Keely Stucke (Integrated Diploma in Wellness and Resilience Coaching)
I decided to research the impact of wellness coaching on cancer patients, as cancer is so common. Cancer is being seen increasingly as a chronic rather than terminal illness due to rising survival rates. As I have no personal experience of cancer, I spoke to a mindfulness teacher/hypnotherapist to hear about techniques she finds helpful with cancer sufferers.
The emphasis of health coaching is on self-management. Those suffering with various Long-Term Conditions report that self-management allows them to get on with their life and be empowered to ask the right questions of their GP. The coaching tenets of positivity, baby steps, recognising challenges, formulating If-then coping strategies, sharing goals and managing relapses are helpful with various long-term conditions. Journalling can help assess the impact of medication, diet and exercise. Peer support can be useful and social inclusion and hobbies are important ways in which people can continue to feel they are more than just their condition. Dawn is 45 and currently lives with two long term conditions, arthritis and chronic back pain. “Living with chronic pain means that… you need to stay focussed on what you can do, not what you can’t. Self management is about learning ways that I can manage my own condition. Not looking for a doctor to give me an answer.” 1.
The profound challenges faced by cancer patients are both physical and mental. 2. Physical symptoms can include a range of eating difficulties, such as nausea, difficulty swallowing, sickness, diarrhoea, constipation or altered taste. So it’s helpful to look at what the patient can eat and when, where the food is prepared, how it is served and whether anything can be added to boost energy. Nine out of ten people with cancer experience fatigue, which may continue long after treatment, so it helps to examine how the patient can plan to meet their housekeeping, parenting and work demands with depleted energy reserves. Around half of cancer sufferers are in pain and feelings of anxiety or depression may make pain worse. Coaching in mindfulness mediation can help patients rewire their brain and reduce pain. “If you’re a regular meditator MRIs show us that the brain is showing less anticipation of pain… And the way brain reacts to that anticipation is by sending more pain signals. The idea with mindfulness is to be with the direct experience, rather than all the thoughts around the experience, which is adding a whole new layer of pain.” 3.
Cancer sufferers have to cope with a range of emotions, which can include fear, grief and anger. One in five cancer sufferers depression after diagnosis. Studies show that Cognitive Behavioural Therapy is helpful for those in psychological distress and more effective after the initial shock of diagnosis has worn off, as well as in the late stages of cancer. While CBT is not proven to prolong life, it can help people cope, as well as lift their spirits through taking back some control. Coaching can help patients examine and reinterpret their beliefs by looking at their thoughts, emotions, behaviours and physical sensations.“Whilst distress is inevitable, there is good evidence.. that CBT is effective in treating depression and anxiety and no patient should be left to struggle with clinically significant symptoms that will impair quality of life and complicate the management of their illness.” 4.
Wellness coaching can also offer some solace to the terminally ill. Frances Trussell, Mindfulness Teacher at Mindfullyhappy talked to me about one of the terminal cancer sufferers she is currently helping who is fearful of dying in pain. “How can I be mindfully as present as possible with my kids, how can I be nourishing myself the right way, actually find joy in going through cookbooks and making beautiful recipes. Recently we were going through films she’s always wanted to watch, happy movies… I’m going to be here lying at home recovering from chemo… that’s shit but how can I create lots of little moments of loveliness.” 5.
The cancer journey is not over even when treatment has finished. It is known that conventional cancer treatment can cause secondary cancers, so focus on lifestyle changes that might help patients avoid secondary cancers is key. People may also need to identify a new career path or adjust to new body image, or cope with fear of recurrence. Cancer coaches who have had personal experience of the disease can really understand how heavily the emotional toll can weigh. To those who have never been through this illness it seems counter-intuitive, but there is an opportunity for awakening and acceptance. Real healing may only really begin in the mind. “Many cancer survivors have spoken about it being connected to a lack of self-care, saying that their healing came as they began to honour themselves more deeply”. 6.
When I began this assignment, I thought that wellness coaching for Long-Term Conditions would be best delivered by those with prior specialist clinical knowledge of that particular LTC. But I now appreciate some of the ways in which a non-clinically trained coach can help a cancer patient, from the dealing with the shock of diagnosis to recovery, or making the most of what time is left. While it can be difficult to asses the impact of health coaching, NHS reviews conclude “Health coaching appears to work best for people who are motivated to change and those who have the most severe disease.” 7. It can also help their carers. And even if they are life-long conditions, it helps to focus on things other than the illness itself, as people are more than their conditions.
- myconditionmylife.org accessed on 11/12/18
- https://www.nhsinform.scot accessed on 9/1/19
- Frances Trussell of mindfullyhappy.com interviewed on 11/1/19
- CBT for Chronic Illness and Palliative Care: A Workbook and Toolkit by N Sage, M Sowden, E Chorlton, and A Edeleanu p. 23
- Your Body Speaks Your Mind by Debbie Shapiro p.183
- Frances Trussell of mindfullyhappy.com interviewed on 11/1/19
- https://eoeleadership.hee.nhs.uk/sites/default/files/Does%20health%20coaching%20work%20-%20a%20review%20of%20empirical%20evidence_0.pdf accessed on 21/1/19
View the course: Integrated Diploma in Wellness and Resilience Coaching