A Spiritual Journey A Spiritual Journey through through

Breast CancerBreast Cancer

Chi-Mei HorngChi-Mei Horng

Associate ProfessorAssociate Professor

Department of Clinical PsychologyDepartment of Clinical Psychology

Fu-Jen Catholic University, TaiwanFu-Jen Catholic University, Taiwan

Body-Mind-SpiritBody-Mind-Spirit

We are all made up with body, mind, We are all made up with body, mind, and spirit. and spirit.

There’re a lot of researches done on There’re a lot of researches done on the relationship between body and the relationship between body and mind. mind.

In treating breast cancer patients, In treating breast cancer patients, the spiritual perspective was less the spiritual perspective was less explored and hardly addressed by explored and hardly addressed by medical professionals. medical professionals.

Research in TaiwanResearch in Taiwan

A Study on Efficacy of Body-Mind-A Study on Efficacy of Body-Mind-Spirit Empowerment and Spirit Empowerment and Education Group for Women with Education Group for Women with Breast CancerBreast Cancer ：： A Pilot Study.A Pilot Study.

Mei-Ya SuMei-Ya Su

Unpublished thesis for School of Unpublished thesis for School of Nursing, National Taiwan UniversityNursing, National Taiwan University, , 2008 2008

ResultsResults

Group process effectively Group process effectively reduced patients’ feelings of anxiety, reduced patients’ feelings of anxiety,

depression, and uncertainty.depression, and uncertainty. increased their confidence about recovery. increased their confidence about recovery. improved their sense of hope toward future improved their sense of hope toward future

life.life. established social support network.established social support network. helped patients to discover helped patients to discover the meanings the meanings

and purposes of their lives. and purposes of their lives.

Research in U.S.(1)Research in U.S.(1)

Religious Practice and Religious Practice and Spirituality in the Psychological Spirituality in the Psychological Adjustment of Survivors of Adjustment of Survivors of Breast Cancer.Breast Cancer.

Purnell JQ, , Andersen BL, , Wilmot JP..

Couns Values. 2009 Apr 1;53(3):165.2009 Apr 1;53(3):165.

ResultsResults

Spiritual well-being was significantly Spiritual well-being was significantly associated with quality of life.associated with quality of life.

Religious practice was Religious practice was notnot significantly associated with quality significantly associated with quality of life.of life.

Research in U.S.(2)Research in U.S.(2)

Effects of Spirituality in Breast Effects of Spirituality in Breast Cancer Survivors.Cancer Survivors.

Meraviglia M..

Oncology Nursing Forum.

2006 Jan 1;33(1):E1-7.2006 Jan 1;33(1):E1-7.

ResultsResults

Meaning in life Meaning in life was positively was positively related to psychological responses related to psychological responses and negatively related to physical and negatively related to physical responses.responses.

Meaning in life mediated the impact Meaning in life mediated the impact of breast cancer on physical and of breast cancer on physical and psychological well-being.psychological well-being.

Research in U.S.(3)Research in U.S.(3)

Examining Spirituality among Examining Spirituality among Women with Breast Cancer.Women with Breast Cancer.

Reynolds ,D..

Holistic Nursing Practice.

2006 May-Jun;20(3):118-21.2006 May-Jun;20(3):118-21.

ResultsResults

Women with breast cancer tried to Women with breast cancer tried to ascribe ascribe meaning for cancer’s occurrencemeaning for cancer’s occurrence and search and search for mechanisms to cope with it.for mechanisms to cope with it.

Spirituality is utilized to gain a sense of Spirituality is utilized to gain a sense of control, reduce stress, and control, reduce stress, and achieve inner achieve inner peacepeace..

Underlying premise: Underlying premise: Taking care of the soul Taking care of the soul is a necessary element in healing the body.is a necessary element in healing the body.

Research in U.S.(4)Research in U.S.(4)

Ethnicity and Spirituality in Ethnicity and Spirituality in Breast Cancer Survivors.Breast Cancer Survivors.

Levine EG, , Yoo G, , Aviv C, , Ewing C, , Au A..

Journal of Cancer Survivors. 2007 2007 Sep;1(3):212-25.Sep;1(3):212-25.

ResultsResults 83% of the women talked about 83% of the women talked about

spirituality.spirituality.

A higher percentage of African-A higher percentage of African-Americans, Latinas, and Christians Americans, Latinas, and Christians felt comforted by God than the other felt comforted by God than the other groups.groups.

ResultsResults The traumatic experience of a breast The traumatic experience of a breast

cancer diagnosis help survivors tocancer diagnosis help survivors to deepen their deepen their faith and appreciation of faith and appreciation of

life.life. change the way change the way they see themselves they see themselves

and their lives.and their lives. change how they relate to people change how they relate to people

around them.around them. change how they change how they relate to Godrelate to God..

Research in CanadaResearch in Canada

Reflecting on Spirituality in the Reflecting on Spirituality in the Context of Breast Cancer Context of Breast Cancer Diagnosis and Treatment.Diagnosis and Treatment.

Gould J, , Wilson S, , Grassau P..

Journal of Canada Oncology Nursing . 2008 Winter;18(1):34-46. 2008 Winter;18(1):34-46.

ResultsResults

Three spiritual themes were Three spiritual themes were revealed: revealed:

Relationship with a Relationship with a Higher Being.Higher Being.

A deepening A deepening sense of self sense of self ..

Spiritual connection with others.Spiritual connection with others.

Research in IranResearch in Iran

Muslim Breast Cancer Survivor Muslim Breast Cancer Survivor Spirituality: Coping Strategy or Spirituality: Coping Strategy or Health Seeking Behavior Hindrance?Health Seeking Behavior Hindrance?

Harandy TF, , Ghofranipour F, , Montazeri A, , Anoosheh M, , Bazargan M, Mohammadi , Mohammadi E, Ahmadi F, Niknami S.E, Ahmadi F, Niknami S.

Health Care Women Int. Health Care Women Int. 2010 2010 Jan;31(1):88-98.Jan;31(1):88-98.

ResultsResults

SpiritualitySpirituality is the primary source of is the primary source of psychological support . psychological support .

Many survivors attributed their Many survivors attributed their cancer to cancer to the will of God. the will of God.

Research in MalaysiaResearch in Malaysia Religion and Spirituality in Coping Religion and Spirituality in Coping

with Advanced Breast Cancer: with Advanced Breast Cancer: Perspectives from Malaysian Muslim Perspectives from Malaysian Muslim Women.Women.

Ahmad F, Muhammad M, Abdullah AA.Ahmad F, Muhammad M, Abdullah AA.

Journal of Religious Health. Journal of Religious Health.

2011 Mar;50(1):36-45.2011 Mar;50(1):36-45.

ResultsResults

Survivors take illness as Survivors take illness as an an awakening sign.awakening sign.

Hope and freedom comes from Hope and freedom comes from surrendering to God. surrendering to God.

The common emphasis of spirituality The common emphasis of spirituality may significantly influence how may significantly influence how people learn to live with cancer.people learn to live with cancer.

What is Spirituality?What is Spirituality?

Spirituality is an individual approach Spirituality is an individual approach of searching for the of searching for the meaning of life, meaning of life, finding finding inner peaceinner peace within oneself within oneself through a very through a very personal connection personal connection between oneself and the entity between oneself and the entity that that one believes in, whether it is called one believes in, whether it is called GodGod or some or some Higher BeingHigher Being..

Spirituality is broader than religion.Spirituality is broader than religion.

Spiritual Beliefs Spiritual Beliefs

Belief in a Higher Being/God gives people Belief in a Higher Being/God gives people hope in the most difficult times in their hope in the most difficult times in their lives. lives.

Spiritual beliefs make a difference in how Spiritual beliefs make a difference in how people view their breast cancer people view their breast cancer experience.experience.

Survivors might realized that this Survivors might realized that this experience is very meaningful to them.experience is very meaningful to them.

Developing the Spiritual Developing the Spiritual Self Self

ReadingReading PrayingPraying MeditatingMeditating Relaxation practices Relaxation practices Being connected with a Higher Being connected with a Higher

Being/GodBeing/God

Hearing the “body talk”Hearing the “body talk”

Finding spiritual meaning Finding spiritual meaning underlying diseases.underlying diseases.

Listening to your heart to find out Listening to your heart to find out who you really are and what you who you really are and what you really want in your life.really want in your life.

Cure vs. HealingCure vs. Healing

"Cure" is about eliminating disease. "Cure" is about eliminating disease.

"Healing" is about recovering a "Healing" is about recovering a sense of inner peace.sense of inner peace.

Focusing on healing process rather Focusing on healing process rather than hoping to get cured.than hoping to get cured.

My personal experienceMy personal experience

I have been working as a clinical psychologist I have been working as a clinical psychologist since 1978 and considering myself as a since 1978 and considering myself as a scientist-practitioner. scientist-practitioner.

Doing psychological assessment by Doing psychological assessment by administering standardized psychological tests.administering standardized psychological tests.

Making diagnosis following certain criterion.Making diagnosis following certain criterion. Practicing psychotherapy with evidence-based Practicing psychotherapy with evidence-based

therapeutic techniques.therapeutic techniques.

Earned doctoral degree at Boston Earned doctoral degree at Boston

University in U.S. in 1994.University in U.S. in 1994. Teaching at clinical psychology Teaching at clinical psychology

department of Fu-Jen Catholic department of Fu-Jen Catholic University since 1994 .University since 1994 .

Served as chairperson of clinical Served as chairperson of clinical psychology department during 2002 psychology department during 2002 to 2005.to 2005.

Diagnosis of Breast Diagnosis of Breast CancerCancer

July, 2005July, 2005

A psychologist who A psychologist who knows allknows all

Quite calm the moment I heard this Quite calm the moment I heard this diagnosis.diagnosis.

In the beginning, ” Everything is In the beginning, ” Everything is under my control.”under my control.”

I actively participated in the decision I actively participated in the decision of my treatment plan: understanding of my treatment plan: understanding every option I have.every option I have.

Following treatment procedure Following treatment procedure cooperatively and energetically.cooperatively and energetically.

Three months later……..Three months later……..

Depressed & Depressed & ConfusedConfused

Why Me? Why Me?

Why Why Now?Now?

On the surface, I was at the peak of my career On the surface, I was at the peak of my career and in the prime time of my life.and in the prime time of my life.

But deep inside, I felt exhausted and But deep inside, I felt exhausted and depressed.depressed.

I was not satisfied with what I’ve been doing I was not satisfied with what I’ve been doing in my profession.in my profession.

I tried to resolve my problems by myself.I tried to resolve my problems by myself.

However…….However…….

My psychological My psychological knowledge knowledge

couldn’t couldn’t

help myself help myself at all !!!at all !!!

Encountering SpiritualityEncountering Spirituality

Reading books discussing spirituality such asReading books discussing spirituality such as

“ “The Healing Power of Illness” , The Healing Power of Illness” ,

“ “Seth Material” , “Conversations with God” ,Seth Material” , “Conversations with God” ,

“ “A New Earth” , ‘The Power of Now”……. A New Earth” , ‘The Power of Now”……. (Material that were not “scientifically (Material that were not “scientifically validated”)validated”)

Attending workshops on spiritualityAttending workshops on spirituality Practicing “Qigong”(Practicing “Qigong”(自發功自發功 ))

Spiritual AwarenessSpiritual Awareness

Acknowledging my beliefs in a Acknowledging my beliefs in a Higher BeingHigher Being

Exploring spiritual meaning of my Exploring spiritual meaning of my illnessillness

Discovering inner beauties of myself Discovering inner beauties of myself and others and others

Finding out who I really amFinding out who I really am Redefining purpose of my lifeRedefining purpose of my life

TransformationTransformation

Realizing breast cancer is a blessing Realizing breast cancer is a blessing in disguise.in disguise.

Experiencing deepest appreciation for Experiencing deepest appreciation for the sacredness of suffering.the sacredness of suffering.

Knowing that one must hold life Knowing that one must hold life gently and learning to let go.gently and learning to let go.

Living in the very present moment.  Living in the very present moment.   Much healthier and happier than Much healthier and happier than

before.before.

Be a “person” first, Be a “person” first, then a “psychologist”then a “psychologist”

Shifting professional interest from Shifting professional interest from empirical psychology to human empirical psychology to human spirituality.spirituality.

Teaching “Spirituality and Teaching “Spirituality and Psychotherapy” ever since.Psychotherapy” ever since.

Addressing more on the spiritual aspects Addressing more on the spiritual aspects of the clients. Focusing on their strength of the clients. Focusing on their strength rather than seeing them as mentally ill. rather than seeing them as mentally ill.

Sharing my spiritual journey with my Sharing my spiritual journey with my colleagues, students, fellow colleagues, students, fellow psychologists…..psychologists…..

Getting many feedbacks from them Getting many feedbacks from them and inspire a lot of self-introspection and inspire a lot of self-introspection among them.among them.

The Journey The Journey

goes goes on……on……

Thanks for your Thanks for your Attention Attention