Presented July 10, 2016 at the Ovarian Cancer National Conference in Washington, DC

1. GROWING UP WITH OVARIAN
CANCER:
FACING THE BATTLE AS A YOUNG ADULT
Julie Larson, LCSW
www.julielarsonlcsw.com

2. AYA DEVELOPMENT CONTINUUM
Adolescent
Emerging
adult
Young
adult
“Young”
adult

3. DEVELOPMENTAL THEORY:
CLASSIC STAGES
• Identity v. role confusion
• Intimacy v. isolation
Erikson
• Conflict management
• Intimacy
• Work
Valliant
• Form a dream
• Cultivate mentor relationships
• Love relationship
• Occupation
Levinson

4. DEVELOPMENTAL THEORY:
CONTEMPORARY
• Age of Identity Exploration
• Age of Instability
• The Self Focused Age
• The Age of Feeling In-Between
• The Age of Possibilities
Arnett: Emerging Adulthood

5. DEVELOPMENTAL TASKS OF AYAS
 Establishing independence from parents
 Financially, housing, decision-making
 Developing long term relationships
 Setting professional goals & aspirations
 Defining identity, body image, values, priorities
 Acknowledging needs & impulses
 Maximizing strengths and negotiating weaknesses

6. EMOTIONAL NEEDS OF AYA SURVIVORS
 Loss of control
 Loss of independence
 Loss of normalcy
 Loss of feeling of invincibility
 Negative impact on career
 Stress of family planning decisions and/or losses
 Strain on relationships
 Isolation/loneliness is a major issue for most AYAs
due to timing of diagnosis and cancer’s impact on
relationships with peers, co-workers, spouses and
other family members

7. PSYCHOLOGICAL ISSUES FOR AYAS
DIAGNOSED WITH CANCER:
Demands of illness
• Isolation
• Vulnerability
• Dependence
• Uncertainty
Demands of life cycle
• Intimacy
• Invulnerability
• Independence
• Control

8. CANCER SURVIVORSHIP:
THE FOCUS IS YOU!
 Identify healthy coping and craft ways continued
use of these tools
 Challenge oneself to embrace new ways of caring
for self. Remain interested in the process.

9. WHAT IS RESILIENCE?
 MYTH: Resilience is a genetic trait. You either
have it or you don’t.
 We are all born with innate resiliency. An inborn
capacity for “self-righting”.
 Resilience is found in a variety of thought
processes and behaviors that can be learned
throughout a lifetime.
 Resilience develops as people grow
and develop better thinking,
self-management skills and knowledge.

10. WHY DOES RESILIENCY MATTER?
 Resilient people often find meaning even in times of
trouble and gain confidence from overcoming
adversity. In this way, resilience can contribute to a
deeply satisfying life.
 Resiliency and Happiness are closely linked
 Happiness involves feeling more positive emotions
than negative emotions.
 Positive emotions help us build skills and internal
resources…a larger repertoire of assets that we
can draw on in stressful times.
 In other words, “Happy people become more
satisfied not simply because they feel better, but
because they develop resources for living well.”
Bauer&Bonanno

11. PERSONAL GROWTH – RESILIENCY!
 Most people who experience a major life crisis or
event experience feelings of grief, anxiety, anger,
and other negative emotions.
 Growth comes not from the avoidance of these
negative emotions but rather from the struggle to
cope with them. Positive
Feelings
Frame of mind
to explore the
world
Build skills & internal
resources
(manifestation of
Resilience)
Find meaning,
fulfillment and
satisfaction
Gain
confidence

12. BUT AM I RESILIENT?
Of course you are!
But…What is your personal “brand” of resiliency?
Can you articulate how you’ve made it this far?
What habits or qualities would you like to cultivate
within yourself as you move forward in your
survivorship?

13.  Make a list of different ways you care for yourself
 Consider your five senses
 How do you care for yourself at:
 Work?
 Home?
 When you are out socially?
 In the middle of the night?
 If being with people is
part of your list, what
are you doing together?
YOUR “PERSONAL BRAND” OF RESILIENCE

14. THE WORK OF BEING AT WORK:
Realize when you are stressed. Why?
What are those triggers?
Certain people?
External Events?
Begin to learn your “Warning Signs”:
The build up to an emotional moment.
Know your people!
Who is good for you?
Who is challenging?
Self Care: The Emotional Ramp Up

15. GRIEVING
 Experience the pain of grief
 Commemorate the loss: An acceptable way of
honoring what has been lost
 Letting go or finding where the loss lives within
 Moving forward
 Grief Counseling can help by sharing the weight of
the emotions and providing a secure base
The loss of a child (real or
fantasized) is a brutal shock and
feels like an assault on self-worth.

17. THE ANGER SADNESS ALLIANCE
SADNESS:
 Sadness is vulnerable.
 Sadness accepts the situation for what it is.
 What helps you feel safe enough to be really sad?
 Pay very close attention to what makes you stop crying?
 Why does THAT matter?
ANGER:
 Anger is active energy.
 Anger gets you fired up and ready to defend yourself, jump
into action!
 Anger rallies you to do something to change the situation.
 What can you do with that energy?
 Do you know your triggers?
Mindfully
consider: Which
emotion tends
to be your
default?

18. CONTINUING THE… FOCUS ON YOU.
 Identify healthy coping and craft ways continued
use of these tools
 Challenge oneself to embrace new ways of caring
for self. Remain interested in the process.
 Recognize and minimize negative self talk

19. “Before we can expect to consciously direct our life, we
need to be able to consciously direct our attention.”
THE VOICE INSIDE YOUR HEAD
 Remember The Voice is well intentioned.
 The Voice has been doing its best to keep you safe and happy.
 Unfortunately, The Voice is operating on outdated guidelines
 The Voice keeps us from experiencing the present moment
MASTERING ATTENTION & “THE VOICE”
INSIDE YOUR HEAD

20. All or Nothing Thinking:
You think of things in “black or white”, “right or wrong”,
“perfect or terrible” categories.
Over Generalizing:
You think of a single negative event as a never-ending
pattern
Magnifying or Minimizing:
You exaggerate the importance of certain things (e.g.
your mistakes or other’s successes) and minimize
other things (e.g. your own desirable qualities or
other’s imperfections).
Shoulds – Musts - Oughts:
You believe you must live up to excessively high
standards, & may also have excessively high
expectations of others. You believe you should have
known/done better, even when that would have been
impossible.
Mind Reading:
You arbitrarily conclude that someone is reacting
negatively to you, & don’t check this out with them.
Fortune Telling:
You anticipate that things will turn out badly, and feel
convinced that your prediction is a fact.
Catastrophizing:
You believe the worst-case scenario will definitely
happen
Personalization:
You see yourself as responsible for events around you
that had little/no responsibility for.
The Danger of Automatic Thoughts

21. AND STILL MORE…THE FOCUS ON YOU.
 Identify healthy coping and craft ways continued
use of these tools
 Challenge oneself to embrace new ways of caring
for self. Remain interested in the process.
 Recognize and minimize negative self talk
 Thoughtfully support AYAs development of sincere
self affirmations
 Identify areas where you can feel control by
compartmentalizing issues and breaking down time
into manageable chunks.

22.  Affirmations are healing, positive messages you
give to yourself to counter your negative self-talk.
 Three Types of Affirmations:
 “I am…” (A statement about you)
 “I can…” (A statement of your potential)
 “I will…” (A statement of change in your life)
CONVERSATIONS WITH YOURSELF!
“The real tragedy of life is not that each of
us doesn’t have enough strengths,
its that we fail to use the ones we have” –
Gallop Organization

23.  Health Care Professionals
 Peers (other who “get it!”)
 Friends and Family: “F.D.R.”
WHO’S WITH ME HERE?
YOU
FEELING
Friends
DOING
Friends
RESPITE
Friends

24.  Remember your feelings about your cancer
experience will likely change day to day.
 Do the work and learn how to care for yourself.
 Try not to ignore your need to share your worries,
fears and questions.
 Often talking with others helps you work through
concerns or uncertainties in a natural way.
 Listen to yourself. Come to understand what you
are feeling, thinking and needing.
 Try not to put on a “happy face” if you are not
feeling that way. Your true feelings are more helpful
to everyone.
“BE GENTLE WITH YOURSELF”