by Katherine Fortenberry
I give great advice. In fact, you could say I have a PhD in advice giving. People regularly invest time and money in me to seek help for their stresses and problems, and I work very hard to listen carefully and work with them to design the interventions that can have the most benefits. It’s understandably an ongoing source of frustration when a patient returns to clinic two weeks after a session spent designing the perfect intervention, without having even started taking the steps we worked out so carefully. This is disheartening to see because I know that the intervention would help with my patients’ anxiety or depression or stress, if only they would do it.
Pot, meet kettle. I recently took a great (and inexpensive!) four week group course through the University of Utah’s Counseling Center, focusing on teaching mindfulness skills and using mindfulness to facilitate work-life balance. With a busy job and a second child on the way, I figured I needed all the help in improving work-life balance I can get. Plus, I love mindfulness, and I regularly teach mindfulness skills and recommend practicing mindfulness to my patients as well as to residents. Mindfulness is evidence-based treatment for anxiety and depression, has been shown to promote more effective patient care, and improves sleep. What doesn’t it do? Unfortunately, I’ve gotten busy in the last few years and let my daily practice lapse. Actually my weekly practice has lapsed. If I’m honest, it’s more of a monthly thing these days. But that reality doesn’t taper my enthusiasm for practicing mindfulness, or my tendency to constantly recommend it.
The University Counseling Center class started with a basic breathing mindfulness activity. It felt great. My mind actually became quiet for almost five minutes. Why don’t I do that more often? As we set goals at the end of class, I enthusiastically committed to meditating twenty minutes a day until our next class. I left the class full of excitement about starting up my meditation practice again. Then seven days later I returned to the class and reported…..failure. I’d actually tried several times to spend some time mindfully breathing after putting my son to bed, because this was the only time I could find twenty quiet minutes during the day. Unfortunately every time I relaxed my mind, I promptly fell asleep.
At the next class, I lowered my expectations to set more achievable goals, committing to taking five minutes each day at work to center myself through using relaxation skills. I recommend this intervention to patients on a regular basis, so I thought it was time to give it a try myself. I downloaded a few apps on my phone so I could easily access five minute guided meditations when I had small breaks at work. And I did it! Well, once.
I felt so frustrated with myself. I know that mindfulness is important. I know it helps me. I’ve been successful practicing mindfulness in the past. And yet, I couldn’t make it happen. This experience made me turn a critical eye to my frustration with my patients. If, with my level of motivation, I can’t make a simple behavior change, how can I expect my patients to do the much bigger things I often ask of them?
My new goal is to take things easier on my patients, and on myself. If I take five minutes of mindful breathing to clear my mind before I see a patient, fantastic. If I only manage a few deep breaths as I walk down the hall, that’s fantastic too. I’ll get there. I need to have compassion for myself, and accept that it’s OK when I don’t model perfect wellness. And furthermore, I need to show this compassion to my patients. I ask a great deal of them; all of their health care providers do. So I will do my best to let go of my frustration with my patients, even when I find myself encouraging the same behavior over and over. Change is hard. Any movement toward a goal deserves credit.
Don’t get me wrong, I plan to keep giving advice. Hey, you! Yes, you. Introducing mindfulness into your life will help you to feel more present, will help reduce your stress, will help you enjoy small things. Read up on it. Listen to some guided meditations. I’ll even give you some resources! And then when you figure out how to make it work in your busy life, please come help me out.
*The Miracle of Mindfulness – by Thich Nhat Hanh
*My favorite introduction to meditation practice. Readable and practical.
Download their app or try their 10 minutes 10 days meditation challenge (all free but the website will try to sell you stuff)
*http://counselingcenter.utah.edu/services/mindfulness.php
The University of Utah Counseling Center on main campus (a world to which residents never venture) offers a number of low-cost mindfulness groups and classes, as well as a selection of free audio downloads.
*http://www.dartmouth.edu/~healthed/relax/downloads.html
The Dartmouth Health promotion website offers a selection of free guided relaxation, imagery, and mindfulness exercises that can be downloaded to an mp3 or other audio player
Katherine Fortenberry, PhD is a Psychologist at the University of Utah Family Medicine Residency Program
Family Medicine Vital Signs 