The Body after Cancer: A Qualitative Study on Breast Cancer Survivors’ Body Representation
Abstract
:1. Introduction
Psychological Interventions on Self-Compassion for Breast Cancer Survivors
2. Materials and Methods
2.1. Institutional Review Board Statement
2.2. Participants
2.3. Psychological Intervention
2.4. Procedure
2.5. Data Analysis
3. Results
3.1. The Relationship with the Body
3.2. Emotions Related to the Body
3.3. Toughts Related to the Body
4. Discussion
Limitations and Future Studies
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Themes | Contents | Examples of Questions | |
---|---|---|---|
Session 1: Setting the Scene Motivation, Setting Goals for Change | Introduction to the group and rules A brief group “ice-breaker” in which women introduce themselves and their reasons for attending the program Theoretical background on body image and self-compassion by the psychologist The body image assessment: participants filled a table focused to have a clear understanding of the problematic and maladaptive cognitive, emotional, and behavioral elements associated with body image before and after diagnosis and oncological treatments. Results were shared with each other into the group Participants defined specific goals on the basis of the results of the body image assessment Participants were invited to complete a “Body Image Diary” every day. The aim of this diary was to help survivors to monitor their body image experience focusing their attention to their body sensations, emotions, and behaviors. | Exploration of individual expectations A body image assessment Group motivational therapy | How did you feel about taking part in this project? What are your body image evaluations? What might be the benefits of attending to this project? What are your beliefs, emotions, and behaviors related to your body image? |
Session 2: The Survivors’ Relationship with their Body Image, Distorted Thinking and Core Beliefs on their Body Image | Questions and feedback about the individual experience with the diary The construction of a timeline of body image: each participant wrote about barriers and facilitators in their relationship with the body every day. Moreover, they reflected on what predisposed to a negative body image by sharing their thoughts to the others in the group. The group discussed about the main related emotions and how practice self-compassion in a traumatic situation, such a breast cancer -The psychologist helps participants to relieve coping behaviors (e.g., avoidance, checking), which actually serve to worsen body image distress in the longer-term. Furthermore, specific behavioral strategies for improving positive behaviors towards their body were provided. These self-tailored strategies typically involve graduated exposure and response prevention interventions that patients develop within the group and set objectives for accomplishing them outside of the group. Finally, the psychologist instructed the patients to stay engaged in healthy activities (e.g., fitness and medications). | Exploring the impact of traumatic events on body image Understanding coping strategies and available safety behaviors Emphasis on thought’s recognition and possible positive consequences on everyday life | What are the main events linked to your body image experiences that you have had over the years? How do you react to these difficult experiences? How can you foster your safety behaviors? |
Session 3: Promoting Emotional Awareness and Self-Defeating Behaviors | Questions and feedback about the individual experience with the diary The “Body and Mind Relaxation”: group members draw on paper their shape and label each of their body’ parts with an emotion. Then, the group discussion aimed at fostering their control on body image in relation to distress-provoking stimuli. In addition, the psychologist proposed various ways in which self-compassion may assist participants in overcoming negative emotions. Participants were encouraged to treat themselves with self-compassion when they dealt with their bodily issues -The psychologist proposed a ‘stop, look, and listen’ technique to identify inner sensations and cognitive distortions. Moreover, specific strategies for modifying cognitive distortions were provided. Patients were instructed to stay in contact with their inner sensations daily, incorporate cognitive restructuring exercises, and discover the emotional and behavioral positive consequences of changes. This way, patients were guided to identify dysfunctional body image-related schema (e.g., cognitive errors) and replaced a faulty self-talk with a new positive one. | Self-monitoring and listening of inner sensations were introduced | To what extent are you in contact with your thoughts and feelings? What happens to make you think or feel a certain way? What does emotional discomfort lead you to do? What do you believe about yourself? How vulnerable do you feel given existing societal pressures? |
Session 4: Reviewing Future Goals to Preserve a Positive Body Image and Support Self-Compassion Attitudes | Questions and feedback about the individual experience with the diary -Participants reviewed the individual and group results and received feedback about attained changes by the conductor. They reflected on what vulnerabilities were activated and unfolded in day-to-day thoughts, emotions, and behaviors and how they learned to stop this self-perpetuating. In addition, participants reviewed their Body Image Diary and the relapse-prevention strategies to cope with future situations that might induce negative body image experiences. Finally, they set goals for further needed changes. | Review of the individual progresses and future goal setting | What have you learned about your body image? How can you manage body image distress, in the future? |
Lemmas (Before the Intervention) | Coeff. | EC (B) | EC (AB) | X2 | p |
---|---|---|---|---|---|
Seek | 0.67 | 5 | 5 | 2.73 | 0.10 |
See | 0.67 | 5 | 5 | 2.73 | 0.10 |
Feel | 0.62 | 6 | 5 | 0.51 | 0.48 |
Unease | 0.60 | 4 | 4 | 1.98 | 0.16 |
Energy | 0.60 | 4 | 4 | 1.98 | 0.16 |
Pleasure | 0.60 | 4 | 4 | 1.98 | 0.16 |
to be able to | 0.60 | 4 | 4 | 1.98 | 0.16 |
Accept | 0.52 | 3 | 3 | 1.36 | 0.24 |
Look | 0.45 | 4 | 3 | 0.01 | 0.93 |
Physique | 0.43 | 2 | 2 | 0.84 | 0.36 |
Lemmas (After the Intervention) | Coeff. | EC (B) | EC (AB) | X2 | p |
Feel | 0.75 | 5 | 5 | 5.00 | 0.03 |
Care | 0.67 | 4 | 4 | 3.64 | 0.06 |
Positive | 0.67 | 4 | 4 | 3.64 | 0.06 |
Cure | 0.60 | 5 | 4 | 1.25 | 0.26 |
Relationship | 0.60 | 5 | 4 | 1.25 | 0.26 |
Look | 0.58 | 3 | 3 | 2.50 | 0.11 |
Time | 0.58 | 3 | 3 | 2.50 | 0.11 |
Pleasure | 0.50 | 4 | 3 | 0.51 | 0.48 |
Ache | 0.33 | 4 | 2 | 0.23 | 0.63 |
Relax | 0.19 | 3 | 1 | 1.11 | 0.29 |
Before the Psychological Intervention | n | After the Psychological Intervention | n | |
---|---|---|---|---|
Relationship with the Body | 1.1 un-acceptance: incapacity to accept the body changed after cancer | 7 | 1.1 un-acceptance: incapacity to accept the body changed after cancer | 3 |
1.2 distance from the body: avoid looking and touching their bodies | 1 | 1.2 staying in contact with the body | 3 | |
1.3 body as a cancer-related reminder | 1 | 1.3 having confidence with the body | 3 | |
1.4 body collaboration: be aware of its efforts | 2 | 1.4 body collaboration: the body role and relevance to sustain the overall well-being | 7 | |
1.5 an “insecure attachment” | 1 | / | 0 | |
Emotions | 2.1 sense of alienation: perception of a body that is not under control | 1 | 2.1 sense of alienation: absence of the bodily sensations | 1 |
2.2 unclear body signals: the body gives information that are difficult to be understood | 1 | / | 0 | |
2.3 fear of cancer recurrence: sensations are linked to the fear of a new cancer diagnosis | 1 | / | 0 | |
2.4 negative emotions: rejection, discomfort, and contempt towards their body | 5 | 2.4 negative emotions: anger, discomfort, sadness, and guilt | 3 | |
2.5 ambivalent emotions: presence of both positive and negative feelings towards the body | 4 | 2.5 ambivalent emotions: presence of both positive and negative feelings towards the body | 4 | |
2.6 sense of gratitude: gratitude for the efforts endured by the body | 3 | 2.6 sense of gratitude: gratitude for bearing oncological treatment; awareness related to the relevance of the total body | 4 | |
Thoughts | 3.1 cognitive burden: fatigue related to the perception of a tired body and body rejection | 4 | 3.1 cognitive burden: fatigue related to the perception of a tired body and body rejection | 3 |
3.2 sense of impotence: impossibility to do something to come back to their bodies before breast cancer | 2 | 3.2 sense of impotence: impossibility to do something to come back to their bodies before breast cancer | 1 | |
3.3 take care and time: listening of inner sensations and relaxation practice. | 4 | 3.3 take care and time: be involved in relaxation practice; more awareness about the importance of the body to promote the overall well-being | 6 | |
/ | 0 | 3.4 the body as a helper: body is now perceived as an ally | 4 |
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Sebri, V.; Durosini, I.; Mazzoni, D.; Pravettoni, G. The Body after Cancer: A Qualitative Study on Breast Cancer Survivors’ Body Representation. Int. J. Environ. Res. Public Health 2022, 19, 12515. https://doi.org/10.3390/ijerph191912515
Sebri V, Durosini I, Mazzoni D, Pravettoni G. The Body after Cancer: A Qualitative Study on Breast Cancer Survivors’ Body Representation. International Journal of Environmental Research and Public Health. 2022; 19(19):12515. https://doi.org/10.3390/ijerph191912515
Chicago/Turabian StyleSebri, Valeria, Ilaria Durosini, Davide Mazzoni, and Gabriella Pravettoni. 2022. "The Body after Cancer: A Qualitative Study on Breast Cancer Survivors’ Body Representation" International Journal of Environmental Research and Public Health 19, no. 19: 12515. https://doi.org/10.3390/ijerph191912515