Emotional Wellness Toolbox

Ease Cancer Stress, Anxiety
with ‘Emotional Wellness Toolbox’
Pioneering Psychotherapist Shares 3 Strategies that Work

A not-so-surprising new study shows stress reduces the effectiveness on drugs on prostate cancer, and even accelerates the disease’s development.

 “More than 150 million Americans will be diagnosed with cancer this year and how they deal with it can have a dramatic effect on their physical and emotional health,” says pioneering cancer psychotherapist Dr. Niki Barr, author of “Emotional Wellness: The Other Half of Treating Cancer” (www.canceremotionalwellbeing.com). 

While the mind-body connection in fighting disease is well-documented, the new study by Wake Forest Baptist Medical Centers reveals just how damaging anxiety and stress can be, Barr says.

The study found that mice implanted with human prostate cancer cells responded well to treatment when they were kept calm and stress free. But when the mice were stressed, their cancer cells didn’t die and tumor growth was unchecked. In another test, mice that were repeatedly stressed actually had tumors get larger.

The researchers found that stress and anxiety set off a chemical chain reaction that affects the cancer cells.

“So finding ways to ease the stress associated with cancer is vital,” says Barr, who has dedicated her practice to cancer patients and their families since 2007 after more than 15 years in counseling. “And part of what causes that anxiety is the feeling that you’ve lost all control of your life.”

To return some of that control to patients, she created the “emotional wellness toolbox,” a checklist of activities and tangible items her patients use to help maintain a positive attitude and sense of well-being through treatment.

 Here are a few of them:

• Diagnosis: Anxiety begins here and, according to the National Cancer Institute, “Anxiety may increase pain, affect sleep and cause nausea and vomiting,” among other problems. Learning to reduce anxiety from the outset can minimize physical pain and discomfort throughout the illness and treatment. Tangible tools include writing materials, a device for favorite music, CD's for guided meditation or relaxation, and a box to hold these materials. Cancer patients and their families can use them to focus for navigating psychologically through cancer.  “A simple technique for immediate relief from anxiety is ‘triangle breathing,’ ” Barr says. “Breathe in, breathe out, then pause- during which you say a word such as ‘calm,’ ‘peace,’ ‘confident;’ it’s remarkably effective!”
• Medical treatment – depression and the unknown: Approximately 25 percent of cancer patients are clinically depressed, she says. By the time of treatment, which is sometimes a gamble in itself, the diagnosis has had more time to settle in, which can throw emotions into a tailspin. Just a few of the tools for battling depression include being proactive in understanding the treatment, maintaining a healthy routine, taking a break from “cancer talk,” creating affirmations – true statements – that keep one moving forward, and keeping a journal.
• Back to “normal”? … After a diagnosis that can feel like being run over by a truck and a cavalcade of tests and treatments, suddenly the whirlwind of cancer “just sort of ends,” Barr says. Shifting gears – again – can be dizzying. Finding your center and moving forward with intention is a great way back to a regular routine. The first step is to collate all records of treatment, including upcoming visits; this puts the recent past and future into context. Next, decide on the kind of life you want to live from here; perhaps a healthier diet and more exercise was a promise made during treatment. Now is the time to make good on it!

“These tips are gathered from working with cancer patients and their families, taking what is most effective to share with other cancer patients and their families,” Barr says. “Sometimes cancer returns; and, sadly, some do not survive cancer.”

“Regardless of the severity of a diagnosis, however, there are good and bad ways to navigate this disease – that should be the primary concern, along with treatment, when you or a loved one are diagnosed.”

About Niki Barr, Ph.D. (@NikiBarrPhD)

Niki Barr, Ph.D. founded a pioneering psychotherapy practice dedicated to working with cancer patients in all stages of the disease, along with their family members, caregivers and friends. In her book, she describes an "emotional wellness toolbox" patients can put together with effective and simple strategies, ready to use at any time, for helping them move forward through cancer. Dr. Barr is a dynamic and popular speaker, sharing her insights with cancer patients and clinicians across the nation.

Overcoming Fear

When Fear Pushes You, Push Back!
4 Tips for Gaining Perspective on Life’s Greatest
Hindrance from Cancer-Surviving Marine

What if you could overcome your fears? What would you do, and how different would you be?

“Most people have no idea of what they’re capable of; I think they’re almost trained by fear to not attempt the amazing things they dream of. But I’m living proof – if you can overcome fear, you can overcome almost anything,” says Jay Platt, whose feats include swimming across the Mississippi River while handcuffed, shackled and blindfolded. He’s subject of the new documentary, “Living Unstoppable,”  (www.LivingUnstoppable.com).  

Platt was living his dream as a U.S. Marine when a cancer syndrome called von Hippel Lindau (VHL) exploded like a bomb on his life. It caused tumors in his brain and on his spine, as well as kidney cancer and the loss of his left eye.

“I was mad at the world, and maybe part of me was afraid of the fact that I would be considered a handicapped person,” says Platt, who was retired from the Marines due to his health.

After a personal journey of acceptance, however, Platt went on accomplish feats many world-class athletes wouldn’t consider. Along with his record-breaking Mississippi swim, he swam from Alcatraz Island to San Francisco with his hands and feet tied, and he was one of fewer than 300 people to have hiked the 2,100-mile southbound Appalachian Trail.

He talks about five areas that helped him overcome fear and anxiety in order to rebuild his body, mind and spirit.

• Focus on the joys in life: When you realize it’s not all about you, the annoying voice that tells you to be afraid begins to shrivel and loses its poison. While still reeling from his diagnosis and its effects on his life, Platt heard the carefree laughter of a severely handicapped girl being pushed in her wheelchair by her mother. “ ‘Listen to the birds, Momma,’ I heard her say – she was just so happy to experience that simple pleasure,” he says. “That, more than anything, sent me on a positive path.” His family, friends and those to whom he donates money through various charities gives Platt strength.
• Spiritual preparation: Just as Platt trains physically for his feats, he finds it essential to work out spiritually in order to stand up to the fear and anxieties that life’s trials bring. To that end, he surrounds himself with positive messages and positive people, including his friend Les Brown, the influential author of the self-help book, “Live Your Dreams.”
• Use setbacks as a motivator: When something bad happens, one of the most common responses is fear – fear that it will happen again; fear that you’re less than you used to be; or irrational fear. Platt always knew he’d be a Marine; when he was forced to retire early, he had to recalibrate his entire life. “One of my favorite quotes is ‘What are you doing now?’ – It doesn’t matter what you used to be,” he says. Platt is always looking forward to achieving his next goal.
• Remember a greater good: When he started experiencing complications from VHL, which first manifested in his left eye, Platt promised God that he’d devote his life to others if he got through the scare. He has kept that promise – his Appalachian Trail hike alone raised $109,000 for charity. “Staying true to a promise might be the most emotionally solid aid to overcoming fear,” Platt says.

About Jay Platt

Jay Platt was medically retired from the Marine Corps in 1998 after suffering complications from the cancer syndrome von Hippel Lindau (VHL), a genetic disease that resulted in brain and spinal tumors, kidney cancer, and the loss of his left eye. When told his future would be considerably dimmer than his past, Platt set out to rebuild himself physically, mentally and spiritually, and to challenge himself by setting demanding physical goals. He was one of fewer than 300 people to have hiked the 2,100-mile southbound Appalachian Trail; one of three to swim from Alcatraz Island to San Francisco with hands and feet tied; and the only person to swim across the Mississippi River while blindfolded, handcuffed and shackled. The proceeds from his adventures and sales of his documentary benefit non-profits, including the VHL Family Alliance.

Paying for College

4 Things Parents Should Know
Before Paying for CollegeFinancial Specialist Shares Ways to Help Your Child
 While Protecting Your Retirement

From $20,000 to $65,000 a year – that’s the tuition cost for one year of college, says John McDonough, a money expert who helps retirees and parents plan for their families’ futures.

“For the 2012–2013 academic year, the average cost for an in-state public college is $22,261. A moderate budget for a private college averaged $43,289,” says McDonough, CEO of Studemont Group College Funding Solutions, www.studemontgroup.com. “But for elite schools, we’re talking about three times the cost of your local state school. Either way, your kid’s higher education can easily shoot into six figures after four years.”

Along with worrying about rising tuition prices, parents also fear for their own futures if their retirement savings are drained by children’s college costs, McDonough says. Only 14 percent, for example, are very confident they’ll have the money to live comfortably in retirement, he says, citing a 2012 survey by the Employee Benefit Research Institute.

“Families feel they’re faced with conflicting goals, but there are numerous ways to pay for college while investing in your future retirement,” says McDonough, who offers insights for parents to keep in mind while planning for their child’s education:

• The ROI of a college education: At a time when so many American families are financially strapped, college is an especially stressful topic because parents know higher learning will help their kids succeed. College graduates earn 84 percent than those with only a high school diploma, according to Georgetown’s Center on Education and the Workforce. Here is how earning breaks down over one’s life time, based on education: a doctoral degree-holder will earn $3.3 million over a lifetime; $2.3 million is estimated for a college graduate; those with only a high school diploma can expect $1.3 million.
• Move retirement assets to qualify for grants: Most parents know about the 529 savings account, but that’s not necessarily the best or only option. Reallocating your retirement assets, such as 401(k)s, can better position a child to qualify for grants and scholarships. This legal and ethical maneuvering may be the single most important factor when considering how to pay for college.
• Know your student’s strengths and weaknesses: Consider independent and objective analysis of your future college student. Assessment might include a personality profile and a detailed search for a future career. Also think about a more nuts-and-bolts approach, including scholarship eligibility, SAT and ACT prep courses, review of admissions essays and an in-depth analysis of chances for enrollment in a student’s top four choices of colleges.
• Make a checklist of financial aid forms: In order to maximize a fair price of higher education, remember there is plenty of data to review. McDonough recommends a checklist with a timeline and notable deadlines. Be ready to troubleshoot the “alphabet soup” of data forms: FAFSA – Free Application For Federal Student Aid; CSS profile – College Scholarship Service; SAR – Student Aid Report; and more. Think about this process as a second job, or find professional help you can trust. 

About John McDonough

John McDonough is the managing member at Studemont Group, which is primarily focused on helping retirees gain peace of mind with unique market rescue and recovery programs. He is also founder, president and CEO of Studemont Group College Funding Solutions. His experience in the financial services industry includes managing partner at Granite Harbor Advisors in Houston and divisional vice president of AXA Equitable/AXA Advisors, the third largest insurance company in the world. McDonough is a member of the prestigious Forum 400, a qualifier at the Court of the Table qualifier for Million Dollar Round Table, an active member in National Association of Insurance and Financial Advisors and Society of Financial Service Professionals, as well as American Association of Life Underwriters. He has completed the course work to sit for the Certified Financial Planner® professional designation exam from Rice University.

Save Your Marriage

When You Think Your Marriage is Over,
Give It One More YearBy: Mort Fertel

One of the questions I'm frequently asked is, "How do you know when it's time to give up on your marriage?"

If you’re considering divorce, I suggest first trying to make it work for at least one more year.

Did you hear that?

Try for at least one more year!

And I mean REALLY try. You can always call it quits. You always have that option. But once you pull that trigger, it's over. No more chances. Your life will never be the same. Do you have kids? Their lives will never be the same.

If you end your marriage, you don't want to have a shred of doubt about what might have been. You don't ever want to look back and wonder if things could have been different. You don't want to ask yourself, “What if this? What if I tried that?”

If you have to end your marriage, you want to know DEEP IN YOUR HEART that you did everything you could to make it work.

Giving it one year of serious effort will also help you to move on with your life and into another relationship with a clear head, should you ultimately divorce. You want to come to a place of healthy closure. That is crucial!  In my experience, the best way to do that is to work at your marriage for at least one additional year. I know it probably seems like a long time, but it's an investment in the rest of your life.

Here's the key point: It's a good investment for the rest of your life whether your marriage succeeds or not. Obviously, it's a good investment if you turn your marriage around. But if you don't, it will not have been a wasted year. It will have been the most important thing you could have done with that year because of the impact on the rest of your life and (if it comes to this) your next relationship.

I have seen too many cases of spouses ending their marriages prematurely, and as a result, never reaching closure in the relationship. A few years later, they find themselves in the same situation with someone else.

Sometimes the progress individuals make in relationship counseling turns out to be more beneficial for them in their next relationship than in their current one.

I remember an instance when a man’s marriage ended in the middle of a seven-week marriage boot camp. The individual asked whether he should continue with the final weeks of the program. I said, "Absolutely."

He responded, "Why? What's the point? My marriage is over."

"You're not doing it for this marriage," I explained. "You're doing it for the benefit of your next one."

Now don't get me wrong; your intention for working on your marriage shouldn’t be simply to benefit your life after marriage. You need to be intent on restoring your current relationship.

But if you fail, your effort will not have been for naught.

Bottom line is this. If you're asking, "When is it time to call it quits?"

The answer is: one year after you think you're done. If after one more year of trying everything in your power to make your marriage work you're still miserable, then you should consider moving on. Until then, hang in there and don't give up.

This topic reminds me of my situation many years ago. I remember learning late one night that my wife had an appointment with a divorce attorney the next morning. We were hours from "done." Who would have thought that we could turn things around at that point?

We did, of course.

It's never too late! In fact (and here's real food for thought), very often the turning point in a marriage is when a couple hits rock bottom. Sometimes it's not until things couldn't get worse that they can get better.

About Mort Fertel

Mort Fertel is a world authority on the psychology of relationships. He has been featured as an expert on ABC, NBC, CBS, PBS and Fox television networks, as well as dozens of publications including Glamour Magazine and Family Circle, to discuss his Marriage Fitness System. His program is endorsed by a wide variety of mental-health professionals, and he has helped save thousands of marriages. Fertel graduated from the University of Pennsylvania, was the CEO of an international nonprofit organization, and is a former marathon runner. He lives with his wife and five children (including triplets!) in Baltimore, MD.

Maintaining Balance in Life

Psychologist Offers 4 Tips for Maintaining
Balance in Difficult Times

It’s no wonder nearly one in 10 Americans suffers from depression.

“Top risk factors include being unable to work or unemployed; having no health insurance; suffering from obesity,” notes psychologist Gregory L. Jantz, citing a Centers for Disease Control study.

“Unfortunately, those topics have dominated headlines for the past five years. What’s worse, by 2020, the World Health Organization estimates depression will be second most debilitating disease worldwide.”

The author of “Overcoming Anxiety, Worry and Fear,” (www.aplaceofhope.com) says these negative emotions along with sustained, excessive stress can lead to depression, which now overshadows other  problems for which patients seek help at his clinic.

“Depression can be rooted in a number of problems, and those need to be addressed – simply taking a pill is not usually effective treatment. Anger, fear and guilt can all be underlying causes, even when the person isn’t aware he’s experiencing those feelings.”

A holistic treatment approach, which may or may not include medication, helps people overcome a bout of the debilitating illness, and learn techniques to manage it themselves, he says.

People at risk of depression can work at maintaining their emotional equilibrium by counterbalancing negative feelings with optimism, hope, and joy. This is most effective if they do this holistically, addressing the four main categories of human need.

“By purposefully feeding the intellectual, relational, physical, and spiritual aspects of your life positive emotions, you can achieve balance,” Jantz says.

He offers these suggestions:

• Intellectual: Be aware of what you’re feeding to your mind. Try reading a positive, uplifting book, and setting aside time in your day to fill yourself up intellectually with constructive, encouraging messages. Be aware of what you are reading and listening to, and seek to counter the negative input we all get with positive influences.
• Relational: Think of a person you really enjoy talking to, someone who makes you feel good about yourself or someone who’s just fun to be around. Plan today to spend time with that person this week, even if it’s just for a moment or two. Make the effort to verbalize your appreciation for his or her positive presence in your day.
• Physical: Physical activity is a wonderful way of promoting emotional health. Engage in some mild exercise this week. Take a walk around the neighborhood. Stroll through a city park. The goals are to get your body moving and to allow you to focus on something other than yourself and your surroundings. Greet your neighbors, stop at the park and watch someone playing with his dog, or cheer at a Little League game. Intentionally open up your focus to include the broader world around you.
• Spiritual Support: Take some time to nourish your spirit. If you are a member of a religious organization, make sure to attend services this week. If you are not, listen to some religious or meditative music. Spend time in quiet reflection, meditation, or prayer. Intentionally engage in an activity that replenishes and reconnects your spirit.

If you are not depressed but feel anxious and stressed, have trouble sleeping or find your not content much of the time, Jantz says it’s time to start taking care of yourself.

“Depression is painful and as debilitating as any other disease,” he says. “Take steps to de-stress your life and to work on emotional balance before it gets worse.”

About Gregory L. Jantz, Ph.D

Gregory L. Jantz has more than 25 years experience in mental health counseling and is the founder of The Center for Counseling and Health Resources, near Seattle, Wash. The Center, “a place for hope,” provides comprehensive, coordinated care from a treatment team that addresses medical, physical, psychological, emotional, nutritional, fitness and spiritual factors involved in recovery. He is the best-selling author of more than 20 books, including “When Your Teenager Becomes…The Stranger in the House.” If you’re concerned you or a loved one may be depressed, visit www.aplaceofhope.com and click the “Are You?” tab for a self-evaluation.