How nature helps empower people going through cancer treatment

Tree of Life Fulfillment mindfulness workshop combines art therapy with guided imagery
The Tree of Life Fulfillment workshop brings the calming experiences of verdant environments to people who are unable to go out into nature.

Carol Mason was on the edge — strung out between depression and high anxiety. She had recently received news that the chemotherapy and its accompanying nausea, vomiting and intense fatigue she had been enduring for months to treat her metastatic breast cancer wasn't working. Her latest scan had revealed new lesions on her bones and liver.

Mason, 70, needed some way to quiet her mind and her fears, and marshal her energy for the road ahead. She was open to anything that would give her a vacation from her current nightmare. That's when she heard about a new approach to traditional mindfulness training. Mindfulness is designed to help people pay attention to present experiences with openness and willingness to be with what is. It can be a powerful self-care tool that helps reduce stress, improve attention and help cultivate self-awareness.

The new mindfulness workshop — called Tree of Life Fulfillment — is offered specifically through the Simms/Mann-UCLA Center for Integrative Oncology, at the UCLA Hematology Oncology office in Encino.

It combines art therapy with a specific type of guided imagery. The curriculum was written and developed at the center by Sydney Siegel, a social work intern at Simms/Mann. Both the art and the imagery are built on people's innate connection to nature, which was just what Mason needed to help get her mind off her current news.

At first, Mason said, she was unsure precisely what to expect, but soon, she closed her eyes and focused on following the sound of Siegel's voice as she instructed Mason and others in the class to envision themselves as a tree located in their own very safe and comforting place in nature.

While this is happening, they are incorporating deep breathing exercises that simulate the tree — taking deep breaths and exhaling, similar to the way a tree absorbs carbon dioxide and releases oxygen.

Soon Mason began to see detailed images of flowers, even catching the scent of a forest fragrance, and she let herself slip away into a world with luminous, colorful redwood trees at the edge of a sunny meadow.

"I felt the dense wood's strength and stability — just what I needed to counter the vulnerability my cancer has imposed on me," Mason said of the workshop. "I also sensed a timelessness in the tree's slow-moving life force that calmed my anxiety about my future."

Walking back to her car, Mason marveled at the power of these simple activities — imagining a forest and drawing — to help her feel at ease. "I was looking forward to enjoying a couple tacos on the way home, instead of ruminating about my ill health," she said. "The workshop had pulled my emotions back from distressing extremes to a relaxed, centered state of mind."

Participants in Tree of Life Fulfillment mindfulness workshops create images of trees, which have been shown to have calming benefits.

Increasing research links nature to mindfulness, creativity and imagination. Trees can be an especially powerful image in this process, said Siegel. One recent study found that even a momentary view of trees, or an image of trees, can enhance positive emotions. Other studies have found that trees have the ability to calm people physically and emotionally.

Taking patients out into nature, however, isn't always an option, especially for those who have trouble leaving their homes due to treatment recovery or are in the hospital. With the support of the team from the Simms/Mann Center, which is part of UCLA’s Jonsson Comprehensive Cancer Center, Siegel found a way to bring the experience of nature to patients: through the use of guided imagery, meditation and art.

Siegel incorporated various evidence-based interventions into the workshop, including acceptance and commitment therapy, which teaches people how to accept their diagnosis and then are guided on how to respond to their emotions; ecotherapy, a type of nature-based therapy that encourages healing through interaction with nature; and art therapy, a type of therapy that allows for creative expression — all forms of psychotherapy that help people cope with mental and physical illnesses.

"Psychosocial support is vital for people diagnosed with cancer," said Kauser Ahmed, clinical psychologist and associate director of the Simms/Mann Center. "That's why it's an essential, integral element of the care that UCLA Health provides to patients as part of their treatment plan."

Ahmed noted that it’s important to make these types of psychosocial support services available not only at UCLA Health facilities in Westwood, but to everyone served by UCLA Hematology Oncology community practices.

"With this class, we're combining established research with innovative techniques that address a person's emotional state," Ahmed said. "Strategies for both physical and emotional well-being are key elements to coping well with cancer."

To help encourage everyone who joined the class to extend the approaches taught in the workshop, Siegel made sure she created a remedy that went beyond the one-hour course.

"I didn't just want people to come for an hour and then go back to the stress and chaos of their medical treatment," Siegel said. "I wanted the benefits to be ongoing for the patients, so I made sure to leave them with tools, such as guided imagery that allows them to connect to nature during radiation and chemotherapy and tree journal drawing exercises that they can use to feel empowered in their daily lives."

Other research has shown that a calm, peaceful state of mind can promote healing, enhancing the mental resilience that patients need as they go through treatment.

John Slifko can vouch for the need for such calm, centered strength. He was diagnosed with pancreatic cancer in 2013 and attended the Tree of Life workshop in the UCLA Encino clinic.

"The workshop has reinforced my instinct that the Tree of Life is healing as a natural part of human experience," Slifko said. "It helped me make walking amid the trees with the sun shining above a daily part of my life. This makes every dimension of my healing and attitude stronger."

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