The National Institutes of Health (NIH) has put itself firmly on record as being deeply concerned about our national epidemic of stress at the individual, organizational and societal levels. NIH’s National Center for Complementary and Integrative Health (NCCIH) broadcast on September 7th its annual Stephen E. Straus Distinguished Lecture in the Science of Complementary Therapies. The lecture was titled A Nation Under Pressure: The Public Health Consequences of Stress in America.
The American Psychological Association (APA) recently documented a worrisome increase in stress in the U.S. population (Stress in America https://www.apa.org/news/press/releases/stress). Uncontrolled stress can cause or worsen anxiety, depression, PTSD and a wide range of clinical conditions affecting every organ system. Medical students, residents and practicing physicians experience higher levels of stress than their age-
Of all the sciences, medicine uniquely combines all domains of the human condition-
Medicine has always attracted the best and the brightest. Most applicants to medical school are also inspired by a desire to be of genuine service and express their deepest human values through their professional lives. This ethic of altruism, compassion, meaning and service distinguishes medical students from most other professional students.
Neena Thomas-
This new patient was a desperate, mid-
Modern life is taking its toll on our nation’s mental and physical health. Physicians and their patients both suffer from stress-
Former Surgeon General Vivek Murthy MD has sounded the alarm regarding our country’s epidemic of stress.(1) He calls for a serious national effort to mitigate the corrosive effect of chronic stress on every organ system. He calls for a nationwide campaign to spread a preventive, behavioral lifestyle prescription of healthy eating, physical activity and genuine social support (other than social media). Based on solid peer-
Behavioral medicine research confirms the value of mind-
Relationships are at the very heart of medicine. I recently saw one of my favorite patients whom I had not seen in 10 years. I have thought of her often since the hospital took over my Estill County practice in Irvine and I moved to Lexington. Wanda always lifted my spirits. She always asked me how I was doing because she cared about me. We joked and laughed while managing her chronic medical conditions. She was good medicine for me.
Defining resilience: The American Psychological Association (APA) describes resilience as “the process of adapting well in the face of adversity, trauma, tragedy, threats or significant sources of stress, such as family and relationship problems, serious health problems or workplace and financial stressors. It means ‘bouncing back’ from difficult experiences.” APA further describes resilience as “ordinary, not extraordinary. People commonly demonstrate resilience.
Wayne Jonas MD is clinical professor of family medicine, Georgetown University, retired Lt. Colonel United States Army Medical Corps and a complementary medicine researcher. He previously served as Director of the Office of Alternative Medicine at NIH, which is now called the National Center for Complementary and Integrative Health. He has recently proposed the HOPE note (Healing Oriented Practices and Environments) as a clinical tool to help physicians….
Anxiety, depression, loneliness and suicide are increasing-
US public health officials are alarmed by a growing mental health epidemic of stress, anxiety, depression, loneliness, substance abuse and suicide. Britain has created a Minister of Loneliness to tackle this ‘sad reality of modern life’ and its $3.5 billion annual drain on UK employers. Vivek Murthy MD is the 21st US Surgeon General. He was also the 19th Surgeon General under president Obama.
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feelings, or sensations you are experiencing. Simply allow your experience, whether you like it or dislike it, remaining open to being present with “what is.” Allowing increases your capacity for “letting things be” and develops the positive personality trait of equanimity.
I: Investigate inner experience with kindness
Investigation means being truly curious, paying close attention and asking yourself, “What is happening inside me?” Experiment and engage in an active inquiry into your experience. Ask yourself questions like: “What most wants attention? How am I experiencing this in my body, my mind, my emotions? What am I believing? What does this feeling want from me?”
Really roll out the welcome mat to all your experience with curiosity, openness and acceptance. Brach reminds us to “Investigate with kindness. Without this heart energy, investigation cannot penetrate; there is not enough safety and openness for real contact.”
N: Natural Awareness (or Non-
The first three steps of RAIN require your active intention on focused attention. In contrast, the N of RAIN expresses the result of these first 3 steps: an experiential, non-
You can use the R.A.I.N. written document(4) and audio recording(5) below as guides for your own practice or as resources for your staff and your patients. Curing our national epidemic of stress can begin with skillfully managing our own.
Resources
- A nation under pressure-
The public health consequences of stress in America September 7, 2017 NIH webinar with Vivek Murthy, MD - Goyal M, Singh S, Sibinga EMS, et al. Meditation Programs for Psychological Stress and Well-
being A Systematic Review and Meta- analysis. JAMA Intern Med. 2014;174(3):357–368. doi:10.1001/jamainternmed.2013.13018 - Tara Brach, PhD, psychologist, founder of Washington Mindfulness Community
- R.A.I.N. handout pdf
- R.A.I.N. practice audio recording (11 minutes)
Former Surgeon General Vivek Murthy MD has sounded the alarm regarding our country’s epidemic of stress.(1) He calls for a serious national effort to mitigate the corrosive effect of chronic stress on every organ system. He calls for a nationwide campaign to spread a preventive, behavioral lifestyle prescription of healthy eating, physical activity and genuine social support (other than social media). Based on solid peer-
Mindfulness is the leading meditation and awareness practice worldwide, with broad applications across the lifespan and across cultures in health, medicine, education, business, law and criminal justice. A 2014 meta-
The R.A.I.N. practice is one of many useful tools taught in MBSR. It was developed by psychologist and mindfulness teacher Tara Brach(3) and serves several useful mindfulness goals. It reminds us to direct our attention to the present moment-
R.A.I.N - A MINDFULNESS BASED STRESS REDUCTION PRACTICE
FALL 2018
BY JOHN A. PATTERSON MD, MSPH, FAAFP
the uncomfortable. It can be a portable tool of self-
Practicing R.A.I.N.
Begin by pausing anytime you remember to do so. The frequency of remembering increases the more often you do the practice, especially if you keep a personal practice journal each day or practice with a dedicated group. This journaling helps you hold yourself accountable to your goal of mindful self-
R: Recognize what is happening
Anywhere, anytime, simply ask yourself: “What is my immediate experience? What is happening inside me right now?” Turn your attention inward with genuine, natural curiosity, letting go of assumptions, automatic responses and preconceived ideas. Listen with kindness to your body, heart, thoughts, emotions, feelings, or sensations just as they are-
A: Allow life to be just as it is
Allowing means “letting be” and “being with” whatever thoughts, emotions,
JOHN A. PATTERSON MD, MSPH, FAAFP
Dr Patterson chairs the Lexington Medical
Senator Alvarado earned his bachelor's degree in biology from Loma Linda University (California) in 1990, and then went on to receive his Doctorate in Medicine in 1994. He completed his medical residency in Internal Medicine and Pediatrics at the University of Kentucky in 1998. Society's Physician Wellness Commission and is certified in Physician Coaching. He is on the family practice faculty UK College of Medicine and teaches nationally for Saybrook School of Integrative Medicine and Health Sciences (San Francisco) and the Center for Mind Body Medicine (Washington, DC). After 30 years in private family practice in Irvine KY, he now operates the Mind Body Studio in Lexington, where he offers integrative mind-
