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Defining Mindfulness in Med School

Listen carefully and you may hear the whispers that mindfulness is becoming yet another buzzword in medicine, following in the steps of “cultural competency,” “narrative medicine,” and the like. It is trendy among its niche and it is being compelled into the curriculum of med schools across Canada and the United States in the hopes of creating a generation of physicians who haven’t burnt out by their ten-year reunions.

Yeah, I’ve heard of mindfulness, but what is it, really?

Mindfulness is the nonjudgmental, open-hearted observation of the reality of the present moment. Mindfulness practice gives awareness to all the large and small emotional, psychological, cognitive, behavioral  and physical manifestations of the day’s events. In the absence of mindfulness, the mind leaves the present moment to remunerate on past events, conversations, and decisions, or to plan for future events — having a tough conversation, preparing the perfectly witty presentation, scheduling time for a meeting, planning a workout, and on and on. The practice of mindfulness aims to overcome the mental treadmill and award full attention to the present.

Lofty definitions aside, how do I actually practice mindfulness?

Like an exercise routine, mindfulness practices come in many shapes and forms to suite an individual’s goals and abilities. The grandmaster of modern mindfulness therapy is Dr. Jon Kabat-Zinn, who designed Mindfulness-Based Stress Reduction therapy (MBSR). MBSR is an eight-week program consisting of one two-hour session every week.

For those who can’t squeeze in an eight-week course among the student union meetings and suturing workshops and shadowing, the easiest way to incorporate mindfulness into daily life is to start small. Wolever et al. (2007) describes the Stop-Breath-Feel technique as a simple way to integrate mindfulness into daily decision-making patterns. As the name suggests, it teaches practitioners to stop before physically reacting to an emotion and simply observe what it is and where it comes from.

Other minimal-commitment strategies include Dr. Wolever’s mindful eating, Dr. Segal’s three-minute coping space, timed sitting meditation, and body scans.

Mindfulness meditation, sitting or otherwise, offers a dedicated time to practice mindfulness in less haste and distraction than daily life. While there are a number of specific techniques, they all involve a type of “body scan,” during which the practitioner surveys every part of the body from the top of the head to the tips of the feet. The goal is to observe any sensation — a tickle, an itch, an aching joint, a pounding headache, a fiery esophagus — without judgment, without reaction, without craving for unpleasant sensations to stop or pleasant sensations to remain.

In addition to these modest suggestions, there are plenty more techniques out there, as revealed by a perfunctory Google search.

How will I actually benefit from mindfulness?

We are all familiar with the looming grey storm cloud of burnout, just over the horizon, threatening the strike of lightning at anytime. You do not need to be told again what it is and why physicians, and even med students, have giant bull’s-eyes on their backs.

But what actually leads to burnout? An ominously simmering pot of sleep deprivation, institutional pressure, compassion fatigue, emotional exhaustion, physical exhaustion, a sense of low personal accomplishment, lack of engagement, and poor emotional return-on-investment, among countless other related factors. Under closer inspection, the bitter theme to this recipe is low self-awareness. In such states, emotional reactions are transferred from a past or future event to the present moment, where they are mixed in with scarcity of time and energy, and thrown on a back-burner, only to angrily and inappropriately boil over, hissing and spitting, at a later date.

To put a band-aid on this problem, physicians are told to put up emotional boundaries. Disregarding the implications on patient care, setting emotional boundaries does not actually deal with the problems that lead to burnout. In fact, this band-aid likely hinders their resolution.

In refreshingly stark contrast, mindfulness aims to resolve the underlying problem, as it exactly promotes the development of self-awareness through nonjudgmental observation. This gives physicians the tools to simultaneously investigate solutions to disease, care for individual patients, and attend to his or her own subjective experiences. This will improve the quality of interactions with colleagues, help maintain relationships with family and friends, and vastly improve quality of life.

But what about my life right now?

As students, we are bombarded with lectures, seminars, workshops, exams, meetings, and functions. We are introduced into a world more chaotic and taxing than any we previously knew. As luck would have it, mindfulness improves concentration, retention, and recall, making all aspects of learning more efficient and successful. Perhaps more importantly, mindfulness provides perspective in the midst of multiplying pressures, stresses, and strains. Those who practice mindfulness do not change their world, but change their perspectives of their world.

Sounds good, right? So, why not start reaping the benefits of mindfulness in your life right now? It only takes three minutes!

Nicole Perkes Nicole Perkes (3 Posts)

Contributing Writer Emeritus

University of British Columbia Faculty of Medicine

Nicole is a Class of 2015 medical student at the University of British Columbia, Canada, who enjoys the unique perspective her bachelor's of tourism management provides her in medicine.