When facing a metastatic breast cancer diagnosis, you may experience an array of challenging emotions, including sadness, fear, and powerlessness. You might find yourself answering the troubling and unanswerable questions, why me? Why now? What is next? These questions inevitably lead to increased emotional distress. Mindfulness is an increasingly popular, effective tool that can help you counter this thought-feeling spiral. This article describes some techniques of mindfulness and covers some research on the benefits of mindfulness for people with metastatic breast cancer.
What is mindfulness
Mindfulness is a present moment, nonjudgmental awareness of our thoughts, emotions, physical sensations, and environment. It has its roots in Buddhist practice, but it has become widely used in the secular Western mainstream. You can read a detailed explanation of it here.
Mindfulness and meditation are related, but they are not exactly the same. Meditation can include mindfulness, but there are other techniques and forms of meditation. Mindfulness can be a meditation practice, but we can also strive to hold a present-moment, nonjudgmental awareness of the present moment all day long.
How mindfulness helps when you have metastatic breast cancer
Practicing mindfulness can help you focus on the here-and-now, rather than the distressing thought-feeling spiral that is common with this diagnosis. It is increasingly used during cancer diagnoses and helps with decreasing our anxiety while improving our mood, emotion regulation, and positive feelings. Studies also show that mindfulness can help with not just the emotions associated with your diagnosis, but even symptoms of treatment and disease progression.
A 2015 study of an eight-week mindfulness-based stress reduction (MBSR) study of women with metastatic breast cancer in the United Kingdom found that the intervention was particularly helpful in reducing emotional reactivity and adjusting to the life disruptions that come from living with metastatic breast cancer. Though the time commitment was challenging for participants, and led many not to enroll in the program, people enrolled in the study had a high level of attendance, completion, and compliance with homework. At the end of the study, participants reported that it improved their anxiety and overall quality of life.
A similar study out of Italy found the MBSR practice led to a significant reduction in fatigue and pain. Before the study, many participants experienced worry and catastrophic thinking about their diagnosis, which in turn led to exhaustion, self-blame, avoidance and emotional reactivity. After the eight-week practice, and at the four-month follow up, these problems had subsided. Participants reported that they found a sense of spiritual reconnection. They were able to reframe their condition, and even developed a sense of existential gratitude. They also developed an accepting attitude toward pain and difficult emotions, which in turn decreases the experience of pain and difficult emotions.
Other studies focused on pain, and found that MBSR improved pain symptoms; and advance-care planning with caregivers, and found MBSR decreases experiences of distress while improving quality fo life, communication, and sleep. In every study, patients liked the MBSR intervention.
How to practice mindfulness
Many of the studies to date focus on MBSR. However, attending an eight-week MBSR course is simply not feasible for most of us. Fortunately, research suggests that incorporating mindfulness outside of MBSR training can be helpful.
There are several techniques for mindfulness, and each brings our thoughts to focus on something, internal or external. Some of the most common mindfulness techniques include:
Sit or lie comfortable and bring your attention to your breath. You can focus on the rise and fall of your chest and belly, or the feeling of air on your nostrils or upper lip. When your mind wanders, don’t judge! Simply bring your attention back to the breath.
Lie down face-up on your bed, couch, or floor. You can begin at either end: your head or your toes. Bring your awareness slowly through your body, focusing on one area at a time. If you notice an area of tightness, rest your attention and send your breath to that area until the tightness clears. You could also imagine a ball of golden light or other healing imagery at any area of tension.
There many ways to do a sitting meditation: You can focus on your breath, watch your thoughts, or meditate on an object, or a word or phrase.
Walking meditation is a mindful walk in silence, at a gentle pace. You focus your attention on your surroundings and bodily sensations. Feel your feet on the ground, pay attention to the feeling of the air on your skin and hair. Notice the feeling in your body parts – legs, hips, shoulders, back, belly, arms, head… Notice your breathing, and pace your breath with your footsteps.
Mindful movement (like hatha yoga)
These are gentle movements performed with attention, preferable in silence or with quiet, relaxing music in the background. Some familiar movements include down-dog, cobra, and child’s pose; standing balancing poses like tree, with one foot resting on the opposite leg; lying on the back while hugging alternate or both knees into your chest; seated forward folds, with one or alternating legs extended directly in front or at an angle; and seated side bends and gentle twists.
This is done by attentively watching an object like a candle, or by holding and paying close attention to any object that interests you. When holding an object, focus on the shape, texture, color, temperature, weight, size, and generally feeling of the object. Depending on the object, you can involve all five of your senses.
Mindful eating is done slowly with deep attention to the texture, flavor, temperature, and aroma of a food. You can involve all of your senses, including the sound you make when you eat. Added benefits of mindful eating is that when you are eating mindfully, you are not likely to overeat; and when you are being nonjudgmental, you can address treatment-related taste changes.
Watching your thoughts
In this form of meditation, you simply sit quietly with your own thoughts, watching the continuous circuit of thinking. Thoughts come and go like clouds in the sky. Unlike clouds, we tend to have repeating patterns of thoughts, and when we are not mindful, we can get carried away with stories that are not present or real. When you get caught up in a mental story, you simply remind yourself to watch your thoughts rather than becoming involved in them.
Mindful triage: the 5-4-3-2-1 technique
When you are in a crisis, one useful tool is the 5-4-3-2-1 technique. To do this, find five things you can see; four things you can feel; three things you can hear; two things you can smell; and one thing you can taste. Do this exercise slowly and nonjudgmentally.
No matter what technique you try, or if you decide to try them all, the benefit comes from a committed practice. Regular practice, setting aside 10-15 minutes every day – preferably at the same time and place – will yield much greater results than an inconsistent practice.
Mindfulness brings peace of mind, which helps when you have metastatic breast cancer.
Does it sound difficult to believe? Maybe, but the studies show that these practices really help. For people with metastatic disease, emotional distress is pervasive and negatively impacts quality of life. Mindfulness tools offer a potential solution.
What mindfulness tools do you like to use? Which ones will you try? We would love to hear from you!
Author: Sarah Murphy, LPC
Sarah Murphy is a Licensed Professional Counselor and coach with more than 12 years of clinical experience. She is staff therapist for Unite for HER and Communications Committee Chair for ACEP. She specializes in energy psychology, including EFT, as well as mindfulness and hypnotherapy.