Emotional effects of a cancer diagnosis - Dee McKiernan


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Emotional effects of a cancer diagnosis - Dee McKiernan

  1. 1. Emotional Effects September 2012of a CancerDiagnosisDee McKiernan (Cert, B.A., MSc )Counselling PsychologistSt. Vincent’s Hospital
  2. 2. Scaling Pick a number between 0-10 that best describes how much distress you have been experiencing in the past week including today. Adapted from the NCCN distress thermometer.
  3. 3. Overview  Responses to a Cancer Diagnosis  Stress and Cancer Related Stress  Stress levels and illness trajectory  What causes Stress ?  What are the effects of Stress ?  Coping, learning ways to manage stress
  4. 4. Responses to a Cancer Diagnosis With the diagnosis of a chronic, potentially life-threatening disease, such as cancer, individuals usually find themselves in a condition of ‘crisis’, facing physical, social and psychological challenges A Cancer diagnosis is one of the most emotionally distressing events for patients throughout medical care (Carlson, Speca, Patel, & Goodey 2004) Distress is very common in patients, yet often undetected.
  5. 5. Stress - Pos v’s Neg... Not all stress is negative... It can have benefits Much of the stress we experience can be both helpful and stimulating It can motivate us into productive actions – nothing like a deadline to motivate! NB - stress is only harmful when it is excessive!!
  6. 6. WHAT IS STRESSTaylor (2006) argues that stress is“ a negative emotional experience accompanied by predictable biochemical, physiological, cognitive and behavioural changes that are directed either toward altering the stressful event or accommodating its effects”
  7. 7. Cancer Related Stress - NCCNThe National Comprehensive Cancer network (2012) defined distress as:“a multi-factorial unpleasant emotional experience of a psychological, social and/or spiritual nature that may interfere with the ability to cope effectively with cancer, its physical symptoms and its treatment”
  8. 8. Typical Emotional Responses Anyone remember feeling like this....
  9. 9. Distress levels & Illness Trajectory10 9 8 7 6 5 4 Illness Column1 3 Column2 2 1 0 These challenges occur at different stages of the illness from diagnosis through treatment, remission, recurrence or survivorship (Carlson, Speca, Patel, & Goodey 2004)
  10. 10. BUTIt is important to note…. that high levels of distress represent a normal healthy adjustment reaction to a cancer diagnosis...
  11. 11. Effects of stress Physical:muscle tension, sweaty palms, chest palpitations, restlessness andnausea, head-aches, neck or back pain, upset stomach, dry mouth Emotional:excessive worry, concern, crying, weeping, feeling hopeless, panicattacks, irritability, jitters, short temper Psychological:distress, anxiety, depression, Generalised Anxiety Disorder
  12. 12. Effects of stress Behavioural:Difficulty falling or staying asleep, Loss of appetite or overeating “comfortfoods”, increased smoking, alcohol consumption, nail biting, absenteeism atwork Cognitively:difficulty concentrating, poor decision making, muddled thinking, memorylapses, undue tiredness, ‘chemo brain’ Prolonged Stress:chronic backache, allergies, migraine headaches, high bloodpressure, IBS, depression
  13. 13. How do you copewith stress....
  14. 14. I help myself by...*When I am stressed I help myself by….. ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________
  15. 15. Identify resources....helps alleviate stress What are my physical strengths?  high energy levels, sporty, and agility What are my emotional strengths?  High self-esteem and confidence, humour and creativity What support systems do I have?  friends, family, ICS, helpline, peer support How is my present lifestyle helping me cope?  Housekeeper, shopping on line, babysitter,
  16. 16. SUPPORT SYSTEMS Family – educate them, offer suggestions Friends – be honest about how your feeling, ask for their support GP / Health Care Professionals / Therapists/ Community Groups Cancer support groups – meet other patients, Online, Blogs, peer support groups
  17. 17. CBT
  18. 18. THOUGHTS Challenge your thoughts - Remember thoughts are not facts!  Exaggerating – magnifying your bad points  Castastrophising – anticipating total disaster  Overgeneralising – expecting everything to go wrong because of one or two bad experiences  Ignoring the positive – overlooking personal strengths Affirmations – I love and approve of myself, I can handle this, I am safe, my health is improving day by day Interrupting those negative automatic thoughts and replacing them with positive self accepting thoughts will help alleviate stress
  19. 19. FEELINGS....  Remember its ok to feel whatever you are feeling  Talk it out.... Its good to talk....  Refocus on what is happening around you, come back to your breath  Journaling - Write it down - 20 mins set an alarm  Distract with a good movie, book, gallery, cooking, time with friends/children...
  20. 20. BEHAVIOUR Meet friends, dont isolate Hobbies and Interests – give you time to unwind Call helpline – speak to other cancer survivors Diet – watch caffeine, sugar, alcohol intake Exercise – generate endorphins (hormones which reduce stress)  bring the dog for a walk  Gardening,  cycle, walk, swim – know your limits Tai Chi, Massage (touch therapies), Reflexology, Yoga Learn to Scale – 1 – 10 – if low what do I need to do Gratitude list
  21. 21. RELAXATION Take time out for you.... Learn to put yourself first Reward and Pamper yourself Bubble baths, shopping, hairdresser, facial, get your nails done, spa weekend Sacred Centre – plant, candle, poem, book Light a candle and just watch the flame Breathing 1 – 4 * Sleep patterns – naps, camomile tea, relaxation cd’s
  22. 22. Techniques to Relax...  Breathing - 1-4*  Diaphragmatic breathing*  PMR*
  23. 23. To finish... Scale ??? 3 sentiments to finish with... Take your pick...
  24. 24. Dee McKiernanCounselling Psychologist (Cert., B.A., MSc.)Oscailt Integrative Health Centre8 Pembroke RoadDublin 4http://www.oscailt.comPh: 01 660 3872 / 087 622 5011Email: info@counsellingindublin.ieWeb: www.counsellingindublin.ie