Mindfulness Programs I Love: “Mindfulness-Based Stress Reduction”

Although I may never be able to prove it, I’m willing to bet that stress played a role in the proliferation of my cancer.

As a result, getting my stress response under control was a high priority, so I started a meditation practice and once the toughest parts of my treatment (chemo, radiation) were done, went searching for a formal class to address anxiety.

My clinical counselor had told me about a book called “Full Catastrophe Living” by Dr. Jon Kabat-Zinn. As it turned out, Kabat-Zinn had been a long-time meditator and, drawing on both Buddhist Dharma and scientific research, developed a stress-reduction program for patients at the UMass Medical School in the 1970s called Mindfulness-Based Stress Reduction (MBSR).

So when I found a Center for Mindfulness at a local university, I jumped at the opportunity to take that same flagship MBSR course.

This is an 8-week class with an additional full-day retreat. The curriculum has been developed to introduce students to mindfulness and help them, over a two month period, develop a practice, both formal and informal to manage stress in their lives.

It is also not cheap! The non-discounted version may cost about $600, depending on where and when you sign up. If I hadn’t had cancer and therefore a powerful reason for needing in-person guidance in mindfulness meditation, I would have considered myself priced out of this course, instead opting for a self-paced, free online version, such as Palouse Mindfulness.

But I used the significant price tag to motivate myself to do each and every homework assignment. The classes themselves were 2.5 hours a week, with daily home practice lasting about 45 minutes to an hour. That’s no small commitment! I had to move around my schedule to be able to fit the practice time in, and even the Center for Mindfulness itself recommended that if you could not accommodate the home practice to wait for a time that you could before signing up for the class.

The teachers were warm and supportive. They genuinely cared about student progress and themselves had a regular practice in addition to having spent time and resources on their own teacher training. As such, the instruction was excellent.

There were a number of resources for the students, including audio and video programs, which are also available to the general public. Currently, as an MBSR alumna, I have access to all the day-long mindfulness retreats for students free of charge. This gives me an opportunity to immerse myself into silent meditation for substantial periods of time in a similarly conducive environment.

The development of a mindfulness practice has more to do with the effort of the student, rather than the expense of a class.

I was struck by how quickly the class registration filled up, and how during the first session, when asked why we were taking the course, so many of us cited the amount of stress and anxiety in our lives. It is a sign of the times that so many people are willing to pay a significant amount of money to take a class to help them get some semblance of control over their inner state.

Actually achieving this was harder than simply paying the cost of admission. This class began with about thirty of us, but fewer than half made it to the very end. A number of people admitted being unable to complete the homework. Some gave up completely. There were others that came for several sessions but then never returned. Everyone was looking for help with stress but not everyone was successful.

As a secular version of Buddhist mindfulness, the course does justice to the tradition. While the expensive registration fee may be off-putting for some (many?), there is tuition assistance available, which I feel is important. As I’ve written before, I don’t feel that it’s appropriate to make mindfulness available only to those rich enough to afford fancy classes.

But in the end, regardless of what type of mindfulness instruction you utilize, what matters is how much effort each student puts into the practice of being mindful.

And that is available to all.

Mindfulness Programs I Love: “Take 5”

Setting time aside for formal meditation is important to me, but what about the hours of the day that I spend off my cushion? As dedicated as I am to my meditation practice, it took a while to find a way to consistently bring mindfulness into the rest of my day.

My workplace was offering an informal program through a Canadian company called MindWell-U, and since I’m always up for trying out anything mindfulness-related, I signed up.

The loading screen of my MindWell-U account. This provided an opportunity to set an intention for the session.

The concept is called “Take 5”. Over a period of 30 days, you are provided a daily computer-based lesson that illustrates different aspects of mindfulness. More importantly, every day you also receive cues to remind yourself to “Take 5” – that is, to take a time-out, settle and focus on five deep breaths. You are provided “Take 5” guidance via a sound clip. As the days progress, the types of cues change. The idea is to notice the present and stay as mindful as possible, establishing space between yourself and emotional reactions.

During every lesson, the program suggested cues for the day (for instance, brushing your teeth) to use to stop and notice where your thoughts are. These changed as the days passed, and by the end, we were encouraged to create our own cues.

Aspects that made a huge difference to me:

1)       Incorporating mindfulness into everyday life: When I wasn’t meditating formally, I would often get lost in day-to-day stressors. The cues provided by the “Take 5” protocol, simple as they were, were what I needed to bring mindfulness into the rest of my life. It also made me more aware of where I already was being mindful, even when I didn’t identify it as such.

For example, when I exercise I have no problem staying present during difficult workouts, and this makes them easier to complete. One benefit of this awareness is that I am more compassionate towards those who are not able to maintain the same focus and I appreciate why they may “psych themselves out” before they’ve even begun exercising. This kind of understanding makes me less judgmental.

An example of one video that provided easy-to-follow messages which reinforced the benefit of being mindful.

2)      Daily video clips: These were minimalistic illustrations, using the color red to signify getting swept up in thought and emotions, and a cool blue to signify being mindfully present. Topics were relevant, the videos were entertaining and short, and were in small enough bites to provide something to work on for the day without feeling like an obligation. Examples of daily lesson topics: “Thoughts Are Not Facts”, “Reversing The Stress Response”, “Turning Off Autopilot” and “Fight, Flight or Take 5”. I found myself looking forward to each session, which I completed in the morning at my desk, prior to the start of my workday.

A sticky note on my computer monitor reminding me to be present by pausing, taking some breaths and feeling into the moment.

3)      Time frame: 30 days is the perfect length of time for creating a new behavior. Again, I already had a solid meditation practice in place; the trick was to take that mindful attitude with me and apply it to the rest of my life.

Important (and sobering) note: it bears mentioning that mindfulness has taken off and is currently being applied to all aspects of our lives, often being a huge money-maker for providers. I myself have invested in programs and classes in the name of getting solid guidance to develop my practice. Ironically, this seems to go against the concept of mindfulness itself, which truly should be available to all, regardless of ability to pay for shiny apps and expensive sessions.

Furthermore, isn’t it antithetical to the Buddhist tradition for companies to encourage their employees to take such classes with the expectation that a more mindful workforce will ultimately result in higher profits?

While I am grateful for any opportunity to expand my mindfulness meditation practice, the above gives me pause. My intention, then, is to use tools like these that further my growth in a way that will also benefit those around me.

Mindfulness Apps I Love: “Insight Timer”

In my last post, I sang the praises of the Calm phone app. However, I admitted that a number of the features are only available to users who subscribe. This was an investment I chose to make because I was dealing with a cancer diagnosis and needed quality meditation support to help with my anxiety.

The opening screen has a peaceful minimalist look.

I also didn’t know about Insight Timer at the time.

For those who are looking for more free options, you’d be hard-pressed to find a better mindfulness phone app than Insight Timer, which I have grown to value highly and use daily. While the app does have a subscription option, I’ve been thoroughly impressed with what it offers to unpaid users.

These are the features that I adore:

1) 15,000+ Meditations! That’s gotta be some sort of record. And there are new meditations being added all the time, which means that you could do a different meditation every day. I constantly keep finding new favorite meditations…

This is just a partial view of the most popular meditation selections. There are so many more to choose from!

2) Variety, variety, variety! The number of options is mind-boggling. Choose from different teachers, lengths, recording types (meditation, music, lecture), and of course, a gazillion categories that encompass any imaginable meditation benefit, origin and practice, not to mention an increasing number of languages — I speak a rather esoteric language from a small country and was still able to find a couple of meditations in the lingo. Truly, it’s worth searching through the app to see what a broad selection is available. If you’re interested in meditating to it or about it or because of it, chances are Insight Timer has it.

The meditation timer function lets you create the perfect session for yourself.

3) The Timer: This is a fully customizable meditation timer that includes a variety of background sounds and meditation bells to choose from, with the ability to set the session length and bell intervals. It’s ideal for those times when you want to meditate without voice guidance. I particularly appreciate that once your session ends, the background sound continues to play in case you want to extend your time.

4) And most importantly, most of the features are FREE! Quite frankly, meditation really should be accessible by all. It doesn’t seem right to limit people’s access to something like this based on their ability to pay for it. Insight Timer does have a “supporter” option, but as the developers explain, the fees support the umpteen teachers and composers who provide content, in addition to keeping the site free for most of us. Read more about Insight Timer‘s philosophy here.

For those who decide to subscribe and support the app, there are a number of benefits available, such as a selection of 10- and 30-day courses, a curated Daily Insight meditation every day, high-quality audio, offline listening and the like.

The only downside to such an overwhelming amount of meditations to choose from is that it can become, well, overwhelming. Additionally, you don’t always know what you’re getting due to the variety of teachers posting material, so you might need to do a little searching around. It’s almost guaranteed, however, that you will find something to suit your needs.

Mindfulness Apps I Love: “Calm”

Following my cancer diagnosis, my General Practitioner wrote me a prescription for Xanax because anxiety resulted in a steep drop in my weight (not a great way to prepare for chemo!). I’m not a pill popper and didn’t like the idea of treating my runaway anxiety with drugs; nonetheless, I relented because my situation seemed out of control. When my radiation oncologist suggested that I try meditation for long term stress relief, I jumped at the idea, but wasn’t sure where to start.

The opening screen of the app reminds you to breathe. I’ve conditioned myself to take an extra deep breath here.

The Calm phone app was enthusiastically recommended by a co-worker, so I tried it. It remains the only phone app to which I’ve ever gotten a lifetime subscription. I used the free version for several weeks but got so hooked I decided to spring for it — since my first meditation with Calm almost exactly two years ago, I have not missed a single day. I also shamelessly plug it to anyone who’ll listen (*ahem*) like I’m doing here.

Features that are worth the price of admission~

Tamara Levitt’s voice: Perfection! Tamara is officially the Head of Content for the Calm app and her voice is so soothing it could cool sunburns. I’ve tried a lot of guided meditations hosted by a variety of speakers and have heard few voices that can compare to hers. Try one of her meditations and you’ll immediately know what I mean.

This little bubble provides a lot of relief!

Breathe bubble: This is a circle that expands and contracts, enabling you to follow along and breathe as it does so. It has “inhale” and “exhale” tones so you can close your eyes if you wish, and you can adjust the pace and pattern (with or without pauses) of breath, albeit minimally. I wish there were a way to personalize it more fully, but I make do with the available options. I used the bubble feature at times when I was too anxious to effectively listen to a guided meditation and I credit it with getting me through some very tough times.

Just a few of the scenes available to play in the background. Love this!

Scenes: I adore this feature! You can select from (at last count) 35 dynamic background visuals with nature sounds or airy musical motifs to play alone or along with the meditations. All these scenes are available in the free version and suit a broad spectrum of moods. I open the web version of the app on my work computer and play this feature in the background all day long. It’s magical!

As an extra bonus, you can set up the background sounds to continue playing after the meditation is over, so that if you fall asleep during your practice, you’re not jarred awake by sudden silence.

And of course, Meditations: Take your pick! There are a vast variety of meditations to choose from, most guided but some with only bells, and there are a number of lengths (in minutes) available. Since I subscribe to the app, I enjoy the Daily Calm, which has a different topic everyday, always led by Tamara, so you can expect a consistent level of quality from them (kind of like a cup o’ java from a favorite coffee chain, but without the caffeine).

Beginners should try the free “7 Days of Calm” learn-to-meditate series that offers a week’s worth of daily 10-minute sessions to ease you into a mindfulness meditation practice.

Be aware: the free version does offer some meditations, but the majority are available only to subscribers, and you’ll soon find yourself craving for more. At that point, you’ll have to decide whether it’s in your budget to commit to the paid version.

The “more” screen showing additional features available. Loads of great stuff here!

There are other features that I use less often but are worth mentioning. A friend of mine swears by the Sleep Stories, which are high quality tales designed to help you nod off, and a number of them are voiced by celebrities like Bob Ross (yes, the ‘happy clouds’ painter — what could be better?), Matthew McConaughey, Stephen Fry and even Peter Jefferson, who used to do the UK shipping forecast which so many in that part of the world found so soothing. Most, although not all, require the paid version of the app.

There are also Masterclass courses offered that I’ve found useful enough to make my family listen to them during long car trips. Topics are broad-ranging and presented by experts in their fields and new courses are added from time to time. Some courses are free, but most require the subscription to progress further than the first class session.

The Music feature offers a generous variety of specially curated musical pieces that are perfect for creating space in your day, like a life vest in stormy seas. I haven’t even come close to making full use of this feature! Many of these are free and worth exploring.

Calm Bodies is a new feature which brings mindful movement into your repertoire of calming tools. I prefer to do yoga on my own, so I haven’t made use of this feature, which unfortunately is limited to subscribers.

There are other perks for subscribers (even a special relaxation room available at select airports!) not available to those using the free version. For me, investing in a well-curated library of meditation and mindfulness options was worth the cost.

Want to stick with the free version? There are still enough great elements available to merit downloading and playing around with the app.

If you are interested in incorporating mindfulness and meditation into your life, the Calm phone app is a great place to begin.

Index Published

Since there are quite a few blog posts on this site, I’ve published an index to make navigation simpler. The index not only links to individual posts, but also provides a short description of what they’re about for anyone who wants to explore what I’ve written but can’t make heads or tails out of my post titles.

I’ve also cleaned up the menu a bit to make it easier to access the “I Didn’t Expect THAT” and “Invisible Effects” post series, in addition to the aforementioned index.

Future housekeeping is forthcoming. Thanks for reading!

I Didn’t Expect THAT: Radiation Tattoos

It’s not the kind of tattoo you’re thinking of.

I’ve written a lot about my chemo experiences for breast cancer, but I also underwent radiation treatment. Compared to chemo, it was a breeze, however, it came with its own surprises. I was preparing myself for potential discomfort and burns, but was caught off-guard when I realized I would get four permanent marks on my body to help align the lasers and make sure that radiation was being delivered where it was needed.

Permanent marks = tattoos. Now, I have nothing against tattoos on other people, though I admit to occasionally thinking, “You realize you’re stuck with that, don’t you?” about a particularly colorful specimen. Sorry, it’s the era I grew up in. I’ve seen absolutely gorgeous tattoos; I just never wanted any myself.

Venus_de_Milo_RAD-TATTOO
Venus de Milo illustrating where three of my four tattoos are (the 4th is hidden by the stub of her arm, but mirrors the visible one on the other side). Not actual size, obviously.

I remember being told about the tattoos and instinctively wanting to protest. It wasn’t about the dots themselves — I keep my dermatologist in business with all the moles that pepper my body. I think it was about not having a say regarding something that was going to be done to me. For me, cancer was about feeling out of control. Being forced to get tattoos was frustrating and completely unexpected. It felt like bait-and-switch, where the focus was on preventing burns and what to do about tender skin, but then ohbytheway, you’re getting tattooed too. It was one more thing to endure.

I know I was blowing this out of proportion. These are just small dots. There are four of them, one on the ribcage below each armpit and two running down the center of my chest. They’re blue, which was a necessity, given my highly mole-y skin. And they’re definitely permanent. I wrestled with the concept but eventually sighed and just accepted it.

rad_tattoo
One of my tattoos, closest to the belly, several inches below the sternum (see Venus). Glasses for reference. Yes, It’s teeny.

Maybe it was the friendships that I developed with the radiation team, maybe it was finishing all my cancer treatments, but my prejudiced view of those tattoos softened over time. Now they meant something to me. Previously, I couldn’t imagine any reason that I would submit to being marked like that. But then I started wishing that the tech had drawn teeny stars or hearts instead of plain dots. And I heard of breast cancer survivors covering mastectomy and implant scars with inked art, or foregoing the reconstruction altogether and allowing their chests to serve as a canvas, making something beautiful out of an emotionally painful situation.

 

 

I’m glad I have my little tattoos.

 

I Didn’t Expect THAT: Chemo Port

When you’re told that you have cancer and will need the full complement of treatments, you focus on the concepts of surgery, chemotherapy and radiation. Chemo, for example, can be frightening to think about because of purported its side effects, so you gloss over the details. But when you get down to a practical level and start learning about exactly how the infusions will take place…

I knew I needed chemo. I assumed that it would be administered intravenously, as in, into an arm vein with the bag o’ drugs hanging from the IV pole. Ahhh, but the drugs are caustic and would cause damage to a smaller vein, so to avoid that, they go directly into a major blood vessel to allow for quicker mixing with blood, faster circulation through your body and much less discomfort. This is done through a port.

Let me be clear: a chemo port is a revolutionary device that has made administration of chemo drugs far easier on the patient. Not having the port would be absolutely miserable and likely necessitate breaks in treatment as the patient recovered.

Port_in_a_box
This little marvel makes chemo much easier. The dark purple circle is a soft membrane into which the needle is inserted (through the skin). The tube delivers the meds straight into a major vessel. Easy peasy!

However, it wasn’t until we were talking about setting up a port implantation appointment that I began to grasp what was actually going to happen: a small disk would be implanted onto my chest wall, just under the skin, from which a thin flexible tube would run up and over my clavicle and then down into the blood vessel (probably the superior vena cava, but I didn’t ask). Once I started infusions, the needle from the bag containing the drugs would be inserted through my skin, through a membrane on the port, and that was it for the needle prick. Simple and relatively painless.

But about that port. To me, “port placement”, as the implantation procedure was called, was surgery. And I wasn’t great at handling surgery. Usually I like a lot of info to prep me for what’s coming, but I couldn’t even handle watching a video of a placement procedure.

Port_Placed
After port placement. I was acutely aware of a foreign body poking out of me. Alien, anyone?

I don’t have a lot of fat on my chest. There was nothing to nestle the port down into, and as a result, after implantation my skin was stretched tight. I could see the lump in my chest and I could see the tube as it ran up from the lump, over the clavicle. Turning my head pulled the skin — ow! I avoided looking at it, let alone touching it. All I could think was that I had an entire year of this.

Eventually the skin stretched to accommodate the port, but because it stuck out like a little knob, I worried about twacking it. When I hit it with a dumbbell during a workout, I cried. Seatbelts were a constant concern; I was afraid that the port would get dislodged and injure me in a car accident. Hugs hurt and I instinctively turned that side away from people. And of course, in the event of a huge catastrophe that resulted in the collapse of society and all modern services including port removal procedures, I might be stuck with that thing on my chest for the rest of my pathetic little life.

Eventually, the day came when I finished my last infusion and my oncologist gave the go-ahead for port removal. That thing was out within a week. Removal was simpler than implantation, done under local anesthesia without the need for fasting, and even all the tugging to get it loose didn’t bother me. I was so happy to have it out.

But I’d carried it inside me longer than I had carried either of my children, so I asked to take the port home. While I had hated it inside me, I was so grateful for what it had done. I mean, I couldn’t just let them throw it out! It was handed to me in a bright pink box designed for dentures (apparently, keeping your port isn’t popular enough for the creation of “used port” containers) and now sits on my desk. I prefer it there rather than in my chest.