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Brian Lehrer: Brian Lehrer on WNYC. We are one year into a pandemic, obviously, and have talked to more doctors in the past year, I think than probably in the whole other history of the show, but let's not forget that just because we're facing this new virus, other health issues continue, including, of course, cancer.

Now any potentially life-threatening illness, COVID-19, cancer, whatever, brings up enormous amounts of fear and anxiety that can make decisions about treatment and thinking about the future more difficult.

A new book offers some help, not with medical treatment, but with how we react to a cancer diagnosis. It's called Coping with Cancer: DBT Skills to Manage Your Emotions--and Balance Uncertainty with Hope. I'm joined now by its co-author, Elizabeth Cohn Stuntz, a psychotherapist, cancer survivor, and Zen practitioner.

She's also the wife of Mayo Stuntz, the chair of New York Public Radio in case that name rings a bell, and she's on the faculty of the Westchester Center for Psychoanalysis and Psychotherapy. Thank you for joining us. It's so nice to have you, Elizabeth.

Elizabeth Cohn Stuntz: Thanks so much. I'm really excited to be on. Our family has been proponents of WNYC for many years. Actually, because WNYC embodies a lot of the parts of Zen and DBT that are central to coping with challenging and uncertainties like cancer.

For us, WNYC is always open to honestly facing things, not shying away from uncomfortable truths, acknowledging the complexity, and then understanding the value of balancing a perspective, by including ideas that may seem to be at odds. Brian, it seems to me that's what you do all the time, and that's what we talk about in our book as most central to coping with challenging and uncertain situations.

Brian Lehrer: Well, it's very nice what you say about WNYC, but let's talk about the other letters, the ones in the subtitle of your book. DBT, remind us of what they stand for.

Elizabeth Cohn Stuntz: DBT stands for dialectical behavior therapy, so DBT for short. It was developed by my co-author, Marsha Linehan, who has actually been named by Time Magazine as one of the geniuses and visionaries whose work has transformed our world. Because in DBT, she's developed clear coping guidelines that have been proven to help people in challenging situations become more resilient, and create a meaningful life.

Brian Lehrer: You write about dialectics, which might have some of us trying to remember our history of philosophy as accepting opposites. You write, "It is possible to be frightened and have hope, you can feel weak and at strong. It is possible to feel helpless, that you can't control everything that is happening, and recognize that there are changes you can make." Break it down for us a little bit. How do we get there, and how does that connect with the basic definition of DBT that you just gave us?

Elizabeth Cohn Stuntz: When you are overwhelmed in a situation, dialectics really means that two opposite ideas can both be true. You can think and feel in more than one way. When you have cancer, it's easy to just oversimplify a situation and reduce things to one way or the other. Either this is a total disaster or no big deal.

You're totally in control, or you're powerless, but with cancer, like the rest of life, it's actually more complex than that. People who are diagnosed are rarely completely healthy, or dying immediately. What people can recognize is that it's possible to both feel weak and act strong, to recognize that there are limits of our control over cancer, and you can still learn effective ways to deal with what's happening.

By teaching people the DBT skills, we teach actual ways that people can be hopeful without being in denial, concrete ways to manage emotions without being overwhelmed by them, nurture relationships, communicate with colleagues and medical providers, and concrete ways to live meaningfully even in the darkest days.

Brian Lehrer: Listeners, we can take a few phone calls for Liz Stuntz on the ideas that she's describing from her book Coping with Cancer. Are you relating to what you're hearing about trying to balance fear and hope? Do you have a question about the DBT approach or where Zen Buddhism comes in which we'll get to in a second? Or anything else about managing the emotional side?

Again, as we're so focused on COVID, most of the time these days, on the show and elsewhere, some of these things can apply I think to any medical condition, the book is particular to cancer. 646-435-7280, 646-435-7280. Where does Zen come in for you, Liz?

Elizabeth Cohn Stuntz: Marsha Linehan is a Zen master, I've actually studied with her as well. What Zen and DBT is based on the practical wisdom of Zen that Linehan has put into practical coping strategies. In Zen, people are open to paying attention to all experience without judging it as one way or the other, and fully seeing what's happening.

When you're coping with cancer, the first part is honestly paying attention to both what's happening and fully facing that without avoiding that, and how we're reacting to it, and that's not so easy. A lot of the strategies in the book are about how to honestly face what's happening because we can't change anything until we fully face what's happening. That's a crucial part of it.

Brian Lehrer: It's a concept you call radical acceptance, right?

Elizabeth Cohn Stuntz: Yes, radical acceptance is a way of fully facing what's happening, and how we're responding to it. When we can radically accept what's happening, then we have the opportunity to see that we have both an immense challenge in front of us, and an opportunity to change not always what's happened, but how we cope with it, and that's where the coping skills are very important.

Brian Lehrer: Tell us a story because you compare in the book your responses to cancer to a patient you call Sarah, and you two make your own dialectic. Can you tell us that story a little bit?

Elizabeth Cohn Stuntz: Sure. People cope in all kinds of ways, and there isn't one right coping style. Some of us are very emotional, like Sarah in the book. Sarah decides she's going to die immediately. She is totally panicked, and she is totally overwhelmed. Others of us are more restrained emotionally. What Linehan calls a reasonable logical mind, and we focus only on the facts.

When I was first diagnosed, I was like, "I got this. I'm a therapist. I can cope." I didn't want to deal with any of my own emotions. Sarah, on the other hand, was overly emotional. We talk in the book a lot about coping being a seesaw, and going back and forth, and having to include both sides of the seesaw. Including both sides of the seesaw means, including both sides of our emotional response, both our emotions and the factual logical part.

We make our best decisions and cope best when we bring together the left-brain rational thinking and the right brain emotions, and we balance them and bring them both in, and know that there's validity of taking both sides. If we only take one side or the other, we miss seeing the whole picture, and we don't make as good a decision, and we don't cope as well.

Brian Lehrer: Let's take a phone call. Jane, in the Bronx, you're on WNYC with Elizabeth Cohn Stuntz. Hi.

Jane: Hi, can you hear me?

Brian Lehrer: Yes. discussion. I appreciate, even though I'm deeply involved in COVID response, talking about something other than COVID. I am a stage IV cancer survivor for the last four years, so knock on wood. I appreciate that what I get from what you're saying is there's just a multiplicity of realities, you wake up every day and in a different way than before, you're like, "Oh, I could either have a short life or a long life, and I have to hold both of those things together."

I'm also interested in what you think about one's family members and friends and support networks, because they also have to, or it helps when they are able to hold multiple realities with you and for you, and that's hard. Some people just only want to see it one way, "You're going to make it through this."

Elizabeth Cohn Stuntz: Absolutely.

Jane: I'm like, "I don't know if I'm going to make it through this." It's hard to hear just unidirectional stuff, although, of course, everybody is doing it with love, and in the spirit of supporting you. I'm wondering if you could talk about the person, of course, but also about the whole network of people around you; family, friends, neighbors, workers, colleagues, et cetera, et cetera, if you know what I'm asking about?

Elizabeth Cohn Stuntz: I totally know what you're asking, and you raise such an important issue. We hope this book is for not just people living with cancer, but their family and their loved ones who are living with cancer as well, and it is very difficult. Those two coping styles that I talked about between Sarah and myself, sometimes we have those with our loved ones, and that's really hard if a loved one wants to focus only on the emotional side, or somebody else wants to focus only on the factual logical side.

You do need to have both the loved one and the person living with cancer. Sometimes the colleagues and sometimes even with our doctors to understand both sides of that. We have two different chapters on that, one on how to talk to your family member about that, and for family members to understand that, and skills about that. Also how to talk to your doctor and your colleagues to say, "Whoa, it's not just one way or the other, and we'd have to look at both sides."

At different moments, our family's taking one side and we're taking the other. We have to remember that both our family and ourselves go back-and-forth all the time. That's why I like that seesaw image to remember at one moment, "I'm really helpful," and at the next moment, "Oh, man, I'm just lost it," and that that's a way we all do.

Brian Lehrer: We have a few more minutes with Elizabeth Cohn Stuntz, psychotherapist, cancer survivor, Zen practitioner, co-author now of Coping with Cancer DBT Skills. Again, DBT is dialectical behavior therapy skills to manage your emotions and balance uncertainty with hope. Here's Jennifer in East Harlem with a DBT question. Jennifer, you're on WNYC. Hello.

Jennifer: Yes. Good morning, and thank you for taking my call, Brian. I'm curious because I'm very familiar with the therapy, but it was my understanding, and this is essentially a variant of cognitive-behavioral or REBT that was really oriented towards working with clients who suffer from the borderline personality disorder.

It actually is a far more rigid variant of CBT and REBT because of the personality profiles of those who suffer from borderline personality disorder. I'm really confused as to why this would be considered more effective or better than CBT or REBT.

Brian Lehrer: Jennifer, thank you very much. Go ahead, and that's right that your co-author Marsha Linehan developed DBT as a way to treat borderline personality disorder originally, which would seem very different from helping people cope with cancer.

Elizabeth Cohn Stuntz: Borderline personality disorder. She's actually started out with helping people that were suicidal, and the diagnostic label that got attached to all of that, and is borderline personality disorder, but her skills are developed for people in challenging situations. Whether you're a borderline personality disorder, or you are suicidal, but her work has now been adapted for all kinds of challenging situations with adolescents, with drug addiction because the skills have been carefully researched and found to be effective in helping people cope in all kinds of challenging situations. It's now being taught in schools to help kids cope. It has adapted and they have seen the use of the skills that way.

Brian Lehrer: Let's get one more caller in here. Nandini in Fort Worth. Nandini, great to hear from you again, you're on WNYC. Hi.

Nandini: Brian, you just made my year by remembering me, my God, okay. [chuckles] Good morning. Yes, this is a fantastic segment, because I did a whole year of DBT group therapy when I took a year off from college at NYU. It was fascinating because it was basically eight hours a day, five days a week of DBT in a room full of similarly, depressed neurotics like me.

The thing that I find really difficult about DBT, and I wasn't successful in the program is how-- Radical acceptance is an extraordinary concept, and I love it, but how do you have radical acceptance when you haven't seen another human being except for your mother or boyfriend in a year? Or that the state in which you live has a governor who thinks that COVID is over?

Like, how can you adopt these ways in which you might feel better, and you might have more calm as you go about your life when everything that's pushing us down, like COVID and politics is such a pervasive force?

Brian Lehrer: Nandini, you might be interested since you name Tex Governor Abbott there lifting all COVID restrictions and calling from Fort Worth, and we're going to do an explicit segment on that on tomorrow's show. In our last minute, Elizabeth, she's putting it in not just the disease context, but whatever the disease is, in the context of the social conditions, be it political or pandemic isolation.

Elizabeth Cohn Stuntz: Absolutely, and it belongs there. Really, it's about facing what's happened, whether it's the political situation, or certainly COVID. Facing our response, which is how isolated we've been, how upset we've been, how off-balance we are, and both facing what's happened, and then saying, looking at what are the ways that we can balance our response by changing how we think about it, how we can regulate our emotions, or change our body, things that we can do with our body so that we can respond to it because it's really not what happens, but how we respond to it, and that there are ways of responding.

We may not be able to change everything that's happening, that COVID's existing, or that cancer exists, but we can decide which ones we can change and how to respond to it.

Brian Lehrer: We have to leave it there because I want to get your book title in and your event in one more time, Coping with Cancer: DBT Skills to Manage Your Emotions--and Balance Uncertainty with Hope. Elizabeth Cohn Stuntz, co-author, and she'll be giving a free talk at noon on March 16th as part of Leading Edge Seminars Buzz Cafe and a webinar there on April 9th. The webinar you can get information at leadingedgeseminars.org for those free events. Thanks so much for coming on with us. This was a really good discussion.

Elizabeth Cohn Stuntz: Thanks so much, Brian.

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