Mindfulness for the Busy GP
Ever notice when you are distracted, trying to ‘multi-task’ with minimal success, or are on automatic pilot? Though acting automatically can be helpful in many situations, problems can arise when we spend most of our lives in this way. Being distracted and zoning out of experiences can affect our relationships and work performance, as well as lead to missing out on moments that add colour and joy to our lives.
So how can we be less distracted and more focussed?
As humans, we tend to try to avoid pain, including painful emotions or unwanted, difficult thoughts. We are good at developing avoidance techniques, such as distracting ourselves with social media, YouTube or TV, or numbing ourselves with substances, such as alcohol or drugs. Mindfulness practices promote qualities such as patience, acceptance and curiosity, which enables us to deal with stress or life’s challenges with better equanimity, skill and tolerance, rather than avoiding them.
Mindfulness techniques are widely and successfully used by psychologists and many other health professionals to improve people’s wellbeing, and to treat and manage clinical conditions, including anxiety and depression (APS 2022).
What is mindfulness?
Mindfulness is defined as a state of non-reactive, non-judgemental awareness of the here and now, with suspension of self-expectations and beliefs about the past or future (the rigid rules or views we may hold of ourselves and others – the musts, shoulds and have to’s) (McKensie & Hassed, 2012). Mindfulness is deliberately paying attention to things we normally may not notice and becoming aware of our present experience as it arises, non-judgementally, with an attitude of curiosity, kindness and compassion. It’s something we can do naturally, but its benefits can be enhanced when we do it consciously.
Active elements of mindfulness are:
- Focus of attention (on what we want to focus on)
- Acceptance (of what we focus our attention on)
- Directive (of our awareness)
- Being authentic (who we are in that moment)
What mindfulness is good for:
- General life (sub-clinical)
- Improving psychological function and wellbeing
- Reducing stress
- Improving sleep, self-regulation, connectedness and positive emotions
- Improving study performance
- Improving work performance
- Clinical conditions
- Chronic Pain
- Addictions (e.g. smoking, alcohol, drugs)
- Attention Deficit Disorder
- Weight management & eating disorders
There is lots of research showing the benefits of mindfulness practices, such as a stronger immune system, lower blood pressure, and reductions in anxiety and depression (McKensie, Hassed & Gear, 2012; APS, 2022).
What mindfulness isn’t
There are several myths or misunderstandings about mindfulness. It isn’t:
- A belief system – you don’t need to have a particular belief system or religion to be able to ‘do’ mindfulness practices.
- A relaxation technique – though people can find it relaxing and meditative, it’s not the intent of mindfulness. It is about fully experiencing the moment you are in. Therefore, it can be ‘uncomfortable’ and ‘unrelaxing’ depending on what you are feeling at the time and what emotions or thoughts arise.
- A way to escape reality – it’s actually about being fully present in the current moment, with a curious, non-judgmental, self-compassionate and kind perspective. Hence, it’s about fully experiencing your current reality, whatever that is – not escaping it.
- A way to turn inwards. Though mindfulness can help you be more aware of your thoughts and feelings, it asks you to be fully aware of the present moment, which includes the situation you are in at that time (what you are seeing, hearing, doing, tasting, smelling). For example, when we are stressed, we are more likely to be ‘stuck’ in our heads ruminating about our problems and unaware of what is happening around us. Mindfulness asks you to be fully present and experiencing the moment you are in, whether it’s having lunch with friends, playing with your children, or listening to your partner share their day.
- A meditation technique – although they both involve focusing on a particular aspect of your reality or experience, such as your breathing or body, the practices can be very different. Many people struggle with the idea of sitting still for 20 minutes and focusing on a mantra, which occurs in some forms of meditation. Mindfulness can be practiced in many different and active ways, such as when going for a walk or making a cup of tea. It doesn’t need to be done sitting crossed legged on the floor – although you can if you want to!
- Beyond the need for scientific evidence. Much research has been conducted on mindfulness. There is lots of evidence that supports the benefits of mindfulness and doing mindfulness practices. However, due to its popularisation, there are practices that may be called mindfulness that are not ‘true’ mindfulness. So it pays to check.
How can it help you as a GP and medical practitioner?
The effectiveness of our stress reactions (fight or flight response) has ensured our survival, and consequently our default setting is one of hypervigilance. Our brains are constantly processing information received through our senses, and stress hormones like adrenaline activate our body’s emergency systems leading to increased stress. Chronic stress reactions can lead to our body systems being vulnerable to disease, with increased risk of high blood pressure, heart disease and diabetes to name a few, as well as an overactive amygdala, leading to low mood, fear and negativity. Does this sound like you?
Practising mindfulness desensitises the stress trigger and allows equilibrium, rather than our body maintaining its hypervigilant state. Mindfulness teaches us to be more aware of what we are feeling and thinking and turn towards what’s uncomfortable by ‘being’ with those feelings rather than trying to avoid them. Mindfulness encourages us to be in the present moment, rather than dwell on the past or worry about the future. Mindfulness practices asks us to pay attention to our senses (what we see, hear, feel, smell and taste) as well as our thoughts and emotions with a non-judgemental, open, curious and accepting attitude to the current experience.
Uses for mindfulness as a GP include:
- As a self-care practice to better manage and respond to personal stressors.
- As a focusing technique to increase awareness in the moment, such as when listening to patients (e.g. reduce distractions and multi-tasking).
- As a practice to introduce to patients (for them to better manage and respond to their own stressors).
- As a focusing technique to increase awareness in the present with family and friends, so you don’t miss out of those important valuable moments that can bring joy and wonder.
- As a focusing technique to increase concentration, focus, and memory retention, beneficial when needing to study or perform well.
- To get off autopilot and savour each moment. It can assist you to ‘slow down’. For example, to be more aware of what is happening ‘right now’, instead of rushing through your day and getting to the end of your patient list on autopilot with minimal recall.
- To increase gratitude, by getting you to be present-focussed and more aware of what you have to be thankful for, rather than future-focussed and constantly striving to achieve the next big goal. For example, Sawyer, Thoroughgood, Stillwell et al. (2022) found that mindfulness can prompt greater levels of gratitude, prosocial motivation, and, in turn, helping behaviour at work. Chen, Wu and Chang (2017) also found increased levels of life satisfaction and gratitude when they had higher levels of mindfulness.
Where to do mindfulness
Mindfulness can be done many different ways – there is never only one way to ‘do’ mindfulness. You don’t have to choose a particular place or moment to do mindfulness – it’s not like going to the gym. Though you can choose to enrol in a formal mindfulness class and do it with others in a group, it’s something you can do anywhere as you go about your daily life – even when you’re sitting in the car or standing in a line. You can also choose to do everyday activities mindfully, like making a cup of tea or coffee, eating lunch, or cooking dinner.
- Mindfulness is about deliberately paying attention to your experience as it unfolds without judgement– noticing what is happening physically in your body and where. It involves being aware of what emotions are arising and the tone of your feelings, as well as noticing the stories you tell yourself.
- The emphasis is always on what is happening, not why it is happening.
- We use our senses – sight, sound, taste, touch and smell – to explore our experience.
- The idea is not to seek a particular experience. There is no right or wrong. Whatever the experience is, it is your experience in that moment.
The more you practice mindfulness, the more you will make it your own, using your own words, phrases and rhythms. Here are some questions you can ask yourself to get you started:
- What can I hear – feel – see – taste – touch – smell?
- What am I feeling physically?
- What sensations am I noticing? Where is it located? Does it change?
- What am I feeling emotionally? How do I know I am feeling… [embarrassed – angry – sad – happy – proud – joyful]
- Where am I feeling this emotion? What physical sensations do I notice about this emotion? How would I describe it?
- What thoughts are arising? What stories am I telling myself [about this experience / today]?
- When starting, keep it simple and focus on one practice only.
- If struggling with mindfulness, focus on your breathing.
- Turn off your phone.
- Mindfulness apps can assist with mindfulness practices and audio.
- Some people find it helpful to keep a journal to record their mindful experiences.
- Experiment with mindfulness and how to include it in your everyday routines.
- Make mindfulness your own, so it suits you and your personality. For example, some people practice mindfulness while gardening, cooking, running, swimming, scuba diving or free-falling from a plane. Others sit in a forest alone, lie in their bed, or sit crossed legged in a class with others. It’s up to you.
APS. (2022). Clinical Mindfulness – using real mindfulness techniques to help give people real life solutions (webinar). APS Professional Development.
Black, Anna. (2012) The Little Pocketbook of Mindfulness. Cico Books. London.
Chen, L.H., Wu, CH. & Chang, JH. (2017). Gratitude and Athletes’ Life Satisfaction: The Moderating Role of Mindfulness. J Happiness Stud 18, 1147–1159 https://doi.org/10.1007/s10902-016-9764-7
McKensie & Hassed (2012) Mindfulness for Life. Exisle Publishing, New Zealand.
Niemiec, R.M. (2012). Mindful living: Character strengths interventions as pathways for the five mindfulness trainings. International Journal of Wellbeing, 2(1), 22–33. doi:10.5502/ijw.v2i1.2
Sawyer, Katina B.,Thoroughgood, Christian N.,Stillwell, Elizabeth E.,Duffy, Michelle K.,Scott, Kristin L.,Adair, Elizabeth A. (2022). Being present and thankful: A multi-study investigation of mindfulness, gratitude, and employee helping behavior. Journal of Applied Psychology, Vol 107(2), 240-262