Every year, at the Center for Mind-Body Medicine's trainings, I meet clinicians—physicians, nurses, PA's, mental health professionals and CAM practitioners- who feel harried and frustrated, sometimes a little lost. They come hoping to reconnect with the inspiration that brought them into medicine; to shed some of the anxieties that hobble them; to find a path to who they are meant to be.
What follows are some simple but powerful ways that have helped thousands of clinicians to find ways of practicing—and living—that work better for their patients and feel better to them.
BREATHE: Slow, deep breathing--in through the nose, out through the mouth, with the belly soft and relaxed--is the simplest, easiest way to quiet the fight or flight and stress responses, and to find an oasis of calm in the middle of harried days. Breathing not only restores physiological homeostasis, it gives us quite literally a "breather" from the constant activity that crams our days.
Most of the research on benefits of deep breathing has been done with 20 min sessions, twice daily, but I've found that even taking 3-4 minute breathing breaks, several times a day, can make all the difference in how I feel and in how I deal with my daily challenges. I'm less reactive, more intelligent, more intuitive, and even, as I exercise compassion for myself, more compassionate to others.
MOVE: Movement is our genetic birthright. Our ancestors walked, lifted, bent, and carried for 6-8 hours each day. This is what our bodies are built for. So it makes sense that all of us need to move around periodically: to get up from the desk; stretch a bit; go out of the office. I know we can't do it as much as we might like—and some of us, like me, can easily forget about it for long periods. Still, a little movement goes a long way toward improving mood and physiological functioning. It also breaks up fixed patterns of thought and behavior. Leave the office for lunch or a walk, or even better, a walk and lunch. You'll likely come back less tense and more energetic.
MEDITATE WITH YOUR COWORKERS: We do this for a couple of minutes before our staffmeetings. Even just a few minutes of soft belly breathing in a group can be a help. I know it helps me to let go of the preoccupations I've brought with me, to be more receptive to what I hear, to be less likely to respond in habitual, counterproductive ways.
Many of our Mind-Body Medicine program graduates have brought an opening meditation into their hospital rounds, daily or weekly office meetings, and case conferences. If you're going to meditate with others, make sure that it has become your regular practice first.
TELL YOUR PATIENTS WHO YOU ARE: One of the major stressors in clinical practice is the disjunction between your patients' expectations and what you, as a clinician, can offer to them. They're certain they're coming to you for medication, but you want them to change their diet, exercise more, and deal with stress. You're not in any rush to prescribe. This sort of misalignment of expectations can create friction, but it is easily avoided.
I've found it enormously helpful—and decidedly stress-relieving—to make sure my patients and I are on the same wavelength. I used to send them a brief description of my practice. Now I ask them to take a look at one of my books—Manifesto for a New Medicine, or Unstuck: Your Guide to the Seven-Stage Journey Out of Depression—before they came to see me. But you don't need to write a book in order to communicate to patients something about who you are and the way you practice health care. Even a brief description of your values and your approach can help preempt misunderstandings.
If patients know who you are before they come, they will have quite a good idea about how you think and what you're like. They can then make up their own minds about whether you're the doctor they really want to see.
With most people, I spend fifteen minutes or so on the phone before they ever come to the office. This takes a bit of time, but I feel it is amazingly valuable. In the long run, it spares me, as well as my prospective patients, much unnecessary frustration and opens the way to an enduring, committed healing partnership.
TAKE A FRESH LOOK: Check in with yourself every so often and ask yourself what you really want to do. It's often very helpful to mobilize your imagination and intuition to help you explore where you would like to be in your daily work and in your profession.
One exercise that I've used for years involves making three drawings. One, draw "Yourself Now." Two, draw "Yourself as You Would Like to Be Practicing." Three, draw how you're going to get from "Where You Are Now" to "Where You'd Like to Be."
I know, I know, if you knew how to get there, you wouldn't be asking. Still, even though your rational mind may not know where you want to be or how you're going to get there, you'll be surprised at what your intuition or "unconscious" or right brain—call it what you will—can come up with. If the answers are helpful, you might want to put the drawings up on your wall. Some are quite amazing—pictures of an office with more open space and more windows on nature; daily yoga practice for oneself as a way to transition to a more integrative practice for one's patients.
If you have trouble making sense of your drawings & the messages they're trying to convey, try again in a few days. Sometimes it takes awhile to open up the channels.
As you do these experiments, remember that the scientific work of a physician is in exploring new frontiers of knowledge, and that our calling is to compassion—for ourselves as well as our patients.
James S. Gordon, MD, is the Founder and Director of The Center for Mind-Body Medicine. He is a clinical professor at Georgetown Medical School, and Dean of the College of Mind-Body Medicine at Saybrook University. He chaired the White House Commission on Complementary and Alternative Medicine Policy. The exercises in this article and others appear in more comprehensive form in Unstuck: Your Guide to the Seven-Stage Journey Out of Depression; they are the basis of CMBM's Mind-Body Medicine Training.
Dr. Gordon will be a featured speaker at Holistic Primary Care's 2011 Heal Thy Practice: Transforming Primary Care conference, Nov. 4-6, 2011 in Long Beach, CA.