Dr. Michelle Fingeret has spent the last 18 years providing body image counseling to adult cancer survivors. As a psychologist specializing in body image and cancer, she’s worked extensively in both outpatient and inpatient settings providing therapy to individuals, couples, and groups.

She recently sat down with Iris to answer five of the most pressing questions we’ve received from people who are dealing with body changes and those who support them.

Q: Chemo has affected my weight, and I’m uncomfortable when people comment on it. How do I deal with this?

A: Oftentimes when people comment on someone’s weight or appearance when they are going through cancer treatment, they intend for these comments to be “well-meaning.” It could be they think the weight loss or weight gain looks “good” on you or they might be expressing concerns to you about weight changes out of care and love for you. Depending on the relationship you have with the person there are a few ways you could choose to respond.

With a close friend/relative, you may choose to be open and vulnerable with them. Explain that right now comments about your weight and appearance are difficult to hear, that you are struggling with these issues. Ask them not to make comments related to how you look. You can even give them alternatives of things to say.

Instead of “You look so great,” “I’m happy to see you gained some weight back,” “You’ve lost a little weight and it looks good on you,” direct them to say things like, “I’m so happy to see you” or “I’m so glad we get to spend time together.”

For someone you aren’t close with, your best bet is to deflect the conversation to a different topic. Change the subject entirely (i.e., talk about current events, sports or entertainment news, or events related to family and kids). Or you can give a shortened explanation about how comments on your appearance are not helpful right now. Consider something like, “Thanks for your concerns but I really don’t want to talk about my weight today.”

Q: Do you have any tips for reconnecting with my body when I don’t feel like myself?

A: I refer to these as tips for promoting body esteem. Body esteem refers to the comfort and confidence you have with your body. Three types of body esteem activities I recommend are: 1) appearance-enhancing, 2) sensory pleasing, and 3) health and fitness-related activities.

Examples of appearance-enhancing activities include getting dressed up or wearing your favorite clothes, putting on make-up, wearing a cheerful color, painting your nails, looking for a nice hat to wear, or trying a new hairstyle (or wig).

Sensory activities include anything that activates one of your 5 senses: being outdoors, wearing something soft or silky, watching a sunset/sunrise, hugging, listening to music, playing a musical instrument, going for a scenic drive, getting a massage, painting, or star gazing.

Health and fitness-related activities do not have to be intense or prolonged. They can be as simple as stretching, playing with children or grandchildren, walking, dancing, meditation, swimming, or gardening.

The key when doing these activities is to do them intentionally and with purpose – taking time to focus on how they make your body feel.  Make your own list of body esteem activities to try and select 3-5 things you will do over the next week. Plan ahead — put them on your calendar! — and pay specific attention to how your body feels in these moments. You can even choose to journal about your experiences as you work to reconnect with your body.

Q: Sometimes I feel like the only thing people can see is how my body has changed. This makes me feel self-conscious and I’d rather avoid social situations altogether. Any tips for getting back out there?

A: People are more influenced by the way you behave rather than how you look. Even if they notice changes to your body, they will tend to pay even more attention to your personality, the content of your conversation, and your body language.  A few tips for getting back out there, especially if you are feeling highly self-conscious and avoiding social situations.

• • • At first, you may wish to select a quiet setting or go somewhere less crowded. Start with a small group of close friends or family, you feel comfortable around and then gradually add other social situations.
    • You can set limits on the amount of time you wish to spend at a gathering. For example, start with 30 minutes and work your way up.
    • You may find it helpful to develop a signal with your partner or close friend so that you can let them know if you start feeling uncomfortable and want to leave.
    • Be aware of mind reading — do not assume you know what other people are thinking, how they feel about you, or what they are noticing about you.
    • Pay attention to your body language: this includes holding your head up straight, smiling and using positive facial expressions, and positioning your body in a way that makes you feel more comfortable. These can help you feel more comfortable and confident.
    • Remember to acknowledge your progress and any efforts you are making in this area.

Q: I’m thinking about dating again. How can I let new partners know about the ways cancer has affected my body without sharing too much too soon?

A: This is an important step, and your openness and willingness to start dating again is something I hope you can give yourself a lot of credit for. There is no clear roadmap for when and how to share information with new partners about how cancer has affected your body. Be patient with yourself and tell a new partner only what you are comfortable with discussing at first. Allow this partner to ask questions, but you set the pace about what information you wish to share.

Over time you may be comfortable revealing additional information. Be sure to ask what your partner is feeling or thinking and be willing to share your thoughts and feelings through an open dialogue. If you feel uncomfortable during intimate moments, speak up. There may be times you need to regroup after interactions that were less than ideal in your mind. You can learn from these situations and adjust your approach.

Q: How can I support a loved one who’s struggling with body image and cancer?

A: The best thing you can do is to listen and provide unconditional care and support for their body image struggles. It is not up to you to solve these problems.

Sometimes when you try to provide a lot of advice or even well-meaning comments about how “great” your loved one looks or how “strong” they are it can make them less willing to share their struggles with you. Your loved one will benefit from having a safe space to discuss their thoughts and feelings about their changed body, especially those that are negative and distressing.

They may need to grieve the loss of a body part. Remind them that it is normal and expected to have body image concerns, and to feel somewhat self-conscious about their body image. Sometimes just being there to listen and comfort them, to tell them you love them and support them is more than enough, and just what they may need.

It’s important to remember that body image is completely subjective and that it involves the way someone feels about their entire body and its physical functioning. Body image changes resulting from cancer can affect physical appearance but also sensory and functional aspects of the body. These changes may be temporary or long-lasting, can come about gradually or suddenly, and may or may not be visible to others. There can be a disconnect between how your loved one sees their own body image and how you see them. You are better able to support your loved one if you try to understand their perspective, even when it differs from yours.

While it’s normal for your loved one to experience some difficulties adjusting to body image changes, many individuals benefit from therapy to help them with coping with their body image concerns. Body image therapy can help individuals learn new coping strategies for managing body image, set realistic expectations for body image outcomes, increase self-confidence in social situations, better prepare for upcoming body and appearance changes, and gain greater long-term body image acceptance.

Learn more about Dr. Fingeret at Fingeret Psychology Services.