The Cancer Directory

Dr Stephen Greer: The Role of a Fighting Spirit and Alleviating Depression

Before Caryle and Ian’s work, back in the mid-80s, psychosocial oncologist Stephen Greer published his work showing how the very different survival times among women with breast cancer depended on the coping style they adopted within a week of the initial diagnosis. The coping styles he defined were:

• a fighting spirit – taking an active stand against your cancer and believing fully that you can affect your survival

• denial - pretending to yourself and others that nothing is seriously wrong

• stoicism or fatalism – leading to becoming resigned to what is happening

• helplessness and hopelessness – becoming anxiously preoccupied, or collapsing.

His findings showed that those with a fighting spirit fared far better than those in the other three categories both in terms of quality of life and overall survival. Those in denial did next best whereas those who were resigned, depressed and anxiously preoccupied did least well of all. At the 13-year point, 80 per cent of those who had started with a fighting spirit were still alive versus only 20 per cent of those who had collapsed into helplessness. Worse, those who had psychologically collapsed had died quickly, within two years of diagnosis. This means that the average survival rate of 60 per cent for breast cancer at five years masks a huge difference between those who do very much better than expected because of a positive belief in themselves compared with those who do very much worse because they do not.

As this difference in survival rate is bigger than that seen with any medical treatment for breast cancer, Dr Greer realized it was very important to identify those who reacted negatively to their diagnosis and help them to change psychologically so that they could begin to believe in themselves more and become less depressed. Through the use of cognitive behavioural techniques, such patients gained self-esteem and confidence, and began to believe they could survive. Lo and behold, his later studies on the survival rates among these women showed great improvement.

The lessons here are:

• It is vital to feel empowered and believe in your ability to heal yourself

• It is vital to lift your depression

• It is vital for healthcare professionals to provide extra psychological help to improve the coping styles of those who have responded by becoming helpless and anxiously preoccupied by their illness.

Dr Candace Pert: The Scientific Basis for the Mind – Body Connection and the Need to Express Emotion

While both Hirschberg and Greer were gathering their data, huge breakthroughs were being made in the laboratory as the science of PNI, or psychoneuroimmunology, was rapidly expanding through the pioneering work of Dr Candace Pert. She studied the connection between our states of mind, the nervous system, the neuroendocrine system, and the function of the immune system and other healing tissues of the body. It all started with her discovery of the receptor for an opiate secreted in the brain. This naturally occurring opiate was later discovered and identified as endorphin (known as enkephalin in the US). This was a breakthrough, as endorphin was a new kind of messenger molecule different from the kind of neurotransmitters we had known about before. Endorphin was the first molecule to be identified as a neuropeptide or informational substance, and further informational substances were found to be present in all tissues of the body.

This finding started an avalanche of discovery so that, by the mid-1990s, a further 200 of these substances had been identified, secreted in response to different feelings and thoughts, and able to radically affect our tissue functioning. As the PNI findings began to link up with the medical studies, it became clear that those who are chronically stressed or lonely had depressed immune function – with both lower numbers and far lower activity levels in the immune cells. Similar findings were made in those with low self-esteem and those who chronically repressed their feelings. It was even found that the blood cells in depressed people actually carried less oxygen than those who are happy. Dr Pert had discovered that unexpressed emotions can become lodged in the body’s tissues in the form of ‘molecules of emotion’ inhibiting organ function.

The lesson here is:

• Stress over which we have no control, loneliness, grief and unexpressed feelings can inhibit both our immune function and tissue-healing capacity. Conversely, becoming happy and self-expressive can revive our tissue functioning.

Dr Susan Kobasa: The Role of Emotional Patterning

Things became even more interesting when it was found that the immune system has a memory, and that painful memories or repeats of past experiences in which a person has failed or been defeated, can also trigger immune collapse. Researcher Dr Susan Kobasa had described a psychological syndrome she termed ‘learned helplessness’, when those who had experienced failure earlier in life tended to keep repeating the pattern. Now science was showing that this result was mirrored in the immune system. On the other hand, she had also found that a ‘personality hardiness’ in those who respond to stress as a stimulating challenge resulted in a similarly healthy immune response. Here, at last, was a reason why earlier researchers could not make a direct link between stress and cancer – it depended not on stress per se, but on how the individual responds to stress.

The lesson here is:

• It is very important to provide psychological support to those who are not coping well and who see themselves as losers in order to change this underlying negative belief and replace it with strong, positive coping skills and experience of success.

Dr Leslie Walker: The Role of Empowering Cancer Treatment

The final piece of the jigsaw appeared more recently from UK researcher Professor Leslie Walker, who has worked for more than 20 years on the connection between mind – body approaches and improved survival in women with breast cancer. His recent study showed a staggering 17.5 per cent increase in survival 13 years after treatment in women who were taught relaxation techniques and, through hypnosis, to believe that their chemotherapy would cure them. In this case, the benefit of the treatment itself was 15 per cent, so the effect of the mind was greater than that of the medicine! Most interesting of all was the fact that the women who achieved this huge rise in survival rate were those whom Walker called ‘women who were too nice’. The medical description was ‘women with a high level of social conformity’ who tended to look after everyone else and bottle-up their own feelings. He also found an increase in immune function after relaxation and hypnotherapy, so once again it appears that a positive belief in cure and recovery is vital.

The lessons here are:

• It is vital to use visualization, affirmations or hypnotherapy to empower your treatments and to develop belief in their ability to cure you.

• It is important to identify and help those who are too ‘other-focused’ and to help them learn how to put themselves first.

Professors Spiegel and Fawzy: The Role of Support

This all fits with earlier studies done in the US, looking at the effects of psychological support on survival in those with breast cancer and melanoma. Professor David Spiegel showed a doubling of the average breast cancer survival time in those who had weekly support; Professor Fawzy showed a drop in the melanoma death rate from 10 per cent to 2 per cent in those who received weekly support, and confirmed an improvement in immune function, too. The emphasis in both interventions was on the expression of feelings (rather than being positive).

The lessons here are that:

• It is vital to receive support in expressing your feelings rather than bottling them up.

• Being positive does not mean hiding your grief or anger.

Blowing the Myth of Positive Thinking

If, while reading this, you have been feeling upset and emotional, please know that those who have a fighting spirit are almost always those who also have strong emotions and a big reaction to their diagnosis. It is absolutely normal to feel shocked and grief-stricken after receiving a diagnosis of a serious illness. Having a fighting spirit does not mean being permanently positive about having cancer and a fixed, determined grin on your face!

Some readers may misinterpret the information above, believing that it is harmful to become emotional or feel despondent at times about what is going on. This could not be further from the truth. According to PNI, a good cry or outburst of anger are just as good for boosting immune function as having a good laugh. It is repressing your feelings and becoming depressed that flatten the immune response. In fact, ‘fighters’ are defined by their ability to face reality, expressing the appropriate emotional response and ‘bottoming out’ with their feelings, and THEN to set about gathering the information and support they need to mount a realistic, proactive response to their situation.

Working Out How You Are Dealing With Your Diagnosis

Do you think you are reacting with a fighting spirit and believe in your power to heal yourself?

If you think you are reacting with anything other than a fighting spirit and want to change this, it important that you find help and support to deal with your diagnosis differently. Please go to the Resources Directory (pages 255–417) to find help in contacting a counsellor or psychologist trained in cognitive behavioural therapy to help you learn a more positive coping style. Your oncology department may also have a clinical psychologist who can help you, especially if your pattern is to give up and collapse in the face of difficulty.

Do you believe in the power of your cancer treatments to cure you?

You may choose to work with a hypnotherapist to develop powerful positive associations with your treatments, or you could use the relaxation and visualization exercises given in Cope Positively with Cancer Treatment, a CD available from Health Creation (call the Helpline on 0845 009 3366), to empower your treatments.

Do you need help from prayer or spiritual healing?

Contact the local prayer group associated with your church or religious group. Find a healer through the National Federation of Spiritual Healers (helpline: 0845 123 2767). They also do distant healing through prayer for those who are unable to get to a healer. Some of their healers will visit the home or hospital if necessary.

Have you got enough psychological support to express your feelings fully?

Find out about local support groups and counsellors from your GP, the hospital or the Resources Directory (pages 255–417).

So, far from pretending you feel all right if you do not, with support, try to face what is really happening to you, express your feelings, and then create an action plan based on your true situation and needs. Once you have done this, you will feel genuinely positive that you have a working plan and are back in control again.

Underlying States of Mind that May Need to Change

As well as the states of mind that arise in reaction to the diagnosis, there is the question of what was going on for you emotionally before you were diagnosed. As you move into your healing journey, it is important to look at the big issues of:

• improving your will to live

• decreasing your stress levels

• learning to express your feelings in everyday life

• letting go of loneliness and depression

• healing emotional wounds from the past

• identifying and changing the ‘limiting beliefs’ by which you live your life.

Looking at your will to live

The nitty-gritty issue for anyone facing a life-threatening diagnosis is the question of how strong is your will to live? This is a highly confrontational question, but a vital one to nail if you are going to succeed in fighting cancer. Carl Jung realized many years ago that all of us have an equal and opposite urge towards life (eros) and towards death (thanetos). When the eros side is strong, we feel powerful and passionate towards life. But when thanetos is dominant, death can seem very seductive.

So, do not feel that you are alone if the diagnosis of cancer has in some way excited you or felt like a good way out of the stress and distress of living. Ultimately, of course, we all have to die. Dying is a totally natural part of living. But it is awfully sad and wrong to give up and allow yourself to die because your spirit has been crushed by loneliness, grief, disappointment or a broken heart.

I have often witnessed incredible healing when someone has genuinely turned the corner and chosen life. For you, perhaps the diagnosis of cancer can be a real turning point and an opportunity to say ‘yes’ again to finding joy in living. This may happen quite naturally because often the diagnosis of cancer itself throws into sharp focus all that is precious about your life. But if you feel ambivalent about living, the best help you can get is to work with a transpersonal or psychosynthesis counsellor who will work with you gently and creatively to rekindle your zest for life. This is explored more fully in Chapter 9.

The problem of stress

A little bit of stress is healthy and often brings out the best in us. But prolonged stress, particularly stress over that which we feel we have no control over is a major depressant of our immune function. It may be hard to accept but, usually, the stress we are experiencing is of our own making. This is either because we get ourselves into or tolerate ridiculously stressful situations or because we have innate self-stressing tendencies, pushing ourselves to unrealistic limits. It really comes down to deciding that your health and happiness is more important than the goals for which you strive. The diagnosis of cancer can be the most perfect excuse to pull out of anything that is causing you stress.

Expressing your feelings

The next new trick you may need to learn is how to express your feelings in everyday life (not only in relation to the diagnosis). You have already discovered how those who are too nice have suppressed immune function. It is good to copy the Europeans and let rip with your feelings! Remember, anger is as good at improving white blood cell activity as laughter.

Getting out of isolation and loneliness

Another problem for our immune system is isolation and loneliness. So, do everything you can to get back into connection with people. This can be through belonging to groups who support and value you – whether that is a regular class, or a support, community or religious group. Nowadays, there are a huge number of growth and development classes you can join, and there are many support groups that either relate specifically to cancer or are less specific, such as women’s or men’s groups.

Getting out of depression, fear and anxiety

Perhaps you have more serious problems mentally and realize that you are actually depressed. Here again, you are not alone! It is estimated that up to 77 per cent of people with cancer are measurably depressed and it is really little wonder with all the uncertainty and trauma that are experienced. Most cancer units have a clinical psychologist whose job it is to help people come out of cancer-related depression or anxiety, so this route might be worth investigating if you feel really down. But a combination of support from a support group, counselling and spiritual healing can be equally good to lift depression. If you consider yourself to be a fearful or anxious person, this is another state of mind that it would be good to change. The best way of cracking fear and anxiety is by learning to relax and, better still, to meditate or to have a soothing massage or aromatherapy.

Freeing ourselves of limiting beliefs

Most of us allow ourselves to be governed by the limiting beliefs we have picked up during our childhood as to what we are able to achieve or not. This means that, if we have learned that we don’t ever succeed, or that we are not loveable or that good things never happen to us, then this is what happens to us. It is like we have been programmed with faulty software, which will always stop us from reaching our potential and achieving what we want. But through the integrated medicine revolution, a huge number of effective ways of changing our state of mind have surfaced, including developing self-esteem and confidence, and replacing negative beliefs with positive ones. If you recognize that you are being run by your limiting beliefs, then NLP (neurolinguistic programming) can be a powerful tool to change this.

Getting the Help You Need

Counselling

The first step is usually finding someone who will listen really well to what you are going through. This is usually found in a counselling relationship and, again, I would recommend transpersonal or psychosynthesis counselling, where the state of the spirit is given attention along with help to change our feelings, beliefs and behaviour in positive ways.

The counselling relationship is often believed to be only about helping you to accept what is happening to you, grieving appropriately and becoming adapted to the change. However, in transpersonal or psychosynthesis counselling, the relationship is more about trying to find out what is right about your life and only needs your focused attention to flourish. Help can be given to try to see the message in the crisis and to grow positively from the experience, rather than just learning to accept what is happening.