Using Mindfulness to Control
Worry and Live Well with
Cancer
Aleezé Moss Sattar, Ph.D.,
Research Associate, Myrna Brind Center of
Integrative Medicine, Thomas Jefferson
University
Stress is…
• the perception of a threat to our physical or
psychological well-being
• coupled with the belief that our resources
are inadequate to cope with this threat.
• worrying – engaging in the what-ifs – can
make us feel stressed
Fight or Flight Response
• When we feel stressed we have a physiological
response in the body. We are hard wired for this
stress response. It is evolutionary and useful
when we are facing a real physical threat.
Fight or Flight Reactivity
• The autonomic nervous system (ANS):
• The sympathetic branch of the ANS is activated
in response to stress, while the parasympathetic
branch is suppressed.
Sympathetic Nervous System
Activation
• Increased
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Heart Rate
Blood Pressure
Breathing Rate
Muscle Tension
• Decreased
• Digestive Function
• Immune Function
• Reproductive Function
Stress Response Activation
• We can actually turn on the stress response
simply by thinking of something stressful. Stress
hormones get released and we have the same
physiological response as if we were actually
under threat.
• Why Zebras Don’t Get Ulcers, Robert M. Sapolsky, 2004 (3rd edition).
Work With the Mind
• If the mind is an important factor in determining
if something is experienced as “stressful”…where
is the mind?...and what is it up to?
Mind Time Travel
• The mind is usually “rehashing,” or “rehearsing.”
Its either in the past or in the future, and rarely
are we right here now.
Stress Response
• When the stress response is frequently and/or
chronically activated, it can become more
damaging than the stressor itself.
Impact of Stress
•
Research shows the negative impact of stress on health
outcomes in cancer patients.
•
Reiche EM, Nunes SO, Morimoto HK. (2004) Stress,
depression, the immune system, and cancer, Lancet
Oncol, 5:617-25.
•
Witek-Janusek L, Gabram S, Mathews HL, (2007).
Psychologic stress, reduced NK cell activity, and
cytokine dysregulation in women experiencing
diagnostic breast biopsy.
Psychoneuroendocrinology, 32:22–35.
Stress Reduction
• We can reduce the negative impact of stress by
learning to regulate the sympathetic nervous
system and promote the activation of the
parasympathetic nervous system.
Parasympathetic Nervous
System
• The parasympathetic nervous system regulates
the relaxation response.
• We are hard-wired for both responses.
• And importantly, we have some control over the
autonomic nervous system.
The Relaxation Response
• We can activate the parasympathetic nervous
system through certain behaviors, including
deep, slow breathing, yoga and other forms of
mindful movement, meditation, prayer, laughter,
art, etc.
Parasympathetic Nervous
System Activation
• Decreased
• Heart Rate
• Blood Pressure
• Breathing Rate
• Muscle Tension
• Increased
• Immune functioning
• Reproductive functioning
Stress Reduction
• Cultivating mindfulness can help us reduce the
negative impact of stress.
What is Mindfulness?
• Moment to moment, non-judgmental
awareness.
• Cultivated by paying attention, on purpose, in
the present moment.
Paying Attention
• Cultivating mindfulness can help us reappraise
our situation and learn to cope more effectively
with stress.
• Jon Kabat-Zinn, Full-Catastrophe Living: Using the Wisdom and of Your
Body and Mind to Face Stress, Pain, and Illness (first published 1990).
A Taste of Mindfulness
• Brief practice of paying attention to the present
moment, without judgment, with an open and
kind attitude
Mindfulness-Based Stress Reduction
• Developed as an outpatient program for
•
•
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heterogeneous patient populations over 30 years
ago by Jon Kabat-Zinn and colleagues at the
University of Massachusetts.
Now offered at more than 300 institutions
Thomas Jefferson University Hospital’s MBSR
program founded 1996.
Typical course: 8 weeks, 2.5 hour classes, plus an
all-day silent retreat.
Benefits of Mindfulness
• Many published studies have documented the
benefits of MBSR and other mindfulness-based
programs:
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decreased stress symptoms
decreased anxiety
decreased depressive symptoms
improved sleep quality
enhanced emotional processing
enhanced coping with the effects of chronic illness
enhanced immune and brain functioning
Benefits of Mindfulness
• Positive benefits for cancer patients including
significant improvements in mood, stress-symptoms,
sleep, health related quality of life, immune
functioning and even brain function.
• Monti D, Kash K, Kunkel E, Brainard G, Wintering N,
Moss A, Newber A. Changes in Cerebral Blood Flow
and Anxiety Associated with an 8-week Mindfulness
Programme in Women with Breast Cancer. Stress and
Health 2012.
•
•
Ledesma D, Kumano H. Mindfulness-based stress reduction
and cancer: A meta-analysis. Psycho-oncology 2009.
Monti, Peterson, Kunkel, et al,). A randomized, controlled
trial of mindfulness-based art therapy (MBAT) for women
with cancer. Psychooncology 2006.
Benefits of Mindfulness
•
Shapiro, Bootzon, Figueredo, et al, The efficacy of mindfulness-based
stress reduction in the treatment of sleep disturbance in women with
breast cancer: an exploratory study. J Psychosom Res, 2003.
•
Speca, Carlson, Goodey, et al, A randomized wait-list controlled clinical
trial: the effects of a mindfulness-based stress reduction program on
mood and symptoms of stress in cancer patients. Psychosom Med, 2002.
•
Saxe, Hebert, Carmody, Kabat-Zinn, et al, Can diet in conjunction with
stress reduction affect the rate of increase in prostate specific antigen
after biochemical recurrence of prostate cancer? J Uro 2001.
•
Tacón, Caldera, Ronaghan, Mindfulness-based stress reduction in women
with breast cancer. Families, Systems and Health, 2004.
Benefits of Mindfulness
• Demonstrated improvements in the immune profiles of
people with breast or prostate cancer, which correspond
with decreased depressive symptoms
• Carlson LE, Speca Speca, M., Faris, P., & Patel, K. (2007). One year
pre-post intervention follow-up of psychological, immune,
endocrine and blood pressure outcomes of mindfulness-based
stress reduction (MBSR) in breast and prostate cancer patients.
Brain, Behavior, and Immunity, 21, 1038-1049.
• Carlson, Speca, Patel, et al, Mindfulness-based stress reduction
in relation to quality of life, mood, symptoms of stress, and
immune parameters in breast and prostate cancer outsubjects.
Psychosom Med, 2003.
• Witek-Janusek, Albuquerque, et al, Effect of mindfulness based
stress reduction on immune function, quality of life and coping in
women newly diagnosed with early stage breast cancer. Brain,
Behav, Immunity, 2008.
Deep Relaxation
Practice: Using the breath
• Learning to activate the relaxation response through the
breath.
• The breath is available to us in each moment.
• Relaxing sighs:
• Inhale through the nose.
• Exhale with through an open mouth, sighing gently.
• Repeat as needed.
• Deep/Diaphragmatic breathing.
Practice: Mindful Attention to
Body Sensations
• In the body scan we systematically move our
attention through various parts of the body,
exploring what is already here.
• The quality of the attention is important – it is
open, curious, nonjudgmental and accepting of
what is already here in the present moment.
Resources
• Three brief practices handout
Resources
• The Mindfulness Institute, Jefferson-Myrna Brind Center of
Integrative Medicine.
www.jeffersonhospital.org/mindfulness/