Coping with the internal monologue


On Maureen’s thread this phrase came up - and for me it put into words what i have been experiencing this inner monologue about cancer that keeps recurring, that i can’t really share as I don’t want to drag my OH down. Jenny’s rant really summed it up for me as well…

I think Ripley mentioned discussing it with a counsellor , has anyone else had professional advice on how to cope with it?


Hi Cathy
I am sitting talking about anything at all and inside my head a voice keeps saying things like - you’re dying. i’m walking in the high street and its back - or someone talks about something and i think - " i won’t be around to see that"… or whats the point…well, thats my inner dialogue and i’m not proud of it ( it is relentless and inexhaustable)on the surface I present the cheery stuff with a gung ho - yes , treatments fine , I feel fine - then i change the subject - How are you?
Now what I find is that i experience myself as being crazy - an outer self and an inner self - and the two are very distinct beasts - often i can manage both my “people” but when I cant i withdraw and don’t answer the phone etc - think about " a short stay in switzerland equivalent… I have seen a counsellor at the hospital twice and she said I was to carve out a few times in the day when i could shut up my inner voice to get some respite - I can only think of total distraction - and I am trying but i find it hard - so persistent is the beast - this might not be what you are talking about and I found it quite hard to write it down - sorry if its irrelevant to you but thought i’d share it in case …i am so sorry you are having such a hard time Cathy , you are so supopotive to people here, and have been great to me …take care - must dash - sister here for cheery coffee jaynexx

I am seeing a counsellor tomorrow, I stopped seeing the lady in oncology because I felt guilty wasting her time. I felt that since I had a good prognosis she ought to be worrying more about those of you who have a lot more to deal with.

My problem is that I am overwhelmed with everything that has happened to me over the years with a mastectomy being the final straw.

Internal monologues are one of the things I want to talk to her about and need help sorting out as they really drag me down. I know they are just thoughts, but they just won’t go away. I am exhausted by them, but none of my friends and family know how bad I feel because I am such a good actress.

I would love to hear any techniques which help banish them when I am laid in bet at night having been woken up by the horrid hot flushes.

Hi Merlyn and Cathy

I think I know how you are feeling.

I was diagnosed in April Grade3, had a lumpectomy followed by chemo. Before the chemo had finished, diagnosed with a regional recurrence. I then had to have a bilateral mastectomy with LD reconstruction in December. Having more chemo now but it looks like I have skin mets and need further surgery- awaiting tests.

The reason I am telling you all this is because things have happened so fast and I don’t think I have had any time to reflect on what has happened, and it was this rotten inner monlogue which eventually brought me to my lowest point ever a few weeks ago. I had to do something. I am now on antidepressants which has helped tremendously, they just seemed to bring me out of an anxious state and have enabled me to think more clearly and sleep better. I do not know if you are on them. Counselling also helps as you feel you can pour your heart out without being judged, or feeling like you are wasting their time, or guilty. Which we should not feel but do.

It also helps to just type how you are feeling either on here, a PM to someone you are freinds with, or for your own personal use. It helps to read it back, but it may make you cry or/and feel better. Like yourself, I was laying awake at night THINKING, THINKING THINKING. It is awful for you. May be even in you exhausted state, you could get up and type your thoughts. I have locked a file on my computer so that only I have access to it, so all my thoughts are written in there. They are sad, mad, OTT, funny and sometimes purely bonkers but it helps. You could speak them into a voice recorder, but I found that hard to do. Especially if I thought my kiddies could be listening. Plus I do not like the sound of my own voice.

Many people have said go for a walk, but for me no matter how far I walked those thoughts were right there with me!!

I hope this helps.


Hi Cathy
I see a counsellor at our Cancer Centre for this very reason, particularly after being told last September that I had significent progression. So much is an act for family and keeping things going and I would find that I would explode if I was taken at face value and they didn’t seem to appreciate what I was going through. I just felt that I needed another outlet rather than put them all through my turmoil. I have to say that I do find it helpful, I only see her once every 6 weeks or so as things have calmed down. She really endorses my strategy of allowing myself a bit of time to dwell on the whole cancer thing and then to put that away and deal with other things.
It’s very hard for the person we live with, i really feel it today as we have just had the news that the wife of a colleague of my husband’s died from cancer (not BC ) yesterday.
Hope you feel better Cathy
Love Kathryn

Hi All

to be honest it really helps me just to know that everyone feels like this.

I may think about going back for some counselling but I am not sure. Work has been my way of turning off the inner monologue but it is slightly losing its ability to do this - after 18 taxol, two lots of infections, a knock back on something to do with my son,and a realisation I am probably going straight back on treatment soon, I am now totally knackered. (jane can I join you in the fatigue club??).

I think these forums are so useful as we can blow away all the pink fluffy stuff and stupid cliches and talk about what is really happening to us.

hope everyone is having a good sunday .


It is good to know other people think what i think
Inteernal Monolouges - is a good description
we all need to be able to say what we really feel


I find when I wake up in the night my Internal Monologue keeps me awake, I found putting a talking cd on or the TV in the background allows me to go back to sleep. When I was first diagnosed Jan06 and then when I was diagnosed with bone mets in May08, I would need a talking cd on to get back to sleep.
Now I put my meditation cd on or the TV and it work 90% of the time for me.
In the day my therapist told me to notice how bad I felt on a scale 0-10 and was that feeling useful at the time. If it was useful (for sorting things out/learning)do nothing, if I wanted to change the feeling I was told change the voice tone of the IM i.e say the same things but in sexy voice, mickey voice or sing the IM then measure on a scale 1-10 and notice if the feeling had changed.
I was given other things as well but this is what I told to do with IM-it works for me, maybe it can help someone else.
Sue x

Hi Cathy

I agree that Maureen’s thread has raised some interesting ideas about how we cope on a daily basis.

Apparently, the internal monologue is always with us. When people talk about meditation they often refer to the “monkey mind” chattering away endlessly. It is totally draining to have this voice yapping at you all day long (possibly on steroids, methinks) about cancer. I think that now when I wake up I don’t actively “remember” that I have cancer – it’s not that I “forget” it – it’s just become an inherent part of me, in the same way that I don’t have to remind myself that I am a woman. However, this daily diatribe could completely dominate my every waking moment if I let it. Whilst I can’t control the cancer that’s appropriated my body, I can try to regain some control over my mind.

I found the counselling helpful on two fronts: a) it was a totally confidential forum where I could be brutally honest and not see someone flinch if I uttered the unutterable. Family and friends try to be supportive but they rarely seem to be able to let you speak your thoughts without trying to offer a solution, usually of the positive kind; b) the counsellor remained objective and proposed strategies to help deconstruct my thoughts. He believed that when you’re diagnosed with cancer the medics’ concept of “quality of life” is geared towards the physical treatment of the condition and doesn’t seem to incorporate one’s emotional and mental well-being. Given what we deal with physically and emotionally with this bas***rd disease, any time off from the cancer chatter would give me a break, however small, and give me some semblance of normality and perhaps even some happiness. That helps with my quality of life.

Strategy-wise - apparently behind every emotion lies a thought which has triggered it, so first you need to identify the thought and then ask why it has been triggered. Then you need to acknowledge the thought, establish if there is any factual evidence behind it. If there is nothing factual to support the notion then that thought needs to be discarded as it serves no practical purpose. If the evidence supports the thought then what can you do to address the emotion it arouses to make you feel better?

I shall give you an example and I hope it doesn’t offend anyone. I was feeling petrified (emotion) about the speed of which cancer can kill you. The thought originated from news of someone who’d been rushed into hospital and died within a matter of days. The counsellor (an ex nurse)observed that the person must have been really ill for that to happen and asked me whether there was any suggestion that I was going to die in a matter of days. Based on my recent scan, bloods, lack of symptoms etc (facts), I answered “no”. He said that it was good that I wasn’t in denial about the grim reality of cancer(acknowledging the thought), but that right now the evidence suggested that it was probably unlikely that I would die in the next couple of days. So, was it of any benefit to me to be consumed by that thought at that particular point in time? No. Then they suggest you have an imaginary place where you visualise putting that thought (a box or a file or a place), until it pops up again and you can run through the same process. So that was one worry ticked off my list and a bit of control regained. I try to apply the same principle to even the most insignificant thoughts - often a much faster process too “do I need to think about this right now?” Yes/No. File. If my answer is yes, I acknowledge what I feel (sad, angry etc) and allow myself to feel it, but I will apply a time-limit.

It’s amazing how much you can accomplish in an hour because the counsellor will probe or give direction to your thoughts. Sometimes I felt that I went there just to cry, other times to vent, other times for guidance. The counsellor will assess where you’re at emotionally and how regularly you should meet. I started off every other week, then monthly and now I leave it as a lifeline for when I think I’m having a mini-crisis or need some support if there are scans or results.

Sorry for the ramble. Hope it helps


thank you so much for all the replies everyone , Ripley- thats really helpful, I am going to come back and read all of these again,


Hi, I know this is a secondaries thread but I have read Maureen’s thread and also, even as a primary, have an internal monologue.

Whilst I appreciate that my monologue is different to what it would be were I dx with secondaries the constant “cancer” in my head remains.

I have just posted about my impending return to work having finished my chemo with just tamoxifen to go and my feelings about that and this thread (found afterwards, duh) kinda echoes what I am feeling.

How on earth do I ever, ever stop cancer being part of my life and a chattering demon in my ear? Will I ever? I never asked for this bedfellow and can’t get rid of it!! I may have “won” this time as everyone tells me but I know that I will never be able to forget. Yes, I might think about it less and less (and I thank God that I don’t have to live with the internal monologue of secondaries), but even if I live another 40 plus years (I am 39, 40 in 3 weeks) I will have this demon sat on my shoulder whispering in my ear “what about that lump/pain etc?”.

Part of me is so desparately trying to ignore it that I refuse mentally to examine myself (yet doggedly physically feel for every lump and bump) and to ignore anything that “might” mean more cancer (intermittent ringing in my right ear/pain in my breast/changed sensation in my nose) whilst the other part screams “it might be cancer!!!” as loud as possible.

For me, this is the worst of cancer. The constant chatter of that horrid, demonic, relentless, additional person in your head. The fact that it will never end and the intolerable sadness that you can’t tell your family/friends really and truly how loud the voice is.

I think I have always treid to make my inner dialogue an outer one too. I don’t have a converntional family or children and perhaps that helps…no one to protect. I have a partner and a few good freinds with whom I can speak the unpseakable, speak the terror, speak the reality as it is for me.

Being able to do that doesn’t stop the monologues but I think it makes them less frightening. ‘Cognitive behavioural strategies’ (putting 'thoughts in boxes, changing the way you think about thoughts and feelings) can be helpful but are for me, superficial after a while. I have seen a therapist regularly for the last five years…someone eclectic/psycho dynamic in her approach) Some times I think she’s uselss, other times I leave soaring knowing I have been heard seriously and that’s what counts. Our most scary thoughts are not simply ‘wild imaginings’ but often have basis in reality.

Ostrich…I think the voices calm down after primary diagnosis…and then become a crescendo as check ups appraoch. I always expected to get recurrence (that wasn’t being negative…it was being utterly realistic) By the time I got to two years from end of tretament I dared to think maybe I had fallen the right side of bad stats…but not to be…recurrence 6 months after that but not quite as I expected.

I still try to be as utterly realistic as I can possibly be, and now i find there are still a few people I can talk the real talk that I want to talk…how I will die, how cancer will kill me, what will happen if? how I might make that eaiser than it otherwise will be, should I/shan’t I go to Switzerland?/how will my partner deal with my death…the hardest thing of all.

Another of the hardest things to deal with is the sheer unpredictability of cancer…treatments aren’t working for me and will soon run out, but how long can I live with my slowly growing cancer…wish I knew but I don’t