I am pretty certain that most of you will have at least heard of mindfulness, but it is such an important approach that it is worth reminding you of its value.
Being happy at all times is an unrealistic aspiration – we all experience grief, loss, pain, anger, fear and sadness. And as clinicians, we are immersed in an emotional environment, witness to the struggles, bereavements, and fears of our patients.
Mindfulness offers a powerful way of helping us move towards greater mental wellbeing, by experiencing the full range of thoughts and feelings that life brings, but with an ability to stay grounded. Whilst it cannot make life any simpler, mindfulness can help us approach life more skilfully.
What is mindfulness?
Mindfulness is often defined as ‘paying attention on purpose moment by moment without judging’.1 It helps us become more aware of our thoughts and feelings so that, instead of being overwhelmed by them, we’re better able to manage them. Learning to do this in a way that suspends judgement and self-criticism can have surprising results.
It is one of many practices of mental training arising from eastern contemplative traditions, specifically Buddhism. The practice has been adapted in the west and secularised, as well as being formalised into Mindfulness Based Stress Reduction (MBSR) and Mindfulness Cognitive Behaviour Therapy (MCBT).
The benefits of mindfulness
These approaches have been used for patients in healthcare systems to address a wide variety of physical and psychological issues. Research shows that MBSR improves quality of life, decreases anxiety and depression, as well as showing significant positive effects for patients with chronic pain, fibromyalgia, multiple sclerosis, generalised anxiety disorder and panic, psoriasis, cancer and health care provider self care.
MCBT has been effective in preventing relapse in patients suffering from recurrent depression and anxiety. In fact, MCBT is more effective than antidepressants at improving quality of life.
Whilst it has often been used in therapeutic settings, mindfulness is relevant to most people who wish to live more purposefully, with greater clarity and wellbeing. The research shows positive effects on the whole persons’ health, including relationships with others.2
Mindfulness could be thought of as giving oneself quality attuned attention – noticing and accepting thoughts, feelings and sensations as they occur, rather than trying to avoid them.
It is often our deft avoidance behaviours that cause the long-term damage – through alcohol, over-eating, responding aggressively or jumping to problem-solving without reflection. By attending effectively to ourselves we become better able to attune effectively with others, and respond richly to them.
Mindfulness at work
As we develop skills in connecting with the present moment, we generate a better capacity to step back in moments of stress; to pause and evaluate. There is evidence that our limbic system – designed to react quickly when we are threatened, actually becomes less reactive through regular mindfulness practice.
At work this may mean we get less caught up in an endless task list, and better connected to the meaning of our work. It might mean that we are more curious about why we experience a challenging patient in a particular way, and that we are better able to notice and respond to the signals that we need a break.
Mindfulness in the workplace is a relatively new area of mindfulness application and research. Nevertheless, initial studies have documented benefits, such as:
- Decreased perceived stress, improved sleep quality and emotional regulation3
- Improved memory and concentration for tasks.4
How to practise mindfulness
I’ve heard some people really struggle with mindfulness. In the first instance, sitting down to notice our thoughts and feelings can feel as unpleasant as standing in the central reservation of the M25.
The aim, however, is not to stop the flow, but just to notice it. As we learn to just notice the traffic, rather than get caught up in it, we feel less like part of us is heading east at 80mph, whilst the other part heads west. Our attention begins to be centred in the moment.
Mindfulness can be taught in groups or one-to-one, and there are also books and on-line courses. For example, the Mental Health Foundation has a register of teachers, and offers an online course.
My personal favourite is the eight-week course described in a book and audio CD by Professor Mark Williams and Danny Penman 'Mindfulness: A Practical Guide to Finding Peace in a Frantic World'.5 Even reading the introductory chapters immerses one in a sense of wisdom, common-sense and grounding.
What could be a better antidote to the frantic frenzy of contemporary general practice?
- Dr Jennifer Napier is a GP in London an honorary research fellow at Queen Mary, University of London where she has researched wellbeing and workforce issues. She is also the founder of Contextualyse, a consulting company focused on supporting organisations to create healthy workplaces
- Kabat-Zinn, J. Full Catastrophe Living. London, 2004: Piatkus Books.
- Carson, J.W., Carson, K.M., Gil, K.M. & Bausom, D.H. Mindfulness-based relationships enhancement. Behavior Therapy 2004: 35; 471-94.
- Wolever, R. et al.. Effective and viable mind-body stress reduction in the workplace: A randomized controlled trial. Journal of Occupational Health Psychology 2012: 17(2); 246-258.
- Levy, D. M., Wobbrock, J. O., Kaszniak, A. W., & Ostergren, M. (2011). Initial results from a study of the effects of meditation on multitasking performance. Proceedings of the 2011 annual conference extended abstracts on Human factors in computing systems, 2011-2016
- Williams, M. & Penman, D. Mindfulness: Finding Peace in a Frantic World. London, 2011: Piatkus Books.