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Upfront About Breast Cancer Podcast

What You Don’t Know Until You Do, with Dr Charlotte Tottman: Episode 3

Episode 3: Upfront About Breast Cancer – What You Don’t Know Until You Do, with Dr Charlotte Tottman: The Showing Up and The Letting Down: Surprises and Disappointments in Relationships 

Let’s be Upfront about surprises and disappointments in relationships. 

In this episode of What You Don’t Know Until You Do, with Dr Charlotte Tottman, we hear about the surprises and disappointments often experienced at various stages of a breast cancer journey and the expectations we often don’t realise we have of others. Charlotte shares her experience of being surprised and thankful for those who stepped up, as well as her experience of feeling let down by those who disappeared.  

We also hear about how best to respond to disappointment, recalibrate expectations and how to clearly communicate your emotional and practical needs to those around you. 

We recommend that listeners exercise self-care when listening to this podcast, as some may find the content upsetting. BCNA’s Helpline provides a free confidential telephone and email service for people diagnosed with breast cancer, their family and friends. Our experienced team can help with your questions and concerns and direct you to relevant resources and services. Call 1800 500 258 or email contact@bcna.org.au

Resources:

Upfront About Breast Cancer is a production of Breast Cancer Network Australia. Our theme music is by the late Tara Simmons, and this episode is proudly brought to you by JT Reid. 

Want to get in touch? Visit our website at bcna.org.au, email us at contact@bcna.org.au, or call our Helpline on 1800 500 258 

TRANSCRIPT:

Ad [00:00:00] BCNA’s helpline provides a free confidential telephone and email service for people diagnosed with breast cancer, their family and friends.  Our experienced team can help with your questions and concerns and direct you to relevant resources and services. Call 1800 500 258 or email contact@bcna.org.au. Welcome to Upfront About Breast Cancer, What You Don't Know Until You Do, with Dr Charlotte Tottman, brought to you by the Breast Cancer Network Australia.

Kellie [00:00:43] Welcome to Upfront About Breast Cancer. I'm Kellie Curtain, and this series is What You Don't Know Until You Do with Dr Charlotte Tottman, who is a clinical psychologist specialising in cancer related distress and also has a lived experience of breast cancer. In this episode, we're going to talk about the expectations we have of others, including those you didn't even know you had. Charlotte's experience is sure to resonate with many as she shares her feelings of being let down by those who disappeared and pleasantly surprised by some who really stepped up when she was diagnosed. A reminder that this conversation with Dr. Charlotte is not scripted. The topics discussed are not intended to replace medical advice, nor necessarily represent the full spectrum of experience or clinical option. So please exercise self care when listening, as the content may be triggering or upsetting for some. Welcome, Dr. Charlotte. This is big, the showing up, yeah, and the letting down, what does that mean?

Charlotte [00:01:45] This is one of those.There's quite a few experiences related to a cancer diagnosis and treatment that I call universal experiences, where I kind of have yet to meet a client that hasn't expressed some form of disappointment or surprise about in this in this setting about how supported and sometimes how let down I felt by people that are important to them in their social network. So it might be immediate family members, extended family members, friends, colleagues, the full gamut. The point that you raised in the intro is that it does relate to expectations, and I was listening to a psychologist and I wish I'd written his name down. He was actually talking about coronavirus a few weeks ago, and he said something like, ‘We don't know what our expectations are. We aren't aware of them. We just operate within them’. And I thought that is so on point because it's not like you sort of sit down 10 years before a diagnosis of breast cancer and go. So in the event that I get a diagnosis of breast cancer, I'm going to expect this of my husband and this of my children and this of my best friend. I mean, you don't you don't know what you expect. And it's only when you actually find yourself either disappointed or surprised that I think then you become aware of what you might have expected from them. And often our expectations are based on what we feel like we might have done in the same situation had the positions been reversed. So if I was in that position, you know, I would have done it differently. I would have provided more support or whatever. So I think it's really interesting to just take a moment to reflect on identifying what your expectations were, even if you had no idea that you had them.

Kellie [00:03:25] So with you, you were diagnosed. You must have had some sort of sense of who was going to step up.

Charlotte [00:03:32] Yeah, I mean, I think that I was very comfortable with my immediate family response and that's where kind of like my expectations were probably met. I was pleasantly surprised, and I've reflected on this a lot since because I was trying to work out like, what was it that made me feel really supported and maybe a bit surprised. And I think it was when people that maybe I didn't have a lot of everyday contact with reached out and provided support. It was about the contact and it was about not requiring anything back from me. So as a mum and a wife and a worker, I'm used to helping others, doing for others, and I'm sure a lot of people listening would relate to that. That's what mothers do. That's what women do. So in this particular part of my life, it was really nice to feel like I didn't have to give of myself to these particular people. So the surprise, I guess, standouts for me was a really old girlfriend girl called Janet that I went to school with. She's just a fabulous, she's a medical professional, she's a fabulous person. She's one of those people that we sort of dip in and each other's in and out of each other's lives every few years. And she just intermittently through my diagnosis and treatment, she just touched base and she sent me some nice things. But it was more about the fact that she just connected with me and I felt like I mattered. And that was a really important that sort of feeling of mattering was, I think, what really stood out for me there. And the other big standout was my sister. Her name's Francesca. We call her Frankie, and she lives in Melbourne and I live in Adelaide, and she is a very accomplished director in an advertising agency. But she has a lot of experience as a carer. She was intimately involved in caring for mum and dad when they were both dying with ovarian and bowel cancer a long time ago when we were in our 20s, and it was quite extraordinary the way she just as soon as I told her she just got on a plane and came to Adelaide and she slipped straight into carer mode, which is, I think I mean, it was really cool. But the thing that I found the coolest was that she sort of she slipped into a busy family, lots of adult children and my husband, and she just was able to find exactly the right spot to plant herself and be super, super useful and helpful and supportive and never crossed any lines. She didn't make anyone feel uncomfortable. She didn't overreach or overstep. She just seemed to know exactly what I needed or we needed. And she did it, which I mean, I just I find myself to this day, just a bit in awe of because I mean, I don't think I'd be able to do that that well.

Kellie [00:06:23] But she's your sister. Have you always been close? Was that a natural thing for her to do?

Charlotte [00:06:29] I think that the way I describe our relationship is growing up I was 14 months old, 14 months older than her and there's just the two of us, and I think that probably I'd be fair in saying that she felt like I wasn't the boss of her, and so, you know, there was some pretty normal teenage tension, I think, through adult years. We didn't live in that. We haven't lived in the same state for a long time, and she was so, so closely connected to mum and dad. And I think sort of at a superficial level, we've always got along very well. But there's been there's been tension over the years, particularly around stuff to do with our parents. She had a much better relationship with them than I did. What's changed since I was diagnosed is we are so close and in the first year after I was diagnosed without any fuss, without grandstanding or making a promise or doing anything kind of over. She just she just rang me every day, every single day and just checked in. Oh. Sorry, just it's not me, it's really nice, and it's really, it's really special. And now, you know, it's not an everyday thing, but it's in every couple a day thing and it's a bit more reciprocal. So, you know, she's hopefully getting a bit more back from me, whereas in the first year after diagnosis, I was really the very fortunate recipient from her. But yeah, she's just a legend. So I guess off the back of our earlier years, maybe on some level, you know, like I said before, perhaps I hadn't expected it to be quite what it turned out to be. And I'd loath to say that there are good things that come out of cancer, but you know, sometimes there are. And for me, this has been one of them that she and I are just hand in glove. We are very we're very connected and it's fab.

Kellie [00:08:32] I'd imagine it's quite common, whether it's a breast cancer diagnosis or any big major event, whether it's celebration or trauma, such as a diagnosis, that people tend to come from everywhere.

Charlotte [00:08:44] No, it's not uncommon. I call it the flocking. And it really is almost instantaneous that as soon as word gets out, there is often a lot of social contact people showing up, people sending things, people reaching out, contacting now with technology, all sorts of different virtual ways of connecting. It can be very affirming and you can feel very supported and like, you matter, and that's all great. I think for some people, it can feel a little bit overwhelming because, you know, it can feel like every one of those contacts requires a response. And that was the thing that I think really resonated for me was that what I really appreciated the most was when I wasn't required to do anything in response. I think it's interesting to just note that the flocking doesn't last and that it's often a fairly temporary phenomenon and it happens after diagnosis. And there's a whole bunch of reasons why people flock to the action if you like. And so some of it's around things like love and care. Really good intention. Some of it's about that thing of being close to the action, and some of it's almost it sounds a little bit voyeuristic, doesn't it? Yeah. Yeah, well, some of it is. Some of it's a little bit like trading on the action. You know, I was there when she found out, I was there when she said, you know it being so that you can kind of some people like that kind of thing of being able to be front and centre where it's all unfolding in those very early days. Some of it's about social expectation. There is certainly within, you know, social networks. There is often a real pressure if you like to be, you know, well, you know, have you sent something? Have you seen them? Have you talked to her? You know that sort of thing to kind of legitimise or validate your position in that person's life? Some of it's this does sound a bit weird. Some of it's social competition. You know, who did more? I took one casserole, I took two. You know, I was I sent flowers. Yeah, I went to the hospital. There's that sort of like, it's almost like a creating the totem pole of, you know,who's at the top of the of the social totem pole, which is all playing out kind of away from the person who's dealing with cancer diagnosis. But it's real, and it explains perhaps why some of this flocking is temporary because of course, once the dust does settle and there isn't an unfolding drama with decisions and new information because that stuff does tend to settle down in the in the weeks that followed diagnosis. You’re not so interesting anymore.

Kellie [00:11:20] Oh, and sort of like the danger has perhaps had just the immediate danger has passed.

Charlotte [00:11:28] Correct. Absolutely. Yeah. I mean, to be fair, also, perhaps some of the need settles. You know, things do equally. Equilibrium does kind of get restored and you find yourself as the as the person going through the treatment. You find yourself figuring out, you know, appointments and where you have to be when in and all of that sort of stuff. So that early rush isn't as perhaps necessary anymore, but there can be then a real sense of what I call the vanishing, which is, you know, kind of the opposite to the flocking. It's sort of like, you know, there was everyone and then suddenly it can feel a little bit like there was no one and a lot of clients have reported, particularly as treatment continues and that, you know what, at the beginning was very unusual and new and interesting, like going to chemo for the first couple of times or going to radiation for the first couple of times, after a while, you know, it becomes part of the rhythm of your life. And people just get back to theirs, and they kind of leave you with it. And so, it can feel, you know, harking back to that conversation we had in the last episode, you know, very emotionally isolating to feel like, you know, now I kind of like I was important and now I'm not. And there are a lot of reasons why people do do disappear. Things like there's a psychological phenomenon called the bystander effect, and that is where humans expect that other people will step in to provide support. They just make an assumption that if there's 10 people in your life or how many people there are in your life, that that if they don't step in that other people will or that other people are, and therefore they don't need to. And that's a psychological phenomenon, and that's very well established. So that can be one of the reasons that people aren't hanging around. People get busy, people get clumsy, people get bored and they get fatigued. They get distressed. Yeah. So, you know, and they get triggered. So if and because of the sort of cancer prevalence rates in Australia, it's far from unlikely that you'll be the only person that your friend or your or your colleague or your family member knows with a cancer experience. And so they may well find it hard to cope with what you're dealing with themselves.

Kellie [00:13:49] I was going to say that it would possibly be quite expected for someone who had either been diagnosed themselves or a close relative would find that, like you said, triggering and not be able to deal with it. So their reaction is to step back. But do you think whilst that's going on for them, what actually is appearing is that they're not there?

Charlotte [00:14:16] That's right, exactly. And this is where communication is so important because I think whenever you can understand why somebody is doing something, my supervisor, scariest woman on the planet, such a legend. And she said to me, ’You know, human beings will accept almost anything if you give them an explanation’. So if if you're able to explain if you as the friend or the family member able to explain and say, ‘Look, I'm really struggling with this and I want to be there for you, but I'm finding that it's triggering me and that's not helpful for me’. And it's probably not all that helpful for you if I'm losing my own togetherness when I'm near you. So I'm going to step back and when I've got my shit together, I'll come back into that into again. Then I think the person who's going through would be like, Yeah, sure, absolutely. I don't actually want to be mopping up your mess as well as my own. That makes complete sense. But without that conversation, that communication, that explanation, it's very hard to understand why your friend has suddenly disappeared.

Kellie [00:15:14] Do you think in the real world, though, if you have that expectation, conscious or otherwise, of perhaps a really close friend that maybe you've been there for, whether it be a cancer diagnosis or something big, if they turn and say, ‘Look, I just can't be there for you at the moment’, you're actually going to be able to reconcile that and say, Oh, sure, what when you thinking, I hang on a minute, I was there, I was there for you and the chips were down. What about me?

Charlotte [00:15:46] Yeah, I think it's very hard. It would do well to have a generosity, generosity of spirit, to be able to be that understanding. Having said that, I certainly know myself and have heard from many clients that having to deal with other people's distress and having to be the person to kind of like, make your friend, your family member, feel okay when you're already feeling like you're drowning in your own stuff. The idea of being released from that is quite appealing, so I think there are multiple parts to it. Absolutely. When we extend support to other humans, sometimes we without realising it, we keep score and we can therefore come to the next part of our life without realising it. With this kind of mental scorecard of like, you know, well, over the years, you know, we've been here, we've been there for you, we've supported you. And then if we don't feel like we've got the reciprocal kind of support that can lead to feeling not just kind of let down in the moment, but actually feeling quite resentful because it's like, whoa, you know,

Kellie [00:16:55] so unconditional isn't really unconditional because in your brain, you've been keeping this mental scorecard.

Charlotte [00:17:02] That's right. And that can be particularly unhelpful. And it is sometimes worth just reflecting on that a little bit and sort of asking yourself, ‘Okay, well, why? Why was I expecting that of them? And is that reasonable, given what I know about that other person or family situation? Is that a reasonable thing?’ And sometimes it might be in which case your disappointment and frustration and possibly anger may be well placed, but it's sometimes good to just look sort of reflect on it and go, Okay, well, wonder why I am? I'm feeling so disappointed, as I said at the beginning, it really is about expectations.

Ad [00:17:36] BCNA’s Online Network is an active peer to peer support community where people affected by breast cancer can find information and connect with others who understand what you're going through. Read posts, write your own, ask a question, start a discussion and support others. The online network is available for you at every stage of your breast cancer journey, as well as your family, partner and friends. For more information visit BCNA dot org dot today you forward slash online network.

Kellie [00:18:09] OK, Charlotte. So if you've got five casseroles that have been delivered by these amazing people that have stepped up, but somewhere deep down, you're expecting a certain person to bring a casserole, and it's not necessarily that you need another casserole, but you want that person to bring you a casserole. Like, do you need to let that go? And how do you do that?

Charlotte [00:18:32] Yeah, absolutely. So this again comes back to expectations and what I recommend when we find ourselves sort of disappointed over and over again where it's, you know, here I am today again. Feeling disappointed that the casserole didn't arrive from that particular friend is to understand that on some level, without realising it each day or each week, we're going into it. Having raised our expectations again after the last disappointment, hoping that this time, this day, this week, is going to be the time when I get my expectations met, where I get my support, where I get my casserole. And if we are being disappointed over and over again, sometimes it's helpful to kind of reflect on the fact that past behaviour in human beings past behaviour best predicts future behaviour. So, if the casserole hasn't come after a few days or a few weeks, the chances are it's not going to come. And if we keep expecting that it is, then we are kind of contributing to our own unhappiness because we are setting ourselves up for disappointment. So it is about on some level recalibrating our expectations, recalibrating just fancy language for changing your expectations. And it's a really easy thing to say. And it's a much harder thing to do, but it is about kind of recognising, Okay, well, this isn't just about the fact that the person with the non-existent casserole hasn't come. It's also about the fact that I keep putting myself out there hoping, and that's the thing it is hope and then follows the disappointment. So it's about going, ‘You know what? There isn't going to be a casserole from that person, and there are probably reasons why’. And sure, it would have been nice, but maybe I can think about what else I can look for, who else I can get casseroles from. But also, maybe I don't need to look to that particular person for a casserole. Maybe I need to look to that particular person for something else.

Kellie [00:20:20] So you need to pivot to stop yourself going down that rabbit hole. Exactly. So when quite often we're overwhelmed with the good wishes and actions of so many and comparatively the negative is less? Why do we tend to remember the bad stuff?

Charlotte [00:20:39] Yeah, absolutely. There is this real tendency to focus on the negative, and that's because human beings are hardwired with this thing called a negative attentional bias. So it's an adaptive response, and it goes back to if you imagine on the plains of Africa, if you've got on the one side of your vision, you've got the wild beasts and the beautiful sunshine and the fabulous wetlands. And then over on the right-hand side of your vision, you've got a little whisper of smoke. What are you going to pay attention to? The whisper of smoke? Because it's a threat. It's danger. Okay, so we pay attention to the negative because our brain goes. That represents danger, doesn't it?

Kellie [00:21:16] So if someone doesn't show up in my life, is that yeah, consciously danger?

Charlotte [00:21:20] Yeah, absolutely. Because if you, so there's this whole study in psychology called social psychology. The safest place to be in as a human is in the centre of a social group. You are safe, you are protected. So if your brain starts to pick up on the activities in your social network that leave you feeling abandoned, rejected alone, vulnerable, then your brain's going danger. I am likely to be left on the plains of Africa. Easy pickings for the hawk. So it is an adaptive response, and that's why we pay more attention to it. And it's very common across all cycle or psychology, not just in psychopharmacology for people to pay more attention to the negative. So if, for example, someone comes in to me and says, you know, I've had two episodes of being really pleasantly surprised and two episodes of feeling really disappointed and let down. It's not surprising at all that they go on to talk a lot about the feeling let down and disappointed, and don't pay much attention to the to the positive surprises. And that's the way the human brain works. But it does explain why we hold on to. Some of that negative stuff.

Kellie [00:22:32] so you've spoken about Frankie and some other friends that really just they got it, they seamlessly stepped up and just without too much direction, it's like someone saying to you, What do you need me to do? Well, by the time you've actually given them something to do, you're exhausted and it's sort of defeated the purpose. Did you have an instance of people who didn't show up for you who vanished?

Charlotte [00:22:59] Yeah, absolutely. And this is tricky for me because I am very conscious of providing an authentic, transparent and real reflection of my experience. And I certainly don't want people who are listening to think that, oh, you know, Charlotte just got kind of like the good end of the stick, because the truth is that we were really let down, but it's such a sensitive subject that it's not something I can go into detail about it. The best way to describe, I guess, how I feel about it is that to unpack it all would be to open old wounds that have kind of started to heal. And so I think what I what I want to just really be clear about is that I was no exception. We were no exception. And this stuff does happen. And you know, on reflection, it maybe was also about perhaps a friendship that perhaps wasn't what we thought it was or maybe had been taking some hits over the years beforehand and we just hadn't noticed. But we certainly felt that we were not like we were no different to everybody else and that there was a really big example of feeling really let down.

Kellie [00:24:10] And perhaps it takes a seismic event like a cancer diagnosis or other trauma that sometimes it's the straw that breaks the camel's back of a year of a relationship.

Charlotte [00:24:24] As a clinician, what I often find myself saying because this is so common is that where it's possible and where somebody feels like they've got the kind of person or resources to do it. I do encourage people to not just fall at the first hurdle and sort of go, Okay, well, I feel let down, so I'm going to step away because just like I was explaining in the last episode that when we feel emotionally vulnerable and we don't get the support that we need, we often step back, which ultimately leads us feeling more emotionally isolated. So I encourage my clients to step forward, even though it's really hard after you feel like you've been let down and to have a conversation with the person concerned. And to really be clear about, Look, this is how I'm feeling and this is what I really need. If you do that, one of two things is going to happen. You're either going to get what you need. So it was probably worth having the conversation or you aren't in which case you're going to really be clear about perhaps where that relationship sits in your life then because it's going to be really clear that, you know, no assumptions. I've been really transparent and clear about what I needed and still it hasn't materialised. So that tells me something about where that relationship sits in my life now. And maybe it's time to look at it a little bit differently, and it might be even time to make a strategic retreat from that relationship, which is what I call a de-escalating behaviour. You don't want to have a big confrontation and then, you know and a big what I call escalating event that's not going to be helpful for anybody, but a quiet kind of like change in the frequency of contact and the way that you relate to one another might be the right thing to do for you at that time.

Kellie [00:26:05] So is it worth considering for those that step up? It's like you have a friend who you love to go dancing with or someone who you like to go to the movies with or someone you like to go shopping with. Is it back considering the roles that people can play?

Charlotte [00:26:20] Yeah, absolutely. And I think coming to understand that there are going to be some people in your life that are good in certain circumstances and can provide you meet your emotional needs in some circumstances and not in others. And being selective and thoughtful, considerate about that is going to mean you're more likely to get your own needs met and be like less likely to be disappointed and more likely for those interactions with those people to be kind of successful and rewarding.

Kellie [00:26:49] Being clear doesn't always mean you get what you want. Does it?

Charlotte [00:26:53] No, it doesn't. No, it doesn't always mean that, but it does leave you in the position of being able to go, ‘Okay. I've kind of left no stone unturned. I haven't just got upset and hurt and stepped away’. I've gone, ‘Okay, well, I'm going to be really clear. And then if this still doesn't work, then I'm not going to be left thinking, Well, I wonder what would have happened if I'd tried or had a conversation or done something more’. If you've done all of that, then at least you know you've got certainty. Whereas I think the difference is if you don't, if you don't try, then the risk is you're left with that uncertainty of life. Not understanding why what happened happened and not really knowing whether it could have been different.

Kellie [00:27:37] Do you have some advice, maybe for those that are supporting someone with a diagnosis? And as you said, you get these flocking. Is this overwhelm of people coming out of the closet, people that haven't been around and all of a sudden they're front and centre doing stuff that can be sort of intimidating for those who are part of your every day who are going to be there long after the rush. And is that when you really need it, it's after that immediate shock. It's after the surgery. It's as life starts to get back on track, not normal, but get back on track and things start to get in a rhythm that you actually, I imagine, really value that checking in and when the casseroles have stopped.

Charlotte [00:28:29] Yeah, exactly that in my notes for today, I write, this is about mattering, it's not about casseroles and flowers. And at the beginning, it's often a lot of casseroles and flowers and a lot of contact and a lot of love. And that's all lovely. That's all great. But as time passes, certainly both from my own experience and from my clients, what people really value is just the text message or the phone call or the invitation for a quick coffee. Just that constant, but probably not frequent small connections that don't disappear where you just feel like people are thinking about you, they haven't forgotten about you. They haven't assumed that everything's back to normal. They haven't assumed that you're okay. Or that it's not so much that you need to feel like other people, you know, see you as broken. In fact, who really wants to feel like that, but more that there's just not this idea that you know you've snapped back and that you know, you don't need any support anymore. It's a really important feeling to feel like there's just that continuity of support.

Kellie [00:29:41] Is the onus always on the care givers, though, is the person who is diagnosed or recovering? Do they have to be a little bit active, too?

Charlotte [00:29:52] It's a hard line to walk, I think. I've had this conversation with a lot of clients over the years where we reflect on the irony that it does often seem to be when we're talking about breast cancer. It's almost always a woman and very frequently a wife and a mother and a grandmother and a daughter who is relating to all of their family and extended family network and kind of having to almost drive the show, you know, let other people know what's going on and what they need. And it feels a little bit ironic because it sort of feels like, well, it arguably should be the other way around. These are habits of lifetimes. These are dynamics in families that are very well established. And just because you become a patient in one, not you don't suddenly stop caring about your kids, or you don't suddenly stop being a wife and a mother and a daughter. And so I think that whether it's onus or whether it's just the continuation of dynamics in relationships, it's still part of the person with the cancer diagnosis and treatment to be, I guess, mindful, and they are going to anyway be in the position of informing the people around them about how they're doing and hopefully what they need.

Kellie [00:31:07] It sounds like pointing out the obvious, but do you need to spell it out for people, especially when you're the one that needs the care?

Charlotte [00:31:14] Yeah, I mean, I think that it's very understandable that the person going through the cancer diagnosis and treatment can feel quite frustrated when their loved ones aren't necessarily meeting their needs. They can feel like, you know, it's the bleeding obvious what I need. Despite that, I do recommend that people like just think and identify what it is they really want from which individuals and then communicate it. And the reason it's helpful is because it just removes or reduces the chance of assumptions being made incorrectly and of misunderstandings. And it increases the chances that you'll actually get support that you need. So it's kind of annoying to have to do it. Granted, but it probably the benefits outweigh the annoying part. One of the things that I think particularly mothers do is protect, and I sometimes use the language. When does protection become deception because in an effort to protect particularly our children from maybe any distress or disruption, we sometimes then don't communicate exactly how we're feeling and because people take in information through their eyes. If I'm largely looking and sounding the same, then the assumption can be from our loved ones that, you know, mum's more or less okay or my wife's more or less okay, or my sisters more or less okay. So sometimes you actually do have to be very clear and transparent about how you're feeling and what you do need. People aren't mind readers, and we sometimes expect, particularly in close family networks, we kind of expect that maybe they are.

Kellie [00:32:48] I don't know. I think a few mother's are mind readers, don't you? OK, so it's really nice when people show up for you. The expected people and those that you don't expect, you know, lovely surprise. And that feels good. And it's not so good when you have those disappointments from those obviously of whom you expected more. And you've talked about a strategic retreat. What about on reflection? So you're coming out the other side, so to speak, or it could have been years on. And if you haven't resolved, it is. You've still kept that mental scoreboard of like, well, you went there for me. On reflection, can you rebuild that? What's a way you can let that go?

Charlotte [00:33:34] I think that some of this comes down to how much time you're prepared to invest in sort of working yourself on holding on to resentment. Resentment is ultimately destructive for the person who's feeling it, often because we think and feel these strong emotions, but we might not communicate them, especially if it's years on. The person who's left sitting with those negative feelings and thoughts is the one. It's like acid on your soul. So I guess from my perspective, it's kind of about making a decision, really about whether you want to let go and who's going to benefit from that. You're going to let go of that resentment. You're going to maybe consider forgiveness. Forgiveness is a really important phenomenon, and the research around forgiveness is and this won't surprise a lot of people, I'm sure, is that the act of forgiveness is mostly to the benefit of the person who's holding onto the resentment. So if I if I could forgive somebody else, then I feel better regardless of how it affects the other person. So being able to kind of like, go, alright, well, how is this resentment and end scorekeeping and disappointment working for me probably isn't working all that well.

Kellie [00:34:44] What about your experience?

Charlotte [00:34:46] Yeah, absolutely. I mean, one of the decisions. That we had to make was how much power do we give this situation over our life? And I talk about the fact that when you have a really strong positive or really strong negative emotion that that can be quite powerful, it can drive you to think and feel and even behave in certain ways if you're feeling very disappointed or very pleasantly surprised. But if you want to let go of something I encourage and not do this myself, I encourage people to kind of get to a position where it feels very neutral. And when I say the word indifference, I'm not meaning that to be unkind or dismissive. It's more like a position where it kind of just doesn't really matter anymore. Yeah, I'm kind of like, I'm okay with it and these things happen. And I sometimes talk about relationships like milk. They've got an expiry date. Just because you've had a relationship with someone doesn't in your life doesn't mean that you are going to have a relationship with someone forever. I mean, if that were the case, goodness may like life would be very complicated. Most people listening, I'm sure, would have had more than one romantic relationship more than one friendship, probably more than one colleague relationship that that now you maybe don't see anymore.

Kellie [00:35:56] So it was a benefit for the time in your life. And yes. So it's about disempowering that anger or that disappointment, is it?

Charlotte [00:36:05] It absolutely is. And it's about recognising that that disappointment and maybe resentment actually does act as a negative force on you, on the person who's holding on to it. And so if you're able to kind of go, okay, and you know, the idea of letting go of stuff, it's like it sounds easy, but it takes practise and it is about kind of going, ‘Okay, I'm going to make a conscious choice, you know, am I going to? Am I going to think about those events and that time in my life and allow that to have power over me? Or am I going to sort of guide, you know what that's done now?’ That was then, and it happened for a reason. And even if I don't know what the reason was, that doesn't really matter because I'm going to kind of move on, move forward and let that be just something that was good was important in my life for a time, but isn't anymore.

Kellie [00:36:53] So casseroles are good, but contact is better.

Charlotte [00:36:57] Yeah, mattering is really important. Yeah.

Kellie [00:37:00] What's your greatest lesson? Do you think of that showing up and letting down for you?

Charlotte [00:37:05] I think just the awareness about not realising you have expectations until they're not met or until they are exceeded, and then reflecting on why those expectations might be there. And I think also just feeling really grateful. And I think a lot of my clients would say this too. That feeling really grateful that maybe this horrible experience did generate a really positive change. You know, that's probably, hopefully going to be with me for the rest of my life

Kellie [00:37:36] In our next episode. We're going to talk about body image, which is a massive topic. Huge. Make sure you join us for that. And don't forget if this episode has helped you, why not share it with someone who might also benefit? You might like to subscribe to the podcast to ensure you never miss an episode and leave a rating and a review. There's also a survey in the show notes, your feedback assists BCNA in creating content that's relevant. BCNA is here for you at every stage of your diagnosis and beyond. You find some amazing resources on the My Journey app. Sign up at my journey dot org dot au. And if you want to connect with others with a shared experience, join BCNA’s Online Network. Sign up on our website. Coming up next time on the podcast, The Mirror Image,

Episode preview [00:38:26] So over the years, each of us would have hundreds of thousands of images in a file in your brain titled ‘This is what I look like’. And then you have cancer treatment. And when you look in the mirror edge, in the mirror image and you see yourself after treatment, the image in the mirror doesn't look the same as the images in your file in your brain that say, ‘this is what I look like’. So it sets up this thing called cognitive dissonance, which is where you're trying to hold two ideas in your head at the same time. This is the physical reflection of everything I've been through and the fact that it is a permanent change, and I am not the same person I was before diagnosis, and I'm never going to be the same person.

Kellie [00:39:09] And we'd also like to extend our thanks to the family of the late Tara Simmons for allowing us to use her beautiful music as our theme for this podcast. Thanks for joining us. I'm Kellie Curtain, and it's good to be upfront with you.

Ends [00:39:24] Thanks for listening to Upfront About Breast Cancer, What You Don't Know Until You Do, with Dr Charlotte Tottman, brought to you by the Breast Cancer Network Australia and proudly supported by JT Reid.