Benefits of Stress Reduction – October 2017 Webinar
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Stress affects most people who are touched by colorectal cancer. Learning to manage chronic stress can be extremely helpful in coping with a cancer diagnosis and maintaining a positive outlook. Andrea Lee, BSN, RN will spend the hour discussing strategies and awareness techniques to manage stress at all points along the cancer continuum. This webinar is a great tool for patients, survivors, caregivers and loved ones.
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Benefits of Stress Reduction – October 2017 Webinar
- 1. Benefits of Stress Reduction Our webinar will begin shortly. WELCOME!
- 2. • Speaker: Andrea Lee, BSN, RN • Archived Webinars: FightCRC.org/webinars • AFTER THE WEBINAR: Expect an email with links to the material & a survey. If you fill it out, we’ll send you an “I booty” bracelet • Ask a question in the panel on the RIGHT SIDE of your screen • Follow along via Twitter – use the hashtag #CRCWebinar Today’s Webinar:
- 3. @FightCRC | FightCRC.org Webinar tech: • We are using LogMeIn GoToWebinar platform • The side control panel can be adjusted using the Orange Arrow • Questions are asked by opening the Questions tab – the arrow opens the box • Not all questions are addressed during the presentation depending on time and quantity but if necessary will be followed up individually • If you are new to GoToWebinar and experience streaming problems you should shut down other high bandwidth services such as Facebook, IM or hangout systems during presentation • The Audio tab allows you to select either your computer or phone to listen.
- 4. Resources:
- 5. Disclaimer : The information and services provided by Fight Colorectal Cancer are for general informational purposes only. The information and services are not intended to be substitutes for professional medical advice, diagnoses or treatment. If you are ill, or suspect that you are ill, see a doctor immediately. In an emergency, call 911 or go to the nearest emergency room. Fight Colorectal Cancer never recommends or endorses any specific physicians, products or treatments for any condition.
- 6. Speaker: Andrea Lee, BSN, RN currently works in Dallas, Texas, as the Oncology Program Manager at Methodist Dallas Medical Center where her work focuses on improving the utilization of Shared Decision Making in oncology by reducing barriers, like stress, to improve patient-provider communication, learning and memory. She is a champion for the integration of traditional cancer care with mindfulness-based stress reduction techniques to improve patient experience and treatment outcomes. She continues her work with FightCRC, because she believes in the work they do to lobby for system improvements, educate patients with accessible educational resources, and provide a community of support for those facing the fear-inducing diagnosis of colorectal cancer.
- 7. The Benefits of Being Present Role of Mindfulness in Managing Cancer-Related Stress Andrea Lee, BSN, RN andrealee2@mhd.com
- 8. Objectives • Recognize the impact of stress on physical and psychological health and wellbeing • Demonstrate how self-compassion can reduce suffering • Identify how stress and mindfulness impact brain function • Integrate real-time stress-reduction techniques
- 9. The Journey by Mary Oliver One day you finally knew what you had to do, and began though the voices around you kept shouting their bad advice though the whole house began to tremble and you felt the old tug at your ankles. “Mend my life!” each voice cried. But you didn’t stop. You knew what you had to do though the wind pried with its still fingers at the very foundations though their melancholy was terrible. It was already late enough, and a wild night, and the road full of fallen branches and stones. But little by little, as you left their voice behind, the stars began to burn though the sheets of clouds, and there was a new voice which you slowly recognized as your own, that kept you company as you strode deeper and deeper into the world, determined to do the only thing you could do determined to save the only life that you could save.
- 10. Introduction Oncology Nurse Navigator: • Sits at center of healthcare team and walks patient through system • Patient advocate • Physician liaison • Develops unique perspective of healthcare system • Sees how all elements of system work together • Understands gaps in care • Serves as a patient advocate ensuring members of multidisciplinary team collaborate on patient care
- 11. Introduction Oncology Program Manager at Methodist Dallas Medical Center: – Working to improve the system for patients and physicians – Promote Shared Decision Making – Facilitate multidisciplinary approach to cancer care – Integrate mindfulness into fabric of traditional cancer care
- 12. Locus of Control
- 13. Cancer-Related Post Traumatic Stress • Cancer-related post-traumatic stress (PTS) – like post-traumatic stress disorder (PTSD) but not as severe • Can occur anytime during or after treatment • Range of reactions: – Repeated frightening thoughts – Being distracted or overexcited – Trouble sleeping – Feeling detached from oneself or reality
- 14. Stress and Oncology Reactive anxiety & depression 22% Major depression 4% Organic mental disorders 3% Personality disorders 2% Anxiety disorders 1% Distressed 32% Patients coping adequately 36%
- 15. Post-Traumatic Growth PTGI Domains Sample Question Appreciation of life I changed my priorities about what is important in life Relating to others I have a greater sense of closeness with others New possibilities in life I am able to do better things with my life Personal strength I know better that I can handle difficulties Spiritual change I have a better understanding of spiritual matters • Linked to resiliency • A positive change experienced as result of the struggle with a major life or traumatic event. • Positive change that occurs after encountering life challenge. • PTG tends to occur in 5 general areas • Research suggests link between mindfulness and PTG
- 16. Exercise An effective way to anchor in the present moment, in body sensation, especially when you’re upset and can’t calm yourself down. • Awareness of sensation • Diaphragmatic breathing • Labeling thoughts
- 17. Stress and Telomeres • Telomeres protect our DNA from degradation • Studies have linked stress to shorter telomeres • Associated with aging and disease • Telomerase: protective enzyme • Mindfulness is proven to increase serum telomerase, having a protective effect on our telomeres and DNA
- 21. Hand Model of the Brain
- 22. Default Mode Network • Mind wandering • Rumination • Confusion • Distorted thinking • Inappropriate negative rxn • Only see what confirms belief (confirmation bias) • Ignore what disconfirms belief • Believe worst possible thing most likely to happen (negativity bias)
- 23. Awareness of Mental Activity *The act of observing your mental activity causes it to change. • Thinking fast and slow • Emotionally charged memory is stickier • Memory is stored as generalizations • Memories co-activate • Have to interrupt the pattern, but first have to become aware of it
- 25. Breaking out of a Thinking/Feeling Loop • Breathe into the feeling • Label thought or emotion • Become aware of mental activity • Practice self-compassion • Reframe/Reorient • Choose Differently
- 27. What is Mindfulness? • Jon Kabat-Zinn Father of mindfulness – Intentionally drawing your attention to the present moment experience with an attitude of kindness and non-judgment –JKZ • Ellen Langer Mother of mindfulness – A flexible state of mind in which we are actively engaged in the present moment and noticing new things –Ellen Langer
- 28. Mindlessness VS Mindfulness Mindless Mindful An inactive state of mind characterized by reliance on past experience and rely on rules or routines to govern behavior Mindfulness is the very simple process of actively noticing new things in the present moment Most of our suffering, psychological and physical, is the direct or indirect effect of mindlessness It’s engaging and enlivening The lights are on but no ones home The end game of meditation is to produce post-meditative mindfulness Problem is you’re not there to know you’re not there Mitigate reactivity of stress response with mindfulness practice as a means of seeing more clearly, understanding situations fully and acting wisely.
- 29. Mindfulness Research Mindfulness and Colorectal Cancer • Cancer Survivor Mindfulness Influences Health Characteristics of Primary Support Person • Mindfulness Practice Reduces Cortisol Blunting During Chemotherapy in CRC patients • Mindfulness and Disgust in Colorectal Cancer Scenarios: Non-judging and Non-reacting Components Predict Avoidance
- 31. Attitudes of Mindfulness • Beginners mind • Non-judgment • Acceptance • Non-striving • Letting go/Letting be • Gratitude • Generosity • Patience • Trust
- 32. Suffering = Pain x Resistance
- 33. Role of Resistance • The Fly
- 34. The One You Feed “A fight is going on inside me,” an old Cherokee man said to the his grandson. “It is a terrible fight and it is between two wolves. One is evil— he is anger, envy, sorrow, regret, greed, arrogance, self-pity, guilt, resentment, inferiority, lies, false pride, superiority and ego.” He continued, “the other is good—he is joy, peace, love, hope, serenity, humility, kindness, benevolence, empathy, generosity, truth, compassion and faith. The same fight is going on inside you—and inside every other person too.” The grandson asked his grandfather “which wolf will win?” The old Cherokee simply replied, “The one you feed.”
- 35. Mindful Self Compassion • How we are oriented to our experience • Internal narrator dictating the story of our lives • Can be self-critical or self-compassionate • Our attention can have a critical quality, or it can be compassionate • Attention training without an attitude of self-compassion can result in a practice that is condemning or judgmental of inner experience • Self- kindness vs. self-judgment – Treating self with care and understanding rather than harsh judgment – Actively soothing and comforting oneself • Common humanity vs. isolation – Seeing own experience as part of larger human experience not isolating or abnormal – Recognizing that life is imperfect (expecting perfection is irrational) • Mindfulness vs over-identification – Allows us to “be” with painful feelings as they are – Avoids extremes of suppressing or running away from painful feelings
- 36. Mindful Self-Compassion When you notice that you’re feeling stress or emotional discomfort, see if you can find the discomfort in your body. Where do you feel it the most? Now, say to yourself, slowly: 1) this is a moment of suffering • That’s mindfulness. Can also say: this hurts or this is stressful 2) suffering is a part of life • That’s common humanity. Can also say: I am not alone. Others are just like me. This is how it feels when a person struggles in this way. Now, put your hands over your heart, or wherever it feels soothing, feel the warmth and gentle touch of your hands. Say to yourself: 3) May I be kind to myself, or May I give myself what I need. See if you can find words for what you need in times like this. May I accept myself as I am. May I forgive myself. May I be patient.
- 37. Allow by Danna Faulds There is no controlling life. Try corralling a lightning bolt. Containing a tornado. Damn a stream and it will create a new channel. Resist, and the tide will sweep you off your feet. Allow, and grace will carry you to higher ground. The only safety lies in letting it all in –the wile and the weak; fear, fantasies, failures and successes. When loss rips off the doors of the heart, or sadness veils your vision with despair, practice becomes simply bearing the truth. In the choice to let go of your known way of being, the whole world is revealed to your new eyes.
- 38. References • Shennan, C., Payne, S., Fenlon, D., (2010).What is the evidence for the use of mindfulness-based interventions in cancer care? A review. Psycho-Oncology DOI: 10.1002/pon.1819 • Bartley, T., (in press), Mindfulness-Based Cognitive Therapy for Cancer: Gently Turning Towards. Oxford: Wiley Blackwell • Hanley, A., Peterson, G., Canto, A., (2014) The relationship between mindfulness and posttraumatic growth with respect to contemplative practice engagement. • Speca, M., Carlson, L.E., Goodey, E., & Angen, M., (2000) A randomised, wait-list controlled clinical trial: The effect of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients. Psychosomatic Medicine, 62, 613-622. • Black, Peng, Sleight, 2017. Mindfulness Practice Reduces Cortisol Blunting During Chemotherapy: A Randomized Controlled Study of Colorectal Cancer Patients • Cancer Survivor Mindfulness Influences Health Characteristics of Primary Support Person: http://mindful.usc.edu/author/admin/
- 39. Resources • Greater Good Science Center: https://greatergood.berkeley.edu/ • Self-Compassion: http://self- compassion.org/category/exercises/ • UCLA Mindful Awareness Research Center (MARC): http://marc.ucla.edu/mindful- meditations • https://www.mindful.org/ • Self Compassion Test: https://centerformsc.org/learn-msc/take- the-self-compassion-test/
- 40. Question & Answer: SNAP A #STRONGARMSELFIE Bayer HealthCare will donate $1 for every photo posted (up to $25,000). Flex a “strong arm” & post it to Twitter or Instagram! (Use the hashtag!)
- 41. Contact Us!
Editor's Notes
- Saw fundamental flaws in our healthcare system by walking journey with patients Paint perspective so that audience sees healthcare from providers perspective (rather than just the patients) Explain how I saw it from patients perspective for first time Hard to reconcile two perspectives and still be good at my job
- Explain what Shared Decision Making is and what I saw as navigator that makes me feel as an administrator that it’s extremely important These are the realities that unfold in a persons life, and it’s not just that person, it’s every life that person touches
- Taking care of yourself becomes survival Have you ever felt like you just wanted to run away from your life? Like you were grasping for a life raft and there was no one around to save you? Stress and Burnout Birth and Death Wreckage of life Air Bnb Travel, studying, books, experience Brought back to Dallas to implement what I learned to make a difference in the system Research on LOC and happiness Externally oriented Focus is on what is happening to me Internally oriented Focus is on what I can do to change things
- Patients may have feelings of shock, helplessness or horror which may lead to cancer-related PTS. PTSD is a specific group of symptoms that affect many survivors of stressful events. These events usually involve the treat of death or serious injury to oneself or others. People who have served as military combat, natural disasters, violent personal attack or other life threatening stress may suffer from PTSD. Fast- implicit unconscious Slow-rational understanding You already know… a major function of your brain is to serve as a memory bank – and a huge one at that. Among the array of memories stored in this vast repository are all of the responses to the various situations and challenges you encounter throughout your day, whether it is your response to the changing weather, food you eat, a near miss on the freeway or an unpleasant encounter with someone you'd rather avoid. How you react to those events and everything else in your life is stored in your brain. How did it all get there? Simple enough: You put it there by your actions. Every time something pleasant happens in your life, something interesting, scary, even the fragrance of a flower, how you respond or react to it is studiously inventoried by your brain, all neatly stored for future reference. Over time, the way we perceive and react to the various events we encountered sets up automatic response patterns. The brain basically operates as a pattern-matching system that scans for a familiar response. When a stressful situation occurs, the brain scans its memory banks looking for previous stressful experiences and how we responded, until it perceives a match. If our past response pattern was to perceive the situation as negative, then it triggers the same emotional reactions you had the previous time — like anxiety, hurt, resignation, or depression. “that all these brain circuits are flexible and can be reshaped with new patterns throughout life. It's never too late to learn or to change.” You may choose to step back when stressful events occur and react compassionately, lovingly or any other way, and your brain will remember this, too. Make any of these your routine reaction and you'll create a positive response pattern that eventually can replace the negative patterns.
- Although the majority of oncology patients experience distress associated with cancer care we do virtually nothing to attend to it in the healthcare system Stress impacts nearly every system in the body. Impairs immune function and glucose metabolism, increases inflammatory markers, creates cardiovascular stress
- Human beings can be changed by their encounters with life challenges, sometimes in radically positive ways. Someone who is already resilient when trauma occurs won’t experience PTG because a resilient person isn’t rocked to the core by an event and doesn’t have to seek a new belief system. Less resilient people on the other hand may go through distress and confusion as they try to understand why this terrible thing happened to them and what that means for their worldview PTG different from resilience Post-Traumatic Growth Inventory (PTGI) evaluates whether/to what extent a person has achieved growth after trauma More research needs to be done to evaluate the role of mindfulness in post-truamatic growth. However, what we know is that mindfulness creates space between thoughts. That space creates a window where we can observe our thinking. When we are able to observe the thinking we are no longer our thinking. We can question it. break it apart. And are better equipped to choose how we see things.
- By drawing your attention to sensation you bring yourself into the present moment If you’re near a window direct your attention to the farthest thing you can see in the distance. This may be a building or a tree. If there’s no window, find the farthest thing from you and direct your attention to that for a moment. Now direct your attention to something in the room about a foot away from you. This could be your hands, or even your computer screen. Become aware of the space between you and your computer screen. Warmly observe yourself in 3-dimensional space. Notice how you were able to focus your attention intentionally, when I gave you direction to do so. This ability to shift our attention at will is what we strengthen through mindfulness practice. Now I want you to direct all of your awareness to feeling the inside of your hands. I do not mean think about your hands. I mean to draw your awareness to the sensation of your hands. Are they touching anything? Can you feel your palms just by focusing on them? Now draw your attention to the seat you are sitting in. Feel how your weight is distributed. If you are not already, sit with both feet so they are flat on the floor. Begin to draw your awareness to the soles of your feet. Feel how your feet hold your entire body up. Notice the subtle sensation of your feet in your shoes. Or if you’re not wearing shoes, feel the sensation of your feet on the floor. I want you to draw your awareness to each of your 5 senses, starting with your sense of hearing. You can do this with your eyes open or with them closed, whatever makes you feel the most comfortable. Begin to notice the sounds you hear in your environment. Direct all your awareness to what you can hear, noticing how each sound arises from and fades back into the silence. Now draw your attention to your sense of smell. What scents are present. Now to your sense of taste. Becoming aware of the sensation of your tongue resting inside your mouth. Now to your sense of sight. Become aware of the light as its shining through your eyelids. Finally I want you to bring your awareness to your sixth sense—interoception. This is the awareness of internal sensations arising from the body. Feel the inside of your chest as it rises and falls with each breath. Not trying to control it, but just noticing whatever arises and allowing it to be as it is. Now down to your abdomen. Feeling your stomach, and the sensations that exist inside the body. If any uncomfortable sensations arise, just notice them. Try labeling them– “worried thought,” “planning thought.” Try not to judge the thoughts as good or bad, but rather allow them to be as they are in this moment. Take a few moments to just become aware of your own mental activity as you follow the breath in and out of the body. Breathing deeply in to the abdomen first and then feeling the chest rise. Try holding the breath for just a moment. Taking a big inhale into the abdomen, then the chest, and pausing for a moment before exhaling. Now exhale slowly, becoming aware of the sensation of air on your nostrils. This is called diaphragmatic breathing, and is a tool to calm your nervous system down that we will explore later in this talk. For now just taking a few deep breaths like this. Feeling the sensation of the breath on the body. Feeling the rise and fall of the chest and abdomen. Any time a thought arises noticing it, labeling it if you can, and letting it go. Does a thought arise suddenly, all at once? Or is it connected to a string of thoughts, one after another? The breath is what connects us to the external world. It is what keeps our body alive. And no matter what the situation, if you are sitting here, there is more right with you than wrong with you. Take a few more breaths like this now. Let’s infuse the breath with a mantra. This can be whatever you Slowly brining your awareness back to the sensations of the body. Check in. How was that?
- During stressful events, the adrenal glands produce hormones that damage, and sometimes kill, immune cells. To replace them, other cells in the immune system take on the job of replicating, which causes their telomeres to become shorter. “Our findings suggest that traumatic and chronic stressful life events are associated with shortening of telomeres in cells of the immune system, but that physical activity may moderate this impact,” said co-author Jue Lin, PhD, associate research biochemist in the laboratory of senior author and Nobel laureate Elizabeth Blackburn, PhD, professor of biochemistry and biophysics at UCSF.
- What is stress? Stressor=an activity, event or other stimulus that causes a stress response Stress response=response by the body to a stimulus, such as fear or pain, that interferes with normal physiological equilibrium (homeostasis) Stress=condition of mental, physical or emotional disharmony (allostasis) A lack of control over our lives combined with excessive demands, unsatisfied needs, unfilfilled expectations, over stimulation, under stimulation or role conflict all cause stress states to develop. Stressor causes stress reaction. With mindfulness training we become aware of our habituated patterns of reacting to stress, which gives us an opportunity to intentionally change how we are in relationship to the stressors in our life. The act of objectively observing our reactions to the stressors in our life, which we will get to in a moment, changes changes the reaction Itself. If I am able to observe my reaction than I am no longer just my reaction. This is very important, because of the deleterious effects stress has on the body. Stress hormones suppress the immune system
- A: there’s an event or situation B: Thought: this is terrible or this is going to hurt so much C: Feeling: stomach tightens, heart pounds etc. B: thought: thought reinforces feeling C: feeling: feeling reinforces thought If left without resolve will spiral out of control. Change your thoughts to change your feelings or change yoru feelings to change your thoughts. Humans are wired to avoid pain and seek pleasure Wellbeing brain Wired to seek eudonic rewards Intrinsic reward we get when we do a good thing just because it makes us feel good Approaches challenges Stress brain Will seek hedonic rewards Chemical stimulus to change how we feel Retreats from challenges Even the mere mention of these things can be activate associations of past experience Memory is stored as generalization One associated feeling will co-activate the memory another Without an awareness of what is happening with you in real time this can quickly get out of hand and an you can feel overwhelmed, scared, sad, anxious without actually undersanding what has happened Mindfulness, which we will get to in a moment, strengthens your capacity for meta-awareness, or an awareness of that which you are aware (I am aware I am remembering a past experience) When we become aware of something we have the power to interrupt the cycle If we are not aware of our own mental activity, however, this can be quite disruptive We can literally become an embodied mental state Thinking about an anxious memory causes me to feel anxious The more anxious I feel the more I think anxious thoughts This thinking/feeling feedback loop should begin to sound familiar Its something we all experience every day, largely outside of our consious awareness When we become this embodied mental state we are the subjective participant in the narrative of our story We want to be the objective narrator, so we can craft the storyline of our lives with intention, rather than acting out parts of a story that may or may not be true I’ll come back to this… but for now i want to teach you an exercise to help 1) become aware of your reactions and 2) bring yourself quickly back into the present so you can regain control over your present moemnt experience Recognition- Notice what is happening Acceptance- make room for the experience and allow it to be as it is. Investigate- get curious about your feelings with an attitude of non-judgment. What is this I’m feeling? What was I just thinking about that is creating this feeling? Non-identification- when you realize you are caught in a subjective thinking/feeling feedback loop take a step back. Warmly observe yourself in 3-dimensional space. Witness the experience you are having in the moment. Remember, the act of observing mental activity causes the mental activity to change. + compassion—monitor inner dialogue for signs of a harsh self critic, and when present, kindly take an attitude toward inner monologue that mirrors the gentle nature you would treat another who is suffering.
- The unconditional way we learn in childhood, we pick up rules before we have a chance to question them. We are given rules and facts and names for everything. And so we are led to believe that there’s a single way of viewing things, but then at some point, somebody tells us that there are other people that might have a different view. If you ask someone if there is only one way of looking at things they will say no, there are many ways of looking at things. And yet we go through our lives looking at things in one way. Our brains are extremely social. Areas involved in self-regulation overlap with those involved in interpersonal communication and plasticity How one brain interacts with another has important effects on how the brain functions: Social interactions are one of the most powerful forms of experience that help shape how the brain gives rise to the mind. “Human connections shape neural connections” Repeated Activation Creates, Strengthens and Maintains Connections: “Neurons which FIRE together WIRE together” Bottom up vs top down information
- Anxiety and depression
- Become aware of your mental activity: Get curious about your perspective—what is this I am feeling? What happened? What was the situation that caused me to feel this way? What was the trigger in the situation? What am I thinking? How am I feeling in relation to what I am thinking? Is what I am thinking accurate? Am I seeing things as they are or as I am? Thinking fast and slow Emotionally charged memory is stickier Memory is stored as generalizations Memories co-activate Have to interrupt the pattern, but first have to become aware of it
- Functions of prefrontal cortex: Body regulation: Sympathetic NS is like Gas while parasympathetic ns is like break. You need both to drive smootly attuned communication: Take in and send information so we resonate and are in tune with each other. Leaving someone feeling felt. Emotional balance: Generate affective states of being. Somatic (body) states interact with limbic states and brainstem states. Allows affective states to become aroused so life has meaning but not too aroused so life becomes chaotic and not too shut down so life becomes rigid. Regulation = monitor + influence Response flexibility: Consider all options before action. What is the most adaptive– the middle prefrontal cortex is the space between impulse and action. Empathy: Conscious awareness and sensitivity to the mind of someone else (mindsight). It is the putting of oneself in someone elses shoes. Having compassion and seeing other points of view. Insight: Mental time travel—the integration of past, present and future knowledge and awareness. Fear modulation: Fear can be modulated or extinguished from the mPFC by neurons that enervate the limbic structures that register threat and opportunity. Intuition: Bottom up communication making it’s way to the rational prefrontal cortex. Gut feeling. Morality Ability to think of the larger social good and enact those behaviors, even when alone.
- Place one hand on belly and one hand on heart Breathe into abdomen feeling it rise first and chest rise second This regulates sympathetic nervous system that causes fight, flight, freeze response When you notice yourself feeling stressed or experiencing a difficult emotion it is helpful to label the thought or emotion. Say to yourself worried thought, planning thought Or I am feeling angry, afraid, confused, shame, despair right now. Witnessing and labeling the content of your mental activity causes the mental activity to change. It shifts the seat of perception from the subjective self experiencing the emotion to the objective self observing your experience. As you name the thought or emotion speak to yourself in a gentle, understanding voice, as if validating for a friend what he or she is feeling “that’s grief” or “that’s longing” Don’t try to change the feeling but just sit with it in a tender way, like you would a small child struggling Tame the harsh inner critic with self-compassion Reframe/reorient Have empathy and compassion with self. Forgive, accept and don’t judge as necessary. How else can I see this situation? What is a silver lining in this negative situation? What learning can I be grateful for? Why doesn’t my typical habituated pattern of behavior work? Choose differently What is rational way of relating to this state of being? Use mindfulness to deconstruct the argument. Plan for reaction as it arises What is hopeful outcome of this situation Change element in environment causing trigger? Can I change anything I don’t like about my environment? Habituate behavior change
- Mechanism of mindfulness: What mindfulness allows you to do:
- You can’t really make a decision that you’re going to be present what does that mean? When people meditate there’s an assumption that over time that will put them into the present. But if you’re actively noticing things—so, you’re going to home tonight and if you live with someone, notice five new things about that person. That person will start to come alive for you. And that facilitates relationship. Become familiar with the body to strengthen and stabilize the mind. How do I habitually react to stress?
- Cancer Survivor Mindfulness Influences Health Characteristics of Primary Support Person Examine psycho-social health symptoms of cancer survivors and their primary social support person (PSSP) 409 Hispanic survivors with CRC diagnosis Assessed perceived stress, dispositional mindfulness and other health-related behaviors In both survivors and PSSP mindfulness negatively associated with stress and poor health habits (smoking, drinking, etc.) In survivor arm inverse association between mindfulness and fatigue that was mediated partially by reduced stress The greater the level of survivor’s mindfulness the lower the level of stress the PSSP conveyed Despite findings that mindfulness has a role in the health of survivors and PSSPs only a small portion of patients reported using mind-body interventions. UCLA Study Mindfulness Practice Reduces Cortisol Blunting During Chemotherapy: A Randomized Controlled Study of Colorectal Cancer Patients Randomized to mindfulness, attention-control, or resting exposure meditation practice during 1 session of chemotherapy Tested acute salivary cortisol response as a marker of neuroendocrine system activity at 20 minute intervals Collected self-reporting assessments on distress, fatigue and mindfulness after conclusion of chemotherapy Findings suggest that mindfulness practice during chemotherapy can reduce the blunting of neuroendocrine profiles typically observed in cancer patients. Mindfulness and Disgust in Colorectal Cancer Scenarios: Non-judging and Non-reacting Components Predict Avoidance When it Makes Sense Mindfulness facilitates greater tolerance of unpleasant emotion and may thus promote better decision making in health settings where emotional avoidance is common. Looked at dispositional mindfulness to predict elicited disgust and avoidance behaviors in scenarios based around CRC screening and Treatment. Randomized 80 volunteers were randomized by gender to disgust or control conditions before completing task assessing immediate avoidance of a disgust elicitor (stoma bag) and anticipated avoidance of a hypothetical CRC drug with disgusting side effects. Those with greater non-judging mindfulness were less disgusted than people with lower mindfulness. when disgusted mindfulness predicted greater anticipated avoidance—those high In the non react facet were more likely to anticipate avoidance of the disgusted drug and immediately avoid touching the stoma bag. Results suggest persons with low mindfulness may fail to attend to emotional experience when making decisions while those higher in non-react and non-judge components may use their disgust to inform both current and future behavior. Mindfulness training may promote more integrated decision-making skills in CRC contexts where disgust is a factor. Cancer-related cognitive impairment (CRCI) is a common, fatigue-related symptom that disrupts cancer survivors' quality of life. Few interventions for CRCI exist. As part of a randomized pilot study targeting cancer-related fatigue, the effects of mindfulness-based stress reduction (MBSR) on survivors' cognitive outcomes were investigated. Up until recently, understanding the impact of a cancer diagnosis on the survivors’ surrounding social networks and PSSP had yet to receive the attention it deserved.
- Intentionally focusing attention with a certain set of attitudes pay attention to one’s internal and external moment to moment experience. suspending interpretation, and attending to the experience itself as it presents in the here and now. Feels like awareness of awareness itself Differentiating sensory awareness from observing/narrating awareness Mindfulness Practice in Colorectal Cancer Patients: Decreases anxiety, depression, stress, mal-adaptive behavior, shame, poor body image Increases happiness, satisfaction, gratitude, optimism, appreciation of body Greater coping, resilience, adaption Partners rate them as more giving, understanding, better communication Intervention can decrease in depression, anxiety, stress, and emotional avoidance
- Each one relies on influences the others. Working on one will lead you to others. Constitute strong foundation The attitudes should be introduced before encountering the techniques themselves. Becoming familiar with the attitudes will allow you to identify and utilize them formally and informally. Nonjudgment: awareness of the constant stream of judging and reacting to inner and outer experiences that we normally get caught up in. if we pay attention to the activity of our mind we are often surprised to discover that we are constantly generating judgments about our experience. The mind labels and categorizes almost everything, and we react in terms of what we think the value to us is. To more effectively handle stress we first must be aware of the automatic judgments we so we can see clearly through our prejudices and fears. Don’t stomp the mind from judging; just be aware that it is happening. No need to judge the judging and make it even more complicated. Patience:
- Make contact with the sensations as they arise in your body. If you’re having difficulty finding the right words, imagine that a dear friend or loved on e is having the same problem as you. What would you say to this person? If your friend would leave with just a few words in mind, what would you like those words to be? what words would you like to deliver, heart to heart? Now see if you can offer the same message to yourself.
- When we allow ourselves to be with what is we have the power to change. Resistance is futile
- Self Compassion Test: https://centerformsc.org/learn-msc/take-the-self-compassion-test/