“Mindfulness” seems to be everywhere in the news today. Books, videos, classes and websites are springing up to help us be more “mindful.” Everyone is talking about it, including your patients. But what is it? And how might it help you in your life and clinical practice?
Most of the research into mindfulness has been a direct consequence of Dr. Jon Kabat-Zinn’s work at the University of Massachusetts, where in 1979 he created the Mindfulness-Based Stress Reduction Clinic to explore the mind-body connection and how it could be used as a vehicle of healing.
He initially recruited participants with significant, chronic diseases, teaching them mindfulness as a tool to alleviate suffering. More than 24,000 participants later, the University of Massachusetts program is still using Mindfulness Based Stress Reduction to alleviate suffering, and interest in mindfulness in the west has increased exponentially. And, though it’s a relatively new concept to most of us, Buddhist practitioners have been using mindfulness for more than 2,000 years.
Mindfulness is defined as a “purposeful attention to the present moment, without judgment. So why would this be useful for relieving suffering? Think about the times when you feel stress. Is the stressor happening in the present moment? Sometimes it is, but more often our stress is related to worries about potential future events or dissatisfaction with things that have already happened that we cannot change.
Next, think about how much time you spend in judgment of yourself and situations. Does beating yourself up about some perceived flaw or mistake make things better? Are you happier? Most of us would say “no.”
Imagine how different your practice would be if you were able to be more present with your patients, to simply concentrate on what is happening in the exam room and not on the myriad of things you have to do – or might not be able to do – if you are behind schedule. How would those appointments change? What would you notice that you might ordinarily miss?
It’s a common misconception that mindfulness practitioners lack emotion or never get upset. Quite the contrary, being mindful means experiencing emotions, both pleasant and unpleasant. However, research shows that mindfulness practitioners are more aware of what their minds are attending to, and as such are less prone to wandering off into protracted ruminations and worries.
Mindfulness practitioners also report richer daily experiences and a greater sense of self awareness and connection to others. These subjective reports correlate with recent functional imaging research, which has shown changes in the brain in as little as eight weeks of regular practice. For example, multiple studies have shown mindfulness practitioners have greater activity in the anterior cingulate gyrus, an area associated with self-regulation.
As the years have gone by, I have increasingly incorporated mindfulness techniques into my work with my patients, but that is not necessary – or even advisable – for most clinicians. Mindfulness is an embodied practice. It’s difficult to advise others if you have not practiced it yourself.
We do know that patients report more positive experiences when they are seen by a provider who practices mindfulness We also have recent research that suggests providers are more resilient and less prone to burnout when they have a regular mindfulness practice. Still, there is still more work to be done to determine the most effective protocols and applications for mindfulness with clinicians and patients.
Looking back, I had no idea what I was signing up for when I began this journey. It has been truly life changing, but my experience has been far different than what I expected.
My own journey began like so many others, as a self-improvement project. I was recently out of training and feeling dissatisfied with some aspects of my life. So, as a person who had previously been able to accomplish things with hard work and dedication, I committed myself to a regular practice with the goals of being more relaxed and, ironically, in control.
Now, I no longer believe that more control is the answer to life’s challenges. At best, control is an illusion. Often, for me, it has been a trap that has led to self-judgment. As I have become more conscious of my desire for control and self-judgment, more and more, I am able to relax, let go, and just be.
For more information about mindfulness in the medical practice, consider reading Dr. Ronald Epstein’s book, Attending: Medicine, Mindfulness, and Humanity. He also offers in-person CME trainings on mindfulness in clinical practice several times a year. Information about Mindfulness classes in Atlanta can be found at atlantamindfulness.com.
Jennifer Whaley, MD
Dr. Whaley practices psychiatry with The Southeast Permanente Medical Group, part of Kaiser Permanente of Georgia. Dr. Whaley received her medical degree from the University of Arkansas and her residency at Emory University. Her clinical practice focuses on children and adolescents, where she seeks to integrate mindfulness and meditation techniques into her practice.