Mindfulness in Medicine

“The awareness that arises

from paying attention

on purpose,

in the present moment,

non-judgmentally.”   Jon Kabat-Zinn

 

Often when I coach my clients, I find myself returning again and again to the topic of mindfulness. It’s as if I can’t escape the power of its ability to quickly refocus a discussion that is beginning to veer off into soul draining rumination about the past or exhausting worry about the future. Returning to the present moment can create a sense of clarity even when a solution appears elusive. It is not as if I purposefully decide that I have to discuss mindfulness with every client, but the ability of even just a few mindful breaths to create the space to reduce stress and shift perspective, makes the introduction of this skill a not infrequent occurrence on my part. 

9 Attitudes to Bring to the Practice of Mindfulness

Jon Kabat-Zinn, who developed the Mindfulness Based Stress Reduction (MBSR) program and founded the Center for Mindfulness at University of Massachusetts Medical Center, proposes  9 attitudes that create a strong foundation for the practice of mindfulness. An interesting way to approach these attitudes is to consider the reflection at the end of each section, which explore how bringing this mindful attitude might make a difference in a medical setting

BEGINNER’S MIND

“In the Beginner’s Mind there are many Possibilities, in the Expert’s Mind there are few.”

                                                                                                             Zen Master Shunryu Suzuki

The quote above encapsulates the wisdom of being able to see each situation with an open mind, that is not clouded by preconceived ideas. Experience and knowledge can still be leveraged, but beginner’s mind allows the mind to be bring an attitude that is fresh and fully attuned to what is actually occurring in the present moment.

Reflection: Consider using beginner’s mind when dealing with a patient that you currently find clinically challenging. Does it help you shift perspective and see new possibilities? 

NON-JUDGING

This tenet of mindfulness, which is articulated in Jon Kabat-Zinn’s definition above, gives us the ability to approach  the present moment without the mindset of criticism, liking and disliking, good and bad that so often overlays how we see our thoughts.By bringing a neutral attention to a situation, we can approach it with focus and balance, without being distracted and drained by emotions  that may cloud our ability to see the situation clearly and act effectively.

Reflection: Consider bringing a non-judging mindset to a difficult conversation with a colleague. Does it help you maintain focus on the topic as opposed to emotion clouding your thoughts?

ACCEPTANCE

Acceptance does not mean giving in to a situation or giving up. Instead, it is about allowing ourselves to see a situation as it really is, rather than being caught in a cycle of hoping and wishing that it was different. Even though at times this may be difficult and unpleasant, accepting reality provides an opportunity to respond appropriately and move forward effectively. 

Reflection: Consider a situation at work that is currently frustrating and draining your energy. What if you accepted the reality of the situation and allowed yourself to brainstorm solutions, as opposed to being stuck wishing things were different?

 

LETTING GO

There is a novel way of catching monkeys in southern India. It involves halving a coconut and cutting a small hole in one side. The coconut is then tied to a tree and a banana put inside. The monkey smells the banana and puts his hand inside and grabs the banana, but is unable to pull it out through the small hole. The monkey will not let go of the banana and so ends up being caught by the farmer.

We all have thoughts and ideas that we hold on to tightly, even when it is apparent that they no longer serve us or may even be doing us harm. There is a feeling that if we just hold on enough something will happen or change. Giving ourselves permission to “just let go” can be an extraordinarily liberating experience, which creates the space in our minds for new opportunities and possibilities to present themselves. 

Reflection: Consider a discussion with a patient that did not go particularly well. You find yourself preoccupied with your conversation with this patient as you move towards your next patient. Practice taking three breaths between each patient. Consciously, practice letting go of any thoughts and emotions from the previous patient as you exhale with each breath. Allow yourself to be fully present for your next patient. 

TRUST

It is impossible to thrive as individuals, if we do not steadily build a wise trust in ourselves. Building this capacity, develops our ability to trust others, which is essential if we are to have healthy, productive relationships.  Building trust is a fine art that requires wisdom, risk and courage, but as columnist and Presbyterian minister  Frank Crane is quoted as saying: “You may be deceived if you trust too much, but you will live in torment unless you trust enough.”

Reflection: Consider a situation where you have dealt with a disrespectful colleague. Try responding to them from a place of trust in yourself, as opposed to a place of anger and fear.

PATIENCE

When we think of the steps that are necessary for a butterfly to emerge, we have an apt metaphor for the virtue of patience. If we tried to force open the chrysalis, in which the caterpillar is transforming into a butterfly, we would kill the  butterfly. Sometimes if we let a moment or a situation evolve in its own time, without trying to rush it forward on some pre-determined schedule, we can allow for unforeseen truths to emerge. In the same way, in stressful moments, by cultivating a mindset of patience we can circumvent anger and frustration, creating the possibility of a calmer, wiser response.

Reflection: Consider a project that you are collaborating on at work. You feel that the other members of the team should be moving faster with their individual contributions. Is an attitude of impatience having a negative impact and undermining the team’s performance? How could a mindset of patience and understanding be used to influence others to work more productively?

NON-STRIVING

Being purpose-driven and  goal-orientated are valuable traits. At times, however, striving can became an intense, perfectionistic straining that may feel unnatural and forced. It may, in fact, be sabotaging our efforts to achieve the best outcome. It may be worthwhile to ease up on the gas and let success unfold from a more mindful, calm place.

Reflection: Consider where perfectionism shows up in your work. How would simply “doing your best” change your sense of wellbeing and performance?

GRATITUDE

Slowing down and cultivating a mind that is open to the frequent small moments in the day that can trigger  gratitude, can create a mental shift from negativity to more positive thinking. By moving from a mindset of tightness and grasping, to one of noticing and appreciating, a sense of freedom from the chains of always needing more can be created. Not only does this allow for greater personal wellbeing, it can create a greater sense of connection and awareness of others and to the good that is around us.

Reflection: Consider the impact that seeing and experiencing moments of joy would have on your mood and mindset. Write down 3 (or more) things that you are grateful for on a daily basis.

GENEROSITY

Open-hearted, non-judgmental  kindness in thought and deed towards oneself and others is at the center of compassion. Compassion is essential for the flourishing of the human spirit. It helps  build and sustain thriving relationships and communities. 

Reflection: Think of a situation where you have been shown generosity and how it made you feel, and what it inspired you to do. How can you bring those feelings to others?

 

Bring your attention for the next 9 days to a different attitude for each day. Keep a journal of the ways in which  practicing each attitude impacts your ability to stay more present and aware during the day. Combine this practice with five minutes sitting meditation practice each morning and evening. Gently sit with your breath; letting your thoughts be as clouds crossing the sky; and returning your focus again and again to your breath.

 

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