By Hugo Davila Grijalva, MD, FACP
When we look at life through the lens of mindfulness, it inevitably leads us to ask some deep questions. Inquiries such as: What am I doing with my life? What is my purpose in life? What do I mean by happiness? How am I treating myself? How am I treating others? How are we treating this land and the planet? These considerations may feel overwhelming and for this reason, we may push them to the depths of our minds. Yet, life often forces us to reflect in this way at transition points, such as a personal or family illness, a death, a job loss, or a natural or political disaster. However, we don鈥檛 need to wait until any of these happen to find what is important in our lives and live in a way that brings us and those around us happiness, health, and peace. Bringing awareness to our day-to-day lives can help us hold these thoughts as a compass to guide us as we navigate through our lives with more ease.
As medical students, residents, and attendings, our guiding principle is first to do no harm. The same is true in mindfulness practice. However, when speaking in the medical context there is an unspoken understanding that the care of others comes first at the expense of the care for ourselves. In approaching our life and patient care in this way, we can become depleted, have an unfulfilling personal life and practice of medicine, and develop health problems. Practicing mindfulness helps us broaden our understanding of 鈥渇irst do no harm鈥 to include ourselves. It can show us a new way of relating to our life and practice that allows us to thrive, and gives us energy and inspiration to care for our patients and the world. In the end, it helps us lead more sustainable, peaceful, healthy, and happy lives by taking action through better choices based on what is present now.
In recent years, the word 鈥渕indfulness鈥 has been significantly diluted. At its best it is used to point towards personal resiliency strategies to improve well-being; at its worst, it equates to corporate wellness programs meant to keep us conforming to the way things are while not changing anything at institutional levels. However, mindfulness is deeply embedded in most spiritual traditions and is profoundly personal. It is meant to wake us up towards how we are living our lives and what we consider important. It may highlight what is good and beautiful, but it may also show us painful truths.
Leading mindless lives is a dangerous deed. On one hand, life goes by without us being present, and we are at risk of missing it. On the other hand, when we go through our lives unconsciously carried away by what we find pleasant and running away from what we find unpleasant, we are not necessarily aware of the harm we do to ourselves, to others and to the planet in the process. This harm often comes in the form of chronic stress, poor nutrition and hydration, lack of exercise and sleep, over-working, over-medicating, substance use and abuse, harsh speech to family, friends, co-workers, students, nurses, nurse assistants, patients, destruction of natural environments, pollution, etc. It may manifest as headaches, heartburn, elevated blood pressure, obesity, dyslipidemia, anxiety, and depression, among many others.
Training in mindfulness teaches us how to care for ourselves first and, as a consequence, to show up more fully, kindly, and longingly to our families and friends. Also to relate more kindly to our patients, co-workers and other members of the health care team. From a place of mindfulness, we may be able to more skillfully communicate with those in positions of power in order to promote changes at a system level for the benefit of all.
Training in mindfulness refers to training our minds to focus on the present moment, with an attitude of friendliness, kindness, and curiosity. Research using formal training in mindfulness has shown benefits including reduced stress, improved emotional regulation, improved quality of life, lower blood pressure, better sleep, reduced anxiety and depression, enhanced focus and concentration, among others. Studies in health care professionals have shown similar results. Most studies have been done using the secular mindfulness training protocols of Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) which are now widely available to the public. MBCT is designed for treatment of depression, while MBSR is designed to address general stress and chronic illness.
While there are many theories and studies showing the mechanisms of these benefits, it all comes down to how we show up in our lives. By paying closer attention to our lives in the present moment with an attitude of kindness and curiosity, we open to what is here now, savoring what brings us pleasure with the freedom to not depend on it for our happiness, and open to the moments that bring us pain without desperately running away. We still 鈥渧isit鈥 the past and future to learn and plan, but we train ourselves to 鈥渞eside鈥 in the present, welcoming what is here now. I would highly encourage all of us to pursue formal training in mindfulness and to continue to practice, as this can have beneficial effects in our lives, and the benefits will ripple out from our ourselves to our families, patients, health-care team, and out to our communities and the world.
Resources on Mindfulness:
- by Jon Kabat-Zinn
- by Bob Stahl
- by Thich Nhat Hanh
References:
- de Vibe M, Bj酶rndal A, Fattah S, Dyrdal GM, Halland E, Tanner-Smith EE. Mindfulness-based stress reduction (MBSR) for improving health, quality of life and social functioning in adults: a systematic review and meta-analysis. Campbell Systematic Reviews 2017:11 doi:
- Goldberg SB, Riordan KM, Sun S, Davidson RJ. The Empirical Status of Mindfulness-Based Interventions: A Systematic Review of 44 Meta-Analyses of Randomized Controlled Trials. Perspect Psychol Sci. 2022 Jan;17(1):108-130. doi: . Epub 2021 Feb 16. PMID: 33593124; PMCID: PMC8364929.
- Sun S, Goldberg SB, Loucks EB, Brewer JA. Mindfulness-based interventions among people of color: A systematic review and meta-analysis. Psychother Res. 2022 Mar;32(3):277-290. doi: . Epub 2021 Jun 7. PMID: 34098859; PMCID: PMC8648858.
About the author: Dr. Hugo Davila is an Internal Medicine Hospitalist, ACP Well-being Champion, and Mindfulness-Based Stress Reduction teacher. He is passionate about the well-being of patients, students, residents and attending physicians, as well as professional fulfillment, social and environmental justice.
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