As the medical community has set out to find strategies for prevention and solutions to lower physicians burnout, what has been coined “mindfulness based stress reduction” has gained much attention and awareness. However “mindfulness based stress reduction” or simply “mindfulness” is a principle proven long before medical researchers decided to reduce it to treatment strategy to promote acceptance amongst a community that might otherwise view it as “fluff” or “quackery”.
Mindfulness is, simply put, the state of being aware or conscious of something. As a therapeutic process, mindfulness is a state achieved by focusing ones awareness on the present moment; acknowledging ones feelings, thoughts and bodily sensations with compassion and without judgment.
While both modernized and popularized today in Western culture, mindfulness has it’s origins in Buddhism, and is thought to date back to over 2500 years ago. Additionally, Hindu origins of mindfulness practices in yoga and meditation date back to over 1500 years ago. Since that time, mindfulness has found its way into Christianity, Judaism, and many other religions and disciplines, and it has taken various forms including prayer, meditation, biofeedback, and others. Over the years mindfulness has proven itself beneficial to smoking cessation, sleep disturbance and even test anxiety. It’s linked to positive outcomes for blood pressure, chronic pain, and even cholesterol.
Now researchers have turned their attention on mindfulness benefits on physician stress relief and physician burnout and are finding promising results. But what does mindfulness look like in the everyday life of a physician? I believe the answer lies in the definition: awareness and acceptance. We are taught in our training to “leave our feelings at the door” when we come into work. We are conditioned to shove any trace of emotion deep down and plow through the day like determined robots. However, what you resist persists. Also, if you consider that there are reported 400 doctors that kill themselves each year, buried emotions seems a less than adequate coping mechanism. Therefore, cultivating mindfulness means acknowledging what’s there in a nonjudgmental and healthy way.
In my residency program, my classmates and I had mantra that we often used to console ourselves: “You either laugh or you cry.” Many days we cried; we cried together and most certainly many of us cried alone. The point is that this mantra created space for the all-of-it; Laughter, anger, sadness, fear and pain. While, I came very close to suicide, it was because we shared a silly mantra that I felt safe enough to reach out to people who I knew would not judge or try to fix me in that dangerous moment of despair.
You may be thinking, “Okay that sounds great, in theory, but when you are an hour behind on a Friday afternoon at 4pm with a waiting room full of sick and angry patients, where does mindfulness fit in there? Or when it’s 6 o’clock, and you just want to go home, but you have 30 charts and a full inbox to clean up, how does mindfulness help you in those moments?” Having specific mindfulness tools that can be implemented in an instant is very useful in these “on the edge” moments. The easiest and most accessible tool is the breath. Breathing brings you back to the present moment, centers and focuses the mind, and calms to body so that you can move into the next action with a bit more ease and efficiency. Additionally, quick visualizations while breathing anchor the relaxation state and create a more sustainable “decompress experience.” Here is quick breathing technique that takes no more than 1 minute to do:
Take yourself away to a quiet corner. Close your eyes, and take one deep breath, then a second, on the third inhale imagine the warmth of the sun bathing over you accompanied by a cool breeze; smell the ocean air and flowers in the distance and hear the swoosh of the ocean. If you want to drop deeper you can imagine seagulls in the distance or your favorite music playing in the distance. Exhale out all the tension and feel your muscles relax starting from you head, face, shoulder, arms, hands (or fists as they may be); relax your chest, belly, legs (be careful if you are standing). As the relaxation washes down to your feel the bottoms of your feet grounded as you inhale again feeling the “sand” under your feet strengthen and support you. Imagine that strength moving right back up your body erecting your spine and giving you a shot of new life. Take one last breath and as you let it out, let out an “Ahhhh” and a little smile.
This technique I call the “60 Second Vacation”.
Besides quick tools to be implemented during those intense moments, mindfulness takes the form of structure to create workability in our lives. Tools such as boundaries, clock reminders to stop working, rituals to transition roles at the end of one task (or space) entering another can be very useful in bringing organization to a perceived chaos.
The result of mindfulness practices such as these is not only lowered stress, but also increased freedom and ultimately peace of mind.
I’ll end with this: My mindfulness practice is yoga. I’ve been on the mat for more than 10 years, and now as a solo practicing physician, entrepreneur, and single mother of a 2 year old this practice is more relevant than ever. But, before my origins as a yogi, mindfulness played a very important role for me. Fifteen years ago, on a night that was almost my last in existence a moment of mindfulness saved my life. I was post call, and more depressed than ever. I had been spiraling for weeks, but that night I had hit my breaking point. There on the end table was a bottle of oxycodone that I had left over from a surgery. I stared at the bottle ready to take the whole thing, but a moment of mindfulness had me pick up the phone instead. With the phone in one hand and a bottle of Percocet in the other, I dialed my best closet friend at the time, Dee. I got voicemail. Mindfulness gave me the strength to dial again, this time my close friend Vu…another voicemail. For a moment, I thought maybe that was a sign that there was no help for me; but there was a pen and a journal laying nearby and before I knew it, I had traded the bottle of pills for the pen. My feeling poured onto paper through snot and tears for what seemed like an endless amount of time. The next morning I awoke to find myself alive.
Be A Part of the Solution. If you like it, Please Share it. And If you would like to learn more about how we create breakthroughs for physicians, visit www.thestressfreemd.com. Maiysha Clairborne MD is an integrative medicine physician and physician wellness coach, and is the author of The Wellness Blueprint and Eat Your Disease Away.