This Sunday, we bring to you an article from our archives. Medical practitioners start experiencing stress right from their graduation days. As if that wasn’t enough, a situation such as the ongoing pandemic brings in (healthcare or frontline) provider burnout and fatigue. Dear doctor, if you would like to overcome stress, please read on to know about some science-backed self-help techniques that we have listed in this write-up.

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Stress has been a common factor behind most health problems in this century. Won’t you agree, doctor? You often advise your patients to try exercising or meditation or therapy because there is no medicine for stress and it is not easy to just get over it. You know it because you experience it first-hand.

A recent review article stated that a doctor’s well-being can be determined by studying his or her physical, psychological and occupational health. [1]. While a combination of these is essential for a fulfilling personal and professional life, an imbalance in any of these can reflect negatively in professionalism and patient care.

Taking into consideration the risks of a high burnout rate faced by doctors, the researchers reviewed and then proposed mindfulness as a means to reduce a negative impact on the wellbeing of doctors.

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What is Mindfulness?

Simply being in the present moment and aware of your mind’s workings in response to the environment can be considered as mindfulness.

The most popular application of ‘Mindfulness’ is Mindfulness Meditation; however, it neither holds any religious or spiritual connotations. There are many techniques other than meditation, which can be clubbed under the term mindfulness. These techniques can be practised by healthy individuals for stress management and are highly recommended for patients of psychiatric disorders.

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How can it help you?

Mindfulness when practised regularly, helps increase your awareness of a stress-triggering environment or situation and other negative experiences such as anxiety, which can deter you from performing your best. It also makes you mindful of your emotions and the response towards people or environments that evoke these emotions.

Using mindfulness as a practice, you can identify the triggers of nervousness or other such negative emotion and gradually minimise the impact of the trigger. Mindfulness can also reduce the chances of errors and enable you to be mentally more present and compassionate towards your patients.

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Self-help mindfulness techniques

We have listed for you some simple self-help mindfulness techniques, which are easy to apply every day and train your mind to evoke a calm response to stress the moment it starts to build up.

1. Finding your ground

Finding your ground requires you to simply let your feet feel the ground beneath. You may be standing in an operation theatre or seated in front of a patient when something may start to make you nervous. What should you do then?

You may continue standing or sitting but ensure your weight is evenly distributed on both the legs. Once you have attained this stance, focus on your feet and feel the floor through your shoes. Become aware of the sensations in your feet and the weight you may feel while reminding yourself how stable the floor feels. The sense of having a stable ground beneath can be very assuring in a moment of anxiety and help reduce any jitters.

2. Focus on the breath

The breath is vital to our existence. This technique only reminds us to continue breathing but with awareness. Imagine an important task at work overwhelming you or being emotionally stressed about not being able to save a life. The weight of such thoughts can disturb your breathing pattern and affect the oxygen intake.

To destress in such situations, simply start taking long, deep breaths while focusing on the inhalation. Alternatively, if you can lie down, take shallow breaths - also known as ‘diaphragmatic breathing’, where you focus on the air circulation from the nose into the abdomen and out from the nose again. Here, the abdomen moves while you inhale and exhale but the chest remains still.

Both these exercises can help you disengage your mind from the negative chatter or anxiety and related sensations. You can perform this exercise at any time of the day and do it just until you start feeling relaxed.

Note: Continuing this exercise for more than a couple minutes may make you feel dizzy, stop the exercise if that happens and go with the shallow breathing technique. Avoid these breathing techniques if you suffer from respiratory problems or any ailment of the heart.

3. Body scan

Stress can often manifest into physical pain or a spasm. Sometimes in the flow of things, if we are not mindful of our worries or anger, we end up with a sprain or a spasm or an unexplainable pain. This normally happens due to the tightening of our muscles around the neck, shoulders and back.

The body scan technique combines focus on breath with progressive muscle relaxation. It is best performed with good back support, so start with lying down on a flat surface, if possible. If not, find yourself a comfortable chair with a proper neck and back support. Once you have relaxed your back and neck, start with taking deep breaths just enough to focus on the inhalation. Gradually, bring your focus on the group of muscles that are tensed or the area where you are experiencing pain. Acknowledge the pain and mentally release the sensation or pain you may feel there. The mind-body connection built through this exercise can help relieve you of the pain sooner than you can imagine.

Note: This exercise may not be suited to those with low self-esteem linked to physical appearance or a part of the body or someone who has recently undergone surgery.

4. Awareness of thoughts

What can you do about worrisome thoughts, unpleasant thoughts, thoughts that make you mellow or angry? This happens to most of us during the day, it’s just that not all of us pause to acknowledge the thoughts. But constantly having such thoughts can become a problem for you and drain your emotional and mental energies.

To stop such a pattern of negative thoughts, one simply has to watch them, watch them as they come and pass. This action can help you slow down, acknowledge them and let them pass without you becoming reactive. You can also label the thoughts as per the emotions they evoke in you, say sadness, anger, happiness and so on. Naming the emotion helps us not get attached to them or get absorbed in them.

5. Mindfulness meditation

We looked at techniques of building awareness while performing different tasks. Mindfulness meditation is a step forward – it requires you to be aware while meditating. Now how can you do that?

Find a place to sit where there is no movement or physical distractions. Sit comfortably with your back straight and eyes shut. Start with focused breathing at a comfortable pace and try to make your thoughts still. The stillness of thoughts brings stillness of mind and this can happen only when you stay in the present moment and do not let thoughts of the past or the future distract you. The present moment in your meditation could be the sound of a bird chirping somewhere or the clock ticking; the challenge is to ensure your concentration does not break and move away from either of these.

Mindfulness meditation is said to help patients of depression and anxiety. Practising it regularly can also help clear your mind and bring calmness to your demeanour – a quality much appreciated in doctors.

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We hope you try out these practices before choosing one that suits you. You can practice one or a combination of a few techniques, which fit into your routine and effectively bring your stress levels down.

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This article was originally published on October 16, 2020.