The body-mind-spirit connection:Making a difference on the cancer journey

Rob Rutledge, MD, Radiation OncologistAssociate Professor, Dalhousie UniversityCEO, The Healing and Cancer Foundation

Goals of people who have been given a cancer diagnosis

• Maximize the chance of recovery• Feel better physically and emotionally• Think more clearly and function better

Overview

Setting the intentionComplete cancer care Empowering your brain physicallyPractical neuroscience SKILLS

Stress and relaxation Meditation Reframing difficult thoughts Taking in the good

Level of spiritQuestions

The 9 Choices of Extremely Happy People Foster and Hicks

• Intention: they commit to being happy• Accountability: they assume personal responsibility for their lives, refusing to

blame others• Identification: they identify what makes them happy, not what others tell them

should make them happy• Centrality: they make what brings them happiness central in their lives• Recasting: they transform stressful problems and trauma into something

meaningful and important• Options: they are open to new possibilities• Appreciation: they choose to deeply appreciate their lives, experiences, and other

people• Giving: they share themselves without expectation of return• Truthfulness: they choose to be honest with themselves and others

Setting the Intention

• In preparation of going into any situation:– How do you want to be in the world?– What do you hope of yourself?

• What’s your intention for this lecture?

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What is Complete Cancer Care?(Integrative medicine)

• Understanding what’s happening– www.Willow.org

• Getting the best from the medical system• Empowering body with healthy lifestyle– Exercise, diet, maintaining reasonable weight, sleep,

relaxation techniques• Healing skills – level of the mind• Nurturing a spiritual life / perspective

Exceptional Cancer Survivors

Exercise! Exercise! Exercise!

NUTRITION

Maintain a reasonable weight

Sleep

Meditation & relaxation

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FOCUSING ON THE MINDThanks to author Rick Hanson!!

Buddha’s Brain and Hardwiring Happiness

www.RickHanson.net

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Your Brain: A Product of Evolution

• ~ 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

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Evolutionary History

The Triune Brain

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Three Motivational and Self-Regulatory Systems

• 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.

Many pathways to STRESS!!!

• Real threat to your life– Jumping out of way of a runaway car

• Perceived threat to your life– Worrying about the test results

• Ego/Social threats– Argument over who does more housework– Public speaking (threat of being ostracized)

• Fear of the unknown– Financial– Relationships

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Stressor Perception Stress

HOW DO YOU EXPERIENCE STRESS?

• 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?

TIME TO DE-STRESS

• Press the ‘pause’ button• Be very curious about the physical sensations• Four slow breaths into the abdomen• Reassure yourself with wisdom and kindness

Update on Stress

• Do you believe stress is harmful for your health?

• 30,000 Americans followed for 8 years• 30% increased risk death if felt stressed• But increased risk only if felt stress was harmful

Oxytocin

• Cuddle hormone• Released during stress reaction• Drives pro-social behaviour• Decreases inflammation, opens up heart

blood vessels, promotes regeneration of heart cells

Stress is not all bad

• If you believe stress is not harmful to your health….– Release hormones which help the brain grow from

stressful experiences• Stressful life is associated with a life of

meaning, fulfillment, and joy• Stress connects us with others

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Your Brain: The Technical Specs

• Size:– 3 pounds of tofu-like tissue– 1.1 trillion brain cells– 85 billion “gray matter" neurons =

• Activity:– Always on 24/7/365 - Instant access to information on demand– 20-25% of blood flow, oxygen, and glucose

• Speed:– Neurons firing around 5 to 50 times a second (or faster)– Signals crossing your brain in a tenth of a second

• Connectivity:– Average neuron makes ~ 5000 connections with other neurons: ~ 500 trillion synapses

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The Connectome - 2

Hagmann, et al., 2008, PLoS Biology, 6:1479-1493

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Facts about Brain and Mind

• As the brain changes, the mind changes.– Mental activity depends upon neural activity.

• As the mind changes, the brain changes.– Transient: brainwaves, local activation– Lasting: epigenetics, neural pruning, “neurons that fire together, wire

together” – Experience-dependent neuroplasticity

• You can use the mind to change the brain to change the mind for the better: self-directed neuroplasticity.

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Christian Nuns, Recalling a Profound Spiritual Experience

Beauregard, et al., Neuroscience Letters, 9/25/06

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Lazar, et al. 2005. Meditation experience is associatedwith increasedcortical thickness.Neuroreport, 16,1893-1897.

Meditation – A life skill

• The Hand Model of the brain

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Meditation - Neural Benefits

• Increased gray matter in the:– Insula - interoception; self-awareness; empathy for emotions– Hippocampus - visual-spatial memory; establishing context; inhibiting amygdala and

cortisol – Prefrontal cortext (PFC) - executive functions; attention control

• Reduced cortical thinning with aging in insula and PFC

• Increased activation of left frontal regions, which lifts mood

• Increased gamma-range brainwaves - may be associated with integration, “coming to singleness,” “unitary awareness”

• Preserved telomere length

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Meditation: Physiological Benefits

Decreases stress-related cortisol

Stronger immune system

Helps many medical conditions, including cardiovascular disease, asthma, type II diabetes, PMS, and chronic pain

Aids wound healing and post-surgical recovery

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Meditation: Psychological Benefits

Improves attention (including for ADHD)

Increases compassion

Increases empathy

Reduces insomnia, anxiety, phobias, eating disorders

Mindfulness-Based Cognitive Therapy for depression decreases relapse

Feeling Better by Examining and Changing

Your Thoughts

With Mindfulness Awareness & Kindness

(based on David Byrne’s Feeling Good)

You can change your mind

• 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 1Mindful of Distressing Thoughts

STEP 2Awareness andInquiry

STEP 3Kind & Rational Response-Acknowledge the difficulty with kindness

-Look at the situation from another perspective-Encourage yourself: “I

can..

Situation:

Mindful of Distressing Thoughts

Awareness andInquiry

Kind & Rational Response

Situation: Tired and irritable during chemo

Mindful of Distressing Thoughts

It’s no use! I don’t have the strength to get through this.

Awareness andInquiry

Kind & Rational Response

Situation: Tired and irritable during chemo

Mindful of Distressing Thoughts

It’s no use! I don’t have the strength to get through this.

Awareness andInquiry 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?

Kind & Rational Response

Situation: Tired and irritable during chemo

Mindful of Distressing Thoughts

It’s no use! I don’t have the strength to get through this.

Awareness andInquiry 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?

Kind & Rational ResponseWho says you always have to be strong. Sometimes to cry and fall apart is the best thing to do. Then it seems I find an inner strength or higher power.

Situation: Tired and irritable during chemo

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Honoring Experience

Your experience matters.

Both for how it feels in the moment and for the lasting residues it leaves behind, woven into the fabric of your brain and being.

Building Inner Strengths

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Inner strengths are grown mainly from positive mental states that are turned into positive neural traits.

Change in neural structure and function (learning, memory) involves activation and installation.

We grow inner strengths by internalizing positive experiences of them and their related factors.

Growing Inner Strengths

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Inner Strengths Include

• Capabilities (e.g., mindfulness, insight, emotional intelligence, resilience, executive functions, impulse control)

• Positive emotions (e.g., gratitude, self-worth, love, self-compassion, secure attachment, gladness, awe, serenity)

• Attitudes (e.g., openness, determination, optimism, confidence, approach orientation, tolerance, self-respect)

• Somatic inclinations (e.g., vitality, relaxation, grit, helpfulness)

• Virtues (e.g., wisdom, patience, energy, generosity, restraint)

What inner strength would you like to build?

• Or what are you struggling with – and find the antidote positive state?

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Inner Strengths Are Built From Brain Structure

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The Brain’s Negativity Bias

• As our ancestors evolved, avoiding “sticks” was more important for survival than getting “carrots.”

• Negative stimuli:– More attention and processing– Greater motivational focus: loss aversion

• Preferential encoding in implicit memory: – We learn faster from pain than pleasure.– Negative interactions: more impactful than positive– Easy to create learned helplessness, hard to undo– Rapid sensitization to negative through cortisol

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Velcro for Bad, Teflon for Good

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Taking in the Good

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Need activation and instillation of the positive!

Without this installation, there is no change in the brain - no useful learning, no healing, no growth.

Positive activation without installation is pleasant, but has no lasting value.

Meanwhile, negative mental states are being preferentially installed into neural structure.

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The Negativity Bias

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Learning to Take in the Good

Have a Good Experience

Enrich It

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“Enriching” Factors

• Duration

• Intensity

• Multimodality –perception, emotion, desire, action

• Novelty

• Personal relevance

Absorb It

Link Positive and Negative Material

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HEAL by Taking in the Good

1. Have a positive experience. Notice it or create it.

2. Enrich the experience through duration, intensity, multimodality, novelty, personal relevance.

3. Absorb the experience by intending and sensing that it is sinking into you as you sink into it.

4. Link positive and negative material. [optional]

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Your Turn

1. Have a positive experience. Notice it or create it.

2. Enrich the experience through duration, intensity, multimodality, novelty, personal relevance.

3. Absorb the experience by intending and sensing that it is sinking into you as you sink into it.

Spirit

The story of my 110-year-old Grandma

Praise for The Healing Circle

“A book for anyone who has ever sought their wholeness in the midst of a cancer crisis. Don’t go to your Doctor’s office without it”Rachel Remen MD, Kitchen table wisdom

“By drawing on the wisdom and experience shared in this book, life’s difficulties can truly become blessing which help us heal our lives.”Bernie Siegel MD, Love, Medicine and Miracles

“The Healing Circle takes us into the realm where integration of body, mind and spirit – our true wellness – can be found.”Gabor Mate, MD, When the Body says No

To learn more or to order books please visitwww.healingandcancer.orgor email info@healingandcancer.org

Questions

Rob.rutledge@nshealth.ca

HealingandCancer.org

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Canadian Cancer Survivor Network Contact Info

Canadian Cancer Survivor Network1750 Courtwood Crescent, Suite 210Ottawa, ON K2C 2B5Telephone / Téléphone : 613-898-1871E-mail jmanthorne@survivornet.ca or mforrest@survivornet.ca Web site www.survivornet.caBlog: http://jackiemanthornescancerblog.blogspot.com/Twitter: @survivornetcaFacebook: www.facebook.com/CanadianSurvivorNet Pinterest: http://pinterest.com/survivornetwork/