Mindfulness meditation can ease stress during treatment.
You might think that a psychotherapist would be better equipped than the average person to deal with the emotional turmoil brought on by a cancer diagnosis. But when Elana Rosenbaum received a diagnosis of non-Hodgkin lymphoma in 1995, she faced her treatment not with the tools of education but with the fruits of meditation.
A senior instructor and mindfulness coach at the Center for Mindfulness in Medicine, Health Care, and Society in Worcester, Mass., and a licensed clinical social worker, Rosenbaum knew that stress makes a bad situation worse, so she turned to a technique known as mindfulness meditation to reduce her stress and keep negative thoughts at bay.
“I felt it important to use what I had been teaching others, which is that there is more right with you than wrong and that your attitude does make a difference,” Rosenbaum says. “There is so much fear around what is happening, but if you stop struggling against what you cannot control, you’re more able to find that peace and strength inside of you that allows you to manage and cope with what you’re going through.”
Rosenbaum says mindfulnessbased stress reduction (MBSR) greatly reduced the stress and anxiety of her treatment, which included a stem cell transplantation that “nearly killed her.” It also helped her tolerate the side effects of treatment. “Mindfulness meditation allowed me to receive and not fight what was going on so I could benefit from treatment,” she explains. “I would lie in bed and look out at the sky, for example, and I would find it very comforting.”
CANCER AND STRESS
Because cancer is one of the most stressful diseases a person can endure, it brings overwhelming anxiety around diagnosis, treatment and the possibility of recurrence, Rosenbaum says. Controlling stress is essential because evidence suggests that the body’s numerous chemical responses to chronic stress may affect cancer growth and perhaps even influence the ability to cope with treatment.
Patients can counter stress by paying attention to the present and drawing on their inner resources and natural capacity for greater well-being via mindfulness meditation. Recognized by many as an effective integrative therapy within the medical community, mindfulness meditation has shown consistent, reliable and clinically relevant reductions in physical and psychological symptoms across a range of medical diagnoses, including cancer.
“Mindfulness meditation is paying attention on purpose, in the present moment, nonjudgmentally,” explains Saki F. Santorelli, EdD, associate professor of medicine at the University of Massachusetts Medical School and executive director of the university’s Center for Mindfulness. “[Negative thoughts] are not to be denied, but they can crowd out what is before us at the moment, such as the beautiful sky or the feeling of being alive even though you’re compromised in some way. These judgments are often inaccurate and can prevent us from seeing things clearly.”
Santorelli says the practice spans 2,500 years and can be found at the core of the world’s meditative traditions, including religions, such as Buddhism. Today, however, it is generally taught as a secular stress reduction modality.
“And mindfulness, it should also be noted, being about attention, is also of necessity universal. Thereis nothing particularly Buddhist about it,” said noted mindfulness proponent Jon Kabat-Zinn, PhD, in a 2003 commentary in the journal Clinical Psychology: Science and Practice. “We are all mindful to one degree or another, moment by moment. It is an inherent human capacity.”
MINDFULNESS AND THE BRAIN
Mindfulness meditation has been associated with lowered activation of the amygdala, an area of the brain associated with fear and stress responses, according to Susan Bauer-Wu, PhD, associate professor of nursing at Emory University in Atlanta. Other regions of the brain that are associated with mindfulness include those involved in focusing attention, adapting to unexpected changes, monitoring and perceiving the environment, and perceiving internal body sensations.
“Neuroscience research points to how mindfulness training can help you be less fearful and stressed, more focused, better able to go with the flow, more aware of what is happening around you, and consequently, respond wisely and be in tune with your body and its needs,” Bauer-Wu says. “Essentially, it diminishes activation of biological stress responses.”
Mindfulness meditation helps to settle the mind during times of emotional turmoil by bringing awareness to a neutral point of focus, oftentimes through breathing techniques, which can stabilize the mind, Bauer-Wu continues. “When you catch yourself feeling agitated, sluggish or confused, you can drop into ‘now’ simply by bringing awareness to an easily accessible point of focus like the breath,” she says. “We don’t try to breathe, it just happens. So any time and any place, the breath can be your anchor.”
Kabat-Zinn, one of the first to introduce mindfulness meditation in the clinical setting, founded the Stress Reduction Clinic at the University of Massachusetts in 1979, making it the oldest and largest such program at an academic medical center. “We’ve had more than 19,000 people complete our eight-week program since the clinic was founded,” says Santorelli, who adds that many of those attending were referred by physicians and other healthcare professionals who emphasize the importance of mindfulness.
As a result of Kabat-Zinn’s work and that of other advocates, mindfulness-based stress reduction has become one of the most researched mind-body programs in the world. According to Santorelli, more than 1,000 papers have been published about mindfulness and MBSR over the past several years, and approximately 125 open trials on mindfulness or MBSR are currently being funded by the National Institutes of Health.
One of the most comprehensive sumaries of evidence regarding MBSR for integrative cancer care was published in 2011 in the international complementary medicine journal Forschende Komplementärmedizin/Research in Complementary Medicine. Researchers analyzed six reviews and 19 original research papers and concluded that MBSR programs can reduce distress and improve quality of life and mood among cancer patients. They also called for more high-quality randomized controlled trials.
A 2010 study of the psychological benefits for cancer patients and their partners participating in MBSR, published in the journal Psycho-Oncology, had a similarly positive conclusion. Researchers found that MBSR programs have demonstrated clinical benefit for an array of illnesses, including cancer.
STAYING GROUNDED IN THE PRESENT
Indeed, MBSR can be of great help to cancer patients both during treatment and after, says Bauer-Wu, author of Leaves Falling Gently: Living Fully with Serious and Life-Limiting Illness through Mindfulness, Compassion, and Connectedness.
“Mindfulness practices can help cancer patients to settle their minds and get grounded in presentmoment experiences and give them a sense of control when it seems like many other aspects of their lives are beyond their control,” she explains. “If the mind is at ease, the body is less constricted and, as a result, will be more comfortable. We know that anxiety is associated with higher levels of symptoms in cancer patients, such as pain, nausea and disturbed sleep. By reducing anxiety through mindfulness meditation, physically they may feel better, too.”
Mindfulness meditation can also help patients gain perspective. “You can recognize the stories that play in your mind and notice what is happening more clearly and objectively,” Bauer-Wu says. “Furthermore, mindfulness helps cancer patients to be more in tune with their bodies so they can make wise decisions as to what their bodies need.”
EASY TO LEARN
MBSR can be learned by almost anyone, though “receptivity and readiness are essential, as with any other type of health behavior change or mental or physical training,” Bauer-Wu says. “There really aren’t any restrictions to its use, although it’s important to recognize that there are different doors to approach this practice. For example, if breathing is challenging, then the breath would not be a good anchor since it’s not a neutral point of awareness for you. Then you would need to explore and identify a different focus, like another part of your body that isn’t uncomfortable or evokes strong emotions.”