Control: It’s All about Perspective

Reprinted by permission from Cancer Fighters Thrive, Winter 2011 edition
Written by Mia James

For many patients a cancer diagnosis can result in a lost sense of control. “When a person gets a diagnosis of cancer, it’s like the carpet they’re standing on is being yanked out from underneath them,” says David Wakefield, PhD, a psychologist and mind-body therapist at Cancer Treatment Centers of America® (CTCA) in Tulsa, Oklahoma.

And the diagnosis is only the beginning. Dr. Wakefield says that this lost sense of control can persist through treatment, as you feel as though your life has been turned upside down. Your former routine is replaced with doctors’ appointments, tests, and treatments, and you may have to make changes in significant areas of your life, including travel, career, and retirement planning. You may become more dependent on others if physical limitations make it difficult for you to care for yourself.

As you meet these new challenges, you are also learning to work with your health care team and to understand the disease and its treatment. You are listening to recommendations, learning a new vocabulary, and absorbing the new reality of your physical limitations. In the face of this new normal, you may find yourself asking, Who’s in charge here, anyway?

Turn Inward to Find Control

Turning inward at this juncture can establish a sense of control for many patients. Control, Dr. Wakefield explains, is in part “a matter of perception.” Therefore, by finding and focusing on factors that you can control, you can feel a greater sense of control overall. “Sometimes we can have perceived control even when we don’t have full control,” he says.

This approach of turning to your mind in times of physical duress and outside challenges is the foundation of mind-body medicine. “Mind-body medicine is using your mind to heal your body,” says Dr. Wakefield. “It’s an innate healing power that we all have.” He explains that we know the body can send messages to the mind (pain, hunger, or fatigue, for example), but a mind-body approach reverses that communication so that the mind is sending messages to the body: “What we’re teaching patients to do is use their mind to give their body messages for health and wholeness.”

Focus on the Present and the Positive

Mind-body therapy can help patients focus on the positive and the present moment — on what they can control. “Almost everything we worry about is in the next hour, at the next appointment,” Dr. Wakefield says. By shifting focus from an unknown and uncontrolled future to the present moment, you automatically gain greater control. Add to that mental shift a positive mindset, and your worries, fears, and discomfort start to lose their hold.

“I try to teach people to ‘marinate’ their mind in the positive,” says Dr. Wakefield. This includes a shift in your response to challenging or unpleasant experiences — focus, he says, on a positive response or reframe the situation in a positive light (What am I learning from this?, for example). As well, look for motivation to be positive about your health: spend time with your children or grandchildren, attend a special event, or plan next summer’s garden. Dr. Wakefield also encourages patients to look for optimistic messages about their situation, such as patients with a similar diagnosis who have had good outcomes. And, he says, there are times when acknowledging your fears can be helpful if it allows you to move forward.

The techniques used in mind-body therapy to help patients gain control vary according to the individual and the situation. Dr. Wakefield says that he encourages patients to tap into their social resources, including friends, family, church, and community, as reaching out for positive support can be empowering. He also teaches a “progressive relaxation response,” which patients can use in a number of situations during treatment when they may not feel that they’re in control, such as when experiencing claustrophobia during an MRI (magnetic resonance imaging scan) or radiation treatment. Dr. Wakefield instructs patients to take command of the situation by closing their eyes, breathing deeply, and taking a mental vacation to somewhere pleasant.

In addition, techniques that distract you from pain or anxiety can help your sense of control, Dr. Wakefield says. For example, humor therapy can temporarily remove you from the weighty reality of treatment and put your mind in a positive place: humor therapy “is like a one-hour vacation from all that seriousness,” he says.

A Patient Gains Control

Gerry Greenhouse, 61, of Albuquerque, New Mexico, says that the most difficult aspect of his diagnosis of non-Hodgkin’s lymphoma was a two-week waiting period between a biopsy and follow-up appointment. “Not knowing the result and [being] fully aware of the consequences of cancer caused extreme stress,” he says. For Gerry, an eighth-grade teacher and middle school athletic director, control seemed to slip further away when he received his diagnosis but was told to wait three months before starting chemotherapy.

Inaction isn’t Gerry’s style. As he puts it, “When my laundry gets dirty, I don’t want to wait months to do it.” Taking an important first step in regaining control over his health, Gerry sought a second opinion at CTCA in Goodyear, Arizona, where he was able to start treatment immediately and also began incorporating mind-body therapy into his treatment plan. He says that Frederick Brunk, MD, his medical oncologist at CTCA, explained that medical therapies would be only a part of his treatment plan and that mind-body techniques would also be incorporated. “He stressed that it was just as important to take care of my whole body and keep a positive attitude,” Gerry says, which allowed him to see that he had control over at least a part of his experience.

Gerry had help achieving that positive attitude from Marcia Murphy, LCS W, his mind-body therapist at CTCA. He says that Murphy also helped his family, who struggled as they adjusted to his condition. Murphy, Gerry, says, “talked to them about my cancer — about how to live with me and about how important it is to stay in the present because by doing that we can stay focused on the here and now, where we have control.” Gerry also found that meditation and contemplation helped him maintain a positive focus and concentrate on aspects of his health and life that he could control.

“I realized that, physically, everything was under control,” Gerry says. “It was going to be up to me to handle it mentally.” Ultimately, Gerry gleaned this valuable lesson from mind-body therapy: “I have learned that the biggest battle with cancer is in your mind.” Using this knowledge to gain control over his prognosis, Gerry is once again very much in charge: “I am teaching, playing rock-and-roll drums, and am mentally strong,” he says.

In Control for the Long Term

It’s clear that you can benefit immediately from mind-body techniques that help you assertively focus on what you can control and on the positive; these tools and the perspective you gain may also contribute to your overall treatment outcome and long-term wellness. By calling upon your mind in this way, you now have another resource, explains Dr. Wakefield, which can work together with your medical treatments and your body to help you heal: “The results are growth and wholeness in all areas of life, not just physically.”