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Lilley Place News

Mindfulness After Cancer

So what is mindfulness?

It seems as if everyone thinks that Mindfulness is a useful tool to cope with cancer but what exactly does it mean? Perhaps the easiest way to describe what mindfulness is to explain with what it is not. Many of us are familiar with the experience of finding ourselves standing in front of an open kitchen cupboard and wondering just what we are looking for; or looking down at a plate of crumbs and being surprised that the delicious piece of chocolate cake seems to have miraculously disappeared. Or perhaps being berated by a frustrated spouse or child who has picked up – when you blandly smile and nod in their direction as you simultaneously grapple with preparing the dinner and confirming dates in your calendar – that you have not really heard what they have been saying. If you can relate to these experiences then you know what mindfulness is not. It is not being on automatic pilot. It is not multi-tasking or being caught up in thoughts of the past or future.

Mindfulness is the opposite of mindlessness. It is the act of very deliberately paying attention to this very moment. Of knowing exactly where your mind is.

The dangers of mindlessness

In the busy-ness of daily life it is quite natural to try to save time by doing multiple tasks simultaneously – driving and talking on the phone, checking our emails or twitter feed whilst eating breakfast, cleaning the bath whilst brushing your teeth. Perhaps it also feels quite natural to use your morning walk or drive to work to plan for the day ahead. And whilst this can make us feel more productive – the research shows that multi-tasking can not only lead to decreased productivity (and an increased risk of making mistakes) but that it can lead to a reduced capacity to focus our attention.

A danger of mindlessness when dealing with cancer is that when your mind gets carried away – you will more than likely be caught up in worries about the future. And these negative thoughts can lead to intense negative emotions such as anger, anxiety, guilt or feeling down. Although feeling bad when we are caught up in scary thoughts about the future is completely normal and understandable, it is how we react next that can make it so much worse.

Unknowingly pushing away painful feelings can make things worse …..

If we start to feel bad – whether it be anxious, guilty, sad or angry – then our automatic reactions can be to try to get rid of any unwanted thoughts and feelings so that we feel better. For example, if you feel anxious you might try to distract yourself by keeping extra busy with housework. Or if you are feeling down you might decide to cancel a planned outing with friends because it seems like too much effort. Whilst it is perfectly natural (and sometimes even helpful) to react in this way, you can see how doing this unknowingly might cause a chain reaction where constant busyness leads to an increased likelihood that you will become exhausted and irritable. And repeatedly withdrawing from social engagements can leads to increased time ruminating on negative thoughts with the result that you can feel even more depressed.

Being mindful is an important first step in managing negativity following a cancer diagnosis. By knowing where your mind is you are more likely to be able to step out of unhelpful automatic ways of reacting that can lead your negative thoughts and feelings to spiral out of control. As well, if you are more able to keep your focus then it is less likely you will get carried away with unhelpful imaginings.

Sometimes it is better to simply let yourself feel

It is instinctive to calm a crying child with soothing touch and by saying something gentle like “there, there, it will be OK”. Similarly you might have had the very natural experience of comforting a dear friend by simply offering a listening ear. Although these ways of responding feel right when responding to other people’s hurt, we often find it difficult to treat ourselves with the same compassion. In fact it is not only common to try to push away our negative thoughts and feelings but to also judge ourselves harshly, to tell ourselves not to be silly, for having those feelings in the first place.

Following an experience with cancer it is natural that we will feel sad and fearful from time to time. Being more mindful can mean being more aware of these difficult feelings in any given moment. Although it might be tempting to try to dismiss our feelings as somehow irrelevant or – even worse – dangerous, this added layer of judgement usually just adds to the pressure.

Although this might be painful, if we let go of struggling against our feelings we might find that, like a wave, they well up and then wash over us, relieving us from the pressure of having to “make things different” to how they are. And this allows our body and mind to very naturally start to feel better.

And moments are precious!

It is a sad truth that many of us take much of our life for granted. The prospect of a full day at work, being available to care for our children or grandchildren, enjoying our food, getting seven or eight hours of (mostly) uninterrupted sleep, having energy to go for a spontaneous walk in the park. Whilst cancer is an ordeal that we would not wish upon our worst enemy, there is no doubt that it has the positive effect of bringing these small fortunes into focus. Following cancer it is these things – occurrences that we would normally dismiss as trivial or even burdensome – that are most precious.

Although you might now have a renewed sense of what is important in life – cancer can also have the effect of making you feel more scattered and less likely to connect to these precious moments. For example, it may be that you have a newfound appreciation for the dawning of the day and yet you find that as soon as you open your eyes in the morning you are consumed with worries about the hours ahead. And although you value moments with your children more than ever, you might find yourself unthinkingly jumping on them for small things that they have or haven’t done. This gap between how you would like to be and how you find yourself can have the effect of making you feel more anxious and remorseful.

Despite our best intentions, when we are caught up in our thoughts, we aren’t really focused on what is happening right now, which as we now know, is the only moment that really matters. Cultivating mindfulness allows us to very deliberately appreciate what is most precious.

Ways to be more mindful

Just like building up our physical strength means regular work outs in the gym, building up mindfulness means repeated practice of paying attention to the present moment. And just as with any new skill, the more you practice, the better you become.

Meditation

One of the most common ways of cultivating mindfulness is by meditating, putting aside a block of at least a few minutes, to pay very deliberate attention to a particular object or sensation. Although the breath (or feelings in different parts of your body) are most commonly used as a focus for meditators, you can use any aspect of your present moment experience to step out of ‘automatic pilot’ and anchor your attention. It can be as simple as stopping to pay attention to the sounds that you can hear around you, or bringing awareness to the full sensory experience – touch, taste, sight and smell – of drinking a cup of tea.

The most common source of frustration when starting out with mindfulness meditation (and the reason most people give up) is mind wandering. In fact repeated mind wandering is inevitable, even for practiced meditators, and does not mean that you are doing anything wrong. The trick is to notice when your mind is no longer focused on the object of your attention (to either thoughts about the future or the past or even about what you are doing now) and then to gently but firmly bring your attention back. And then repeat this every time single time your mind strays away. With repeated practice you will notice that your mind will wander a little less, or at the very least, feel a little more steady, despite the constant stream of thoughts.

Mindfulness of everyday activities

Think about 1 or 2 activities that you do each day that you normally take for granted or do automatically. Now make a commitment, even if it just for a minute or two, to really bring your mind to the details of that experience – each time that you do it. For example, when taking a shower allow yourself to be fully present in the experience: notice the water on your skin, the smell of the soap, how the bubbles look on your skin … when you find that your mind wanders to things you have to do, worries about the future or concerns about the past, gently bring your mind back to the task at hand, again and again.

You can use this mindfulness technique with other routine daily tasks such as eating a meal, washing the dishes, having a coffee, waiting at the doctors, being with your partner, or going to bed at night. The possibilities are endless. Whatever you are doing, concentrate on how all your senses are experiencing the activity – really notice the details and the richness of this small piece of your life.

Developing a regular practice

As well as a books and CD’s there are an ever increasing range of apps that you can download onto your smart devices (eg. your ipad or phone) which guide and support you to develop a meditation practice. Smiling Minds is an easy to use and free Australian app that was originally developed for children that has expanded to include adults in its target audience. A popular British app that comes at a cost (a small monthly fee) is Headspace – it provides straightforward instructions to help you progressively learn the basics of meditation. An equally popular American alternative (that comes with an annual fee) is CALM – an app that includes a different 10 minute “daily calm” meditation each day together with guided meditation programmes and podcasts from a variety of experts in the field of meditation and self-care. For those who are more confident to choose their practice – Insight Timer – is completely free of charge and allows you to pick and choose from meditations led by a variety of experienced international mindfulness teachers or to simply set the timer and meditate without guidance. Buddhify is a low cost app and one of the few that allows you to pay upfront. It is designed to help you to integrate mindfulness and meditation into everyday life with very short exercises (led by different instructors) designed to help bring clarity and calm into routine events such as waking up, eating, going for a walk or taking a work break. They even include some meditations specifically targeted for people who are feeling unwell or in pain.

8 week Mindfulness Programme

Most of the evidence that has accumulated in the field of mindfulness has been based on the 8 week mindfulness based programmes initially devised by Jon Kabat-Zinn from the University of Massachusetts. Mindfulness Based Cognitive Therapy (MBCT) is an 8 week programme that integrates aspects of cognitive and behaviour therapy with mindfulness meditation. These programmes have been demonstrated to not only help people to feel less anxious and depressed after cancer but also to help with increasing attentional capacity, perceived pain, effects of cancer and cancer treatments and with overall physical well-being.

The Cancer Wellbeing Centre and Lilly Place Clinical Psychology regularly run 8 week MBCT programmes for people who are committed to enhancing their health and well-being, including for people impacted by cancer. If you would like to know more about our programme please speak to your psychologist or give us a call to register your interest.

By training your mind to be present purposefully and regularly, you will start to become more focused and present – even when you are not meditating. And this is just the beginning. If you can combine your practice with an attitude of curiosity and compassion (versus judging yourself harshly) then it might just be that you can begin to accept yourself exactly as you find yourself in each precious moment. And you may just find that you start to feel better.

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