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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You may find it helpful to say to yourself “in” on the inbreath and “out” on the outbreath. Use your breath as an anchor to bring you into the present moment and help you tune intentionally into your natural state of calm awareness and restful alertness.
“O” is for “Open” and “Observe”
Expand the field of your awareness beyond your breathing, including a sense of the body as a whole, your posture, your facial expression and the sensations on your skin. Notice all your sense perceptions-
Naming your emotions without self judgment helps to cultivate emotional intelligence, magnifying the benefits of uplifting emotions and reducing the power of distressing emotions. Opening your heart to your own stress, difficult emotions and suffering can nurture your natural capacity for human affiliation and social support and your capacity to help relieve the stress and suffering of other people and all living things. Your own self-
“P” is for “Proceed”/new “Possibilities”
After this intentional slowing down, stepping off the treadmill and out of the rat race, take the benefits of this practice into the next moment, the next task, the next meeting, the next conversation, the next relationship-
Notice the world around you, experiencing how things really are, tapping into your intuitive inner wisdom for what you need right now-
Proceed without any expectation of how others will act or speak or behave. Be realistic about your inability to control the pace at which other people are moving. Know with increasing confidence that you can consciously choose the pace of your own mind and body, where you place your attention and whether you perceive your cup as half empty or half full. Feel your inner relaxation response naturally balancing your stress response. With an open, curious mind, experiment with the S.T.O.P. practice several times a day, anywhere, anytime-
As you take control of where you place your attention, you will understand why ‘mindfulness’ is also translated as ‘heartfulness.’ Refining your ability to slow down and S.T.O.P. can help you promote resilience, manage stress, prevent burnout and cultivate compassion. Keeping a log of your practice can be extremely helpful. The following questions are taken from the S.T.O.P. practice log (3) below.
What was the situation? What was going on with you when you thought to S.T.O.P.? (body, mind, emotion) What did you notice WHILE you were practicing? (body, mind, emotion) What did you notice AFTER your practice? (body, mind, emotion, action) What did you learn?
Resources
1. U Mass Medical Center for Mindfulness in Medicine, Health Care and Society
2. Downloadable basic S.T.O.P. instruction summary
3. Downloadable detailed 1 week S.T.O.P. practice log
Modern life is taking its toll on our nation’s mental and physical health. Physicians and their patients both suffer from stress-
“S” is for “Stop” and take Stock
Aren’t there times when you just need a break-
Step out of the doing mode and into the being mode. Reconnect with yourself and your natural inner resources of resilience, relaxation, peacefulness, compassion and wisdom. Really tune in-
S.T.O.P. A SIMPLE MINDFULNESS PRACTICE FOR PHYSICIANS AND PATIENTS
SUMMER 2018
BY JOHN A. PATTERSON MD, MSPH, FAAFP
Even if you don’t remember this entire sequence, just remember the word stop. Have the intention to truly inquire into the three primary domains of your experience-
Alternatively, you might ask, ‘What is absent from my experience right now-
“T” is for “Take” a Breath
Take a normal, natural breath, directing your full attention to breathing. Even one breath experienced with your full, unhurried attention can counteract the stress response. Feel the physical sensations of each inbreath and each outbreath-
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-
