At the end of 2024, I was diagnosed with prostate cancer.
Unsurprisingly, in the few days immediately after receiving the news, I was caught up in a huge storm of emotions.
Some emotions hit me hard, some crept up on me, some came and went, some lingered.
There was shock, sadness, anger and also there were some strange feelings of guilt and loss.
But, there is no doubt that the strongest emotion was fear - fear of what was ahead of me, fear for my family, and fear that I may not be able to handle all of the fear that was engulfing me.
And the truth is that fears of one sort or another are emotions that we all face frequently.
Sometimes, our fears are smaller - nagging, draining doubts that envelope us constantly like mist that never clears.
Sometimes, they are confrontational, explosive, life changing tempests.
So how do we fight our fears?
I’m certainly no invincible fear-conqueror, but I think it’s a good idea to start by looking closely at what your fears really are.
Examine the fear
If you’re told you have cancer, the reasons for your fear are largely self-evident.
You’re going to go through a period of huge upheaval. You’re probably going to have some brutal treatment. You might die.
But, sometimes when we are fearful, especially when we are dealing with the misty, clingy, nagging fears, we may not necessarily be sure what exactly we are afraid of.
It therefore helps if we try to examine our fears to try to determine what their source or sources really are.
However, this needs to be a process of self-reflection to gain insight, rather than an exercise in rumination. You need to ask yourself about the objective facts and what you can do about them - what is it that am I really afraid of? What can I do to manage this?
You need to avoid rumination because that involves repetitively focusing on your distress without moving toward solutions. It is typically a passive process characterised by negative thinking: Why me? What have I done to deserve this? What is wrong with me that I am so afraid?
Focusing on the facts is important, because it is positive, forward-looking and solution-focused. Rumination is unhelpful because it is a negatively self-focused doom loop. There is more on this here.
Now, of course I am writing this 7 months after I was facing this storm. So it is easy to make this sound simple. It is isn’t.
When you are plunged into a crisis, you will inevitably be anxious and stressed and those are precisely the conditions that can create the cycle of negative over-thinking. So, my point is that you need to be intentional in dragging yourself out of that, so that you can take the more positive approach. You might need a counsellor, therapist, or coach to help you.
But, if you can get clearer on the source of your fears, you can work on how to deal with them.
Face the facts
You can work on your fears by changing the way you think about them. You defuse their power by coming to the realisation that you’re overplaying the consequences in your mind (de-catastrophising).
Asking questions like ‘what’s the worst that can happen?‘ or ‘how likely is it really that this will go badly?’ can help here.
In my case, I needed to focus on the evidence - what are the test results saying? Are there other tests I need before we get the full picture? What are the typical prognoses for somebody with my pathology?
The key is is to think about your thoughts (this is metacognition) and recognise when they are unhelpful, unbalanced or not based on facts and evidence.
This was really helpful for me at the time and it is generally a helpful way to deal with a lot of the day to day fears we face in life.
Again, I know I am making this sound simple. You won’t do this perfectly all time. You might not even do it most of the time at the beginning. But if you can at least do it some of the time, you can begin to bring your fears under control.
Own your response and your motivations
But there are circumstances (and until I had a full picture of the evidence, mine was one of them), where there are unquestionably big, scary, consequences if things don’t work out.
In that kind of situation, pretty much all that you can do in the moment is embrace the fear, accept that this discomfort is completely normal in this situation and take all the practical steps you can to put yourself in the best position to meet what is in front of you.
So for me, that meant researching the disease, getting the best possible advice, and taking steps to get the treatment I needed as soon as I could.
But, it is also important to tap into your potential sources of motivation. Ask yourself: Why is it important for me to get through this? What will be positive about the future when I do? Who do I need to do this for apart from myself?
This was especially powerful for me. At my first post-diagnosis consultation my consultant discussed my prognosis and the treatment options. What struck me most powerfully in that conversation was news of the invasiveness and long term, possibly life-long consequences of the different treatment options.
It was all quite shocking. But on the journey home, as my wife and I were talking through the options, I said to her “all that really matters is that I stay alive until the kids have grown up. I just need to do whatever gives me the best chance of doing that.”
So, that was my motivation and guiding light - I would do whatever was most likely to help me stay alive for the next 10 years or so while my then 11 and 16 year old daughters grew to adulthood.
Fear of Consequences
But what about big fears about something more abstract than a life threatening illness - fears about difficult or highly consequential decisions for example?
I think that most of the same principles apply: gather the facts, manage your thinking, take a solution focused, forward looking approach, tap into your motivations.
Then, once you have done all the research and preparation you can, you just need to trust that whatever you do, you will be doing it for the right reasons and with right intentions.
The value of fear
Another way of looking at fear, is to realise that the fear is just an indication of how important something is for you.
It’s usually a sign that you are confronting something that can move you forward or set you back a long way.
In her book, Comfortable with Uncertainty, Pema Chodron says that “fear is a natural reaction of moving closer to the truth.” She says that if we confront our fears rather than run away from them, “then our experience becomes very vivid. Things become very clear when there is nowhere to escape.”
Of course, having the courage to confront our fears is really what our struggle is all about.
And since, in many cases, fear springs from a lack of confidence and self-doubt, we need to work hard on overcoming the inner voices of the self-criticism that undermine us.
As Pema Chodron (again) says, we can find the path to courage by cultivating a genuine appreciation of ourselves, by developing self-compassion and by recognising our potential for love, generosity, kindness and goodness.
Based on my experiences, I would add, that we can also gain courage and comfort by reflecting on the love, compassion and care shown to us by those who love us, and those who are helping us.
Big fears, like those that I had to confront, come and go.
But I think the reality is that overcoming fears of one kind or another is a life-long struggle.
Maybe recognising that is another important step in the right direction.
Related Posts
My posts on decision making are here.
My posts on confidence are here.
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