Mindfulness and Cognitive Behavioural Therapy Improves Sexual Health and Intimacy in Couples After Prostate Cancer

*To access the resource links mentioned in the video, scroll down to “How can you practice Mindfulness and CBT

Psychological and Sexual Health after Prostate Cancer

There are many changes to the body and to one’s sex life after prostate cancer, and it can be difficult to adapt to these changes. Couples can experience feelings of anxiety or stress around intimacy, or frustration that sexual function is not where it once was. Sexual problems can affect both the survivor’s and partner’s self-esteem. These feelings can further impair sexual functioning, taking couples farther away from the satisfying sex lives they want to be having.

In addition to this, the whole cancer journey can be quite stressful, so it is not uncommon for both partners to experience feelings of intense worry, anxiety, depression and fear surrounding the diagnosis and treatment process.

Mindfulness and Cognitive Behavioural therapy are psychological therapies that can help couples develop skills and tools to cope with and adjust to changes in sexual function after cancer. These skills can also help couples manage distressing and negative thoughts and feelings surrounding the prostate cancer journey.

What is Mindfulness?

Mindfulness can be defined as present-moment, non-judgmental awareness. This means intentionally bringing awareness to your thoughts, feelings, and bodily sensations through practices such as meditation, yoga, or even walks. Prostate cancer survivors who practice mindfulness have reduced anxiety and distress related to their diagnosis for improved quality of life.

What is Cognitive Behavioural Therapy (CBT)?

Cognitive Behavioural Therapy (CBT) is a type of psychological treatment that focuses on identifying and challenging negative thoughts and behaviours. Practicing CBT techniques helps survivors cope with symptoms after hormonal treatments and can even help manage fatigue. It can also increase survivors’ self-esteem post-treatment.

Mindfulness and CBT for Sexual Intimacy after Prostate Cancer

UBC’s Sexual Health Lab recently looked at how couples’ sexual intimacy was impacted by 4 weeks of either group CBT or group mindfulness therapy.

We found that for couples who practiced mindfulness, they had significantly lower levels of anxiety and distressing thoughts about their sex lives when they were assessed 6 months after finishing mindfulness therapy. For couples who practiced CBT, survivors had short-term improvements in their sexual satisfaction, and both members of the couple reported better relationship quality.

The biggest take away here is that mindfulness and CBT are effective at improving mental health after cancer, and now we have found that they are also helpful at improving sexual intimacy.

How Can You Practice Mindfulness and CBT?

Here are links to websites with completely free resources for practicing CBT and mindfulness.
You can choose to look at just one therapy or both; both have benefits.
Mindfulness will involve a lot of meditation practice and CBT involves reading and filling out worksheets.

Mindfulness

The goal of practicing mindfulness is to develop attention-training along with non-judgment.

There are two ways to practice mindfulness: one is formally, through audio recorded mindfulness meditation, and the second is informally, which involves being presently aware in the moment while doing a familiar task such as doing the dishes, folding laundry, or going for a walk. Being mindful means paying attention to all of your sensations while doing a task: your physical sensations such as touch, what you smell or hear, or even taste, and your emotional sensations, like your thoughts and feelings.

Mindfulness Goals:

For the best results try to formally meditate once a day and to practice 10 minutes of informal mindfulness a day.

Long term, try to continue with regular formal meditation practice, thinking of mindfulness as a daily task for your mental health, just like brushing your teeth or exercising is for your physical health.

Mindfulness Website Links:

Palouse Mindfulness
https://palousemindfulness.com/
This website consists of many meditations and readings as well as a full formal guide to mindfulness. If you want a very structured approach at meditation, this website is an excellent choice.

UCLA Health
https://www.uclahealth.org/marc/mindful-meditations
This website consists of a small selection of meditations that are also available in several different languages. As well, each meditation has a downloadable transcript available to read.

Free Mindfulness
https://www.freemindfulness.org/download
This website has many different mindfulness meditations to choose from, arranged by type (breathing, guided imagery, body scans, etc.). Note that in each category, meditations are listed from shortest to longest (least to most challenging) so try to start small!

CBT

The goal of CBT is to challenge negative thoughts.

In order to challenge our thoughts, we have to recognize them and identify them in a given situation. We then need to examine these thoughts and notice when they are distorted or “unhealthy”. Sometimes, simply being able to label a thought as a distortion can be enough to reduce the power it has over us. Other times, we need CBT skills to help us challenge those thoughts before they have a negative impact on our behaviour, our mood, or how we feel.

The resources below will teach you how to do this.

CBT Goals:

For the best results try to work on 1 guide or worksheet a week, and revisit it 2 to 3 times in a week. 

Over time, you’ll find that cognitive behavioural therapy will help you manage these distressing thoughts when they actually come up in life. Long term, reach out to these worksheets when you need them: when you feel like you are having reoccurring stressful thoughts or thoughts that you can no longer manage.

CBT Website Links:

Therapist aids
https://www.therapistaid.com/therapy-guides/cbt/adults
This website has several free comprehensive CBT guides, as well as some extra worksheets in the ‘worksheet’ tab at the top. We recommend working on these three guides: ‘Cognitive Restructuring’, ‘CBT Psychoeducation’, and ‘Behavioural Activation’.

Positive Psychology
https://positivepsychology.com/cbt-cognitive-behavioral-therapy-techniques-worksheets/
This is a long blog style post that it explains CBT basics and how to practice it. It also contains multiple different worksheets to do on your own.

Mindfulness and CBT for Sexual Health and Intimacy

You can apply both of these therapeutic skills to your sexual health and intimacy as well. While practicing and learning these therapies, think of ways in which they would be useful in sexual situations where you may have negative or upsetting thoughts.

It is also important to access resources on sexual health and intimacy after cancer. Mindfulness and CBT are great therapies to add into this.

To learn about intimacy and sexual function after prostate cancer, check out Module 2: Sexuality and Prostate Cancer Video Series.

Additional Readings

If you feel like you want to explore these therapies further, here are some books for purchase that expand on these.

Mindfulness

Full Catastrophe Living: Using The Wisdom of Your Body And Mind To Face Stress, Pain, And Illness by Jon Kabat-Zin
Amazon, Chapters

A Mindfulness-Based Stress Reduction Workbook by Bob Stahl and Elisha Goldstein
Amazon, Chapters

10% Happier: How I Tamed the Voice in My Head, Reduced Stress Without Losing My Edge, and Found Self-Help That Actually Works by Dan Harris
Amazon, Chapters

For Women:
Better Sex Through Mindfulness by Lori Brotto
Amazon, Chapters

CBT

Mind Over Mood, Second Edition: Change How You Feel by Changing the Way You Think by Dennis Greenberger and Christine A. Padesky
Amazon, Chapters

The Feeling Good Handbook by David D. Burns
Amazon, Chapters

Behavioural Therapy for Dummies by Rhena Branch and Rob Willson
Amazon, Chapters

Click here to learn more about the UBC sexual health lab https://brottolab.med.ubc.ca/

This project was supported by the Movember foundation and the Vancouver Coastal Health Research Institute.

CONTACT

pcsc@vch.ca   |   604-875-4485  |   844-483-1449 (toll-free)