When Amanda Enayati, age 52, was undergoing breast cancer treatment, she had a lot of people praying for her. Her one request? “I asked them to please focus their prayers on my right boob.”
Enayati’s often irreverent sense of humor has served her well as she has navigated through a significant amount of trauma in her life. “The book of my life is a virtual encyclopedia of disaster,” she jokes.
While life has dealt her a lot of blows, her experiences have also sparked a deep interest in the science behind stress and resilience. She turned the techniques she learned while managing treatment and recovery from breast cancer into her 2015 book, Seeking Serenity: The 10 New Rules for Health and Happiness in the Age of Anxiety. It has lessons for everyone, but particularly for anyone who is facing cancer.
A Rocky Start
When she was 11, Enayati and her family fled from Iran. It was 1978, and it was a traumatic experience for a kid. They lived with relatives in Europe for five years before settling in Los Angeles in the ’80s. In 2000, she moved to New York City.
In 2007, when she was 39, came the diagnosis of advanced breast cancer. Enayati was raising a 1-year-old boy and a 2-year-old girl. She felt a lump, which she assumed was a clogged milk duct from breast feeding. A biopsy following a mammogram and an ultrasound revealed that she had Stage III lobular breast cancer, which develops in the milk ducts. The tumor was large (9 centimeters, or about 3 1/2 inches), which is associated with a lower likelihood of survival; the cancer had spread to her lymph nodes and chest muscle.
“I felt like the ceiling was closing in on me when I heard that news,” she recalls. She had a right-side mastectomy as well as a significant amount of chest muscle removed. “I felt like I couldn’t breathe after the surgery, ” she says. “You don’t realize how much we use our chest muscles, even for breathing.”
An intense year of chemotherapy and radiation followed. “I felt like I had no power at all,” says Enayati. “I had no hair. I was so skinny, so weak, and I just looked like a shriveled raisin.”
Her already low morale sank even further when an oncologist told her that only a small percentage of women with her diagnosis are still alive, let alone thriving, after five years. “I was furious, and I told him never to say those numbers again,” Enayati remembers.
That’s when she started to turn her life around.
Feeling a desperate need for community and connection, Enayati sought out support groups but found that most of them focused on fear and grief. “That is valid, of course, but so many people’s identities became wholly about illness and not about healing. I was devastated, but I couldn’t stay in the pain. I had to define myself as a person beyond the cancer in order to survive.”
This switch in perspective, “reframing the narrative,” became one of her main strategies. She sought out accounts of women with dire prognoses who’d survived. “Every time I learned about someone who survived, I would hold that close and think, This could be me. I could survive.”
Reframing the narrative is a technique that she would learn later is central to cognitive behavioral therapy (CBT), which has been shown to reduce depression and anxiety and improve quality of life in people with cancer (see “Changing My Mind”). It is available at many cancer centers.
And she discovered the healing power of creativity—“Be creative” became rule #3. Enayati had always wanted to be a writer, but she was working as a lawyer and management consultant and had “big visions of what being a writer was ‘supposed’ to look like.”
After her diagnosis, all that fell away. She simply wrote, dubbing her blog Practical Magic. “Writing just 10 minutes each day gave me a little sense of power. It was a way of surviving and staying in the world of the living and of keeping my mind off dire possibilities.”
This, too, is backed by research. Expressive writing about feelings, often guided by a therapist, has been shown to improve emotional health and enhance immune function in women with breast cancer.
A few months later, Enayati’s blog attracted the attention of editors and agents. CNN asked her to write a column on stress, which evolved into her book.
Imparting Her Wisdom
Enayati now travels around the country to speak about the importance of reducing stress in our lives and to offer tips—her “practical magic,” as it were. She also devotes a significant amount of time to talking one-on-one with women currently grappling with breast cancer (see “Reaching Out” below). “I will talk to anyone who tracks me down and calls me—any and all,” she says. “I was one of the few people I knew who was in real big trouble but survived.”
Enayati doesn’t shy away from the fact that some people with cancer will fare very poorly and die. But some will also beat everyone’s expectations and go on to survive and thrive for a long time. Again, she talks about flipping the narrative.
“There is no reason not to hope and expect to be part of the latter group,” she says. “I don’t believe in false hope, but I also don’t believe in false hopelessness.”
Mindfulness for People with Cancer
“Be present” is rule #10 in Amanda Enayati’s book, Seeking Serenity: The 10 New Rules for Health and Happiness in the Age of Anxiety. It’s the essence of mindfulness, the practice of consciously returning your attention to the present moment without judging whether you are doing it “properly” and without trying to shut out other thoughts. One evidence-based form of mindfulness training, mindfulness-based stress reduction (MBSR), has been shown to significantly reduce anxiety, depression and pain.
In recent years, an offshoot of MBSR specifically geared to cancer patients has evolved. Called mindfulness-based cancer recovery (MBCR), it’s offered at many cancer centers around the country. MBCR programs typically offer weekly meetings and daily home practice of a variety of mindfulness and yoga exercises over the course of eight weeks. The focus is on concerns common to people with cancer: loss of control, uncertainty about the future, distress, depression, anxiety and fear of recurrence, as well as symptoms such as fatigue, pain, cognitive impairment and insomnia. Both the American Society of Clinical Oncology and the Society of Integrative Oncology support mindfulness-based stress reduction in their latest guidelines for integrative therapies during and after breast cancer treatment.
“Narratives of survival and narratives of healing were a real lifeline for me, and so I try to be that lifeline for others,” says Enayati. She can be reached through her website, AmandaEnayati.com, and via Twitter (@AmandaEnayati) and Facebook (facebook.com/AmandaEnayatiAuthor).