Monday, December 1, 2014

"The power of staying with awful feelings - lessons from my 8-year-old patient" by Dr. Rob Rutledge

Many years ago, as I walked onto the children’s cancer ward, I was taken aback by the scene of a young mother holding her daughter tight to her chest. The mother was sobbing uncontrollably and the little girl was saying softly, “It’s going to be OK, Mommy. It’s going to be OK.”
Tara was 8-years-old and had been trying to comfort her mother during the hours it took them to travel from their First Nations community to the neurosurgery ward.  Unfortunately Tara had an advanced brain tumour which had spread throughout her brain and spine.  I soon found out I would be her Radiation Oncologist.  Meeting Tara officially was no less remarkable than when I saw her from afar on the ward. Looking into her dark brown eyes for the first time, I felt the world fall away and time being held completely still. My mind seemed to expand with a sense of peace and joy. 
Kids getting radiotherapy for this type of cancer need to lay face down in a mask alone in the radiation room for about twenty minutes daily for six weeks. We bribe them with toys from the ‘Tickle Trunk’ to help encourage them to stay completely still.  However, Tara was not interested in receiving toys. Instead, she regularly went shopping for gifts to give to the Radiation Therapists. At Walmart she had created a picture of herself in a wedding gown to give to the staff. Her smile was beautiful, a white veil framing her dark hair. My heart ached when I saw that picture – her chances of living to adulthood were so slim.
On the last day of radiotherapy we give the kids a certificate signed by their treatment team to celebrate their bravery. However, Tara seemed more excited to give me a gift instead. She presented me with a dream-catcher (a web-shaped lattice garnered with a feather that, according to native tradition, wards off the bad dreams and helps us remember the good).  I was so touched by  this gift the tears welled up in my eyes.  How can an 8-year-old know that I watch my dreams closely – listening for messages from God to guide me on my path.   
I continued to see Tara in follow-up – and I was not happy. I had chosen a dose of radiation that was too high which caused her more than expected side effects. She was struggling in school, and I felt she had lost her shine. But Tara and her mother seemed happy in their lives. The time was rolling on and Tara had gotten through the first four years of follow up when these tumours are mostly likely to come back.  Tara’s Mom smiled more and more with each visit.
Tara suddenly died. We were all crushed.
We began to question why she died. I believe she had had an uncontrolled seizure caused by radiation scarring. An autopsy was planned and I was invited to attend. I knew from deep within my soul that I would not  walk away from the pain of this experience. A few days later I held Tara’s brain in my hands.  It was the strangest experience. But there was no reconciliation. No brilliant reflections. No moment of meaning. Just one big ‘DON’T UNDERSTAND’.
I have learned a lot about the power of staying with the difficult emotions since Tara died. I knew I could grow and heal by staying open when I was feeling most vulnerable. I remember standing outside the door of a young mother whose tumour had just come back in her brain. As I reached for the doorknob I didn’t know what words I would use to tell her this terrible news. I was scared and upset by how it might go. But I knew again, I would not run away. I would be completely present to her and the awful feelings coming up in my gut.
As the years go by and I continue to stay with my anxiety it seems that the awareness I bring to the act of breaking bad news has grown. I believe I create a space of peace and connection that people can palpate at some level even if they completely break down.  In those times we are sharing life’s wholeness – we can hold both the terrible implications of the news and the preciousness of the moment. The person in front of me seems to sense that I’m not scared of dying or being with people who are going to die, and it gives them permission to enjoy their lives now. 
My understanding of the healing process and the power of staying with our difficult emotions has evolved over the years.  I work with a brilliant Mindfulness Teacher, Dr. Timothy Walker, in offering weekend retreats for people affected by cancer.  Tim describes certain types of emotional pain as a knot or an entanglement of psychic energy.  The steps to transforming the energy is to first recognize when it comes up as a physical or emotional sensation – then to simply stay with those feelings (and to temporarily drop any storyline we are telling ourselves about what is happening).  When we stay present it seems the emotional tangles begin to unravel by some unknown process, and the blockage can be released. When I practice this technique in daily life I feel more alive, like the stuck energy has been liberated to help me be present to the next person I will see. 
Part of the ‘work’ of spiritual growth is to look more carefully at the storylines and assumptions that cause our distress. For instance, I had to clearly question why I felt so awful breaking bad news.  The thought “this shouldn’t happen to young mothers” was changed to “this is happening now - how do I want to respond?”  and “how can I bring love into this terrible situation?” 
I also found that seeing a therapist was invaluable in transforming feelings and issues I couldn’t figure out on my own or that were just too overwhelming to contemplate (like the fear of death). The feeling of not being good enough is not so dominant in my life because I worked with a therapist, and I have learned to reframe immature core beliefs.
Remarkably the process of staying with the difficult feelings somehow facilitates conscious understanding.  It seems to me there is something within us that wants us to grow and heal.  When we sit with our pain, and allow the emotions to shift and change, the miracle of new insights seems to be released from within.
Tara’s dreamcatcher hangs on my office wall.  And on the days when I’m feeling like I want to run away from my awful feelings, it seems to whisper to me “Stay. Simply stay”.


Friday, November 14, 2014

Empowerment Essential #4: Improving Brain Function

In 20 years working as an oncologist and running cancer support groups, I have learned that most people who have been given a cancer diagnosis wish for two main things:
1.     They want to be cured of their cancer (or they want to live for many, many  years with a great quality of life), and
2.     They want to feel better. They want the awful feelings of stress and fear to settle down so they can enjoy their lives.

I am heartened and grateful for many wonderful not-for-profit organizations who support thousands of people in achieving their goals by providing them with the information and teaching them crucial life skills for the cancer journey. The first three of these “Empowerment Essentials” are

#1 – Getting the best care from the medical system
#2 – Empowering your body with loving habits like exercise and diet.
#3 – Working with difficult feelings, settling stress levels and reframing distressing thoughts

Information is power

When I first began my practice in the mid-1990s my cancer patients often shook with nervousness the first time they met me.  These days those who are recently diagnosed often nod at me as I explain their diagnosis and treatment – because they understand what is happening, often with access to great people and resources that support them in their journey.  

I’ve noticed the second wave of empowerment over the last decade. People hear the message about exercise and healthy diet through multiple media before they get to me. It makes me smile because in most cases it will increase their chance of cure and longevity - and they will feel better when they make these loving lifestyle choices.

A new goal: Improving brain function

Though my patients going through treatment have identified “brain fog” (problems with memory and concentration) as a major issue for as long as I’ve been practicing, more recently people on the cancer journey have started asking for help.  So I am now hearing another goal: “I just want to be able to think clearly again”.

Fortunately, we’re in the midst of another revolution in empowerment based on neuroscience and scientifically-proven techniques which help people think and function more effectively.  Your brain will continue to change and set down new neural connections throughout your lifetime.  You can actually choose which brain pathways (feelings and abilities) you want to nurture.  My hope in writing this article is to offer some practical advice using a few techniques that can help your brain function much better.

I’ve referred to the first three Empowerment Essentials above because you’ll need to draw on these same skills to maximize how well your brain works. Here are some specifics for brain care:

1.     Getting the best care from the medical system includes drawing on the expertise of different specialists.  Ask your oncologist or nurse directly “Is there someone in the medical system who can help me learn some ways to think more clearly?” Or if you’re suffering from excessive fatigue ask if someone can help you with ways to manage your energy levels.  Perhaps an Occupational therapist or Physiotherapist could help you problem-solve ways to manage tasks and fatigue. They may also teach your exercises to increase your physical stamina.
2.     Talk to your family doctor about any issues relating to changes in your thinking/memory.  There are many possible correctable causes to symptoms of fatigue and fuzzy thinking. 
3.     See a nutritionist! They can assess if you’re getting enough of your B-vitamins (key chemicals used by the brain) or whether you need to take a multi-vitamin. Science is also showing that flavenoids (found in berries and other foods) can sometimes help clear the ‘foggy feeling’.
4.     Loving your body through exercise is absolutely critical to improving brain function.   During a moderate 30 minute workout a hormone in your brain called Brain-Derived Neurotrophic Factor is released which primes the brain to learn and remember better afterwards. It also appears weight training is a key component to increasing brain blood flow and overall function.  One of my 79-year-old prostate cancer patients, who was still running a flower business when he began hormone treatment, started pumping iron with a much younger group. He noticed that on the days he worked out, he was mentally much crisper at work – like he was able to push oxygen up into his brain. 
5.     Decreasing stress and anxiety is key to maximum mental performance. Working with an expert like a psychologist or taking a course like mindfulness-based stress reduction will prime your brain to use the higher level thinking, and bypass the primitive stress-brain pathways.  When our stress levels are lower, we actually grow new brain cells in the hippocampus which is the part of the brain responsible for creating new memories.

Meditation is the new ‘Exercise’

Practicing meditation or some other relaxation technique in which you work to slow down some of the mental chatter is a critical skill in improving your brain function.  A daily practice resets our baseline stress level (what I call our stress-o-meter) to a lower level.  Our brains are better able to focus on what is in front of us when we practice meditation.  Even in this moment your brain is simultaneously processing more than a dozen inputs (sights, sounds, feelings in your body, thoughts…). When the stress-o-meter is on low, it’s as if the dials from all these inputs is set at a lower level – which allows you to focus more easily on the one thing you rest your attention on.

The power of “Taking in the Good”

Dr. Rick Hanson, author of Buddha’s Brain and Hardwiring Happiness, points to our evolutionary biology to explain the ‘negativity bias’. We are primed to learn from and remember negative experiences while the positive states (peace, confidence, gratitude) usually bypass our memory systems. We ruminate on our difficulties and forget to allow ourselves to experience the good.  Learning the skill of “taking in the good” is very important for two reasons. Firstly, we can train our brains to experience more of the positive emotions and we’ll feel better.  Secondly, when feel happier our brains also function better – we literally see much more of what’s happening around us, and our inherent creativity is primed to go.

The simplest explanation of how to ‘Take in the Good’ is to stay with positive feelings when they arise in your attention for at 10-20 seconds at least six times a day. For example, if you notice a feeling of gratitude (“oh, I love my grandchild so much”) then stay with the heart-felt feeling.  Let it sink into your psyche and spirit.  Hold it there and let your body absorb that wonderful feeling for at least a dozen seconds. You are literally setting down new connections in your brain that will make it easier to re-experience those same feelings the next time you are primed to feel grateful. 

You can also practice this technique by generating the emotional state without the external cue.  As an example when you write down simple things (seeing sunshine, or sipping a hot cup of tea on a cold morning) in a gratitude journal every night for a few weeks, your perception of the world will change – you will be more grateful – and your brain will work better.

Neuroscience is a burgeoning field and new information is constantly arising to help you become an expert in your own brain care. Learn and practice the techniques and habits that make most sense to you.  Your brain will continue to grow and change with time – and you can make a huge difference in how you think and function. That’s one fact worth remembering.


Monday, November 3, 2014

Connect with the spiritual aspects of our lives.........


Given on the Sunday morning of a weekend retreat, Drs. Rob Rutledge and Timothy Walker offer ways to connect with the spiritual aspects of our lives in the midst of the often chaotic psychological turbulence of living with a cancer diagnosis.














Tuesday, October 14, 2014

Healing and Cancer - Stories of Empowerment

Dr. Rob Rutledge, MD, Oncologist and Associate Professor, tells the stories of ordinary yet remarkable people affected by cancer, and how they were able to empower themselves at levels of body, mind and spirit on the cancer journey.

https://www.youtube.com/watch?v=NZMr1u84dIA

Tuesday, October 7, 2014

Reverse Vegas, the Pastor, and the Miracle Man
by Dr. Rob Rutledge

When my boss asked me to give a talk at an African-Canadian prostate cancer support group he has organized here in Halifax, little did I know what great pleasure was in store for me.

Rocco Rossi, President of Prostate Cancer Canada, was in attendance that evening, and addressed this lively group of about twenty men in a modest community hall before I gave my talk. Rocco began by describing how he became connected to the prostate cancer world. His uncle at age 53 was diagnosed with an aggressive cancer and later died. This uncle was a ‘man’s man’ – never sharing what was really going on inside, keeping his problems to himself, never reaching out for help. Rocco lamented this as an opportunity lost – men affected by prostate cancer can raise awareness, urge their family and friends to get a screening PSA blood test, and be open about their feelings with their loved ones. He finished in a rousing plea that a prostate cancer support group should be a ‘Reverse Vegas’: while respecting confidentiality of individuals ‘what happens in a prostate cancer support group doesn’t stay in the prostate cancer support group.’

It was heartening for me to hear the message I’ve been sharing with diverse audiences for years. Being open and honest about our emotions is healthy. It connects us deeply with our loved ones. It normalizes the fact that we all can suffer with difficult emotions throughout our lifetimes – and that mental health issues are expectation not a weakness. Rocco confirmed it takes courage and strength to be open with others which ultimately is healing for everyone.

The next person to speak was the Pastor of the local church who was asked to say a prayer before my talk.  Rev. Dr. Lennett J. Anderson is not a big man but his smile lights up the entire room. Here is a man of God who embodies the living spirit. In his prayer, his enthusiasm for life resonates through his voice, taking us into a deep and joyous place. In unison, the group finishes with a heart-felt ‘Amen’.

I can’t stop thinking about the Pastor since hearing him speak. How is it that he lives in this state of joy and peace? The principles neuroplasticity dictate that the way we view the world gets hardwired into our brains. Rev. Lennett has lived a life so full of love and gratitude for the world and everyone in it that the neural pathways to experiencing spirit are deeply engrained while the pathways to the negative emotions have withered away. And yet I feel there is something much more mysterious here. His presence is other worldly, and yet familiar, somehow pointing me to recognize something in myself.
The eyes of the group come to rest on me.  My talk outlines the basics of prostate cancer, screening and treatment. I focus on how prostate cancer cells are usually very slow growing, and how men can potentially influence the growth rates of cancer cells through healthy habits like exercise, low fat diets high in fruits and vegetables with Vitamin D, maintaining a reasonable weight and so on. The talk gets interactive very quickly. Lots of chatter. Guys asking about erectile function and their PSA results. PCC President Rocco chimes in with reflections like "the worst cause of ED is death.  No blue pill after that.  We keep you alive and you have options!" Hoots and lots of joking.

After the talk, my boss introduces me to one of the men: his “Miracle” patient. He is a hefty fellow with a twinkle in his eye and an infectious smile who had told the group he has had cancer three times.  My boss clarifies his story: his lung cancer had spread to the bone, a situation that his physician deem incurable. In seventeen years of practice this man’s medical oncologist has never seen another case of someone alive and without evidence of cancer so many years after chemotherapy. I shake this man’s hand and quip “You can’t trust those doctors, they’re about as good as the weatherman”.


Miracles happen.  You’re not a statistic, you’re a person. You can always do better than the average. And you never know the blessings life will show you in the most humble of places.

Monday, October 6, 2014

Aim for FAME

Flo is a registered Psychologist and Cancer survivor who has attened two 'Skills for Healng' Weekend retreats. She reflects on the overlap between the free program she has designed (with fellow experts) called cancerplan4life.com and our teachings at HealingandCancer.org

http://www.youtube.com/watch?v=QNV1Eeg6BAE&feature=youtu.be

Friday, October 3, 2014

Holding painful emotions: Not too close, not too far, just right
by Dr. Rob Rutledge.

Dr. Russ Harris, an Australian family physician, psychotherapist and best-selling author teaches that painful emotions are a natural part of life. Whenever there is a gap between what we are expecting (or hoping for) and the reality of the situation, difficult feelings like disappointment, frustration and grief tend to follow. For people first diagnosed with cancer this ‘reality gap’ can be especially painful as everything in life can feel as though it’s been completely shattered. Add the fear of dying to the mix and we can end up experiencing one difficult emotion after another.
Dr. Harris uses the following demonstration to illustrate how we can work with these painful emotions so we can enjoy our lives more and feel better. Imagine writing down all your most painful emotions on a piece of paper. These could include fear, anger, despair, or feelings of being inadequate or completely isolated, and so on. Then imagine that within the room surrounding you are all the things that make your life rich, full and meaningful. You could visualize your loved ones standing around smiling at you. You could imagine other positive aspects of your life you’re grateful for like your passions, hobbies, friends, work, sense of a higher spirituality surrounding you.
Grab onto that piece of paper with the painful emotions and bring it right up to your face so it’s touching your nose.  Dr. Harris describes this action as being fused with your difficult emotions such that you cannot ‘see’ anything else.  With our emotions in our face we would act out or act on whatever difficult feelings arose in the moment.  We’d be angry at the world, blaming others, the medical system, God, and everything else for our problems.  Fusing with our painful emotions would dominate our reaction to family members, adding negativity to exchanges. Alternatively, we would withdraw from connecting with others because of self-pity and depression. When the piece of paper is masking our eyes we can get so absorbed or overwhelmed by the painful emotions that we get separated from the people that we love and things that give us joy.
Next, grab onto your ‘painful emotions’ paper with two hands and push it away as far as possible from you. Stretch out your arms so hard that your shoulders feel like they could pop out of their sockets. Hold those difficult emotions there for a long time and see what you feel. This is called distancing ourselves from our emotions or sometimes ‘suppressing’, pushing them away because we don’t want to deal with what’s come up. We might try to numb the pain with drugs/alcohol or distract ourselves with in incessant activity. Twisting our face away from our painful sheet is uncomfortable and takes lots of energy. However, most of us are very good at it because that’s what we’ve been taught do from a young age.  We hear these ongoing messages from parents and so many others: Don’t feel angry! Don’t feel sad! (Granny is going to Heaven, no need to cry about her). Don’t be excited! (Children should be seen not heard). Essentially we’re taught not to feel. Add the pop culture advice “You have to stay positive if you have a cancer diagnosis” and you have a recipe for numbing all our feelings – good and bad.
Instead, the wise approach is to drop our hands and lay our paper of painful emotions on our lap. From this position we can begin to truly appreciate all the things surrounding us that give us joy and meaning.  Our painful emotions are still there – but we don’t need to let them dominate our thoughts and actions, nor spend our energy trying to push them away. Our emotions (painful and positive) are our life energy, and we can let them flow through us. We can honour them for stretching our hearts - allowing us to appreciate the beauty of life as it is here right now.


Learn more about Dr. Harris’ work at www.actmindfully.com.au

Friday, September 26, 2014

Caregiving Goes Both Ways

RobRutledgeby Dr. Rob Rutledge, MD, FRCPC

Many years ago, I sat at the bedside of a woman who had recently been diagnosed with cancer. She was a lively spirit and was recovering nicely from her operation. At the end of the conversation she looked at me intensely and said, “Whatever you do – don’t tell my husband I have cancer.”  As a young physician I did not have the experience to explore why she felt this way.
As I was walking off the cancer ward, I was beckoned by a man who introduced himself as the husband of my patient.  He pulled me into a side room and the first thing he said to me was, “Whatever you do – don’t tell my wife she has cancer.”

What’s going on here? This is an extreme example of two people trying to protect their loved ones – and the truth is almost everyone does this to some degree.  It comes from a deep place of love. Whether it’s the person with the diagnosis or the family members / friend, the reasoning goes something like “She/he shouldn’t have to deal with me looking so stressed or hurt – having cancer is hard enough without having to take care of me.”  The problem is this ‘spare-my-partner-from-my-emotions’ strategy just doesn’t work.

Putting on the mask of positivity in front of our loved one causes a chiasm in the relationship. Firstly, people who know us well can see right through the mask. Not only are we not ‘protecting’ them from our natural emotions, the meta-message we’re sending them is “I can’t cope with this situation.  Let’s just try to remain positive and make out as best we can.” A conspiracy of silence develops and both parties end up feeling isolated. The real opportunity for mutual support and coming together as a couple (or as family members / friends) is lost. There is a much better way.

During our ‘Skills for Healing’ weekend retreats Dr. Timothy Walker, a psychotherapist and brilliant teacher, and I teach people mindfulness-based cognitive therapy – also called ‘reframing distressing thoughts’.  The technique is based on Dr. David Byrne’s classic self-help book “Feeling Good”.  Cognitive science has proven that our thoughts are the source of our emotions, and if our thoughts are irrational or exaggerated they can cause us unnecessary emotional suffering. For instance if we think “I’m no good” we can easily become depressed.

Tim and I take the weekend attendees through reframing the following thought: “I have to be the strong one. Can’t let him/ her know how I really feel. If I fall apart, that will make it worse for him/ her.”  Though we introduce this thought as originating from the family member/friend, it could as easily be the thought of the person with the cancer diagnosis.

The steps in reframing this distressing thought are as follows.
1.)  The first step is to be able to recognize our distressing thoughts.  This example “I have to be the strong one. Can’t let him/her know how I really feel…” is trickier than most exaggerated thoughts because the thinker may truly believe this is the best way to approach the situation. They may never question that their approach is actually causing everyone to feel worse.
2.)  The second step is to look at the thought with a rationale perspective using the following questions:
a)  What emotions follow from this way of thinking?  In this example of having to be the strong one, the emotional fallout can be varied. Most people feel isolated and lonely.  Others can feel a sense of resentment.  Generally there is an internal feeling of conflict and stress when people think this way.
b)  How does my body feel when I have this thought?  The feelings of isolation can manifest as depressive symptoms (eg. lack of energy). While resentment and stress manifests in the body in many ways.  (headache, acidy stomach, insomnia…..)
c)  Is this a helpful/ harmful thought?  As soon as people acknowledge that creating a separation in the relationship is hurtful they will agree that this is a harmful way of thinking – they are then primed for ‘reframing’.
d)  Is the thought exaggerated or irrational? This part of the exercise is done as if a lawyer were making a case against this way of thinking.  Some of the reasoning surrounding the thought may be good but the lawyer’s job is to point out the flaws. Take the phrase “I have to be the strong one”.  That sounds fixed as if one has to be the strong one 100% of the time. And the statement “If I fall apart, that will make it worse for him/ her” is a major assumption. The truth is we don’t know how our loved ones will react when we express our vulnerability. The roles of ‘caregiver’ and the ‘cancer patient’ evaporate when the person who has the cancer diagnosis is listening to (caring for) the caregiver expressing their emotional truth. The relationship can become much closer when ‘care’ flows in both directions.
3.)  The third step of reframing requires both kindness and wisdom. It’s as if your wise grandmother or a compassionate friend were offering you advice. Reframing starts with an acknowledgment of how difficult the situation is. You could say to yourself :  “This is tough. I have a lot of love for my partner/friend.  It’s awful to see them suffer….”  Add the wisdom garnered from step 2. For example you could reframe by thinking: “It’s best to be honest with each other about feelings. It creates more intimacy, and is truly supportive.”  Add something about possibility and how we can empower each other: “Maybe consoling me will make her/him feel better.”

Some extra advice:  There are times when you as the family member will decide to withhold some of your grief or distress because it won’t be helpful at that moment.  At minimum I’d recommend you ‘repair’ your distancing by saying something at a later time to your loved one such as “Last week I was feeling really badly when such and such was happening”.  Your loved one will probably say they knew you were hurting – and it will be a good opportunity for you both to discuss what was so upsetting about the situation.

I also recommend that family members / friends have at least one other person in their life with whom they can be totally open and honest.  Connecting deeply with others is healing and will allow you to tap into your natural resilience and strength.

Studies show family members suffer as much distress as those with the diagnosis.  It’s tough work but made much easier when we open to our loved ones and allow them to support us on our journey together.



Dr. Rob Rutledge is a Radiation Oncologist in Halifax, Nova Scotia, specializing in breast, prostate and pediatric cancers. He is also an Associate Professor in the Faculty of Medicine at Dalhousie University.
In 1999, Rob co-created the ‘Skills for Healing’ Cancer Weekend Retreats. These weekend support groups teach a powerful and integrated approach to the cancer diagnosis and ways to heal at levels of body, mind and spirit. To date, more than 1,600 people have attended the retreats in over 20 cities across Canada and abroad. 
Rob also leads the Healing and Cancer Foundation, a Registered Charity, that freely offers educational videos, documentaries, and webcasting seminars – and he is co-author of a book called The Healing Circle, which captures the teachings and inspirational stories from the weekend retreats.
In 2010, Rob received Cancer Care Nova Scotia’s Award for Excellence in Patient Care and, in 2006 Doctors Nova Scotia presented him with the Health Promotion Award in recognition of his contribution to physician health and health promotion in cancer patients.

Thursday, September 25, 2014

'Staying real and staying positive' by Flo Stang.

Flo joined us at the "Skills for Healing" Weekend Retreat at Brigadoon Village in Spring of 2012. You will enjoy reading Flo's beautifully honest and humorous post Perk # 81: My First Breast Cancer Retreat from her blog - The Perks Of Having Cancer: Follow Florence's Challenge To Find 100 Perks Of Having Cancer. 



Brigadoon Village (as magical a place as it sounds)
On Friday, April 13th, Shawn and I traveled to Nova Scotia to attend the “Skills For Healing” breast cancer weekend retreat.   I was rather quiet on the drive, which prompted Shawn to ask, “Is everything okay?”   Suddenly an image came to mind of a plane landing, and a voice in my head said, “Ladies and Gentlemen we are making our final descent into the land of breast cancer.”   It was sort of like the feeling I got the first time I went to the cancer clinic.  Although I had been diagnosed for many months, there was a surreal quality about actually being there.  My mind was telling me, “You know Flo, you must really have breast cancer if you are sitting in a cancer clinic.”   But this time the voice said, “You know Flo, you must really be a breast cancer survivor if you are going to one of those retreats.”
Attending this retreat has been one of the most healing parts of my cancer journey (as well as one of the perks of having cancer!).  The wonderful facilitators, Dr. Rob Rutledge, and Dr. Timothy Walker (http://healingandcancer.org/)  simply exuded love and compassion as they taught skills such as meditation, yoga, how to re-frame our thoughts, and how to honour our bodies.  For me, these concepts were not new, and while it was a good opportunity for me to brush up on my existing skills, the real healing came from being part of the group: the healing circle.
While I have many “cyber-friends”  who share my diagnosis, this was the first time I was actually in a room full of women on various stages of their breast cancer journey.  It was so liberating to just be able to take off my wig and not worry about the shock value of others seeing me that way.  For the first time, having breast cancer did not make me different.  I was among kindred spirits.  Not only was I able to take off my hair, but I also took off my “Super Cancer Hero” cape and spilled my guts about my deepest fears and anxieties.   I cried.  Not one of those movie star cries, where a few tears creep down the cheek without ever disturbing the make-up.  No, this was more of a wounded animal howl accompanied by lots of snot and mascara-stained tears.  Oh, but it felt so good to open that floodgate!
I realized that I have been so intent on maintaining a positive attitude, that I have suppressed many of my “negative” emotions.  On this retreat I discovered that when it comes to feelings, it does not have to be one or the other.   In other words, allowing myself to feel anger, sadness and fear does not diminish my positive attitude.  As one lady said, “It is possible to experience joy amid suffering.”
I learned so much from this group of women, and I will carry their stories in my heart forever.  I have permission to share one of these stories with you.  Jody Cook is a 35 year old Paramedic from Bridgewater, Nova Scotia.  The first time I saw Jody, I was mesmerized by her presence.  She has one of those smiles that just lights up a room and you can’t help but to smile back.  Her sparkling eyes hinted at a mischievous spirit, which even her recent chemo could not dim.
Jody is the single mom to 9 year old Olivia and 12 year old Rodney (she is also the owner of a deaf horse, which Shawn feels I should mention).   In February, Jody underwent a double mastectomy.  That did not make her any different from many of the other women at our retreat.  What did make her stand out however, is how she carried this new body of hers.   Man, she rocked the survivor look!    Seeing Jody, so confident and comfortable with her flat chest made me feel kind of sheepish about the wad of cotton batting that I had stuffed into the left side of my bra.  Rather than lament about the loss of her hair, Jody saw it as an opportunity to experiment with different hair colors and styles.  However, she was just as comfortable going bald.  What most impressed me about this beautiful woman was her incredible openness and honesty.   In a group discussion about stress, most of us were willing to open up a little and show our human side.  Jody told this story: “One day I was feeling really tired and stressed and the kids were just driving me nuts.  I got so frustrated I turned to them and yelled: WOULD THE BOTH OF YOU JUST F**K RIGHT OFF NOW!”  The group erupted in laughter.  That story opened the space for all of us to be honest and show our vulnerable side.  Thanks Jody!
Dark haired Jody
Blonde Jody
Medium-brown haired Jody
Tip: Allowing yourself to feel anger, sadness, fear and other “healing feelings”  does not diminish your positive attitude.

Saturday, August 30, 2014

How empowering your brain can empower your life along the cancer journey. At talk presented at InspireHealth.

InspireHealth is a world-class integrative cancer centre. The government of British Columbia funds medical physicians and complementary practitioners to provide individualized counselling and services for people diagnosed with cancer. They do research on complementary techniques, and publish a monthly research update written for the lay public. They have a great website InspireHealth.ca and offer webcasts and other services for free.

I love presenting at InspireHealth because the people who attend the talks really 'get it'. They've done enough groundwork along the self-empowerment path that I can take them to the deeper levels of acceptance, peace and love.

I was quite excited giving this talk because I could include the recent brain science I had been studying.  Here it is, enjoy: https://www.youtube.com/watch?v=Hf08wyeB7UI&list=UUJ2xpeSPwmrloNTGynL240A

Wednesday, August 20, 2014

"Take a deep breath … but not too deep" by Dr. Rob Rutledge

Take a deep breath … but not too deep

The room fell silent. We each slowly breathed in and out, being very curious about the sensations of a simple breath. I could feel my body relaxing more and more with each breath.  I looked up at the middle-aged woman and her daughter. Their eyes were closed, their faces softened and content. Even Ben, the medical student, seems to have found a moment of deep peace after a hectic clinic day.

Fifteen minutes earlier, the consultation had started out in a routine fashion. Margaret had been through an uncomplicated breast cancer surgery, and was to see me for radiotherapy.  Dressed immaculately in a soft cream-coloured suit, she stood to greet me, beaming and holding my hand in hers.  “It’s such a pleasure to meet you. I feel so grateful. I’ve read about you online and really like your holistic approach….” She is gushing with enthusiasm, speaks of nursing her mother through a recent diagnosis, and the wonderful care she received at the cancer centre.  The lines come one after another. She also admits she’s anxious, takes the occasional nerve pill, has always been scared of hospitals.  I listen and we joke, enjoying each other’s company.

Her daughter, a lovely woman in her late thirties, sits beside her Mom smiling. She’s travelled from afar to be there around the time of the surgery and radiation.  The young woman winks at me, as if to say ‘I know my Mom is anxious’ and when I begin my physical exam by feeling her Mother’s neck from behind she chirps in “Look Mom, you’re getting a free massage too.”

Her mother in the meantime is trying to settle herself down by doing a deep breathing exercise. Her shoulders heave under my hands, and I notice that she continues to hyperventilate with her eyes closed when I ask her to lie down.  My inclination is to let her know ‘you’re breathing is making you feel worse’ but I wait till we are sitting down again.

Margaret tells me she’s claustrophobic and wants to take a valium prior to each treatment. I describe that people lying on the radiation machine have lots of space around their faces (not like an MRI scan). I suggest she can learn a relaxation and visualization technique from a psychosocial specialist that she could practice to reduce any anxiety she might have prior to or during her treatment.  Ben agrees to take Margaret on a tour of the radiation treatment machines so that she might feel less anxious about the unknown.

Margaret’s daughter pulls out her cell phone to show her mother a simple animation to teach the relaxation breath. A ball rises up for five seconds in a tube of slowly bubbling water, then drops slowly down to the bottom of the column over the next five seconds. The pattern continues. This app can be adjusted for varying times of up-phase and down-phase. Margaret peers into the phone and tries to time her breathing to correspond with the ball movement. Again her chest is heaving with each in-breath.

I have to stop the exercise. I’m delighted that they are so pro-active in empowering themselves to learn this essential healing skill – but Margaret’s technique is not helping her.  I offer a short explanation before we practice the breathing technique again.

Learning to tap into the relaxation response when we feel stressed is an essential healing skill. The concept is to activate the parasympathetic nervous system, invoking relaxation, by tricking our mind into believing everything is completely fine using the body’s ability to engage a specific breathing technique. This is what I call the body-mind connection (the signals go from the body to settle the mind).  When we breathe slowly and deeply into the abdomen (instead of breathing into our chests), we engage the diaphragm (the muscle that separates our lungs from our abdominal organs) and the vagus nerve that stimulates the relaxation centre in our brain.  If the out-breath is longer than the in-breath, then the relaxation effect is further enhanced.  The point here is that using the upper chest and ribs and lifting the shoulders to breathe causes more of the stress reaction.  Meanwhile, breathing into one’s belly instead of one’s chest promotes relaxation. 

I take Margaret, her daughter, and the medical student through the following technique:
1.   When you recognize you’re stressed, press the ‘pause’ button
2.   Become very curious about the sensations in your body (stay curious).  Let go of the thoughts about the situation.
3.   Take four slow breaths deep into the abdomen (or belly). Allow the shoulders and upper chest to be still or quiet.  Try lengthening the out-breath compared with the in-breath.
4.   Use the kind and wise part of your brain to direct your thoughts and actions.  You may hear reassurance like “I can get through this situation with peace and love” or “I’ve gotten through tough scenarios before and I can get through this one”.
5.   Keep coming back to the breath and your inner guide as need be.

Practicing relaxation everyday by meditating, or prayer, or positive affirmations/self-talk is a great way to reset the stress-o-meter to a much more peaceful level.  When or if we run into stressful situations, it’s easier to regain that grounded and loving state through a ‘relaxation breath’ technique as described above.

PS- Thank you, Margaret, for providing the inspiration to create this blog entry and for sharing in wonderful moments of mutual learning, peace and joy!