Emotional Paths: Healing Mind & Spirit In Breast Cancer

Christina Hibbert, PsyD

Thank you so much. That was so kind. I appreciate it.

Jennifer Simmons, MD

I have been looking forward to our talk. Can you just start us off by briefly telling us about your background? What made you go into this field, and how did you arrive at this place professionally?

Christina Hibbert, PsyD

Yes, I, as you said, unintentionally ended up becoming a clinical psychologist through my personal growth experiences. The first major one was my youngest sister, who died of kidney cancer when she was eight. I was 18 and in college, and I was.

Jennifer Simmons, MD

Oh, my goodness.

Christina Hibbert, PsyD

Yes. It was hard. I wasn’t been sure what I wanted to do for a major. I was originally going to be a fashion designer, and then I realized, oh yes, I don’t know how to sew and I don’t know how to draw. That’s not going to happen. But I wanted to be a speaker, and that wasn’t a possible major. Then my sister died, and I went through my grief process and went to counseling for the first time. I realized that, as an 18-year-old, I knew something that other 18-year-olds didn’t yet know, most of them badly. I felt like I was in a good position to help people. that started my interest in psychology.

Then, all of my life experiences going through postpartum depression with all my children’s childbirth. that led me to focus on postpartum depression and mental health. I’ve also lost another sister who died in 2007 of an overdose of Tylenol and alcohol, just after her husband died of melanoma. We had three kids, and I was pregnant with our fourth, and suddenly we inherited our two nephews, and we went from three to six children. talk about trauma. I’ve had a lot of trauma, and suddenly I started learning about it and helping people with it. Of course, four years ago, in July, I was diagnosed with breast cancer. that led me to now, four years, three months later, but who’s counting? Now I’m focusing on the trauma and the mental and emotional aspects of the journey with breast cancer. Because it’s been tough. For me, I’ve had 14 surgeries. I did the chemo. I’ve had all kinds of lasting complications and chronic health issues. I just got back from my second trip to the Mayo Clinic in Rochester, Minnesota, because of lasting issues. All of that, of course, impacts her mental and emotional well-being. and I feel like it’s the aspect that is least talked about and that we’re at least prepared for. That’s where I am today with that. All of my personal experiences have pretty much led me to where I am professionally.

Jennifer Simmons, MD

Can you start by telling us that you had a triple negative diagnosis? Can you tell us a little bit about that time around when you were diagnosed, how you were diagnosed, and then what your treatment plan looked like?

Christina Hibbert, PsyD

Yes, of course. It was ironic because I had made a goal that year to be the healthiest I had ever been. I’ve been an avid exerciser and pretty much ate healthy, but I stepped everything up. I was in a healthy place physically. I was also in a good place professionally. I had just created a whole two-day program that I was teaching Wibw, and I was in the middle of writing my fourth book and ready to get it published. The Big One: Mastery of Motherhood. The big one that I’ve been waiting to do. Then I just went in for a mammogram, and it was a follow-up mammogram because I had found a lump and I had had a biopsy about six months ago, about eight months before. It was nothing; it was just dense breast tissue.

Jennifer Simmons, MD

Was this in 2018? That was a year before.

Christina Hibbert, PsyD

This was about eight months before she was supposed to come back six months later. But I was busy doing this event, and life got busy.

Jennifer Simmons, MD

On the way.

Christina Hibbert, PsyD

But I came as soon as I could, and it was a good thing I did because they had just hired a breast radiology specialist, which I didn’t even know was a thing. That’s something that everybody should know is a thing, and you can ask for that. My cancer was stage one triple negative when they found it.

Jennifer Simmons, MD

To have the same thing that was biopsied in 2018.

Christina Hibbert, PsyD

No, that was just fat or just part of the breast tissue.

Jennifer Simmons, MD

Is it the same breast? That was your call to action?

Christina Hibbert, PsyD

Yes, it was.

Jennifer Simmons, MD

Your body is saying to pay attention to me?

Christina Hibbert, PsyD

Yes. active and backing up my mother, who is a three-time breast cancer survivor. We had looked into genetic testing, too. My mother had been tested twice. Both times, what they told us was that it was inconclusive. Because of that, I asked myself, and my sisters and my brother are doctors. I didn’t ever do the testing at that point. I was diagnosed with breast cancer, triple-negative breast cancer, stage one. Then I was tested for genetics. Two weeks later, I got the test results back, and what it was was a variant of uncertain significance. Again, I didn’t know what that was, but I wish I had known because I had the same variant that my mother had. A week later,  when I got the results, they reclassified it as part of the BRCA1 genetic mutation. I do carry that as well. Yes,  I was like, Bam, go, go, go. I had a double mastectomy a week to the day after I was diagnosed.

Jennifer Simmons, MD

Wow.

Christina Hibbert, PsyD

Because of my family history, my doctor, my breast surgeon, just knew that I had the same genetics as my mom, and she had a variant. It was stage one. We didn’t want it to spread with a triple negative, and that’s not good. and we thought I could avoid chemo, but it ended up being that I chose to do chemo because just that one chance that that little speck got into my bloodstream and metastasized, I didn’t want to take that chance with six having already lost a mother, a father, and an aunt and uncle. A lot of them, well, they were all very scared of me.

Jennifer Simmons, MD

What did you have for chemotherapy?

Christina Hibbert, PsyD

I ended up doing more of what they would do for metastatic breast cancer, which was taxotere and carboplatin. I did four rounds, and I did cold capping. I did, and I was able to save my hair.

Jennifer Simmons, MD

Can you tell people about that experience? Because I don’t know that everyone knows.

Christina Hibbert, PsyD

That’s another thing that I didn’t know about. There are many things I wish I had learned about, but some things I wish I had known earlier. Yes, cold capping. where these freezing caps that you keep have negative temperatures; mine was -25 to 30 degrees in dry ice, and you switch out the caps every 20 to 30 minutes, depending on your routine, your hair, all of that, and your chemo. You start an hour before chemo. You do it all through chemo, and they do it for me. It was for four to four and a half hours after. It’s like a major brain freeze now. But the idea is to try to freeze the scalp while you’re having the biggest infusion of the chemotherapy drug. Yes. It doesn’t get to those follicles as much.

Jennifer Simmons, MD

It’s to divert blood supply to the scalp so that chemotherapy is not a selective treatment. What happens is that it’s going to go to any rapidly growing cells or any rapidly dividing cells. Our hair follicles happen to be rapidly dividing, just like all the cells that line our gut. That’s why people get nauseated, have diarrhea, have an upset stomach, and all of that with chemotherapy. Cold capping has been around for a long time. But still, I don’t know why it hasn’t universally caught on now. It’s not successful with everything. If you have myosin-based chemotherapy, it’s not as successful because that is even more toxic to the hair follicles. But most people do cold capping, and you have to do it from the very start. If you even have one cycle of chemotherapy without it, it won’t work. You have to do it from the very start, but people maintain probably about 75% of their hair. Did you find that to be true for you?

Christina Hibbert, PsyD

Yes, I say I lost probably 20%, and I have a lot of hair, and it’s thick and that helps, but mostly around here, where it’s harder to get the seal in. But it was just a it was a look. It was a gift. I didn’t look sick. I didn’t go out. everybody knew that I was on chemotherapy. I didn’t have to lose my hair. It was just an extra thing, and for my kids, honestly, I wasn’t even sure I was going to do it because I wasn’t sure it would work. After all, like you say, I don’t know why it’s not more popular. I do know that most insurance won’t cover it, and it’s expensive. You have to rent the equipment,  and it’s intense and a lot of work. It hasn’t happened for a long time, either. But my kids were the ones who were like, I don’t want you to go bald. I’d had a friend who had died the year before cancer, and my daughter said to me, To me, cancer is you. You do chemotherapy, you get sick, you go bald, and you die. Even for my kids, it was a big gift just to not have to do that.

Jennifer Simmons, MD

You can understand why they feel that way because those are the most prevalent images.

Christina Hibbert, PsyD

Yes.

Jennifer Simmons, MD

I do want to mention that I don’t know if it’s still true, but there used to be an organization called the Rapunzel Project, and they will if you send them your tax return. It’s not a need-based qualification, but if you send them your tax return, I believe that they will pay for or highly subsidize your cold caps. Yes, everyone who is embarking on chemotherapy and wishes to preserve their hair. It’s worth a try, no matter what. You can speak to how onerous the process is, but if money is your barrier, the Rapunzel project will help significantly with that.

Christina Hibbert, PsyD

Yes, that’s right.

Jennifer Simmons, MD

How hard was it to wear the caps? Did you have to bring your dry ice with you?

Christina Hibbert, PsyD

Yes. I had to drive two hours to chemo every time. it was intense, I’ll say. But for me, it was worth it. It wasn’t the end of the world. You can’t have, like, a massive, like I said, brain freeze or a headache. My doctor would give me Advan, and I’d take Elite. You just feel that way for a while. But I have to say one thing that did help with chemo was you’re busy changing out the caps. I was able to have people there to help. They were the ones who helped me wear my caps. My friends could have something to do, or my husband could have something to do. It did; I was never sitting in chemo thinking about it. I was too busy to even think about what was happening. Yes, in that sense, it helped me and protected me emotionally in that way.

Jennifer Simmons, MD

That’s good. I’m glad to hear that. Yes, it does give everyone around you purpose and is not something that we should talk about because part of the difficulty with a cancer journey is not only what you’re going through but also how other people are experiencing it. Some people are wonderful, and others are so uncomfortable that they get lost in the process and don’t know what they are doing. They don’t know what to say to you. Can you talk about how the experience was for the people around you, and what did it tell you about your relationships?

Christina Hibbert, PsyD

This is such a good question, and I’m glad you asked it because, as you said, this is important and we all feel it. You feel the lifting of friendships; the ones that are going to be there for you settle out to the bottom, and the others get caught in the trap and never show up. It seems like for me, I felt and heard this from a lot of other women who’ve been through it: that sometimes it’s the ones you least expect that are going to be there for you, and the ones that you thought would be there for you can’t handle it or whatever it is; they aren’t. and I have to say that the day I was diagnosed, I had already been pretty active on social media. Like I said, I published a couple of books and things like that. I had made a decision, and I thought a lot about it. I wondered: should I share this publicly or not? I decided to be public, and I was going to share everything.

I did. I have shared everything from my crying to the pain of it to the successes, whatever they might be. I felt like it was crazy at first, but I feel like many people were there for me at the beginning when I was having my double mastectomy I was going through chemotherapy. Again, some of the people that I thought would be there couldn’t and weren’t even a couple of my kids, like one of my sons, who was my adopted son, but who was my sister’s son. He flat-out told me, It’s too hard for me. I just can’t be around you; I had to respect that.

Jennifer Simmons, MD

But because of the thought of facing death again for someone that had to be terrifying.

Christina Hibbert, PsyD

My kids, it was just hard. For me, that’s a whole other aspect of just my guilt about not being able to be there for them. Who is seated in the way that I wanted to. But for me, people would come to visit. I got cards; I got people sending me things from around the world, gifts, and all kinds of things. It was insane. I thought, Why do we do this for cancer treatment, but not for, like, if I had done this already? I have a blog and website, and I had gone on a few years earlier and said, I’m the face of depression, and no one sent me a card or gave me a gift.

No one showed up to visit, but depression can be just as deadly knowing that my sister’s death was ruled a suicide. Another friend of mine lost her life to suicide as well. She dropped her daughter at my house, drove to the Grand Canyon, and jumped. I again feel more trauma. But right after chemo was done, though, it was like crickets. That’s what I felt like. I felt like I had been on this conveyor belt of treatment through all the treatments, just doing what the doctor said. that for me was, I lost my right implant. I lost my left implant. I had gotten infections and, like I said, extra surgeries—things that I wasn’t expecting. But once the chemo is done, it’s like everybody just just they think you’re done.  I started saying, Hey, guess what? When you’re told you’re done, you’re not done. I felt like I was left in the middle of the Sahara Desert, dumped off this conveyor belt. I’m looking around. Where did everybody go? What just happened? Yes. What do I do is the pile of emotion there. 

Jennifer Simmons, MD

I call that the quiet after the storm. it’s terrifying. Because you’re busy before, you’re first busy getting the diagnosis, then you’re busy collecting information, then you’re busy with appointments, and then you’re busy with treatments. All of a sudden, the busyness goes away, it’s quiet, and you’re left on your own. Now what?.

Christina Hibbert, PsyD

I love that person. That’s perfect.

Jennifer Simmons, MD

What did you do in your time now? What? You stayed pretty busy because you had a ton of surgeries. I don’t think I’ve ever been a surgeon for 20 years. I don’t think anyone knows your story. Tell me what went wrong there.

Christina Hibbert, PsyD

Like I said, I had gotten staph infections first in my right implant. Did you have one?

Jennifer Simmons, MD

Bilateral mastectomy with immediate implant reconstruction?  

Christina Hibbert, PsyD

No, with Expanders.

Jennifer Simmons, MD

Okay. Just expanders.

Christina Hibbert, PsyD

I did that for two months, and when I was ready to do the expanded surgery, I opted to do a complete, total hysterectomy at the same time because I’d had all my kids and also because I had the BRCA1 genetic mutation. I thought, Okay, I’m going to have these two surgeries at the same time. I had a double mastectomy. I have these two, or three surgeries done. I’m not undergoing surgery, but my body doesn’t like things in me. Now that. rejected the first implant once the implants were changed; later, they rejected the second implant. After coming out of chemo, I was not only still very sick; in fact, I started feeling better, and then I started feeling worse.

It turned out I ended up with kidney stones—pretty huge kidney stones from the carboplatin, mostly. ended up with surgery for that to get rid of those, and then when this was all during COVID periods, it all started, and then when I was able to, I went back to try the reconstruction again. We did expanders again, and I got an infection, and we were able to somehow salvage the expander. My doctor was able to exchange it for a new expander, use antibiotic beads, and salvage it. Then everything was fine. I went to the exchange surgery, did that, and got another infection. But we were able to save it—save the implant without it coming out. But in my mind, at that point, I was like, Wait a minute, why is my body just hating everything I put in me?  Of course, my surgeon is saying that there’s only a 30% chance that this will happen. Well, there’s only a 5% chance this will happen. Well, this would rarely happen. He hadn’t ever had anyone who had had these reactions like I had. After that, I had my implants, and I had my reconstruction.

I started feeling a little bit better for maybe a month. Then I started getting worse, worse, worse. I just knew it. I had researched it. I knew I had a breast implant illness, and I had to go find a doctor who would believe me and who would start over. I wanted to start over and do a deep flap and get rid of the implants, and I had been flat; I had had one breast just for me; it just didn’t feel like myself, especially as a speaker and everything. Being in public, I just wanted to look and feel like me. We started over with a DIEP flap reconstruction. That was what went well. But the very next day, I had a hematoma. I had to go back in for surgery to fix that. A week later, I ended up in the ER with a strangulated hernia. probably something a stitch pulled or something got nicked, and it ended up being a four-inch tear, with two feet of intestines shooting through this and clamping down, and they rushed me into emergency surgery. I wake up, and they have put a hernia mesh in me. This is like a square this big.

Jennifer Simmons, MD

Oh, I’m. Well aware. I was a surgeon for a long time.

Christina Hibbert, PsyD

Yes, you’re right. But I didn’t know they were going to do that. I had just gotten my implants out, which made me sick. I thought and asked my surgeon, Is this safe? I just got implants. I don’t think I want this in me. He said, No, in five weeks, it’ll absorb into your body. It’ll be fine. Well, fast forward two years until almost exactly a year ago, and I ended up getting the mesh out because, again, I was having all the symptoms I had with breast implant illness. I had gastroparesis, and my stomach was paralyzed. They thought my colon was paralyzed. I was starting to get fatty liver, high cholesterol, and all kinds of crazy things. I had that removed. When he went in to remove it, it was completely intact. It had never dissolved, absorbed, or anything. It looked like it came out of the box, and my body was rejecting it. At the same time, he repaired my abdominal wall, which had also been severely damaged by the hernia.

The right side of my abdominal wall is worn away in the rectus abdominals. He had to stitch them all back together, and he used skin from my back. He took a big piece of skin from my back and used the skin to repair the hernias. There were three hernias and three new hernias. Then he tried to tighten the right side using the skin from my back. I don’t have any devices on me; that’s all great. But unfortunately, this all left me with a chronic illness, as we now know. What I now know is that I have muscle activation syndrome, and that is why my body keeps reacting, which is for anyone who doesn’t know. You are allergic to anything in your body and to external things too, and you get these allergic reaction-type taste sensations from your crimes.

Jennifer Simmons, MD

Unfortunately, yes. That’s what’s happening to you.

Christina Hibbert, PsyD

Too, because of all the surgeries and ehlers-danlos, which I’ve probably had for a while, but that’s probably why all of my tissue, which is for anyone who has no connective tissue disorder, probably why I’ve had so many hernias. I have a hiatal hernia right now, and I’m just trying to learn to live with these illnesses and chronic constipation as a result. severe enough to send me to the Mayo Clinic in Minnesota. I live in Arizona. There is one here, but they don’t take my insurance. It’s stupid. But anyway, it has been a long haul, let’s say. I look great. I look healthy right now. You look.

Jennifer Simmons, MD

Great. You do look great.

Christina Hibbert, PsyD

But, well, most of the time, and yes, it’s all from the breast. Breast cancer triggered it all. Set it all off, yes.

Jennifer Simmons, MD

In your experience, if this were happening to someone else, you would go back and say, Where are your triggers? Like, what started all of this for you? Have you been able to go back and do that work? And think about that.

Christina Hibbert, PsyD

Yes, I was. I started seeing a therapist right away. I knew that I would need it through breast cancer, even when I thought I was only going to be three to six months old and I’d be done. then you move on because you don’t have any clue that this is going to change you forever. This is what I wish they could talk to us about. This is going to change you forever. It’s not necessarily an awful thing. You’re going to be different. But prepare us for this trauma that’s happening to our body. Even just hearing the words you have, cancer is trauma. Every surgery is a trauma. Chemo is trauma, and it’s happening. It’s actual genetic trauma. It’s medical trauma happening to the body. Not to mention how doctors might or might not respond to or believe us, or how they care for us as adults. Sometimes, that can be traumatic too., I was in therapy the whole time, and I’m still in therapy, but I didn’t start the trauma work until after the first 13 surgeries. Those all happened in the first 17 months. After all of that, I felt like I was alone and everybody had disappeared. I had this mountain of trauma, especially because of all the surgeries. It was just a lot and a lot of emergency stops. the strangulated hernia, he was not soft. It’s just scary. 

Jennifer Simmons, MD

That is a true surgical emergency.

Christina Hibbert, PsyD

Yes, exactly. I started working with a trauma therapist anyway, and we started doing some EMDR. eye movement desensitization and reprocessing. For those who don’t know, it’s a very effective way to heal trauma. I was at that time diagnosed with PTSD. No wonder, and I have been working on that since I kept feeling sick or having more problems. It’s continued. I started doing ketamine-assisted therapy about two years ago. I did my first round. When you do ketamine, it’s a psychedelic for those who don’t know. This is the wave of the future for trauma work and some other kinds of issues that are not responding to other treatments.

Let’s say, like your depression or suicidality, that thing. I wasn’t sure about it. I was thinking,  I don’t; I’ve never done a drug in my life. I don’t drink alcohol, even though I thought this was going to be a crazy experience, but it’s just effective. It is psychedelic, and you take that for me. I’ve done it in an office—a psychiatrist’s office under IV. Then,  you have a nurse; they’re monitoring your blood pressure; they’re watching you and everything. Then I do therapy with my therapist at the same time. Some people don’t do it at the same time, but you need to do the processing and integrate what you learned through your experience with them. At least they say within 72 hours. But now, that has been powerful. Of course, when you get in there, to me, it feels like a truth serum because it’s like whatever you most need. s.

Jennifer Simmons, MD

I think it is a true serum.

Christina Hibbert, PsyD

Yes, it is. The biggest traumas come up to the surface. I went in to deal with breast cancer, but I started dealing with my sister’s death,  my second sister’s suicide, my anger, and my friend’s suicide. I’ve gone back. I’ve done four rounds now, at six sessions per round. It’s not like you’re doing it forever. But after I had surgery again last year, of course, all this trauma came back up, and I did it again. It’s been very helpful, very powerful, and healing. It helps you get to the core faster than any other method I’ve ever known. For me, it has just worked better than any other trauma therapy that I’ve tried. Not that I don’t still do some of the others I do. We still do some EMDR and things like that, but it’s helped a lot, and I just go back when I need to because when you’ve had trauma and complex trauma, that’s what has had meaning for me. I would say most breast cancer survivors have had complex trauma issues or more than one thing happened right there.

Jennifer Simmons, MD

There’s a lot of data on that. when you take the population of women that present with early disease as you did, bout 30% of them will have complex trauma in their background. But when you start to get into the people that present with metastatic disease, later disease, and a more significant disease burden, now you’re talking about 80% of them having complex trauma in their background. These are not insignificant numbers. I don’t think that most of us walk around with an awareness of the fact that our bodies are keeping score and that we are seemingly okay in this minute. But reliving a past trauma again and again is enough to cause a chemical shift in our body. Cancer is a normal response to an abnormal environment. It is the effect of that chemical shift that happens as a result of reliving that trauma over and over again, even though you’re not aware of it, whether it’s ever-present or not.

Christina Hibbert, PsyD

Fact. Yes. Thank you for saying that. I’d love to see that research because, just with PTSD, 82.5% of breast cancer survivors end up with symptoms of PTSD. just for free. All of you listening just to give you some perspective: 20% of the general population who have a traumatic event end up with PTSD. That’s one in five versus four out of five. and I, because I talk about this a lot, did a big TED Talk-type speech with an organization recently about trauma, PTSD, and breast cancer survivors. I hear from many women, and I do a support group, a monthly emotional support group online, where they say things like it’s been 12 years, 20 years, five years, whatever.

I never even no one’s ever said the word trauma to me. No one’s ever explained that I’ve been traumatized. I know that feeling. When my sister died, I remember being in therapy and him saying trauma. I said, Wait a minute, I’ve been traumatized. That’s emotional trauma and mental trauma. Just to explain complex trauma, is when you have just more than one traumatic event and it builds up. A lot of times, it starts in childhood. I do have some developmental trauma—not severe, but a little bit in my past as well. A lot of people do have complex trauma; it’s trauma from your whole life. That’s different than someone who, let’s say, witnesses a horrific event and has PTSD as a result and goes in for therapy for that one event. 

It’s for me; it was like, Where do we even start? Take your pick of all these things that have happened in my life, including all of the stuff that happened during breast cancer, but it can be healed. It’s just a very complex process that takes time and much work. You have to commit to this work when you want to do it when you’re ready because it’s hard and it does make you feel worse for a little bit because things are coming up and you do have to deal with things like this. But yes, in time it can heal you, not just physically, which is important, but mentally, emotionally, spiritually, and your relationship socially as well. That’s all part of healing.

Jennifer Simmons, MD

As you mentioned, there are a lot of times when you sit in that discomfort. The reason why therapy is like ketamine or effective is that when we stay in that trauma loop when we relive that over and over and over again with the outcome that has become imprinted in us, that connection, that connection is imprinted. It’s hardwired into our brains. The thing about ketamine, and I don’t think that ketamine is going to be the definitive drug, is that I suspect that psilocybin will be the definitive drug for this type of therapy. it being very successfully trialed at Hopkins and other institutions, particularly in the metastatic cancer population, metastatic breast cancer in particular, because what it allows for is a rewiring of your circuitry, and not that the trauma didn’t happen, but that we can give it a different ending, maybe a safe ending. But I will say that there are no four words that are more traumatic to a woman than having breast cancer.

Christina Hibbert, PsyD

I agree.

Jennifer Simmons, MD

Like you said, it forever changes you.

Christina Hibbert, PsyD

It does.

Jennifer Simmons, MD

Can you explain what the experience is like during your ketamine journey? Because people are curious as to what is involved.

Christina Hibbert, PsyD

I get this question a lot. Like I said, it’s hard to explain. Let me just say that the first time I did it, I was like, well, I get why people do drugs. that’s all pretty good, But at the same time, it’s a truth serum and the thing your ghosts are going to resurface. The whole point of it is dissociative action. We think we hear that word, and we think, Oh, that’s like psychotic. People are dissociated. But the point is, the drug, the psilocybin, the ketamine, the mushrooms—whatever it is, whatever drug it is—they’re using there. they’re studying many of them right now.

It’s supposed to make you dissociate. meaning that you’re not stuck in that thinking brain like you were just talking about. It does allow us to be completely rewired. For me, I’m an overthinker, like a try-to-achieve person. It’s helpful for me to not be analyzing things. That’s not how it works. Traditional therapy—a lot of it is—okay, let’s try to think about this or feel this. This is just whatever comes. You do; they call it; they describe it as you’re going on a journey, and you do travel in the sense that sometimes you’re seeing you’re going to a place like, I feel like I’m in Hawaii or I feel like I’m on an iceberg. Talking about loneliness for me, I feel like that has been one of the biggest traumas to me. I’ve never felt as lonely as I have since I finished breast cancer treatment, active treatment. and I would see images of being; I’m seeing an iceberg. I’m on a snowy mountain. I’m on a train, and it won’t stop. It’s going right through the mountain. just these visual descriptions that, when you go back and look at them, well, of course, that’s how I feel. I feel like an iceberg. I feel like I’m on a train that won’t stop. It’s just that I can’t. I’m not even climbing the mountains like it’s just plowing through me.

That’s breast cancer. then sometimes it will be people that I’ve lost seeing or reliving it with my friend who died by jumping off the Grand Canyon. I had a very intense experience where I was like telling myself about it, bawling hysterically every time I’m bawling hysterically. It’s a very big emotional release. I will say that, for me, it’s cathartic. But I was describing what happened to her and exactly what happened. We know now, and I was imagining that I was her doing it. It can be very intense. That’s why you have to be ready for it. You have to be ready to be willing to look at things you don’t want to look at because they will come out. But when they come up, as you said, we have that opportunity to change it, to change the outcome, to have the cathartic release, and to be able to view it differently because we have processed it at such a deep and powerful level. You can’t go that deep that fast. I don’t feel like without some help to get there.  That’s what the drug does.

Jennifer Simmons, MD

Yes. It’s a facilitator.

Christina Hibbert, PsyD

That’s what I feel like.

Jennifer Simmons, MD

What have you learned? What was your message? What are you supposed to take away from this? Because for most of us, the people who do well afterward are the ones who can see it as a message. See it as an opportunity; see it as a chance to do it better afterward than we were doing it before. This is not to blame anyone or shame anyone, because much of what happened to us before, much of what brought us to the table, certainly in your case, wasn’t anything of your wrongdoing. You were exposed, as many of us are unintentionally exposed, to these things that have catastrophic effects on our health. What were you able to uncover for yourself, and how can you use that to move forward in a positive direction?

Christina Hibbert, PsyD

I completely agree that for me, I do feel like everything I’ve been through, and my first book is called This Is How We Grow, and the quote on the front says, When life throws you in the mud, plant yourself and grow. I went into this experience thinking that, and that’s how I’ve felt and thought about life. Not that I haven’t felt the trauma and the pain too; I do, but I’ve had that in the background. But I will say that the past, especially the past couple of years, has been intense with the trauma and the trauma work. then, things keep happening and going wrong, and even I keep thinking, Am I to the end?

Maybe I’m at the end, but now I’m learning to live with chronic illness. I want everybody listening to know that you are not alone. If you are feeling overwhelmed, if you’re feeling angry, if you’re feeling sad, if you’re feeling scared, if you’re feeling traumatized, whatever you’re feeling is perfect, like you said. I’ve said that many times in a perfectly normal response to a very abnormal situation. At the same time, we can heal. I feel like there’s a part of me that still likes dealing. Then there’s this part of me that’s healing. for me, this is this experience of breast cancer., I feel called to make a change in how we deal with the mental, emotional, and traumatic aspects of breast cancer. To speak about it, to talk about it, to do a support group for women that they have a place if they don’t have somewhere to talk about the emotions of it because we do get this message. Going back to what we talked about, beginning with people not understanding, just be positive, just be grateful you’re alive, and I’ll be fine. I’m tired of that. It’s just lipstick.

Jennifer Simmons, MD

It’s not realistic. That’s what we call toxic positivity.

Christina Hibbert, PsyD

Positivity. Yes. I’m over it. No, feel what you feel. Acknowledge it, look at it, take it somewhere for help, and then try to do the work because you’re right. If we don’t do the work—the healing work, the mental, emotional, spiritual, and social healing work—in addition to the physical healing work, we aren’t going to ever move forward in life. We’re going to be stuck here because that’s what trauma is. It’s like you’re stuck in that moment. PTSD is when you’re stuck in that moment. It’s bringing all these symptoms up all the time.

Jennifer Simmons, MD

You can’t get out of the loop.

Christina Hibbert, PsyD

I’m considering going to a three-week stay in the Minnesota rehab program because I need to learn how to get out of that loop. It comes to my chronic symptoms and how to deal with them physically, mentally, emotionally, and in all other ways. I just feel like, for me, that’s what I’ve gotten from it: I’m glad that I can. I almost just said it without pausing, but I am glad that I’ve had a hard experience in this way; I wouldn’t wish for it. I never wanted it. I wouldn’t. But in this way, I have experienced the gamut of what can happen and go wrong. I was in stage one of cancer, and everybody hears that, and they think, Oh, that’s easy.

Jennifer Simmons, MD

Oh, yes, you’re fine.

Christina Hibbert, PsyD

Yes.

Jennifer Simmons, MD

You got this.

Christina Hibbert, PsyD

Yes, you got it. Yes. My gosh. Yes. But I’ve had to learn how to feel what I feel. Let it be okay. Be gentle with me. Take care of myself and put my needs up there. I used to say, We’ve got eight people in our family, and I’m number eight on the list. Well, not anymore. I’m number one because I need to be because I can’t help the other seven if I’m not number one. I’m no good to anybody. If I’m not good to myself, I need to be good to myself. I’m doing that. I learned about self-care, and I’m still trying to figure out the identity piece of it. I will say that’s what I was talking about. Like you’re changed forever. A lot of you out there might be feeling like you’re lost or that you just don’t recognize yourself. You don’t feel like yourself. There are many ways we can do that. I understand that I’m such a doer.

I get up with Pops and Marcel, and I just feel like I’m going to pass out half the time. I can’t even exercise the way I used to. I’m having to relearn that or learn a new way. But it’s okay because we become somebody new and we give ourselves, hopefully, time and space to allow that process to allow us to ask the question, Who am I now and be able to have room for all of the answers. Well, here are all the things I like about who I am now or hate about my life right now. But these are all the blessings, too, and these are all the great things. I’ve become much closer with my husband and my children, and I do value life in such a bigger and broader way. I can serve and help many people. I’m passionate about this, like trying to get out there and go and teach providers who deal with the physical side of cancer care how to incorporate some more questions about emotional care,  where to refer people, and to just make a change in that way. I feel like I can. I’m working on a book about this, of course. I feel like in the future I’m going to be able to help a lot of people because of what I’ve been through.

Jennifer Simmons, MD

To continue to ask, Who am I now? Because that will change. Who you are today is not going to be who you are in six months, six months from now, or six months from now. to be asking that question, knowing that the answer is going to change.

Christina Hibbert, PsyD

That’s supposed to happen. It’s okay. That’s a thing. You look at things too, because who we are now is our hope. There are a lot of ways we’re just much stronger and better.

Jennifer Simmons, MD

If you had a magic wand and could change how we approach breast cancer patients and how we support them, what would you change?

Christina Hibbert, PsyD

I would change this dialog about the trauma and the mental and emotional aspects, and I would start from day one. Having that discussion about this is a big experience. A lot of people feel like it’s traumatic. It can be very emotionally and mentally difficult. I’m here to listen or hear. Here’s somebody who’s here to listen to you. Here’s this group that you can talk to to keep that dialog going throughout. I just feel like if we just talked about that more and even talked about things like that,  you probably are going to hit a point where you feel lonely, where you feel like people have disappeared. I just feel like when we prepare people, we’re not scaring them. We’re not making it harder for them. We’re just preparing them. If it doesn’t happen, it doesn’t happen. Great. That’s a great experience. But otherwise, then you just don’t feel like there’s something wrong with you. I felt like something was wrong with me because no one mentioned this. Now I feel like I’m all alone. I have all this trauma. It must just be me. Well, no. If we just normalize it by talking about it throughout the process, I just think it’d be much easier for us to get through, to know we’re not alone, to not feel that extreme loneliness, and to be able to know where to turn, know who to talk to, know what we’ve been through, and get the help we need so much sooner. Just that’s what I feel like. I wish I could wave a wand and every woman could get that experience.

Jennifer Simmons, MD

I agree with you. It’s not going to happen in the context of seeing your doctor or your surgeon, because they’re not meant for that. But I do think that in the same way that your medical oncologist didn’t clue you into the cold, perhaps huge pieces are missing from the system and they need to be added in. In addition to seeing your radiation oncologist and your medical oncologist, we need to bring nutrition into it. We need to bring therapy into it. We need to offer people a very well-rounded package so that they can get the most out of therapy but can start to heal while you’re there. We need to start healing the day these diagnoses happen. We can’t wait until afterward. It can’t be something that is seen as an extra outside of the system. We have to build it, and we have to help these people heal properly and heal early because the more damage that happens, the harder it is to heal.

Christina Hibbert, PsyD

Yes. When you have it built in again, it normalizes it and makes it part of the process that is part of the wound. It’s also part of the healing that needs to happen. I love that.

Jennifer Simmons, MD

It was so wonderful to have you here today. I enjoyed our talk. I hope this is the first of many talks between us in the future. I wish you so much luck and healing on your journey. I had the great privilege of seeing many people heal from chronic illnesses. I know that healing happens, and I see miracles every day. I pray for one for you.

Christina Hibbert, PsyD

Thank you all. That means so much to be me.

Jennifer Simmons, MD

So welcome. It’s Dr. Jenn. Bye for now.