Writing therapy helps breast cancer survivors overcome anxiety and depression linked with body image concerns.

Macquarie University has reported that writing therapy can help reduce breast cancer survivors’ body image related distress by 30 per cent in just three months. In a study conducted this year by Professor Kerry Sherman from Macquarie’s Centre for Emotional Health and Department of Psychology, it was found that women who have a greater sense of self-compassion after a breast cancer diagnosis are less likely to experience anxiety and depression linked with body image concerns.

Sherman says, “Body image 'disturbance' affects one in three breast cancer survivors, and about 25 per cent of women develop long-lasting anxiety and depression.”

According to Australian Breast Cancer Research, breast cancer is the second most commonly diagnosed cancer in Australian women, with one in eight women being diagnosed with breast cancer by the age of 85. The estimation of the number of women being affected with body image concerns, anxiety and depression is huge, which is why Macquarie University is being proactive in their research to find ways to help those who have been affected by such a destructive illness.

In the ‘Self‐compassion and hope in the context of body image disturbance and distress in breast cancer survivors’ study published this year in the journal Psycho-Oncology, Sherman’s team surveyed 215 women from Breast Cancer Network Australia , the peak national body for people affected by breast cancer. The participants were questioned on self-compassion, hope, body image and psychological distress.

It was found that self-compassion has a strong relationship with body image distress, while hope has a strong relationship with anxiety and depression.

Professor Sherman's research team has developed an online writing therapy called My Changed Body, designed to alleviate the negative feelings many breast cancer survivors have about how their body looks and feels, which can impair recovery.

In the My Changed Body intervention, women write about how they feel about their own body after cancer surgery and treatment, and a negative experience they’ve had regarding the changes to their body. Then they write about how they would advise a close friend in a similar situation.

“In most circumstances, women show understanding and kindness and concern when they write to a close friend,” says Sherman. “Doing this helps them put a little distance from their own troubles, shifting their focus instead to how they might be able to help another person.” At the end of the exercise, they’re asked to write a compassionate letter to themselves but with the audience of all breast cancer survivors in mind.

To assess the intervention’s effectiveness, Sherman's team conducted a randomised control trial with 304 participants across Australia. The results were published in the Journal of Clinical Oncology. Some women who took part also had lymphoedema - swelling in the arm caused by the removal of the lymph nodes and cancer treatment.

The trial was successful, Sherman says, with most women reporting improved perception of their body image. On average, body image-related distress was reduced by 30 per cent, anxiety was reduced by 30 per cent, and depression by 24 per cent - even up to three months after they’d done the writing exercise.

“This research aimed to encourage women to think much more positively about themselves and appraise what happened to their body in a positive way,” she says. “We hope by being more self-compassionate they will look at themselves differently.”

Macquarie University plans to conduct more research to determine how this self-compassionate writing therapy combined with hope can further help breast cancer survivors in their recovery long term.

Professor Kerry Sherman is Deputy Head of the Department of Psychology and a member of the Centre for Emotional Health.