Coping with Cancer: Mindfulness Based Cognitive Therapy

In this guest post Dr. Patricia Rockman describes the use of Mindfulness Based Cognitive Therapy for cancer.

Mindfulness and Cancer

Mindfulness is entering the culture everywhere, from healthcare, work, and education, to colouring books and sport. However, it is within the field of healthcare that it enjoys the most research-backed support. Here we find it being used for many health conditions, including cancer. You might be wondering, what could mindfulness possibly have to do with cancer?

Mindfulness is defined in many ways, the most common being:

“The awareness that emerges from paying attention, in a particular way, on purpose to the present moment without judgment and with kindness.”

Mindfulness helps us deal with our relationship to experience, our reactions to what befalls us and how this shows up in thoughts, emotions, bodily sensations and behaviours. Through a variety of practices we learn to regulate emotions, attention and behaviour to better manage the emotional and physical pains and stresses of life.

Catastrophic illness, like cancer, often brings with it a number of moods and emotions including depression, anxiety, worry, fear and anger, to name a few. Mindfulness can help us to manage the ups and downs (often downs) of the cancer experience. In a recent meta-analysis (a review of many studies) mindfulness-based interventions were found to be effective for mood related problems secondary to cancer (ref 1).

Mindfulness Based Cognitive Therapy and Cancer

Mindfulness Based Cognitive Therapy is an extension of Mindfulness practice. It combines Mindfulness practice with the psychotherapeutic tools of Cognitive Behaviour Therapy.

Cognitive Behaviour Therapy (CBT) is an evidence-based psychotherapy technique that deals with the interplay between a person’s experience and their thoughts, emotions and behaviours. Its focus is on our beliefs and thoughts and how these get in our way, often perpetuating suffering. Through CBT we learn perspective taking, to re-appraise our ideas about life events, and to be less immersed in, and identified with, what we think.

Both Mindfulness and CBT teach us that “thoughts are not facts.” In other words, don’t believe everything you think.

MBCT brings together these two powerful treatments in one program. This combination was originally designed and shown to prevent depressive relapse (ref 2) and has since been shown to have application for a wide variety of other conditions including cancer, acute anxiety and depression (ref 2).

What Does Mindfulness Based Cognitive Therapy for Cancer Involve?

At the Centre for Mindfulness Studies we have developed a Mindfulness Based Cognitive Therapy training course for cancer. Specifically, the course is designed for anyone struggling with a cancer diagnosis, prognosis, experience during treatment, or coping with the aftermath.

Our course consists of an orientation session followed by eight 2.5 hour sessions spread over eight weeks.

The course starts with an initial orientation session. This session consists of a one-on-one consultation with myself or one of the other instructors, introductions and welcoming of the participants, and a discussion of what the coming weeks will entail.

Broadly speaking, the course teaches meditation, movement practices and cognitive tools, and also includes some classic teaching.

Each practice (or self-help tool) is taught to the group using a process of contemplative dialogue (inquiry) to increase the participants’ capacity for self reflection and awareness of their unfolding experience.  It allows for  new perspective on how they manage difficulty and thus, the possibility of more  effective responding techniques. There is also home practice incorporated into the workshop series, and participants receive handouts and downloads of the meditations to use at home or during treatment (if needed).

The program is designed to be progressive. It begins with awareness practices, working with the senses and sensations, and moves toward turning toward the difficult (body and psyche), and ultimately involves self-care and how to extend the learning from these sessions.

Participants are invited to contribute, to participate, but they don’t have to with respect to speaking. They are expected to engage in the practices inside and outside the sessions, although it is understood that those who are undergoing or recovering from cancer treatment will have varied abilities to do this.

Participants will come away with another way of coping with their emotional and physical pain and the suffering that often results.

They will learn short and long meditative practices, both formal and informal methods that can be used in daily life. They will learn to have more compassion for themselves and hopefully others, more knowledge about themselves and their reactions and how to manage these more skillfully. They will learn tools that can be used during treatment and beyond to manage the emotional and physical effects of a cancer diagnosis and treatment experience.

Hopefully, those in the program will also come away with more joy and the ability to experience each moment as it unfolds without getting lost in the past that is gone or the possible future that has not come.

The arrival and ongoing experience of cancer can often leave us feeling confused, out of control, passive, subject to an unknown future, and without ways to navigate the process. Mindfulness Based Cognitive Therapy is one way to help us be with this difficult illness and manage it with more skill and hopefully, equanimity.

In my follow-up post (which you can read here), I describe my personal story of cancer and what it’s taught me about using Mindfulness to help deal with life events skillfully, and with a little more ease.

Patricia Rockman
MD, CCFP, FCFP
Associate Professor, University of Toronto, Department of Family and Community Medicine
Senior Director Education and Clinical Services, Centre for Mindfulness Studies

 References

1. Segal, V.Z et al, Archives of General Psychiatry 2010; 67( 12):1256-1264
2. Hoffman, S.G. et al, Journal of Consulting and Clinical Psychology, 2010; 78(2): 169-183