Increasing the Quality of Life for Someone With a Life-Threatening Illness Like Cancer - Free Self-Help

By Diana Holbourn

Article Summary

Welcome

This article gives advice on several things to do with increasing the quality of life and trying to increase the chances of survival for people with life-threatening illnesses like cancer, including ways of reducing stress when severely ill, relaxation, suggestions on healing relationships while there's still time, recommendations on making the home more comfortable, tips on getting the best out of communication with doctors, ways medical treatment for cancer can be made a bit more bearable, suggestions on a good diet for a weakened digestive system, pain relief, the relief of some other unpleasant symptoms, and joining a support group to be with others who can give comfort and encouragement and maybe practical help and advice.

The Main Contents

Background Information About This Article

The Self-Help Information in the Article

  1. A Few Suggestions on Decreasing Stress
  2. Things That Can Cause Emotional Damage, and Ways of Resolving It so as to Create an Environment More Suited to Healing
  3. Making Our Living Environment More Cheerful and Comforting
  4. Communicating With Doctors
  5. The Best Attitudes For Healing
  6. Support Groups
  7. Meditating to Feel More Relaxed
  8. Thinking More Positively
  9. Eating Healthily
  10. Alleviating Some Symptoms of Disease and Side Effects of Treatment Naturally
  11. Pain Relief
  12. Talking to Children About the Illness
  13. Coming to Terms With Dying

Part One
A Few Suggestions on Decreasing Stress

Thinking

Jane thinks:

This self-help book says that people's thoughts and emotions can influence their health quite dramatically sometimes. I'll be interested to know how the author explains that. But it says it's been found that more people have heart attacks on Monday morning at the beginning of the working day than at any other time of the week, and that in men under 50, a known predictor of heart problems is job dissatisfaction. So that could be an indicator that the well-being of the mind and body are connected.

Stressed out at work

I wonder if the reason heart attacks can be linked to job dissatisfaction is because people unhappy with life are more likely to turn to things that can be substitutes for a fulfilling life like unhealthy food for comfort. Still, I've heard that stress can make things worse.

I've heard that stress can prevent the immune system from functioning so well, so diseases can gain a foothold where they wouldn't normally. Maybe one reason for the placebo effect is that if people feel more optimistic that they can be cured, they'll be less stressed, and so their immune system can function better and help fight things off.

And I think stress can damage people in other ways. I've heard that they say angry, aggressive people are more likely to have heart problems, and I read an article recently on a medical website that said there was a study of thousands of civil servants that found that those who lived in homes where there was quite a bit of conflict were a bit more likely to suffer heart problems than the average. I don't know how reliable the survey was. But I think that thing about angry, stressed people being more likely to develop heart problems is conventional wisdom nowadays anyway.

So maybe the chemicals released into the body when people are stressed and angry play a bigger part in physical health than we might think.

Relaxation

The book says it's important to care for ourselves in ways that'll reduce our stress as much as possible, and also to get as healthy as we can, given our circumstances, because the more a body is cared for, the better it will be at fighting off disease.

So it says that it's important to eat healthily, and to do enough exercise, within our limits, and not to let other people put more burdens on us than we feel we can cope with so we don't get stressed out by them.

Despairing

It also says that if we're full of thoughts that make us stressed, like self-condemnation, resentment, self-pity or whatever else makes us feel bad, then our immune systems will be damaged because of the stress those cause us. It says stress releases hormones into the system that can damage us if we're stressed for some time so they keep being produced. Stress can be useful in the short term sometimes because it can give us the motivation we sometimes need to do things, but if the stress hormones stay in the system for a long time, they're bad for us.

I remember now that I read about a man who had an accident during the Second World War, when he was training off the Hawaiian islands. He'd been getting ready to jump off a barge when a big wave lifted up the barge and knocked him off balance and threw him onto the beach, where he landed so hard that he broke three ribs, and one of them punctured one of his lungs.

He was taken to hospital. But after three months, the doctors said he showed absolutely no improvement. He was shocked.

After a good think, he thought that worry might be preventing him from getting better. He'd been used to leading an active life, and yet for the past few months, he'd been able to do nothing but lie in bed all day and think. So he'd started to worry and worry: He worried about whether he'd be able to do anything worthwhile in life; he worried about whether he'd be a cripple all his life; and he worried about whether he'd ever be able to get married and live a normal life.

He persuaded his doctor to move him up to the next ward, where the patients were allowed to do almost anything they wanted to do. There was a much livelier atmosphere.

While he was on that ward, he learned to play bridge, and became an enthusiastic player, playing it almost every evening. He also became interested in oil painting, and someone instructed him in it every afternoon. He also tried soap and wood carving, and read some books on it that he found very interesting.

He said he kept himself so busy he had no time to worry about his physical condition. He even had time to read books on psychology that the Red Cross gave him.

He said that at the end of three months, all the medical staff came to him and congratulated him on making "an amazing improvement". He was very happy about that.

He said that when he had nothing to do but lie on his back and worry, he made no improvement at all. He even goes so far as to say he thinks he was "poisoning" his body with worry. Nothing would heal. But as soon as he got his mind off himself by doing all the activities he did in the other ward, he started to make this "amazing improvement".

He said that since then, he'd been able to lead a normal life again, completely healed.

Of course, I'm sure that doesn't mean a life-threatening illness could be cured by a simple change of attitude. Or any other illness, or injury. And there might have been other reasons besides his change of attitude why he got so much better than he had done before. I think the point is that the body might respond much better to treatment if we can do things to stop ourselves being so stressed, and to improve our quality of life as far as we can.

Being an Adrenaline Junkie

Adrenaline rush

With some people, it's as if they're addicted to stress hormones. Chemicals like that can make us feel more alert and alive. So with some people, when things are going well in their lives, they'll do things to deliberately make themselves stressed, like picking an argument, or waiting till the last minute to do things so they have to do them in a great hurry, when they had lots of time at first.

I can't imagine you'd do that, Mum. I know you've always got stressed easily, but I never thought you might like it.

No, I'd better not say that to her.

The thing is that this book says that our immune system can function much better when we're not stressed. So to increase its chances of working well for us and working well with any medical treatment we're being given to give us the best possible chances of survival, we need to pamper ourselves and do as much to make life easy for ourselves as we can, within reason.

Ways of Helping our Immune System by Decreasing Stress in Our Lives

The book says that it'll help if we can think encouraging thoughts and do our best to settle any unresolved issues in our lives that are making us unhappy, and then try to focus on things that make us feel good about ourselves, like what we've done well in life.

And it says that another thing that can increase our immune system's chances of working well for us is if we eat the best foods we can and live as healthily as we can.

In Case Anyone Blames Themselves For Getting the Disease

All this doesn't mean we caused the disease by being stressed. There are lots of things that can cause cancer and other serious illnesses. It just means we can help our bodies fight it off if we do as much as we can to help them.

Even if we think we're the ones to blame for getting cancer or any other life-threatening illness we've got because we've been smokers or whatever, it'll help us more if we don't dwell on that but try to focus on what we can do about it now.

Some Characteristics of Long-Term Survivors of Life-Threatening Illness

This book says that some characteristics of long-term survivors of life-threatening illness include:

Modifying Our Attitudes

Anxiety

The author says it's important to examine our lives and attitudes to see if we really want to continue living like we do, or if we could do with changing. She gives an example of attitudes in her life she decided she needed to change, saying she grew up thinking bad feelings like anger were unacceptable and it was important to be nice all the time, and also that it was important for her to always perform at her best; so she got really anxious if she thought she wasn't up to the standards she wanted for herself in something at any time. But she realised after she got leukaemia that those attitudes were just making her stressed all the time, putting unnecessary pressure on her, and there was no need for them. So she decided to rethink her attitudes.

She also managed to become more positive in her attitudes. For example, she says that one day, she was in the shower and saw lots of her hair falling out and got really depressed, because it felt as if a part of her was going down the drain. But then one day, she thought of the idea of thinking of the shower water as a powerful torrent of healing light flowing over her, bringing her vitality and energy.

Just that change of perspective changed her feelings in the shower from depression and powerlessness to hope and positivity.

A Technique for Feeling Calmer and More Positive

Being loving to yourself

She says that when she was still feeling powerless to do anything to help herself, she felt as if she really didn't have any energy. She felt so bad that she wanted her life to end right there and then. When she went to bed, she would pray she'd never wake up.

But then she started doing something that helped quite a bit with her mood. Every morning when she woke up, she'd imagine that Jesus Christ was sitting on the end of her bed. I know you don't believe in Jesus, but listen to this, because you could still adapt the ideas in it to suit you better. I don't think the author's got any particular religion either, but she still found this helpful:

She says she would imagine him sitting there, and think to herself that he knew more about healing than anyone else, so she'd concentrate all her attention on him for a while. She would think about his life and character. She thought there might have been lots of times in his life when he was really tired because the crowds were making demands on him all the time, and he might have longed sometimes to just slip away quietly and become a carpenter again, but he never gave up, because he cared about them so much. She reflected on his strength to never give up, and his gentleness and caring and acceptance of people, and his passionate commitment to truth and social justice, the anger at people who exploited others he had because he cared about them, and the energy and commitment he put into his everyday activities.

Then she would imagine all these qualities as light that was radiating from his body. She used every ounce of her concentration and could imagine the light was gradually filling the whole room. She imagined it surrounding her body, and with each inward breath, she imagined she was breathing it in, breathing in all those good qualities of character into herself.

She found it very calming and uplifting.

I know you don't believe Jesus was God or that he did miracles or anything, but you don't have to even believe he really existed, and this still might work for you, since maybe you could just imagine the image he has - a very caring man, dedicated to helping other people, sometimes going without food because he was so busy trying to help them that he was at it for hours and hours without a break - that's what the Bible says, - boldly speaking out where he saw injustice, calling on rich people to share their wealth with the poor, passionately committed to people's well-being. The Bible says that one day, he wanted to get away and rest, so he went off with his disciples by boat to somewhere quiet to have a break, but the crowds saw where he was heading and got there over land before he'd arrived, so they were waiting for him. But instead of being angry with them, he just got down to trying to help them again straightaway. The Bible says he had compassion on them because they were so needy. That's how caring he was. And he cared enough to spend time with people the polite society rejected as outcasts like prostitutes, and encouraged them to change rather than condemning them for their past.

So maybe you could try imagining Jesus as an inspirational authority figure with all those good qualities, and try imagining what the author imagined every morning. Or something like that.

She says that no matter what state she woke up in - pain, discomfort, depression, despair or whatever, within minutes of starting to imagine that, she'd begin to feel a sense of peace and healing, and it would change her attitude to things. It would give her strength to survive the day.

Throughout the day, and when she was troubled by fears in the night, she would imagine she was wrapped up in the light of these lovely qualities Jesus had, and she'd feel comforted.

She says she knows all the good feelings she felt might just have been products of her imagination rather than being really anything to do with Christ himself; but she says anyhow, she'd far rather have experienced the feelings of comfort and peace she got from imagining those things than the feelings of powerlessness and despair.

She says the technique gets easier and easier to do the more you try it.

She thought that even if she ended up dying, focusing so much on doing things that made her feel peaceful would at least mean she died feeling as emotionally comfortable as she could, rather than in fear, full of the thoughts of self-criticism and negativity she'd had before.

Making Sure Our Priorities Are Right

She says it can help people focus on what really matters so they can make the most of the time they've got left if they ask themselves questions like:

If we ask ourselves those questions regularly, it'll help us focus on what really matters while we can, since if we realise that we're not living life to the full, then, within the bounds of the limitations we have, we can think about how to improve things.

Using the Imagination to Help Ourselves Feel More Positive

The author says it was a struggle for her to give up old negative ways of thinking, since there were some ways of thinking she had that she liked, even though she knew they weren't helpful really. But as she got more and more into new ways of thinking, she started enjoying them more and feeling happier to leave old destructive ways of thinking behind. So that would have helped her immune system.

She says other people might feel the same way.

She says that it does sound like a lot to ask to expect someone to change the way they think about things when they're already struggling with so much else; but she found it easier than she might have done, because she didn't change her thinking patterns by trying to discipline herself to change negative thoughts to positive ones; she instead started using meditation techniques to change her feelings to positive ones, so her thoughts would follow. So, for example, she did that stuff about imagining feeling positive healing light around her, and that kind of thing.

She says the mind can so often be worrying about the future or dwelling on the past that it can cause a lot of anxiety; but focusing on feeling better in the present can relieve that, at least for a while, and it makes it easier to start imagining restful things.


Part Two
Things That Can Cause Emotional Damage, and Ways of Resolving It so as to Create an Environment More Suited to Healing

The author of the book says that a lot of people she's spoken to who've had cancer haven't viewed it entirely negatively; in fact, they've said that positive things have come out of it, and even that it was a blessing in disguise, since it made them stop and take a good look at their lives, and they changed a lot of things that had been wrong in their relationships and the way they had viewed themselves and the world for some time. The book says that if you think of your cancer as a monster lurking in your body that you have to defeat at all costs and you get anxious about it, then that can increase your stress hormones and hamper your body's ability to fight the illness. But if you take a more relaxed attitude, hopeful that at least something positive will come out of it, trying to live life to the full as much as you can, trying to bring relaxation and fun into life where you can, as well as resolving any issues you can that've caused you emotional damage and doing your best to let go of past hurts so you can enjoy the life you have as much as you can now, then the body has a better chance of recovery, because you'll be helping your immune system by being less stressed; and even if you don't recover physically, your quality of life will at least be better while you're living.

The author discusses some types of emotional damage people can live with, and ways of overcoming it:

Low Self-Esteem

No job satisfaction

She says that sometimes, taking to heart what people said when they teased us at school, or what parents said when they criticised us unhelpfully, or feeling rejected by others, can make us think we're not good enough. Some people get damaged long-term by that kind of thinking, always thinking they aren't as good as others, so they haven't got the courage to go for careers they might really like or to build relationships, or do other things they might really enjoy, but will take courage to begin because it means approaching others.

Not doing as well as they could in life gives them a further bad image of themselves, especially if other people don't think they're capable of doing better because they don't themselves.

The first step to getting rid of that kind of thinking can be to acknowledge that that's the way you think and that it isn't helpful.

Then, it's important to find ways of letting go of that kind of thinking and being willing to see things in a new way.

Changing Our Thinking by Thinking About Changing the Words we Use

One way people can put too much pressure on themselves to be who they're not and don't need to be, leading to them thinking of themselves as failures when they fall short, is by thinking they need to live up to standards they don't need to. If you use words like "I should" and "I ought to" a lot, it might mean you're doing that. So it can help to try to replace them with words that give you more leeway, like "It'll be nice if I can be like that, but it's not really essential at the moment". That can make your thinking more healthy, because it means you're not putting so much pressure on yourself when you don't need to.

Another thing is that there are quite a few phrases that might indicate that we're restricting our chances in life.

Embarrassed It can be good if we watch out for when we use the word "But" at the beginning of a sentence, because it might mean we're about to make an excuse as to why we can't do something when we could really if we tried. Also the word "can't" can mean that. Some people are worried about failure; but if we go for something and think we've made a bit of a fool of ourselves, everybody's probably too busy thinking about themselves to care that much anyway. And if we succeed in what we set out to do rather than failing, we'll have good feelings and a sense of fulfilment because we have.

Another way we can limit ourselves is by thinking, "if only" things were different. It can make us waste time on regrets or on thinking we can't do something as things stand, whereas we'd be better off putting our thoughts into planning how we can get around difficulties and do those things after all if it's possible, or to do other things we'd like to do.

I heard that when Thomas Edison was inventing his light bulb, he tried hundreds of times before he made it work. Before he did, someone asked him how it felt to keep failing at it, or something, and he said he hadn't failed; he'd just discovered hundreds of ways not to do it.

I think it was him who said that a lot of people have never discovered they're geniuses because they've given up, thinking they'd failed, just before they achieved something great.

Doing More Things We Enjoy

Doing something enjoyable

It's often the way that the better we treat ourselves, the better we'll treat others. Some people have found that, and said that before they did, they didn't think it was ethical to spend time on their own enjoyment because they thought they should spend all their time caring for others instead, or that they didn't think they deserved to take time out for themselves. But they found that when they did, they became happier, and that made them more cheerful and loving around others, so everyone felt better.

So you could have a think about what you'd enjoy and spend more time on it. Would you like to get out to see more films, or go for walks in the countryside, or watch more sunsets, or watch children playing in the park, or go to the beach and watch the waves? Or what?

Would you like to bring more flowers indoors, or get nice pictures to put on the walls? Would you like to listen to more soothing or uplifting music?

Not Worrying Too Much About Not Being Good at Something

Silly me

You could try to catch yourself when you're putting yourself down and try turning it into a positive. For example, if you start thinking, "I've never been any good at this", you could maybe alter your thinking to, "I'm better at other things than I am at this". Or something like that.

Everyone makes mistakes; and when you do, instead of feeling bad about it, you could just see it as an educational experience you can learn from to help you do better next time.

Sharing Feelings and Good Wishes

Also, if someone compliments you, be willing to accept it. And giving sincere compliments can make you feel good as well, especially if you know the person you're complimenting likes it.

Cuddle

The book recommends you enjoy any love and attention people give you; and take the opportunity to tell people things you'd like them to know that are important, like that you love them. Sometimes, people can be really touched when you start talking like that, and it can start conversations about their feelings for you, and you can end up feeling a lot closer sometimes. That's what I've heard.

Sharing other types of feelings can be healing too.

Sometimes, people have never had any practice in expressing feelings, because they came from families that didn't, or they think they'll be a burden to people if they tell them how they feel about things like their illness, or about things they're not happy with in life. But expressing feelings can help get them out of the system and increase understanding between people. And if the people you tell about things like your illness turn out to be supportive, you can end up feeling comforted and encouraged.

Sometimes, if you're not used to talking about your feelings, it can be easier to start off saying just a little bit, and then build up to expressing more feelings as you get used to it and encouraged that it's allright to do that.

Helping Others

Happy doing the ironing

This book also recommends that people do what they can to help others in whatever ways they can, and take time to listen to them. It says that even if you can't help people that much, the fact that you want to can be the important thing, and they can value even little things. It says that when people start focusing outward on being loving to others and caring about their welfare, that's when self-esteem can go up, because we're feeling we're doing something worthwhile and that makes us feel better about ourselves, and when we're focused on being loving and caring to others, it means we're not dragging ourselves down with negative thoughts about our problems. So life can become much more fulfilling. We might think we're no use to anyone, but even listening to them or telling them how much we've appreciated them over the years can make them happier, so it can make us feel more fulfilled.

Of course, it's important though not to get bogged down in other people's problems that make us start feeling miserable because we don't know what to do to help them solve them. That could make our self-esteem go down instead!

Depression

Depressed

The author gives a couple of suggestions on things that could help lift depression a bit:

Creating a Routine For Ourselves

She says that sometimes, she felt so despairing that getting up in the morning seemed an impossible task and it was difficult to do anything.

She says that one thing that helped was making a timetable for her day, broken up into little chunks so she'd know they wouldn't take long, but very close together so she'd have an incentive to keep moving.

So, for instance, she wrote down that between 7:00-7-20 AM would be her time to get up and have a shower; between 7:20-7:30 would be her time to tidy the bedroom and make the bed; between 7:30-7:45 would be breakfast time; from 7:45 till 8:00 would be the time to clean the kitchen; from 8:00-8:30 would be time to tidy the house; and so on.

Wow, talk about getting moving!

She says she's given that example because she knows other people will be feeling really despairing and depressed just like she did, and she hopes it might help a bit.

She says that sometimes, if you really feel bad and can't manage much, it's worth doing at least one thing to make your house look nicer every day, because it'll make you feel more self-respecting, and you'll at least feel as if you've achieved something. You can't pressure yourself to achieve too much when you feel ill. So you can be pleased when you've done even little things, like tidied a drawer or cupboard, or changed the bed, or dusted a room, or got flowers to put around the house, or something.

And looking after ourselves and trying to put as much purpose as we can into life can help us feel more self-respecting, so if we try to stick to a routine as far as it's possible, like getting up at a certain time in the morning and having a shower every day, it can help us feel pleased that we're caring for ourselves and can help get us in a better frame of mind sometimes.

You can feel better if instead of feeling bad about the things that haven't been done, you can acknowledge that it's difficult in the circumstances and feel pleased with what you have achieved.

Making Our Surroundings Nicer

When you feel up to it, it can help to contact other understanding people like a support group, or perhaps a help-line. If you get lonely or feel more scared when you're isolated, the company might help.

Other ways of getting rid of loneliness and other bad feelings for a while could be reading good books and listening to good music, and maybe enjoying looking at nature.

Angry It can also help if you do what you can to create a nice, warm and loving environment around you, rather than one where you'll be made angry by things you don't really need to expose yourself to, or scared by horror films, or depressed by gloomy information you don't really need to read, like things in the news, or whatever.

Some people think of their cancer cells or other disease as "out to get them". It can help your peace of mind if you change the way you think of them, so you think of them as just blundering unintelligent weaklings who can be killed by chemotherapy or whatever, who are behaving the way they are because they've forgotten how to behave properly.

Expressing Feelings

Crying

The author says that when we do feel fearful or angry or whatever, it's important not to suppress the feeling, but to allow ourselves to experience it and then move on. Sometimes, we might see or hear something that triggers off a memory that fills us with emotions in the most inappropriate place, like in a crowded room. If when we can, we get away to somewhere tranquil where we like being, or anywhere we're happier about expressing the feeling, we can sometimes help ourselves calm it if we acknowledge that we've got it, and then reassure ourselves that it's allright to have it, and then let ourselves experience it for a while before moving on.

For instance, if we're feeling fearful or depressed, or overwhelmed by things, it's understandable that we might feel that way, and especially for people who've felt under pressure to hide feelings like that in the past, it can be healing to acknowledge that the feeling's there, even saying to ourselves, "This is how it feels to feel fearful; this is the way I'm feeling"; and then to assure ourselves that it's allright to feel that way. The reassurance we give ourselves can help to calm the feelings sometimes.

We might need to experience the feeling for a while before it goes away. But the relief of thinking to ourselves that it's no surprise we feel that way can help us overcome it.

A Comment or Two on Forgiveness

Though it might be difficult, it can help our peace of mind if we let past hurts go. We're the only one being hurt from day to day if we hold on to them, or at least, we're hurting ourselves more than we might realise. I think someone once said, "Every sixty seconds you're angry is one minute gone from your life where you could have been experiencing peace of mind instead". Forgiveness can be a healing thing for us because it lets us let go of past hurts that are still affecting us.

And forgiving ourselves for living in ways that weren't good for us in the past, either physically or for our peace of mind, can be healing for our emotions as well. The important thing now is that we live the rest of our lives in ways that'll make them fulfilling and as happy as they can be in the circumstances.

The author goes more in-depth into the benefits of forgiveness and recommends a way forgiveness can be made easier a bit later, saying that forgiving isn't like condoning what people have done as if we think it was allright after all, but like letting go of the hurt still being carried around because of it.

I'll let you know what she says in a minute.

An Exercise For Calming Feelings For a While

She says that sometimes panic and despair can get really bad, but one thing that might help calm it for a while is focusing with all the concentration we can muster on something else. There's a technique we can do where we close our eyes and then focus all our concentration on the big toe of our right foot, not on pondering on it, but thinking about how it feels. We might need to wriggle it about a bit so we can feel it more. We can pay attention to how warm or cool it is, and how it feels against our shoe or sock or the air, like whether it's putting any pressure on the shoe, or whether the air's cooler around it, and that kind of thing.

The author says that this technique can calm even strong emotions, since when we take our focus of attention off them and focus with as much concentration as we can on something totally different, they lose their momentum.

It can also make us aware of sounds and other things in our environment we just hadn't noticed before we became calmer, that we start to enjoy.

Techniques For Calming Panic Before Doing a Relaxation Exercise

Scared

The author says that when we feel overwhelmed by panicky or anxious thoughts, we can do a relaxation exercise to calm down. If the anxious thoughts are important, they'll come back to us when we've finished, so we don't have to worry about forgetting something that matters. If we're in a calmer frame of mind when they come back, we might be in a fitter state to deal with what they're making us think anyway.

We shouldn't think of panic as something we need to fight, since that'll stop us relaxing. Instead, we can think of panicky feelings as lost, frightened, over-tired children, clamouring for our attention right now. Like tired agitated children, they need reassuring and putting to bed.

Some people find it helpful to actually imagine putting their panicky feelings to bed and turning the lights off.

Some people find it helps to imagine putting them into the basket under a hot air balloon and then letting them soar away into the sky.

Some people find it useful to imagine them surrounded by light, and then melting away into the light.

Or some people like to imagine they're putting their problems and unsettling feelings in a boat at the edge of a river, and then pushing it off and watching it float away downstream.

People can invent their own images to symbolise sending them away for a while.

Anger

Anger

The author says that some people have never learned to express anger healthily because they weren't taught to or never learned by observing others do so as a child, or they were taught that it was bad to express it. She says that she never learned to express anger and other feelings healthily. So she kept them inside, not even realising she had any anger, and then she'd take them out on other people when they didn't deserve it because it had to come out at some point, and when she realised she was doing it in the middle of doing it, part of her didn't want to apologise, because her feelings made her think that if she was feeling bad, she wanted to make someone else feel bad.

She says that she was depressed for some time and now feels sure that a lot of it was a mask for the anger she didn't dare express a lot of the time. Depression's one of the body's ways of saying something's wrong with life and needs to change.

She says her daughter's much better at expressing anger than she was, saying exactly what she thinks, being direct. She says she would sometimes walk away from her daughter hurling accusations back over her shoulder, and her daughter would tell her not to walk away but to come right back and say that.

She says she also learned how important it was to listen to other people when they were angry. For instance, her daughter was doing a lot of hard work for her school once and really looking forward to a field trip that got cancelled. On the day she got the letter saying it was cancelled, she still had to do some work for her school, so she did; but after a while, she burst out in anger saying how annoyed she was that after all that, the field trip had got cancelled. She used a swearword, and her mother the author interrupted her saying she didn't want language like that used in the house; but her daughter told her to be quiet and listen. Then she carried on, saying she was annoyed and wanted to cry. Then she did, and then she felt better.

The author says that if she'd insisted on talking about the swearword instead of doing what her daughter wanted and just listening, they might have argued and gone away feeling annoyed with each other, and her daughter wouldn't have got the anger about her trip being cancelled out of her system. So she was glad she listened instead. She raised the matter of language at another time.

She says that although she knows she can handle her own and other people's anger badly, she doesn't keep chiding herself over it, because she recognises that people take time to learn the best ways of doing things.

She says that often, cancer sufferers can get irritable and angry with those who look after them when they don't deserve it, and that can be hard on the person trying to care for them; but there's often another emotion behind the anger and irritability, like fear. Or the main emotion might be anger, but it's about something that has nothing to do with the person bearing the brunt of the anger. So it's worth having a think about the real reasons we feel the way we do, and trying to resolve those.

Some Ways of Expressing Anger

If we're angry because of things that have happened in the past, there are things we can do. If it's not easy for you to simply let go of old hurts, anger can be released in several healthy ways. The author says it's important that it is released, because otherwise it can turn into longstanding resentment, and the chemicals involved in that are the same ones involved in stress that make the immune system function less effectively while they're hanging around.

So she suggests some things people can do that might help:

Of course, there's the old beating pillows routine.

Writing a letter

Some people find it helpful to write a letter to the person who made them angry, going into detail about how angry they feel and exactly why. Writing can get emotions out of the system and so make people feel calmer. You don't have to send the letter. Just writing it can help.

Some people find it helpful to draw images that represent how angry they are.

Energetic exercise Some people find it helps to do something energetic like energetic dancing, or swimming, or some other kind of exercise or hard work.

The important thing is to recognise when we're angry, and then to do something to get the energy out of the system.

Drawing can help us uncover and get other emotions out of the system as well.

Guilt

The author says guilt can be one of the most destructive emotions there is, because it keeps people locked in self-condemnation, whereas what people really need is to be able to acknowledge mistakes, resolve to learn from them, and move on. Of course, people can feel guilty for really serious things sometimes; but other people can feel far more guilty than they need to over little things. people who do that can reassure themselves that everyone makes mistakes. Mistakes can be thought of as learning experiences, or just natural human imperfections - and everyone has imperfections - it's part of being human.

if we've done something we're ashamed of that's hurt someone, we're better off focusing on how we can resolve it if we can, rather than mulling over what we did till it just makes us feel worse. Better to just apologise if possible, make amends if necessary, think through what we can learn by the experience, and then move on. It's important to take responsibility for moving things forward, rather than to get stuck in the past, where we'll only have more and more feelings that upset us.

Anyone feeling guilty about something they genuinely consider serious could look back on it and try to remember the feelings they had and circumstances they were in when they did what they feel guilty about. That might help to stop them feeling so guilty, since, for example, they might have been under provocation when they did what they did, and might not have been thinking clearly because they were too emotional. Remembering how they felt then can give them a clearer perspective on things, that calms their emotions of guilt.

Blame

Accusing

Blaming other people for things that have gone wrong in our lives can keep us stuck feeling helpless to do anything about them. Instead of focusing our attention on who's to blame for things, it can be more helpful if we focus it on asking ourselves what we can do to make the situation better.

It might feel daunting to make the effort to change things instead of focusing our attention on blaming people for what we're unhappy with or thinking about how we could be happier if only things were different, but we'll end up a lot more contented if we try.

Bargaining

The author says that one attitude that can stop any efforts we do make to increase our quality of life from working for us is if we set our standards too high, so we think things like, "If I can only stick to this diet well enough, I'll get well". So we put ourselves under pressure to perform, just when we need to be relaxing and making our lives less stressful. It's good to do everything we can to improve our health, but it should never be at the expense of our quality of life. If we focus on improving our quality of life as our main goal rather than getting cured at all costs, then we'll be more relaxed, and that'll be good for our bodies; but if we end up dying anyway, it won't mean we've failed, because we might have improved our quality of life while we were living. But if we go all out for a cure and sacrifice our quality of life because we're concentrating so much on finding one rather than on enjoying life, and then we die anyway, we could die feeling like failures, and that would be a pity.

Healing Relationships

This book says that often, people might want to just forget past hurtful relationships, but the hurt is still there underneath the surface, affecting their lives even if they don't really realise it. So it's as if they're still connected to that person.

Ways the hurt can still be influencing us even if the person's not around any more or they're even dead, can be in the attitudes we have to things because of our experiences with them. We might have made conscious or subconscious rules about life that aren't really helpful to us, like:

That kind of thing.

The author says that if we can forgive the person who hurt us and move on, it can free up a lot of energy we previously put into all the negativity, and we can feel a lot better for it. We might have to make a decision to let go of the hurt several times before it goes away for good, but it'll be worth it.

Some people don't want to forgive past hurts, because they almost like holding onto them, because they think they have a right to be angry about them, and they like feeling the anger against the person because they think the person deserves it. But it's only our own peace of mind we're hurting when we do that.

The author says there was a man she knew called Jeremy, who was always angry with his mother and argued with her whenever they were with each other, because he was so upset with her for neglecting him. After he was diagnosed with cancer, he complained about her for some time; but when he accepted that he might not have long at all to live, he realised his anger was exhausting and depressing him, and decided that if he only had a few months left, he'd change his ways, because he wanted the quality of his remaining life to be as good as it could be.

That was his motivation for healing his relationship with his mother, and he felt a lot better after that, because since then, he's learned to keep his sense of humour and to have a new perspective on things when he's around her, recognising that she can't love him in the way he'd have liked, but that she does love him in her own way.

He didn't die after all when the doctors thought he would, but went into remission.

The author says that when we forgive the past, our attitudes can soften, because we can sometimes be less driven by anger, and we can develop a new understanding of other people's failings. So we can be more able to cultivate compassion for other people, the same compassion we'd like others to have for us.

More About Forgiveness

The author says that to forgive is to let go of the past so we can respond with openness to the present, without being burdened by the hurt or clutter of what happened before. She says sometimes forgiveness is easy, and sometimes very difficult.

She says she heard an AIDS worker give the definition of forgiveness: Forgiveness is giving up all hope for a better past.

She says there was a man called John who had a bitter relationship with his father, Eric. They'd fallen out over some business dealings years earlier, and the dad had never forgiven his son and once wrote an angry letter to him disowning him as his son. The son knew his dad was in therapy for some emotional problems, but even so, he was very hurt and shocked by the nastiness of the letter, and couldn't easily put it out of his mind. He made up his mind never to be alone with his father again, and was so worried about the effect his father might have on him that he even moved to another area to make it less likely they'd meet.

A while after the son, John, was diagnosed with AIDS, he realised there was a lot of hurt and unresolved grief in his relationship with his dad. He was scared to forgive his dad because he worried it might make him vulnerable to being hurt once again. He was angry with his dad for having made his life miserable, and with himself for having allowed his dad's nasty criticisms to affect him so much.

He hadn't heard from his dad since he'd become ill.

It was getting near Christmas, and John was thinking about how many Christmases he might have left to live. Then, he suddenly felt tired of the pain and grief he'd been carrying around with him for so long. He didn't want to die feeling that way. Then for the first time, he felt a kind of pity and compassion for his dad, and realised how much he'd like his love and acceptance. He thought that maybe his dad would just like that from him as well.

So he decided then and there to let go of the past, to accept it as it was, and to give his dad what he wanted from him so much. He got delivered to his dad a Christmas present of a big basket of fruit, with a simple note telling his dad about how he loved him.

When he did that, he felt a great emotional release, and it was as if a big weight had been taken off his shoulders. He felt even better when his dad phoned him to tell him it was the best present he could ever want.

He felt a lot of peace and serenity after that, knowing he'd let go of all the hurt, and hoping for a more friendly future relationship with his father.

The author says that forgiving someone isn't the same as condoning what they did. We can still think that what they did was totally unacceptable, and have a perfect right to express anger over it. But if we can let go of the hurt it's still causing us, we can feel a lot of peace that we wouldn't otherwise feel.

She says she was seeing someone in the hospital called Miriam, who had a lot of difficulty sleeping. It turned out that it wasn't the pain that was keeping her awake as much as the fear that if she went to sleep, she wouldn't wake up again. She wanted to talk about unresolved issues in her life, that mainly had to do with her son. She'd held anger towards him for years and years because of some expensive family business decisions he'd made twenty years before. She'd been punishing him ever since by never letting him feel close to her.

When she told the author that, she stopped for a minute, and then looked at the author with "eyes that sparkled with recognition". The author says that Miriam realised she'd been punishing herself just as much as she'd been punishing her son.

Right then and there, Miriam healed the relationship in her own mind, and resolved to speak with her son first thing the next morning, after she'd had a good night's sleep.

Insomnia

Trying to get to sleep

The author says that emotional issues can often disrupt people's sleep or give them insomnia. Sometimes, they go to the doctor and are just prescribed sleeping tablets rather than being helped or encouraged to investigate and deal with the causes of the problem. They can become addicted, and soon, they can't sleep without the tablets.

The author advises that such people deal with whatever prevented them from sleeping in the first place, though it won't be easy, and come off the sleeping tablets gradually when they feel ready. Sometimes, a support group can help people deal with emotional issues. It can be easier to deal with some things with the understanding and support of others than in isolation.

One Technique for Forgiving

The author says a lot of people have found this helpful:

You sit somewhere comfortable where you can be quiet, and then first take some long, slow breaths, imagining you're breathing in peace and relaxation. And when you breathe out, with every breath, imagine you're breathing out all your anxieties and tension.

After a while, let your breathing go back to its own natural rhythm. Then think of someone you love. Let yourself feel the love and warmth you feel towards them, and imagine it flowing out from you to them.

Enjoy the experience, noticing how easy it is to feel warmth and love for them.

Then let the image of the person fade slowly away.

Then think of someone you feel indifferent towards, an acquaintance you hardly know, maybe someone you say hello to while they're serving you in a shop, - someone you don't know well enough to have any feelings for, good or bad.

Try to get a good image of the person in your mind, and then imagine warmth and compassion flowing out from you to them. It might feel strange to imagine that when you hardly know them, but keep trying, as if you're just allowing kind feelings to flow out from you to them.

Then in your own time, let the image of them gently fade away.

Then bring to mind the image of a person who has hurt you. Imagine them clearly. Notice if your body's tensing up, and just passively relax so the tension softens. While you imagine the person, allow whatever forgiveness and love you're able to muster to flow out from you to them. Don't worry if you find it difficult. Just imagine whatever compassion and understanding you have for them flowing out from you to them. Hurt and anger that's been around for a long time could be hard to shift, but imagine those feelings softening and melting away into light. Let go of the pain of unforgivingness.


It might be best to start by imagining someone we don't need to forgive that much, and do the technique on several occasions, where we think of someone we need to forgive more on each one.

Or we might need to practice imagining forgiving the same person several times before we really think we've forgiven them.

But when we have, it can release a burden and leave us free to experience greater peace.

Not Putting Pressure On Ourselves to Forgive

We should be understanding with ourselves if we don't feel like forgiving someone straightaway. We can forgive ourselves for not wanting to forgive them. We have to go at our own pace, and not try to put pressure on ourselves to forgive, since that'll just increase the tension we're trying to get rid of. So we need to be gentle with ourselves.

Forgiving ourselves can be just as important as forgiving others.


Part Three
Making Our Living Environment More Cheerful and Comforting

Making Our Home and Surroundings More Bright And Cheerful

Making the place more cheerful

The author gives a few suggestions on things we can do to make our surroundings more uplifting:

One thing she says is that if you're used to wearing sombre colours or have them around you, it can actually lift your mood if you start wearing brighter colours for a change, or having more colourful things around you, like pictures or plants, or other things you like the idea of.

She gives a couple of examples of how people have enriched their lives with little things that brought more colour into their lives.

Blushing

One example is of a man she knew who had a severe illness, one of the effects of which was frequent diarrhoea. One day, he decided he was on the toilet so often that he'd take advantage of the amount of time he had to spend there. He chose a time when he thought he wouldn't need to go for about an hour, and went shopping and bought some brightly-coloured, intricately-patterned flowering plants to put there. That meant he could happily sit looking at their beauty and complex patterns for ages if he wanted.

The author says there was a woman she knew who always used to wear black, who seemed entirely dedicated to her high-powered job, working long hours, not being willing to slow down at first even when she knew she had cancer. She had hardly any friends and had never married. She didn't tell anyone she had cancer, not even her mother.

It turned out that she was so dedicated to her work because she thought that if she kept herself really busy, she wouldn't have to focus on how miserable she was.

But what started her emotional healing was when one day, in the drab-looking hospital for an appointment, she saw a geranium plant in a cracked pot that was half-dead from lack of care. She felt sorry for it, and the day after she saw it, asked if she could take it home. The staff agreed she could. On the way home, she bought a new pot for it. She gave it new and better soil, and started caring for it.

It started her healing her emotions, because taking care of something else made her feel like taking more care of herself.

As she looked after the plant, she softened, and began to smile more. It was difficult for her to give up her old lifestyle with its constant buzz of the business life and pressure of deadlines , and her detachment from other people. But she gradually began to make time in her life for other things, like books, music and crafts. At first, she got a book about geraniums. She was intrigued by what colour flowers hers might have when it bloomed. She was excited the day it burst into red flowers.

As she changed, her home did. She bought other plants to go with her geranium, and she put more colour into her life, and more expressiveness. She went and bought a stray cat to have as a pet. It was an affectionate little thing.

She'd come to own several houses in her business career, one of which was a cottage by the sea. She'd hardly ever been there. But now it became her hobby. She redecorated it at weekends in a cheerful colour scheme once her chemotherapy was over, and put flowers in it. She started making the garden nice, and came to find it soothing, and to feel a connection with life. Her priorities began to change as she began to feel more peaceful. She made friends with people near her cottage, and within a year, had moved down there to live.

Music

Music can be really enjoyable, so we could pay more attention to listening to the music we like most, and maybe even investigate music we hadn't paid much attention to before to see if we like it.

Music can help us feel more energetic sometimes and give our mood a lift. Or it can soothe us at other times.

Pets and Other Animals

Rabbit

Pets can be a comfort when people are miserable. So you might find them comforting if you feel you could look after one. The author says some people feel closer to a pet than to the people around them. Stroking and cuddling a pet or watching it play can be soothing. And they can show love in return that can be calming. Obviously we'd need one with a calm temperament, since some are rowdy things.

Some people get a lot of pleasure from watching birds in the garden as well. The author says she knew one woman who would always go out to the country when her chemotherapy was over and feed and watch the birds. She said she'd immediately feel better when she got there, since being with them made her feel peaceful and connected with life.

Pets like cats and dogs might enjoy being around you when you're not feeling active, (so long as they get the exercise they need somehow), because it means you'll often be there for them to give them pats and cuddles whenever they want. The author says cats and dogs seem to know when people are unwell and will often calm themselves down and be gentle around you. And they can be a good distraction when people are in pain. They can be soothing and comforting.


Part Four
Communicating With Doctors

I think that in the past few years, trainee doctors have started learning a bit about communication skills at medical school. I'm not sure about that. But they never used to learn that kind of thing, as far as I'm aware. So some doctors are much better at communicating in a helpful way than others.

There are a few things we can do if we need our doctor to communicate with us more helpfully:

The author says that a lot of people find they forget a lot of the things their doctor said to them when they walk out the door of their doctor's office, especially if they're under emotional strain at the time. So it can sometimes help if we can take a friend or someone with us to remind us of things later that maybe they've remembered but we haven't, and so they can discuss them with us so we might understand them better or so it will clarify questions in our minds that we can ask the doctor next time.

We should feel free to ask the doctor questions. If we don't think they're being answered to our satisfaction, we could say something like,

"Sorry, Doctor, but would you mind repeating what you said in a simpler way? It's really important for me to understand all this so I know what my choices are so I can make good decisions."

Lots of people write out the questions they'd like to ask the doctor before they go, and then work down the list.

Writing down the answers as well can be a good idea. You could maybe just say something to the doctor like,

"I'm not always very good at remembering things, so do you mind if I write down what you say?"

A lot of people find that taping the conversation with their doctor is very helpful. It can be good to have such a record of it for the future, to remind us of the information we were given.

If we encourage our doctors by thanking them for their help, it can make them more willing to help.

If We'd Like a Second Opinion

If we feel we'd like a second opinion about our problems or the treatment they want us to have, there's no harm in asking. The book says it can easily be arranged. It says we should ask the doctor or his secretary for all our reports, results and Xrays and such things so we can show them to the doctor we get the second opinion from, and then make an appointment with another doctor, or ask our own doctor to refer us to one.

The book says that occasionally a doctor will be unhappy that we want a second opinion, but it's our life and our bodies that are going to be treated, so we should have the right to get what we want.

In fact, it says that if we want a third or fourth or fifth opinion, that's still our right.

If we feel our doctor's really unsupportive, we've got the right and should change to another one.


Part Five
The Best Attitudes For Healing

If we do things to make ourselves feel optimistic and peaceful a lot of the time so we can hope to keep our stress levels at the minimum possible level if we can, then our body's in a better position to heal itself.

Not Taking Much Notice of Doctors' Pessimistic Predictions

Head shaking

One important thing is that we have a good relationship with our doctor. If the doctor's attitude stresses us out too much, it might be as well to find another doctor, or at least to arrange for some comfort and support from someone else after we've seen the doctor. Some doctors can be overly pessimistic, feeling sure we're going to die soon, when actually, lots of people live past the time their doctor thought they would die, and even recover completely when their doctor didn't expect them to. Or some doctors pour scorn on efforts we're making to help ourselves have a better chance of survival, like increasing our quality of life and eating more nourishing food, when in reality, although the doctor might be very good at what they do, they don't have a clue about what benefits these things can have, because they're not experienced in these things but only in their own field of expertise, that they seem to think is the be-all-and-end-all of treatment. So we shouldn't let the doctor's attitude make us too pessimistic.

Some doctors are much more encouraging than others, so just because one doctor may say something you're doing for yourself just won't do any good, it doesn't mean they all would.

Making Decisions About What Treatment to Have

Confused

When making a decision about the kinds of treatments we're going to have, both medical and non-medical, it can be a good idea to give ourselves a set amount of time to gather as much information as we can about various types of treatment, and wait to make the decision till a date we've decided on as our deadline for finding out the information, maybe a couple of weeks later. If we've found out all the information we can first, we can make a better-informed decision, and so we're more likely to trust in the treatment we've chosen to have, and that can be important for our peace of mind and stress levels.

Our Attitude to Treatment Can Make a Big Difference

We can also make a big difference to our state of mind by the kinds of attitudes we have to our treatment while it's going on. For example, if you have chemotherapy, and you spend time imagining it being like a torrent of healing light flowing through you that zaps all the diseased cells so new, vibrant and energetic ones can thrive, it can make you feel a lot more optimistic, and if you're in good spirits when you have the treatment, chances are you'll stand up to it better.

If you do a relaxation technique feeling optimistic that it'll increase your quality of life because of the peace of mind it'll give you, it'll benefit you far more than if you do the same technique reluctantly, only because you're desperately anxious to do things to increase your chances of not dying. If you do it grudgingly, it's not likely to relax you, because you won't really get into the spirit of the relaxation.

So it's best to focus on the good it's doing you, rather than worrying over what you're doing it to try to prevent.


Part Six
Support Groups

Support groups can be good because you can be in an environment with people who understand and identify with what you're going through because they're going through something similar, so supportive friendships can be built up. And sometimes it's easier to talk about feelings with people going through something similar but who aren't close enough to get really upset about what you're saying like friends and family might.

Sometimes, friends and family don't know how to respond when you bring up the problems you're having, but fellow support group members who've experienced similar things will be able to empathise more and maybe be better able to talk through them with you more because they know more about situations like that.

Or sometimes, expressing feelings in a support group and having them validated, and getting used to talking about them, can give people courage to talk about them with their loved ones.

Sad

Support groups can also be helpful and comforting as well in situations where during a long illness, the person with it might look allright a lot of the time, so everyone in their family's pleased because they assume they're well again, and so they get on with their lives, so the one with the illness is left to dwell on how serious things really are alone, deprived of the attention they got when they looked ill.

Or sometimes, family members can feel so overwhelmed by the illness that the person with the illness feels as if they have to comfort the others! So it can be nice to go to a group and feel supported themselves.

Sometimes, talking things through in a support group can help you come to decisions about things you were unsure about before, or give you the courage to discuss problems at home.

One woman the author knew in a support group had had cancer and seemed to be recovering. When she'd got ill, her husband was really supportive. While she was recovering from surgery and picking up her responsibilities to her young children and husband gradually, he helped her and did what he could to pamper her. One thing he did was to buy her an expensive car with a phone in it.

At first, he did what he could for her, but as she began to look well, she found herself doing more and more of the heavier duties like carrying the shopping, and the baby upstairs, and things like that. She wanted to act as normally as possible, because she wanted to believe that everything was going well. Sometimes she felt as if she wanted to cope, but at other times, she wanted more of his support.

After talking it through in the support group, she realised he must love and value her a lot to have given her the car, and he must have thought she'd be around for a long time to do that. She decided it would be best to give him some guidance as to what she wanted from him.

She went home and started a discussion with him about what she was and wasn't happy to do. Her husband said he was grateful she'd brought the matter up, because he'd wondered whether he should bring it up, but felt awkward about it, because she always seemed so capable, and he thought she might get upset if he started talking about it because she might want to forget things related to the illness.

The author says that a lot of our dilemmas, we make for ourselves, because of a lack of communication, because there are issues we're reluctant to confront because the idea of talking about them makes us feel stressed. But confronting them early on can mean we do it before they get really serious and cause more problems.

Partners can come to many support groups if they like. Some people who are ill like theirs there, and some would prefer they weren't so they can talk through things without them for a while.

Support groups can often be encouraging, because chances are, there'll be people there who've done a good job of surviving their illness and are living way past when the doctors said they wouldn't be around, and so they can be an inspiration to others, and give them ideas on good things to try.

Or people can feel a lot of relief when they find out that they're not the only ones struggling to cope and that people are understanding and supportive.

The author says there was one woman called Marianne in a support group she was in, who'd only been diagnosed with breast cancer six weeks earlier. She was a busy mother of three children. She'd found a lump in her breast, and the doctor had said it was probably nothing to worry about but advised her to have a mammogram as soon as possible just in case, since her mother had died of breast cancer when she was 70. She went to have one the next day. It came back positive, and within a few days of her finding the lump, she was sent into hospital and had surgery.

She woke up without one of her breasts. She'd known that might happen, but she was still shocked. The doctor said the cancer had spread beyond her breast, so she'd have to have chemotherapy and radiotherapy.

She received a loving welcome when she got home not long afterwards, and was really moved by all the cards and flowers and things from people.

Over the next few weeks, she seemed to be recovering from surgery well, and gradually got back into the routine of things, until six weeks later, she was back to normal, as busy as she'd ever been, preparing the children's breakfasts and lunches and clearing up the kitchen, and then dropping the children off to school on her way to have radiotherapy. When she had chemotherapy, she only felt bad for a couple of days.

Her husband did a great job of looking after things when she was in the hospital again. But when she seemed to be getting well, he went back to work, and the children assumed she must be allright again since she was back to all her old duties.

Crying

Perhaps her own expectations of herself were too high, because she was crying when she told her story in the support group, sure she'd never be the same again and convinced there must be something seriously wrong with her because the slightest thing made her tearful. She didn't want to let the children know everything wasn't quite allright or tell her husband, since she thought they'd been through so much already. So she felt isolated, alone in her experience, beginning to be fearful that the cancer had spread to her brain.

But as she finished telling her story, and realised how it sounded - she'd been through so much so recently, so it was no wonder she got tearful easily, she began to laugh a bit at her concerns, realising it was silly to worry about crying so easily.

And after the other members of the group had reminded her of how much had happened recently and that it was bound to take a while to come to terms with it all, and yet how much she was achieving in spite of that, she began to realise she was doing a great job, and realised she must have been setting standards for herself that were too high. After hearing other group members talk about their experiences, some of which were similar to her own, she felt a lot more relaxed.

As well as allowing people to express distressing feelings in a hopefully compassionate environment, support groups can sometimes be places where you can find camaraderie and good humour.

Some people are worried about joining support groups because they fear that there'll be people there who are sicker than them and probably going to die. But since there's a possibility that we all might die soon, talking through the issues related to it in a supportive environment where anxieties about it can be acknowledged and accepted has been helpful to some people, because once they've come to terms with the fact that it might happen, that's one anxiety lessened, and thus one hindrance to their peace of mind and quality of life dealt with, so they can heal their emotions better.

Finding a Good Support Group

Being supportive

Some support groups are probably a lot better than others. If we try one and don't like the atmosphere for some reason, we could always try another one if there is one in our area.

The best support groups will have rules about how what's discussed in the group should remain confidential unless a person gives permission to another one to mention something about them outside the group.

Discussions should remain about the way things are for people, rather than delving into theories about how people ought to behave, which could make people feel pressured or as if they're failing.

And no criticism of another person's feelings is allowed.

And everyone is listened to. One person talks at a time, so everyone feels heard.


Part Seven
Meditating to Feel More Relaxed

The author says meditation is like a relaxation technique. It's relaxation for the mind. It involves focusing entirely on the present as much as we can, so worries about the future and upsets over the past don't crowd in and ruin our happiness.

She says there are lots of different techniques. One isn't better than any other; the important thing is that we find one that works for us personally.

The Basics of What's Involved in Meditation and How it Can Help

Relaxing

During meditation, the heart rate can slow, blood pressure can drop, the breathing can slow down, the muscles relax, and the body comes to feel at rest, as the mind becomes tranquil. At least, that's what's supposed to happen.

The author says that before we get into a meditation session proper, one way of relaxing to get us in the mood for it is by tensing groups of muscles up in turn and slowly relaxing them, focusing on the sensations of relaxation in them as they unwind. For instance, clenching a fist, holding it for several seconds like that, and then slowly unclenching it, and then doing the same with the other one; and moving on to tensing and relaxing the arm muscles, by bending our arms or straightening them out till they're tense, and then releasing the tension, and so on.

After that, we can sit calmly. Or we can use the muscle relaxation thing as a type of meditation in itself, which would involve focusing all our concentration on it for a while.

We don't have to do the muscle relaxation thing before we start. It's just one way of relaxing the body and centring the mind on the present moment, so all worries about the future, ruminations on the past and busy or depressing thoughts about our lives now, get pushed into the background so they stop worrying us for the time being, so we can relax better. That's what meditation's for - to help us focus on something restful instead of all our depressing thoughts or whatever.

If worrying irrelevant thoughts do come to our minds while we're relaxing, instead of dwelling on them, the idea of meditation is that we just notice we've had them and let them go, as if we're detached from them for the time being, thinking of them as if they're cars going past, or something like that, that we notice and then forget.

A house plant

It helps if we focus on something else the whole time, if not the tensing and relaxing of our muscles, then something like a picture or an object or a calming phrase, because it's easier for other thoughts to drift out of the mind if we're focused on something else than it would be if we simply tried to empty the mind, because the mind can't stay empty for long. Some thoughts will be likely to come along and fill it, so the idea is that we fill it deliberately, but with something calming. The most calming thing to fill it will be something that doesn't make our minds active, because it's one single thing we can pull our attention back to whenever other thoughts come into the mind that would otherwise make it less restful. That's the idea of focusing our concentration on one thing - to stop all kinds of other thoughts crowding into our minds and making us unnecessarily anxious.

We can do the same with unpleasant feelings that come into our minds during meditation - just acknowledging to ourselves that we've started to get them, and then instead of mulling them over, drawing our attention back to the restful thing we're focusing on, and letting them fade. After all, we don't need to have a lot of the depressing or anxious thoughts and feelings that go on in our heads a lot of the time.

We don't have to criticize ourselves if our thoughts and feelings do disturb our peace; we can just notice we've had them and they're doing that, and allow them to fade, as if we're just watching them go by, so we can get back to feeling more peaceful again.

We can focus our concentration on something in the room with us, like maybe a candle, or even something like the bridge of our nose. Anything we find restful to look at. Or we can focus on something in the imagination, like closing our eyes and imagining we're sitting by a river with logs gently floating past on the current. We could imagine intruding thoughts are the logs going past, and we could imagine we're watching the centre of the gentle river itself as our main focus of attention, aware of the logs (our thoughts) going by, but not focusing on any one in particular.

Or another way of doing things is to focus on a phrase we repeat over and over again to ourselves, perhaps in rhythm with our breaths in and out, like, "I'm becoming soothed and relaxed", for instance.

Focusing the concentration on something like that can stop the mind wandering and getting full of distracting little thoughts that can spoil the state of relaxation.

A flower

Some people find it most helpful to focus on a phrase they repeat, while other people prefer focusing on something visual, such as a picture of a nature scene or another nice picture or image, candles, flowers, or even just a spot on the wall. The important thing is that it should be an image the eyes can rest on without creating a lot of activity in the mind. That way, it can help to calm the mind, because people can keep refocusing on it every time their thoughts drift away, and so they're not distracted out of their relaxation for long by worries or anything.

Because stilling the mind like that can relax it and so it isn't so stressed by emotions, which, when they're strong, can inhibit its logical powers while they're taking the mind over because they swamp it with so many emotional signals that the intelligent part of the mind can't function so freely, and because stilling the mind can free it from being full of thoughts that aren't really important, someone whose mind is calmed and uncluttered because they've become good at meditation can find that solutions to bigger problems can come to them more easily afterwards.

Strong Feelings

Unhappy

Sometimes, though, stilling the mind during meditation allows strong emotions previously pushed into the background to surface, and they can't be just observed and let go easily. Some people want to stop their meditation if that happens, but the author recommends that people allow themselves to let the emotions happen and fade naturally, still observing them rather than getting entangled in them; because when they're out of the system, a greater peace can follow, though it might take several meditation sessions before that happens.

How Often and Long it's Usual to Meditate For

The calmness of mind often built up while meditating can last for some time after the meditation session's finished. But it's good to do a relaxation exercise regularly, maybe twice a day or more, to increase the amount of time we're feeling calm.

There aren't any rules on how long people should meditate for each time. Some people find they get most of the benefits of meditation in the first ten minutes or so, and then their concentration seriously wavers. So meditating a little and often can be the best for them.

Some people are under the impression that it must take a long time to learn meditation techniques, but actually, they're easy to learn.

Some people find it helpful to meditate for as long as forty minutes in each session. In fact, they enjoy it so much that soon, they want to meditate for longer.

Using Meditation Techniques Casually in Everyday Life

After a while, the technique of observing thoughts and feelings and then letting them go practiced in meditation can become a habit, so people can just let thoughts go in everyday life sometimes rather than getting absorbed in them. That can free people from anxiety to some extent, because when worries about things that don't really need to be thought about come into the mind, people can just think, "Oh, I've started to worry about such-and-such", and let it just go past, and focus their attention back on what they were doing, whether that be the housework or whatever, rather than getting absorbed in the worries and getting more and more anxious because of them.

Of course, it's important to think through the real concerns we have and resolve them, rather than pushing them away. But a lot of the thoughts we have are just endless repeats of worries we have, that can get more and more exaggerated the more we think about them, so they can just ruin our day for no good reason. We'll probably know the difference. We could set aside a time in the day to deal with the important stuff if we decide that would be a good idea, perhaps writing down or making a mental note of anything that really needs consideration till then, while letting the rest go if we can.

Where to Meditate

The author says it's best to go somewhere where you'll be comfortable and won't get disturbed. It could be the same place every time in your house, and to help create a restful atmosphere, you could maybe have a nice picture of nature or something calming there, or maybe fresh flowers.

It's best to wear loose-fitting clothes that won't be a distraction because they're uncomfortable and won't restrict the breathing.

If the place you choose is specially set aside for meditation, it may be that after a while, you'll begin to feel calmer as soon as you go there each time.

It may be that you have to ask other family members not to disturb you while you're meditating. Or maybe you could invite them to join in.

It'll be better if the environment you're meditating in's quiet, since then you won't be distracted. But it doesn't matter that much if there are sounds.

Speaking on the phone

Some people like to take the phone off the hook. One thing that can help is if you let friends know what time you've decided to have your meditation sessions, explaining that you consider meditation to be really important in your hoped-for recovery, so they can phone or visit you at other times, although you can say they could come and join you in meditation if they like.

If something does happen to interrupt your meditation, don't worry; the author recommends you just take a couple of slow deep breaths so you can come out of the meditation comfortably slowly rather than being jolted out of it, open your eyes, stretch, get up slowly, and do whatever you need to do, knowing you can go back to meditating afterwards.

Relaxing by Slowing Down the Breathing

Some people worry about whether they're really meditating or meditating deeply enough for it to work. But there's no need to worry. You can tell if you're meditating, since if you are, your mind will become a lot quieter than normal, and your breathing will be light. You don't have to reach a certain depth of meditation to benefit. If you're feeling a lot more relaxed, that's what counts.

It's good, though, to start the sessions by breathing slowly and deeply for a little while, because slow breathing can help release tension and make you feel calmer.

If you feel light-headed while you're controlling your breathing like that, you're probably breathing in too much at once; so try slowing it down more, and also breathing in less at one time. Breathing through the nose, or at least breathing in through it, with the mouth shut, can help with that.

If it's difficult to breathe in through the nose, it won't mean you can't do the breathing exercise. Breathing through partially-closed lips can be as good. If breathing any way's difficult, there's no need to get anxious about not being able to do the breathing exercise, since it's not essential.

Some people find they start coughing when they focus on their breathing. But the author says doing the breathing technique while focusing the attention elsewhere can help with that. Some people find it helpful to focus their attention on their abdomen, which rises and falls as you breathe in and out, or right at the entrance of their nostrils where the air goes in.

Some meditation techniques involve focusing all the attention on the breath as it goes in and out, not breathing in a particular rhythm but just observing the breath as it flows. That's a way of keeping focused on what's happening in the here-and-now rather than allowing the mind to get full of worries about the future and upsets over the past. Again, if any distracting thoughts come into the mind, the idea is to notice you're having them and then let them go, pulling your attention back to your breathing.

Some people get agitated when they think about their breathing too much, so they could try another technique instead.

A Quick Technique for Releasing Tension

Relief from tension

Anyone who's found they're feeling agitated after trying to focus on their breathing can do a quick technique the author suggests that'll hopefully relieve the tension. It's called the Quick Release technique. Here's what you do:

  1. Take a deep breath in and then breathe out with a long sigh. Drop your shoulders. People can hunch them when they're tensed, so dropping them can help relax them. If you drop them slowly, you can sometimes feel a nice sensation of gradual relaxation in them.
  2. Let the muscles in your face and forehead and jaw go limp, so they relax.
  3. Keep your breathing calm and easy.

Other Breathing Techniques

One technique some people use for stilling the mind so as to relax them by distracting them from worries and other thoughts is to count each time they breathe in or out. So they think "One", when they breathe in the first breath, "Two" when they breathe it out, "Three" when they breathe in the next breath, "Four" when they breathe it out, and so on, maybe up to 100. Or maybe up to ten and then back down again, and then to ten again and backwards back down again, and so on. Or some variation of that.

The counting has to be done slowly though, because it's best if the breathing's fairly slow and preferably shallow, because fast breathing can make people feel more tense and anxious.

If you do do that technique, you don't have to worry about losing count; the numbers aren't important; what's important is that you have something to focus on to stop your mind becoming cluttered with all kinds of distracting thoughts that stop you relaxing. If all kinds of thoughts start to intrude into your mind, don't worry either, but just notice it's happening and gently refocus your attention on counting in rhythm with your breaths. After all, meditation isn't about having a still mind but about noticing what thoughts are going past and then letting them go rather than becoming bogged down in them. So having the thoughts when you're trying to focus on something else is nothing to be annoyed about and doesn't mean you're failing in the meditation practice. So if you lose count, you could just go back to the beginning, or back to wherever you like.

Another breathing technique is to count slowly to four as you breathe in, hold your breath to the count of four, and then release it to the count of four. After a while, you can try counting for a bit longer, for instance six or eight, or longer than that. It's important to do what's comfortable though, so count for less if it's uncomfortable for you to count for longer.

Again though, it is important to breathe slowly.

The breathing techniques can be done anywhere. Any time you're out and you feel a bit anxious, you can try calming your breathing, either while you're waiting to do something, or while something's going on that you don't have to give your full attention to. Even just breathing slowly for a few minutes makes some people feel calmer.

Another technique is to imagine there's a little bowl of tiny flower petals just under your nose, and that if you're not careful, your breath will make them blow away. This can quickly quieten the breath down, and focuses the mind on it rather than on intruding nagging thoughts.

It can help to do the "Quick Release" technique before doing any of the breathing techniques, as a way of quickly easing some tension.

Music

Some people find that soothing music played quietly in the background helps them relax while they're meditating. Other people find it distracting. It's worth experimenting with it to see if any type helps you get to a relaxed state.

Meditate For Any Length of Time

Don't worry about not being able to meditate for long in any one go. Some people have said people need to meditate for hours at one time for it to do any good; but that's not true. People can get a lot of benefit in much less time than that.

But you might find it useful to set time periods for yourself when you first start, for instance having 2 20-minute sessions a day. Some people find it so relaxing they want to go far beyond that, because they find the time goes quickly.

Some people find it helpful and comforting to meditate in groups. And it can sometimes be easier to concentrate on it if you have a tape that talks you through it.

Falling Asleep While Meditating

Sleeping

Some people get annoyed because they keep falling asleep while they're trying to meditate. It's normal for our bodies to drift off to sleep if we close our eyes and relax. It can help if we learn to meditate in a comfortable upright chair with our legs and arms uncrossed, or cross-legged on a cushion on the floor, so we don't get quite comfortable enough to be lulled to sleep.

But anyone feeling particularly unwell or on medication that makes them drowsy can meditate somewhere more comfortable, and schedule their meditation sessions perhaps just after a sleep when they're feeling more refreshed and alert.

In fact, they could lie down. Some people find it helpful to use cushions to make themselves as pain-free as possible.

A nice dream

But falling asleep during meditation isn't necessarily a bad thing, since sleep can refresh the body. In fact, using the relaxation techniques last thing at night can make sleep come more easily and be more refreshing.

When you want to stay awake all through your meditation, it can help to meditate before a meal rather than after a heavy meal, since they can make people drowsy. Also, it can help if you time your sessions to be at the times of day when you usually feel most alert.

Scheduling Time to Meditate

It's best to schedule time into your day for meditation rather than just thinking you'll do it when you feel like it, because it'll be easy not to get around to it if you do that. It's easy to get involved in other things and put something off till later and later until you find the whole day's gone and you haven't done it. Even if you think you've got a busy day, it can still be worth finding time where you can schedule it in, because of the refreshment it'll hopefully give you.

Meditating While in Pain

The author says a lot of people find meditation very useful in helping with pain. One reason is that pain can be made a lot worse by tension. Some people might not realise they're tense at all till they relax deeply and then notice the difference.

Also, pain can seem worse when the mind has all its attention focused on it. When the mind's absorbed in something else, sometimes the pain isn't so noticeable. It depends how bad it is.

Sitting Positions for Those Not in Pain

Anyone not in pain might find it helpful to meditate sitting in a comfortable chair, and allowing the feet to rest flat on the floor, or maybe on a cushion if they only just reach the floor. The shoes can be taken off if it's more comfortable that way. It can help if you're sitting up as straight as is comfortable rather than slouching, since it might make you feel more alert.

It can be good to loosen any clothing that's so tight it could become a distraction, and to let the hands rest comfortably in the lap in a position where they're relaxed but they won't slide off and be a distraction.

Possible Side Effects of Meditation

It is just possible that if you get deeply into meditation, you could experience side effects.

Strange Sensations

With Some people, the activity of their brain changes while they're meditating deeply in such a way that their perceptions get distorted so they feel as if some of their body parts are much bigger, or they can feel as if they've lost touch with their bodies, or that they're one with the universe rather than a separate entity. This isn't harmful and the brain can get back to normal again quickly enough.

Light-Headedness

Some people with low blood pressure or low haemoglobin levels might experience light-headedness or nausea during meditation. That can be alleviated if they lie down for their meditation sessions.

Meditation's known to lower the blood pressure. For anyone who feels a bit light-headed when they finish, it's best if they stretch slowly and get up in a leisurely way, rather than all of a sudden, which can make people dizzy for a few seconds as the blood pressure suddenly rises. So you could perhaps sit up slowly first, then breathe a few long slow breaths, then move your feet and hands around a bit, and then gradually become more active.

Since meditation can lower the blood pressure, some people taking drugs to lower the blood pressure find that after a few weeks, they often feel light-headed during it, because the drugs in combination with the meditation are making it too low. So they can find it useful to go back to the doctor, have their blood pressure checked again, and be put on a lower dose of drugs.

Feeling Restless and Agitated

Some people find they become anxious when they start to meditate, because they're scared of relaxing because they feel as if they'll be off their guard and not so in control of things. It can help to make the environment feel safe, such as locking the door if that calms the mind a bit. But experimenting with meditating just a bit at first and then gradually building it up can help. If you take a curious attitude to the meditation, interested to see what it'll do, then that can change the attitude a bit. You can always come out of the meditation when you want to anyway.

Having to Move During the Meditation

If you're meditating and then become uncomfortable and think you'll feel better lying down, there's no harm in stopping the meditation to do that.

Or if you need to stop to cough or scratch yourself or change your position or anything like that, there's no harm in doing that either. You can just start again when you've finished.

If you want a glass of water nearby, there's no harm in that. It's important to be comfortable.

Don't Compare One Meditation Session to Another

Disappointed

You might think one meditation session you had was amazing. But don't compare the rest to it and feel disappointed, because you might still be getting something good out of the less amazing ones. The main idea is that they relax you; so if they're doing that, then that's the important thing. If you start feeling negative about them in any way, they'll stop relaxing you so much. So try to enjoy each one just for itself.

Don't start meditating with any expectations about how uplifting it'll be, how long you'll be able to meditate for, or anything like that. The thing that makes it worthwhile is to enjoy every new moment as it happens as an experience in itself.

Coming Out of Meditation

It's best to come out of meditation slowly. One reason is that some people find it so soothing that to come out of it feels like taking on a burden after being released from it for a while.

So it's best to be gentle with yourself and start your normal activities gradually.


Part Eight
Thinking More Positively

People tend to have set ways of thinking. Some people habitually focus on the negatives of every situation, while some are more positive and optimistic. But pessimistic, negative people can change and start feeling more positive and optimistic, so their bodies will be better able to fight their illness.

It's easier for optimistic people to fight the illness, both because pessimistic people are less likely to think taking steps to become more healthy is worthwhile and so they're less likely to make the effort to help themselves, and because negative thoughts cause stress that weakens the immune system so it damages the body's ability to fight. The thoughts can have a more powerful effect on us than many people think. So it's worth trying to cultivate the habit of thinking more positively and optimistically. It's certainly possible to learn to do that.

People can start by observing their thoughts, although sometimes they have to be quick to catch them, since they flow through the mind quickly and can often be forgotten seconds afterwards, but can leave negative feelings in the mind because they were worries, or pessimistic predictions, or critical, judgmental thoughts about ourselves and others that can make us gloomy if we stay in that frame of mind for long. But if we do stay in that frame of mind for a while, since we'll have more thoughts like that, it should at least be possible to catch ourselves having some of them, so we'll know what kinds of negative thoughts we need to counteract.

Anxious

For some people, worrying is such a habit that if they haven't got anything to worry about, they worry about that.

Other people expect to fail at everything, and then they do, because expecting to fail means they don't bother putting the effort and enthusiasm into things that would enable them to succeed. But when they do fail, they don't plan how to do better next time; it just reinforces their opinion of themselves as failures.

But people can change. It takes effort, but it's certainly possible to develop a much more positive outlook on life.

Some people are reluctant to give up negative thoughts because it feels as if they would be taking on a personality that's alien to them. But it won't be that dramatic; and people get to enjoy being more positive. And the changes in your personality won't get out of your control or be things you don't want. You can choose how much you change.

Dejected

Sometimes, people are negative because of lessons they learned as a child they can't even remember, but that taught them to view things in an inappropriate way, for instance, if they failed badly at one thing and it gave them the impression they're a failure, so they don't try anything new, or get anxious if they have to, even now. Or sometimes the negativity could have been useful at one time, such as if they were bullied at school and started anxiously feeling as if it was best that they kept out of the way of people, and that did stop them being bullied, but now it just hampers their quality of life, because they're too anxious to make friends.

Using the Imagination to Change Thinking Habits

It's easiest to change negative thinking with the imagination, because that can match the emotions that can make negative thoughts so powerful and hard to shift by conjuring up positive emotions, which can change the attitude much faster than just trying to think ourselves into being more positive, because feelings are more powerful than thoughts. For instance, someone who's always anxious about failing could imagine themselves doing something they'd really like to do, and doing it well, rather than just trying to persuade themselves that they can succeed. They could conjure up in their minds feelings of elation at having done it well, and that can make people feel more optimistic, so chances are they'll try harder for what they want, so they're more likely to succeed in getting it. Once they do, they'll feel more confident that they can succeed at things, and those feelings of confidence can carry them on to greater things.

It works best to do that kind of thing in detail, with them taking time to imagine all the feelings they'd have if they succeeded.

It also works best to do relaxation techniques first, because then people will be more in the mood to get right into the spirit of the day-dream.

So what could happen is that a person could imagine going through the thing they're worried about failing from start to finish, imagining it as realistically as they can, starting off by imagining feeling confident, or if it's something like an exam, just a little anxious perhaps, to motivate themselves to keep alert and want to succeed. Then, they can imagine going through the event, perhaps finding it a bit of a challenge, but succeeding in the end, and feeling pleased with themselves.

They could draw on any memories of when they did succeed in doing similar things, if they have any, to help them imagine what it would be like.

People can day-dream about succeeding several times if it makes them feel more confident each time.

That's one kind of technique you can use to help yourself learn to feel more positive and optimistic about things.

Some people think they're no good at using their imagination. But people are really. We often do it briefly without even thinking about it. For instance, if someone suggests we go for an ice-cream, an image of that might flash briefly through our minds, though it's quickly forgotten.

So we can practice building up to imagining more complex things, imagining more and more details in them and imagining them for longer as we get used to it.

We Can Tell That the Way We Think Affects the Body

We can tell that the way we think affects the body, since if we imagine someone in front of a blackboard looking at us with a mischievous grin and then scratching their long fingernails down the board, chances are we'll physically shiver.

Or if we imagine eating our favourite food, chances are we'll get more saliva in the mouth.

On a beach

So imagining good things can affect the body as well as imagining bad ones. For instance, imagining relaxing on a warm sunny beach listening to the gentle sound of waves lapping the shore might make us physically less tense.

So you can see how it follows that you can do your bit mentally to make your body as good an environment for healing to take place as it can be.

Overcoming Negativity Caused by the Gloomy Predictions of Doctors

Feeling hopeless

Some doctors are so pessimistic and so sure about their pessimistic predictions that they can cause patients to become really downhearted. In fact, if they give a gloomy prediction as to when a patient will die, the patient might think it's not worth making the effort to do things that might help in their healing, like meditation, making an effort to become more positive in the way they think, eating more healthily and giving up bad habits. They might sink into gloom and die exactly when the doctor said they would. But if the doctor tells them that many people do in fact beat the odds, and suggests things they can do to help themselves do that, then chances are, they'll put effort into increasing their quality of life and living more healthily, and so their body will have a better chance of fighting the illness off.

The author of this book says she knows lots of people who are living past when their doctor said they'd die. She says she was running a support group of 18 people once where she asked them how many of them were "running late for their own funerals", in other words had lived beyond the time the doctor said they'd die. Twelve of them had, and of the others, some hadn't been given a time limit, and some hadn't reached it yet. The author herself says she's living years beyond when the doctors said she'd die. She went into remission and became healthy, after the doctors said she only had a few months to live.

So she recommends people don't take any pessimism they get from their doctors all that seriously. She says some doctors might be really good at treating people physically, but can really drag them down with their pessimistic and hopeless predictions. So she recommends that if people are feeling gloomy after going to their doctors, they do something uplifting and try to get to be around positive, optimistic people who can help lift their spirits.

Imagining a Positive Future

So despite what the doctor said, you can still dream of living, because they might be wrong. You can spend time relaxing and then imagining your quality of life increasing and doing things you'd love to do, imagining all the positive emotions you might feel while you're doing them. Chances are, it'll have a positive effect on your body as well as on your mind.

Countering Depressing Thoughts With Positive Mental Images

Having a picnic

Just as beautiful things like flowers or sunsets can lift the spirit, so can images we dream up in the imagination. If we can practice bringing some nice images to mind, probably several times a day, we can end up automatically bringing them to mind when we start to feel depressed, and that can help us feel better.

First, we need to find an image we like, maybe one of something about the future we'd like to aim for, or something about our lives that we'd really enjoy doing more of.

Then, as well as enjoying imagining it, we can actually aim for what we're dreaming of in real life.

Or the image can be something else that gives us comfort, like imagining being on a warm sunny beach, imagining actually feeling the warmth and seeing the brightness of the sun, smelling the sea air, feeling full of vitality as we watch children playing and birds flying above, and so on.

Great garden

Or we could imagine being in a beautiful garden as vividly as we can, or wherever we like the idea of being.

We can spend as long as we like imagining these things, going off into a refreshing day-dream.

It's best to close the eyes if we're going to imagine something like that.

Or we could imagine something simpler, like being bathed in a comforting glow of light and warmth.

We might be able to think of lots of things we like the idea of imagining once we get into the spirit of things.

The author says one woman she knew cut out pictures that represented what she was hoping for in the future, and put them in a collage along with hopeful messages, and hung it above her bed, and then every night and morning, she'd look at it for a while and it would encourage her.

One little boy the author knew would imagine his cancer cells as being weeds, and his chemotherapy as being weed-killer, carried in backpacks with hand sprayers by men on patrol. He'd imagine that whenever they saw a weed, they'd spray it with the weed killer, and it would wither and die. He would imagine all the disease-fighting cells in his immune system as being like little men in white overalls coming along in trucks, cars, jeeps, motorbikes and helicopters, to pick up the dead weeds, putting them into wheelbarrows and dumping them over a cliff into the sea.

The author says the most important thing when choosing a set of images to imagine is that they must be about something that's easy for us to imagine because it's related to our own experience or knowledge.

Research has found that people recover better from hospital procedures if they're not anxious about what's happening. The more relaxed a person is, the better position the body will be in to cope physically. So what people think of their chemotherapy matters. If they think of it as a necessary evil, a toxic mix flowing into their bodies, they're likely to be tense and anxious about it and so are likely to experience more side effects from it than someone who imagines it as being like liquid gold, for example, powerfully pouring healing energy into the body.

It's the same with radiotherapy - people could think of it as powerful rays of frightening destruction, or powerful rays of healing light. That kind of thing.

Drawing Images

If it's difficult to imagine things at first, drawing things can help sometimes. People can draw what they like the idea of, filling in details as they think of them, and then it might be easier to imagine what they've drawn than imagining something from scratch.

Also, drawing can sometimes show up areas of negativity a person didn't really realise they still had, that could do with being dealt with.


Part Nine
Eating Healthily

There are lots of books on the best diet to eat when you've got cancer, but they can be frustrating, partly because they give conflicting advice, and partly because to follow some of them, you'd need servants to help prepare the elaborate things they say you need, or vast amounts of money to buy them. The author of this book says that while it's important to have a good diet, it isn't so important that people need to get panicky or start condemning themselves as failures if they're not strictly eating what any diet regime says they should.

She says it's understandable that people can get confused and anxious because of all the strict and impractical diet regimes out there and the way they conflict with each other. For instance, one book might say it's very important to eat lots and lots of garlic or celery, while another one says they should be avoided altogether.

She says that while it's important to eat healthily, any diet planning that robs someone of their peace of mind is self-defeating. It's important to eat healthily, but it's more important not to put pressure on yourself but to feel comfortable with what you're doing so you get peace of mind about it, so the body can be as relaxed as possible, which is the state in which it's most likely to be able to heal.

So people don't need to feel under pressure to make dramatic changes. It's part of having a good quality of life to enjoy food. If you think of a diet that would be good for you - and I know you know the basics of healthy eating advice - then see the advice as a set of guidelines that you can move towards at your own pace.

It's important that your diet's one that you feel must be doing you good, because that'll help the body as well as the sense of optimism you'll get from it. But it ought to be one you can easily prepare and that you're happy with.

The author says she's counselled thousands of people with life-threatening illnesses, and among the long-term survivors, what's most striking about them is not their diet but their attitude of cultivating peace of mind and trying to make the most of each day.

Seeking Professional Advice on Diet

People eating

If you want more advice on the best cleansing and most nutritious diet to eat in your circumstances, it might be as well to go to the doctor and ask to be referred to a nutritionalist or someone who has experience of advising on diets for people with life-threatening illnesses.

But if you see one and they turn out to be telling you to do things you think are impractical or disagreeable, don't get anxious about it. These people sometimes make mistakes or don't take all your circumstances into consideration. Just try to find another one, or discuss with them why you think what they're suggesting is impractical and ask if they can modify their suggestions. There isn't one strict diet it's important to be on. There are a whole variety of options for your diet. So it's possible for a therapist to tailor a diet to suit you rather than trying to make you accept something that might not be easy for you. So that's what they should be doing. If you're unhappy with anything they suggest, don't feel under pressure to accept it; discuss with them how they could alter it for you.

Guidelines on Diet

Healthy food

Although the author says people shouldn't put themselves under pressure to follow a diet that isn't practical for them or that they're not comfortable with for any other reason, she gives guidelines that can help the body if they're worked towards. Here are some of the things she says:

It might be worth looking for books of healthy, easy-to-prepare recipes.


Part Ten
Alleviating Some Symptoms of Disease and Side Effects of Treatment Naturally

The author says that sometimes, doctors can be far more concerned with treating the disease itself than in helping people with it overcome the side effects of treatment or calm some of its symptoms in the meantime before treatment begins to work. She says some people are more distressed by the side effects and symptoms than by having the disease itself. But there are natural remedies that can be very effective for a lot of things.

She recommends people consult their doctor before taking any of the ones she suggests, and then give the doctor feedback on how well they worked, in case the doctor might suggest them to other people in future. They won't be things that interfere with treatment, but just complement it.

She goes through a list of common symptoms and side effects, and suggests things people can do. I'll tell you some of the things she says:

Anaemia

Some Causes

Anaemia's caused when there aren't enough red blood cells to carry oxygen around the body. Oxygen's necessary for energy and keeping the body healthy in other ways. Some of it needs to be carried around in the bloodstream.

One reason people can become anaemic is if they lose more blood than their bodies can easily replace. Sometimes that can happen because cancer impairs the bone marrow's ability to make blood. And some of the drugs people get treated with can stop it producing so much, including some of the ones used in chemotherapy. Some cancers can make the red blood cells very fragile.

Possible Symptoms

Things People Can Do to Help Themselves

The doctor can prescribe iron tablets for anaemia and might want to look into possible causes. But as well as consulting the doctor, there are things people can do themselves to help. There are foods that are rich in iron and other things that can help the body make red blood cells:

Doctors might advise blood transfusions if the situation's really bad.

Bowel Obstructions

Sometimes, cancer can block the digestive tract from functioning properly, or the bowel can be blocked because of scar tissue from operations, or other things. It can be very painful. Waste and gas can't pass, or only a bit does. If nothing can, vomiting can follow.

It's often treated by surgery, and then the bowel's given a rest for a while, as people are given nutrients via a drip.

Afterwards, it can be important to eat soft foods to prevent inflammation in the still-tender parts that would cause it to get blocked again. It's important not to eat foods that could cause constipation like cheese and other dairy products (except yoghurt). Other foods that can cause constipation are products with white flour in them, cooked eggs, and red meats. Also avoid anything else you've noticed makes you constipated.

Also, foods high in fibre could irritate the bowel by causing diarrhoea and so should be avoided, like bran, muesli, and fruit and vegetable skins.

Slippery Elm Powder

The author says that slippery elm powder is really good for keeping the bowel free of further problems as far as possible. She says it comes from the bark of a tree, and was used for centuries by the American Indians as a gruel for their babies to soothe upset stomachs and nourish them. She says it puts a kind of slimy coating over the whole of the gastrointestinal tract, which is very soothing to the smooth muscle of the stomach and small intestine and helps the body heal damaged tissue. It helps regulate the bowel and is useful for people suffering diarrhoea, nausea or constipation.

She says it can be bought in health food shops and doesn't have any side effects.

She says it's best used in powdered form, because it can be best absorbed that way, but it can be bought in tablets.

The author says the easiest way to ingest the powder is if you mix it with a bit of low fat yoghurt or soft, peeled, stewed fruit. She suggests that a couple of heaped teaspoonsful of the powder are mixed with it and taken three times a day, 20 minutes before each meal.

She says you can take it as often as you feel you need it, and she's known people who've virtually lived on the powder and yoghurt for over a week.

It's important to consult with a doctor before doing such things though.

Digestive Problems and Problems Eating

The author says chemotherapy can disrupt the digestive processes, but various dietary supplements can help. She goes into a lot of detail about them. If you read the book, you'll find out more.

For people suffering with a dry mouth that stops them swallowing easily and causes other problems, she says there's even a thing called artificial saliva that can be bought from a chemist. She says it's worth doing, because saliva not only moistens the mouth and evaporates a lot more slowly than water, but it has mild antiseptic properties, so it can keep infections at bay that can be painful if allowed to flourish because the mouth's ability to produce saliva has been damaged.

She recommends that people with digestive problems avoid very acidic, spicy, or salty foods such as citrus fruits or juices, tomatoes, strawberries, pineapples, pepper and chilli powder.

She says very hot foods can be irritating, while cool foods can be soothing.

She says that people with chewing problems will find it easier to eat moist, soft food, and might even benefit from taking in nutrients through a straw instead of trying to eat, such as nutritious soups and vegetable juices.

She says a blender can be used to crush foods up to make them easier to eat. It's best if you eat soft, smooth foods.

She says tilting the head back to swallow can make it easier. Doing relaxation techniques before the meal can also make it easier, since tension makes things more difficult.

Diarrhoea

The author says there are several different causes of diarrhoea, including infections, and disruption to the system caused by chemotherapy. A doctor's advice ought to be sought. And there are natural remedies that can be investigated in addition to the treatment the doctor recommends.

Also, the author recommends avoiding certain foods:

Foods to Avoid with Diarrhoea

Sad and fed up

Wow. It could be quite a challenge to work out what you can still eat!

She recommends people make sure they keep up their fluid intake, since they'll be losing a lot with the diarrhoea.

Diarrhoea causes valuable minerals to be lost from the body. She says some of these can be made up for by eating bananas and potatoes.

She recommends people could have pureed or grated fruits or cooked vegetables.

She suggests people could make meals small and frequent.

She suggests that when people have diarrhoea and other digestive problems, they don't drink any fluid for half an hour before each meal and 90 minutes afterwards, except the fluid taken with tablets. Water can dilute the minerals in the body; so to get their full effect, it can be best not to drink too much fluid with food.

On the other hand, I've heard that with some digestive problems, you need to drink fluid with meals to help the food along down the system, to stop dry food getting stuck in the gut and causing pain.

She recommends people don't eat food that's either very hot or very cold.

She says many people have found their diarrhoea alleviated by taking iron tablets. They ought only to be taken after consultation with a doctor though, since too much iron is toxic to the liver. But it may be that the relief the tablets bring outweighs the risk.

Colostomies and Ileostomies

After a person's had bowel surgery that's meant they've had to start wearing bags to collect their waste, the hospital should put them in touch with an advice and support group. If it doesn't, it's worth asking them if they can.

The author says that bowel upsets can happen while people are getting used to living with their bags, and even after they've begun eating foods again that they can usually tolerate well. But the upsets don't necessarily mean the food has to be given up, because they can be caused by stress, medication, tiredness and other things, besides physical intolerance to them. Also, foods that your body isn't tolerating today might be perfectly allright for you if you have a little break before trying them again.

You should eat slowly, chewing your food a lot, if it's comfortable, breaking it up as much as possible before swallowing. That should help prevent the risk of obstructions. And it's best if people can keep their mouths closed all the time, since it'll prevent them swallowing so much air, since that could cause discomfort in the system. You know trapped wind can be painful.

It's especially important to chew food very well if it's hard food like nuts and cereals, because improperly broken down foods can cause blockages in the system. Hard foods like that could even be avoided or ground up.

It's important that people drink plenty of fluids, preferably at least two litres a day, to prevent dehydration. The author says the contents of an ileostomy bag will always be of a liquid consistency, and drinking less fluid won't thicken them. So fluid intake will be extra important.

More salt can be lost than normal, so it's important to eat an adequate amount, though the amount in the diet shouldn't need to be increased.

Coldness in the Bones

Cold

The author says that quite a lot of people with cancer feel as if their bones are really cold, and no clothing they put on seems to help. She says she used to feel as if her bones were made of ice. She says the only thing she found that helped her was ginger tea. She gives instructions for people who want to make their own. I know you can buy it. I don't know if there's any difference. She recommends people drink a small cup every hour or two, or before they go to bed.

Constant Tiredness

Some people constantly feel too tired to prepare meals. And feeling exhausted can be very depressing. And then once you've got depression, you lose your motivation to do things, so that increases the problem of not getting enough to eat, or not bothering to put in the extra effort needed to make what you eat healthy.

The author says it's important to consult with a doctor to try to find out the cause of the fatigue. There could be a number of reasons. A few of them are if the body's undernourished, if you're anaemic because your haemoglobin levels are low; (Haemoglobin's the protein in the red blood cells that binds to oxygen so they can circulate it around the body); it might be that lung capacity is restricted so not enough oxygen's getting into the body in the first place; it could be one of the effects of the illness you've got or depression; or some other reason.

While the cause is being found and treated, it's possible to get nourishing food without using that much energy.

Grandpa

The author recommends that if there's anyone around who offers to help you, you accept it. It's unlikely they'd have offered if they weren't genuinely willing to help. And if they're helping out of their own goodwill, it should make them feel good about themselves. She says one of the things life's about is people helping each other, so people shouldn't be unwilling to accept help.

Tips That Could Lessen the Burden of Preparing Meals When Fatigued

The author gives several tips on making the preparation of meals easier:

Meals can be prepared ahead of time when you're not feeling too bad, and frozen in individual servings.

Keep easy-to-prepare meals in the house, such as frozen ready meals, canned tuna, salmon or sardines, eggs (preferably free-range), muesli bars, and so on.

Eat small meals often. Small meals can raise the energy levels. Heavy ones can make you more sleepy.

You can use home delivery services to get shopping. You can shop online from a lot of supermarkets, and they'll deliver what you ordered.

If someone's willing to make some carrot-based vegetable juices for you and your body can tolerate them, let them do that, because they can be very effective at picking people's energy levels up, depending on what's wrong with you. The author says she's known them to make quite a difference within a week, when people have started drinking a few glasses a day.

There are supplements you can get from health food shops that can give you more energy, though it's probably best to consult with a doctor before taking dietary supplements.

Ordinary vitamin and mineral supplements can help as well as specially-designed ones.

Liver Disease

The author says some people get a lot of pain when they've got cancer in the liver and some don't. Some get indigestion with certain foods while some don't. But certain foods can often make people feel sick, so anyone with liver cancer could try avoiding them to see if things improve, or to generally make it easier for the liver to function:

She says that anyone who feels tired by the end of the day will have a tired digestive tract as well, so it's best to eat the biggest meals earlier on and just have something light in the evening.

Loss of Appetite

It'll be no wonder if people lose their appetite if it's recommended they give up all the nicest things! But maybe there are lots of things people can eat that I haven't thought of.

But the author says people can lose their appetite for a number of reasons. It can be a side effect of the disease you've got, a result of treatment, or caused by depression and anxiety.

The author says that losing an appetite for foods previously enjoyed can really destroy people's enjoyment of life. Food can be one of the things that makes life good. But she gives some suggestions as to how people can give themselves more of an appetite.

She says it's just as well to consult with a doctor to try to find out what the cause of the loss of appetite is though.

She says chemotherapy can put people off food and then they lose interest in it, and some people find that everything seems to have a metallic taste after chemotherapy. This should go away after a while.

She says that if anxiety, depression or fear are causing the loss of appetite, it's important to seek healing from those things, maybe with the help of a friend, a support group or a professional.

When the main cause of the loss of appetite has been eliminated, then there are things you can do to stimulate your appetite. She makes several suggestions:

Memory Loss and Lack of Concentration

The author says it's common for people to find their memory's terrible after a diagnosis of a life-threatening illness. Stress can cause it, and in fact things like stress and shock are common causes.

It's common for people under stress to forget things really quickly. For example, they might be introduced to someone and then almost immediately, they've forgotten their name. You might forget where you put your keys, more than usual. Or you might forget where you put your glasses, even when you're wearing them.

Actually, I had an embarrassing experience once when I was stressed. Someone was telling me something, and I was listening and thought I was paying attention, but I asked them a question and they answered and sounded a little irritated, and then I remembered they'd told me the answer only about thirty seconds before.

I know some people do that all the time. But if it happens suddenly out of the blue and you're stressed, it could well be the stress causing it, and the symptoms might well improve when you feel calmer.

If you're that worried, it'll probably be worth seeing a doctor about it though.

When your memory's going through a bad patch like that, it's easy to forget what the doctor told you, or to forget to take your medication.

Making lists of things can help, and so can having a set place where you always leave your keys and glasses and other things.

You can get tablet dispensers that have compartments for each day of the week, where each day's labelled, and you put the tablets you're going to want on each day in each day's compartments beforehand, and then you can tell if you've taken a tablet you're supposed to have taken that day by whether it's there or not.

Some people take a small tape recorder when they go to the doctor so they can record what the doctor says. Then they can listen back to it whenever they want.

Some people write down the questions they want to ask their doctor, and ask the doctor to write down the answers.

It can be good to get a friend or family member to go to the doctor with you, because they might remember things you didn't, and it's good anyway to have someone else there to discuss things with.

Feeling Sick

Some Possible Causes of Nausea

Bad reaction

The author says it's common for people with cancer and other life-threatening diseases to experience nausea. Sometimes, chemotherapy and radiotherapy can cause it.

Or sometimes it can be an effect of the illness itself, for instance if there's a tumour in the stomach or liver. It's important to discuss persistent nausea with the doctor, to see if the cause can be discovered. Sometimes it can be caused by the disease if there's a kidney or bowel obstruction, or pressure on the brain. Sometimes, cancer can cause nausea indirectly by leading to the release of too much calcium into the bloodstream.

Anxiety, fear or depression can cause or increase nausea.

Infections can cause it; so can eating too much or drinking too much alcohol; a stomach ulcer can cause it, and so can eating something that doesn't agree with you for some reason.

People can think every symptom must be to do with their disease or its treatment, but sometimes, they're completely unrelated.

Some chemotherapy drugs can make people feel sick and even be sick. But they don't all. Some are very mild and don't have side effects.

Radiotherapy can cause nausea if it's around the stomach area.

Also, people react to treatments in different ways.

Taking Anti-Nausea Medication

If you go on the kind of chemotherapy that makes you feel sick, the doctor's likely to prescribe an anti-nausea drug. Some people can control their nausea without it, while some prefer to take it as soon as they start the chemotherapy, and some prefer to wait and see if they do feel sick before taking it. Sometimes, it's given in the same solution the chemotherapy's in.

If it's given to you to take by mouth, it's best not to wait before taking it, because it's easier to get rid of nausea when it's only mild than when it's severe.

Some people find the side effects of an anti-nausea drug to be worse than feeling sick itself. If you do, it's best to ask the doctor if you can go on a different anti-nausea drug instead.

Some people find they're very restless and jittery after chemotherapy, and that stops them sleeping and disturbs their emotional well-being. This is likely to be a side effect of anti-nausea medication rather than the chemotherapy, so it's worth speaking to the doctor about changing it to another drug.

Feeling Sick When Thinking About Treatment

The author says that sometimes, after someone's been in treatment for a while, or if they had a particularly bad reaction to chemotherapy once, they can start to feel sick, or even be sick, when they just think about how another session's coming up. Sometimes, even the sight, thought or smell of the hospital can make people feel sick.

Worrying about mental health

Some people think they must be weak or becoming a bit mentally unsound when this happens. But they don't need to worry, because it doesn't mean that. Since the body and mind are so interconnected, if the body's used to feeling sick because of the treatment, the brain will bring to mind its stored memories of us feeling sick when something associated with the treatment happens that brings it to mind, since quickly bringing to mind memories of what things are like is one of the ways it helps us recognise them again quickly, so you feel sick again.

Chemotherapy can be more tolerable if you do relaxation techniques in the days leading up to it, and maybe even take a relaxation tape into the hospital with you to listen to while you have it. If you're used to the voice on the tape, even its familiarity can be comforting.

Some people have no problems at all with chemotherapy. But if it's becoming a real burden, it might be worth consulting with a doctor about whether they think it would be allright to have a break from it for a while, or go on a less intensive regime.

Trying to Eat When Feeling Sick

Chemotherapy drugs are broken down in the body by the liver. So since it's being given so much work to do, it's worth eating a diet that'll be as gentle on it as possible if you can.

If the cause of the nausea isn't eliminated, whatever it is, there are at least things that can cut down its effects.

Some foods aggravate people's nausea, while other people can eat the same things with no effect.

It's important not to eat things you don't really like just because you think they're good for you. It should be possible to find things you enjoy even if you have to give up a lot of stuff. There might be recipe books around with a lot of good alternative ideas for foods.

People tend to just lose their appetite with persistent nausea, and it can be upsetting when they're already losing weight, or their lack of food makes them feel as if they haven't got any energy.

Some people find their nausea goes away when they eat something. It probably depends on its cause.

Some people can't imagine ever feeling better again. It's understandable they should feel that way, especially if they've been sick for a while; but there is hope, since a lot of people who felt really sick during treatment feel really good again within weeks of it finishing.

The author says side effects of treatment can be reduced quite a bit if people are on a nourishing diet, drinking vegetable juices and taking vitamin and mineral supplements, meditating, and keeping a positive outlook on life and their treatment.

Foods It's Best to Avoid When Feeling Sick

The author says it's best to avoid the usual culprits when feeling sick or about to have treatment that might make you feel sick: oranges and orange juice, fried foods and other fatty and oily food, cheese and all other dairy products except low-fat probiotic yoghurt, alcohol, cooked eggs, and complex mixtures of foods.

Having said that, some people can tolerate soft-boiled, poached or lightly scrambled eggs better than hard-boiled ones.

With other foods, some people might feel sick after eating them while other people can tolerate them well; so it's worth experimenting a bit.

It's best to keep the diet simple while having bouts of nausea, maybe sticking to only two or three foods per meal.

It might be as well to consult a naturopath who's had a lot of experience with your particular type of illness about the best vitamin supplements to take with your illness, if you can get one recommended to you by other patients or a cancer charity or organisation.

It's best to tell your doctor and specialist if you're intending to take vitamin supplements though, since although they probably won't know that much about them so they might not be all that enthusiastic, just occasionally, dietary supplements can interact badly with other things you're taking or cause other problems for someone in your condition, so it's worth asking a doctor about that.

The author says slippery elm powder can be good for nausea as well, mixed with soft foods like mashed banana or whatever you like, to make it more palatable, as well as other remedies.

Other Tips For Eating While Feeling Sick

The author gives several tips. Here's an idea of what she says:

Over-Eating

The author says that some drugs patients are given stimulate the appetite so much that they end up over-eating and put on lots of weight. She says if the weight's difficult to shift after treatment's finished, it's worth going on a good exercise regime.

Having Oxygen Available at Home

Some people get very breathless when doing things that they probably didn't think twice about before, like getting up to have a shower. For anyone who finds it difficult to breathe as soon as they become active, they could consult with their doctor about having an oxygen cylinder in their home that they can breathe out of for several minutes before doing anything active to make breathing easier. You can even get portable ones you can carry out of the house with you.

Shingles

Shingles is a painful illness that can especially affect people whose immune systems are suppressed. It's best to avoid children with chicken pox, because when adults catch it, it can turn into shingles, which is much, much worse.

Itchy Skin

The author says it's common for people with some conditions to get skin irritations, and people are best seeing their doctor about them. But sometimes people get itchiness and it's difficult to find out the cause, but it often just happens in one particular area of the skin or scalp, and using an anti-dandruff shampoo on the skin or an anti-bacterial wash can sometimes help.

Actually, a couple of people have told me they find putting hand cream on an itchy area makes the itch go away. Someone asked me if I had some hand cream not long ago because they had an itch, and they put it on their foot!

Then again, it probably depends on what's causing the itch. Some skin conditions might make the skin so sensitive it stings or something.

Watery Eyes

Tearful

The author says that some people on chemotherapy get an over-production of tears, and they don't understand why. They're told it's not a side effect of the drugs. But she says she's met enough cancer patients to know that it tends to clear up when treatment finishes and so it does seem to be a side effect of a drug. Well, either that or chemotherapy just makes people tearful. She assures people that they don't need to worry and just advises they keep a tissue handy till it goes away.


Part Eleven
Pain Relief

The author says that although some people are scared of the pain of cancer, it actually varies a lot in its effects on people from very painful to not at all, and when it is painful, the pain can often be controlled with drugs. She says that while some people have such a disease, they'll worry that any pain they get is related to it and must mean the disease is getting worse; but it might be something completely unrelated, like arthritis or whatever. So it's important to discuss it with a doctor and find out the cause.

But she says there are natural methods of pain relief that can work alongside what the doctor suggests, although she advises discussing them with the doctor before doing them:

Thinking of Pain as Being on a Scale From 0 to 10

She says it can help to think of pain as being on a scale from 0 to 10, with 0 meaning you're not in pain at all, and 10 meaning it's important to do something serious about it this minute.

It helps give other people some idea about how much pain you're in if you can talk about it as if it's on a scale like that. Also, when you get familiar with thinking of your pain as if it's on a scale, you'll have an idea right away of what to do to relieve it when it's on any particular number.

Reading For instance, when it's on a 3, maybe some diversionary activity will stop you noticing it so it'll be as if it's not there. So getting absorbed in a good book or reading something else you find interesting might stop you feeling it, or maybe going for a walk, talking to other people, or doing whatever else you enjoy.

If it's on a 5, it might mean doing a relaxation technique to relieve it. Relaxation exercises can work to relieve some pain, because tension can make some pain a lot worse. The author says that muscles can release lactic acid when they're tense, and that irritates the surrounding tissues; and pain can make people hold themselves more tensely, so the muscles release more, and that causes more pain, and so on. So relaxing relieves all the pain the tension's causing.

If the pain's a 7, it might mean having a painkiller, or increasing your dose of them.

And so on.

The author says people's pain thresholds vary a lot. She says some people can tolerate a lot of pain, while for some people, when pain starts, they immediately feel fearful, so they get tense, and they can't think of anything else, and both those things make the pain seem worse.

Sometimes pain can wear people down over time, so they get less and less able to cope with it as time goes on, so they need more effective pain relief.

Rainy

She says that sometimes, things like the weather, tiredness, boredom, fear, or thinking about some unpleasant part of treatment that's going to happen to us can make pain feel worse. It's easier to shrug it off if we're feeling full of energy and good humour.

The author says boredom can make pain feel a lot worse. Getting absorbed in something can take the mind off it so it doesn't bother us so much, up to a certain point. Looking at nature might help, or playing a game like scrabble with someone, or listening to a book on tape. I think it's possible to get quite a few from the library nowadays. Or whatever we enjoy doing.

Artist Some people find arts and crafts helpful, like knitting, tapestry, painting or other things.

Massage

If someone can give you a gentle massage, that can be good, because it can be relaxing, and help areas held stiffly because of the pain become less tense and so more mobile. The author says that everyone with a serious disease is bound to have muscular tension. She says that when people are in pain, they'll often hold the painful part in an unnatural position unconsciously to protect it from being bumped; but the muscle tension causes it and the surrounding area to become more painful. For instance, tensing the shoulder for some time could cause pain in the neck and arms. Relaxing the tension with gentle massage can get rid of all the pain caused by the tension, just leaving you to deal with the original pain.

Deep massage, where the person doing the massage digs their fingers in and is quite rough, can sometimes be risky for people whose cancer's spreading in the body, - some people think that because such massage increases the circulation a lot, the blood could spread it faster. There's a debate about whether it can. Some say it takes more than just the circulation of the blood to spread cancer cells. But certainly, people would need to be very cautious when massaging the area with the tumour with any type of massage. But in any case, very gentle massage should be fine for most of the body.

Anyone wanting to seek the services of a professional therapist who does massage should find one who's trained in massaging people with serious illness, so they don't do anything that could increase the pain or be risky, and they should consult a doctor before going.

But any care-giver could give a gentle massage.

It can be good to rest painful parts of the body on pillows or something, and to elevate them if there's any swelling in them, since that helps fluid drain away from them.

The author says massage can lead to deep relaxation. And the nurturing it provides can give people more of a sense of well-being. She says it can improve the overall circulation, which is usually beneficial because toxins in particular areas can flow away and be eliminated, nutrients can spread more effectively around the body, and cold areas can warm up because of the increased blood flow in them; and it can relieve muscle spasms that could be causing pain, discomfort or making it more difficult to move.

Just touch can be very comforting, like a hand held or face stroked.

The author says that if a care-giver does those things, it can feel nice for them to feel appreciated, even just with a smile or loving gesture in return, - that's all it could take for them to know you appreciate it.

Warmth

Simple warmth can relieve pain sometimes. Putting a hot water bottle maybe wrapped in a towel against the affected area can help. It's best to check regularly that it's not leaking though, if you use it often.

There are also specially-made products for warming painful areas.

Exercise

Gentle exercise

The author says that something involving exercise can be a helpful distraction from pain, perhaps a favourite sport, or only a gentle walk. For people who can't manage things like that, there are exercises you can do in bed, that can help relieve stiffness and make circulation better. Rotating the ankles, and tensing and gently releasing the tension in muscles throughout the body in turn can be helpful for that. For instance, clenching a fist and then slowly relaxing it, and then bending an arm up tight and slowly relaxing that, and so on.

For anyone who can manage it, vigorous exercise can help relieve some pain. Apart from the distraction, the brain can release endorphins during it, which are natural pain relievers. It can also do that when people have a really good laugh or cry. So people can end up feeling pleasantly relaxed.

Exercising

The author says some people find they can control their pain just by exercising. She says some people find the pain increases at first, but then it goes away and stays away for an hour or more. I'd think it would be best to consult with a doctor or someone first before trying it though.

She says she knew someone who had her exercise bike moved into her bedroom, and used to go on it several times a day. She would start off slowly, since it was quite painful at first, but then the pain lessened gradually and she was able to increase her speed bit by bit till she would cycle quite energetically for about ten minutes. She said it would give her pain relief for about one and a half to two hours.

Cheerful The author says people have found a lot of pain relief through hearty laughter as well. So she recommends people gather things around them that they find humorous, and take a lot of time to enjoy them, perhaps funny videos, funny books, and so on. She says that if people can have a good laugh, their cheerfulness can give them a more healthy perspective on things as well. She recommends people don't hold back, but try laughing as heartily as they can. It's good internal exercise.

Poetry and Music

The author says some people find absorption and a good distraction from pain in writing poetry, or reading it.

Music can engage the feelings and help distract and soothe as well. The author says it can sometimes lift people out of depressed feelings. Pain can feel worse when people are depressed. She says a lot of people with depression won't feel like bothering to make the effort to do something, even though it might help. But if they can just muster up the motivation to try it, they can be glad they did.

Doing Something Caring for Others

Where it's possible, some people find that if they involve themselves in doing thoughtful and caring things for others, they don't feel their pain so keenly, because they're absorbed in something that takes their focus of attention away from themselves and their pain so it can stop bothering them for a while. Pain's worse if it's allowed to play on the mind.

Breathing Techniques

The author says that when people are in pain, they tense up and their breathing can become laboured or restricted. That's partly often to do with emotions as well, like fear or uncertainty. If you can relax your breathing, you can end up feeling more relaxed all round, and so the tension that's making your pain worse should ease.

One way of getting the breathing into a more healthy rhythm is by breathing in a way that's absolutely under our control, for instance, slowly breathing in to the count of four, holding the breath for the count of four, and then breathing out to the count of four. The breathing doesn't necessarily have to be deep. It's breathing slowly that can be relaxing. So gradually lengthening our count so we end up breathing in to the count of eight or even ten, say, and then holding our breath for the same count or a shorter one, and then breathing out counting to the same number we breathed in to or a higher one, can help. We can experiment with what number feels most comfortable to us at any one time. It's what we're comfortable with that's the important thing, and making the breathing slow and controlled.

Another technique is to breathe in and focus our attention on restfully pausing for a second or two while we hold our breath, and then breathe out, and then focus our attention on restfully pausing for a little while when we've done that. The pauses might not be very long at first, but if we enjoy it, they might naturally get longer. The important thing is that it feels calming to us. If it doesn't, there's no point in doing it.

Some people find it relaxing to imagine breathing in love, and breathing out anxiety. So with each inward breath, you'd imagine love, and when you breathe out, you'd imagine that fear and worry are draining out of your system. Some people find it useful to think of anxiety and love as being different colours, like love being a soft pink or something, and anxiety being something dreary maybe.

Taking Strong Painkillers

The author says that some people worry that strong painkillers will disrupt the body's ability to heal itself. But she says that actually, they don't; but what can is being in severe pain, because the body has to focus all its energy on that, so it lessens its ability to use its energy to help fight the disease.

She says that sometimes, people are really dispirited and depressed because of all the pain, but even just a couple of days' worth of good pain relief prescribed by a doctor, where they get the opportunity for a good sleep, can restore their spirits so they can come off it again for a while and can better fight it.

Some people worry that strong drugs like morphine will turn them into drug addicts, or that if they're being prescribed them, it must mean they're in the final stages of their disease and they'll die soon. But neither of those things is necessarily the case. If people really need the morphine to dull pain, then it's worth taking, and it's not going to give them as intense an experience of the good feelings it can give people as it would if they weren't in any pain when they took it. Properly prescribed, it shouldn't become addictive. But anyone whose concerned, especially anyone who's had a drug problem in the past, should speak to their doctor about it.

The author advises people to get a written summary of their medical history from their doctor so if you have to see another one after hours, it'll be easier and less hassle for you to give them the information they need.

It's essential that if you're taking medication by mouth, you have a chart of when you've got to take each thing, so you don't forget.

If you're taking painkillers on a routine basis, say every four hours, it's as well to still take them even if your pain's not that strong, since it takes much longer for painkillers to relieve it once it has got strong.

One thing about painkillers is that they can cause constipation; so if that happens, it'll be worth asking the doctor prescribing them to give you something for that, and also to eat foods that help, and avoid ones that can contribute to it.

Pain Management With the Help of Professionals

There are pain management clinics that can give good advice on pain control. Also, there might well be a palliative care nurse connected to a community nursing team in your area. It might be as well to ask your doctor to be referred to the community nursing team, since doctors themselves tend not to be that specialised in pain relief, so it can help to be referred to someone who's more trained in it. And if the doctors don't seem to be that motivated to refer you to someone, keep asking until they do. There's no good reason people should have to put up with pain.


Part Twelve
Talking to Children About the Illness

There are some guidelines about talking to children about the illness here. Maybe it'll be helpful to discuss them in a support group where other people might have young children and might find them helpful:

Why It's a Good Idea to Tell Your Children About the Illness You Have

Child

The author says that some people are reluctant to tell their children about their disease. But it's best to really, since children tend to be able to cope with more than adults sometimes give them credit for, and chances are they'll pick up on the fact that something's wrong, and worry over it and imagine things that might even be much worse than the reality if they don't know what's going on. If they're not told, they might find out and think they weren't told because they weren't considered important enough to know. Or they might think that something too terrible for the family to talk about is happening and be full of anxiety about what, and grow up with a fear of illness.

When children aren't well informed, they can develop all kinds of misunderstandings, such as blaming themselves for what happened, maybe thinking they stressed their parents out by misbehaving and now one of them's ill so it must be their fault, or thinking that because an elderly relative died in hospital, now one of their parents is going in, it must mean they're going to die too.

A lot of people have been surprised at how supportive their children were once they found out the truth. Also, any positive things that come out of your experience of the illness can be good learning experiences for children.

Deciding Who Should Tell the Children

If you think you can tell them without getting too upset, you're probably the best person to do that. There's no harm in shedding a few tears in front of them, and in fact that can be like giving them permission to feel sad, in case they otherwise feel awkward about showing their feelings around you in case it upsets you. But getting too upset would make them feel burdened.

Some people find it easier to tell them when a close relative's around, or to let the relative tell them, as long as the children get on well with the relative.

Alternatively, your doctor could explain things to them.

It's reasonable to want a bit of time to come to terms with the diagnosis, though, before telling them, although it's best not to leave it too long.

Deciding How to Tell The Children

Child

Children can feel most secure if they have an idea about what's going to happen next. (Actually, so does everyone.) So after you explain what's wrong with you, it's probably best to explain a bit about what your treatment will involve, and about any other things you're thinking of doing to try to help your body revitalise itself, like any dietary changes you're thinking of making and changes in your normal routine. It'll be good if you can leave them with a sense of hope that things can be done.

The kinds of things it'll be reassuring for them to know in advance are whether your treatment will mean you have to stay away from home for a while and whether there will be any changes at home.

It's good if they know what to expect as far as possible, so you could explain to them the likely side effects of any drugs you're taking, and assure them you'll tell them if there are any changes to your treatment, and how you're feeling as it goes along.

It's best to give them time to think about what you've said and ask questions if they want to.

It can be good to tell them one by one at first, since then you can alter how you tell them according to how old they are. Then you could perhaps talk to them together, but speak in a language the youngest will understand.

The explanation doesn't have to be long or complicated. At first, it could simply just be something basic like,

"You might have noticed I've been feeling sick quite a lot of the time recently and haven't had much energy to play with you. It's because I've got a disease called cancer. But the doctors are doing everything they can to try to get rid of it for me. Some days I'll feel allright and some days I'll feel sick. I'm sad and angry that I've got this illness; but I'm hoping it'll go away and things can get back to how they were. I might have to go into hospital sometimes, but whatever happens, I'll make sure you get looked after."

Sometimes it helps to rehearse what you think you'll say beforehand, and think about what questions they might want to ask you and plan answers to them.

Deciding How Much to Tell Them

It's best that you make whatever you tell them easy to understand, and give them an idea of what's happened and what will happen next. But you don't have to go into great lengthy detail. If you tell them the basics and then wait for them to ask questions, their questions will give you an idea of how much information they can handle at the moment, and they can always come back and ask more when they're ready.

Sometimes it can be helpful if you ask them to tell you what they think cancer or whatever illness you've got is, so you can correct any misunderstandings they have, and find out how much they already know, so you get more of an idea of how much to tell them.

What Not to Do

The author gives a list of things Not to do:

Talking About Death and Dying

The author says that a lot of people don't like talking about death and dying because it seems morbid or pessimistic or negative. But it's healthy to talk about it really. It's good if children think it's OK to approach the subject and talk about their feelings with you. Lots of people feel really awkward about talking about it and that's understandable. But it's best to really. Children might have lots of fears that you can help reassure them about, like thinking no one would look after them, when arrangements are bound to be made really for caring for them.

Children are bound to be familiar with the concept of death, since they see it on television and might have seen dead insects and animals, for instance. But very young children might think that it's reversible, and slightly older ones might think it's always possible to give it the slip if you try. It's best to let them ask questions so you can find out what they do and don't think, rather than to give them lots of information that might confuse them.

It's allright to tell them you don't know the answer to a question they ask. There might be lots of things it's difficult to know the answer to. If the doctor might know, you could reassure the children that you'll ask.

It's important not to give them too much information so they're overloaded with details and know lots of things that might make them fearful. Young children only really need to know the basics.

Just as you might go through different emotions towards your illness, like depression or anger, the children might do that as well; and they might act them out in different ways. So it's important to communicate with them to find out what's going on with them, and to try to reassure them as much as possible.

Getting the Timing Right

Tantrum

It can be difficult to get the timing of talking to them right, since, for example, you might have just geared yourself up to have a deep and meaningful conversation with them when they go off to play next-door; or they might ask you a deep and meaningful question when you're in the middle of cooking dinner and something's about to boil over, and the baby's screaming. It can help if you can keep a sense of humour. It can be hard to do sometimes, but it can stop you getting stressed so much.

When You Have to Go to Hospital

The author says very young children fear separation and strangers and unfamiliar surroundings; so when you're going to go to hospital, it can be best to try and arrange for someone familiar to them to look after them in their own home.

Try to reassure them about your stay there as much as you can. It could comfort them a bit to know you'll be thinking of them and sending them good wishes.

Hospitals aren't necessarily child-friendly environments, so it can help if you take some toys or something that they can play with when they come to visit you, maybe buying some little things for them that they won't be familiar with playing with at home, so they have novelty value.

The author makes other suggestions as to what you could do to keep them entertained and so you can feel close to each other:

If Children Are Fearful About Going to Visit the Hospital or Other Things

Taking blood pressure

The author gives some advice to the parent or whoever is caring for the children while their ill parent's in hospital:

If children refuse to go to the hospital, don't try to make them. Ask them about what's bothering them, because they might be worried or fearful about going, because maybe they're scared of what the illness or the treatment's doing to the ill parent, or they just don't know what to say, or something. It can help to talk to them to try and find out what their fear is and then talk it through with them, trying to reassure them.

They can be reassured about things if you can encourage them to behave normally, maybe suggesting they tell the ill parent about how things are going at school, how any pets are, how their friends are, and so on. They'll hopefully find it easy to do that.

It can also help the child if you encourage them to make little gifts they can bring to their ill parent in hospital. Focusing on that will take their minds off their worries a bit, and creating something they enjoy creating and that they hope will please the parent might give them a good feeling that they're contributing something positive. (Of course, it will be nice for the ill parent to get them as well.)

Reassuring and Encouraging the Children

It can be nice for the children and the parent in hospital if the children are encouraged by whoever's looking after them to make a "Welcome Home" banner for their parent when they come out of hospital. It could be as simple or as complex as they know how to make it. They could also help with nice things like putting flowers in their returning parent's bedroom, making nice drawings for them, and making food they know the parent likes.

It's important to encourage the children and make them feel wanted by noticing any nice things they do and showing love and appreciation for them.

It's often important to keep young children's visits to the hospital short. It'll be better if you can try to arrange their visits for a time when their ill parent's feeling at their most refreshed or pain-free, if possible, maybe soon after they've had medication.

If the ill parent is unconscious or barely conscious when the children go, the other parent or whoever they're with can reassure them that that means they aren't in pain.

Young children especially can worry that something they've done might have caused your illness, like even if they had resentful thoughts about you, they can worry that the ill feeling might have somehow transmitted itself to you and caused disease. So it's important to find out about their worries and to reassure them from time to time that they can't blame themselves for what's happened because nothing they've thought or done caused it.

Children's Behaviour

Fighting

It's best to tell the children's teachers early on in your illness that you've got it, in the hope that they'll support them, and so if the children behave in any unusual ways, they can let you know.

Teenagers can sometimes become difficult to deal with, because they might be asked to do more for you just at the time when they're getting more into the idea of staying out with friends and breaking away from parents. Other teenagers might want to take on more responsibility for caring for you than they should be doing if they're going to still have time for other things. Children can behave in several different ways. But if their behaviour becomes a real problem, it's no disgrace to seek outside help in dealing with them. A school counsellor might be able to help. Or the hospital, or your local children's hospital, might be able to refer you to someone who can help, or to some books or support groups that can help children understand their reactions better.

Children can react in all kinds of ways. It can be helpful to find out what the feelings are behind them. Sometimes, children can feel more comfortable drawing pictures of how they view the illness and relations in the family than talking about them. Sometimes, you can get young children to play with dolls and tell them they represent members of the family, and then listen in to their play and see what kinds of attitudes come out, and then you can discuss them with them.

Sometimes, with older children who are behaving in inconsiderate ways, it can help to write them a letter explaining how you feel about their behaviour and expressing the wish that you could get on better. The letter should be aimed at making them feel touched or thoughtful, not to express anger against them, which will only make them angry.

If relationships are strained in the family, family counselling can sometimes help to improve things. Even if not everyone agrees to go, it can still be useful for those who do.

Changes in Routine

The author says children get used to things being a certain way, so when changes happen that they can't understand, they can get worried and confused. So it's best to give simple explanations for the changes in you and in life. For instance, if your hair starts falling out with the chemotherapy, it'll be reassuring for them if you can explain simply that it's a common side effect of your treatment. That way, they shouldn't start worrying that something terrible might be happening and it's part of the disease. Or if you've changed your diet to a more healthy one, you could simply explain that you're trying to do the best for your body.

Children can be more accepting of changes and disabilities than adults, once things are explained to them. So chances are that if you're not upset when you tell them what's going on, they won't be either.

You don't have to go into lots of detail. But be willing to answer questions, and if you hear your children talking to their friends about your disease, offer to talk to their friends if they like.

Accepting More Help

Mowing the lawn

Changes in routine might mean you having to accept more help from children or other relatives, or friends and neighbours. You could delegate some of the housework to the children.

If they do things for you that aren't done quite in the way you do them and yet they're still done allright, it's not worth making a fuss about.

Accept the support of others in doing things around the house and other things, since then it'll mean you can save your energies for the things that are really precious to you, maybe quality time playing or talking with the children.

Try not to give the children so much of the housework that they resent not having enough free time for themselves. Some of the things you ask them to do could be fun things, like picking flowers from the garden for you.

Washing up

Maybe a local teenager could come in sometimes to do a bit of work for you for not much money.

If you can afford paid care for very young children, don't feel a failure if you feel you have to get some. It's best if once you've found someone good, you can stick with them so the children aren't daunted by too many new things. But you'll be able to enjoy your children better, and maybe be nicer to them, if you have time alone that makes you feel refreshed, rather than feeling under pressure to look after them all the time.


Part Thirteen
Coming to Terms With Dying

The author says that while it's useful if people with life-threatening illnesses can have lifestyles that are as healthy as they can be, both physically and emotionally, attaining peace of mind is a better goal to aim for than being cured. Some people go all out to do everything they can to be cured, and lose their peace of mind in the process, because caring that much about being cured will make them extra anxious at every setback, which will ironically create an environment where the body's less able to heal itself, besides lowering their quality of life, at the very time when they need to be making the most of it they possibly can because they might not have much life left, whatever they do. And if they don't succeed in getting cured and they know they're probably going to die in the end, they can feel like failures and end their lives feeling miserable, which is a shame.

If, on the other hand, people can accept that they might die, then dying with peace can be a satisfactory end. But if, in working towards peace of mind, the best environment for the body to heal is created and a cure takes place, so much the better.

Of course, it's common for people to be anxious and depressed or despairing to some extent when they get bad news. A few days of despair here and there isn't going to diminish your body's chances of fighting the illness. But if you're anxious or in some other kind of emotional distress all the time, you seriously need to work towards changing that.

When Family Members Don't Want to Let Go

The author says that sometimes, because family and friends are upset that the one with the illness might die, they try to convince them to eat things they don't like and do relaxation routines they're not comfortable with, and other things, because they think it'll give them the best chance of staying alive. But that can be counterproductive. Loved ones could ponder on the question: Since there is a chance that they're going to die whatever you do, wouldn't you rather have their possible last weeks and months as cheerful as possible for them, rather than ones where you're pressuring them to do what you think will give them the best chance of a cure, even though, while you have the best possible intentions and are only doing what you're doing out of concern for them, it's antagonising them? That would lower their quality of life, and perhaps stress them out so their bodies aren't in the best state for healing to take place.

The author says that often, the loved ones of the person with the illness are more upset about them possibly dying than they themselves are. If the person with the illness would rather live out the little time they have left doing things they enjoy, rather than trying to increase their time here by doing things they'd rather not be doing, then that should be honoured.

It's possible to write a living will, where you say you don't want any medical treatment that'll prolong your life in certain circumstances, if quality of life is more important to you than living the longest you can.

A lot of people suffering life-threatening illnesses reach the point where quality of life is far more important to them than trying to make sure they live the longest they can. Sometimes, they can reach the point of thinking that long before other family members do. That can cause conflict. For instance, you might decide you've had enough of treatments and being in hospital and would like to stay at home surrounded by as many loving people as possible, and that's the way you'd like to die if you're going to. But other family members might be urging you to carry on with treatment. The situation needs to be talked through thoroughly so they can understand your feelings as well as possible, and you can understand theirs, so you can address what's really bothering them. They might be fearful of loss and future isolation, or feel sure they'd feel guilty about you dying if they didn't make every effort they could to keep you alive, or maybe feel out of control of the situation and powerless to influence it if they think you're giving up. There might be a number of issues and worries that might surface if you talk things through with them and find out what's really bothering them. Then maybe you'll be able to reassure them and persuade them that what you want is best for you.

It's normal for the person suffering the life-threatening illness to go through all kinds of emotions and attitudes to it as well, for instance one day feeling more accepting or cheerful, and then getting a negative test result and feeling despairing all of a sudden. It can help to work through the issues that are making you feel the way you do so you can hopefully resolve them to some extent, and then you can feel more peaceful.

Dealing With the Practical Issues

The author says some people prefer to talk about the practical aspects of dying not long after they've been diagnosed with the illness. It isn't morbid to do that. In fact it's helpful, because it'll mean the family have less dilemmas to worry about if you do get close to death or die.

Making a will's a good idea. It doesn't mean you're giving in to the idea that you're going to die. Lawyers recommend people make a will even when they're young. (But then, they would!) But it can be helpful to have made one just in case you die.

Some people also find it useful to give instructions to the family about the way they'd like their children educated, and things like that.

One thing that can be really nice is if people make tapes for their children to listen to when they reach certain ages or times in their lives, or to leave them something in writing.

It can also be good and a relief to give the family instructions about anything you feel strongly about, like how long you'd want to be on a life support machine, how sedated you'd want to be in the late stages - whether you want all pain blocked out as far as possible by sedatives as well as painkillers, or whether you'd be willing to experience a certain amount of pain if it meant being more alert, and able to communicate with people better. You might want to tell them your thoughts about whether you'd want to be at home when you're near to dying or in hospital, and who you'd want around you in your last days and hours.

There are lots of such things it might be useful to discuss, and not just with the family, but also with the doctor or visiting nurse. Such conversations can be awkward to start, but they can end up being really worthwhile.

A lot of people aren't all that scared of dying itself, but it's the process of dying that frightens them. They can worry about whether they'll be in a lot of pain, or whether they'll be able to breathe freely, or whether they'll be all alone or in an unfriendly environment.

Pain

Pain can be managed. The author says some people worry about taking painkillers in the early stages of their disease because they think their bodies will get used to them so they won't be so effective so they won't work so well in the later stages when they really need them. But there are painkillers of different strengths around, and sometimes different combinations of painkillers are used that interact together.

It's as well to ask at the hospital if there's a palliative care team attached to the hospital, or anything like that nearby, who specialise in alleviating pain and making people as comfortable as possible throughout the illness. People who are trained to do that are more expert in it than ordinary doctors. It'll be valuable to get yourself on their books if you can.

Breathing

Breathing can be made easier with oxygen.

Also, someone used to doing relaxation techniques will know that when they're relaxed, their breathing can become light and shallow because the body doesn't need so much oxygen for fuel since it's so relaxed. So breathing can become less laboured. Then when the brain's receiving less oxygen, people can become sleepy and sometimes drift off into unconsciousness. So relaxation techniques are a good thing to do. The author says that a lot of people she's sat with in their last hours drift away very peacefully.

She says that others she's known have been in such good spirits in their last hours that they said it didn't feel like dying.

So there are certainly things that can be done if it comes to that. Don't expect that doctors are going to arrange things for you without you asking though. They might need pushing a bit before they help.

There are cancer charities and other ones for people with serious illnesses that I'm sure could give you lots of good advice or information, about that, and also about loads of other things to do with your illness. I'm sure the major ones have got lots of good information pages on the Internet. They should come up quickly in searches. So I think it would be worth having a browse to see what you can find.


Notes

This article is written slightly differently to most articles. It comes with a very short fictional story about someone finding out information to help increase the quality of life of her mother who has a life-threatening illness, - not a real person but a representative of others - and the article's presented as if it's what she's found out and what she's thinking of telling her mother.

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The Story

The Way Things Are Before They Begin to Improve

Very upset

Jane is middle-aged when her mother, Josephine, gets diagnosed with cancer. At first, they're both very upset. But after a while, Jane resolves to try to find out information that could make her mum's illness less painful, or even help to reverse it. Jane recently had a serious illness herself that she worries might come back, so she hopes the information will be useful for her as well.

She's heard of pain management clinics where patients get taught techniques of controlling their pain to some extent, and about how relaxation techniques can help to make pain less severe because tension makes it worse; and she wants to find out a lot more about what people can do themselves to make a severe illness less of a burden and increase their chances of recovering from it.

She finds a self-help book written by a woman who says she was diagnosed several years earlier with leukaemia and only given a few months to live, but she got treatment, and changed some things in her life, and went into remission and is still around years later, and now runs an organisation to help people with life-threatening diseases.

Jane reads the book, hoping to be able to find some good advice in it she can tell her mum about.

She finds some things she thinks it would be good to talk about. She thinks through what to say to her mum over the coming weeks.

Her mum's interested in what she says, and it lifts her spirits a bit.



The End


Note that if you choose to try out some or all of the recovery techniques described in this article, they may take practice before they begin to work.

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Disclaimer:
The articles are written in such a way as to convey the impression that they are not written by an expert, so as to make it clear that the advice should not be followed without question.

The author has a qualification endorsed by the Institute of Psychiatry and has led a group for people recovering from anxiety disorders and done other such things; yet she is not an expert on people's problems, and has simply taken information from books and articles that do come from people more expert in the field.

There is no guarantee that the solutions the people in the articles hope will help them will work for everybody, and you should consider yourself the best judge of whether to follow their example in trying them out.


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