“We’re so used to pretending that we’re good at multitasking and we’re not.” - Dr. Pippa Moss
What if I told you a few simple exercises could help you
- cut down on stress,
- focus better,
- improve your sleep and
- make you calmer in the face of uncertainty?
These are just some of the benefits reported by staff of Mental Health and Addictions Services in Amherst, Nova Scotia, after participating in a six-week mindfulness program. So, what’s the secret? Can practising mindfulness really improve your wellbeing? More and more research is pointing that way.
But first, what exactly is mindfulness?
If you ask five people what ‘mindfulness’ is, you’d likely get five different answers; still, some common themes would emerge: the ability to consciously focus on the moment, an awareness of your body and breathing, and the ability to control your emotions.
One believer in the practice is Ashwin Varghese, MBBS, MSc, FRCPC, a psychiatrist and assistant professor in the Department of Psychiatry (Faculty of Medicine) at Dalhousie University. Dr. Varghese has engaged in mindfulness exercises for the past 13 years. His particular interests are in seated meditation and yoga. He credits this discipline with helping him maintain wellness while completing his specialty training and, now, his busy practice.
“I see mindfulness as a technology for understanding ourselves and for understanding the lived human experience. It’s really about giving us tools to better manage and handle life.”
Mindful of the hype (i.e. there is research to back this up)
Mindfulness is not a cure-all, but an increasing number of research studies are supporting the long-held belief that mindfulness practices offer tangible health and relational benefits. This research is leading to more acceptance and integration of these practices in government, education and health care settings, and law enforcement and legal professions.
“In the mental health field, mindfulness-based clinical interventions are now very common,” said Dr. Varghese, outlining variations like mindfulness-based cognitive therapy (MBCT), mindfulness-based stress reduction (MBSR) and Mindful Awareness Practices (MAPS).
Links have been made between mindfulness practices and reduced anxiety scores and depressive symptoms. Some studies have also associated mindfulness with physiological benefits like improved blood pressure, altered immune reactivity, changes in inflammatory gene expression, reduced cirrhosis symptoms, and changes in brain structure and function.
“There’s been an explosion of research. Particularly with the advancement of neuroimaging technology, we’ve been able to get a better understanding of what may be happening at a neuro-physiological level. I think that helps demystify the practice,” said Dr. Varghese.
Introducing mindfulness to mental health workers
Dr. Varghese decided to pilot a six-week mindfulness program to benefit his colleagues at the mental health clinic in Amherst where he works. The timing seemed right.
High burnout remains an ongoing risk among health care workers. Added to that, restructuring of the Nova Scotia Health Authority was causing particular stress and uncertainty. Beth Wallace, Dr. Varghese’s colleague from the Atlantic Contemplative Centre, had also just finished her certificate program in Mindful Facilitation through the Mindful Awareness Research Center at the UCLA Semel Neuroscience Institute — making her the first Canadian accredited to deliver the esteemed center’s six-week MAPS program.
“Enhancing compassion, empathy and resiliency, and reducing burnout. In my opinion, mindfulness programs have the potential to augment the innate humanity of the physician,” said Dr. Varghese.
Did the mindfulness program aid health care workers in Amherst?
The program in Amherst that Ms. Wallace and Dr. Varghese collaborated on consisted of one third instruction, one third workshop exercises and a third practice (e.g. posture, breathing, working with difficult emotions, cultivating positive emotions, and how to integrate meditation into home life, etc.)
“It came at a pretty interesting time,” said John Rossong, manager for Mental Health and Addictions in the county northern zone. “I haven’t historically been high-anxiety, but the last year or two I’ve been anxious at times because of my new role. The mindfulness training really helped me settle, focus and recognize things I have control of, and also to be okay with some uncertainty. To learn to sometimes let it go — that was huge for me.”
Pippa Moss, MBBS, FRCPC, is a child and adolescent psychiatrist who works in five different clinics in Nova Scotia as well as in Toronto. She admits her life can be hectic and she often finds herself trying to multitask.
“What I got out of the program is really learning to be in the moment rather than being distracted by extraneous things. For example, at night now when my mind runs with thoughts such as ‘I’ve got to do this and that the next day’, I can settle it by focusing in on my breathing. I sleep so much better and I think I’m probably more efficient in terms of the day-to-day stuff.”
Participants were given forms to fill out before and after the training. The first was a five-facet questionnaire with a comprehensive mindfulness rating scale. The second was a perceived stress scale (an attempt to quantify stress). After the training was complete, the same tests were administered along with a qualitative feedback form.
“With the quantitative data, we were able to statistically demonstrate significant changes in a well-studied, self-report mindfulness scale when comparing pre- and post-program responses,” said Dr. Varghese. “To me, this suggests that the participants were engaged with mindfulness practice sufficiently to experience some of its well-documented benefits.”
In addition to reduced emotional reactivity and more openness when listening to clients, improved teamwork was also a noted benefit.
“I found it to be a really nice way to destress at work and to share some of the burden we carry as health care workers. It was nice to feel like you’re not alone,” said Ewelina Zaremba, MD, a family doctor at the clinic.
Dr. Varghese plans to do further analysis of data collected at the three and six-month post-program mark. He eventually hopes to do a larger study with a control group and added markers and measures. He and Ms. Wallace are also discussing the possibility of doing a retreat to refresh skills, given the interest expressed by his colleagues to keep this training going.
Quick facts about the program in Amherst
- Clinically-validated and developed at the UCLA Mindful Awareness Research Center
- Lasted 6 weeks (1.5 to 2 hours per week)
- Integrated into the start of the workday (Tuesdays mornings)
- Mix of self-directed and group activities. Some “homework” to practice concepts.
- Delivered onsite in a conference room
- 13 participants (including all psychiatrists at the clinic, one family doctor, some senior clinicians and area-managers)
- Funded and organized through the Department of Psychiatry at Amherst
Will mindfulness transform your life?
“There’s a term that’s used quite often in this work and that’s ‘brain fitness.’ Just like back in the ‘70s we introduced participACTION in Canada to get youth moving more — at the time that was kind of a radical idea. If you weren’t an athlete, why would you be out jogging?” Ms. Wallace said with a laugh.
“We’re realizing now that we can apply the same kind of practice and care to our minds and brains that we do to our bodies. Many people predict that within 10 or 15 years, brain fitness will be just another routine part of the general health we offer ourselves.”
Mr. Rossong, for one, intends to continue the exercises he learned during the program. His biggest take away?
“It’s okay when you feel a strong emotion, like frustration or anger. The question is to not have it overcome your life. What are you going to do with it? How do you look at it? When you ask yourself those questions it creates a bit of pause and that is something that has added to my quality of life,” he said.
Dr. Zaremba is also continuing her efforts.
“Even today, I had quite a stressful morning,” she said. “I’ve been sitting here doing the deep breathing and reminding myself to take five minutes to come back to my breath and be in the moment and not allow my mind to race ahead. If you stop and centre yourself, it just keeps you from spiraling.”
Dr. Moss believes mindfulness is not something new; rather, a skill that we’ve lost.
“My grandmother and my mother had to learn how to cope with quiet. They were not constantly active and having information pass before their eyes. There were times where they were waiting for things, for example on a train or at the doctor’s office or for a meal to cook. Waiting was just something that you needed to learn to do. The difference now is that we’re so busy that we’ve lost the ability to focus and to actually fully experience the moment. Mindfulness takes you back to that.”
Tips for getting started with mindfulness
-By Beth Wallace
It can be a little daunting when you’re first getting started. If you Google “meditation” or “mindfulness” – you can imagine the plethora of things that pop up on your screen. One of the challenges right now is separating the wheat from the chaff.
For personal instruction, it’s important to find somebody who has been practising for a long time, ideally an accredited instructor or someone who is associated with a reputable meditation or research centre.
Some well-respected centres that I’d recommend checking out are the
- UCLA Mindful Awareness Research Center (MARC)
- Center for Mindfulness, University of Massachusetts Medical School
- The Centre for Mindfulness Studies (Toronto)
If you like reading, there are also some real thought leaders in the world of mindfulness. People like Jon Kabat-Zinn — the founder of MBSR and who’s widely respected as being the father of secular mindfulness in the Western world. Also, teachers like Sharon Salzburg and Diana Winston, among many others.
Ultimately, since mindfulness is a felt experience, you really just have to explore resources and find a fit. To give a plug for the magazine I used to work for (because I know that they’re reputable) I’d suggest looking at Mindful magazine and its website www.mindful.org. The website has many wonderful, free resources on it (as does UCLA’s center – link above).
Note: For West Coast Fellows, BCALM (BC Association For Living Mindfully) based in Victoria comes recommended by Dr. Rachel Carson, FRCPC (Nephrology and Internal Medicine, Nanaimo Regional General Hospital). She writes, “The Executive Director, Dr. Mark Sherman (CCFP) runs ‘Mindfulness in Medicine’ and ‘Mindfulness for Physicians’ courses that also live up to the hype.” Check it out at www.bcalm.ca