Mindfulness for Physicians
Original release: April 2, 2020
Updated: July 22, 2021
Content Attribution
Bulletin development: Marc-Antoine Landry, MD, Edmonton, AB
Dr. Landry teaches mindfulness to medical students at the University of Alberta and is a practicing Neonatologist. For additional mindfulness resources, please visit Dr. Landry’s website.
Why Mindfulness?
Mindfulness is a tool that you carry with you and can be readily available when you need it most. We all experience some degree of distress—we may not experience the same intensity or the same storyline, but we share a similar process. Mindfulness can help you reduce your distress as mindfulness addresses it at the source level – at the basic level of our senses – at the level we experience life.
From the scientific literature, we can find many articles in which mindfulness shows a reduction of stress, anxiety, burnout or depression in physicians or trainees. UK’s General Medical Council recommends the use of mindfulness training to increase well-being and resilience to stress during medical school.
What is Mindfulness?
Mindfulness has been defined in many different ways in the scientific literature. Mindful awareness can be seen as three skills working together. The first skill is the ability to focus on a specific sensory experience. The second skill is the ability to keep track of the sensory events you experience moment by moment. The third skill is the ability to not interfere with the sensory experiences as they come and go in a kind of hands-off relationship to the sensory event. Just as you can go to the gym to train your muscles to get more endurance, strength, and flexibility, you can train your awareness to become more mindful.
How Do You Practice Mindfulness?
There are many ways to practice mindfulness. A great way to start involves these four steps:
1) Notice: acknowledge the sensory experience that draws your attention (you see a door)
2) Label: say a neutral and simple word to yourself to support the act of noticing (label SEE)
3) Soak: for a brief instant — 1 to 5 seconds — you soak your awareness into what you noticed in step one. Be curious and explore the details of the sensory experience for a brief instant
4) Repeat: release and allow your attention to notice a new or the same sensory experience, label it, soak into it and repeat
Choosing a Mindfulness Exercise
When you experience distress, there are three mindful strategies that you can use. You can turn your attention toward the experience, anchor your attention away from it, or alternate between turning toward and anchoring away. Irrespective of which strategy you take and which mindfulness practice you use, you develop your baseline mindful awareness.
Explore what works for you.
Turn Toward
Shinzen Young, a mindfulness expert, uses this formula: Suffering = Discomfort x Resistance
The discomfort is a sensory experience, whether it is physical (pain), mental (confusion), or emotional (unpleasant emotion). At a sensory level, the discomfort does not come with a story. The stories, ideas, thoughts and feelings that come with the discomfort are what the resistance is. Discover how the inner reactivity manifests at the level of your senses — explore your mind and body from a sensorial perspective. Listen to a guided exploration of your mind and emotional body (5 min).
You can now apply mindful awareness to turn toward the experience of suffering and appreciate, untangle and discover the sensory experiences that create resistance. Doing so, you may find that the distress is much less. What used to be overwhelming may become bearable. Listen to the “See, Hear, Feel” instructions (5 min) and guided practice (10 min).
Anchor Away
Alternatively, with mindfulness, you can choose to anchor your attention away from the discomfort. You can select an object of focus (not related to your discomfort) to pay attention to. An object of focus is a specific sensory experience or an aspect of the sensory experience that you want to focus on.
Feel Rest: In this mindfulness practice, the object of focus is relaxation or restful sensations in the body.
Listen to the “Feel Rest” instructions (5 min) and guided practice (11 min).
Feel Good: In this mindfulness practice, the object of focus is positive emotional sensations in the body.
Listen to the “Feel Good” instructions (7 min) and guided practice (12 min).
Where and When to Practice and for How Long
You can practice anywhere at any time of the day such as before and after meeting with a patient, when you are waiting, before going to bed, when you walk from the parking lot, when you listen to a report… You can practice for short bursts of 30 seconds here and there and aim for a total of 10 minutes per day.
You can find all the audio resources mentioned in this Education Bulletin here.