Managing the Expectations of Others as the title of the blog.

By Healing and Cancer Foundation April 15, 2015

Chapter Blog Chapter 9 – Karen – Accepting and Aspiring

Read Chapter Nine:  Karen – Accepting and Aspiring

Watch the Video:  Qi Gong (like Tai Chi) – This standing energy exercise refreshes the vital energy of the body, mind and spirit.


Dr. Rob RutledgeBlog by Dr. Rob Rutledge
Managing the Expectations of Others

“Karen – Accepting and Aspiring” was the very first chapter I wrote for The Healing Circle. I knew it would be easy because I could cut and paste large sections of an email Karen had sent to her friends explaining her approach to her recent breast cancer diagnosis at age 40.

More than 9 years later, I am still impressed with the depth and breadth of the lived wisdom contained in this chapter.  First, Karen sends out a group email updating her friends and family.  Instead of spending valuable energy explaining what’s happening to each and every person as they email, call or drop by, she does it efficiently and quickly.  Being open and authentic with everyone bypasses the issue of trying to hide her emotions from friends and colleagues.  Karen has more energy for healing when she allows herself to feel exactly what she is feeling in every given moment – at home, at work, and with friends.

Managing expectations of others is something we can do proactively.  One of my patients, a physiotherapist, didn’t want to be pitied by others (especially her colleagues and clients) after being diagnosed with breast cancer and having to undergo chemotherapy.  As she was going to cancel her appointments for more than six months, I encouraged her to write a letter which her clinic staff would hand out to every client. It saves the guessing and having people think of the worst-case scenarios.  I also encouraged her to be explicit about how people should treat her.  Specifically she wanted everyone to act “business as usual” and for her clients to tease her as they had in the past.  I imagine if I got that letter, it would make it easier for me to come into an appointment knowing I didn’t need to say I’m sorry and that I could just be myself.  This physiotherapist also arranged for one person to coordinate the food donations, and another to be the gate-keeper for visits.  She felt much better after sending out a group email to everyone as Karen had done.

 The second reflection arises from the first paragraph of Karen’s group email in which she warns the readers that the content may be “a little bit raw and a lot personal” and that people can opt out from reading more.  The teaching here is that not everyone has the ability to hold the tension of seeing a loved one suffer.  The degree to which we can stay with our own difficult feelings (fear, sadness, frustration), accept the uncertainty of the future, and own the truth of our own mortality, is the degree to which we can simply be present when a friend or a family member is really hurting.  Often, we don’t need to do anything. We don’t need to say something encouraging just to be positive, though that has its place too.  Karen shows great insight by recognizing that there is a spectrum of personalities in her colleagues, friends and family, and not all of them can be emotionally supportive to her. Instead of being angry or judgemental about the friends who bail on her, she respects their perspectives and truly cares for each one of them, and finds her support in those who can.

Being proactive in managing the expectations of family members and friends, and forgiving those who don’t have the capacity to be supportive, are ways to preserve our life energy for what’s most important and express our love and wisdom in the world.

 P.S.  I last spoke to Karen a month ago and she is doing great!  Her kids (youngest is now 12) are growing up and flourishing in a multitude of activities. Karen continues to work part-time as an anaesthetist, and is the Program Director for over 100 resident doctors.  Thanks to modern medicine and everything she has done to empower her body, she’s able to share her love and wisdom with her loved ones and so many young physicians.

Dr. Rob Rutledge is a Radiation Oncologist in Halifax, Nova Scotia, specializing in breast, prostate and pediatric cancers. He is also an Associate Professor in the Faculty of Medicine at Dalhousie University.

In 1999, Rob co-created the ‘Skills for Healing’ Cancer Weekend Retreats. These weekend support groups teach a powerful and integrated approach to the cancer diagnosis and ways to heal at levels of body, mind and spirit. To date, more than 1,600 people have attended the retreats in over 20 cities across Canada and abroad.

Rob also leads the Healing and Cancer Foundation, a Registered Charity, that freely offers educational videos, documentaries, and webcasting seminars – and he is co-author of a book called The Healing Circle, which captures the teachings and inspirational stories from the weekend retreats.

In 2010, Rob received Cancer Care Nova Scotia’s Award for Excellence in Patient Care and, in 2006 Doctors Nova Scotia presented him with the Health Promotion Award in recognition of his contribution to physician health and health promotion in cancer patients.

Dr. Timothy WalkerBlog by Dr. Timothy Walker

Karen – Living in the Land of the Unknown

Rob’s friend Karen came to one of our retreats within a year of being diagnosed and at a time when her emails had already become part of our presentations.  It was a delight to meet her and get to know her and I was impressed with her willingness to speak her truth and to expose her vulnerabilities to the rest of the people at the retreat. For us, she is the one who coined the phrase “having cancer is living in the land of the unknown”. This phrase encapsulated her struggle around the uncertainty of how long she might have with her children who at the time were still quite young (3 and 5).  In our small group discussions she explored this terrible fear she had of leaving them at such a tender age. She looked at it from all angles actually imagining how her kids would cope without her and how they would grow up without her loving presence and wise guidance. This was very brave indeed.

Karen’s bravery did not go unrewarded, as she was so willing to jump in with both feet and explore all of her fears one by one she was also able to release a lot of pent up emotions that she had been carrying around since her diagnosis. Through her tears she actually let her heart and her body open to examining that which she was most afraid of, with the support of the small group. If she were to die while her children were still young, she voiced, she would want to leave a legacy for them through writing, recorded stories and videos. She would also want them to always know how much she loved them and that in whatever way she could she would maintain that stream of love pouring into them for their entire lives. Everyone listening was deeply touched.

Then after a period of silence, while she was drying her tears, she spoke again with a sense of deep realization. She said even though it would be hard for her children she had a profound confidence in them and in her husband. They would survive and eventually thrive even without her being there. She realized it was her own sense of projected loss of them that most wounded her heart. This realization actually brought her great solace and peace despite the horror of imagining the worst. A calm came over her as if a great burden had been lifted and not long after, her keen sense of humor and compassion for others was shining again.

When introducing the discussion of our greatest fears, I usually mention my childhood nightmares.  This time I’d recalled my Dad making me look under the bed and in the closet with a flashlight to examine if there were real monsters there. In the closing circle of the retreat Karen said that she was so glad that she looked under the bed and deep into the closet to find that even if there were monsters there, living in the land of the unknown, they weren’t as scary as she had assumed they were and that she was learning they were monsters that she could gradually befriend.


Timothy Walker Ph.D. is a mindfulness teacher and psychotherapist  living in Halifax Nova Scotia with over 30 years experience integrating mindfulness into counselling, education and healthcare. He is co-author of the The Healing Circle: integrating science, wisdom and compassion in reclaiming wholeness on the cancer journey and co-founded with Dr Rob Rutledge the Healing and Cancer Foundation. He designed and has taught with Dr. Rutledge the Skills for Healing Weekend Retreats for people living with cancer and their family members 42 times since 1999 in 20 cities across North America touching the lives of more than 1600 people. He has taught at Dalhousie University, Acadia University, and Mount St. Vincent University as well as hundreds of workshops, seminars and retreats Internationally. In his private practice, The Healing Circle, Timothy sees individuals, couples and families and welcomes distant consultations.

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