Taking Care of Yourself

Has claustrophobia ever kept you from getting an MRI? Or a fear of needles made routine bloodwork or IV chemotherapy difficult? If so, then you might benefit from a new self-soothing technique. 

While far from an exhaustive list, the seven below are simple ways to help you calm down or move past an emotional block in the moment.

Take some time to experiment with these tools, whether your hard places are connected to diagnostic tests, cancer treatment or something else entirely. They may help you build emotional resilience, so that you, too, can bounce back from challenging situations. 

Chop wood, carry water 

Changing the way you do even the simplest task can pull your attention away from emotional distress and focus it sharply on what’s happening here and now in the physical world. The Zen Buddhist phrase “chop wood, carry water” reflects this principle. 

Almost any activity can be made meditative. That’s why adult coloring books have become so popular. Even doing something more slowly than usual can have the same effect. Try brushing your teeth or hair one day using your non-dominant hand, for instance, or taking a different route to work.  

It’s not necessarily the activity that matters; it’s the mindset. Some people do woodwork. Others rake leaves, ride a stationary bike or knit.

“It’s the meditative effects they’re after,” explains Clinical Nurse Michael Eckenfels, one of the therapists in MD Anderson’s Psychiatric Oncology Center, “not necessarily all those scarves. Any activity involving repetitive motion will do.”

Change your ‘mind’s voice’  

Whose voice do you normally hear inside your head? Most people have an “inner voice” or “inner monologue” that’s running almost constantly. It’s the one that makes observations like: 

• “Hmm. Where did I put my keys?” 
• “Uh-oh. Looks like it’s laundry day.” 
• “What?! I don’t even know what that emoji means.” 

Reading famous quotes, such as Dr. Martin Luther King Jr.’s “I have a dream …” or President John F. Kennedy’s “Ask not what your country can do for you …,” can often make your inner voice sound like the person who originally said them. 

But you can change this inner voice deliberately, too, by making it speak more softly, slowly or gently. You can also change its tone, inflection or diction to make it more comforting, or even replace a negative message with something more validating or encouraging. This is particularly useful if your inner voice is often critical. 

“You can even borrow someone else’s voice, if that works better for you,” says Eckenfels. 

Take a six-second pause 

 Holocaust survivor Viktor Frankl is often credited with observing that, “Between stimulus and response is a space. And in that space is our power to choose our response.” 

 The most primitive part of our brains, the amygdala, has but one job: to decide if something is “dangerous” or “not dangerous.” If the amygdala malfunctions, it can hijack the whole system. That’s why we react in knee-jerk ways sometimes — ways that we normally wouldn’t respond — during high-energy situations. 

 “To combat this,” says Eckenfels, “deliberately pause for six seconds the next time you find yourself getting really agitated about something. This will give you time to respond instead of react, and actually decide what you’re going to do, instead of letting impulse determine it.” 

Whether it’s an umpire’s bad call at a baseball game or a clueless driver who cut you off in traffic, it can be useful to ask yourself: “Is it really worth getting so worked up about this?” 

Release some oxytocin

 Oxytocin is the neurotransmitter of connection. It’s the hormone released by the hypothalamus when someone smiles at us and we feel uplifted. It’s also released during cuddling and sexual intimacy. 

 “Not everyone’s a hugger,” notes Eckenfels. But you can still enjoy the benefits of oxytocin by: 

• Petting a dog or cat 
• Hugging a pillow  
• Smiling at or doing something nice for someone  
• Getting or giving a massage 
• Thinking of someone with whom you feel safe 

Name it to tame it

Sometimes, just taking a moment to notice and label exactly how you’re feeling can help calm you down when you’re upset. It’s been shown to decrease activity in the part of the brain responsible for reacting emotionally and channel it to the part of the brain responsible for more analytical thinking.

 “If you don’t know the right words, search for ‘emotions chart’ or ‘feelings chart’ on the internet, and use the language you find there to help identify your emotions,” suggests Eckenfels. 

Often, just realizing that you feel jealous rather than angry can be useful — and help you unravel why you feel that way. 

Progressive muscle relaxation

Progressive muscle relaxation is a technique that releases tension through tightening and releasing different muscle groups in sequence. Usually, people start at the top of the head and work their way slowly down the body, but there are many different variations. Experiment until you find one that works well for you, or try a relaxation app that has new versions daily, if you don’t like repetition. 

 “Progressive muscle relaxation is something that’s been really well-researched and used for a long time, so we know it works,” says Eckenfels. “The really great thing about it is that once you learn how, it can be done almost anywhere — even on a bus or in a waiting room.”

Connect with nature

 Being in the natural world has a documented soothing effect on many people. It makes them feel less stressed and better able to cope with life’s challenges. 

 But don’t despair if you can’t get out into the wilderness every day. You can reap almost the same benefits by sitting outside in a park or garden, looking out a window or watching fish swim in an aquarium. 

 You can also change the background on your phone or the screensaver on your computer to a soothing outdoor scene and use that to shift your focus. 

“Right now, my desktop’s screensaver is a picture I took of the Appalachian Trail in Maine,” says Eckenfels. “Whenever I’m stressed, I look at it and remember how it felt to hike a path that wound seemingly endlessly through the woods. And I feel myself relax.”

 The main thing to remember, he says, is that “the best time to develop resilience techniques is before you need them.” 

So, experiment to see which ones work best for you, then practice them regularly.  

Request an appointment at MD Anderson online or by calling 1-877-632-6789.

Anxiety is a normal reaction to a perceived threat or stressful situation. It can range from mild nervousness to a full-blown panic attack. In some cases, it may be helpful; in others, it may not.

The nervousness you feel before a work presentation, for instance, might spur you to prepare for it a little better, giving you more confidence when the time comes to actually deliver it. But the fear you feel before cancer treatment or a medical scan doesn’t really help anyone.

Problems arise when we feel more anxious than a given situation warrants, or it interferes with our ability to work, sleep, and interact normally with others. 

Here are some tips to help you better understand why you’re feeling anxiety, and what you can do to relieve it.

What does anxiety feel like?

Anxiety can cause a wide range of feelings. You could experience a general sense of worry about the future, a sensation of tension in your head and shoulders, or an urge to avoid certain people or situations.

Other physical symptoms of anxiety may include:

• Rapid heartbeat
• Quick, shallow breathing
• Nausea
• Chest pain
• Light-headedness
• Fear of dying
• Tingling sensation or numbness
• Upset stomach/urge to empty your bladder or bowels

All of these physical effects are nature’s way of preparing you for “fight or flight” — in other words, a fight for your life or a quick sprint away from danger to save it. So, there’s nothing wrong with you for feeling this way, and you’re not crazy or broken. 

Why do I react like this to stressful situations?

Think back to prehistoric times, when people lived in caves instead of cities. What would’ve been the most significant threat to personal safety? 

Back then, it was likely fierce predators like lions, tigers, bears, and so forth, which were all around humans in the natural world. And if you encountered one of those face-to-face, it would make perfect sense to feel anxiety, right? 

So, anxiety evolved as a way of helping to keep us out of danger. It gave us an evolutionary advantage by alerting us to when situations were not safe. 

Common ways to cope with anxiety

Escaping dangerous predators is a far cry from the types of stressors most people face today. But the feelings we experience now can be just as intense, especially when you’re dealing with a cancer diagnosis or cancer treatment. 

The brain and body are always trying to keep us safe by learning what sort of things around us are related to threats. For example, the sound of a predator’s growl or footsteps nearby is a signal that we are unsafe. But when you go through something scary like cancer, your brain starts associating certain sensory memories with being unsafe, whether it’s true or not. That’s why some patients tell me that just the smell of hand sanitizer or the act of putting on a mask can trigger a panic attack.

Fortunately, there are lots of tools available to help. Here are three of the most common:

• Psychotherapy: Talk therapy with a licensed therapist can help identify the sources of your anxiety and find ways to reduce them.
• Medications: Whether they’re taken daily or on an as-needed basis, anti-anxiety drugs work best when used in tandem with psychotherapy. They can only be prescribed by a licensed physician, such as a psychiatrist or your primary care doctor.
• Lifestyle choices: These could be coping mechanisms you use to reduce anxiety in the moment, or conscious choices you make to reduce the overall number of stressors in your life.

Physical activity can help reduce anxiety

Sometimes, just a little aerobic activity can help dispel anxiety, by burning off some of that nervous energy. Jumping jacks, wall jumps and brisk walking are all things you can do almost anywhere to increase your heart rate.

Box breathing can be done anywhere

If you’re not in a place where physical activity is possible, consider a simple breathing exercise instead.

In “box breathing,” also known as “square breathing,” you take four seconds each to perform four different steps, then repeat the sequence at least three times:

1. Breathe in through your nose.
2. Hold it.
3. Breathe out through your mouth.
4. Hold it. 

It sounds deceptively simple. But it really works, and it’s something you can do almost anywhere — even when you’re having your blood drawn or getting an MRI done. 

Use 5-sense grounding to help you refocus

In this exercise, you take several minutes to check in with yourself physically and identify:

• 5 things you can see
• 4 things you can feel
• 3 things you can hear
• 2 things you can smell
• 1 thing you can taste

Refocusing your attention on the physical world really brings you back into the moment. This method is especially helpful when you’re in the throes of an anxiety attack or feeling disconnected from your body.

6-sense self-soothing

This exercise is a little different from the previous one because it involves actions rather than perceptions, even if they’re only in your imagination.

• Sight: Picture a loved one or a beautiful bouquet of flowers in your head.
• Touch: Feel the softness of a fuzzy blanket or the warmth of a bubble bath.
• Sound: Listen to rain falling, a cozy fire crackling, or calming music.
• Smell: Rub a favorite scented lotion on your skin, or burn some candles.
• Taste: Savor a few pieces of sour candy or dark chocolate.
• Movement: Take a leisurely walk or do some gentle stretches.

While these may sound really simple, there’s a lot of research behind them that shows they’re proven ways to make you feel better.

Keep in mind, though, that the “taste” exercise is not a license to eat mindlessly. It’s about being intentional in savoring small quantities of something with a really strong flavor. So, think about the people in those TV commercials who act like they’ve never tasted chocolate before, and try to get that level of enjoyment.

Make a plan to manage anxiety

As our emotional intensity increases, our ability to think clearly decreases. So, take time to experiment with these methods when you’re feeling calm. Then, practice! Make the ones that work best for you as convenient as possible. That may mean storing a hard copy of the steps in your purse or bookmarking a video on YouTube.

The key is to make a plan before you need it. That way, you won’t have to worry about figuring out what to do when you’re stressed in the moment. Because you’ll already know. And you can just look at the plan you made earlier and carry it out. 

When to seek help

Anxiety can be uncomfortable, but it’s actually a sign that our bodies and brains are working the way they’re supposed to. Ultimately, anxiety is designed to keep us safe.

But if you find yourself avoiding normal activities, turning to substances like drugs or alcohol for relief, or becoming unusually irritable with your loved ones due to anxiety, it’s probably time to seek help.

MD Anderson patients and their caregivers can get support by contacting Social Work or the Psychiatric Oncology Center, or by sending a message to their care team through myChart.

Request an appointment at MD Anderson online or by calling 1-877-632-6789.