mark d. gilbert, md, director, mind-body medicine skills group program,
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‘ Choosing the Path Less Traveled…. ’ Resilience , Optimism and Hope in Cancer Survivorship. Mark D. Gilbert, MD, Director, Mind-Body Medicine Skills Group Program, University Arizona Health Network, - PowerPoint PPT PresentationTRANSCRIPT
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Mark D. Gilbert, MD,
Director, Mind-Body Medicine Skills Group Program,
University Arizona Health Network,
Associate Director, Psychosocial Oncology and Director of Professional Development, Arizona Cancer Center;
Associate Professor of Clinical Psychiatry,
University of Arizona
‘Choosing the Path Less Traveled….’
Resilience, Optimism and Hope in Cancer Survivorship
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Compassion means to be intensely together with those who suffer.
The point of this attentive presence with a patient is not on curing or fixing a problem – instead, it is simply being in the moment.
Compassion welcomes and provides sanctuary for all that is unpredictable, imperfect, incomplete, awkward, pinched and unspoken.
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BurnoutA debilitating psychological condition brought about by unrelieved work stress, resulting in:
• Depleted energy and emotional exhaustion
• Lowered resistance to illness
• Increased depersonalization in interpersonal relationships (patients become numbers)
• Increased dissatisfaction and pessimism
Increased absenteeism and work inefficiency
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Education
- Illness
- MBM
-Stress
- Imagery
- Spirituality
- Forgiveness
- Hope
- Nutrition
- Humor
- Cognitive
Restructuring
- Emotional
Awareness
- Sleep Hygiene
- Movement
Awareness
- CAM
Relaxation Techniques
Autogenic Training
Meditation
- focusing
- mindfulness
- movement
Biofeedback
Guided Imagery
Music and Sound
Genograms
Life Maps
Spirit Boxes
CBT exercises
Journaling
Eating Meditation
YogaFacilitator lead Talking Circle
Resilience in the EyeResponsibility – Attitude – Awareness Purpose – Empowerment- Connection
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PNI of Resilience, Optimism and Hope
strong social bonds
DHEA Cortisol Hb1ac Hardiness Positive Emotional Granularity Switching Cognitive Set
Hippocampal Volume and HPA axisChildhood trauma
Stress InoculationCRH 1 and CRH 2
Locus Ceruleus and NENPY
COMTGalanin
SerotoninDopamine
Neural Reward CircuitryActin-Polymerization Protein (APP)
cAMP response element binding proteinBrain-derived neurotropic actor (BDNF)
Fear=learning and extinction of amygdala response
The Tree on Resilience Mountain –Other Contributions
Emotional Development
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Resilience, Optimism and Hope
Optimism
optimists believe that discrepancies between their goals and their current attainment will be resolved- minimizing depression, anger and shame
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PNI of Resilience, Optimism and Hope
Hope as a noun (there is always hope), a verb (I hope) an adjective (hopeful) and an adverb (hopefully)
With cancer hope of a cure or prolonged survival, and in terminal illness hope defined as a struggle to come to terms with the multiple losses in a changing reality
hiding or distorting the truth is not hope-engendering;hope best engineered through honesty and empathy by framing hope in a wider context (relationships, belief, control, dignity, inner peace, humor, meaningful events, achievable treatment goals - Clayton)
Hope
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Emotional Life as a Cancer Survivor FEAR (RECURRENCE AND FUTURE TESTS AND TREATMENTS e.g. THE AVASTIN STORY)
SEPARATION
RE-ENTRY
FEELING REMNANTS
ROLE CHANGE
NEW PERSPECTIVES
RENEWED RELATIONSHIPS
RENEWED PURPOSE
SYMPTOMS (PAIN, FATIGUE, BRAIN FOG, INFERTILITY, SEX)
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Living as a Cancer Survivor
The 10 Choices that will Determine Which Road The Survivor Will Take