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Upfront About Breast Cancer Podcast

What You Don’t Know Until You Do, with Dr Charlotte Tottman: Episode 5

Episode 5: Upfront About Breast Cancer – What You Don’t Know Until You Do, with Dr Charlotte Tottman: The Snow Globe Effect: Change of Perspective 

Let’s be Upfront about the change in perspective that often follows a breast cancer diagnosis. 

In this episode of What You Don’t Know Until You Do, with Dr Charlotte Tottman, we hear about the Snow Globe Effect, an analogy Charlotte uses to explain how a cancer experience can change a person’s perspective, values, priorities and how they live their life. 

We explore confronting mortality, re-thinking past choices and decisions and how we can be empowered to live our best life going forward.  

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 [00:00:41] Welcome back to Upfront About Breast Cancer What You Don't Know Until You Do with Dr Charlotte Tottman, a clinical psychologist whom for many years has specialised in cancer distress. She now has another perspective that of lived experience after being diagnosed with breast cancer three years ago. In this episode, Charlotte's going to explain how her cancer experience can change a person's perspective, values, priorities and basically how they live their life. Re-assessment happens to almost everyone, including her. Charlotte calls it the snow globe effect. Just a reminder that this episode of Upfront About Breast Cancer is unscripted. The topics discussed don't replace medical advice or represent the full spectrum of experience or clinical options. So please exercise self-care when listening to this podcast, as the content may be triggering or upsetting for some. Dr. Charlotte. Welcome the snow globe. I have this vision of giving it a good shake. And what happens?

Charlotte [00:01:44] Hi, Kellie. Just to be clear, for those people who might be thinking, I'm not quite entirely sure what a snow globe is, it's one of those little things you quite often see like in a tourist shop where it's a transparent sphere. So it's a circle filled with water, and it's often got a little landscape thing in it and a bunch of things that are meant to be snowflakes. So the analogy that I use for someone's experience following a cancer diagnosis is that if you think about the snow globe, is your life and then cancer shakes up your life, and all those little snowflakes are your values and priorities. And when they settle after diagnosis, none of them settle exactly where they were before. And so some things that used to matter don't matter anymore, and some things that didn't matter sometimes now do. It's a pretty significant effect, and it often isn't one that's given a name. And people can kind of wonder, like, why am I feeling some of this stuff? And is it just specific to me and a bit like some of the things that we've discussed in the previous episodes? This kind of falls into the category of a universal experience. I have yet to meet somebody who hasn't had some sort of a perspective shift.

Kellie [00:02:59] I think it's a fantastic analogy because when you think of for want of a better word, sometimes tacky tourist mementos that you buy it and you give it a good shake and it's all really pretty. And then it just settles, and it sits there on the shelf doing pretty much nothing until someone shakes it up. And that's really what happens when you get a major life event or in your case, a breast cancer diagnosis. So, can you talk us through how your snow globe was given a shake and what happened to your snowflakes?

Charlotte [00:03:30] Yeah, mine definitely got a shake. And the thing that I've, I guess observed as a therapist is that the effect is different on everybody like cancer and like cancer treatment in response to cancer treatment. It's a very individual experience, and there's no rule with this stuff. Sometimes it's a perspective shift that happens almost immediately. I've had some clients sort of say as they were sitting in the in the room with their surgeon that their, you know, their whole perspective on life change. And I've had other people talk about it as something that's happened, you know, one to three years down the track. So it is very variable for me. I think probably I started to really do the review and reflection, which is kind of the process that happens. You start to kind of look back at the decisions, the choices, the commitments, the obligations that you've made to that point in your life. And because for a lot of people, not everybody, certainly, but for a lot of people, cancer comes at a point in your life where you have got a whole lot of stuff established. You know, you might have a family, you might have a home, you might have a career, you've made a whole bunch of decisions that were all mostly made with good intent and thought. But the cancer diagnosis kind of point gives you this opportunity to kind of look at all of those decisions and where you find yourself and sort of wonder, would I have done it differently if I knew what was coming? And if I've got another chance because it can feel a little bit like a second go at life, like almost like a reset button or a do over. If I'm not entirely happy with where I'm at or some of those decisions, do I want to do it a bit differently now? It's not about making massive life changes. I mean, that certainly does happen. It's more subtle than that. It's more about a perspective change and about recognising what I said before, about how some things just become much more important. And some things just kind of aren't important anymore. So, we let go of a bunch of stuff, but also sometimes. As we do pay a lot more attention to some other stuff.

Kellie [00:05:31] We often hear people who have had a major life event or a diagnosis of some sort. Get this clarity and say don't sweat the small stuff.

Charlotte [00:05:42] I mean, I've reflected on, you know, what are the things? And they were quite a few that the changes were for me and one of them was definitely not sweating the small stuff that can be quite an interesting thing in itself, because what can feel almost quite liberating to the person of just sort of going like, I'm just going to let go of a whole load of crap and I'm not going to get fussed by things that maybe I would have got bent out of shape about before. When your family members are used to you caring about the small stuff, it can be a little unsettling when you appear to be not so much zen because that's often not how it comes across. It can. It can appear like you basically don't give a stuff. And a lot of my clients and certainly me included report feeling much less tolerant about things like we're just kind of not so interested, and it doesn't have to be in an aggressive or dismissive way. But there is this sense of like if I'm only on this earth once and if there's a chance that I might be here for a shorter time than I maybe thought, I don't want to spend it worrying about stuff I don’t care about.That's lovely, but it can be a bit odd, and especially because sometimes we feel this and our perspective changes, but because we are not necessarily clued in to what this what, what is actually going on. We might not voice it. We might not say I've had this kind of like revelation, and I'm, you know, I'm conscious that my values and priorities have shifted. I don't think those conversations happen very often. So I think sometimes we're feeling it. We might be doing it, but we might not be actually aware about it and talking about it.

Kellie [00:07:13] Okay, so my personal circumstance? What did you consciously or unconsciously change?

Charlotte [00:07:21] So there are about five things. One was that I got better at saying no, so that the technical term for that is boundary setting, which is where you basically draw a line of what you will and won't do. I think the difference is because I've reflected on this. I'm a fairly socially avoidant person anyway. Like I just am. The work that I do means that I have fairly intense conversations all day, every day in my working life and on the weekends and after hours. I don't really want to talk to other people. I kind of I kind of like just like having some downtime. So I'm fairly socially avoidant anyway. But what I noticed in the aftermath of diagnosis was that I stopped apologising for it. And I just was more comfortable saying, No, no, thank you. Not today, not this weekend, and often actually saying, Look, I'm practising self-care. Sounds wonderful. Sounds like a lovely thing to be doing, but for me, I'm going to look after myself and decline. And that's been a really good change.

Kellie [00:08:19] It's almost like a green card for someone that's had a diagnosis, isn't it? Because people will respect that, whereas as well, person or someone that isn't recovering who says, you know, bit of self-care today can raise some eyebrows? Sorry, it's a bit of a free pass is not. That should be used.

Charlotte [00:08:37] Well, it should be used. And I think that's one of the weirdly beneficial things about a cancer experience is it does give you that licence. There is a latitude and an acceptance, a willingness in your loved ones. I think then, that you might not ever get any other time that you can actually go, ‘Do you know what? I am going to make some changes’, and the hardest ones are the first few. And that's where if they go well and you go, Okay, well, I was able to kind of like, say no and draw that line and not do that thing I didn't want to do. And the world didn't stop turning. Nobody's rejected me. You know, my relationships are still intact. Then it gets easier to practise that going forward.

Kellie [00:09:14] So was it saying no to social activities or no to other things as well?

Charlotte [00:09:19] I think probably mostly it was social. I mean, it makes it sound like I have a big social life, and I definitely don't. But I think it was mostly in terms of the no the saying no at the beginning. Anyway, it was it was about social stuff later and we'll talk about this in the next episode. Later, it came about sittings and boundaries for my work. But in the short term, it was probably social stuff. Next thing I talk about is the fact that I got less bothered by controlling all of the nuts and bolts of my life. So there's a big difference between liking control, which most humans do, because it makes us feel secure and makes life predictable and much. It feels much safer. So most people like control, that's not the same as being controlling, which is a whole other thing. I got better at letting some of my control preference go. I still like control, but there's a bunch of stuff that I just I just don't care about so much anymore, and I'm okay with that. For example, I used to really like everything in its place, so everything would have to be back in its place at the end of the day or the end of the weekend. And my children will attest to that. I have pretty high standards, and I would hold myself and pretty much everyone around me, my family again to these high standards, I have adjusted those standards a bit. I mean, I haven't, you know, dropped them. I haven't completely let my life go, but I have definitely moderated some of that stuff. So I think I'm just a little bit more loose. And that's a good feeling like, you know, letting go, you think about control, letting go. It is. It's a loosening up, and that's been a good thing for me. And that definitely fits into that. Not sweating the small stuff sort of thing. Not holding on to. I found myself, you know, a while ago thinking about and I would never have had this insight if it were not for my cancer experience. I was getting quite bent out of shape about a particular situation in the extended family. It doesn't matter about the details, but I wanted a certain thing to go a particular way and it was quite obvious it was not going to go that way. And then I and then I said to myself, Why does it matter? And I went, Yeah, no, it doesn't matter. And I was just in that moment able to let it go. Now, four years ago, before diagnosis, that conversation in my head would never have happened. I would have been striving through more, you know, conscious effort and probably conversations with other people in the extended family to make it be the way I wanted it to be. And now I'm just like, Yeah, now I can let that go.

Kellie [00:11:52] But is that because you've got bigger fish to fry, so to speak? I mean, all of a sudden you've got a major health crisis?

Charlotte [00:11:59] Yeah, yeah, absolutely. I think it absolutely refocuses your attention on the stuff that really does matter. And that's and that's the thing about the snow globe has that kind of bi-directional effect where, you know, you do let go of some stuff, but you do then pay more attention to other stuff. And so on that score, I now pay a lot more attention to what I call the fundamentals, so things like sleep, exercise and nutrition. Now that might sound a bit strange. As a clinical psychologist, you'd think, Oh, that was probably part of my focus anyway. No, not really. It wasn't really. I took that stuff for granted, and I think probably that's not an uncommon experience. Now I make time for those things. I am conscious now I am no saint and I certainly, you know, don't manage to always maintain my, you know, ideal behaviours. But I'm very much more aware of and committed to it. And I do things like I say to my husband, I need to spend 15 minutes on the treadmill after work, so we need to make space in our evening for that. Whereas beforehand, I just would have kind of made a promise that I'd do it and to myself and then not, you know, that sort of stuff. So I really have changed the investment and the commitment to those things.

Kellie [00:13:13] I would suggest that a knock to your mortality would be a very good reason to do that.

Charlotte [00:13:17] And that's the thing that the Snow Globe does do is that it reflects the fear that comes with confronting your mortality. The thing about a cancer diagnosis is and for those listening, I apologise for repeating myself from an earlier episode, but it takes a nebulous idea that something sort of bad could happen to us at any point in life, and it turns it into a concrete reality. And so suddenly I am that person who this potentially life threatening thing has happened to. And I think the other thing is that when you find yourself having conversations with people like your oncologist about the likelihood you are going to be alive in five years because they tend to talk in these five year brackets, because that's how the research has been done on the follow up studies. It's incredibly confronting. So it's one thing to just be diagnosed and to go, Oh my God, this is, you know, this is scary and I've got all the treatment to go through all of that. But even once you get through all the treatment and you might feel reasonably safe, then then you are having these very, very full on conversations about, you know, fifty. I was having a conversation about what percentage there was. I was going to be alive in five years time and my mum died of ovarian cancer at 59. So for me, it felt like, Oh my god, this becomes very real. Doesn't be really that we're all going to die one day. And then all of a sudden, somehow we've got a tangible timeline, even though no one has a crystal ball. But the threats sort of not there. There may be a real. That's right. And and whilst breast cancer has, you know, amazing stats, best of any cancer in Australia, there's still a whole lot of fear and there is the reality that things can go bad at some later point in time. So I think that that's a big driver in why we start to look so critically at the decisions that we've made and whether we want to keep living life according to the same kind of values and priorities that we might have had up until then.

Kellie [00:15:15] I'm interested in that. Given your line of work and your profession is to spend your day talking to people about cancer distress that again, once it's you, that it's happening. Who it must just give it a whole new level of understanding?

Charlotte [00:15:33] Yeah, it really does. And I think that's one of the things that, you know, and that's why we have the title to our podcast series that we do that I didn't really understand this. The strength of the force, like I knew this was a thing because I've seen it every day in my consulting rooms. But when it's you and I found myself really feeling the burden of the responsibility that I found myself at 54 with, you know, so, you know, children in their early 20s. You know, we had our own home and our rooms and odd careers, and there was a lot of stuff going on and it sounds really good. It sounds like we were in this place where we had kind of all the pieces of the puzzle, you know, we'd want them, but because I felt vulnerable and I felt scared, and I also felt like I was kind of trapped by my own decisions of the past where I just all of a sudden I just wanted this simple life I just wanted. I just wanted the freedom to be able to do anything, you know, and I didn't know what anything was. I hadn't figured that bit out, but what I felt was I couldn't get to the anything because I was so caught. The analogy I came up with the other day was wrapped up in barbed wire spaghetti, where I just couldn't get out because of all of this responsibility that I felt I didn't have the inside. I didn't know that that's what I was feeling. I was just really struggling to deal with this shift in my perspective, and my poor husband did not know what was going on with me. And he was playing catch up, and of course, he's going through his own stuff at the same time. And it was a really, really challenging period for us.

Ad [00:17:21] 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 [00:17:55] So you mentioned that for you, it came around a year after diagnosis. So for you specifically and for a lot of others, the treatment or the surgery, the immediate medical appointments, all that sort of stuff has finished. Yeah. And the outside world where we're moving right along, it's right and everything's back. And yet you're as you just internally, you know, in your barbed wire. Yeah, knowing you want change, but you don't know why you want change and what change that is going to be. Yes, so. Were you an easy person to live with at that point?

Charlotte [00:18:33] Oh, no, oh no. I was so I was so challenging.

Kellie [00:18:43] That's a nice adjective, isn't it?

Charlotte [00:18:45] Yes, I'm sure my husband could think of others. Poor bugger. It was. Yeah, and I was. I was hard. And I think a lot of that was because I was in this flux. I was in this like state of, you know, I'm trying to get back, I'm trying to reclaim my life. I'm trying to, you know, my quest to get back to normal, which we all know doesn't happen. But I was also struggling with all of this internal shifting of my perspective, but with no ability for, you know, for a person, you'd think with my training there might have been a bit more insight, but there just wasn't.

Kellie [00:19:21] But they must have been more pressure to because that pressure on yourself is like, I am a psychologist. I'm excited. I know stuff and I need to have it together sorted.

Charlotte [00:19:31] Absolutely, and I need to have the answers and Rob saying to me, like, ‘What is going on with you?’ And I'm going, ‘I don't know’. I'm like, ‘I just want to get out of my skin like, this is just intolerable’. But it wasn't until I had some time off later down the track, which is what we will be discussing in our next episode, that I actually was able to start to put the pieces together. But one of the one of the things that I've really also understood retrospectively about this is that I had for a long time counselled my clients in the first year after treatment. So in that first, when you finish hospital based treatment, when you're post-treatment adjustment and recovery begins, I had long cancel my clients to not make any big decisions in that first 12 months. And now I understand why I was doing that.

Kellie [00:20:18] Because well, but it doesn't sound like you did in that first 12 months. I mean, saying no seems actually a very sensible thing to do and letting go of control and some of the small stuff.

Charlotte [00:20:31] Yes. And that was all very, I think, kind of appropriate and measured and didn't put anything really on the line or at risk. But I certainly felt vulnerable to maybe making some hasty, possibly impulsive decisions. Now I didn't. But I think, you know, I certainly say some of that stuff floated around in my head. And so what I say to my clients and what I think I was even there when I didn't really understand what was going on, I just instinctively knew this wasn't the time to be making wholesale changes is the risk is that if you are feeling really emotional and you are being driven by strong emotions, the risk is that you'll make an emotion-based decision. And that's a very different type of decision making than an information-based decision. And the problem with emotion-based decisions is when we go back and look at them retrospectively and go, Why did I make that decision? Why did I chuck away that job or sell my house or leave my partner or whatever? We can't find the rationale because there wasn't one because it was an emotion-based decision, not an information-based decision. So, in that first year, even though you know there, probably for most people, are large parts of that first year where you don't feel too bad at all and you might feel like I'm not an emotional kind of like train wreck. So I probably could make some smart decisions. Just as a blanket general rule. I do encourage people to just be very careful in that first year because it can be a bit of a rollercoaster.

Kellie [00:21:59] And not just for the person diagnosed or recovering. There's usually a whole network connected with that person. Yeah, yeah. Partners, children, friends and all of a sudden you get clarity with your life as a consequence of a diagnosis. Hmm. And then everybody else is left playing catch up.

Charlotte [00:22:22] Yeah. When I first came up with the analogy of the snow globe effect, initially I thought it was just all positive, like it was this like, you know, call time where you could have a reset and you could have a do over and you could like, you know, identify all the things that you really that really matter to you. And you could have this clarity in these increased motivation to be able to live consistent consistently with that, those new values and priorities and that sounded cool. But if you've got an existing life with existing obligations and commitments and expectations of others built on years and years of experience, and you then suddenly turn around and change some of that stuff, and you don't necessarily. But even if you do communicate it, there's no guarantee that it's going to fit with the set up of your life or the people in your life.  

Kellie [00:23:15] So it's all very well to say I'm going to throw in that job. But if you've got a mortgage and other financial commitments, that would hardly make a whole lot of sense, even though it might feel liberating and good.

Charlotte [00:23:26] Yeah, I mean, if you're an engineer, yeah, if you're an engineer and you decide that, actually I'd rather go and work in aged care like it's a really nice idea, and it might have a great deal of purpose and meaning for you. But whether that's going to translate into the into meeting the existing commitments and obligations that you have, that's a very big thing. And that can set up a lot of tension. And it can make things very difficult in your life in a way that you may not have anticipated. And it can also be very hard for the people around you. I mean, my husband said it was kind of like trying to support. He was trying to support me. But he said it was kind of like trying to support jelly like it was just, you know, moving all the time. And he couldn't get hold of it. He couldn't kind of like, get a grip. And so he was wondering, you know, when is this going to settle down?  

Kellie [00:24:20] I want to know who's ever tried to hold jelly.

Charlotte [00:24:22] I know, I know. But it was. It was really hard. And I think that's the thing is that I've kind of then looked at the snow globe effect and gone, OK, well, if this is going to happen and it does, and if it's got kind of like a positive side and perhaps more of a tricky side as well, then I think as the person who's having that perspective change, it's almost beholden upon us to be very mindful about the force of it and the fact that it can be a force for good. But it can be also very tricky and it's kind of like a superpower and therefore it should be used really responsibly.

Kellie [00:24:57] Yeah. And I'd imagine it's also hard to know for the people around you whether it's a passing phase like these new revelations. So all of a sudden you want to throw any job and go backpacking or something else. How do you know you've mentioned give it 12 months before? Yes, or anything radical, but you did do something a little radical, didn't you?

Charlotte [00:25:18] So yes, we did make a pretty big change and consistent with what I was saying, it wasn't in the first 12 months, about 20 months after diagnosis, we made a big tree change. It's the best decision we've ever made and I would credit cancer with that. We would never have done it if it hadn't been for my breast cancer diagnosis. I think I might have thought about at some point. But certainly we were both very, very interested in a different pace of life and a bit more space, which sounds ridiculous because in Adelaide, most people do have quite a bit of space. But anyway, it was it was just a fantastic thing that we've done. And so again, without wanting to be pollyanna, I do view my breast cancer experience as having given me, given us, even in that respect, that clarity, but also the motivation to do it. Like, I think beforehand, we might have gone, Oh yeah, that might be nice, but we would never have done what was required to make it happen. Whereas now or last year when it happened, it was kind of like, No, this is really important to us now. And so, we want to make it happen, and I am scared the cancer will come back and Rob’s scared too. And so it's like, this is living life. This is living in the moment. This is not sorry. This is not die wondering, you know, it's like, we're going to do it. So it has been it's been amazing.

Kellie [00:26:37] It sounds fortunate that you are both on the same page.

Charlotte [00:26:41] Yeah.

Kellie [00:26:42] What about those that don't enjoy that harmony of arriving at the same place?

Charlotte [00:26:48] Yes. And I see a lot of that in my consulting room, and it is very tricky because it can obviously create a divide where there maybe wasn't a divide before in a relationship or it can exacerbate something that might have been there. So if you're already feeling like I am not quite sure that hubby and I are on the same page, and then all of a sudden, I've got all of this newfound clarity and motivation, and he's going, I'm just so not there. And also, you might not even be having those conversations. You might not even be actually on the same page enough to be talking about, you know, this is what I'm feeling and this is what I'm thinking, and this is what I'd like to be doing differently. So it can be very tricky when I'm working with people who are going through this sort of stuff. I quite often will suggest that we get their partner into the consulting room, not not for all of therapy, but for some of it. And it can be really helpful to get to just get some of this stuff actually expressed and add on the table so that people can understand that there has been this perspective shift and why it's happened and that it's actually really common and really normal. And then it's about kind of finding a way to work through it a bit more together than apart.

Kellie [00:27:59] So how do you use your new superpower for want of a better word without blowing up your life?

Charlotte [00:28:07] Yeah, you have to be really mindful of it. And I think that's the thing is that in psychology, what we're fundamentally going for most of the time is increased awareness. So if what you come to understand, maybe from listening to us talking today is that, yeah, that's happened to me. Then it's about going, okay, well, what really has changed? What is more important to me and what maybe don't I care about so much? And then? It's maybe about communicating some of that stuff to the people who are around you. I mean, I think that one of the things that's been interesting in for me is in the prep for this podcast series. One of my daughters has been around. While I've been doing that, she's been helping me with some stuff and she's heard me doing some of the prep, and she's learnt some stuff that she didn't know before because I had not communicated it to her. And so I think that sometimes, particularly in those intimate relationships, in those family unit relationships, we do just sort of fall into the trap of taking each other for granted. And we don't necessarily express explicitly. What I've noticed, what's different about me now, and it can be so helpful because it plugs people into your newfound perspective and it gives them a way of being able to understand, not be kind of trying to support jelly and then be able to go, Oh, right, well, now this makes sense to me. And if it makes sense to me, I can kind of work with it and get used to it rather than just sitting on the sidelines going like what is actually going on with her.

Kellie [00:29:31] So from a support person's point of view, when someone gets the clarity, shakes the snow globe and bam, everything comes and they sort of shed their skin like a snake, so to speak, because they're letting go of all the stuff that seems small fry. Mm hmm. Do people tend to throw the baby out with the bathwater a little bit like sometimes do true radical good.

Charlotte [00:29:58] Yes, yes. Go too far. Absolutely. And I think, because this might be maybe the first opportunity where they've got this really unique combination of the clarity and the motivation, but also that licence we were talking about before where there's sort of this permission within their friendship network or their family, where it's kind of like, well, I kind of can do anything you can, like most things, have too much of a good thing. So it is about kind of being very mindful and sort of thinking about, OK, there is action and reaction. And if I've been behaving in a certain way for the last 10, 20, 30, 40 years and I all of a sudden change that it's unlikely that there won't be a reaction. So, you know, do I care about that? And probably the answer for, you know, some key people in your life will be, yeah, I really do care about that. I don't want to blow up my life. And so it's about recognising that there might be a real it might be quite seductive to be quite extreme, you know, and do the do the big shift, do the big change, but understand that every one of those reactions behaviours is likely to have some sort of a reaction, a response or I think someone else as well. That's right. And in fact, someone else and you're you're going to feel that, yeah, you don't get you don't get away with that scot free.

Kellie [00:31:24] Okay, so you did do a tree change. What about someone that does feel that need to recalibrate for whatever reason? Can't do the big stuff? Yes. Is there something that you can still do to get something from that idea?

Charlotte [00:31:41] Yeah, yeah. I think what it comes back to is really being clear about what your values, what you're perhaps new realigned values are, so it might sound a bit thin, and I'm very mindful of that. But if you've if you've decided that I, for example, might want a bit more space in my life, I might want a bit more fresh air, I might want a bit more contact with nature, the earth, animals, the environment, then sure. I mean, a tree change is one way to get that. But that's not necessarily an option for a lot of people. But there are a lot of smaller things that you can do that are going to give you that sensory experience of being more connected to the environment. You can spend more time. I mean, you can restructure your life so that you spend maybe like, you know, an extra 20 minutes, 30 minutes each day. Being outside rather than inside, you can get more connected with the Earth through things like gardening. You can spend time with animals. You, I mean, certainly, I'm a big advocate for that. So there are ways that you can, if you like, approximate something that you know you might be quite seduced by the idea of the big change. But just because you can't have that doesn't mean that you can't have smaller versions of it. And that's what it's about. Mission is, and that's what approximating is. It's doing a version of it. That's not exactly what you're going for, but it's but it's approximating it. And I think that that's actually a valuable thing to engage in because small change is much more sustainable over time. Big changes, you know, how many times do you move house in your life? How many big relationships do you have? How many big career change do you have? Not that many, but you can make small changes that you can keep sustained in your life that can really change the quality of your every day, every hour, every afternoon. And that's what I think a lot of people want in the aftermath of a cancer treatment experience, they want a better quality of life, they want to feel like this is living.

Kellie [00:33:38] The snow globe, it's both fascinating and an amazing thought process behind someone that receives a cancer diagnosis and what happens to the values and perspective after the treatment stops.

Charlotte [00:33:51] And it's a very powerful thing, and it can be used in a kind of really positive way. It can also have some unexpected negative consequences that we might not anticipate. And so it's important to just be, you know, that awareness thing, to be really mindful and thoughtful and develop your awareness around what exactly has changed for you and communicate that to the people in your life.

Kellie [00:34:13] Thank you, Charlotte. If this episode has helped you or may help someone you know, you can support the show in the following ways to allow us to continue to be upfront with you and reach more people through our meaningful content. Subscribe to ensure you never miss an episode. Download so you always have an episode ready to listen to and leave us a rating and review and tell us what you liked. Also complete the survey you'll find in the show notes, it helps us tailor and create content that's relevant to our members and their breast cancer diagnosis. And don't forget My Journey, tailored information for every stage of your diagnosis. Sign up at my journey dot org dot au. And if you'd like to connect with others for support, join BCNAs Online Network. It's available 24 hours, seven days a week, all the details are on BCNA’s website. Coming up next time, let's talk about the meltdown.

Episode preview [00:35:12] Was it an epiphany, oh my God, or was it? No. I just can't. No. Yeah, it was. I was just like, I'm broken, like, I am done. I was in this stage of adjustment called resistance, so I was very resistant to the fact that there had been this colossal event in my life and that everything was different. It wasn't like an epiphany. It was just like a face slam into the dirt. And I went home and I rang my oncologist because I knew she would be pleased in a weird kind of way because I said to her, ‘I'm going to take a break’. And she said, ‘Oh, thank God, Charlotte’ and I am so frustrated with myself that it took me getting to that point to do what I counsel my clients to do, which is to take it easy.

Kellie [00:35:58] Our theme music was composed by the late Tara Simmons, who lost her life to breast cancer with thanks to her family for allowing us to use it in the podcast. I'm Kellie Curtain. Thanks for being upfront with us.

Ends [00:36:13] 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.