Surge Capacity

However you want to describe my personality, I’m a good person in a crisis. I am able to assess and understand data pretty quickly, and I’ve honed my ability to collaborate and find solutions amidst the chaos while holding myself aloof from the emotions. It helps that I’m usually able to wait to fall apart until after the initial phase has passed.

And yet, I find myself depleted a lot more lately. I find myself less able to gather myself, rise to the occasion, triage the issues, and hold it all together. I find myself less able to bring the influx of energy or surge that may be necessary when a myriad of issues must be dealt with. Having MBC, two children, a busy non-profit and lots of advocacy opportunities, in the midst of a global pandemic AND the chaos of the election, has more often brought me to the place of needing to take a break recently.

For me, this depletion translates into a lack of an ability to keep my anger under control and usually means that I lash out more at various people, including my family, as well as a deep exhaustion that sets in towards the end of the day and the end of the week. When I see the pattern (or someone else sees it and brings it to my attention), that usually means I need to take a break or take a step back from something. Knowing which balls can be dropped or set down for a time is pretty vital for my mental health and wellbeing.

When I find myself in this place of depletion, some adjustments are warranted and I have some tried and true methods. Yet, I find that lately, those methods aren’t working as well. I was puzzled for a bit and then, I found this article on Medium.com about Surge Capacity and the light bulb went off.

The author describes it this way …

In those early months, I, along with most of the rest of the country, was using “surge capacity” to operate, as Ann Masten, PhD, a psychologist and professor of child development at the University of Minnesota, calls it. Surge capacity is a collection of adaptive systems — mental and physical — that humans draw on for short-term survival in acutely stressful situations, such as natural disasters. But natural disasters occur over a short period, even if recovery is long. Pandemics are different — the disaster itself stretches out indefinitely.

“The pandemic has demonstrated both what we can do with surge capacity and the limits of surge capacity,” says Masten. When it’s depleted, it has to be renewed. But what happens when you struggle to renew it because the emergency phase has now become chronic?

my highlights to the original text

Now I don’t subscribe to the view that MBC is chronic because it will shorten my life span, but the word itself does a good job of explaining how our surge capacity doesn’t translate well to a situation or situations that just keep going. As so many other people have written, living in a natural disaster that just keeps going and going and going isn’t the “norm” for the vast majority of people. Those of us in the cancer community, we are used to the treat, scan, repeat mode of life we have to employ to stay alive and yet, as the author asks: “How do you adjust to an ever-changing situation where the “new normal” is indefinite uncertainty?”

To answer these questions, the author also spoke with Pauline Boss, PhD, a family therapist and professor emeritus of social sciences at the University of Minnesota who specializes in “ambiguous loss” and Michael Maddaus, MD, a professor of thoracic surgeryat the University of Minnesota and a motivational speaker who promotes the idea of a “resilience bank account.” While no one has the answer for everyone, by speaking with these there experts, the author came up with a list of suggestions that have resonated with me through the lens of my MBC experience and now living in these unprecedented times.

First, accept that life is different right now. OK, I get it, that sounds a little trite, but Maddaus advocates for “radical acceptance.” Just as those of us in the MBC community have to come to the understanding that life will never be the same, that there is no going back, so do we have to look at this pandemic as altering the face of the world irrevocably and forever. When we first accept that this is what we have to deal with, then we can move into looking at ways to actually deal with it.

Second, expect less from yourself. For those of us accustomed to achieving and accomplishing everything on our daily list, this is a big one. Our routines are vastly different, the expectations from outside and inside are different, and we have to make adjustments that reflect this new situation. Just as I had to learn that I can’t jump out of bed each morning and be operating at 100% right away after my diagnosis with MBC, so to I need to see that my capacity to be productive is very different during this pandemic.

[Masten] says people are having to live their lives without the support of so many systems that have partly or fully broken down, whether it’s schools, hospitals, churches, family support, or other systems that we relied on. We need to recognize that we’re grieving multiple losses while managing the ongoing impact of trauma and uncertainty. The malaise so many of us feel, a sort of disinterested boredom, is common in research on burnout, Masten says. But other emotions accompany it: disappointment, anger, grief, sadness, exhaustion, stress, fear, anxiety — and no one can function at full capacity with all that going on.

Grief is an emotion the MBC community is pretty well acquainted with. One of my favorite episodes on the podcast, Our MBC Life, is the Remembrance episode. Grief is one of those things that doesn’t end and that can interfere with every function of every day life. When we are grieving so many different things all at once, it can be catastrophic and so …

Third, we need to recognize the different aspects of grief. The five (5) stages of grief: denial, anger, bargaining, depression, and acceptance, are often misunderstood as happening in a straight line that ends. However, I have come to see that grief is often cyclical, with those of us in that process experiencing the different stages at multiple times and in multiple permutations.

“Our new normal is always feeling a little off balance, like trying to stand in a dinghy on rough seas, and not knowing when the storm will pass.”

Sound a lot like having to deal with MBC to me.

Fourth, experiment with “both-and” thinking. This one is a little hard for me to grasp since I’m so grounded in reality, but it could go something like this … the pandemic is a really awful thing and people are dying every day … AND … we’ve been able to have some amazing family time because my husband is working from home and is engaging with my kids more and differently. It’s a different take on looking for a silver lining that I often talk about. It’s an acknowledgment of what “IS” (a/k/a reality) with a small shift in perspective.

Fifth, look for activities, new and old, that continue to fulfill you. For me, I’ve always enjoyed cross-stitching and crafts. In the busyness of life before MBC and before the pandemic, I often neglected these activities in favor of the things that need to get done, like laundry or wrapping Christmas presents or potty training or homework. The list just goes on and on. Through my diagnosis with MBC, I’ve been reminded over and over that I need to fill my cup before I can be an effective mom or partner.

… Maddaus explains why it makes sense that creative activities like cooking, gardening, painting, house projects — or even building your own imaginary island out of pixels — can be fulfilling right now. He references the book The Molecule of More, which explores how dopamine influences our experiences and happiness, in describing the types of activities most likely to bring us joy.

“There are two ways the brain deals with the world: the future and things we need to go after, and the here and now, seeing things and touching things,” Maddaus says. “Rather than being at the mercy of what’s going on, we can use the elements of our natural reward system and construct things to do that are good no matter what.”

Sixth, focus on maintaining and strengthening important relationships. We’ve been spending a lot more one-on-one time with the boys and, as I included above, my husband has been able to engage with them more than he ever has before because he’s working from home. I’ve rekindled my love of writing letters and getting to know some pen pals.

Additionally, this category includes reaching out to help others. Everyone is dealing with the pandemic in their own way; at the same time, those of us cancer-havers have been hit more significantly as a group. The need to stay socially distanced, especially while immunocompromised, and seek regular medical care during a time when going to the hospital or cancer center is more dangerous than staying home, has been rough on our community. Those that are newly diagnosed are entering our community without the “usual” support system, such as it is, and are feeling more isolated as a result. We’re all also looking at the fact that the rate of cancer diagnoses is only half of what it was pre-pandemic and the experts feel that this is because many people are skipping screenings.

All of this is adding up to a crisis coming in the cancer community and likely in the metastatic cancer communities since more people will be diagnosed at a later stage. I don’t have answers for what will happen or how we will all deal with this, just that it’s on my mind and definitely influences how I’ve made a point to reach out and support those who are newly diagnosed so that there will be a pattern of support in place. Locally, the 305 Pink Pack, does an excellent job of supporting cancer havers in active treatment and has recently established their Thriver fund, which will continue to support those of us in the metastatic community through our endless “scan, treat, repeat” pattern of life.

Seventh, begin slowly building your resilience bank account. The areas Maddaus specifically advocates focusing on are sleep, nutrition, exercise, meditation, self-compassion, gratitude, connection, and saying no. Regardless of whether you are handling a terminal cancer diagnosis or a global pandemic, we can all use more of each of these!

Now, it’s your turn. Do these 7 ideas resonate with you? Are there other things that do? Please share how you are dealing with your own surge capacity!