Due to my own developing interest in mindfulness in my own practice as an optometrist, and for the wider community of health practitioners, I thought it was worth asking mindfulness teachers and psychologists about how health practitioners can be mindful in their practice and interactions with patients. I was fortunate enough to receive responses from Kathryn Choules, who has trained under Jon Kabat-Zinn and runs mindfulness programs in Western Australia; and clinical psychologist Samantha Clarke, who has a strong foundation in providing mindfulness-based interventions and runs wellness retreats for health professionals. This is what they had to say……. Enjoy!! Amanda – founder MHC.  :-)

Kathryn Choules on Mindfulness for health practitioners

“Mindfulness is now a subject that health professionals must know about. In the last three decades, mindfulness has moved from being an esoteric practice engaged in by contemplatives to being part of mainstream health care (see https://www.mindandmovement.com.au/mindfulness-from-woo-woo-to-mainstream/).

A key factor in this move has been the work of Jon Kabat-Zinn (PhD) and his colleagues at the Center for Mindfulness in Medicine, Healthcare and Society at the Medical School of the University of Massachusetts. Well over 30 years ago he developed the Mindfulness Based Stress Reduction program (MBSR) as a public health measure for patients who had chronic health conditions. Most of these patients had had many years of treatment by the medical system and were still suffering. The research which has accompanied the tens of thousands of people who have gone through the MBSR and similar mindfulness programs has now established that mindfulness brings a variety of physical and mental health benefits. As a result, in the UK, patients who are referred to evidence-based mindfulness programs have the cost of the program covered by the government.

Before exploring some of the benefits shown in the research, let’s look at what mindfulness is. One definition describes mindfulness as:

The awareness that emerges as a by-product of cultivating three related skills: (1) intentionally paying attention to moment-by-moment events as they unfold in the internal and external world; (2) noticing habitual reactions to such events, often characterized by aversion or attachment (commonly resulting in rumination and avoidance); and (3) cultivating the ability to respond to events, and to reactions to them, with an attitude of open curiosity and compassion. (Williams et al 2015)

The capacity to be present, without reactivity, alluded to in this definition is quite different to our usual way of being. Humans have inherited a fight or flight reaction which is great for keeping us alive in dangerous situations. Unfortunately our stress reactivity is often quite unhelpful in dealing with the challenges of modern living. Our very reactivity is the cause of physical and mental health problems. Learning to observe and be with our inner experience (thoughts, emotions, judgements, intentions, moods this) and external experience (relationships, location, noise) without reactivity, turns out to be an incredibly skilful capacity to cultivate. Mindfulness is developed through formal meditation and through informal daily activities to which we bring our complete attention.

Some of the general benefits from developing mindfulness shown from the growing research base include:

• reduced rumination, decreased negative effect, anxiety and depressive symptoms
• increased capacity to manage stress
• boosts to working memory (the memory needed to hold and manipulate information for a complex task)
• increased focus and concentration
• enhanced emotional intelligence
• enhanced relationships

The strength of the evidence base for the MBSR has been recognised by the US Substance Abuse and Mental Health Services Administration and it is included in the National Registry of Evidence-based Programs and Practices – no mean feat.

Research into mindfulness programs for patients with particular illnesses/conditions has shown benefits for patients with chronic pain, psoriasis, breast cancer and more. The increased immune functioning shown to develop through mindfulness is one factor in these health benefits.

It is no accident that health professionals have been among the “early adopters” in this current wave of mindfulness. They can assess the research and see its relevance to their own well-being. Mindfulness is now part of the training for health care professionals at leading universities. I was recently at the University of Notre Dame in Fremantle for the launch of its mindfulness program for medical students. Acknowledging the challenges of working in healthcare, the University has taken a proactive approach and incorporated mindfulness into the curriculum. These future doctors were learning skills to be present and attentive to their patients as well as develop good self-care habits. Enhanced resilience follows. Recognising the complex demands of working in healthcare, university courses are acknowledging the mental and emotional cost this work can have.

Mindfulness supports a healthcare practitioner to be mentally sharp, able to attentively listen, capable of retaining and manipulating information relevant to the case and able to connect with the patient. Present moment awareness furthers good science and compassionate care. Healthcare practitioners who cultivate mindfulness of looking after themselves and their (future) patients.”

Samantha Clarke on Mindfulness for health practitioners

Mindfulness is really a skill that can be developed and the 3 key elements are intention, attention and acceptance. We see that being able to bring an accepting and curious attitude into our interactions with patients can be vital for rapport to be developed which is the foundational ingredient to effective treatment. Further mindfulness skills can help to ensure we respond to our clients rather than reacting and it can provide a breathing space between the client’s behaviour and the therapist to ensure that we are responding in a skilful conscious way.

Mindfulness and brief meditations have also been linked to reducing burn out in these helping professions. Just a few minutes between client interactions can enhance your effectiveness in the session and also ensure you are reducing your own stress response. Being mindful can help us tune in more quickly to feelings of transference and counter transference which are key processes for psychotherapy. Being able to tune into our body awareness can give us feedback of the unsaid things occurring within the session.

Suggested formal and informal mindfulness practices and how these can be integrated into clinical practice:

• Brief 5 minute meditations on breath, body scan and sounds between sessions
• Whilst in session holding 10% of your attention on your own breath and body posture
• 5 mins of mindful stretching between sessions
• Mindful walk after you finish work
• A cut off point on the drive home where after this point you spend the next part of the drive letting go of thoughts about work and clients
• Attending a yoga or qi gong class – some organisations even have yoga and meditation sessions as part of their daily schedule

Kathryn Choules (PhD)

Kathryn Choules (PhD) is a researcher and qualified instructor of Mindfulness Based Stress Reduction from the Medical School of the University of Massachusetts. She has been teaching mindfulness to healthcare professionals since 2014. She is the founder of Mind and Movement offering mindfulness programs in Western Australia: www.mindandmovement.com.au

Samantha Clarke (PhD)

Samantha Clarke is a Clinical Psychologist, Personal Trainer and Director of Sunshine Coast Clinical Psychology in Queensland. Samantha incorporates an holistic approach to healthcare, placing emphasis on helping each individual move towards a more fulfilling and meaningful life.

Samantha’s work has a strong foundation in providing Mindfulness-based interventions and she is particularly interested in assisting people with addressing lifestyle difficulties and overall wellness. Her PhD is focused on connecting individual meaning into health practices to enhance goal achievement and overall wellbeing.

Merging two of her passions – travel and wellness – Samantha founded Mind Body Resilience wellness retreats held in Australia and overseas. These wellness intensives assist health professionals reconnect with their sense of meaning, combat burnout and kick-start their overall health.

Held in stunning natural locales the retreats combine evidence based psychological strategies, along with movement practices and nutritional needs to arm participants with the skills needed to bounce back from stress, pursue goals and address barriers that ultimately arise in life.

The dates for the next Noosa retreat are 17 – 22nd August and 13 – 16th October.

The next retreat for health professionals is in Byron Bay from 28th October to 2nd November.

MBR also create specialised retreat experiences tailored for your friends.

Contact Sam@scclinpsych.com.au for more details

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