Joy is a deep unshakeable positive emotion of elation that is unconditional and knows no limits. Joy encompasses laughter, hope, wonder, compassion, generosity, forgiveness, purpose, and kindness. Wait a minute....Joy, gratitude, wonder, awe? An article on gratitude on a cancer survival website!? Do not be afraid, this is not a space for toxic positivity, “everything happens for a reason” (fantastic, tell me the reason!). Let’s not feed into the toxic positivity machine. Cancer is an awful life-altering, life-threatening event, but what we do with the emotions that follow the diagnosis matter a great deal.

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Joy is so much deeper and more vast than simply happiness and gratification. Happiness is great, but when we just feel happiness after a good outcomes, it limits us to just those fleeting moments where we are always on the hedonistic treadmill searching for the next dopamine hit of pleasure. For example, “I can only be happy when my scan is clear and I’m done with chemotherapy.” Of course I want a clear scan! Of course I want to eat chocolate chip cookies all day long! They taste good! However, even if it isn’t clear or if my counts don’t come back up or I choose to eat kale and broccoli sprouts, I can still have joy. My joy is not contingent upon an outcome or situation. I will laugh and see the beauty in this world despite the awful circumstances of cancer, and nothing can shake that. Joy is finding that inner strength to feel peace even though life is unimaginably hard, scary, or sad, but sometimes cultivating joy takes some work. 

 

We are very complex human beings that can feel a spectrum of emotions from minute to minute. It is hard not to fall into a downward emotional spiral when you receive a cancer diagnosis, but to quote poet and cancer survivor Mark Nepo, “To be broken is no reason to see all things as broken.” You get to choose how you see the world and how you react emotionally to situations. The duality of life is when we hold both the good and the bad; we can hold heavy emotions like anger at cancer but gratitude that its treatable. Embracing positive emotions while feeling and releasing negative emotions of guilt, anger, shape can be cathartic and healing. The catchy saying “feel it to heal it” does ring true. Expressing forgiveness and releasing the past can allow us to focus on the positives in life, get unstuck from negativity and stay in the moment.

 

Stress is the state of tension or worry in the face of a challenge. Responding to an acute stress is an invaluable skill (that lion is going to eat you, RUN!). However, living with and experiencing chronic stress and persistent negative emotions is bad for our bodies. Chronic stress and being constantly in fight or flight mode causes the brain to trigger the sympathetic nervous system to release norepinephrine and stimulates the hypothalamic-pituitary-adrenal axis (HPA) to release epinephrine and glucocorticoids like cortisol. These stress neurotransmitters and hormones cause increased inflammation, expression of oncogenes, cause the tumor cells to grow, spread and evade immune cells and decrease the function of the immune system. 

 

Conversely, when we are able to feel relaxed, our body shifts into the parasympathetic state of resting, digesting, and repair. In this state, the body releases feel good hormones and neurotransmitters dopamine, serotonin, oxytocin, and endorphins which translate into lower blood pressure, heart rate, stress hormone cortisol and increased white blood cell activity (including natural killer cells) and removal of cancer cells and infections. So how can we achieve this happier state? 

 

Stress management can increase the body’s parasympathetic nervous system response, stop the release of cortisol and boost the body’s immune system. A 10-week Cognitive Behavioral Stress Management intervention in women with breast cancer increased lymphocyte proliferation, a type of white blood cell used as a marker of immunity, compared to breast cancer survivor control not receiving stress management therapy. Additionally, natural killer cells were increased in melanoma patients practicing stress management and relaxation techniques compared to melanoma patient controls not receiving the techniques. Furthermore, the melanoma patients receiving stress management techniques showed better 5-year survival and lower recurrence rates.

 

Another tool to promote positive emotions, connection, and mindfulness is that of Self-Compassion, pioneered by Dr. Kristin Neff. The practice of Self-Compassion uses self-kindness in the face of challenges, reflects on our common humanity of shared suffering and then mindfully notices the emotions that arise. For example: My Dear Self, cancer is incredibly scary and not what you expected in your life. We all experience scary, unpredictable and difficult times, and I see you feeling fear and anxiety. Practicing Self-Compassion is a way to be gentle toward yourself instead of getting angry when life doesn’t turn out the way you want it to, realizing that we all encounter challenges, and then mindfully, non-judgmentally observing the thoughts and emotions that arise during these challenges. It is a beautiful practice blending kindness, humanity, and mindfulness. 

 

Laughter and smiling have very positive effects on our bodies. Laughter increases natural killer cell activity (infection and cancer fighting cells), makes us feel less stressed and more relaxed, and enables us to be in the resting and digesting parasympathetic response instead of the fight-or-flight fear sympathetic response. Positive emotions decrease our blood pressure, heart rate and stress hormone cortisol. Physiologically, when we laugh, our vagus nerve (the super long nerve that extends from our brain to our diaphragm) is stimulated by the diaphragm bouncing up and down. The vagus nerve then signals to the brain to activate the parasympathetic nervous system to relax. One study found that just listening to audio of laughter for 5 minutes increased heart rate variability (a marker of well-being and being in a relaxed, parasympathetic state).

 

Gratitude is a very powerful way to embrace good emotions. When we notice and focus on the good in our life, it makes us feel better. Writing in a daily gratitude journal improves sleep and lowers blood pressure. Interestingly, expressing gratitude to others has been shown to have more benefits for the one giving the gratitude that the one receiving. Writing notes or messages of gratitude each day creates positive emotions and staves off depression. 

 

In the words of His Holiness Dalai Lama and Archbishop Desmond Tutu in The Book of Joy,  “Lasting happiness cannot be found in pursuit of any goal of achievement. It does not reside in fortune or fame. It resides only in the human mind and heart, and it is here that we hope you will find it.”