Mindfulness-Based Cognitive Therapy for Cancer E-Book

Trish Bartley

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 581

Veröffentlichungsjahr: 2011

Beschreibung

Mindfulness-based Cognitive Therapy for Cancer presents an eight-week course for MBCT which has been tried and tested over ten years of clinical use, and is targeted specifically for people with cancer.

• There is growing evidence of mindfulness as a successful and cost-effective intervention for reducing the negative psychological impact of cancer and treatment
• Draws upon the author’s experience of working with people with cancer, and her own recent experience of using mindfulness with cancer diagnosis and treatment
• Stories from cancer patients illustrate the learning and key themes of the course
• Includes new short practices and group processes developed by the author

Leseprobe

Table of Contents

Cover

Praise for Mindfulness-Based Cognitive Therapy for Cancer

Title page

Copyright page

Dedication

Contributors

Foreword

Preface

Acknowledgements

Introduction

Contents Overview

Part One – Mindfulness and The Cancer Journey

Part Two – The MBCT for Cancer Programme

Part Three – The Practitioner Teacher and a Three Circle Model

Personal Story

Trish

Diagnosis

Part One: Mindfulness and The Cancer Journey

Chapter One: Mindfulness and Cancer

Introduction

Will Mindfulness Help Me?

What Does Mindfulness Offer? Is It Safe?

What is Involved on the Course?

Developing Course Themes

A Cognitive Model of Cancer Distress

Jane, David and Sheila

What Comes Next

Chapter Two: Cancer – The Psychological Implications

Introduction

The Trauma of Cancer

Distress

Coping with Cancer

Avoidance

Rumination

Treatment for Distress

Summary

Chapter Three: Cancer – The Medical Implications

Introduction

Diagnosis

Treatment

Treatment Choices

Physical Effects of Treatment

After Treatment

Three Groups of Patients

Chapter Four: The First Circle – Cancer and the Circle of Suffering

Inner Ring – Cancer

Middle Ring – Four Reactions

Outer Ring – A Cognitive Model of Cancer Distress

Summary

Personal Story

Beryl

Diagnosis

Treatment

Post Treatment

Mindfulness

Part Two: The Mindfulness-Based Cognitive Therapy for Cancer Programme

Chapter Five: Starting Out

Introduction

When is the Best Time to Take a Course?

Preparing for the Course

The Orientation and Assessment Process

Personal Story

Sally

Diagnosis

Treatment

Mindfulness

Chapter Six: The Eight Week Course

Introduction

Week One

Automatic Pilot

Key Tasks for Teachers – Week One

Introduction

Beginning the Course

Building the Community

Personal Intentions

Practice

Week One Teaching

MBCT for Cancer – A Brief Overview

Week One Practice – The Body Scan

Story

Week One Short Practice

Concluding the Session

Concluding

Programme

Week Two

Dealing with Barriers

Key Tasks for Teachers – Week Two

Introduction

Week Two Practice

Home Practice Review

Building the Community

Week Two Exercise

Week Two Short Practice

Story

Concluding the Session

Concluding

Programme

Week Three

Befriending the Breath and the Body in Movement

Key Tasks for Teachers – Week Three

Introduction

Week Three Practice

Last Week’s Home Practice

Week Three Exercise

Week three short practice

Story

Week Three – Sitting Practice

Concluding the Session

Concluding

Programme

Week Four

Learning to Respond

Key Tasks for Teachers – Week Four

Introduction

Week Four Practice

Last Week’s Home Practice

Three Minute Breathing Space (3MBS)

Week Four Exercise

Week 4 Teaching

Week Four Short Practices

Concluding the Session

Programme

Week Five

Gently Being with the Difficult

Key Tasks for Teachers – Week Five

Introduction – A Shift of Focus

Week Five Practice

Week Five Teaching

Last Week’s Home Practice

Half Way Review

Week 5 Exercise

Week 5 Teaching

Concluding

Programme

Week Six

Thoughts are not Facts

Key Tasks for Teachers – Week Six

Introduction

Sitting Practice

Inquiry – Thoughts and Thinking

Last Week’s Home Practice

Sea of Reactions – Thoughts

Mountain Meditation

Concluding the Session

Programme

All Day

Key Tasks for Teachers – All Day

All Day Programme

Week Seven

Taking Care of Myself

Key Tasks for Teachers – Week Seven

Sitting Practice

Last Week’s Home Practice

What Is Nurturing? What Is Draining?

Spiral Signature and Action Plan

Concluding the Session

Programme

Week Eight

Going Beyond Fear

Key Tasks for Teachers – Week Eight

Introduction

Home Practice Review

Action Plans

Course Review

Programme

The Follow Up Class

Gently Turning Towards

Key Tasks For Teachers For Follow Up Class

Introduction

The Practice

Review of Last Month’s Home Practice

Session practice (2) – a new intention

Goodbye to The Group

Programme

Chapter Seven: The Second Circle: Mindful Awareness and the Circle Of Practice

Introduction

At The Centre

Middle Ring

Outer Ring

Summary

Personal Story

Derek

Diagnosis

Treatment

Chapter Eight: The Practices

Introduction

The Core Practices

Introduction

Body Scan within MBCT-Ca

Body Scan and The Four MBCT-Ca Movements

Mindful Movement within MBCT-Ca

Mindful Movement and The Four MBCT-Ca Movements

Sitting Practice within MBCT-Ca

Being with the Difficult Practice

Sitting Practice and The Four MBCT-Ca Movements

The Short Practices

Overview

MBCT for Cancer Short Practices

The Pause

Coming to the Breath

Standing In Mountain

Breathing With (Kabat-Zinn, 1990)

The Physical Barometer

Coming to the Breath with Kindness

The Thread Exercises

Breathing Spaces Notes

The Extended Breathing Space (Responding)

The Breathing Space (Responding) Plus Action Step

Following Next

Personal Story

Bridget

The Beginning

Mindfulness and what it Offered

Mindfulness and Love

Chapter Nine: Mindfulness in Palliative Care

The Mindfulness Groups

Assessment

Key Tasks for Teachers – Palliative Care Group

Intention

Coming Back

Sitting Practice

Turning Towards The Difficult

Poetry and Story

Kindness

Dedicating The Practice

Reflection Session: The Loss of a Group Member

Chapter Ten: After The Eight Week Course

Introduction

Programme and Course Review

Follow Up

Working One To One

Chapter Eleven: The Third Circle – Being and the Circle of Presence

Introduction

The Circle of Presence

Summary

Part Three: The Practitioner Teacher

Chapter Twelve: Introducing the Teacher

Introduction

Mindfulness Practice and Teacher Training

Cancer in our Society

The Challenges of Working with People with Cancer

Qualities of Teacher

Chapter Thirteen: Embodying the Practice

Introduction

Teaching

1. Intention

2. Practice

3. Reflection

Conclusion

Chapter Fourteen: Facilitating The Learning

Introduction

The Experiential Nature of Learning

Facilitating Learning within the Group

2. Forming The Circle

2. Holding the Circle

3. Moving Out Beyond the Circle

Conclusion

Chapter Fifteen: The Three Circle Model: A Formulation of MBCT for Cancer (MBCT-Ca)

Introduction

The Three Circle Model

Relating across the Circles

The Inner Rings

The Middle Rings

The Outer Rings

Recurrence

Compassion and Kindness

Personal Story

Geraint

Introduction

Diagnosis

The Future

Looking Beyond

Epilogue

Resources and Links

Resources

Web Links

Materials

Bibliography

Sources and Permissions

Subject Index

Praise for Mindfulness-Based Cognitive Therapy for Cancer

A profoundly compassionate offering of affirmation and possibility in the face of the difficult and the unwanted. Trish Bartley and her colleagues are to be congratulated on a magnificent contribution to the field of mindfulness and cancer care. May it touch the millions who could benefit from it.

Jon Kabat-Zinn, Professor of Medicine Emeritus, Author of ‘Coming to Our Senses: Healing Ourselves and the World Through Mindfulness’

Trish Bartley has succeeded in writing a book that speaks to the deepest fears of cancer sufferers with such compassion that no-one can fail to draw hope and healing from her words. Drawing on her own experience of cancer, and on her skill as a mindfulness teacher, she has pioneered a combination of mindfulness and cognitive therapy. The implications of what she says goes far wider than any clinic – to the heart of what it means to be fully human and fully alive in the presence of our own death.

Mark Williams, Director of the Oxford Mindfulness Centre, Co-author of ‘The Mindful Way Through Depression and Mindfulness: A Practical Guide to Finding Peace in a Frantic World’

What a gift of a book. Alongside her own experience of living with cancer, Trish Bartley also has many years’ experience of teaching and developing the MBCT-Ca programme – this combination of the personal and professional makes for a beautiful combination of personal story; a clear and practical manual for the eight-week programme; and poems and insights from the many people Trish has taught. This book will be invaluable to patients and health professionals alike. Read this book carefully. It is a precious jewel.

Vidyamala Burch, Author of ‘Living Well with Pain and Illness: The Mindful Way to Free Yourself From Suffering’

As mindfulness becomes more main stream, what we need are mindfulness developments guided by clear intentions, adapted to new populations with creativity while maintaining the essence and integrity of MBCT and MBSR. Mindfulness-Based Cognitive Therapy for Cancer offers such an adaptation. It has a clear rationale, pragmatic and clinically tested innovations, clear guidance for MBCT teachers and poignant clinical illustrations. The book is imbued with compassion, courage and a sense of common humanity. It will be highly valued both by people with life threatening diseases and health care professionals offering mindfulness classes to people with cancer. Trish Bartley is an MBCT therapist who teaches mindfulness with enormous heart, drawing from a well of experience and knowledge. She writes with a clear, authoritative, compelling and inspiring voice.

Willem Kuyken, Professor of Clinical Psychology and Co-Founder of Mood Disorders Centre, University of Exeter, UK

This edition first published 2012

© 2012 Trish Bartley

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Library of Congress Cataloging-in-Publication Data

Bartley, Trish.

 Mindfulness-based cognitive therapy for cancer : gently turning towards / Trish Bartley.

p. ; cm.

 Includes bibliographical references and index.

 ISBN 978-1-119-95405-7 (cloth) – ISBN 978-0-470-68383-5 (pbk.)

 I. Title.

 [DNLM: 1. Neoplasms–psychology. 2. Neoplasms–therapy. 3. Cognitive Therapy–methods. QZ 266]

 LC classification not assigned

 616.99'40651–dc23

2011024246

A catalogue record for this book is available from the British Library.

This book is published in the following electronic formats: ePDFs 9781119960058; Wiley Online Library 9781119960041; ePub 9781119954958; eMobi 9781119954965

To

Jules, Christos, Eleni and Aris,

Christopher and Natasha,

and

all those who journey with uncertainty,

especially the Alaw mindfulness course participants,

my teachers all.

Contributors

Author

Trish Bartley Mindfulness Teacher at Alaw Unit Ysbyty Gwynedd Hospital Bangor, Gwynedd Wales, UK Mindfulness Teacher Trainer The Centre for Mindfulness, Research and Practice (CMRP) School of Psychology Bangor University Wales, UK www.trishbartley.co.uk / [email protected]

Contributors

Ursula Bates Director of Psychosocial and Bereavement Services Principal Clinical Psychologist Blackrock Hospice Our Lady’s Hospice and Care Services Blackrock Co. Dublin, Ireland 00-353-1206-4000 [email protected]

Stirling Moorey Consultant Medical Psychotherapist South London and Maudsley NHS Foundation Trust and Honorary Senior Lecturer Institute of Psychiatry London, UK

Nicholas SA Stuart Consultant Medical Oncologist Alaw Unit, Ysbyty Gwynedd Hospital Bangor Gwynedd, UK [email protected]

Foreword

Mindfulness-based cognitive therapy (MBCT) is already well-established as a treatment for the prevention of recurrent depression. Now, in this important book, Trish Bartley describes how, over a ten-year period, she has extended and developed the original MBCT framework to meet the needs of cancer patients. The impetus for this mindfulness-based cognitive therapy for cancer (MBCT-Ca) programme came from Trish’s own first personal encounter with cancer (she has had a further encounter while actually writing this book). This experience, together with her involvement with teaching and training in MBCT from the early days of its development, make Trish uniquely suited to the task she has undertaken.

In common with all mindfulness-based approaches to the relief of distress, MBCT-Ca is grounded in the view that our suffering actually arises more from the way in which we relate to experiences of pain, discomfort and difficulty than to the experiences themselves. This view suggests the possibility that we can substantially reduce distress by learning a different relationship to unpleasant and unwanted experiences, even if we can do little to change the experiences themselves. Anyone who works with cancer, who has cancer themselves, or who cares about someone close to them who has cancer, will know only too well that cancer and its treatment can offer one opportunity after another to experience pain, discomfort, anger, fear, and despair. It can seem wholly natural and understandable that we might be very distressed by these experiences, to the point where any suggestion that ‘there may be another way to relate to these experiences’ has to be approached with great sensitivity. It is here that Trish’s direct personal experience of being both a cancer patient and a teacher of, literally, hundreds of cancer patients passing through the MBCT-Ca programme are so helpful.

This fertile interface, coupled with Trish’s personal background in meditative disciplines, has led very naturally to a focus on the heart quality of compassion as a central feature of MBCT-Ca. The emphasis on opening to and caring for others’ suffering, as well as one’s own, on connecting with the common humanity shared with all who are touched by cancer, and on reaching beyond the isolation that pain and distress can so often reinforce, is one of the most lovely and powerful features of this approach. The fundamental importance of kindness and compassion within mindfulness-based applications has not always been explicitly acknowledged. This is changing – we now, for example, have empirical evidence that increases in self-compassion are one of the main routes through which MBCT for depression has its beneficial effects (Kuyken et al., 2010). I hope that the sensitive and heartfelt focus on compassion within this book may further alert those working with mindfulness-based applications more generally to the healing qualities of this universal capacity we all share.

The book also describes many further creative adaptations of the basic MBCT framework to the particular needs of patients with cancer – the development of a range of new brief practices, of ways to become more sensitive to the messages of the body, and of ways to ‘deconstruct’ experiences of suffering into their elements, to name but a few. Throughout, the description of the details of practice is held in a wider container of warmth, compassion, and a great sensitivity to the dynamics of group process.

Trish invites us to think widely: ‘Maybe we can play with the possibility that what we do as teachers and as participants in mindfulness classes affects far more than we imagine. The ripples that spread out may continue spreading a long way, for a long time, maybe forever’. I hope that many who are touched by cancer will feel the benefits from this timely book and of the care that has led to it.

John Teasdale, PhD.,

Cambridge, England, April 2011

Preface

Our experience is the only experience there is. This is the ultimate teacher.

(Pema Chödrön, 1997)

I have written this book for all those who are interested in the potential of mindfulness for people with cancer. You may be a health professional wanting to learn about the relevance of mindfulness to your work. You may be a mindfulness-based teacher currently working with people with cancer – or you may be teaching in a different context, and considering translating your experience into oncology, or work with people who have life threatening or life limiting illness. You may be someone who has had cancer and want to read about mindfulness and what it might offer people like you.

Central to this book is the voice of those who are bringing mindfulness into their lives as they journey with cancer. There is an intention in writing this that their experience will inform and inspire those of us working in the fields of mindfulness and oncology – influencing our professional practice in the care of those we work for. There is also an aspiration that this book will support further research into the psychological impact of mindfulness-based interventions for people with cancer.

This is the first published outline of Mindfulness-Based Cognitive Therapy for Cancer (MBCT-Ca), which has been specifically adapted for cancer patients. The eight week programme described in detail here was developed directly out of Mindfulness-Based Cognitive Therapy (MBCT) for Depression (Segal et al., 2002) and Mindfulness-Based Stress Reduction (MBSR) (Kabat-Zinn, 1990). This book shares the learning from teaching MBCT-Ca to over thirty groups of cancer patients. It is drawn from over ten years’ experience of evaluating, developing and refining the programme. If there is any heart in these pages, it comes directly from the course participants and their courage in turning towards their experience. If there is any lack of clarity or confusion, it is entirely mine as author.