Cognitive Behavioral Therapy (CBT) is an evidence-based approach to mental health that helps individuals understand how their thoughts, feelings, and behaviors are interconnected. A simple way to summarize it is:

What you think and do affects how you feel.

In CBT, we learn that distress isn’t just caused by events themselves, but by how we interpret those events and how we respond to them. These interpretations (thoughts) and reactions (behaviors) can become patterns—some helpful, others unhelpful.

When we face something as difficult as cancer, it's completely normal to experience fear, sadness, anger, or uncertainty. CBT offers tools to better understand and manage these emotional responses, without denying the reality of what you're going through.

How CBT Works: The Thought-Feeling-Behavior Cycle

CBT teaches that:

Thoughts influence how we feel emotionally and physically.

Those feelings influence what we do.

Our behaviors then reinforce our thoughts, continuing the cycle.

This process often happens automatically and outside of our awareness. CBT helps bring these patterns into conscious focus so that we can make changes when they are not serving us well.

For example:

A thought like "My cancer will definitely come back" may lead to intense anxiety and avoidance of medical appointments.

A more balanced thought, such as "My team is watching me closely, and many people live long, full lives after early-stage cancer," can reduce distress and encourage proactive health behaviors.

Key Insight: CBT does not ask you to deny reality—it helps you relate to reality in a more helpful, manageable way.

Getting "Stuck" in Patterns

It's common to get stuck in unhelpful thought patterns during a cancer journey, such as:

Catastrophic thinking (“This is the beginning of the end.”)

Black-and-white thinking (“If the scan isn’t perfect, everything is bad.”)

Personalizing outcomes (“If I had caught this sooner, I wouldn’t be in this position.”)

CBT helps you notice these patterns and gently challenge them. Sometimes the most powerful step is simply observing a thought without immediately accepting it as truth.

Practice Tip: Try Noticing Your Thoughts

Over the next two weeks, try this simple CBT-based practice:

Gently notice your thoughts, especially when you're feeling overwhelmed, anxious, or discouraged.

Ask yourself:

What am I thinking right now?

Is this thought 100% true?

Is there a more balanced or compassionate way to look at this?

Offer yourself a calming reminder, like:

“I have a strong medical team monitoring my health.”

You’re not trying to “positive think” your way out of reality. You’re learning to widen the lens so you can also see what’s stable, supportive, or reassuring.

Glimmers: Moments of Calm and Connection

When distress feels high, try to connect with your “glimmers”—small, meaningful moments that bring peace or connection. These could include:

A warm cup of tea

A conversation with someone who listens

Time in nature

Music that soothes you

These moments activate your body’s calming system, which makes it easier to process your thoughts and emotions from a grounded place.

Final Thought

CBT isn’t a quick fix. It’s a set of tools you practice over time to build more flexible thinking and more compassionate responses to life’s challenges. In the context of cancer care, it can help reduce emotional suffering—even when the physical reality cannot be changed.

If you're open to it, working with an Iris mental health professional trained in CBT can help you tailor these strategies more specifically to your unique experiences.