CCSN's Remarkable Cancer Survivor's Guide to a Healthy Relationship with Stress

C C S N ’ S R E M A R K A B L E C A N C E R
S U R V I V O R ’ S G U I D E T O
A H E A L T H Y R E L A T I O N S H I P W I T H S T R E S S
W E E K 5 W I T H D R .
N O V E M B E R 1 2 R O B R U T L E D G E

YO U R G OA L S F O R T H I S S E R I E S
•Maximize your chance of recovery
•Feel better emotionally
•Think more clearly and function better
•Connect more deeply
•Grow psychologically / spiritually

W H A T I S C O M P L E T E C A N C E R C A R E ?
( I N T E G R AT I V E O N C O L O G Y )
• Understanding what’s happening to you
• Getting the best from the medical system
• Empowering yourself with healthy lifestyle
- Exercise, diet, sleep, relaxation techniques
• Settling the mind
• Nurturing your spirit

TA K E H O M E P O I N T S
( W H A T R E M A R K A B L E C A N C E R S U R V I V O R S D O )
• Build resilience through self-care and connection
• Reframe stress as enhancing
• You can unleash your healing potential and
profoundly influence your health and happiness

T O DAY ’ S W E B I N A R C O N T E N T
• Stress overview
• How to optimize your brain function
• Settling sudden stress
• Resetting your stress levels
• Reframing stress as enhancing
• Working on core beliefs / source of stress
• Q+A

T H E U P S I D E O F S T R E S S
B Y K E L LY M C G O N I G A L , P H D

Dr. Rick Hanson
Buddha’s Brain and Hardwiring Happiness
8

9
Y O U R B R A I N : A P R O D U C T O F E V O L U T I O N
• ~ 4+ billion years of earth
• 3.5 billion years of life
• 650 million years of multi-celled organisms
• 600 million years of nervous system
• ~ 200 million years of mammals
• ~ 60 million years of primates
• ~ 6 million years ago: last common ancestor with chimpanzees, our closest relative
among the “great apes”
• 2.5 million years of tool-making (starting with brains 1/3 our size)
• ~ 150,000 years of homo sapiens
• ~ 50,000 years of modern humans
• ~ 6000 years of blue, green, hazel eyes
• Living in tribes of 100-150, competing for food, tribal warfare

10
E VO L U T I O N A RY H I S TO RY
The Triune Brain

11
T H R E E M O T I VAT I O N A L A N D
S E L F - R E G U L ATO RY S YS T E M S
• Avoid Harms:
• Predators, natural hazards, aggression, pain
• Primary need, tends to trump all others
• Approach Rewards:
• Food, shelter, mating, pleasure
• Mammals: rich emotions and sustained pursuit
• Attach to Others:
• Bonding, language, empathy, cooperation, love
• Taps older Avoiding and Approaching networks
Each system can draw on the other two for its ends

WHAT IS STRESS?
• A condition in which an individual
perceives the demands of a situation
as exceeding their resources
• Richard Lazarus and Susan Folkman

S T R E S S O R P E R C E P T I O N S T R E S S

M A N Y PAT H W AYS TO S T R E S S ! ! !
• Real threat to your life
• Jumping out of way of a runaway car
• Perceived threat to your life
• Thinking about an upcoming medical visit
• Ego/Social threats
• Argument over who does more housework
• Public speaking (threat of being ostracized)
• Fear of the unknown
• Financial
• Relationships
14

H O W D O YO U E X P E R I E N C E S T R E S S
•What are your triggers ?
•What happens in your body?
•What emotions do you feel?
•What happens to your thinking?
•What thoughts do you have?
• What do you say about yourself?
• How do you label other people/situations?

M I N D F U L N E S S I S F I R S T S T E P
T O D E - S T R E S S I N G
•The earlier you recognize your reaction, the
easier it is to settle it down

T I M E T O D E - S T R E S S
•Press the ‘pause’ button
•Be very curious about the physical sensations
•Four slow breaths into the abdomen
•Longer slower smoother out-breath
•Reassure yourself with wisdom and kindness

P H YS I C A L E F F E C T S O F
LO N G - T E R M S T R E S S
• DELETERIOUS TO ALL ORGAN SYSTEMS
• Diabetes, hypertension, heart disease
• Mutes the normal stress reaction
• Dampens the immune system
• Chronic fatigue syndrome
• Inflammatory disease
• Damage our brain

H O W D O YO U E X P E R I E N C E L O N G
T E R M S T R E S S
•What happens to your body?
•What happens to your thinking?
•What emotions do you feel?

B U I L D I N G Y O U R S T R E S S H A R D I N E S S
•Our brains flip back and forth between being in a
state of irritability/stress vs wise/compassionate
•When your prefrontal lobe is active you’re much
less prone to being triggered, and much quicker to
recover
•Health habits promoting frontal lobe activity?
21

H A N D M O D E L O F B R A I N

E X E R C I S E ! E X E R C I S E ! E X E R C I S E !

L O W G LYC E M I C D I E T /
P L A N T- B A S E D D I E T

P R A C T I C E A R E L A X AT I O N T E C H N I Q U E

S T R E S S V S
P E R F O R M A N C E C U R V E

W H AT ’ S Y O U R
R E L AT I O N S H I P T O W A R D S
S T R E S S ?
A – Stress is toxic and should be avoided, reduced and
managed
• When stressed do you think: “My life is toxic. This is
too much. I’m not doing this right. I’m inadequate.”
B – Stress should be accepted, utilized and embraced
• “My anxiety means that something important is at
stake. Here’s a good opportunity to learn….”
Resilience

R E F R A M I N G S T R E S S
•This mind-set shift could profoundly improve
your health for the rest of your life

D O YO U B E L I E V E S T R E S S I S
H A R M F U L T O YO U R H E A LT H ?
A) Yes
B) No

P E R C E P T I O N O F S T R E S S
P R E D I C T S M O R TA L I T Y
•30,000 Americans followed for 8 years
•30% increased risk death if they felt stressed
•But increased risk only if they felt stress was
harmful to their health

D I D Y O U E X P E R I E N C E A
G R E AT D E A L O F S T R E S S
Y E S T E R D AY ?
• 2006 Gallop poll, 125 000 people
• age15-75 yo, 121 countries
• Stress index= % of people saying yes
• Average 33%, (5-71%), USA = 43%
• Higher stress correlates with
• Well being, life expectancy, health, satisfaction
• GDP, productivity
• Sense of community
Resilience

H I G H L E V E L S O F S T R E S S
A S S O C I AT E D W I T H …
•Angry, depressed, sad, worried
•Joy, love, laughter
•Health, satisfaction
•“I feel my life is meaningful” most
closely associated with feeling
stressed
Resilience

D E F I N I N G S T R E S S
•Stress is what occurs when something
important to you is at stake
•an internal experience
Resilience

C A L M I N G Y O U R S E L F V S E M B R A C I N G
T H E A N X I E T Y
B R O O K E T A L J O U R N A L O F E X P E R I M E N T A L P S Y C H O L O G Y 2 0 1 4
• Study of people about to give a persuasive speech
• Randomized to say
• “I am calm” or “I am excited”
• Those remaining ‘excited’ were more confident,
and rated as more persuasive, confident and
competent
Resilience

R E F R A M I N G S T R E S S
• Social Stress Test
• Eg. Columbia business students giving
persuasive speech
• Reframed ‘stress reaction’ as helpful
• More confident, determined, and excited
• DHEA promotes learning during stressful situations
• Believing stress not harmful opens up heart vessels
• Consistent with feelings of joy or courage

OX Y T O C I N – ‘ C U D D L E H O R M O N E ’
• Oxytocin is released during stress reaction
• Increases empathy and insight
• Drives pro-social behaviour
• Tend and befriend
• Decreases inflammation, opens up heart blood
vessels, promotes regeneration of heart cells
• Take home message – when you’re feeling stressed
tell someone or do something for someone else

B R A I N C H E M I C A L S R E L E A S E D
D U R I N G S T R E S S R E A C T I O N
• Oxytocin – Social caregiving system
• Dopamine – reward system
• Increases optimism, dampens fears
• Primes the brain for physical action (won’t freeze)
• Seritonin – attunement system
• Enhances perception, intuition, self-control
• Understanding what’s needed, biggest impact
39

“ C H A L L E N G E ” P H YS I O L O G Y A N D
P E A K P E R F O R M A N C E
•Still feel stress - AND
•Excited, energized, enthusiastic, confident…
Resilience

O T H E R I N T E R V E N T I O N S T O
R E F R A M E S T R E S S
•“I am calm” vs “I am excited”
•Fixed mindset vs Growth mindset
•Opportunity to grow, learn, become stronger

C O R P O R AT E W O R L D I N T E R V E N T I O N
1 – Acknowledge the stress
• Notice the sensations / thoughts
2 – Welcome the stress
• Something that you care about is at stake
• Why does it matter? What is the priority?
3 – Make use of the energy

R E F R A M I N G D I S T R E S S I N G T H O U G H T S
( T H E S O U R C E O F M O S T S T R E S S )
•Based on Dr. David Byrne’s ‘Feeing Good’
•Cognitive therapy, CBT
•Our thoughts influence our emotions
•Eg. “I’m no good” leads to depression

YO U C A N C H A N G E YO U R
M I N D
• You can change the way you think and
look at things
• You can change your underlying beliefs
and thought patterns
• These will change how you see your self,
your life, others, the world
• This will change how you feel, emotions,
moods, outlook, attitude and productivity

STEP 1
Mindful of
Distressing
Thoughts
STEP 2
Awareness and
Inquiry
1. What emotions
follow from this way of
thinking?
2. How does my body
feel?
3. Is this a helpful or
harmful thought?
4. Exaggerated,
irrational?
STEP 3
Kind & Rational
Response
-Acknowledge the difficulty
with kindness
-Look at the situation from
another perspective
-Encourage yourself: “I can..
Situation:

Mindful of
Distressing
Thoughts
Awareness and
Inquiry
1. What emotions
follow from this way
of thinking?
2. How does my
body feel?
harmful thought?
4. Exaggerated,
irrational?
Kind & Rational
Response
Situation: (person) did (something)

Mindful of
Distressing
Thoughts
(action) is bad.
(person) is bad.
People should
not act this way
Awareness and
Inquiry
Kind & Rational
Response

Mindful of
Distressing
Thoughts
(action) is bad.
(person) is bad.
People should
not act this way
Awareness and
Inquiry
1. What emotions
of thinking?
2. How does my
body feel?
harmful thought?
4. Exaggerated,
irrational?
Kind & Rational
Response

Mindful of
Distressing
Thoughts
(action) is bad.
(person) is bad.
People should
not act this way.
Awareness and
Inquiry
1. What emotions
of thinking?
2. How does my
body feel?
harmful thought?
4. Exaggerated,
irrational?
Kind & Rational
Response
-Acknowledge the
difficulty with
kindness
-Look at the
situation from
another
perspective
-Encourage
yourself: “I can..

Mindful of
Distressing
Thoughts
(action) is bad.
(person) is bad.
People should not
act this way
Awareness and
Inquiry
1. What emotions
of thinking?
2. How does my body
feel?
harmful thought?
4. Exaggerated,
irrational?
Kind & Rational
Response
Ahhh. This is
(disappointing).
- It doesn’t help
to get myself
worked up. They
are doing their
best.
(Compassion for
others). (You act
appropriately).

Mindful of
Distressing
Thoughts
Awareness and
Inquiry
1. What emotions
of thinking?
2. How does my
body feel?
harmful thought?
4. Exaggerated,
irrational?
Kind & Rational
Response
Situation: (Difficult situation eg. cancer diagnosis)

Mindful of
Distressing
Thoughts
This is bad. I
can’t handle this.
Life should not
be this way.
Awareness and
Inquiry
Kind & Rational
Response

Mindful of
Distressing
Thoughts
This is bad. I
Life should not
be this way.
Awareness and
Inquiry
1. What emotions
of thinking?
2. How does my
body feel?
harmful thought?
4. Exaggerated,
irrational?
Kind & Rational
Response

Mindful of
Distressing
Thoughts
This is bad. I
Life should not
be this way.
Awareness and
Inquiry
1. What emotions
of thinking?
2. How does my
body feel?
harmful thought?
4. Exaggerated,
irrational?
Kind & Rational
Response
-Acknowledge the
difficulty with
kindness
-Look at the
situation from
another
perspective
-Encourage
yourself: “I can..

Mindful of
Distressing
Thoughts
This is bad. I
Life should not
be this way.
Awareness and
Inquiry
1. What emotions
of thinking?
2. How does my
body feel?
harmful thought?
4. Exaggerated,
irrational?
Kind & Rational
Response
Ahhh. This is
(stressful). - It
doesn’t help to
get myself
worked up. I
can take action
– and make the
best of it.
Choose love and
connection.

G O O D S T R E S S , B A D S T R E S S ?

S E T T I N G T H E I N T E N T I O N
•In preparation of going into any situation:
•How do you want to be in the world?
•What do you hope of yourself?
•As a ritual, going into difficult situations,
and in the middle of chaos

Q U E S T I O N S ?
Dr. Rob Rutledge, Oncologist
Associate Professor of Medicine
HealingandCancer.org

C A N A D I A N C A N C E R
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