“My problem is not my reconstructed breasts, but how my body changed afterwards. I have always struggled with the pounds and now, after so much effort, I find myself gaining weight again from the treatments. Every time I look in the mirror I see a me that I thought I left a long time ago, that I don’t like and that hurts me. Diets have no effect. I know it’s not up to me, and this makes me even more angry. destiny “(Elena).
Answers Florence Didier, psychologist and psychotherapist at the European Institute of Oncology in Milan.
Cara Elena,
unfortunately the body can change a lot due to oncological treatments, therapies that involve the administration of cortisone often associated with chemotherapy, hormonal treatments that induce a forced menopause that is different from natural menopause. Studies show that weight gain is common during the first year after breast cancer diagnosis, especially in women receiving ‘adjuvant therapy’ to avoid relapse. In a study by Goodwin et al. 84% of breast cancer patients gained weight to varying degrees between 2.5 and 6.2 kg.
Fault of the care, in part yes of course. But this change needs to be understood more broadly. We can get help from PNEI psychoneuroimmunoendocrinology. We know that when we are under stress – and a diagnosis of cancer, surgery, oncological therapies are important stresses – the adrenal glands produce a specific hormone, cortisol, essential for survival, because it provides energy in moments of need. But, since the energy released into the blood is not used for physical exertion, the body stores it in the form of fat. What are the warning signs? Tiredness and lack of energy (especially in the morning, when you get up), irritability, hunger pangs (especially the desire for sugar and sweets) are typical when the values of this hormone are not normal.
Above all, however, it is also necessary to understand the psychological reasons that can be hidden behind the “uncontrolled” increase in one’s weight. Food for many of us is used as an anti-stress, as a means that can help us “manage” emotions, such as calm down, calm anxiety, anger, soothe sadness, worse filling a sense of emptiness. Food can console. Those who tend to use food as a stress reliever often forget that in reality, body movement, action, and therefore physical activity is one of the best ways to release emotional tension, especially anger. You don’t need to become a high-level sportsman, spend hours running. Activities such as yoga, tai chi, dance can also help relieve psycho-physical tension. In addition, expressing, sharing with someone that we perceive positive, empathetic, openly welcoming emotions, feelings, thoughts, especially negative ones, helps to regulate one’s emotions, to lower inner tension.
How to get out of the sense of frustration, of helplessness that can be created when the body changes? First of all it is necessary to change attitude towards ourselves, to change perspective, to perceive the “problem” of weight. Struggling against yourself will only create even more tension and dissatisfaction.
Every disease, every physical problem, big or small, serious or less serious, carries a message within itself that we must learn to grasp, to welcome. Then only in this way will our attitude change and transform: we will no longer perceive the problem of the body as a problem to fight against but a healthier and more constructive attitude will be born, an attitude of self-help, of care. Each body change brings attention not only to the body but also to ourselves in our totality, mind / body / emotions / thoughts / sensations / behaviors. We can grasp these aspects, these messages of the body or we can ignore them. It is up to us to decide.
When the body gets sick, when it changes, a fundamental thing is at stake: self-esteem. This is why talking about self-esteem is a fundamental premise for weight loss. It is essential to be able to deeply understand the link between self-esteem and body weight. Losing weight does not have to become a real battle in which there is an open conflict between the person and his body. If the person bases the sense of personal value on the body, experienced in an aesthetic sense, if the evaluation of oneself is centered mainly on the shape of the body, on weight, the battle is already lost from the start.
Focusing on the aesthetic aspect and basing one’s self-esteem, the sense of one’s personal security, the sense of personal value on this is profoundly reductive. If you do not inhabit the inner space, if you do not recognize all its richness, its resources, the diet will fail from a psychological point of view. Everything becomes complicated if you pursue an external, ideal image. We compare ourselves to others, we try to prove that we are not outdone. We continue to measure our value on the basis of regulatory models, external to us. From my point of view, dear reader, it is therefore necessary to understand if you still have these issues open about its value, if you believe that by losing weight you will be able to increase your self-esteem because you are convinced that this lies in having a body with a certain shape and size .
The person struggling with his weight thinks he is taking care of his body while in reality he is moving further and further away from it. The relationship with food and the body will be a constant battleground. The body, far from being considered a part of itself that is showing needs, asking to be heard, becomes an object on which to intervene. You don’t listen to the body, you try to control it, moving further and further away from it.
Taking care of the body in some cases without integrating an adequate psychotherapeutic approach risks increasing the split with the body, which becomes reduced to an object to be manipulated. In this perspective, the body is experienced as hostile, wrong. Become persecutory. The body, in reality, is to be considered the seat of the inner voice that draws attention to inner needs. When the body gets sick, when it changes, it is offering the way to understand itself, to recognize itself.
Beginning to “look within” and discover the true needs in psychological terms is the way of an authentic transformation. If the person really begins to take care of himself, weight loss ceases to be a struggle to achieve an ideal image and becomes a self-care. Then the relationship with the body changes completely, which will no longer be an enemy but an ally in the path of weight loss.
Only by “feeding” the interior space can we truly change the relationship with the body, with food. In this perspective, the perception of oneself is transformed. It will be about taking care of oneself, a path of recovery of eros, of one’s own vitality.
A warm greeting
Florence Didier