastating.

While mastectomy as a treatment for cancer can be very effective, it is nevertheless a very radical and in some cases life changing event. For many women it can impact on the way they see themselves and also how they feel about themselves. It can alter their view on the world and life itself.

For a woman (and I want to add man too, as breast cancer can and does affect men) it can severely impact on self-esteem, her sex drive and how she feels about her body, her body image and herself as a woman.

Journalist, Thandie Fletcher recipient of the 2012 Michelle Lang Fellowship conducted a year long study into the effect of breast cancer and breast reconstruction on Canadian women; describes how women can feel a sense of disconnection from their bodies and a diminished sense of femininity. She considers that breast reconstruction can improve self-esteem and their sense of wellbeing (1)

While it may not be an easy road, with support and understanding of a loving partner it is possible to come to terms and accept the reality of a mastectomy. Communication and love is really vital if she is to learn to love her post-mastectomy body and feel good about herself again.

The key is communication and it is vital that she has the opportunity to talk about things from the outset. Seeing a counsellor can help and there is a place too for couple counselling. Just as any couple will need to come to terms with a major illness within the relationship they will need to grieve and move to a different place psychologically. This applies equally to both parties. Having the opportunity to talk can help to mentally prepare for what is in effect a, life changing event.

It is important to consider that the psychological impact of a mastectomy are as important in terms of healing as is the physical wound. Seeing a counsellor or psychologist prior to surgery can help in preparing for the event. Even if a woman knows intellectually that surgery is the right option, at a heart level she may want to resist this invasive and radical treatment as she wants to hold on to her pre-surgery self. It is because our relationship with our body is so intensely personal that we may feel very protective and resistant at the thought of losing something so precious. Even surgery such as a partial mastectomy or any reconstructive procedure can have a major impact on the psyche.

Because breasts are seen as nurturing and related to motherhood and also sexuality, a mastectomy can drastically alter a woman’s perception of herself and her association with her identity.  Loss of one or both breasts can have a major impact on femininity. The sense of grief may be profound.

Time, they say is a healer. Given time as a woman heals from mastectomy her life can return to what it was before the surgery.

What can help.

Adopting a philosophical outlook and learning to accept that while mastectomy was not something that was wanted, it was something that was medically needed.  It was Shakespeare who said, “there’s nothing either good or bad but thinking makes it so.” (2)

Try to keep a positive outlook. Keep a small notebook handy and at the end of each day write down three things that you appreciate and that you are grateful for.

Talk to others who have had a mastectomy and find out what helped them.

Consider all the options available to you such as reconstruction using your own skin tissue, implants, breast expanders or any combination of methods to enhance the appearance of your breasts. Also consider prosthetic breasts to give you greater confidence.  A prosthesis can do a lot to help normalise your image – and it is worth taking time to ensure you find the right one for you

Spend time on yourself pampering and focusing on beauty treatments for the whole you. Take up exercises such as yoga and tai-chi. Seek out a massage therapist and learn to really enjoy sensuous pleasure, touch and nurturing. As a body therapist as well as a talking therapist, I cannot recommend enough, how overcoming your anxieties about your body can help you to feel good about yourself again. Remember it may take some time to feel comfortable about yourself naked once again.

Eat well and seek out food that will enhance your well-being from the inside. What to wear initially is always a dilemma, but with some clever wardrobe tweaks and the art of layering, you can look gorgeously chic. Wear clothes that make you feel comfortable and less self-conscious initially, such as scarves and baggy tops, over time take little trips out without them and your confidence will grow.

Spend time with a counsellor or psychotherapist to reflect on your personal journey, where you have come from and where you are going. Acknowledge your sadness, loss and grief. Experience your emotions do not try to deny them

Take up mindfulness meditation, develop your spiritual side and engage in voluntary or charitable activities for others.

Talk with your partner about things that they appreciate about you, that they find attractive and womanly about you. Be open and don’t shy away from talking about difficult things. Do not assume your partner understands.

Tell yourself that you are worthy of love and attention. Learn to be “self caring.” Everyday give yourself something with love, a magazine, a coffee, a bunch of flowers, a bath in fragrant oils. As you do so, say your name out loud and say, “I am giving you this ……. with love.”

Remember, while you may have lost your breast/breasts, you have not lost you.
It is about redefining yourself as a person and as a woman. Let today be the start of the rest of your life.

Until next time, Steve Clifford, Cognitive Behavioural Psychotherapist.

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(1) Fletcher, T. (2012).”Mastectomies can leave women with devastating emotional scars,” National Post, Post Media News.

(2) “Six principles of optimum health,”
Rodriguez, D. (2014) “Keeping your self-esteem after a mastectomy,” Everyday

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