I’m a pretty high-strung, caffeinated person. I get impatient during yoga class. My mind wanders, I try to “acknowledge this and come back to the present” like the teacher says, and it wanders again. And again. I sometimes feel like I don’t have time to be mindful, even though I have time to play games on my phone.
But even I have to admit that mindfulness works. I function better in the afternoons when I go outside, away from my desk at lunch. I feel less anxious when I take slow, deep breaths and let go of things I can’t control.
What Is Mindfulness and How Can It Help Me?
But is there more to mindfulness than deep breaths? And does it really help people with illnesses like cancer? I went to John Schorling, MD, director of the UVA Mindfulness Center, with my questions.
What is mindfulness?
Schorling: There are lots of definitions of mindfulness. The one we use is “intentional present moment awareness without judgment and with kindness.” Our natural tendency is to be caught up in thoughts and not paying attention to what is going on right now, so we have to remember to do this.
Mindfulness is paying attention to what is going on right now, in the present moment. Again, due to the tendency for our minds to wander, we often don’t pay attention to the present. There are several consequences of this:
- The things we think about are often stressful, and our thinking is not productive. It’s focused on worrying and not on what’s actually happening. Recognizing the worrying, letting it go, and focusing on the present can be very helpful in reducing stress.
- We miss out on parts of our lives as they are happening.
“Without judgment” refers to our tendency to judge our experience and want more of things that are pleasant and less of things that are unpleasant. Then we base our happiness on our circumstances. At times, we pursue pleasure at the expense of our well-being, perhaps by eating or drinking too much or having too much screen time.
With mindfulness, we learn to focus on accepting things as they are, without judgment. If we’re feeling unhappy and we notice the urge to eat something, we can pause to recognize the feeling without judging it. Feeling unhappy isn’t good or bad. It’s just the way we are feeling right now.
Often, noticing this changes our relationship to the feeling. We don’t feel like we have to do something to make it go away as quickly as possible. We can just be with it, and often it changes on its own.
Finally, mindfulness brings kindness to our own experience. Rather than judging ourselves for being unhappy, we can respond to our situation with kindness, the way a good friend would if we told them how we were feeling.
What is mindfulness-based stress reduction, and how did it start?
Schorling: 25 years ago, Maria Tussi Kluge and Allie Rudolph established the UVA Mindfulness Center as one of the country’s first such centers in an academic institution. Mindfulness-Based Stress Reduction (MBSR) courses are our core offerings.
MBSR was developed by Jon Kabat-Zinn and first taught in the University of Massachusetts Stress Management Clinic in 1979. It applied age-old practices of meditation and mindfulness to healthcare.
The benefits for patients quickly became apparent and led to several formal research studies. These studies confirmed that participants’ stress levels decreased and well-being increased.
Jon, with help from Saki Santorelli, began offering courses to teach others how to teach MBSR. They taught Maria and Allie, who were pioneers in pursuing this training. Since Jon, Saki, and their colleagues taught all approved MBSR teachers, there was a high level of consistency in offerings.
Funding agencies were willing to support research studies since MBSR was a well-documented intervention that could be replicated outside research settings. Foundations provided much of the initial funding. With time, this expanded to include federal funding from:
- National Institutes of Health
- Department of Veterans Affairs (VA)
- Department of Defense
The research showed that MBSR and other related interventions worked. Interest in mindfulness grew and moved from healthcare into education, teaching, business, law and beyond.
In 2005, we published our first UVA research study on MBSR, showing its positive impact among patients with chronic pain. At the time, there were 129 mindfulness references in the research database PubMed. Now there are over 8,000, and the benefits of MBSR have been well established.
MBSR teachers all use the same curriculum, meeting for 2 to 2 ½ hours a week for 8 weeks, with an all-day silent retreat after the sixth class.
Can MBSR help with severe stress, such as in cases of traumatic events?
Schorling: Yes, MBSR can help with severe stress. In studies, the VA found it effective for treating PTSD.
Having said this, mindfulness practices can also trigger symptoms related to trauma. Individuals with a history of trauma should discuss whether taking a class is appropriate with their care provider and MBSR teacher.
Mindfulness experts now recommend teaching MBSR in a trauma-informed way, as we do at the Mindfulness Center. Most of us have suffered some form of trauma in our lives.
If someone has a medical condition, does mindfulness benefit their physical health? Or is it more of a tool to deal with pain and other side effects?
Schorling: Evidence shows that mindfulness can improve well-being and pain as well as physical health. MBSR decreases stress, anxiety, and depression and improves quality of life for individuals with and without physical illnesses.
We did a study at UVA of individuals with heart palpitations. They didn’t have serious heart problems, but the palpitations were severe enough to interfere with daily activities. Those who we randomly selected for an MBSR course showed significant decreases in palpitation frequency and improvements in quality of life.
Take An MBSR Class
The UVA Mindfulness Center has online classes for healthcare providers and the general public.
Other studies outside of UVA showed:
- Improvements in immune function
- Decreases in blood pressure in people with hypertension
- Improvements in pain and function in those with chronic back pain
- Improvements in patients with rheumatoid arthritis
- Fewer symptoms among those with irritable bowel syndrome
How can MBSR benefit us during the COVID-19 pandemic?
Schorling: There’s so much disruption right now, and it’s easy to feel overwhelmed. Mindfulness is about learning a new way of being. It gives us more resources to deal with the inevitable stresses that we’re all facing.
In particular, mindfulness training helps us:
- Recognize our thoughts when we’re getting caught up in worrying
- Let the thoughts go and return attention to the present moment
- Be less judgmental of both ourselves and of others
- Respond to difficult situations with more kindness and compassion
How have the MBSR classes helped past participants?
Schorling: Often participants say the classes have been life-changing, that they have learned new ways of relating to their lives in positive ways. Many noted specific benefits, especially decreases in stress and improvements in mental wellbeing.
Burnout is very common among healthcare providers now. At the Mindfulness Center, we have been teaching dedicated mindfulness courses for healthcare providers for almost 20 years. Participants have noted significant decreases in stress and burnout and increases in self-compassion.
Participants have stated:
- “I feel very passionate about this and can speak from experience. Mindfulness changed my perception of my work and my wellbeing. The course was truly transformational for me.”
- “This course was amazing and more than I thought it was going to be. I have noticed a major change in myself and how I approach things.”
- “I did not think it was going to be as helpful as it was, and after only 1 week I saw a decrease in my negative stress responses.”
For those unable to take a class, do you have any quick tips for dealing with stressful moments?
Schorling: Try these 10 tips for reducing stress.
- Take a few minutes in the morning to be quiet and meditate – sit or lie down and be with yourself. Gaze out the window, listen to the sounds of nature, or take a quiet walk.
- Become aware of body tension that may build during the day (shoulders raised, stomach or jaw tight). Focus on releasing tension or tightness as you breathe out.
- Use breaks to truly relax. Take a brief walk, do a few slow body stretches, sit or lie down, and close your eyes to recoup.
- Change your environment: Eat lunch away from work areas or outside, noticing the air and sun. Or choose to eat lunch in silence once a week. Eat slowly and be with yourself.
- Decide to “pause” for 1-3 minutes every hour during the day. Become aware of your breathing and body sensations. Take four or five nice long breaths, noticing the rise and fall of the abdomen. Use everyday cues as reminders to center yourself – the phone ringing, opening a door, or brushing your teeth.
- Take time during the day to share non work-related topics with colleagues or friends. Notice when you appreciate another person and let them know it.
- Note your reaction or response to difficult concerns or encounters. Focus energy and attention on those aspects under your control; practice letting go of things outside of your control.
- Notice if you’re rushing or multitasking and what thoughts, feelings and sensations accompany the rushing.
- When transitioning from one activity to another (e.g., work to home), take time to come back to this present moment. Quietly prepare yourself for change, for being with others.
- At the end of the day, remember the day’s activities and experiences. Acknowledge (in writing if you’d like) three things for which you are grateful.
How can I learn more about mindfulness and MBSR?
Schorling: Join us daily for a virtual meditation. You can also take one of our online classes.
15-Minute Virtual Meditation
Who: Open to the general public
When: 4 p.m., Monday-Friday
Cost: Free
Online MBSR: Fostering Resilience in the Time of COVID-19
Who: Open to the general public.
When: Mondays, Sept. 28–Nov. 16, 6:30-8:30 p.m, plus a silent retreat on Saturday, Nov. 7, 9-1 p.m.
Cost: $325. Partial scholarships are available.
Online Mindfulness for Healthcare Providers: Fostering Resilience in the Time of COVID-19
Who: This class is for healthcare providers
When: Wednesdays, Sept. 30-Nov. 18, 6:30-8:30 p.m., plus a silent retreat on Saturday, Nov. 7, 9-1 p.m.
Cost: $325. Free for UVA Health employees.
