I recently read the book “Body Kindness” by Rebecca Stritchfield.  She is a Registered Dietitian who sheds some light on how and why we may not be kind to our body which can directly impact our emotional health.  You may be thinking, “what does it mean to be kind to our bodies? I feed it, I move it, I hydrate it – am I not doing this right?”   

Let’s start by thinking how we talk to ourselves about ourselves.  Would you talk to someone the way you talk to yourself?  Are you more concerned about your body’s size or shape rather than your healthful eating habits?  Now think about your food choices.  Do you label food as “good” or “bad?”  Do you make rigid rules around what you can or can’t eat causing a fear of food?  For example, only organic foods are healthy; I don’t like salmon, but I eat it because it’s good for me; this is expensive so it must be healthy.  Are there entire food groups that have been eliminated from your diet potentially resulting in not getting adequate nutrients to heal and nurture your body?  These types of behaviors are just a few examples of not being kind to ourselves in both a physical and emotional way. 

So, how do you set up your own body kindness standards?  This isn’t something that someone else can do for you.  The first step?  Determine your why.  Why should I be kind to myself?  Is it for your emotional and physical health to support you through treatment and beyond?  Is it so you can be happy and healthy for your family, grandchildren, friends, or for your work/career?  Make yourself a priority.  Regularly thinking of ways to improve yourself isn’t being selfish.  You deserve it.  Practicing body kindness is just that – a practice.  You will find that you need to work at it.  The more positive energy you put into it, the more positive energy you will generate.   

Here are some final thoughts that may be helpful as you begin your journey to body kindness: 

• Start with small goals.  Choose one new vegetable or one new recipe to try each week.  Walk for 30 minutes three days a week.  Meditate for 10 minutes every day. 
• Practice convivial eating.  This means enjoying meals with company and creating an inviting environment for your meal.  Maybe sit down for a family dinner at least 3 nights per week or set the table with flowers.   
• Move away from diet culture and unrealistic body images.  Focus instead on a healthy lifestyle and nurturing your emotional health. 
• Don’t be afraid to ask for help.  Lean on your family, friends, or the Unite for HER community. 

• Find something to be grateful for every day. 
• Do something for yourself every day.  Take a bath, keep a gratitude journal, read, cook with family/friends, plant an herb garden, have some tea, volunteer, practice spirituality, do something nice for someone, take a nap, practice deep breathing, clean out a closet and donate, try a new exercise, call an old friend. 

If you are curious about trying Reiki and incorporating it into your personalized plan, keep reading to learn more about this unique and gentle practice from one of our trusted providers.  

Rae Whatley is a Reiki Master from Philadelphia and one of the Unite for HER providers; she has been working as a Reiki practitioner for over 20 years. Prior to becoming a Reiki master, Rae worked as a massage therapist. She now exclusively practices Reiki because of how gentle, simple and effective it can be for so many people.  

What is Reiki?

While different types of energy treatments exist, Rae specializes in Japanese Reiki. It is a gentle, hands-on energy treatment.  

What does a typical Reiki session look like?

Your experience may vary depending on the style of your provider. During an in-person Reiki session, clients typically lay on a massage table, reclining chair, sofa or bed. However, you can receive Reiki sitting up or in whatever position you are most comfortable.  

Reiki can consist of touching and/or hovering hands over the body to transfer energy. Some providers go through a traditional series of hand movements. Others focus on treating more specific spots. For example, if you recently had surgery or radiation on a specific part of the body, your provider may work mostly on those areas as long as you are comfortable.  

Distance Reiki

While Reiki is typically a hands-on practice, it can also be experienced virtually. This is a great alternative to those who are not near a Reiki provider or may be concerned about COVID exposure. A Distance Reiki session may look a little different, but works the same way. Through a video or phone session, the provider will go through hand positions as if they were there in person. Most people report they can feel the energy as if their hands were actually touching them. 

During a session, many people fall asleep or feel as though their mind has shut down. If you struggle with racing thoughts (especially when trying to rest), Reiki can help to create peace, quiet, and calmness.  

Is Reiki safe for cancer patients?

What is wonderful about Reiki is it will not create negative side effects in combination with any medications you may be taking. Whether you are undergoing chemotherapy, radiation, or even if you if you recently had surgery or lymph nodes removed, you can still use Reiki safely and effectively.  

What are the benefits of Reiki?

Reiki is known for managing pain, aiding digestion, boosting energy, regulating sleep, and helping with circulation. Overall, Reiki helps to balance the body. The body is designed to cope with a variety of situations. At times, it can be out of balance due to medical issues, environmental factors, or emotional distress. Reiki is considered a mind-body-spirit treatment as it helps to balance the three. As a result, once your body is more in balance, you will notice benefits such as a more supportive immune system, restful sleep, and decreased feelings of anxiety and depression.   

To learn more about Reiki, visit our resources at uniteforher.org/reiki

Mental health counseling can be an effective tool to manage and address these feelings. According to the research, counseling offers specific benefits for people with cancer. These benefits include: 

Learning to Cope

How do you wrap your head around this diagnosis? Your family and friends can offer support and empathy, but a counselor offers a neutral, safe space to process and come to terms with the reality of a cancer diagnosis. We are professionals, trained to help people handle crises. In Unite for HER, all our clinicians are experienced in working with cancer patients. We use that expertise to help you process what’s happening, as well as to develop strategies to take home with you.  

Reduce feelings of overwhelm and increase a sense of control

Which doctor? Which hospital? Should I get a second opinion? If they disagree, which do I follow? Lumpectomy or mastectomy? Reconstruction or prosthetics? Cold capping? Gel booties? Sometimes the sheer number of decisions, and their weightiness, leaves us feeling overwhelmed. Counselors can’t answer the questions, but we can help you develop a sense of efficacy while you are making them. That sense of control is very important when it comes to emotional wellbeing.  

Manage anxiety and depression

Depression rates range, according to studies, from ¼ to 70% of cancer patients. Anxiety rates reach nearly 50% among this population. Counseling is particularly good at addressing these issues. Learning to think about how we are thinking about ourselves, our lives, and our issues helps us to think more clearly and helpfully about them. Trauma-informed approaches help get at the deeper issues. It all helps you better deal with the diagnosis and all the emotions that brings up.  

Cope with symptoms and side effects

There’s a lot to get adjusted to and working with a professional can help. Research suggests that people who work with mental health professionals during treatment have better success with long-term compliance. She who has a why to live can deal with any how, to paraphrase Nietzsche. Counseling helps you get clear on and connected to the why so you can handle the how.  

Deal with emotional concerns

The roller coaster. Body image. Intimacy and sexuality. Meaning. Loss of control. These and many other issues are the stuff of great therapy sessions. Creating a sense of meaning around our cancer stories helps us feel better, not just about cancer but about ourselves.  

Manage fear and worry about the future

Staying present and getting off the merry-go-round of future anxiety is easier said than done, until we practice. Counseling offers a chance to practice, as well as to build a toolkit for resilience. The lessons and insights gained in counseling move out of the therapy room and into our lives. People say they are better for it. 

When you are going through a crisis, it’s reasonable to arm yourself with tools that will help you successfully navigate the crisis. Counseling is one of those tools. It also is a place to learn and practice those tools. If you’d like to use your passport to set up a counseling session, check out our provider list here. 

Sarah Murphy LPC, Unite for HER Staff Counselor

*Please talk with your healthcare provider before you begin a new exercise routine.

Cancer, treatment and bone density

There are many factors of breast cancer and its treatment that lead to bone density loss. Often the treatments themselves directly affect muscle and bones; in other cases, the effects are ancillary to treatments. Here are some ways in which treatment can affect our muscle and bone health:

• Some of the side effects of our very necessary cancer treatments can affect our muscles and bones, making them weaker.
• Steroids, which are so important in combatting nausea and fatigue right after chemotherapy treatments, can cause muscle weakness and decrease bone density over the long term.
• The fatigue and sickness caused by treatment often lead us to be less active; being less active is also a factor that leads to muscle weakness and bone density loss.
• Treatment-related appetite changes can cause us to not take in the nutrition we need to keep our muscles and bones healthy and strong.

Estrogen and bone density

Another important factor linked to decreased bone density is estrogen, which is a key component of bone density and bone health. This explains why osteoporosis becomes an issue for postmenopausal women among the non-cancer population: as estrogen levels decrease, so does bone density. The same is true for women who have been treated for breast cancer, especially for those with hormone-positive cancers who use hormone therapies, or who have had their ovaries removed or shut down. The resulting loss of estrogen can cascade down to a loss in bone density.

The importance of bone density and how exercise helps

Bone density is something to pay attention to. When our bones lose density, they become more brittle. This makes us more fragile; we become more likely to break bones if we fall. In extreme cases, even sudden movements can lead to breakage. However, much of that risk can be offset by engaging in an exercise routine.

According to Harvard Health Publishing, bones lose density at a rate of 1% per year beginning at around age 40. Among those who have had breast or ovarian cancer and their treatments, the rates are higher. When the loss is severe, the bones become fragile. 

Osteoporosis means “porous bones.” With osteoporosis, the body hasn’t produced enough new bone cells to replace the ones that die off naturally. In the US, about 8 million women and 2 million men have osteoporosis, putting them at greater risk for bone breakage. In fact, it is estimated that osteoporosis causes more than two million broken bones per year. These bones can break after a minor fall, a sudden movement, or even a sneeze.

Building bones

Did you know that bones grow throughout our lives? Our bones are living tissue and building them is a matter of using them. Just like using muscles causes them to get stronger, doing exercises that put stress on our bones helps them get stronger. 

Many studies have shown that strength training can slow bone loss or even build bone density, and some researchers are focusing particularly on people who have been treated for breast or gynecologic cancers. A 2016 study of breast cancer survivors, for example, found that a combined program of cardio and strength training significantly improved bone density after 26 weeks.

Types of exercise

Cardiovascular exercise: These exercises get our hearts pumping. They can (and usually are) weight-bearing, as we are bearing our own body weight. Among these are:

• Walking
• Jogging
• Cycling
• Dancing

Strength/Resistance training: These exercises not only strengthen our bones. They also help build stronger muscles, which protect us from falls. These exercises are also shown to reduce cancer-related fatigue, boost our moods, and improve our overall quality of life. Examples include:

• Lifting free weights like dumbbells or heavy objects like cans
• Using weight machines
• Using resistance bands
• Doing calisthenics like wall push-ups, leg squats, and crunches

Many styles of yoga offer a combination of cardio and strength/resistance training, and can be fun and rewarding, as they also promote relaxation and wellbeing. All of the forms of exercise can help improve our muscles and bone density, our joints, and our mood and wellbeing.

Making it real: creating a workout plan to keep your bones healthy

The study from 2016 involved an hour of exercise three days per week. The hour included 20 minutes of cardiovascular exercise, 25 minutes of circuit-style resistance training, and 15 minutes of core strengthening and stretching. 

If you were to create this kind of exercise routine at home, you could walk or cycle, or use a machine like an elliptical or stationary bike, for 20 minutes. Then you could use apps like Female Fitness or a 7-minute workout for the strength training portion and wind-down. 

Unite for HER offers online yoga classes and fitness programs for passport holders.

Sarah Murphy LPC, Unite for HER Staff Counselor

Unfortunately, the system in the US does not universally encompass mental and emotional care in cancer treatment. This has costs, not only in terms of emotional wellbeing, but perhaps in resilience and ability to heal. Energy psychology techniques may fill the emotional need of cancer patients particularly well. These modalities often focus on addressing and clearing underlying emotional traumas. They also provide effective self-soothing routines that may help cancer patients navigate the emotions that often accompany diagnosis.

Mental Health Matters

The stress-inflammation-disease cycle

Researchers in the field of cardiovascular disease were the first to identify the role of stress in disease. Today, most of us understand fact that stress leads to disease. And a cancer diagnosis itself is stressful! This explains why treating emotions associated with cancer is so important.

Episodic stress is an important part of life, mediating injury and pathogenic assault. When pathogens attack cells, or cells are injured, they become inflamed, holding fluid. This is because of a cascade of activity on the molecular level. In other cases, it is the threat of assault that causes inflammation. In these cases, the hypothalamus (a region in the limbic brain) signals to the pituitary body (often called the master gland) to tell the adrenal glands to release adrenaline. This cycle is known as the HPA axis.

Under normal stress conditions, this action reduces inflammation. However, when people experience chronic stress, this cycle of inflammation–healing–homeostasis is disrupted. Researchers have found that this is at least partly because an immune system cell or cytokine called interleukin 6 (IL6) triggers inflammation in times of stress. And IL6 is implicated in cancer, as well as a host of other diseases including diabetes, autoimmune disease, obesity, depression, and anxiety.

It might not be unreasonable, then, to wonder if decreasing stress levels might assist in the healing response of those with cancer diagnoses, and to prevent cancer occurrence in the first place.

With its capacity to decrease stress, could Energy Psychology play a role in remission?

Kelly Turner studied cases of unexpected and medically unexplained remission, conducting interviews with people who had experienced these seemingly miraculous cures. She distilled the data and found seven key factors that were almost universal. She writes about them in her book Radical Remission.

Among the factors identified are eliminating negative emotions and increasing positive emotions. While the sentence is easy to write, achieving the essence is not! However, EP methods are known for their ability to heal underlying traumas and the ensuing energy disruptions, which lead to distress and may contribute to disease.

The research: treating the emotions associated with cancer using EP

EFT improves physiological markers of health

Bach et al published a study in the Journal of Evidence-Based Integrative Medicine in 2019, examining the psychological and physiological outcomes for people (n=203) who attended a four-day EFT workshop. In this study, participants experienced reductions in anxiety, depression, PTSD, pain, and cravings, and an increase in happiness. Several physiological markers were taken of some study participants (n=31). Interestingly, they found a significant increase in Immunoglobin A (SigA), an antibody that plays a role in immune function, and decreases in resting heart rate, cortisol, and blood pressure.

EFT for chemo brain

Laura Track et al conducted a randomized, controlled study of EFT for cancer-related cognitive impairment (CRCI; aka “chemo brain”). The study was published by EClinicalNews in August of 2021. Participants were 121 patients in Belgium and the UK who met diagnostic criteria for cognitive impairment. The study lasted 16 weeks. For the first eight weeks, half of the participants received instruction in EFT tapping and tapped with a clinician and at home, while the other half waited. They all took a second cognitive test and other assessments. Then, the second group got EFT training. Not surprisingly, the difference between groups at eight weeks was significant, with the tapping group achieving a reduction in cognitive impairment. The second group “caught up” at 16-weeks, after they had done eight weeks of tapping.

EFT for side effects of treatment

Baker and Hoffman published a study in 2014, investigating the effect of EFT tapping on depression, anxiety, and side-effects of hormone therapies used to treat some types of breast cancer. The side effects include pain, fatigue, and menopausal symptoms such as hot flashes and night sweats. The study participants (n=41) received three weeks of instructed EFT and we assigned self-tapping for the next nine weeks. Again, the participants achieved statistically significant improvements in total mood, depression, anxiety, and fatigue, as well as a reduction in hot flashes and the experience of hot flash as problematic.

Pain in cancer patients

Niken, Wahyuningsih, and Prasetyorini published a case study in 2020, documenting the experience of four cancer patients who complained of moderate to severe pain. They found that using EFT reduced the experience of pain.

Spiritual EFT for self-concept of women with mastectomy

Afriyanti and Wenni used Spiritual EFT in a quasi-experimental study of 33 women who had had mastectomies. At baseline, only three had a good self-concept. After three days of tapping, the number had risen to ten. This improvement was statistically significant and gives rise to some questions, including what would happen if the intervention lasted more than three days.

Pilot study in Australia found EFT helped decrease anxiety in cancer patients

Peta Stapleton conducted a pilot study of group EFT for palliative care among cancer patients. Researchers randomly assigned thirty-two cancer patients to either EFT or treatment as usual (TAU). The EFT group received two-hour EFT sessions, led by a trained psychologist, for four weeks. Delivery moved from in-person to Zoom after the Covid-19 lockdown. All patients completed assessments for depression, anxiety, PTSD, quality of life, happiness, pain, hope, and meaning of life. After treatment, the EFT group received significant reductions in anxiety, and trends toward improvements in meaning of life, quality of life, PTSD and happiness. The TAU group did not receive any benefits. These results were compelling enough to launch a full study, which is now underway.

Advanced Integrative Therapy (AIT)

Advanced Integrative Therapy, or AIT, is another energy psychology technique. Practitioners of AIT have used this energy psychology technique to address the underlying emotional causes of cancer. They are seeing good enough anecdotal evidence to warrant a full study. Today, a study of AIT and cancer is underway, with preliminary data expected this spring.

Stories from the (virtual) treatment room

Mis-hearing leads to PTSD-like symptoms, relieved with EFT

A woman in her early 50’s was diagnosed with breast cancer. As often happens to people diagnosed with cancer, she was in the throes of shock and distress when she met with her oncologist. Clients often report that they can’t “take in” what their doctors are telling them. They leave appointments wondering what was just said, and realizing that they have many questions they forgot to ask. In this case, the client mis-heard “grade 4 tumor” as “stage 4 cancer.”

Although she quickly realized her error and understood that she did not have metastatic breast cancer, she was extremely distressed about the idea and still felt terrified. In our individual counseling session, we tapped together using emotional freedom techniques (EFT) Tearless Trauma and Tell the Story protocols. During our session, we were able to reduce her distress and worked to clear her trauma. Thankfully, she experienced a reduction in subjective units of distress (SUDs) from a ten to a zero. Moreover, she stayed clear of distress in subsequent counseling sessions four to six weeks later.

Fear of recurrence

For women with breast cancer who have some understanding of the mind-body connection, fear of recurrence can create what seems like a trap. These women often express a fear that their fear is going to create a negative outcome. Effortfully trying not to think about it, or to think positive thoughts instead, often proves futile. One woman in such a paradoxical trap came for therapy and we began using EFT to manage her fear of recurrence. Her distress reduced during the session. Additionally, having EFT as a self-help tool provided her with a coping tool that she used regularly to help manage her fear as it arose.

Experience of tapping in groups

In regular facilitated support groups, women with various cancer types use EFT at the beginning of the sessions to come together and relax. Often, we use the “constricted breathing” technique to demonstrate and reinforce the physiological effect of tapping. (In this technique, tapping on constricted breathing allows the breath to become fuller and more satisfying/less constricted). Most women achieve a feeling of un-constricted breath after one round of tapping. They also report feeling more relaxed, more present, and, in one case, feeling “warm and tingly.”

A vision for the future

Because of the deep emotional distress that cancer patients often feel, it is important to provide them with tools and support to reduce these feelings. Again, we need to focus on treating emotions associated with cancer. Energy psychology techniques have a demonstrated ability to reduce subjective distress. Moreover, these are tools that therapists can use clinically, and clients can use as ongoing self-help practices. Incorporating mind-body techniques such as these for the management of mood and stress in people with cancer can provide a tremendous benefit to patients’ subjective wellbeing. Because of the role of stress in disease progression, these tools may even improve outcomes.

Written by Staff Counselor Sarah Murphy LPC

With more than 20 years of experience, Rae Whatley is one of our vette d Reiki therapists on our expansive list of providers. Her practice is beneficial for both those preparing for surgery and those recovering. Rae also uses Reiki to help her clients mitigate cancer treatment side effects such as pain, nausea, headaches, feelings of depression and more.

What is Reiki?

Reiki is a Japanese energy healing technique, originally designed for the improvement of the body, mind and spirit. The energy of Reiki is wonderful for improving your mood, your digestion, and sleep. At Unite for HER, we offer both in person Reiki sessions as well as Distance Reiki, which is performed virtually and has been found just as effective and calming.

Rae’s Calming Ritual

Rae encourages you to try this: Place one hand on your forehead, and one hand supporting the base of your skull. Sit like this for a few minutes and breathe slowly. This ritual can lower your blood pressure, bring your heart rate down, and soon you will begin to feel more centered.