Read Chapter Twenty: How to Reframe Stress in Your Doctor’s
Office
Watch the Video: The Science of Relaxation and Meditation for Cancer Seminar – Drs. Rutledge and Walker review the science of mindfulness and neuroplasticity (the brain’s ability to change) as it relates to the cancer diagnosis.
Blog by Dr. Rob Rutledge
How to Reframe Stress in Your Doctor’s Office
You are going into your doctor’s office to get test results. You notice that you’re feeling stressed (heart pounding, short of breath, sweaty palms or feeling scared and can hardly think). You then remember to do the simple relaxation technique described in chapter 20 of the Healing Circle (link above). You press the pause button, become curious about the physical sensations in your body, take four slow breaths into your abdomen, then use the wise and compassionate part of your brain to reassure yourself. For instance ‘I can deal with whatever arises…I’ll take this one step at a time…’. This simple technique typically will help your body and mind settle down so you can listen more easily to your doctor, ask appropriate questions, and participate more fully in the conversation.
Five years after writing the chapter about stress, I still believe the advice is essential. Since then the neuroscience and basic strategies of working with stressful situations have evolved. Multiple studies now show that your attitude about stress has a profound influence on your health, how you feel, and even on which hormones are released in your brain during a stress reaction.
In a study published this year by Dr. Alia Crum et al, students in Columbia University’s Business School were asked to deliver a persuasive talk in front of a group of ‘experts’ who would evaluate their speaking style and give them feedback. To compound the stress, the experts were instructed to interrupt the students frequently, pointing out their deficiencies, and correcting their delivery. Mid-speech the experts complained “Your body language is all wrong – look more directly at us. Stand up straight.” or “Stop. Stop. That’s such a weak example. Think of a better one and keep on going.” Every student reported that it was a stressful experience.
The researchers broke up the students in two equal groups. Each group watched a 3-minute video just before their speech. The first group’s video described the negative influence of stress on a person’s health and happiness – with lines like “Stress is much worse for your health than we had imagined.” The second group watched a video emphasizing that stress can be enhancing to their lives. “Stress helps us to grow and learn. It helps develop our strengths and provides us with a challenge.” Compared with the ‘stress is all bad’ group the students who viewed the ‘stress as enhancing’ video reported feeling more confident, more determined and more excited about their speeches. A second difference between the groups occurred in the blood levels of a key hormone, DHEA.
DHEA is a molecule related to the testosterone pathway. During exercise DHEA is released which helps the muscles learn how to fire more effectively. Challenging the muscle during workouts makes those muscles stronger and stronger over a period of weeks. Exercise is a stress on our physical bodies and we adapt by getting stronger. In the brain DHEA is a key neuro-steroid which teaches the brain how to learn during stressful experiences. Instead of being so stressed that you can’t think or remember, DHEA seems to keep the learning and memory centres online despite the alarm bells going off in other parts of the brain. The students who learned that ‘stress can be enhancing’ had higher levels of DHEA both during and after the speeches. The next time that they had to give a presentation they would be better able to draw on the lessons learned from their stressful speaking experience.
Other research also shows how reframing stressful situations changes our physiology to a more positive state including studies measuring the facial muscle tone. Furrowing our brow is related to a negative stress response while increased muscle tension around our eyes is related to a positive response to stress. These same smiling muscles fire when we experience joy, gratitude and forgiveness. Our attitude affects our bodily response.
The second key hormone released by our brains during a stressful situation is oxytocin. Known as the cuddle hormone because we get a shot of this healing chemical when we hug, oxytocin has a number of very beneficial effects on our body including decreasing inflammation, helping heart cells repair, opening up our heart arteries, and others. Remarkably, oxytocin also primes us to reach out to others for help during stress. From an evolutionary perspective, when we’re feeling worried we look for allies, and when we’re feeling sick we reach out to loved ones to take care of us. Our tribal instinct is to band together to our mates when we’re at our most vulnerable. We can influence the Oxytocin rush by asking for help, or lending a hand. Connecting with others is healing.
So how can we apply the latest neuroscience to the stress of waiting in the doctor’s office? Start with that attitude that it’s natural to feel stressed going into a situation full of unknowns. Even if you practice a relaxation technique, it’s unlikely you’ll settle yourself to a perfectly peaceful state. (Be kind to yourself when you realize that you’re still stressed). Instead of getting caught up in the many negative thoughts that can surface (‘This is toxic, I can’t cope, life is unfair, stress is awful for me…’), start to look for the opportunity in this situation. What can I learn? How can I grow as a person? You can ask practical questions: ‘How can I get the best care from the medical system?’ ‘What techniques are helpful in settling down my body and mind?’ And even bring in higher spiritual principles: ‘How can I bring love and gratitude into this moment?’ ‘How can I reach out to others to make good out of a difficult situation?’ ‘How do I want to bring my spirit into this world?’
Stressful events are going to happen to all of us. It’s part of living. Instead of trying to make all the feelings go away so we’ll feel better faster, we can embrace stressful situations as an opportunity to grow. Reframing the stress will prime your brain to learn what you can – so the next time you’re in a similar circumstance you’ll be better able to work with the situation.
And don’t forget to hug someone! Your body will love you for it.
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.
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