1. ‘Choosing the Path Less Traveled….’
Resilience, Optimism and Hope in Cancer Survivorship
Mark D. Gilbert, MD,
Director, Mind-Body Medicine Skills Group Program,
University Arizona Health Network,
Associate Director, Psychosocial Oncology and Director of Professional Development, Arizona Cancer Center;
Associate Professor of Clinical Psychiatry,
University of Arizona

2. Compassion means to be intensely together with those who suffer.
The point of this attentive presence with a patient is not on curing or fixing a problem – instead, it is simply being in the moment.
Compassion welcomes and provides sanctuary for all that is unpredictable, imperfect, incomplete, awkward, pinched and unspoken.

3. Burnout
A debilitating psychological condition brought about by unrelieved work stress, resulting in:
Depleted energy and emotional exhaustion
Lowered resistance to illness
Increased depersonalization in interpersonal
relationships (patients become numbers)
Increased dissatisfaction and pessimism
Increased absenteeism and work inefficiency

4. Facilitator lead Talking Circle
Relaxation Techniques
Autogenic Training
Meditation
- focusing
- mindfulness
- movement
Biofeedback
Guided Imagery
Music and Sound
Genograms
Life Maps
Spirit Boxes
CBT exercises
Journaling
Eating Meditation
Yoga
Education
- Illness
- MBM
-Stress
- Imagery
- Spirituality
- Forgiveness
- Hope
- Nutrition
- Humor
- Cognitive
Restructuring
- Emotional
Awareness
- Sleep Hygiene
- Movement
- CAM
Resilience in the Eye
Responsibility – Attitude – Awareness Purpose – Empowerment- Connection
Facilitator lead Talking Circle

5. PNI of Resilience, Optimism and Hope
strong social bonds
DHEA
Cortisol
Hb1ac
Hardiness
Positive Emotional Granularity
Switching Cognitive Set
Hippocampal Volume and HPA axis
Childhood trauma
Stress Inoculation
CRH 1 and CRH 2
Locus Ceruleus and NE
NPY
COMT
Galanin
Serotonin
Dopamine
Neural Reward Circuitry
Actin-Polymerization Protein (APP)
cAMP response element binding protein
Brain-derived neurotropic actor (BDNF)
Fear=learning and extinction of amygdala response
Emotional Development
The Tree on Resilience Mountain –Other Contributions

6. Resilience, Optimism and Hope
optimists believe that discrepancies between their goals and their current attainment will be resolved- minimizing depression, anger and shame

7. PNI of Resilience, Optimism and Hope
Hope as a noun (there is always hope), a verb (I hope) an adjective (hopeful) and an adverb (hopefully)
With cancer hope of a cure or prolonged survival, and in terminal illness hope defined as a struggle to come to terms with the multiple losses in a changing reality
hiding or distorting the truth is not hope-engendering;
hope best engineered through honesty and empathy by framing hope in a wider context (relationships, belief, control, dignity, inner peace, humor, meaningful events, achievable treatment goals - Clayton)

8. Emotional Life as a Cancer Survivor
FEAR (RECURRENCE AND FUTURE TESTS AND TREATMENTS e.g. THE AVASTIN STORY)
SEPARATION
RE-ENTRY
FEELING REMNANTS
ROLE CHANGE
NEW PERSPECTIVES
RENEWED RELATIONSHIPS
RENEWED PURPOSE
SYMPTOMS (PAIN, FATIGUE, BRAIN FOG, INFERTILITY, SEX)

9. Living as a Cancer Survivor
The 10 Choices that will Determine
Which Road The Survivor Will Take