Life with Cancer: Anxiety in Grief

By Sarah Brooks, LPC, Oncology Clinical Therapist, Inova Life with Cancer

“No one ever told me grief felt so like fear.” – C.S. Lewis

When we are grieving, anxiety may emerge as part of our experience. Anxious thoughts and concurrent bodily responses can be adaptive in certain situations, but when they begin to pervade our everyday life and impact our physical and emotional functioning, we want to explore below the surface.

Why do I feel anxious or fearful in grief?

Fear of our grief reactions or an active attempt to push away or suppress our grief – Sometimes, we fear the intense and distressing emotions that come with grief. We fear they will incapacitate us or embarrass us and that we’ll be out of control. But if we avoid or don’t allow for natural expression of emotion, it can come out “sideways” in the form of anxiety.

Our new, firsthand knowledge that life is uncertain, that we have no real control, and that the “unlikely” can happen to us – Much of what we believed about our lives and our futures has been shattered. We may start to overestimate the likelihood of bad things happening and feel that disaster can strike at any moment. We feel unsafe. In grief, we are tasked with learning to live in an unpredictable world we cannot control.

Our desire to feel safe – Chronic anxiety or worry can make us feel like we are preparing for any negative outcome that comes our way. We reason that if we think through it now, we won’t be caught off guard in the future. But what we are really doing is causing ourselves distress in the current moment.

What may help us cope with anxiety?

We are all helped in different ways, but here are some strategies to try when you’re feeling anxious:

• Acknowledge and name your fear/anxiety – In the moment, name what’s happening. “I feel afraid that when my daughter doesn’t call me back right away, something bad has happened.” View this thought with self-compassion and nonjudgment.

• Notice where the fear starts – Which part of your body reacts? For example, you may feel your chest constrict and your stomach doing flip-flops.

• Begin to soothe your nervous system – Simply lengthening your exhale (in relation to your inhale) soothes your nervous system and your “flight-fight-freeze” response. Send breath and loving compassion to those places in your body where you feel those anxious reactions.

• Ground yourself in the present moment – Try this grounding exercise: out loud, name five things you can see, four things you can feel, three things you can hear, two things you can smell and one thing that you can taste. Breathe.

• Change your environment – If you are inside, head out for some fresh air; if you are outside, move inside and find a place to rest.

• Engage in regular self-care, including physical exercise – Taking care of your physical body can help release emotion and help your gain confidence in your own resilience and strength.

• Ask, “What do I need now?” – When anxiety comes up, work to identify what would help in the moment. Reassurance, connection, comfort? What are simple and realistic ways you can address these needs in the moment?  

• Cultivate self-trust – Create an affirmation or mantra like “Right now, everything is fine. If something arises, I trust myself to respond accordingly. If there’s something I cannot solve, I trust myself to ask for help.”

“If something arises, I trust myself to respond accordingly. If there’s something I cannot solve, I trust myself to ask for help.”

• Use your brain’s powers for “good,” not anxiety – If you must imagine something, why not imagine a positive outcome? It won’t influence things either way, but it will make day-to-day living easier for you. Or better yet, practice mindfulness in the present moment. Fully experience the here and now, and when it feels achievable, practice cultivating a sense of gratitude.

Life with Cancer, a program of Inova Schar Cancer Institute, has become Northern Virginia’s leading cancer education and support organization. We offer a variety of programs and services for patients, survivors and their family members to help individuals cope with cancer, its treatments and survivorship in the best possible way. For counseling and education, programs, support groups and resources, please contact:

703-206-5433 (703-206-LIFE) or lifewithcancer@inova.org