Microsoft Word - Stress Transcript

International Myeloma Foundation
Moderator: Susie Novis
11-19-10/6:00 p.m. CT
Confirmation # 74936962
Page 1
International Myeloma Foundation
Moderator:
Susie Novis
November 19, 2010
6:00 p.m. CT
Operator:
Good afternoon. My name is (Lisa) and I'll be your conference operator.
At this time, I would like to welcome everyone to the Living Well with
Myeloma conference call. All lines have been placed on mute to prevent any
background noise.
After the speakers' remarks, there will be a Question and Answer session. If
you would like to ask a question during that time, simply press star then the
number one of your telephone keypad. If you'd like to withdraw your
question, please press the pound key. Thank you.
I would now like to turn the call over to Susie Novis, President of (IMS).
Ma'am, you may begin.
Susie Novis:
Thank you. It's my pleasure to welcome you to the IMS Living Well with
Myeloma teleconference series, Hope, stress, myeloma and the holidays. This
is the final call for this year and we're delighted to have (Greg Patchini) with
us as tonight's speaker.
We've known (Greg) for many years and he was a frequent and often
requested speaker at our support group leaders retreat. So just to give you a
little background on (Greg), he is licensed professional counselor and certified
psychotherapist and he's in private practice with over 30 years experience in
the profession.

International Myeloma Foundation
Moderator: Susie Novis
11-19-10/6:00 p.m. CT
Confirmation # 74936962
Page 2
For the last 20 years, (Greg) has focused on support of the chronically and
terminally ill, their caregivers and the medical professionals who served them.
He's also an author of a book for illness survivor and their families called
"Journey Beyond Diagnosis," which I really, really recommend.
(Greg) speaks locally and nationally on this and other related topics. So for
those of you on the call, if you haven't already so, I really suggest that you go
to the website www.myeloma.oxford and download or view (Greg's)
materials for tonight's call. It's under New and Noteworthy, which is on the
right hand side. It's in a red box.
If you don't have access to your computer, just grab a pen and paper and
you'll be all set and I wanted to thank you, (Greg) for being on tonight's call.
So, (Greg), we'll turn it over to you.
(Greg Patchini):
Thank you, Susie. Good evening to each and every one of you. I hope you're
doing well. We're going to take a little journey together and then just a
minute, I'm going to go the agenda. If you had that in front of you, we'll talk
about that in a minute.
But before we do that, I'm going to have you do something with me. I want
you to go to page 3 in the set you have there. It's called your holiday stress
and what I like you to do is take maybe 30 seconds to just list some of the
things that you expect to be stressing you through the holidays or maybe
you're already feeling.
And it could be something simple like a can or pumpkin pie for Thanksgiving
or to be something a little more significant like will I have the strength to do
the things I hope to do through this holiday season.
So take just a minute, I'm going to turn some music on in the background and
make a couple of notes on that page about the things you expect to be
stressing you during the holiday season. There's no right or wrong answer.
Whatever comes to my mind is completely acceptable.

International Myeloma Foundation
Moderator: Susie Novis
11-19-10/6:00 p.m. CT
Confirmation # 74936962
Page 3
And in a minute, a little bit later on, I'm going to back to you with some of
those and we're going to have everybody get to hear what you've written and
you'll hear what other people have written as well.
OK, the sorts of things that you think maybe complicating the holidays for
yourself or the person that you're supporting. It could be a physical issue or it
could be a matter how your heart emotionally is going to do through this time.
It could be something with relationships. It could be financial.
Anything that you expect to be stressing you during this time, just makes
some notes about that on that page that it says "your holiday stress." Just take
another 10 seconds or so to make notes about that and then we're going to
over the agenda.
OK, so put that aside for just a minute and go to the page that says, overview.
We're going to take a minute to talk about that. We've already done the
introductions. We've started the process of two-sided card and let's now go
over to the rest of that agenda or the overview. We're going to talk about
your holiday stress a little bit.
At that point, I'm going to ask people to respond and the operator help you get
into the conference call then we're going to talk about something called stress
drain and the nature of discomfort. We're going to talk about the difference
between stress and stressors, between suffering and pain, and discomfort in
general.
And it affects us any time especially during the holidays. After that, we're
going to look at something called "Hope and your holiday gift." We're going
to focus on hope, the nature of hope, and maybe speak about (inaudible) that
you're not familiar with.
And then we're going to close with some other ideas that I have that hopefully
we'll help through the holidays and make the time more comfortable and more
meaningful, OK. The evaluation at the end, we're actually not going to do
that. We're just going leave that be and take the time for questions and
answers, OK?

International Myeloma Foundation
Moderator: Susie Novis
11-19-10/6:00 p.m. CT
Confirmation # 74936962
Page 4
So at this point, I'm going to have do one more thing. I want you to go to
page 5 and you're set there, and it talks about hope and your holiday gift. And
on that page, I wanted to just take a couple of minutes and I want you to make
some notes about the things that give you hope.
What is it that sparks that feeling in you that you know your experiences are
being expanded, feeling better, feeling hopeful. What is it that gives you that?
And if you could think about things that are not necessarily attached to
physical outcomes with your illness, that might be useful.
It's natural to want to go there, but I'd like to talk about it in a little different
way and we'll see more about that later. So take just a minute to write down
things that's sparking your sense of hope.
Here's an example, I had someone recently say to me. I saw a family at the
bookstore on a Saturday night. That told me there is still hope. She's got a
(tongue) and cheek, but she was also telling me that that meant something to
her.
So take a minute to make some notes on that fifth page titled "Hope in Your
Holiday Gift" about the things that make you feel a sense of hope, OK. So
just take a few seconds to do that and when you're done with that, we're going
to take some calls about the things that are stressing you or that you kind of
imagine or expect will be stressing you.
Once we're done with that, we're going to talk about stress strain and the
nature of discomfort and you have a page that list all that and we're going to
fill in the blanks together, OK. So, Operator, if you will, I'd like to
(inaudible) some people listening about the things that they expect are going
to be stressing them. Can we take some calls for that?
Operator:
At this time, if you do have a question or comments, please press star one on
your telephone keypad. Our first question will come from the line of (Ray
Alson).
(Ray Alson):
Hello.

International Myeloma Foundation
Moderator: Susie Novis
11-19-10/6:00 p.m. CT
Confirmation # 74936962
Page 5
(Greg Patchini):
Hi, (Ray).
(Ray Alson):
Having to get major dose of chemo on Monday and meeting family support
and afraid to ask them because it will ruin their Thanksgiving.
(Greg Patchini):
So there's a sense for you that if you step forward with what you really need
right now, it's going to be a spoiler for them?
(Ray Alson):
Yes, because it's will be for three weeks and it starts Monday. So I haven't
asked them because I know it's going to ruin their holiday.
(Greg Patchini):
Do they know that you're dealing with cancer?
(Ray Alson):
Yes, they just don't know this new part.
(Greg Patchini):
They don't know that you're going to be doing chemo?
(Ray Alson):
Yes, and needing three weeks support.
(Greg Patchini):
OK, so just break in the news could be a stressor and then the thought of
having to ask for help or not asking for help in this situation is going to be
pressure for you?
(Ray Alson):
Yes.
(Greg Patchini):
OK, thank you for sharing that. Let's take someone else's call. I appreciate
that, OK.
Operator, do we have another call?
Operator:
Yes, our next question comes from the line of (Brenda Jenkin).
(Brenda Jenkin): Yes, my stress right now is trying to find a presentation. Can you give me that
web address again?
Susie Novis:
Can you hear me?
(Brenda Jenkin): Yes, I can.

International Myeloma Foundation
Moderator: Susie Novis
11-19-10/6:00 p.m. CT
Confirmation # 74936962
Page 6
Susie Novis:
All right, it's www.myeloma.org.
(Brenda Jenkin): OK.
Susie Novis:
All right.
(Greg Patchini):
Good. Anybody else just called in with some pressures for the holidays?
Susie Novis:
(Lisa), do we have another call in the cue?
Operator:
Sorry, we have no questions.
(Greg Patchini):
OK, we're actually going to come back to what (Ray) shared in terms of
asking people for help. Let me just mention this as an aside.
Everybody has heard about the Type A personality, the Type B personality.
There are some researches out there that suggest that there's a Type C
personality and in my own work, I've seen this a lot. I lead a couple of groups
every week for people with cancer and it happens almost weekly that we talk
about this issue.
The Type C personality is the kind of person that tends to put everybody else
first and that kind of person has a hard time asking for help themselves.
Unfortunately, we all have needs and when we constantly give to others
without checking our own needs, there can be quietly and slowly a very thin
level of resentment that can build up. That can actually be hard on our bodies.
So one of the things that it can help is rather than saying yes, learning to say
no, learning to honor our needs. There's a very important difference between
being selfish and being self loving. You know, everybody has heard that
quote from the Old Testament, I think, that says, love thy neighbor as thy self.
We often think about loving others, but the premise of that particular notion is
based on our loving ourselves first and so many of us have learned not to do
that and (inaudible) complications. So I invite anyone listening to learn to
how recognize your own needs because if you've been always been taking
care of others.

International Myeloma Foundation
Moderator: Susie Novis
11-19-10/6:00 p.m. CT
Confirmation # 74936962
Page 7
It's very it can be really tricky to even know what is needed so it takes
practice and patience to know what it is that you're about and then to honor
that and ask for what you need. Knowing that others love you and that their
desire is to help you and that in the case of the woman who called in, while it
may be stressful for them and difficult to hear, it's very possible I don't know
you and I don't know my family.
But they may rally to you in a way that you didn't expect when you come
forward with your need. OK. So let's kind of step forward then and talk
about the next page, which is page 4 I believe. The subtitle on that page is
"Stress Drain and the Nature of Discomfort."
So what you can do is follow along with me and we're going to fill this in as
we go. The first section is going to talk about the difference between stress
and stressors. So the first blank there in the heading is stressors and we're
going to define stressors and we're going to define stress and we're going to
compare those two differences.
And hopefully this information will help as you go into the holidays.
Recognizing what's actually going on and what it's work in terms of the
amount of stress that you feel, OK. A stressor, that's the first one. The first
blank under the heading of stressor and there's an equal sign, OK.
Stressor usually an event in the physical world that has the potential to stress
us and I'll read that again. Stressor, it's usually an event in the physical world
that the potential to stress us.
OK, having said that let's compare that to stress that's the second section
there. Stressors are internal reaction to that event usually accompanied by
uncomfortable thoughts or feelings that can affect our behavior. So what it
was saying here is that there are stressors in our lives every day and every
way.
You're constantly exposed to things that have the potential to make
uncomfortable, but whether or not we are uncomfortable is based on our
response to that stressor. Our response could be neutral and what would be a
stress for one person, for us isn't or somebody else may not react to a

International Myeloma Foundation
Moderator: Susie Novis
11-19-10/6:00 p.m. CT
Confirmation # 74936962
Page 8
particular event with the reaction stress, but we would and therefore, we feel
the stress.
As an example, let's say we have this conversation in the middle January and
as we talk a snow storm comes through and one area the country gets hit
pretty hard and let's say there are 30 people listening and half of those people
may have a reaction that says, boy, I love the snow.
I'm looking out. I'm sitting at home in the living room and I see the snow
falling and it makes me feel really good. OK, the stressor was the snowfall,
but for them there was no stress. Somebody else may say, I got to get up and
work in the morning. It's going to take me an extra 40 minutes to get there. I
see that snow and I'm starting to feel bad.
OK, their reaction to the external event produces stress in them. The good
news about this and we're going to talk about this probably in a couple of
different ways as we go. That we can regulate how much stress we feel
depending on how we respond to the stressors around us.
There's nothing right or wrong about your response. If you get some news
about your treatment that you don't like and you start to feel uncomfortable
that doesn't mean you're doing something. It just means you're choosing a
particular response to that external event. We'll see more about this as we go.
And that what you might do, we're going to have time at the end for questions
and answers so if you have a question as I talk, make a note somewhere on the
sheets that you've downloaded or on pad and I'll be happy to take those
questions at the end. OK?
All right, let's talk now about the difference between pain and suffering.
Suffering is the first blank in that next section. OK, the difference between
pain and suffering. Pain is an uncomfortable part of life we all experienced
whether physically, emotionally, mentally or for some perhaps even
spiritually that happens now.
Let me read that again, pain versus suffering. Pain is an uncomfortable part of
life we all experienced whether physically, emotionally, mentally or for some

International Myeloma Foundation
Moderator: Susie Novis
11-19-10/6:00 p.m. CT
Confirmation # 74936962
Page 9
spiritually that happens now. Pain is a part of life. I'm sort of preaching to
the choir here because if you're in treatment or someone you love is in
treatment, you've had moments of pain physically and emotionally, mentally
and maybe even spiritually.
The next section is suffering. So that's the first word. The first blank under
that section, the second part is suffering. A mental or emotional response to
pain after future that is optional. At times, our reaction to pain in the moment
also adds suffering to that pain.
So let's take a minute to talk about the difference here. If you're in a bad car
accident and you get bruises. When it happened it hurts and for a few days or
weeks or even months after it happened, the places where your bruise will still
hurt and that is pain.
If the car accident was a year ago and you think back on it and you start to get
upset thinking that was some of the worst pain I've ever had. Now, you're
suffering. The pain you feel from treatment or from witnessing someone you
love go through physical pain that's real and that's now.
But if you start having thoughts like, will this be as difficult next year as it is
today? That's suffering. Pain happens in the moment as a consequence of an
experience we're having now. Suffering is a set of thoughts about what might
happen or what has happened and that's something we have choice about.
You stab your toe and it hurts, you don't have much choice about that. If
you're thinking three weeks later about how much it hurt, you can decide not
to think that and when you do think about it when it's outside the moment,
you're creating suffering for yourself.
When it happens in the moment, that's a natural part of life, there's nothing
wrong with it and that's pain. There's nothing wrong with thinking about or
anticipating pain or pain from the past. It's not about right or wrong. One of
the cord presets that I'm trying to communicate tonight through this
conference is the choices that we can make.

International Myeloma Foundation
Moderator: Susie Novis
11-19-10/6:00 p.m. CT
Confirmation # 74936962
Page 10
If you're not practiced at it, if you don't have a lot of experience with it, it's
going to feel awkward and maybe even wrong. Like I should be concerned, I
should be fearful about how things are going to go. A lot of our culture
support staff. A lot of minds raises with things that they have no control of
and it's not wrong, but we can choose to do something differently.
Let me take a moment to speak to this a little bit and more detailed because it
can be confusing. You have an absolute right to whatever you feel in
relationship to the situation you're in with your illness or any situation that's
difficult for you whether it's a child or spouse or a job. If it's troubling you,
you have a right to those feelings.
Emotions are not right or wrong. They're simply guide post. Guide post that
gives direction towards the things that make us feel better and the things that
make us feel worse. So whatever you're feeling in response to your situation,
you have an absolute right to and nobody can take that away from you and I
certainly have no desire to.
But with practice, you begin to recognize that you can shift in and out of these
emotions if you want to because you want to feeling something different if
just for a moment. The idea is to learn to be a master of your emotional self
and your mental self rather than it being master of you.
There's a book called "Dune" and in that book he says, I am not my fear. I
see it's coming and it's going, but I am not fear. When we are afraid, it can
feel like that's all there is, but it's a fact that when you're fearful you're the
same person that has the capacity to feel hope, to feel strength, to feel love
and joy.
It doesn't mean that you should shift it. It just means that you can because in
the moment of fear resides also within you all the emotions and with practice,
you begin to recognize. When you're not in a place of comfort and you learn
to shift it.
We're going to talk about how to do that in this next section. Fill in more
about this in the last section on that page called the nature of discomfort.

International Myeloma Foundation
Moderator: Susie Novis
11-19-10/6:00 p.m. CT
Confirmation # 74936962
Page 11
Again, if you have any questions, as we go, please make not and we'll take
those at the end.
The nature of discomfort. When we find ourselves in emotional, mental or
spiritual discomfort, one of two things is probably occurring. We are back
there in the past or out there in the future. I'm going to read that again. When
we find ourselves in emotional, mental or spiritual discomfort, one of two
things is probably occurring. We are back there in the past or we out there in
the future.
Let me speak to that and then I'll fill in that last section. With practice, you'll
realize that if you're uncomfortable at an emotional or mental level, you're
probably thinking about something that happened already or something that
might happen. Again, there's nothing wrong with that.
However, some believe that if there is the divine the divine exists in this
moment because this is the only thing that is eternal. This moment always is.
We don't know that they'll be a next moment and the moment that just past is
simply a (inaudible). It's a thought, but right now, we're all on the phone call.
It's the only that's alive in any of our lives. It has life in it. So there's a
simple thing you can do to help train yourself so that you begin to regulate the
amount of discomfort you're walking in. It's a simple thing, but the idea is
that every time you walk through a door way. You check in.
You walk into the kitchen, you check in. You get in the car, you check in.
You walk into somebody else's office, you check in. And what are you
checking in for? You're asking yourself what's going on in my mind right
now. Where are my thoughts?
Where are my feelings? If you're uncomfortable, there's a good chance that
your thoughts and feelings are focused on something that has already
happened or something that might happen. And so when you walk through
that doorway and you check in and you're uncomfortable, and you noticed
that you're thinking about something that might be or something that has
been.

International Myeloma Foundation
Moderator: Susie Novis
11-19-10/6:00 p.m. CT
Confirmation # 74936962
Page 12
You can decide to bring yourself back into what's happening right now or you
can decide for right now I need to feel this pain or I need to feel the sadness.
It's about choice, but the more you check in, the more you choose and the
more choose, the more you set yourself up to be the master of those reactions
rather than them having master over you.
Let's go to that section in parentheses at the very bottom of this page. This
past or future thinking may take the form of comparing or shaming self, which
may produce great discomfort too. I'll read that again. This past or future
thinking may take the form of comparing or shaming self, which may produce
great discomfort too.
So typically if we're uncomfortable and less were in physical pain in the
moment and we're going to talk about this a little bit more too. If we're
uncomfortable in the moment and we're not in physical pain right now, you're
probably either thinking about something scary or uncomfortable from the
past or scary and uncomfortable about what might happen in the future.
But there are two other things that can make you uncomfortable in the
moment that have to do typically with past or future thinking. One is
comparing yourself to somebody else and in that comparison so often we
don't measure up and then we feel uncomfortable.
And when that happens we look down on ourselves and we are we see
ourselves and that's what what shame is. Shame isn't when we've done
something wrong. Shame is when we feel we are wrong and shame is really
poisonous to the body. So if you walk through the doorway and you check in
with your thoughts and you find that you're comparing yourself to someone
else and that makes you uncomfortable or you're feeling that you are broken
or there's something wrong with you.
That's shame and that's hard on us, and I would invite to shift out of that. If
nothing else, love yourself in that moment by saying something very simple
like I regard who I am. I care about me. I'll give you a replacement for the
thoughts and feelings that are pulling you down in that moment, OK?

International Myeloma Foundation
Moderator: Susie Novis
11-19-10/6:00 p.m. CT
Confirmation # 74936962
Page 13
And that can bring hope. OK, speaking of hope, what I would like to do now
is take some calls about the sorts of things that give you hope. The sorts of
thing that you jotted down, if somebody would like to call in and share with
all of us the sorts of things that make you feel hopeful. Can we take some
calls?
Operator:
At this time (inaudible).
(Greg Patchini):
We'll just wait for a minute and see if anybody would like to share a thing
about hope.
Operator:
OK, our first question will come from, again, from (Ray).
(Ray):
Job my job is willing to work with me. I traveled all the time and now
they've given some things that will keep me in my home office.
(Greg Patchini):
So their support of you during this time feels like hope to you?
(Ray):
It definitely feels like hope.
(Greg Patchini):
Very good. That's a good example. It's not attached to outcome. It's an
experience. Thank you for sharing that. Any other callers?
Operator:
There are no further questions at this time.
(Greg Patchini):
OK. On that page, it talks about hope in your holiday gift. I'd like to share
something with you that to me maybe one of the most important things I'm
going to say in this teleconference. I'm going to share a quote with you and
it's a gift to you from this writer.
It's a nation writer by the Lu, the second word, Xun. I'm going to read this to
you and then I'm going to tell you why I think it's so important because it has
to do hardly enough with what we're learning about neuroscience.
So let me read this quote to you by Lu Xun. It says, hope is like a path in the
country side. Originally, there was no path because people are walking all the
time in the same spot, a way appears.

International Myeloma Foundation
Moderator: Susie Novis
11-19-10/6:00 p.m. CT
Confirmation # 74936962
Page 14
And I'll read it to you again, hope is like a path in the country side.
Originally, there was no path because people are walking all the time in the
same spot, a way appears.
hope is like a path in the country side. Originally, there was no path because
people are walking all the time in the same spot, a way appears.
To me that's just a beautiful image. You can imagine the hillside that is just a
meadow and grassy and there's nothing there. It's just open and beautiful and
then one day somebody decides to walk across it to get from one place to
another and the grass begins to get maddened. Someone else notices that that
way has been taken and they pick the same path, and then a few days later, the
original worker comes back and sees the path that was left and walks it again.
And then again, and soon more people in the village noticed that there's a way
that was not there before and they start traveling it and now you have a path
where there was none. What is wonderful for me about this quote and about
hope is that neuroscience is telling us that the brain acts exactly this way.
That when we persist in a particular set of thoughts, the brain creates
neuropaths and I love the word, it's a path, neuropaths to support that
particular set of thoughts or feelings so that if you consistently think in ways
that are scary or sad, there's nothing wrong with that. But what's happening
is you are walking in your mind in the same place repeatedly and a path is
created there.
On the other hand, if you consistently, frequently entertain thoughts that feel
hopeful about anything, the mind creates neuropaths and a network of
synapses at the cellular level to support those particular thoughts and feelings,
and pretty soon, there's a path there of hope or of joy or of love.
And there's another piece to this that is really interesting to me. It has again
to do with neuroscience and biochemistry. What I'm learning to understand is
that at the cellular level if we feel fearful or angry or sad a lot at the level of
the cell, there are receptor sites for the neuropeptides that are released as
chemicals in the body associated with those particular emotions.

International Myeloma Foundation
Moderator: Susie Novis
11-19-10/6:00 p.m. CT
Confirmation # 74936962
Page 15
So you imagine at the cellular level there's a keyhole and it's got only one
key that will fit it. And let's see if the key that is a neuropeptide in the shape
of sadness. When we feel sad, it releases chemicals and they have a shape,
and it's the shape of the key of sadness. And as it moves into cellular level,
there's a key hole that that sadness fits into.
The more we feel sad, the more the cell says, we got to make space for all of
these keys that look like sadness and they remove keyholes that could have
the key that fits for hope or joy or love to make space for the keys that look
like sadness. So the more we feel sadness, the more keyholes are created at
the cellular level to receive the hormones, the neuropeptides and the shape of
sadness and there's no more room for hope or joy.
This explains why it's difficult if you've been sad or scared or angry for a
long time to start feeling something different because a requirement is that the
cell's change shape in a very basic level. On the other hand, if we begin to
experience hope, here's comes the key in the shape of hope and there's no
space for it on the cell, the cell says we got to start making some space for the
key in the shape of hope.
So it begins to create its form to have a receptor site for the neuropeptides
related to hope and the more we feel hope or joy or love. The more cell says
we've got to reconstruct here to make space and it begins to push out of the
way, the receptor sites for fear or sadness or anger. And so, the more you feel
hope or joy or love, the more difficult it is to feel sadness or hurt or
hopelessness.
It takes practice, but this is something we can regulate. We can actually shift
the way we operated the cellular level by our thoughts and our feelings and
first of all, it takes being aware. And that's what the whole idea of going
through the doorway as it gives us a place to be aware.
So that is a quote that I give you, that I hope will support you through the
holidays and you can take with you perhaps carry you over some of the humps
that you're going to be dealing with as you go through this next couple of
months.

International Myeloma Foundation
Moderator: Susie Novis
11-19-10/6:00 p.m. CT
Confirmation # 74936962
Page 16
All right, let's go to the last page. We're going to do something this page is
called the gift that keeps on giving and I'm going to explain this to you. The
second one we're actually going to do together. I'm going to take you
through an experience that will hopefully make you feel a little better.
So let me share with you in the next slide that can help with difficult emotions
and stress during the holidays. The name of the book is called "Journey
Beyond Diagnosis" and it uses the metaphor of a long trip. And when you're
traveling and driving and something happens on the highway, got a flat tire or
you need some assistance, you call "Triple A" and that's the name of the first
exercise, "Triple A."
And this an exercise that deals with difficult emotions, sadness, anger, fear.
The first thing to do in dealing with any difficult emotion is to acknowledge it.
So that's the first A. Acknowledge what you feel. Things won't change
unless they're acknowledged. You don't like your job. You feel
uncomfortable at the end of the day and it's been like for months and months.
If you don't acknowledge that you're uncomfortable, you won't start thinking
about making some kind of a change in your profession or where you work.
So the first thing that has to happen is acknowledging what's going on. I'm
sad. I'm scared. I'm angry.
Once you acknowledge it, the second step is to accept it. I mean sort of try to
express this in terms that might be closer to home with your illness. Let's say
that you got a doctor's appointment in three weeks just before New Year and
as you begin to think about it, you get more and more anxious and this is just
follow up.
It's been a year since treatment is over and you've had another check up and
you're saying to yourself, why am I so anxious? I'm doing fine. The reports
are all good. What's going on with me that I keep getting uncomfortable?
I've got to get over this, OK? That's an example of acknowledging that
you're anxious, but not accepting it.
So the first thing is to acknowledge it. The second step is to accept it. When
you accept that you feel anxious, there's space in you. When we have an

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emotion that's uncomfortable, and we shame ourselves for it, we can get stock
there. But if you accept it, hold yourself and brace yourself for that feeling
something opens and then we flow naturally and to the third step, which is
action.
So you have to acknowledge it and then accept it and then you'll act typically
in a different way. I was talking to a group early this week and these are
parents of kids with disabilities. And we've talked about what it might be like
if you have a child who's young and they're behind in development and it's
their 16th birthday and all the other kids all the other kids are learning to
drive.
But this child is far from that and at the 16th birthday, a parent might get
really sad about that. They've acknowledged that their sad, but if what to say
to themselves is this is not right. I've got to be here. My kid is pain and my
family is in pain, how can I be sad? And they fight themselves with that
emotion, what happens is they check out.
They can't move forward because they're wresting with their feeling, but if
they can simply say to themselves. You know, it's OK that I'm sad about this,
it's reasonable. I have a right to that. They love themselves with that
emotion. What's going to happen is their actions are going to change.
They're going to open up and they're going to be able to be more present now
because they haven't got stuck fighting themselves with that feeling, OK?
That's the first exercise. The second exercise is called the "Snow Globe
Express" and what I want to do before we go into filing those blanks in. I
want to actually take you through this exercise. I'm going to put some music
on and actually invite you to get comfortable. You're going to hear the music
in the background and you're going to hear my voice and this is a chance to
put the papers aside and just to give yourself permission to experience this
together.
There is no right or wrong way to do this. I'd like you to put your feet flat on
the floor and just have your hands in your lap open, and just take a few deep
breaths. This is time for you it's time to take a little rest in the middle of

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whatever pressures you may already be feeling with the holidays or that you
maybe with your current condition with your illness.
This time is just for you and to start we'll take a few deep breaths and as you
inhale and exhale notice the rhythms of your breath. Notice the way your
chest and your belly rise and fall as you inhale and exhale. This time is just
for you. There's no right or wrong way to do this.
And now without changing but your attention, I want to notice at the very top
of your head. With your awareness at the top your head, notice any
temperature there. Maybe you feel gentle breeze from (heater) in your home.
With your attention at the top your head now, simply relax the very top of
your head.
And allow that relaxation to go down at the back of the head, across the
forehead, around the eyes, the ears, the lips, the tongue, the jaw all relax.
Relaxations through the neck and the throat across the shoulders, the shoulder
joints more so often there's tension as of hands are comfortably massaging
those large muscles.
Down through the upper arms, the elbows, the lower arms, all relax. The
wrists and palms of the hands, the back of the hands, each finger and each
thumb at the very tip relaxation, down through the chest, the upper back and
the shoulder blades, the middle back, the upper belly, the lower back and the
lower belly all relax.
Relaxation through the hips, through the groin, the upper legs, the knees, the
lower legs, all relax, down to the tops of the feet, the bottoms of the feet and
all the toes to the very tip relaxation. Take just a few seconds to experience
whatever comfort you may have created for yourself.
Continue to breathe deeply and fully, and now brining with you whatever
comfort you've created and like to see yourself in a place that always brings
you comfort. Maybe it's a special room in your home or may it's place
outdoors, just see yourself there. And invite your eyes to look around the
environment of this comfortable place and your imagination, what do you see?

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Perhaps you see future or the face of a loved one. Perhaps you see mountains
or beach water. Taken the sights of this place as you continue to relax, what
do you hear in this place? Someone's voice, perhaps a gentle breeze or
crackle of leaves or water, birds? Notice the sound of this special place.
Notice any fragrances or aromas that come in this place that special and
comforting to you.
Lastly, what do you feel physically there? Notice the furniture or the earth
beneath you. Reach out your hand and experience the texture of something
near you in this comfortable place. Continuing to relax and continuing to
breathe deeply and using your imagination in this very special place for
comfort you.
In fact if you notice in the distance, someone to punish you and that you love,
walking towards you from the distance, and as they approach you, you noticed
that they have something. A gift and you know in your heart that is a gift for
you, and you know that this gift is special. And as you relax in this place, and
as this person you love approaches you.
You feel more and more anticipation to receive an open (inaudible) bringing.
And how they're close and closer just before you know and have a box,
they're extending this gift to you and invite you to receive this gift. When you
feel ready to open it and as you open it, you feel something very special.
What you find inside is a snow globe and as you pick the snow globe from out
of the box, you feel that there's something very special about it. That this is
no ordinary snow globe and so holding the snow globe in both hands, if you'd
like thank the person that's given it to you.
They accept your appreciation and they walk away. Leaving you in the
comfort of this special place holding this very special object, this object is
snow globe with very special properties. This snow globe has the capacity to
receive into it. Any thought or feeling that's troubling you in this moment.
And so as you said in this comfortable place with the snow globe, with the
special properties in your hands.

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I'd like you to send into the snow globe thoughts or feelings that are
uncomfortable for you in this moment, and as you release them, notice the
snow globe draws them right through the glass and contains them inside that
ball. And if you have more than one thought or feeling that's uncomfortable,
release it into the snow globe and watch it absorb it in.
It takes it in as if that's its job. It's happy to receive it. It has no effect on the
snow globe. It simply receives it and as you released those thoughts in the
snow globe. Notice the shift in yourself. What I'd like you to do now with
the snow globe containing whatever thoughts and feelings that you would
rather not be holding right now contained in that snow globe.
I want you to sit the snow globe down and begin to slowly step away and
notice that the farther you step away from the snow globe, the more
comfortable you are because you're stepping away from the concerns and
worries that were troubling you contained in that snow globe.
And so walk away as far as you like bringing with you comfort and leaving in
the snow globe those things which you rather not carry in this moment. As
you continue to breathe deeply, in just a minute, I'm going to invite you to
return your awareness to the place you are.
Knowing that whatever comfort you've created for yourself is in there waiting
to be recreated any time you can take the time to give it to yourself. And so
gently, you can either leave the snow globe with those words in it knowing
that you can return and retrieve it anytime or bringing the snow globe with
those worries and concerns inside it.
Gently bring your attention to the room you are, back to the place that you're
participating from, notice your surroundings as you're ready open your eyes
and bring your awareness back. Now check in with yourself for just a minute
and notice any shift.
This exercise is designed to give you an experience of your capacity to
separate yourself from your thoughts and feelings. It gives you an experience
of regulating yourself, creating distance from those thoughts and feelings that
are not supportive to you in this moment.

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If it returns an emotion that is uncomfortable and you want to experience it, so
be it. If it shows up at a time that you don't want to experience it, the
invitation is to send it back to the snow globe. You have a capacity to do that.
In my experience, many of you have just done that.
So if you're ready, let's walk through the steps for the snow globe express.
Step 1 is to relax your mind and that's what we did when we did the
progressive relaxation and then you took yourself to a comfortable place,
which is step 2. See yourself in a comfortable place.
Step 3 is to imagine holding a magic snow globe. Step 3, imagine holding a
magic snow globe and step 4 is send troubles or worries into the snow globe.
Send troubles or worries into the snow globe. OK, so let's move to the last
exercise and then I'll have some closing comments and then we'll take
questions.
The name of the last exercise is hope, fear and your body. Hope, fear and
your body. The first step in this exercise is to recognize this fear constricts us
and hurts. I'm sure many of you have seen the commercial on TV that says
depression hurts. That's one of those pharmaceutical companies. It's true.
Difficult emotions do hurt us. Not just emotionally, but physically.
So the first step in this exercise is to recognize this fear constricts us and hurts.
You can put any emotion in there that's difficult fear, sadness, anger,
confusion, hopelessness, those emotions constrict us and hurt. There's
nothing wrong with them, but that's the effect they have.
Step 2, recognize hope, love or trust expand us and feel good. Just like the
commercial says depression hurts. Hope, love, trust, they expands us and they
feel good not just mentally and emotionally, but physically.
Again, there is no right or wrong about any emotion, but part of what I've
tried to communicate in our teleconference is that we can become choiceful
about what we experience at the emotional and mental level. So the last step,
step 3, is to choose.

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If you're feeling something uncomfortable, using the tools we've talked about
earlier, you can choose to shift into something that feels better and if you can't
there's nothing wrong with it. It takes practice and it takes patience. The
more you practice it, the stronger the neuropathways are that easier or become
to experience emotions that feel better.
All right, and then the last thing at the bottom of the page. It's sort of tongue
and cheek, some closing thoughts. It's called dugs, drivers and doorknobs and
that's going to be a reiteration of what we've been talking about for a good
part of our time together.
In closing, remember, we walk in either love and trust or fear and doubt.
Most of time, if we're uncomfortable in some state of fear and doubt. If we're
comfortable, we're in some state of love and trust. So I'll say it again. In
closing, remember, we walk in either love and trust or fear and doubt.
Fear robs us of energy and hurts. So unless you're being chaffed by a dog or
run over by a crazy driver, try love. In other words, fear is a natural response
to a threatening situation. If you're out for a walk and you hear a dog and you
feel fearful, your body is going to have a reaction that it designs to get you out
of that situation.
That's a good time to be afraid or if you're driving and somebody's coming at
you and you have, of course, a fear based reaction and you're able to dive that
person that's about to hit you. That's a good time to be afraid. Pretty much
outside of those kinds of situations, fear is a waste of our energy. So I'll say it
again, fear robs us of energy and hurts so unless you're being chased by a dog
or run over by a crazy driver, try love.
Every time you walk through a doorway, ask yourself, is this fear or love I'm
walking in. Practice this to get hope. The more you do it, the more you create
in your body a pathway that supports hope that supports love and trust.
And lastly, before we take questions. Let me just say to you that wherever
you are. In this country or another country, I wish you well and I wish you
more hope through the holidays. If you've got the handouts, you've got my

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phone number. If you don't have the handouts and you like me to speak to
your group, wherever you are. I'm happy to talk with you about that.
You can reach me at 314-993-9111 or you can e-mail me at pacebene@att.net.
OK, happy to take any questions that might be out there at this point.
Susie Novis:
(Lisa), do we have any any calls, any questions, comments?
Operator:
And that is star one for any questions or comments. OK, and our first
question will come from the line of (Mary).
(Mary):
Thank you for this lovely exercise. I've noticed in my self-talk, I sometimes
refer to my disease as my myeloma. What are your thoughts on owning the
disease?
(Greg Patchini):
That's a good question. Each of us has the capacity for wellness and illness.
What we have kind of set our minds to I think becomes us. There's nothing
with referring to it as your myeloma, your body is containing. But I don't
know that necessarily your spirit or your thoughts or your emotions have to.
There's a lot out there about visualization to release illness and to see yourself
well and there's been some pretty good results with people that the
visualization is to see their body without disease at the cellular level, at the
level blood illness, at the level of tumors that can be useful.
So like we've talked about today, the body does respond to our thinking. So
just like we create neuropathways based on thoughts of hope or thoughts of
sadness or fear. If you persists in thoughts, it's one thing to say it's my
myeloma and you tell someone that.
But if you claim that and you walk consistently with that belief as if you're
attaching yourself to it and I don't know of any hard science that can back this
up, but to me it make sense that that disease might want to stay with you
because you keep taking it by the hand by referring it to as yours.
There's no shame in that. There's nothing wrong with it, (Mary), but I think
the question suggest that you are wondering about the power that you're

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giving the disease by calling it yours and I would just say go with your own
instincts that suggest it's probably more useful to just say I have an illness.
Thank you for the question, too.
(Mary):
Thank you.
Operator:
Our next question comes from (Michael).
(Greg Patchini):
Hello, (Michael).
(Michael):
Hello, (Greg). How are you?
(Greg Patchini):
I'm fine. How about you?
(Michael):
I'm terrific.
(Greg Patchini):
Good.
(Michael):
I don't have a question right now, but I just didn't expect an hour of imagery
like that. It was really a nice thing (inaudible) came at a nice time for me. So
so thanks for that.
(Greg Patchini):
You're welcome and thanks for sharing that and you you can do this on your
own any time.
(Michael):
Yes, I know how do it, but I never do it.
(Greg Patchini):
OK.
(Michael):
Having a disease is a busy activity.
(Greg Patchini):
Yes.
(Michael):
And you can get really you can get really wound up and free activities.
(Greg Patchini):
Right.
(Michael):
Real wound up in it.

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(Greg Patchini):
Well, there's no question about what's required at the level of the physical to
deal with the significant illness. I would invite to just as you're acting on your
own behalf to get to the doctor, to get the treatments, the process and the other
procedures in place to take the time out of your life to do that.
You've been able to make time for that. It's an act of love for yourself
because you want to heal. I'd invite you to find a way to heal yourself and
love yourself by niching somewhere in your day to do these kinds of things as
well.
(Michael):
That's an excellent advice, (Greg).
(Greg Patchini):
You're welcome.
(Michael):
It kind of come in at a nicer day for me so thanks for that.
(Greg Patchini):
You're welcome. I'm glad it did, (Michael).
(Michael):
OK.
(Greg Patchini):
Take care.
(Michael):
OK, you too.
Operator:
And our next question comes from the (Ralph).
(Greg Patchini):
Hello, (Ralph).
(Ralph):
Hi, Greg.
(Greg Patchini):
Doing OK?
(Ralph):
Yes, excellent. (Inaudible) is that I have young children.
(Greg Patchini):
Yes.
(Ralph):
What are your thoughts on getting them to relax a little more? There are times
where they get upset with me (inaudible) my disease.

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(Greg Patchini):
Can you tell me a little more about that?
(Ralph):
Well, they're school age children. They're not little kids. They're middle
school (inaudible) age and there are times I've been dealing with this
disease for quite some time and there are many times that my youngest in
particular will get upset just knowing that I have the disease. You know,
worried that I'm going to die. So I was wondering what your thoughts were
some things that maybe could say to them to could maybe ease their mind.
(Greg Patchini):
Can you tell me what you're doing, (Ralph), when that happens? How do you
respond to them?
(Ralph):
Basically, we've been honest. Honest the whole time and that seems to work
the best because they could think. Other things are wrong if you're not being
upfront with them, but it's just something that pops up every once in a while
that the kids will just be upset because obviously, you know, besides me
facing this, they are as well.
(Greg Patchini):
Absolutely.
(Ralph):
And it's just very difficult sometimes.
(Greg Patchini):
I can only imagine. First of all, I think that's it's fascinating to me that each
of us carry so much wisdom. You already answered your question. I couldn't
give a better answer to what to do with the child that's concerned about your
illness and that is speaking the truth.
That the thing that that I could add to that would be invite them to speak
their truth to you, which you probably are already doing. The only other thing
that you might consider is the conversation about these sorts of things we've
discussed. How old is this youngest?
(Ralph):
Thirteen.
(Greg Patchini):
Thirteen. OK, so you might take a walk or sit down sometime when they're
doing OK. Maybe not in time when they're really upset because at that time
that's what happens with anxiety. We lose oxygen to the brain and we don't

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think so clearly. So it might be better to have this conversation when they're
well, when they're calm.
And just just sit down and say let's talk about how this goes. There are
times when you I know you get really upset and so do I, and we have absolute
right to feel those things. I would never want to take that away from you. But
it's hard, it feels really bad to feel so upset and so you know what? We can
actually do some things to feel better.
So you might give them a little sort of tutorial on how to change their thinking
and feeling not that it's bad, but because it hurts. They might decide to give
themselves a break sometimes. Just kind of walk them through that.
(Ralph):
OK, great. Thanks, (Greg). I appreciate it.
(Greg Patchini):
Thank you, (Ralph).
Operator:
Again, if you have any questions or comments, please press star one at this
time.
Our next question will come from (Robin).
(Greg Patchini):
Hello, (Robin).
(Robin):
Hi, (Greg). Looking to see if you can give us some tips in how to handle
those guilty feelings when you're trying to make the holidays perfect and
everybody just really appreciate the time together.
(Greg Patchini):
Guilty feelings about not being able to fully yourself or
(Robin):
Trying to orchestrate happiness, I guess.
(Greg Patchini):
So the feelings about having trouble doing that?
(Robin):
Right, right, just wanting everyone to relax and enjoy each other and to just
make it memorable.

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(Greg Patchini):
Well, it depends on, you know, if you're with a large group of people, this can
be harder to do. If it's like with your immediate family, you know, you could
kind of prime the situation going into it. Let's say it's Thanksgiving and this
is coming up this really very quickly.
What you could say to people is, you know, you can call everybody or you
can do a conference call with them or you can e-mail folks. Just sent out a
little broadcast to them and say OK, we're going through a difficult time. I
mean, if this is what you want, it doesn't mean you have to do this.
But if this useful, if this sounds like a good idea then what you could do is
simply like I said it's not an e-mail or call people or talk to them when you see
them before the holiday and say we want this to be a really nice time together.
Actually this happened to me with my younger sister and it was going into her
last Christmas and New Years and everybody came into town and we just
kind of talked about it. She sort of lead the way. Let's enjoy each other. We
know that this is a difficult time, but we also know that we can still love and
hold love in our hearts.
So let's make a choice. We can talk about the sad stuff if we want to or we
can put it on hold until after the holidays. But let's edge out some time in
there that we are going to just laugh like crazy, hold each other, play, do the
things we've always done. Of course, this is difficult, but let's make this a
special time regardless.
(Robin):
OK, thank you.
(Greg Patchini):
You're welcome.
Operator:
And again, if you do have a question, please press star one this time.
Our next question will come from the line of (Medeo).
(Greg Patchini):
Hello, (Medeo).
(Medeo):
Hello, yes. This is (inaudible). I'm a primary care physician as well as a
patient. I just want to share some of my thought. I'm sorry this is my first

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time to attend this quarterly meeting. Unfortunately, this is the last time of the
year.
I feel this is very helpful for myself, but experience want to share with
everybody. I'm 69 years old. Just past my birthday.
(Greg Patchini):
Happy birthday.
(Medeo):
It was three years ago, I started to symptom, which is GI symptoms,
dyspepsia, (inaudible). I have been one of the most hard working physician in
the hospitals in the private practice. I would say top three of the most
(inaudible) obstetric family practices (inaudible).
We always say there are time to (inaudible) that over do it, over work, but you
know, you can do what I didn't do what I preach. Yes, and I worked too hard.
I think it end up to be a (inaudible) paying for the prices at this times, that the
immune system was low or I fear it's in the past, a few years, I've been so
tired and don't have time to sleep.
I usually design my professional work. I also have public services during the
night. So as a, you know, public service as a medical association presidency
and so forth.
(Greg Patchini):
I see.
(Medeo):
I think disease actually kind of God's (inaudible) that giving you early
warning that I need to take, you know, hands off. And I was it takes upon
nearly one year. First with GI symptom goes through the all GI work up
and thus (inaudible) you name it. I got everything.
Finally, I finally GI did a biopsy (inaudible) become edematous and (where)
it's come from. OK, so, finally, they got to do it a blood test and then finally
found out the protein was high. So they did electrophoresis and then finally,
(inaudible) refer to the hematology.
And finally, they got the diagnosis of (inaudible) biopsy diagnosis. Yes, so in
the past as we understand as primary care, multiple myeloma is only life

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expectancy in one to three years. But now with new development, we are able
to over 10 years or even longer so that's (inaudible).
(Greg Patchini):
Yes.
(Medeo):
Now with this kind of find in this situation, that's what prompt me to be in
retire early retirement at age up to 32 years old (inaudible) 5-year practice,
that is medical practice and even goes two years ago, (inaudible) retirement,
but I still go back and sometimes, you know, just kind of (inaudible) my part
time works until about last week finally, my second totally retirement.
(Greg Patchini):
Yes.
(Medeo):
I think it's because of (inaudible) urgent care as patient of the sick people
(inaudible) and sickness of it.
(Greg Patchini):
So you've decided to pay pay attention to that and take care of yourself to
step away?
(Medeo):
Right, so I think those the advantage is to give me because of this illness
that I got return and then I can see like you say, you can see the people
concerning and you know, we always say when (inaudible) I'm not afraid of
test.
But when you're facing that possibility and you are really not afraid of it
because that means you're not just just plain talk (inaudible) it's possibility,
however, the knowledge is still power.
And as you mention that you know, to first, just like a psychiatrist.
Number one, it did you were angry and denier and then you end up to be
acceptance, recognize and trying to manage before it. But you have to
manage ways knowledge. That we always preach to manage and that early
prevention is much better than treatment.
And that is really, I got a patient actually a couple of them. They had
(inaudible) of colon cancer 10 years ago, told them to get a resection. They

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say we are religious people, God would take care of it. So (inaudible) it's too
late. That I've been telling each time.
So you still it's a good thing (inaudible) religion, but you also have a
knowledge. Now, what you've got brings you to the physician. So those are
things that I think I also fear the people. There's a different personality I
know among (inaudible).
Some of the people would keep (inaudible) themselves with the result
(inaudible) to their friends or relatives.
(Greg Patchini):
Right.
(Medeo):
-- which is (inaudible) you know, my wi-fi that kind of personality. We'll
my (inaudible) is I would like to say too more often talk. I say well,
sometimes this (inaudible) to be have an illness. In fact, by talking to other
people, care about people, you get a recommendation from others.
(Greg Patchini):
Yes, Dr. (inaudible) for a minute. Can I interrupt? I think we want to take
some more calls so I appreciate your perspective and congratulations on your
retirement and I hope you feel more and more strength than and wellness.
Operator:
Thank you. At this time, if you would like to ask a question, please press star
one on your telephone keypad. Again, that is star one if you do have any
questions or comments for the doctor.
Currently, we do not have any further question.
(Greg Patchini):
OK.
Susie Novis:
So this is Susie Novis again and first of all, I've really want to thank you,
(Greg) for a really, really terrific call. It was wonderful and I have to tell you
that my colleagues here and I were following your lead and we're so relax
now and we feel really like good and energized and it was incredibly helpful.
(Greg Patchini):
Good. Thank you.

International Myeloma Foundation
Moderator: Susie Novis
11-19-10/6:00 p.m. CT
Confirmation # 74936962
Page 32
Susie Novis:
So I'd like to thank everyone who participated on tonight's call and I just want
to wish you a very happy and healthy and stress free holiday season and I
hope that you remember how to do the exercise that Greg let us through.
Just as a reminder, the annual meeting of the American Society of
Hematology, which is a big hematologic meeting that takes place once a year
will once again meet December 3rd through the 7th, and I want to know that
the IMF will be there in 4th and we'll be reporting back on the latest advances
in the treatment for myeloma. So I want to make sure to go to our website.
You'll be able to read about it and hear about it as we'll be filming and doing
interviews with all the key leading investigators and myeloma experts.
I also want to remind you that our hotline team is here to answer your
questions, they can be reached on our toll free number, which is 800-452-
2873. That hotline is available Monday through Friday, 9 a.m. to 4 p.m. and
that's Pacific Standard time.
So, (Greg), once again thank you so very, very much. It was really wonderful
and once again, everyone have a great weekend and a wonderful
Thanksgiving.
(Greg Patchini):
Thank you, Susie. Same to you and yours.
Operator:
This does conclude today's conference call, you may now disconnect.
END