Being in attendance: Where medicine and meditation merge

Troy Parks
Staff Writer
AMA Wire
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In a hospital setting, physicians are often called “attendings.” One expert in the merging of meditation and medicine recently spoke to physicians about the importance of making that word matter by being in attendance at each moment of the day to heal and maintain your own well-being so that you can be a better healer for your patients.

At the start of a session at the International Conference on Physician Health in Boston, Jon Kabat-Zinn, PhD, professor of medicine emeritus and creator of the Mindfulness-Based Stress Reduction Clinic and the Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical School, led attendees in a mindfulness activity from the first moment to “drop in on your own presence in your mind.”

“Befriend the present moment, by befriending the feeling and the sensations of the breath moving in and out of your body, because it’s always here,” he said. “Without any contrivance, you’re not forcing anything to happen, you’re simply tuning in to what’s already happening.”

“You’re not trying to achieve any special feeling,” he said, “you’re simply attending … the present moment is really the only moment we are ever inhabiting.”

Focusing on joy in practice, the conference brought together the best minds around the globe with attendees and presenters from the United Kingdom, Norway, New Zealand, Canada and the U.S., just to name a few.

“It’s not merely work-life balance, which some people have the idea that there’s some magical work-life balance and if I only get that formula then it will all fall together for me,” Dr. Kabat-Zinn said. “There’s only life. And so if you don’t bring your life to work, there’s no life in work; and when you get home you have no energy for life either so we’re talking about one seamless whole.”

“What is healing? My working definition of healing is coming to terms with things as they are,” he said. “It’s a process. You can, sooner or later, come to terms with the actuality of things … as they are, not as I want them to be, not as if we could magically fix them, but now.”

“And it turns out that when you do this you recruit a seemingly infinite array of interior capacities and capabilities and intelligences that very often we have no idea that our mind thinks.”

The most important muscle to exercise

Everyone needs to exercise and physicians offer that advice to their patients all the time. But the most important muscle to exercise is the muscle of your own presence of mind, Dr. Kabat-Zinn said. “ It’s the muscle of living the life that’s yours to live and living it in a way that’s ethical, that is generous and that is clear.”

Burning yourself out by helping everybody else and ignoring where the source is coming from is not the way to wellness, he said. “Medicine and meditation—if you notice they kind of sound a little alike,” he said. “We now know about the plasticity of not just the brain but of the entire organism … medicine and meditation are linked at the etymological core. Meditation can actually transform your brain.”

Dr. Kabat-Zinn started practicing meditation when he was a student at the Massachusetts Institute of Technology (MIT). “I had to, to survive MIT,” he told the audience. “It wasn’t optional. It was either protect my own mind or it would be consumed by the stuff going on.”

Then he brought out his meditation cushion and sat comfortably on a table top on the stage.

Just remove the arrow

“I want you to know that this is a behavior change,” he said. “You have to be willing to carve out 45 minutes a day, at least, 6 days a week. Who’s got time for that? The important thing is that the quality of our doing and the quality of joy that we can experience isn’t some kind of magical pot of gold at the end of some rainbow. It’s completely integrated into every aspect of life unfolding.”

Thinking too much about where you’re going, where you’ve been, what could happen and what you want to happen can block your ability to be present—to be in attendance, he said. “Most of what we tell ourselves is not true and it seriously compounds the suffering.”

“The Buddha actually recognized that … let’s say you get shot by an arrow,” he said. “Instead of taking out the arrow or addressing the how to do that, you actually want to know who shot it and why, where it came from, what the kind of wood it was, what the kind of feathers are—but wait a minute, now you’re shooting yourself with another arrow.”

“Let’s say there’s an earthquake or a death in the family—that happens,” he said, “it’s part of life. How are we to deal with it? Well, if you shoot yourself with the other arrow of ‘you’re to blame for this yourself, nobody’s any good, I’m not any good’—do you hear that narrative? That’s what’s going on in the mind over time and it’s toxic.”

How to get started

Practicing meditation has nothing to do with your posture, Dr. Kabat-Zinn said. You can do it lying down, sitting, standing, walking, running, chopping vegetables, in a chair, on the floor—as long as you’re being mindful and present in the moment it will be effective. There is no time when you are awake in which it is wrong to be present: to be fully awake.

Often your mind seems to be “not getting with the program” right off the bat, he said. But each thought and emotion that comes is valid and must be recognized and allowed to pass.

How do you overcome the overwhelming amount of thoughts that occupy your mind? “One way is to exercise the muscle, and that means practice,” Dr. Kabat-Zinn said. “You make time. I do it early in the morning before the day starts. You can even do it in bed, there’s no excuse.”

Even if you’re anxious, being aware of your anxiety is in itself being present. Investigate that awareness. Do it for five minutes, ten minutes or an hour.

“Play, not work, but play at the joy of being who you already are,” he said. “From the point of view of joy … it’s here already if we can only get out of our own ways.”

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