Wise Words From a Psychiatrist About PBM

Today I had a wonderful ‘visit’ with a psychiatrist. He’s helping me personally, and also helping me put together a program for women facing and recovering from breast reconstruction. Helping women like me cope with the psychological effects of recovery. It was very informative, he told me that the psychology behind the decision to have prophylactic bilateral mastectomy is very interesting. He said that it obviously shows a strong woman, a woman that is willing to face the fear and pain of the surgery and reconstruction to prolong her life. It also shows that the woman is thoughtful of her health, willing to go through the surgery and reconstruction to stay healthy instead of taking the chance that she won’t get breast cancer. It also shows that she is more concerned about having a long healthy life than she is about how she looks, and is willing to give up her breasts to live a longer life. I think this is very important for the women that are faced with the comment “it’s just like having implants”, because I think the most hurtful part of that statement ISN’T the suggestion that we won’t face more hurt or emotions or trauma than a woman getting implants, but that we are doing it because of how we want to look. Those people that say those things have no idea that we will never look like a ‘normal’ woman again, and that the size of the implant has nothing to do with replacing or making better the breasts we had prior to surgery. There is simply no comparison between our bodies before and after surgery.

I mentioned to him that many of my ‘breast friends’ seem to be going through a little depression. He explained it very well in that we put so much of our energy and emotions into getting through the surgery. We create possitive energy for ourselves without even realizing it, just to get us through, because although we have support from our family and friends, no one really knows how much it takes just to get through it. Once we are through the mastectomy and are facing the delays and trials of reconstruction, we hit a low point because we have expended so much energy getting through to the recovery, just surviving and being there for our family and friends. Although we need them, we often end up having to put on a brave face for them, and it’s just sometimes more than we can do. We fall into a depression, where we need to sleep and withdraw and recover the energy that it took us just to get through the surgery. Not to mention the grieving process, because there is a grieving process as we lose a part of our body, and it doesn’t mean we’re shallow or vain to mourn that loss.

As he explained that to me I felt a light bulb go off! That’s exactly right! And it immediately brought to mind my little break down at Scorpion Bay in Baja after finding the lump that lead to all of this. I remember being devistated, and crying and crying, not because of what I faced, but because it was the only time I felt that I could. Once I came home and started my journey for real I needed to be strong for my family. I couldn’t break down and be devistated in front of them, if i did, who would get them through it?

I think having a ‘group’ would be great. I know there are a lot of groups out there talking about breast cancer, or other types of cancer, but I really feel that my focus with my own projects should be reconstruction. And luckily he’s willing to help out as well. So now I’m putting together a little session for women in the area that are facing this journey too. I can’t wait to get started.


  1. This is great! I was very relieved when I read this because I feel your psychiatrist knew exactly what I feel. It makes me feel less crazy because I am not alone with these feelings. I am pre-surgery so I have not reached all of this yet. But I worry because I am so “OK” with my decision to have my breasts removed and reconstructed to make sure that I do not get breast cancer. I feel like I am waiting to hit rock bottom. I know it’s coming, but I still feel very numb and like I am going through the motions I need to to get through this. I am jealous that I am not close to you! I would love to meet up with women who are on the same path as me. Thank you so much for sharing. You have helped me the most out of anyone in my life. That is not because they don’t care, they do! You just get it! You are truly my “breast friend!” Lot’s of love!! ~Lori

  2. I can’t agree more with what Lori has posted. That is EXACTLY how I feel. I have been given a provisional date of 10th January for PBM with DIEP reconstruction and feel almost like it must be happening to someone else. I feel completely fine about it. ALl my friends are saying how brave I am etc etc but I am frightenly at ease with it all. To me, this can only mean that the post-op anticlimax is on its way and I don’t know how I’m going to deal with it. I don’t think I ll be able to admit to my husband and friends if (when?) I get depressed. Will they think that its all over with and I should get on with it? The thought of having no-one to confide in post-op a burden, or confidng and then becoming frightens me more than the surgery itself.

  3. Amazing! I am 1 year out from my PBM and find it very interesting what the psychiatrist had to say about a woman who has this surgery. I totally agree. I think that is what I really wanted to hear from my co-workers instead of “oh that happened while you were on your 6 week vacation”. Or “my breast augmentation was very painful–I know how you feel”. If I did not have FORCE to help me through this last year I’m not sure what I would have done. I was 110% ready for my surgery and no one could have talked me out of it, BUT I really think that someone should be recommended/referred to you just in case you have a hard time prior to or after the surgery. A group is a great idea. I don’t really feel like I belong to any kind of cancer group–I haven’t had cancer, haven’t survived cancer and feel like a phony even doing a “cancer” walk. I feel at least somewhat at home on FORCE, but even there I have never tested for the BRCA gene so I can’t feel their pain in that regard. Anyway—-best of luck to you–I know you will do great things!

  4. I felt exactly the same way that this psychiatrist described. All of my friends and family have been extremely supportive thus far. I had my PBM on Jan 7, 2011 and my feelings remain the same. It is somewhat painful, but I would much rather be here to experience the pain than to be taken down by breast cancer one day.
    I had ADH and lobular neoplasia turn up in my right breast 3 different times in 4 years, so when it appeared in my left breast last summer, that made my decision. I have not regretted it yet and don’t think I ever will. Thank you Michele for this wonderful blog and website where women can share their stories! Good luck to you!

  5. Hi ladies,
    Sorry for commenting so late. I love the idea of a support group! PBM or BC survivor. At the point of reconstruction we are all in the same boat as far as I am concerned.
    Sue you are not a “phony” I had cancer but didn’t need chemo because I chose double mastectomies. I felt like a “phone” as well, because I skipped chemo.
    At this point we are the same and need to support each other. Reconstruction is full of ups and downs and different for every one of us.
    Depression is a part of this process.
    I personally don’t think that anyone will ever really know how difficult our journey is, unless they have gone thru reconstruction. So I don’t get upset with myself, or upset with others if they are not as supportive as I would like them to be. Or if they think it’s the same as a “BOOB JOB”!
    I am thankful to God to have gotten this far. I have a wonderful supportive Husband and family. Yes 2 very Helpful and supportive friends!
    I am sooooooo looking forward to a “group” Michelle’s site has been soooooo helpful for me. Even as I was facing the mastectomies, before reconstruction. Her pictures and story gave me a sense of what to expect.
    When I share with any one, I feel as though I have given a little piece of my burden away. Maybe just maybe it will help some one in the future. This “sharing thing” helps greatly with my depression.

  6. Thank you, thank you, thank you!!!
    I am just catching up with your blog and the videos after being a new joiner to the BRCA Sisterhood. I had my mastectomies, enlarger placements, ovary removal and a “major” hernia repair all on the same day this past Feb. The enlargers are full and I am waiting for surgery. I’ve been thinking these small bouts of depression were from the lack of hormones but I am soooooo glad to hear of others having the same issues that I am.
    I am so grateful to have discovered my breast friends!

  7. I haven’t had a mastectomy, but I thought this might be useful to someone who has with the economy being what it is. Perhaps you know a good place to post this. Land’s End sells mastectomy swimwear. Right now they have lots of them on clearance in their overstock section, some for $20. If you use the code DONNER pin 1585 this weekend you get an extra 40% off and free shipping. It made some of the suits super affordable; I know specialty clothing often is pricey.

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