Writing and Healing After a Cancer Diagnosis
April 24, 2014

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The second April 2014 Breastcancer.org podcast features Pamela Post-Ferrante, a four-time breast cancer survivor, writer, teacher, and workshop leader. She wrote her book, Writing and Healing: A Mindful Guide for Cancer Survivors, to help others use writing and mindfulness to heal themselves. Listen to the podcast to hear Pamela discuss:

  • how writing helped her heal
  • how the exercises in her book have helped others
  • why therapeutic writing is so powerful

Running time: 33:41

These podcasts, along with all the other vital content and community support at Breastcancer.org, only exist because of the generous donations of listeners like you. Please visit Breastcancer.org/support to learn how you can help keep our services free for you and the millions of women who depend on us.

Show Full Transcript

Jamie DePolo: Hello, everyone. I‘m Jamie DePolo. I’m a senior editor at Breastcancer.org. Welcome to our latest podcast. I’m very, very thrilled and excited to have our guest with us today. Her name is Pamela Post-Ferrante, you may know her. She is a cancer survivor, a writer, a teacher, and a workshop leader. She has taught in Lesley University’s graduate school of Expressive Therapies from 2003 to 2011 and leads sessions privately and in Boston-area hospitals for cancer survivors. She’s been published in several books, magazines, journals, and you may have heard her on NPR where she’s been interviewed. She wrote her book, Writing and Healing: A Mindful Guide for Cancer Survivors, to help others.

Pamela, welcome. It’s so nice to have you here with us today.

Pamela Post-Ferrante: Thank you. It’s great to be here.

Jamie DePolo: So your book and its quest to help people is what we’re going to focus on today. But to start with, I’m wondering if you could just give us a brief history of your experiences with breast cancer, because you’re a multiple diagnosis survivor, which is wonderful. But it’s also not that common.

Pamela Post-Ferrante: Yes. I actually had no family history of breast cancer, so in my 40s, my mid 40s, when I received a call that there was something suspicious on my mammogram, I was really stunned. And then I went on to have wide excision surgery and then radiation after that. And I thought, well okay, that’s over. And then on my first mammogram, checkup mammogram, it happened again in the other breast. So I had that, and then I ended up, in the course of five years, I ended up having eight surgeries. And the final two were, final four were mastectomies and reconstructions. So it’s totally changed my life. And also my marriage didn’t survive it, and I lost my home.

So I was a very different person. I also lost my community. And there was just no going back to who I was after all of that.

Jamie DePolo: I can only imagine. That’s so…your whole world was turned upside down, basically.

Pamela Post-Ferrante: Yes. That’s what happened.

Jamie DePolo: And now, were you writing all along this whole time? Give us a little bit of your history as a writer.

Pamela Post-Ferrante: Yes. My history as a writer is actually, it’s very interesting, writing and teaching writing weave in and out of my story. I had first taught writing, used therapeutic writing -- the very same prompts that I used with my cancer survivors I’d used with children who had emotional issues. I did them on a one-to-one for a long time, and that’s where I developed my prompts. And I suspect that’s where I also developed my need to write.

And so when I had a little time, I began to write short stories. And I loved it. I absolutely loved it. What I noticed was when I wrote through a character… I had a young girl that I decided to write about, and when I wrote about her, it was years later that I found out that actually she was writing about my life. She was the vehicle for my early life, which I had no memory of, some of it having to do with my mother’s illness and leaving me with different grandmothers through most of my first years. But the little girl knew.

And then I realized, I asked my mother, and then I realized it was all true. And I thought, my heavens. Just beneath the surface of my thinking mind there is this amazing ability to create something that will actually be healing, and it was very healing for me.

Jamie DePolo: Wow. That is powerful. So all those memories were there, you just couldn’t access them until you, in a sense, used a different voice.

Pamela Post-Ferrante: Yes.

Jamie DePolo: And now, speaking of voices, I also wonder. You talk about in your book how you feel that cancer has a voice. And did that voice, when you were being diagnosed and treated those multiple times, did that kind of overwhelm you? Did your voice get drowned out because of the cancer?

Pamela Post-Ferrante: It was essentially…when I was diagnosed the third time, I began to become quiet in my life. And there were a lot of other things happening, too. But the fourth time I specifically remember coming home and being in bed, and I was mute. I couldn’t write, I didn’t want to talk except for asking for maybe a glass of water. I just had two more huge surgeries and went back into the hospital a couple of times for that particular surgery. And I thought, I’m never going to be me again. I’m never going to be able to talk again. I really felt that way.

And then, I just decided to push myself, and I did an exercise that I was giving to the children I was working with, which was to just take a first line, open a book and point my finger at a line and begin a story there. And if I was really brave, I could find an ending line. But I’d write for about five minutes, and that broke the silence. Again, writing about something that had nothing to do with me and using creativity.

Jamie DePolo: Very, very interesting. Now, I know you’ve also said that your body was cured after you went through breast cancer treatment, but you needed to sort of heal yourself emotionally or your spirit, and I’m wondering, did the healing of yourself, your inner being, and your ability to start to write again, those were tied together? It sounds like they were.

Pamela Post-Ferrante: Yes. And of course, it was a longer process than that moment in that bed where I was facing silence from myself. What happened was, I had many graces in my life. And I was able to move, find an apartment, have my children for the summer, and then find another place to live so I had that stability. And I went into a graduate program, an advanced graduate program in expressive therapies, and I began the sessions of, to create the sessions of the book. And I knew writing was healing, though it was the kind I use through expressive writing from prompts.

But I wanted it to be more than that, so I put in everything I knew to be healing into the sessions. The healing themes, that was important. There are 12 sessions, and I wanted to put in healing themes so that when people were writing, they were writing in that context. And in that way you avoid getting stuck in negativity and fear and self-pity, which are all normal states of mind for cancer survivors at times. But they’re attitudes you don’t want to solidify by writing them over and over.

So that was really important. And I created guided meditations and put in mindfulness in the sense that I taught people how to follow the breath within the meditations. And there’s a CD of the meditations that comes with the book. So that was very important. And the theme of the session was in the meditation, too. Like the first session is Self Care, and I run six together, and the last of those…the first session, I’m sorry, is Safe Place, and the last of those sessions is Self Care. We do the sessions in between that help us follow the breath and help us find our voice.

And then the next six sessions, I usually do a little break of a month. The next six sessions, they begin with Inner Healer and they end with Writing and Gathering in Gratitude. So I put a lot of thought into what the topics of the sessions were so that they would be healing. So you have writing which is healing. You have sharing which is healing. Listening is very healing. We have to learn to listen because usually when someone’s talking, we’re thinking about what we want to say next. So we learn to listen to someone’s words, and we again call it witnessing because there is something almost holy about it.

Jamie DePolo: Okay. Just to explain to the listeners, we kind of jumped into this both feet. When you talk about expressive writing and you talk about writing with prompts, could you just explain how, like, what makes expressive writing different from any other type of writing, and how one would write with a prompt?

Pamela Post-Ferrante: Yes. That’s right. We did jump over that. Well, that was the early work that I did with middle school boys on a one-to-one. They’re probably the most reluctant population to do anything taught, right? But I would give them… as an example, I would give them something I’d cut out from a magazine, and I’d put it on a card and I’d say, “Here’s the picture, and you’re the reporter, and write the story that goes with this picture.”

Jamie DePolo: Okay. And it could be a picture of anything?

Pamela Post-Ferrante: Well, you know, I would have a picture that might be interesting, like a deep sea diver or a picture of…usually I used Time magazine or Newsweek or something like that.

Jamie DePolo: Okay. So something that they would be interested in.

Pamela Post-Ferrante: Yeah. With a person in it and a, yeah. And something going on. I mean, they could write whatever they thought it might be.

Jamie DePolo: Okay.

Pamela Post-Ferrante: And also they’d take objects from baskets, and here I practiced a little mindfulness. I’d have them spend about five minutes looking at the object, say, it was a pinecone, and looking at it and using all their senses. How did it feel, did it smell like anything? I always advised them not to taste it, but…what would it sound like, you know, if it had a voice and had a sound? Things like that were very nonthreatening. And those are the prompts that I basically began my sessions with. I wrote everything else around using a prompt to take away the fear of the blank page, to encourage creativity, which is healing in itself, and to make it fun. Because creating is fun and writing these stories are fun, and that is the way people develop their voices. But they also wrote about things they could get under their mind that was worried about things, making lists about things, and the meditation helped this, too. But they could go under that mind to a deeper, a deeper self who might carry feelings.

And I want to say that it was interesting that no one wrote, ever wrote, about something they weren’t comfortable with. See, this was sort of giving the power to the person who was writing. So there were never any times when people were triggered or upset by something that they had written.

Jamie DePolo: Okay, because…

Pamela Post-Ferrante: Because they were in control.

Jamie DePolo: Exactly. Exactly. And then, if you could talk a little bit about expressive writing, like what does that mean? If somebody had your book in front of them and were trying to write from these prompts that you supply in the book, what would you call expressive writing, or how would you describe it?

Pamela Post-Ferrante: Well, expressive writing is, well, it’s creative writing is really the way I describe it, or the way I use it in my sessions. And I’m not asking a question, like, “how are you feeling today or tell me if you’re hurting” or anything like that. I’m giving someone something outside of himself and they’re writing a little story. And I tend to want them to be short, in about five minutes. Stories have a beginning, a middle, and an end, and this expressive writing has a beginning, middle, and an end. And so it comes full circle. And interestingly enough, mandalas are very healing and they are circles.

Jamie DePolo: Very interesting. Very interesting. I’m curious, too, about the meditation aspect of it, whether it’s middle-school aged boys or whether it’s people who’ve been diagnosed with cancer. At least in my experience, most people have had to write at some point in their life in school. Not everyone has had to meditate or has made the time to be mindful and to think in that way. Does anybody ever balk or is hesitant about that part of your workshop or your healing process?

Pamela Post-Ferrante: No, because we don’t really think about it as learning to meditate. The breath is written into all of the meditations that I have, so people sit, and the breath, breathe in, breathe out, just flows into the meditation. And sometimes that phrase will be repeated 11 times. I thought I just wanted to read to you a part of one of the meditations to give you an idea. This is on self care and it’s using starlight. I have a theme of nature in each meditation, and so it’s breathing starlight. And remember the importance of making time for yourself, to rest and be creative.

“If there are clouds in your starlit night, breathe them away as you breathe out overwork , as you breathe out perfectionism, as you breathe out exhaustion. Breathe in, breathe out. Breathe in the gift of this time you have for you here and now.”

So that’s the way it is introduced, the breath is introduced. And I’ll do that much slower so it takes on its own rhythm in the meditation.

Jamie DePolo: Sure.

Pamela Post-Ferrante: And that’s how mindfulness comes into it. And after a meditation we do the writing exercises. So people will go to a deeper level and write about things that they weren’t thinking about in their daily surface mind.

Jamie DePolo: Okay. That makes a lot of sense, and that’s very interesting, too, because I’m just judging by some of the people I know, if I said, “Well, it’s a very healing program and you have to meditate.” And they would say, “Oh, I don’t know.” But the way you introduce it and the way it’s all woven together, it makes very good sense, and it’s almost kind of sneaking it in there in a way that it doesn’t really seem like a meditation. It’s more like a focus on yourself before you begin to write.

Pamela Post-Ferrante: That’s right. And so that’s the way it began. And I don’t even think I began to think about putting meditation in when I started these sessions. It just happened, and then I realized what I was doing and I increased it. And also I want to say, I didn’t meditate with the boys. Out the room they would have… and I didn’t have time with them to do the guided meditations. My sessions often last about two hours.

Jamie DePolo: Okay. Okay. And each chapter in your book is one session, is that correct?

Pamela Post-Ferrante: That’s right.

Jamie DePolo: Okay. And you said it would take about six months to go through all the sessions, or people can sort of do this at their own pace? Do you have recommended pacing, I guess, for doing the sessions?

Pamela Post-Ferrante: Well, what I used seemed to work best for people, and when I work in hospitals they’re on this format, too. We do one session a week for six weeks, and a session is two hours. And then I offer in-between session exercises if people want to do them, they don’t have to. And you can also use the book on your own. It has a meditation CD so people… I say that’s fine, but at least find a writing buddy so you have someone to share your writing with because that helps strengthen the voice and is very important to have someone who you’re doing the writing, sharing the writing with. [Editor's Note: Pamela offers the following to clarify pacing the sessions: "I have used the schedule: The first six sessions in the fall, take a break for holidays and start up again in early spring. The winter weather had something to do with this. You can do them any way, though. You can lead the twelve straight through. You can lead six over a weekend, three a day with lunch and breaks. You could do them daily, but the logistics are difficult unless you are on retreat. I led them once a month for a 'repeat' group and that was too long a break."]

Jamie DePolo: Yes.

Pamela Post-Ferrante: Hopefully someone who’s also doing the sessions.

Jamie DePolo: Sure. I could see that. I’m also wondering, do you know if anyone, like, say they’re very isolated or maybe it would be hard to find someone who was a writing buddy. Do you know of anybody who’s using this and perhaps blogging their writing and then sort of sharing their writing that way, or is that not appropriate?

Pamela Post-Ferrante: Well, there’ll be all sorts of ways that people probably can… I’ve never thought of a way to use this online because of the therapeutic aspect and the privacy aspect, but it’s possible. I’m sure it’s possible to blog something. But I would think it would be easy to find someone. You can just, you can put a note up in a hospital or maybe, I don’t know if you have a place on your website where people can communicate…

Jamie DePolo: Yes. We have Discussion Boards. Yes.

Pamela Post-Ferrante: Yeah. So that would be a good place. “I’m looking for someone to be my writing buddy,” or it’s also a good way to form a group.

Jamie DePolo: Definitely. Definitely. Is that the way most people that you know have used the book is in a group, or is it really more just a couple people together?

Pamela Post-Ferrante: I know more about the groups because I’ve led many of them. I suspect I don’t know as much about people who are leading them, or who are doing them on their own. I’d like to know more about that. That really interests me. But the reason I wrote the book was, I couldn’t be everywhere to do the sessions. Also, hospitals were not wanting to pay me to do anything, and I wasn’t charging much. So I realized the times are coming when it would be nice to have something out there where people can form groups themselves, or at least have a writing buddy, for no more than the cost of the book.

And also, health professionals are using this. I know at Mass General there are…they have five books, and two groups are up and running in their cancer center.

Jamie DePolo: Oh, that’s wonderful.

Pamela Post-Ferrante: Yeah. So health professionals are interested in this as well.

Jamie DePolo: I’m curious, too. I know you’ve led many groups using this whole, this series of exercises. Is it possible that you could give us some examples of how you’ve seen people heal through the sessions, or just good things that you’ve seen happen during the sessions?

Pamela Post-Ferrante: Yes. Actually, at the end of each session I ask people to write about something that was meaningful to them or how the book helped or that sort of thing. Actually, I don’t have any of those quotes in front of me, but I do know that people became more solid after having written and shared. And one woman, I remember, she said, she had this feeling. She wasn’t sure what it was, and then she realized it was happiness. And I’ll never forget that.

Jamie DePolo: Oh, wow.

Pamela Post-Ferrante: Oh, and there was one woman…I also have led the group for healing professionals. I led the book for nurses at Children’s Hospital, oncology nurses. And one of them wrote at the end that when she was in the sessions and doing the writing and meditation, her back pain spasm went away and that I should think of charging her HMO. So, you know, there’re probably a lot of people who… well, and people have gone on to write, too. That’s something that’s very interesting. Someone has just written a memoir about their childhood. Someone else published a book of poetry. And there are lots of ways people take it into their life.

I think probably what I would say most of all is that it makes people stronger. There’s a way that they…because cancer sort of tears you down, and it does make people stronger to have expressed their feelings through something, and to have everything safe. To have every, no one’s criticizing. Everything is safe. And the voice gets stronger and you get stronger and you feel better about yourself.

And someone else wrote, “The more I write the lighter I feel. The heaviness of my history falls from my shoulders one by one.” I actually memorized that one.

Jamie DePolo: That’s a good one. And because I’m assuming, too, most people that go through the sessions aren’t writers to begin with. I mean, obviously, they may have written, but they’re not, that’s not their job, they do other things. And so, to me it’s quite amazing that people connect with themselves in that way and then feel so empowered that they continue to do it, whether it’s to write poetry or a memoir or whatever they want to do. Even start a blog. That’s a powerful thing, and to me it seems like that would then keep that healing process going because they’re continuing to be creative and continuing to write.

Pamela Post-Ferrante: Absolutely. And it’s true for the other things in the session, too. When I’m leading the groups I feel really good. And when I have a break or I get into doing publicity, it kind of drifts away. So one has to kind of keep it up. But at least you know it’s there. You know the opportunity is there. And I just found a response that someone sent to me after she read my blog on Breastcancer.org. I hadn’t seen her for a while. She said, “I just read the blog. I’m so moved by it. It reminded me of all the levels on which our group bonded, and how the sessions helped to heal me emotionally and spiritually. Your words really spoke to me as I continue to heal from this surgery.” And she had told me she had surgery for something totally unrelated to cancer. “And reflect upon all the procedures of the past.” So it stays with people.

Jamie DePolo: Yes. And it kind of reminds me of another point that I thought about your book, is that it’s so richly layered that it seems almost timeless. And I’m thinking that somebody could go through these sessions and then almost immediately turn around and do them all again, because they would be in a different place, they would have different thoughts, and they would get a whole new set of meanings from it. Have you heard of people doing that? Do people do these more than once? Is it something they continue to do?

Pamela Post-Ferrante: Well, I can speak to my own experience with leading the groups. I had one group, and somebody dropped out and somebody came in, but basically it’s the same group, that we did it four times. Not necessarily consecutively, but we might have a year that we didn’t and then they’d call me, and I’d say, “Okay!” The interesting thing, and you put your finger on it, is that given a prompt today you’ll write one thing, given it tomorrow or the next day you’ll write something else. So you’re really writing about what’s in you, so that you could do it… I mean, I think it would be wonderful to be constantly doing them. And who knows, that might be possible.

Jamie DePolo: Sure. Now I’m also wondering, too, the way the book is set up, it is aimed at cancer survivors. But to me it almost feels like it could be useful to anyone who’s gone through some sort of traumatic life event, whether perhaps it’s the loss of a spouse or significant other, a child, a loss of a job, a move, anything like that. Have you heard about people other than cancer survivors using the sessions in the book and the process?

Pamela Post-Ferrante: Well, as I said, I did lead them for caretakers. I think that’s such an incredibly stressful job. And the book is about healing, it’s not about illness. So you’re absolutely right. It could be used for anything, and that actually was pointed out to me before I published the book. And I realized that I had created it for cancer survivors and that’s where it was going to stay, because I was afraid if I wrote for anyone who’s gone through something hard or in times of trouble, then I wouldn’t reach cancer survivors.

Jamie DePolo: Oh, I see. Okay.

Pamela Post-Ferrante: So that’s the reason I kept it for the population that I really, I’m one of and care deeply about.

Jamie DePolo: Sure. Sure. That makes absolute sense. I’m curious, too. If there’s someone who’s listening to us right now, perhaps someone who’s been to our site, a breast cancer survivor, who hasn’t really written very much and might be a little bit hesitant to start, perhaps they’ve seen the book. What sort of pointers would you give to that person to get started, to help her find her voice, and, I guess, not be afraid of her voice, of what she might find? Because I’m assuming some people might be a little bit scared of that, of what they find below the surface.

Pamela Post-Ferrante: Well, as I said before, you write what you’re ready to hear or to know, when you’re writing this way. You write what you’re ready to experience. You say it aloud to the group. But to answer your question in a more general way, the book was created totally for people who had not written, and hence the prompts.

Jamie DePolo: Okay.

Pamela Post-Ferrante: And the sort of the fun that comes in, writing from a cartoon card or writing from an unfinished sentence. I mean, there’s a bit of joy and creativity that comes in this way, and that’s probably as important as anything. I think people realize, might realize some things from their past, but in a group setting there’s this great joy of coming together in community. There’s never anything critical said about a writing. If anything is said, mainly it’s witnessing. If anything is said, it’s simply, “Oh, that was a wonderful image.” Or, “Maybe you could write about that more.” Or just something like that.

But basically it’s silence. So there’s no worry about other people commenting on your writing. And I never met anybody who hasn’t ended up writing really beautifully, because they’re writing from a deep, safe place. The first session is Safe Place and it’s both within you that you find, and it’s also within the rooms that people come to for the sessions. And I actually have something that I read every time, or that someone who leads it would read, saying that whatever you hear in this room stays here in this room. So is there’s great confidentiality, and it always ends up being a great kind of love between the people who are doing this and sharing. So I think if you haven’t written at all, it’s just fine.

Jamie DePolo: Okay. Okay. Well, it sounds amazing. Again, if you’re just sort of listening, we’re talking to Pamela Post-Ferrante. Her book is called Writing and Healing: A Mindful Guide for Cancer Survivors. And we’re so delighted that she came today to be on our podcast and share some of her wisdom and her healing guidance with us. Pamela, was there anything you’d like to close out with before we say goodbye?

Pamela Post-Ferrante: Well, I want to thank you…

Jamie DePolo: Thank you.

Pamela Post-Ferrante: …for these interesting questions and being so insightful about the work, and just to say that it is multi-layered, but the book is very clear. And also the book has been designed with pictures of nature, and that credit goes to the designer. [Editor's Note: The designer is Carolyn Kasper Design.] And there’s a lot of sort of space in the book. And someone said to me once, “Just opening the book I let out a breath of stress, and just looking through the book.” And that goes to my designer. And I hope people will give it a try.

Jamie DePolo: Sure. So just opening the book was calming for some people.

Pamela Post-Ferrante: Yes. Yes. Just opening it.

Jamie DePolo: That’s pretty amazing, because calming to me, anyway, is almost the first step toward healing. So people begin healing just by opening the book. I can’t think of a more positive and amazing endorsement for this process that you’ve created. That’s pretty fantastic.

Pamela Post-Ferrante: Thank you.

Jamie DePolo: Again, Pamela Post-Ferrante, thank you so much for joining us today.

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