2022 10 Working with Difficult Thoughts for CCSN.pdf
0 likes106 views
The document discusses the importance of reframing difficult thoughts and emotions during the cancer journey, emphasizing self-compassion and living a values-based life. It introduces Acceptance and Commitment Training (ACT) principles, suggesting mindfulness and cognitive techniques to manage challenging emotions, aiming to empower patients in their recovery process. It also highlights a cancer patient empowerment program that includes daily emails, exercise, relaxation techniques, and dietary advice.
2022 10 Working with Difficult Thoughts for CCSN.pdf
- 1. T H E P O W E R O F R E F R A M I N G : E S S E N T I A L S K I L L S O N T H E C A N C E R J O U R N E Y W I T H D R . R O B R U T L E D G E O N C O L O G I S T , A S S O C I A T E P R O F E S S O R , D A L H O U S I E U N I V E R S I T Y
- 2. TA K E H O M E M E S S A G E S •Difficult thoughts and feelings are normal •We don’t need to struggle against them •We can choose to live a values-based life even when difficult thoughts/feelings show up •Self-compassion is very helpful in making changes
- 3. YO U R G OA L S A F T E R C A N C E R •Maximize your chance of recovery •Function better, think more clearly •Live a more meaningful life •E.g. connect more deeply •Grow psychologically / spiritually
- 4. W H AT I S C O M P L E T E C A N C E R C A R E ? ( I N T E G R AT I V E O N C O L O G Y ) • Understanding what’s happening to you • Getting the best from the medical system • Empowering yourself with healthy lifestyle - Exercise, diet, sleep, relaxation techniques • Healing with your mind • Nurturing a spiritual perspective
- 5. A G E N D A • Thoughts are not a problem • Principles of ACT training • Setting your intention • Mindfulness • Fusion and defusion of thoughts • Reframing difficult thoughts • Q+A
- 6. C O M M O N T H O U G H T S A F T E R C A N C E R • ‘The medical system sucks’ • ‘This is all too much / I can’t do it’ • ‘I’m all alone / nobody understands me’ • ‘I have to be the strong one’ • ‘I have to stay positive’
- 8. E V O L U T I O N A N D T H O U G H T • Humans plan for the future and learn from the past • Thoughts are both helpful and not helpful • Negativity bias increases our anxiety • Two aspects of your mind: thinking and observing • Emotions are normal • E.g. mourn our losses • Frustration / disappointment with medical system
- 9. P R I N C I P L E S O F A C C E P TA N C E A N D C O M M I T M E N T T R A I N I N G •ACT focuses on increasing psychological flexibility and living a more meaningful life •Difficult thoughts and emotions are not a problem, but our struggle with them causes excess suffering •‘Feeling good’ is not the goal •Instead: Act in a way consistent with our values
- 11. A C C E P TA N C E • Opening up and making room for unwanted private experiences (thoughts, feelings, urges, sensations) • You don’t have to ‘like’ the experience • Instead of fighting or running away • We make room for them – free flow, they come and go as they choose • This helps us act effectively and improve our life
- 13. CancerPEP.org Spirit PEP List of 20 most common values What are your top 5 values? • Loyalty • Spirituality • Humility • Compassion • Honesty • Kindness • Integrity • Selflessness • Determination • Generosity • Courage • Tolerance • Trustworthiness • Equanimity • Altruism • Appreciation • Empathy • Toughness • Self-Reliance • Attentiveness
- 14. CancerPEP.org Spirit PEP • Authenticity • Achievement • Adventure • Authority • Autonomy • Balance • Beauty • Boldness • Compassion • Challenge • Citizenship • Community • Competency • Contribution • Creativity • Curiosity • Determination • Fairness • Faith • Fame • Friendships • Fun • Growth • Happiness • Honesty • Humor • Influence • Inner Harmony • Justice • Kindness • Knowledge • Leadership • Learning • Love • Loyalty • Meaningful Work • Openness • Optimism • Peace • Pleasure • Poise • Popularity • Recognition • Religion • Reputation • Respect • Responsibility • Security • Self-Respect • Service • Spirituality • Stability • Success • Status • Trustworthiness • Wealth • Wisdom
- 15. S E T T I N G YO U R I N T E N T I O N • How do you want to be in the world? • What do you hope of yourself? • What’s most important to you? • What really matters, deep in your heart? • How do you want to treat yourself, others and the world around you? • As a ritual, going into difficult situations, and in the middle of chaos
- 16. C O N TA C T W I T H T H E P R E S E N T M O M E N T ( B E H E R E N O W ) • Flexibly paying attention • Narrowing, broadening, shifting, or sustaining attention • Depending on what’s most useful • Physical world, inner processes, or both • Engaging fully in our experience
- 17. M I N D F U L N E S S • Diverse set of skills (accepting painful feelings, savoring experience, observing, grounding…) • “Awarenessing”, not a thinking process • Attitude of openness and curiosity • Flexibility of attention – narrow to broad • Quality of kindness, ‘heartfulness’
- 18. M I N D F U L N E S S O F O U R T H O U G H T S • Imagine a transcript of everything you think • The good, the bad, and the ugly • When stressed / upset we often ‘fuse’ with our (negative or exaggerated) thoughts • We ‘get hooked’ or ‘entangled’ • If we can notice – we can choose to ‘defuse’ from unhelpful thoughts
- 19. H A N D S A S T H O U G H T S A N D F E E L I N G S M E TA P H O R • Imagine everything you see represents everything that is important in your life • Slowly cover your eyes with your hands • Look around you (through gaps in your fingers) • How does that affect your view of the world? • We’re disconnected, hard to focus and do things • Set hands on lap: Easier to take action when you can see clearly
- 20. D E F U S I O N : U N H O O K I N G F R O M T H O U G H T S • Lots of different techniques to unhook (e.g. ‘I can’t cope’) • “I am just having the thought that” • “I’m noticing I’m having the thought that” • “Thank you, mind, for that thought” • Thought balloon • ‘Leaves on a stream’ meditation • How old is this story • “Aha, there’s the ‘I can’t cope’ story”
- 22. C O G N I T I V E B E H AV I O U R A L T H E R A P Y • Our thoughts influence our emotions • E.g. ‘I’m useless leads’ to depression
- 23. Feeling Better by Examining and Changing Your Thoughts With Mindfulness Awareness & Kindness
- 24. 10 cognitive distortions: 1) All or nothing thinking 2) Overgeneralization 3) Mental filter 4) Disqualifying the positive 5) Magnification + minimialization 6) Jumping to conclusion 7) Emotional reasoning 8) Should statements 9) Labelling and mislabelling 10) Personalization
- 25. 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
- 26. STEP 1 Mindful of Distressing Thoughts STEP 2 Awareness and Inquiry STEP 3 Kind & Rational Response -Acknowledge the difficulty with kindness -Look at the situation from another perspective -Encourage yourself: “I can … -Act according to your values Situation:
- 27. Mindful of Distressing Thoughts Awareness and Inquiry Kind & Rational Response Situation: Tired and irritable during chemo
- 28. Mindful of Distressing Thoughts It’s no use! I don’t have the strength to get through this. Awareness and Inquiry Kind & Rational Response Situation: Tired and irritable during chemo
- 29. Mindful of Distressing Thoughts It’s no use! I don’t have the strength to get through this. Awareness and Inquiry 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
- 30. Mindful of Distressing Thoughts It’s no use! I don’t have the strength to get through this. Awareness and Inquiry 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 -Acknowledge the difficulty with kindness -Look at the situation from another perspective -Encourage yourself: “I can … -Act according to your values Situation: Tired and irritable during chemo
- 31. Mindful of Distressing Thoughts It’s no use! I don’t have the strength to get through this. Awareness and Inquiry 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 Who 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.
- 32. Mindful of Distressing Thoughts Awareness and Inquiry Kind & Rational Response Situation: Delay in diagnosis…..
- 33. Mindful of Distressing Thoughts The medical system sucks. Awareness and Inquiry Kind & Rational Response Situation: Delay in diagnosis…..
- 34. Mindful of Distressing Thoughts The medical system sucks. Awareness and Inquiry 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: Delay in diagnosis…..
- 35. Mindful of Distressing Thoughts The medical system sucks. Awareness and Inquiry 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 -Acknowledge the difficulty with kindness -Look at the situation from another perspective -Encourage yourself: “I can … -Act according to your values Situation: Delay in diagnosis…..
- 36. Mindful of Distressing Thoughts The medical system sucks. Awareness and Inquiry 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 This is frustrating but I can learn how to get the best care from what they offer – and I can really make a difference by empowering my body
- 37. Mindful of Distressing Thoughts Awareness and Inquiry Kind &Rational Response Situation: Tired and needs ride…..
- 38. Mindful of Distressing Thoughts I hate asking for help. I’m the friggin one that takes care of everyone else. I can’t bear needing their help. I’ll handle this myself. Awareness and Inquiry 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 needs ride…..
- 39. Mindful of Distressing Thoughts I’m the one that always takes care of others. I can’t bear needing their help. I’ll handle this myself. Awareness and Inquiry 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 It is scary but maybe now it is my time to receive and be open to the love & compassion of friends and family. (Spiritual lesson, a circle of giving and receiving)
- 40. Mindful of Automatic Thoughts They say you are supposed to stay positive but I feel awful, angry, helpless, filled with despair, I’m afraid I am making it worse Awareness and Inquiry Kind &Rational Response
- 41. Mindful of Automatic Thoughts They say you are supposed to stay positive but I feel awful, angry, helpless, filled with despair, I’m afraid I am making it worse Awareness and Inquiry 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
- 42. Mindful of Automatic Thoughts They say you are supposed to stay positive but I feel awful, angry, helpless, filled with despair, I’m afraid I am making it worse Awareness and Inquiry 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 It’s natural to have strong and negative feelings. I am learning to comfort myself and ask for reassurance from others. I can work with my state of mind and that helps.
- 43. Mindful of Automatic Thoughts I hate feeling weak and helpless. I don’t want everyone feeling sorry for me. Awareness and Inquiry Kind & Rational Response
- 44. Mindful of Automatic Thoughts I hate feeling weak and helpless. Don’t want everyone feeling sorry for me. Awareness and Inquiry 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
- 45. Mindful of Automatic Thoughts I hate feeling weak and helpless. Don’t want everyone feeling sorry for me. Awareness and Inquiry 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 I do like how kind and gentle my spouse/friend has become. The people who reach out are so kind and generous, it’s a privilege to receive the gift of their good will and love.
- 46. Family Member Mindful of Distressing Thoughts 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. Awareness and Inquiry Kind & Rational Response
- 47. Family Member Mindful of Distressing Thoughts 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. Awareness and Inquiry 1. What emotions follow from this way of thinking? 2. How does my body feel? 3. Is this a helpful / harmful thought? 4. Exaggerated, irrational? Kind & Rational Response
- 48. Family Member YMindful of Distressing Thoughts 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. Awareness and Inquiry 1. What emotions follow from this way of thinking? 2. How does my body feel? 3. Is this a helpful / harmful thought? 4. Exaggerated, irrational? Kind & Rational Response It’s best to be honest with each other about feelings. Creates more intimacy, and is truly supportive. If I fall apart how do I know it will make her/him feel worse. Maybe consoling me will make her/him feel better.
- 49. C A N C E R PAT I E N T E M P O W E R M E N T P R O G R A M •Please join our trial starting in November •Six month of daily emails with PEP videos •Exercise, strength training •Relaxation techniques using biofeedback •Dietary advice •Connection / interactive videoconferences
- 50. Dr. Rob Rutledge, Oncologist Associate Professor of Medicine CancerPEP.org
- 51. C A N A D I A N C A N C E R S U R V I V O R N E T W O R K C O N TA C T I N F O 1750 Courtwood Crescent, Suite 210 Ottawa, ON K2C 2B5 Telephone / Téléphone : 613-898-1871 E-mail: jmanthorne@survivornet.ca or info@survivornet.ca Website: www.survivornet.ca Twitter: @survivornetca Facebook: www.facebook.com/CanadianSurvivorNet Instagram: @survivornet_ca Pinterest: http://pinterest.com/survivornetwork/
- 52. Q U E S T I O N S F O R D I S C U S S I O N •What automatic and distressing thoughts come up? •About yourself, others, world outside •E.g. medical system, sex life, relationships •What do you do when they arise?