Mindfulness has gained a lot of awareness and attention over the last few years as the medical community has set out to find strategies for prevention of physicians burnout. What has been coined “mindfulness-based stress reduction” or “mindfulness” is a principle proven long before medical researchers decided to reduce it to treatment strategy to promote acceptance among the physician community. This very useful tool today is becoming widely used in our community, where it was once viewed as “fluff” or “quackery.” Mindfulness is, simply put, the state of being aware — the state of being conscious of something. As a therapeutic process, mindfulness is a state achieved by focusing one’s awareness on the present moment, acknowledging one’s thoughts, feelings and body sensations with compassion and without judgment. While both modernized and popularized today in Western culture, mindfulness has its 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 in 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 cholesterol. Now researchers have turned their attention on mindfulness benefits on physician burnout and physician stress relief 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 persist. Also, if you consider that there are reportedly 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. You may be thinking, “OK, that sounds great in theory, but when you are an hour behind on a Friday afternoon at 4 p.m. 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 one minute to do: Take yourself 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 two-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 closest friend at the time. I got voicemail. Mindfulness gave me the strength to dial again, another close friend … 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 lying 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. Source
