Benefits of Stress Reduction – October 2017 Webinar
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Transcript of Benefits of Stress Reduction – October 2017 Webinar
Benefits of Stress Reduction
Our webinar will begin shortly.
• Speaker: Andrea Lee, BSN, RN
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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
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
The Benefits of Being Present
Role of Mindfulness in Managing Cancer-Related Stress
Andrea Lee, BSN, RN [email protected]
• 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
The Journey by Mary Oliver
One day you finally knew what you had to do, and beganthough 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 dodetermined to save the only life that you could save.
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
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
Locus of Control
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
Stress and Oncology
Reactive anxiety &
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
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
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
Thinking/Feeling Feedback Loop
Hand Model of the Brain
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)
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
Breaking out of a Thinking/Feeling Loop
• Breathe into the feeling
• Label thought or emotion
• Become aware of mental activity
• Practice self-compassion
• Choose Differently
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
Mindlessness VS Mindfulness
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.
Mindfulness ResearchMindfulness 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
Attitudes of Mindfulness
• Beginners mind • Non-judgment• Acceptance • Non-striving • Letting go/Letting
be• Gratitude• Generosity• Patience • Trust
Suffering = Pain x Resistance
Role of Resistance
• The Fly
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.”
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
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.
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.
• 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/
Resources• Greater Good Science Center:
https://greatergood.berkeley.edu/• Self-Compassion: http://self-
compassion.org/category/exercises/• UCLA Mindful Awareness Research Center
• https://www.mindful.org/• Self Compassion Test:
Question & Answer:
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