Re-building self-esteem after breast cancer

Our self-esteem, basically how we feel about ourselves and our ability to get through life’s ups and downs, can take a real knock after going through breast cancer.

And no wonder. To me, it felt as if everything I knew about life had been turned on its head. When I was diagnosed, I was only 35 and felt pretty invincible. I had never experienced serious illness for myself or even my family. I went from a normal girl living life to a cancer patient in the space of a few hours, an identity that I had no idea how to fill. I felt a sudden loss of control over my body and my life decisions.

We all have a mental picture in our heads of who we are as a person. What our strengths and weaknesses are and how others perceive us. But cancer can leave you feeling very unsure about who you are, how you feel about life and your place in it. And inevitably, unsure about how others view us too. It was the subtle shift in how people looked at me, the well-meaning but sometimes hurtful comments, and the internal struggle of feeling like my identity had been reduced to "cancer patient." I did not want people to see me as weak or vulnerable or looking different and my self-esteem took a real knock because of it.

Why does cancer knock our self-esteem?

Cancer can force us to re-assess how we find self-worth. You may have been someone whose self-esteem came from performing well in your career, but after going through breast cancer you just don’t seem to have the same care for your work as you did before or you have been left with fatigue or brain fog and just can’t be as productive as you used to be. Or maybe your self-esteem came from your role as a good wife, mother, daughter or friend, but now fatigue, mental health struggles or continued side effects from treatment have left you unable to contribute in the same way. I have spoken to so many women who found the role change from family carer to someone who needed caring for themselves, to be a very challenging transition. Or maybe you got your confidence from being someone who focused on being a fit and healthy person, leaving you feeling confused or ashamed that cancer came for you anyway and now live with the uncertainty of feeling ‘what did I do wrong’?

Physical and emotional scars after breast cancer

Then come the physical changes. We live in a world that places immense value on physical appearance and breast cancer treatment can leave us with many changes to our body. Before my diagnosis, I had large breasts and I will admit they had been a point of pride for me. After my double mastectomy, I felt this part of my identity was gone, to be replaced with smaller breasts and no nipples; it was hard to recognise myself in the mirror and see such a big change. The impact on our self-esteem isn't vanity – it's a natural response to significant changes in how we look and feel. We  are living in a body we may no longer trust or recognise.

The scars are not just physical, they are also emotional. I thought of myself as very strong and resilient. But with breast cancer and the side effects of treatment and menopause, I developed severe anxiety and moments of depression. This left me feeling much less confident in how I was handling everything, as well as how I felt in social settings. We may not recognise ourselves anymore as the impact of the trauma of cancer (and yes, I do consider it trauma) manifests itself in our mental health.

Why haven’t I bounced back yet?

So, when it comes to moving forward after breast cancer, there’s little wonder we can be faced with the challenge of low self-esteem. Sometimes, the people closest to us don't understand why we can't just "bounce back" or "be grateful" for survival and these well-intentioned pressures can make it even harder to process what we’ve been through and guilty that we are not doing better. We are pressured to shift our identity back from ‘cancer patient’ to ‘healthy person’ with little time or grace.

We’re also faced with our impressions of how fellow breast cancer survivors are handling recovery. It can be tempting to compare ourselves negatively to someone we may see on social media who appears to have recovered ‘better’ than us. Someone who seems to be relishing life after cancer, doing sponsored mountain climbs or raising money for charity while we haven’t got off the sofa all day as we’re so tired. This can create shame, guilt or despair; why aren’t we feeling better yet, why is this easier for other people than for us?

All of this impacts how we feel about ourselves.

You’re not alone in this feeling

Something that is powerful to understand, is that you are not alone. I am yet to meet a woman who has come to me for coaching who has not experienced some kind of knock to their self-esteem after breast cancer. I certainly did. It does not mean you are weak or not resilient. It means you are normal. There is also nothing wrong with taking time to grieve your old life. In fact, it is healthy. But how can we start to move forward after breast cancer into a place of acceptance of your new life? In a way that builds our self-compassion and self-esteem?

Here's what I want you to know: rebuilding your self-esteem after cancer is possible, and you deserve to feel confident again. This isn't about "getting back to normal" – it's about embracing and loving who you are now. We are not the same person as we were before our cancer diagnosis. And although that can come with an understandable sense of loss, it can also be liberating!

Here is a chance to re-build life in a way that is more authentic to us. To re-consider what we now consider ‘success’ to be. For me, I used to hold most of my self-worth in my career. I was not able to go back to work full time after treatment and haven’t since. I just couldn’t handle the hours and the stress anymore. Where once I held shame about this and continued to push myself too hard to prove I was still the same as I once was, I have now come to a place of acceptance. I hold self-compassion for what my mind and body has been through and I know that pushing myself too hard inevitably leads to burnout. Believe me, that has not been an easy lesson to learn, but in taking the pressure off of my expectations of myself, and learning to accept what I now capable of, I have been able to build my self-esteem back up slowly and change careers to one that suited my abilities.

Being kinder in your expectations

How can you reconsider what you now think of as success? We can start by taking a look at our expectations. If what we are expecting of ourselves is not kind, helpful or realistic; our self esteem is going to keep taking knocks when we don’t live up to those expectations. Say you used to go out for long walks 3 times a week pre cancer and found it easy, but now you find yourself running out of puff half way through and needing to rest for the remainder of the day. If your expectation of yourself is that you should still be able to do this and you keep forcing yourself to try those long walks but getting the same result, how are you going to feel about yourself? Frustrated, annoyed, ashamed? But if instead you choose to honour how your body currently feels and decide to reduce this to a 20-minute walk close to home 2 times a week, and you manage to achieve this without feeling tired or having to rest, now how will you feel? It feels amazing to achieve a goal we set for ourselves, so let’s not make life too hard for ourselves. Set goals that are realistic, achievable and feel good. Most importantly, are these things you actually want to do? You may not feel the same way about the goals you used to have before cancer as you do now. There’s no rulebook saying you have to stick to what worked for you before. Cancer throws that rulebook out the window! What makes you feel good about yourself? Lean into it.

How we talk to ourselves

Let me ask, what is your internal dialogue like? How do you talk to yourself? When something goes wrong or you make a mistake, what does that inner voice say to you? Is it kind and compassionate or are you more likely to get annoyed with yourself and call yourself an idiot? If you saw a friend make that same mistake, what would you say to them? I’m guessing you wouldn’t call them an idiot! You may instead try to make them feel better about it; to realise it’s just a mistake and doesn’t mean anything about them as a person. But why do we find it so difficult to do this for ourselves?

There is nothing wrong with experiencing negative thoughts, we are only human and our brains naturally have a negativity bias. In fact, it can take some pressure off to realise how normal and natural this is. But... we can get into the habit of talking to ourselves negatively and we can take it too far. And it’s even easier to do when we’re tired, unwell or feeling anxious. If you notice that a simple mistake or not achieving a goal ends up with you berating yourself and feeling terrible, then it is worth becoming more aware of this internal voice.

Thoughts are not facts.

It is in our control to choose how we think about something. We don’t have to believe what our brains are telling us. But first we need to be aware of those thoughts and the impact they are having. Some tools that can help with this include meditation, journaling, breathwork, mindfulness, and working with a counsellor or coach. Once we are able to recognise our negative thoughts we can question them. Is this true? Is this kind? What are some alternative ways of thinking about this? We can then choose to change our first thought to one that is kinder and more helpful; what we would say to a friend in the same situation.

Learning to nurture yourself after breast cancer

Practise being your own biggest cheerleader. In Compassion Focussed Therapy, they use a tool called the Perfect Nurturer. In your mind imagine someone who would be the Perfect Nurturer for you (a life coach, an old school teacher you loved, a parent…) and be honest with them about how you are feeling at the moment, then take the time to think about how that perfect nurturer would respond; what would they say to you to help you face your feelings or actions in a way that was kind and compassionate and built you up? This isn’t easy work to do but you deserve it. When you realise what it is you do need to now to nurture yourself, how can you communicate these needs clearly to yourself and to the people in your life?

Attaching meaning to breast cancer

It can also help to attach meaning to what you been through. This may seem impossible right now but for me, as the years have gone by, I have begun to realise the positives that breast cancer brought into my life. I have more empathy now, I treat myself and others with more kindness, I am able to be more emotionally vulnerable with my loved ones and it has led me to my new career, as a breast cancer coach for women who are now beyond breast cancer and are looking to move forward in life. Realising these things made me feel good about myself.

Some questions to ask yourself:

• What did you learn about yourself during this experience?

• In what ways did you find strength during breast cancer treatment and afterwards?

• In what ways did breast cancer change your values and priorities in life?

• How can you live more in accordance with your values?

When we know what our core values in life are, and then begin to make decisions that honour those, our lives will begin to feel more authentic and therefore have more meaning, which can be so helpful in feeling good about ourselves. If you would like to do some work on values discovery, here is a useful quiz.

You don’t have to do this alone

Lastly, I want to come back to you not being alone with these feelings. Finding a community of people with similar experiences that can understand how you feel can be a real balm for the soul and a boost to how we feel about ourselves. Consider joining a local support group or a supportive online forum, such as Breast Friends and allowing yourself to share what is going on for you. We are just as deserving of support after treatment as we are  during it.

To finish, I would like to share with you the idea of Kintsugi. In Japan, when a piece of pottery is broken, they do not throw it away. Instead, they use gold lacquer to mend the pieces, resulting in a new piece of pottery that embraces the imperfections, making it unique and special.

Just like you.

An example of Kintsugi

I have created a free downloadable workbook on how to Re-build Self-Esteem after Breast Cancer, packed with practical coaching activities to get you started on the path to re-discovering your self worth and embracing life's next steps.

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How to work with me

Hi I’m Kirstie and I was diagnosed with triple negative breast cancer in 2015 aged 35. After recognising the lack of support for women post treatment,  I trained as a life and wellness coach to support women who have are now beyond breast cancer to navigate life’s next chapter.

Why not invest in yourself with my Moving Beyond coaching package. We will have 6 x 121 online coaching sessions together where I provide a safe space to explore how you are feeling about life after breast cancer and how to move forward in life with hope and positivity. We can work together on whatever is coming up for you, whether that is re-building self-esteem, changes to relationships, lifestyle and health or dealing with cancer induced menopause, from someone that has walked the path themselves.

I’d love to organise a free chat to answer any questions or just to hear your story.

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