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Finding Strength by Embracing my Vulnerability
Dealing with trauma, anxiety and depression as a two-time leukemia survivor, Marell Tomeh shares her story
When I was 19, I was starting to make decisions about where my life would take me. I was planning a trip with friends, working hard at university and thinking long-term about my aspirations. This came to a sudden halt the moment I was diagnosed with acute lymphoblastic leukemia.
I cancelled my trip, but didn’t want to burden my friends with my bad news. I had always been the one to support other people, rarely asking for help myself. To protect my vulnerability and preserve some sense of normalcy, I kept my diagnosis private, and in retrospect, this is probably the worst thing I could have done.
I spent much of the next two years of my treatment worrying about who knew what, and about people seeing me without hair and potentially judging my significant weight gain, not knowing the steroids I was taking contributed to this. The medication caused my mood to fluctuate, making my mental health harder to manage. I had trouble managing my expectations of myself, comparing myself to my peers and feeling a sense of urgency to “catch up.”
I fell into a deep depression and it took some time to acknowledge it and admit that I was struggling. I became more and more anxious in public and social settings. I developed a stutter and felt as though I had lost my sense of humour and ability to engage in conversation. Socializing became awkward and uncomfortable, and schoolwork became frustrating.
A few years after my treatment ended, I relapsed. This time, I needed a bone marrow donor and had no choice but to open up about my cancer. This made a huge difference in my mental health and my healing. I stopped seeing vulnerability as a weakness and, as a result, quit being so afraid.
A cancer diagnosis interrupts life. As a young adult with cancer I feel like my life milestones have been pushed back and I am falling further behind all of my peers. Before my diagnosis, I took pride in knowing I worked well under pressure and could multitask with ease. I thought getting back to school would help me get back to ”normal,” but I am still struggling with “chemo brain’” and dealing with the repercussions—mental and physical—that come with cancer, and find it all too stressful and overwhelming.
Surviving Childhood Cancer: From Confidence Buster to Confidence Builder
After going through something as traumatic as cancer, my stress response has become more sensitive. So, I have decided to take some time away from school and work to care for myself. I am re-examining my priorities and figuring out how to build a meaningful life that can also support my real-world concerns, like finding health coverage for my ongoing medical expenses.
My goal is to use my cancer experience to help other people. I want to create a safe space for other patients and survivors to express themselves and support their healing. Nothing good comes from leaving your wounds unattended but we can find strength in acknowledging and embracing them.
Marell Tomeh is a two-time leukemia survivor and bone marrow transplant recipient. As a young adult cancer survivor, Marell shares her story and hopes to shed light on the obstacles associated with trauma, anxiety and depression.
Marell shared her story first-hand on May 14 at 2021 POGO AfterCare Education Day, where she spoke about The Lived Experience: Navigating School and Work after Cancer.
Virtual Counselling to Help Childhood Cancer Survivors
A conversation about the mental health of childhood cancer survivors with registered psychotherapist Carly Fleming.
Q: How are the mental health needs of childhood cancer survivors unique?
A: Individuals who experience cancer as a child often carry the pieces of this experience with them into adulthood. This could be in the form of lasting physical pain/impairments or emotional trauma resulting from their treatment. They may also experience worry and anxiety about their future health, grief from losing friends to childhood cancer and guilt that they survived, or changes in family dynamics that came about as a result of their cancer. This is all a heavy load to carry. Often in childhood or the teen years, they aren’t emotionally ready to process the enormity of these things. But once adulthood arrives, the true weight and gravity of childhood experiences can come to light, resulting in mental health challenges. Survivors often feel that there is something wrong with them if they are still struggling years after being “cured.” Each person will experience things differently, but it makes sense that childhood cancer survivors may need to work through the emotional issues they are facing in order to live life to the fullest.
Q: What do you think healthcare teams can do to help their patients’ mental health?
A: The answer to this is simple. Ask good questions. Of course, asking good questions isn’t as easy as it may seem. When we ask good questions, we are open to any answers, not just the ones we predict or want to hear. When we ask good questions, we try to stay away from yes/no responses and leave room for complex, nuanced answers. When we ask good questions, we recognize that there may be uncomfortable silences, or the answers may make us feel uncomfortable, and that’s ok. When we ask good questions, we lead with curiosity.
Q: What has changed about counselling during COVID-19?
A: Before COVID-19, we had the technology to offer virtual counselling but rarely used it. In the past year, the vast majority of mental health services have gone virtual, forcing clinicians and clients to adjust quickly. I think the most significant change has been in our attitudes towards virtual counselling. We used to look at it as a second option, a sub-optimal choice when in-person meetings weren’t possible. This means some clinicians and clients weren’t fully bought into the idea of counselling this way. Now that we have been forced to adapt quickly to this modality, we have seen the good things about in-person counselling happen virtually. Plus, we are able to connect with people who live far away or have difficulty travelling to in-person settings. From the standpoint of counselling, the pandemic has created incredible opportunities to connect in ways that make it far less burdensome for our clients.
Q: Do you prefer virtual counselling? What are the challenges when treating a childhood cancer survivor virtually instead of in person?
A: It can take a little longer to establish a new relationship between counsellor and client online. Without the in-person connection, we sometimes have to work harder and be more patient before the wonderful feeling of connection arrives. This can be problematic when the client feels apprehensive about meeting with a counsellor. Arranging a few shorter meetings to get through the initial “meet and greet” or intake questions can help. Making sure we take time to make a connection in non-clinical terms is also really important. Just some simple chatting about their life and sharing of some common ground can make a huge difference. Another challenge is ensuring the client’s full attention to the online meeting. When we used to meet in person, clients would come into our office and have very few other demands/distractions. Now that clients connect with us from their homes/offices/cars, there are many other demands on their attention. Vulnerability is compromised when they aren’t in a private, quiet space.
Q: What do you mean by vulnerability?
A: To truly explore what is meaningful to an individual, we need to get them to take down their defences. Many survivors put on a brave face, but that is not where the healing and transformation occur. Vulnerability is essential to good mental health care.
Q: At POGO AfterCare Education Day, what do you hope to convey in your session?
A: I hope to convey optimism about how the move to virtual counselling during the pandemic is an opportunity to create more accessible mental health care for childhood cancer survivors. I want to share some of the experiences and insights that I have gathered after the past year of providing virtual psychotherapy. Lastly, I plan to highlight some specific safety measures to ensure we are ready to help our clients should we identify in a virtual appointment that their safety may be at risk.
I am looking forward to learning from the other presenters about their experience in providing care to childhood cancer survivors over this challenging year.
Carly Fleming is a Registered Psychotherapist and founder of everwell Integrated Health Professionals, a virtual counselling group in Hamilton, Ontario, offering a range of services to guide meaning and healing. She has worked as a counsellor in private practice and various healthcare settings for over 15 years, specializing in grief and loss, parenting, coping with illness, and life transitions.
You can hear from Carly first-hand at the 2021 POGO AfterCare Education Day, where she will be presenting with Pediatric Psychologist, Sara Ahola-Kohut about Optimizing Online Mental Health Counselling for Childhood Cancer Survivors.
Mental Health Support for Childhood Cancer Survivors
$1M Donation to Help POGO Transitions Program Expand Services
POGO is a proud recipient of a $1M donation from the Slaight Family Foundation as part of their $30M Mental Health Initiative supporting 19 Canadian organizations.
The funding, divided equally over four years, enables expansion of the POGO School and Work Transitions Program. This program supports childhood cancer survivors facing significant learning challenges—resulting from their cancer and/or treatment—which can interfere with their ability to achieve their educational and career goals. Furthermore, the impact of COVID-19 on the mental and emotional well-being of childhood cancer survivors has been substantial. Many are experiencing heightened anxiety regarding school or job security. Due to underlying conditions they may have as a result of their disease or its treatment, they fear they are at higher risk for developing complications if they catch COVID-19.
POGO Counsellors work one-on-one with survivors to help them develop plans and implement strategies to improve their academic or employment success, which in turn supports their mental health and emotional well-being. POGO will expand school- and work-related counselling to childhood cancer survivors, including services for francophone survivors and youth still on treatment, and grow the skill- and community-building Survivor-to-Survivor Network. We will also enhance program evaluation by incorporating outcomes related to survivor mental health and emotional well-being.
This generous investment, the largest donation from a family foundation in POGO’s history, helps POGO achieve an objective of the Childhood Cancer Care Plan to improve access to psychosocial and mental health services for survivors. It also demonstrates confidence and trust by a prominent donor in POGO to positively impact the childhood cancer care system, in particular care for childhood cancer survivors.
The 2021 Survivor to Survivor Network Workshop Series is Coming Soon!
The S2S facilitators are being matched with topic experts from the community and are starting to build their workshops. Here’s what you have to look forward to.
Anuraj’s workshop will be about coping with cognitive effects of childhood cancer treatment. He’ll talk about day-to-day challenges; school, work, and life impacts, strategies to manage cognitive impacts, and how to find support if you need it.
Harman is going to teach other survivors about how meditation and mindfulness can be used to influence behaviour. Some of his topics will be: the mind/body connection, being mindful of how we talk to ourselves, how to start meditating and cognitive behavioural therapy.
Sara’s workshop is called, “Will They Understand? The Personal Disclosure Dilemma at School and Work.” She’ll discuss when, how much and what personal health information to disclose; why it’s important; the pros and cons of disclosure; who to talk to for support and information; and your legal rights.
If you’re considering college as your academic path, Emelia will teach you how to get on it and what to expect, including: classroom accommodations/accessibility services, programs for people with disabilities or high school certificates, ways to pay for college, different pathways to college, and living at home or in residence.
All workshops will be hosted virtually. Information about the workshop dates and how to register will be coming soon.
Creative Corner with Josh – eNews
Josh is an incredibly talented guitar player, who also happens to be a survivor. Check out his video!
(If you are using Internet Explorer, video may not load as intended).
If you have an interest in learning how to play guitar (or just want to hear great music), he is your man! To see and hear more of Josh:
YouTube: @Josh Taylor–Brown
Facebook: @Josh Taylor-Brown Music
Instagram: @J.tbrown
If you’re interested in taking guitar lessons, Josh would love to hear from you at jtaylorbrownz28@gmail.com