This webinar discusses key elements of how to stay connected, experiencing positive emotions and close relationships after a cancer diagnosis including side effects from treatment resulting in erectile dysfunction, reviewing evidence from neuroscience on data related to meditation and intimacy, and learning practical ways to live an authentic life connected with those you love.

1. Staying Mindfully Connected and
Experiencing Intimacy after a
Cancer Diagnosis.
DR. GABRIELA ILIE
PSYCHOLOGY PROFESSOR
DALHOUSIE UNIVERSITY, FACULTY OF MEDICINE
HALIFAX , NOVA SCOTIA

2. Outline
• Domains of intervention
• The body-mind connection
• Close relationships and sexual connection after a cancer diagnosis.
• On the importance of physical touch
• Practical solutions for erectile dysfunction
• Cognitive reframing – is there another way to look at this?
• 7 Mindful Attitudes for great sexual intimacy and connection for Men and
Women in Ideal and less than ideal bodily circumstances
• Towards a healthier, more positive relationship to sex
• Developing kindness and love towards ourselves: seeing with mindfulness
and authenticity
• Intimacy
• Examples
• Summing up
• Questions and Answers

3. DOMAINS OF INTERVENTION
• We can intervene in three domains:
• World (including relationships)
• Body
• Mind
• All three are important. And they work together.
• We have limited influence over world and body.
• In the mind:
• Much more influence
• Changes stay with us wherever we go

4. THE MIND/BRAIN SYSTEM
BRAIN MIND
Ways in which the brain can change mind:
For better:
A little caffeine: more alertness
Thicker insula: more self-awareness, empathy
More left prefrontal activation: more happiness
For worse:
Intoxication: slower reaction time
Concussion: can alter your personality, affects your mood and thinking
Cortisol /stress-based shrinkage of hippocampus: less capacity for contextual
memory

5. THE MIND/BRAIN SYSTEM
MIND BRAIN
Ways in which the mind can change the brain:
Scan illustrates activity in the primary
somatosensory cortex. This area is
highly active during pain and rest. But
activity is far less during meditation
and pain.
The Journal of Neuroscience, 2011

6. THE MIND/BRAIN SYSTEM
MIND BRAIN
Ways in which the mind can change the brain:
Study revealed that meditation
literally rebuilds the brain’s gray
matter in 8 weeks.
Harvard University, Lazar and
colleagues (2005)

7. THE MIND/BRAIN SYSTEM
• What flows through the mind sculpts your brain. Immaterial
experience leaves material traces behind.
• Meditation -> Increased blood/nutrient flow to active regions
• Altered epigenetics (gene expression altered through thoughts
and behaviours that promote self-healing and transformation)

8. Sexual intimacy after a cancer
diagnosis
• Masturbation
• Improve your orgasm after surgery by doing Kegel/
• Pelvic floor exercises
• Involve your partner – use physical and emotional intimacy to build up
penetration or use sexual toys.
• Oral medication for ED – even for a short time to give you the
confidence and sexual potency you need
• Have sex – with or without sexual penetration, use touching, intimacy
• Cuddle and explore each other’s body even in the absence of sex.
• Slow down, slow way, way down.

9. ON THE IMPORTANCE OF
PHYSICAL TOUCH
• Literature review: positive gentle touch has a powerful healing effect
(reduces stress, inflammation).
• Hand on heart – breaks the survival response. Can pre-empt stress response
altogether.
• Oxytocin – direct and immediate antidote to stress hormone cortisol
– Hormone of safety and trust, bonding and belonging, calm and connect
– Brain’s direct and immediate antidote to stress hormone cortisol
• ”A single exposure to oxytocin can create a lifelong change in the brain.“ (Dr.
Sue Carter,)

10. A THOUSAND KISSES DEEP
LEONARD COHEN
You came to me this morning
And you handled me like meat
You'd have to be a man to know
How good that feels, how sweet
My mirror twin, my next of kin
I'd know you in my sleep
And who but you would take me in
A thousand kisses deep
I loved you when you opened
Like a lily to the heat
You see I'm just another snowman
Standing in the rain and sleet
Who loved you with his frozen love
His secondhand physique
With all he is and all he was
A thousand kisses deep
I know you had to lie to me
I know you had to cheat
To pose all hot and high
Behind the veils of sheer deceit
Our perfect porn aristocrat
So elegant and cheap
I'm old but I'm still into that
A thousand kisses deep
But I'm still working with the wine
Still dancing cheek to cheek
The band is playing Auld Lang Syne
But the heart will not retreat
I ran with Diz, I sang with Ray
I never had their sweet
But once or twice they let me play
A thousand kisses deep
I loved you when you opened
Like a lily to the heat
You see I'm just another snowman
Standing in the rain and sleet
Who loved you with his frozen love
His second-hand physique
With all he is and all he was
A thousand kisses deep
But you don't need to hear me now
And every word I speak
It counts against me anyhow
A thousand kisses deep

11. PRACTICAL SOLUTIONS FOR ERECTILE
DYSFUNCTION
“Neurons that fire together wire together.”
Cant do the same thing over and over again and expect different results!
Go from Mindlessness to Mindfullness. Start a Meditation practice.
Practice Mindfulness – paying attention, being in the present moment
Slow way, way down.
Remember that where your attention goes, your energy goes. Give yourself permission to relax and let
go.
Notice - be aware
Stop Stress with Belly Breathing.
Reassure yourself – she/he is having a good time=I am having a good time
Mirror neurons! That is why the porn business is a trillion dollars industry.
People watch others have a good time because it helps them have a good time.

12. Bringing attention back to HERE & NOW
Your partner is in front of you right now
Letting go of the tendency to escape from being in the present moment
Direct experience beyond concepts
Enjoying your senses – stay curious in a child like mind state
Schedule a play day; schedule a silly date
Experience without editing or exaggerating
Awake from social conditioning and engage in new activities that awake your senses: take dance lessons,
PRACTICAL SOLUTIONS FOR ERECTILE
DYSFUNCTION

13. COGNITIVE Reframing
is there another way to look at this
• Cancer diagnosis - just another part of my evolving sexual life
• The reality is that sex changes for every man and every woman as they go through
each decade of their life.
• I could choose to see my cancer as part of this progression.

14. 7 MINDFUL ATTITUDES FOR GREAT SEXUAL
INTIMACY AND CONNECTION FOR MEN AND
WOMEN IN LESS THAN IDEAL CIRCUMSTANCES
Non-Judging
Patience
Beginners Mind
Trust
Non-striving
Acceptance
Letting go

15. 7 MINDFUL ATTITUDES 7 MINDFUL ATTITUDES FOR
GREAT SEXUAL INTIMACY AND CONNECTION
FOR MEN AND WOMEN IN IDEAL CIRCUMSTANCES
Non-Judging
Patience
Beginners Mind
Trust
Non-striving
Acceptance
Letting go

16. WE NEED TO HAVE A HEALTHIER MORE
POSITIVE RELATIONSHIP TO SEX
• Orgasm – negative connotations, yet a normal part of life
• Orgasm is a process controlled by the autonomic nervous system. This is a
part of the nervous system that deals with the things we don’t consciously
control. Like digestion, heart rate and sexual arousal
• - examples in the scientific literature: in vitro
• You don’t need genitals to have an orgasm – paraplegics; eyebrows stroke;
brushing teeth.
• Could stimulate an orgasm reflex on a dead person’s body

17. • When we are mindfully looking we are really looking inwards and we begin to truly see.
• What do you truly see with no “guards” or “shields” – when you just look within?
• How many of us, after a cancer diagnosis, are just “waiting to be inspired”?
• What ever the answer – if it comes from an authentic place – is the perfect place to start.
• Authenticity – remarkable attributes of cancer survivors (Rob Rutledge and Tim Walker, The
Healing Circle; Kelly Turner, Radical Remission: The Nine Key Factors That Can Make a Real
Difference; Bernie Siegel, Love, Medicine and Miracles; Antony de Mello, Awareness)
– Don’t deny your true feelings. This is not about “putting up a happy face”. Allow what
you're actually feeling, rather than fighting against it. And then permit the thoughts and
feelings to simply pass on through, with acceptance and without judgment.
Key elements leading to true connection
We need to develop a healthier more positive relationship to our sense of self
Seeing with mindfulness
and authenticity

18. “I am not this hair, I am not this skin, I
am the spirit that lives within” Rumi
Key elements leading to true connection

19. Do you want a place to start?
• Take a mental “picture” of yourself and stay with it. See what you see.
Because seeing is always about what you see within.
• Looking “hearing or seeing” is photographing with your heart.
• Take a mental “picture” of someone you love and stay with it. See what
you see. Remembering that seeing is always about what you see within.
• Can you step away from what is within you and “truly” see this other
being? What do you see then?
• Don’t be afraid to look. And look fully, with your inner eyes fully opened.
Be present, be mindful, be aware. And let go of wanting to see it your way.
Key elements leading to true connection

20. Bring your whole being in the present
moment and
present yourSelf

21. Mindful presence meditation
• Find a meditation routine that helps you get in touch with your
authentic self. A routine that speaks to you in ways you can accept
and understand.
– Deidentification: I have many emotions, thoughts, memories,
accomplishments, ways of being – and I am not my emotions, thoughts,
memories, accomplishments, ways of being. I am a center of pure
awareness, consciousness and choice.
• The raisin meditation. Just as there is so much flavor in one
raisin… there is so much beingness and fulness in You.
– Find ways to express kindness towards self
» Ho’oponopono, the Hawaiian practice of full responsibility, reconciliation,
healing and forgiveness

22. Mindful presence meditation
• Self-affirmations:
– May I be kind to myself in this moment
– May I accept this moment exactly as it is
– May I accept myself in this moment exactly as I am
– May I give myself all the compassion I need to respond to this moment
wisely

23. Practice mindfulness
• If and when you notice negative thoughts and
emotions, don't struggle to suppress or change
them, and don't act them out either; instead,
simply experience them and let them be.
• Allow what you're actually feeling, rather than
fighting against it. And then permit the thoughts
and feelings to simply pass on through, with
acceptance and without judgment.

24. Close relationships after a
cancer diagnosis
- Intimacy -
• Yes, they are possible.
• Key elements to experiencing connectedness
remain the same no matter the outer form:
presence, authenticity, self-seduction,
• Understanding Intimacy and various types of
intimacy that exist
– Emotional, spiritual, intellectual, financial, sleep,
unconditional, aesthetic, play,/recreational,
work/task driven, sexual

25. Some examples of
Connection exercises

26. Soul gazing
• This is an intense exercise that will help you and your partner
connect on a deeper level. It can have a huge impact on your sense
of connectedness, but it’s not for the faint of heart!
• To try this exercise, face your partner in a seated position. Move so
close to one another that your knees are nearly touching, and look
into each other’s eyes.
• Hold eye contact for three to five minutes. Yes, you can blink. No,
you can’t talk.
• If the silence is uncomfortable, choose a song that is pleasant to
both of you or meaningful in terms of your relationship and hold
eye contact until the song ends (Gray, 2014).
• Practice this exercise a few times a week to deepen your
connection with your partner.

27. Unstructured activities
• Is there something you can do together,
• Is there something you can do regularly,
• Is enjoyable (or at least not unpleasant) for
both people, and
• Is there something that allows you to
communicate in a healthy and productive way.

28. Communicate through Music
• Share music that resonates deeply with your
personal life story, reflects your thinking/your
current state of mind, articulate some of your
most deeply held beliefs. Express who you are
thought music and let the other see you and
experience yourself thought this auditory
means of communication.

29. Communicate through movies
• Share a movie that resonates deeply with your
personal life story, reflects your thinking/your
current state of mind, or where you are coming from,
or that articulate some of your most deeply held
beliefs. Express who you are thought a movie or a
video and let the other see you and experience
yourself thought this visual and auditory symbol of
communication.

30. Communicate through books
• Share a book that had a deep impact on your
life and your thinking or that resonates deeply
with your personal life story, reflects your
thinking/your current state of mind, or where
you are coming from, or that articulate some
of your most deeply held beliefs. Express who
you are thought a book and let the other see
you and experience yourself thought this
visual symbol of communication.

31. Uninterrupted listening
• Another simple but powerful exercise is called Uninterrupted Listening, and it’s
exactly what it sounds like (Gray, 2014). We all need to feel heard, understood, and
cared for, and this exercise can help both you and your partner feel this way.
• Set a timer for this exercise (three to five minutes will usually do the trick) and let
your partner talk. They can talk about whatever is on their mind – work, school,
you, the kids, friends or family, stress – it’s all fair game.
• While they are speaking, your job is to do one thing and one thing only: to listen.
Do not speak at all until the timer goes off. Simply listen to your partner and soak
it all in. However, while you may not speak during this time, you are free to give
your partner non-verbal encouragement or empathy through body language, facial
expressions, or meaningful looks.
• When the timer goes off, switch roles and try the exercise again. You may find that
one partner is much chattier than the other, but don’t worry – this is totally
normal.

32. The Weekly CEO meeting
• This exercise provides you and your partner with an opportunity to interact as
adults (no kids allowed) and without distractions (no phones, tablets, or
laptops allowed).
• Schedule a non-negotiable chunk of time (30 minutes is a good default) once
a week for you and your partner to talk about how you both are doing, your
relationship as a couple, any unfinished arguments or grievances, or any
needs that are not being met.
• You can start the exercise with questions like:
– How do you feel about us today?
– Is there anything you feel incomplete about from this past week that you would
like to talk about?
– How can I make you feel more loved in the coming days?
• The answers to these questions should lead you and your partner in a healthy
and productive discussion about your selves and your relationship. Make sure
to do this regularly to keep on top of any issues and ensure that things don’t
get swept under the rug or put on the back burner for too long (Gray, 2014).

33. What are you grateful for?
• Another quick and easy exercise, this exercise can be engaged in anywhere
the two of you are together. You only need your words and your imagination!
• List five things you are grateful for that involves your partner and/or your
relationship
• You could have one partner go first and list all five things, or you and your
partner could alternate saying one of your five things at a time. However you
decide to do it, be creative and don’t afraid to get silly with your partner!
• As an example, you could ask your partner, “What are five things that you love
that I have done for you lately?”
• Their answers might be something like, “Taking out the trash, cuddling with
me, buying me green apples because you know they are my favourite, and
watching my favorite movie with me.”

34. Shared Qualities
• List at least three answers for each:
– Movies, books, or music we like…
– We have fun when we…
– As a couple, we’re good at…
– As a couple, our weaknesses are…
– Unique things we have in common…
– Qualities we value in a person…
– Three goals for our future…

35. Make a list of connection questions that are meaningful to you
For example:
1. Is there anything I can do for you in this moment to help you feel more comfortable or loved?
2. How can I better support you in your life?
3. Is there anything I have done in the past week that may have unknowingly hurt you?
4. When you come home from work, what can I do or say that will make you feel the most loved?
5. Is there any kind of physical touch that I can engage in more that helps you to feel loved?
6. Do you think you will need more closeness or more alone time over the next couple of days?
7. Is there any argument that we had this past week that you feel incomplete about?
8. How do you feel about our sex life lately?
9. What are the main stressors currently in your life, and is there any way I can alleviate that stress
for you, if only a small amount?
10. When do you find speaking difficult and how can I best support you through those moments?
Declutter your relationship

36. Break convention – stepping outside
of your comfort zone
• Tell me something weird about yourself.
• Tell me your favorite ice cream flavor.
• Tell me a wonderfully random childhood
anecdote.

37. Pregnancy planned or unplanned –
issues to consider
• Medical decisions become even more complex after cancer
diagnosis.
• If having children is important to you, one of the most critical things
you can do as you're planning your treatment is talk to your doctor
about your fertility options.
• While the medical concerns have been addressed and you
understand how your diagnosis and treatment will impact your
parenthood then you also need to consider how you feel about
becoming a parent.
• Just as you may need to adapt your ways of intimately relating with
another person you may need to adapt your definition of
parenthood and ways in which you will relate with your children
and help them raise. This discussion is beyond the scope of this
presentation but I am happy to take questions.

38. Summing up
• Mind, body, behavior connection leading to
intimacy and connection
• Importance of presence and mindfulness,
kindness and compassion towards one self
and reframing
• Practical solutions to ED
• Exercises and activities
• Issues to consider moving forward

39. Questions and Answers
THANK YOU!!

40. Canadian Cancer Survivor Network
Contact Info
1750 Courtwood Crescent, Suite 210
Ottawa, ON K2C 2B5
Telephone / Téléphone : 613-898-1871
E-mail: jmanthorne@survivornet.ca or info@survivornet.ca
Website: www.survivornet.ca
Twitter: @survivornetca
Facebook: www.facebook.com/CanadianSurvivorNet
Instagram: @survivornet_ca
Pinterest: http://pinterest.com/survivornetwork/
Dr. Gabriela Ilie: Gabriela.Ilie@dal.ca
Website: HealingandCancer.org