Breast cancer takes a toll on your physical, emotional, and mental health. While the physical effects are often visible to others, the silent pain can cause the most turmoil for people living with this disease.

While being positive and surrounding yourself with positive people can be powerful, it can also be harmful. When too much positivity causes you to avoid discomfort or dismiss your feelings and emotions, the unintended effects can become toxic.

It’s not easy to push back on toxic positivity when you have breast cancer, but it’s possible.

We asked two experts to share what toxic positivity is, how it can be harmful — especially to people living with cancer — what you can do to deal with it, and how others can support you.

“Toxic positivity is the implicit or explicit pressure we feel to stay positive or strong in the face of profound adversity,” says Stephanie McLeod-Estevez, LCPC, a psychotherapist and breast cancer survivor who has specialized in working with the breast cancer community since 2016.

Toxic positivity can be self-imposed or caused by external pressures like a friend, family member, or healthcare professional. McLeod-Estevez says it’s toxic because it leaves little room for the perceived negative thoughts and feelings that are natural to experience when facing a life threatening illness.

A big concern with this belief system is it denies human emotion. It can also lead to isolation if you’re not feeling supported and validated when sharing negative emotions.

“Very often, toxic positivity includes dismissing negative feelings or emotions,” says Dr. Eleonora Teplinsky, a board certified medical oncologist and the Head of Breast Medical Oncology at Valley-Mount Sinai Comprehensive Cancer Care in Paramus, New Jersey. Teplinsky says toxic positivity can make patients feel that their emotions aren’t legitimate or valid, and this isn’t what people need.

According to the American Cancer Society, studies have shown that a positive attitude doesn’t change the course of your cancer. In fact, they stress the normalcy of feelings like sadness, distress, fear, and anxiety when learning to deal with cancer.

Moreover, Teplinsky says trying to be overly positive can be very harmful to people, especially those who have cancer because it negates and invalidates what they’re feeling and doesn’t allow them a space to discuss their feelings and emotions.

McLeod-Estevez says toxic positivity is harmful because expressing your genuine thoughts and feelings is not only good self-care, it’s actually crucial for mental health and awareness. “When we feel pressure to only be positive, we’re denying ourselves the therapeutic release that comes with expression,” she says.

Dismissing these emotions leads to higher levels of stress and distress. McLeod-Estevez also says it leaves you more vulnerable to higher levels of anxiety, depression, and PTSD because you’re repressing or avoiding your feelings.

Toxic positivity also feeds the fear that is already present because of breast cancer, making it more difficult to diffuse these feelings because you’re not able to get relief by sharing this with someone who cares, says McLeod-Estevez.

Pushing back on toxic positivity starts with yourself. For some people, this means managing it on their own. But for others, seeking help from a professional is the first step. Here are some ways to push back against toxic positivity.

First, get support

McLeod-Estevez recommends finding a therapist who specializes in working with people with cancer. She also suggests joining a support group or other peer-driven community, so that you decrease your isolation. “Normalizing is vital for dealing with toxic positivity,” she adds.

Speak up and be honest about your feelings

According to Teplinsky, the most important thing you can do is to speak up and be honest about how you’re feeling.

For example, when faced with toxic positivity, she recommends saying something like “acknowledging my emotions helps me to process what I’m going through” or “I don’t feel positive or happy right now, but that’s okay, and my feelings and emotions are not permanent.”

“Focusing on things that help you heal and grieve is really important and surrounding yourself with people that help with that is important,” she adds.

Look for ways to express your feelings

Getting in touch with your thoughts and feelings is the first step. The next is to find healthy ways to express them. McLeod-Estevez’s two favorites are writing and art therapy.

Surround yourself with the right people

McLeod-Estevez says to listen to who and what feels good and be thoughtful of who you allow into your inner circle. If someone is contributing to your toxic positivity, McLeod-Estevez says it’s likely a sign that they’re dealing with the fear cancer sparks.

“Since my diagnosis, I’ve learned to distance myself from people who don’t make me feel like my best self. If a person doesn’t support your dreams or decisions, or if their behaviors are toxic and hold you back, they don’t deserve you.”

— Sara Reinold

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Take time to focus on your breath

Slow down and practice grounding exercises, like breathing techniques, meditation, and yoga. Getting back into your body will help diffuse the anxiety and pressure you’re feeling, says McLeod-Estevez.

If you’re looking for ways to support a loved one going through breast cancer, the best thing you can do is hold space for them and get support yourself.

Hold space for the person going through treatment

Holding space for someone going through treatment means letting them know you’re there for them, no matter what. McLeod-Estevez recommends letting them know that you want to know how it’s really going.

Teplinsky says caregivers, friends, and family can provide support by asking what their loved ones need. For example, it’s OK to say, “You’re going through a hard time, and I don’t know what to say, but I am here for you. What can I do?”

“Very often, people don’t realize that they are practicing toxic positivity and that their comments are hurtful,” she adds.

Get support for yourself

These existential dilemmas impact everyone. That’s why McLeod-Estevez says getting support for yourself can help.

Everyone experiences breast cancer differently. How you manage the journey from diagnosis and treatment to life after or with cancer is best guided by you. The support you need will change based on where you’re at in the course of the disease.

Identifying and accepting difficult emotions is critical to your journey — and this includes all feelings and emotions. Pushing back on toxic positivity is not easy. But with the right support, you can learn ways to address and cope with it.