These are some of the most trying times many of us have ever confronted. There is so much uncertainty about what is to come, and we have less opportunity for social support than in other crises. Some are already ill, others know someone who is, and many are caring for those who have COVID-19. In these circumstances, it can be easy to feel frightened and overwhelmed. Having a regular mindfulness practice can be helpful. Practicing intentionally bringing your attention to your present moment experience may provide a refuge, a place of calm in the midst of chaos. You can do this using free meditation recordings that can be downloaded from the Mindfulness Center website https://med.virginia.edu/mindfulness-center/continue-your-practice/audio-recordings/ . A number of brief mindfulness practices can also be helpful at times like these.
I found myself chuckling as I read this prologue in my mindfulness exercise last week. I’m a teacher of MBSR, Mindfulness Based Stress Reduction, and I teach awareness. However, my life gets filled up with professional duties and personal responsibilities. During these times, I can find myself reacting more when operating in the fast lane, rather than showing up, pausing, and being present. Days can turn into weeks, weeks into months and before I know it, 6 months to a year have gone by. I wonder, where did the time go? When I think back over these months, I can’t tell you what I did most of that time. I can tell you what I didn’t do. I didn’t write that thank you note. I didn’t make the effort to get together with friends. I didn’t get that garden planted, visit my brother, or plan to go barn dancing or play music. I also know this can be a sign of “burnout”.
Almost all of us have suffered trauma during our lives—that is, a time or times when we were unable to effectively meet a threat, whether physical and/or emotional, and were not supported by others. Sometimes such experiences result in the development of post-traumatic stress disorder (PTSD). Symptoms of PTSD include the fight, flight or freeze responses in which a person reacts to a situation reminiscent of the original traumatic event by leaving, shouting, or going numb. Often, however, trauma results in symptoms that are not as severe, such as an increase in anxiety when one returns to the site of a near-serious accident. The complex relationship between trauma and mindfulness has become better understood over the last several years. Mindfulness can be helpful in dealing with trauma. The practice of mindfulness can increase awareness of the effects of trauma and may lead to the recognition of additional choices in how to respond effectively.
I’ve been talking to medical students this week about empathy and compassion before they begin their clinical rotations. One of the points I’ve made is that humans’ brains are wired so that helping others who are experiencing difficulty activates areas associated with feeling positive emotions. This contributes to why practicing compassion, being aware of another person’s suffering and having the desire to alleviate it, is protective of burnout for those in the helping professions. Another important point is understanding the difference between empathy and empathic awareness. Empathy, feeling what another person is feeling, arises spontaneously as a result of similar areas of the brain being stimulated whether we are experiencing an emotion ourselves or witnessing someone else who is experiencing it. Empathic awareness, being aware of the feelings we are experiencing in the presence of another, is different than empathy.
Thanksgiving will once again be here soon. It is a time that promotes pausing to take stock of those things we appreciate and are grateful for. Like many people, I learned the origin story of the pilgrims’ Thanksgiving in grade school. However, I only recently discovered that Thanksgiving was not established as a national holiday until Abraham Lincoln did so in 1863, in the middle of the Civil War. Even in that time of hardship and sacrifice for many, Lincoln believed there were reasons to give thanks, and he also acknowledged “all those who have become widows, orphans, mourners or sufferers in the lamentable civil strife in which we are unavoidably engaged”
All of us have certain things that tend to trigger strong emotional reactions like anger. When they occur, we often externalize their causes. If feeling a lack of respect from others is a trigger, we can be quick to rationalize our reaction as being justified because other people “should” be respectful. If we just feel that respect for others is a desirable but not necessary quality, we might note its absence, yet might not be triggered by it. Someone else might not be angered by lack of respect, but would be by perceiving someone else as lazy. These strong reactions often feel natural and justified, and we may not question them. They are our reality, like the water in this David Foster Wallace story: “There are these two young fish swimming along and they happen to meet an older fish swimming the other way, who nods at them and says ‘Morning boys. How’s the water?’ And the two young fish swim on for a bit, and then eventually one of them looks over at the other and goes ‘What the hell is water?’...
Two Mindfulness-Based Stress Reduction (MBSR) courses started at UVa this week. In our introduction to the class we are teaching for healthcare providers, Matt Goodman and I briefly reflected on the history of the Mindfulness Center, with which we have been affiliated for 23 and 18 years respectively. This led me to want to expand on this a bit more. MBSR courses remain the core offerings of the Mindfulness Center as they have for the past 24 years, since the Mindfulness Center was established by Maria Tussi Kluge and Allie Rudolph as one of the first such centers in an academic institution in the country. MBSR was developed by Jon Kabat-Zinn and first taught in the University of Massachusetts Stress Management Clinic in 1979. The benefits for patients quickly became apparent, and led to several formal research studies.
By John Schorling Last year, I wrote a Monthly Musing about the UVa men’s basketball team and the disappointment they and many others felt as a result of their loss in the first round of the 2018 NCAA tournament. I did end it by saying that this year “might even end with UVa finally winning a national championship”. Things are very different now as the team has gone from the first number 1 seed to ever lose to a number 16 seed to winning the tournament and yes, becoming national champions. This is considered by many to be one of the most remarkable turn-arounds in sports history. Yet it didn’t just happen. A big part of what made it possible were the choices the coaches and the players made in how they dealt with this historic loss. Their story has become an inspiring lesson in how it is possible to grow through adversity.
This study, which was a collaboration between the UVa Mindfulness Center, the Charlottesville Albemarle Rescue Squad and the UVa Departments of Surgery and Psychiatry, investigated whether a Mindfulness for Healthcare Providers (MHP) course can reduce distress and promote wellbeing among emergency medical services (EMS) providers. The MHP course is a modified version of Mindfulness-Based Stress Reduction taught in eight 2.5 hour weekly sessions with an all day retreat. A total of 15 EMS providers enrolled in the course and 11 completed it. After the course, EMS providers endorsed statistically significant increases in compassion satisfaction, trait mindfulness, and decreases in burnout compared to the beginning of the program.
By Teresa Miller What’s true about the nature of mindfulness? How does it resemble the summer season? Like the fireflies of June whose lights flicker on and off in random, moving patterns, steady unceasing mindfulness is elusive. We may be meditating with attention on the breath, only to realize that suddenly we’re miles away from our bodies, lost in a movie trailer about our life – as it was 15 minutes ago or 15 years ago. Like the fireworks of July whose sounds, colors and shapes entertain and distract us, mindful concentration may be punctuated by sudden strident thoughts or emotions that sidetrack us.