Massachusetts Medical Society: COVID Mindfulness

COVID Mindfulness

Mindfulness

Mindfulness and Compassion: Building Tools to Remain Calm and Steady with the Stresses of Health Care (3.25 credits)

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During this time of uncertainty and anxiety, take a moment to steady yourself and use these calming, helpful techniques to keep you and your patients safe.

Welcome to this resource webpage designed to provide support and help you to build calm and steadiness during this unprecedented time of uncertainty and change. Gail Gazelle, MD, MCC, and Paula Gardiner, MD, MPH, are physicians and trained mindfulness meditation teachers who have provided these meditations and short talks to steady you and bring calm to your days. (See below for bios.)

During this time, there are so many new concerns, fears, and worries, such as safety, financial insecurity, and the challenges of homeschooling kids. There is so much busyness in mastering new work demands and medical information, moving to telemedicine, and caring for sick patients with COVID-19. While we can’t change many of the external factors that keep us busy in our days, mindfulness and meditation can help with the internal busyness of our minds.

Whatever your specialty, your training may not have prepared you to handle all that may arise in times of challenges like COVID-19. We all have our ways of coping with extreme stress. Mindfulness and meditation may provide a well-needed respite from all the stress you encounter on any given day. They can help you build compassion for yourself and others, and better meet the challenges you face. Multiple studies have demonstrated that, in addition to a myriad of health benefits, mindfulness decreases physician burnout, indicating that, along with meditation, it can help you build resilience that can lead to a career of fulfillment and satisfaction.

These meditations and short talks provide information about mindfulness as well as practice meditating. Whether you are new to meditation or an experienced practitioner, you’ll gain the tools you need to not only survive this time but also to thrive.

Please send any feedback and/or suggestions regarding this series to mmscmecertification@mms.org.


MeditationMeditation of Gratitude for the Body (15 minutes)

Because COVID-19 has resulted in so much change and uncertainty, we can get caught in fears about our health and that of our loved ones. In the present moment, however, our body is likely doing a great deal of work, much of which we take for granted. This meditation practice helps you experience appreciation for what your body is doing well, which can build more ease and steadiness.

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Covid MountainCompassion Break for Clinicians

In this 10-minute meditation, there is a brief body scan followed by exercise of noticing how we are holding stress in our body, acknowledging others also feel this way, and offering kindness to ourselves and others knowing we are doing the best we can.

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Meditation 2Meditation of Appreciation for Doctors (10 minutes)

In this difficult time, doctors and nurses are stretched to their fullest. In ways many can barely imagine, you are working long hours and caring for the sickest patients, often without adequate personal protective equipment and at risk to your own safety. Today and every day, the sacrifices you are making deserve to be applauded. You deserve good health, safety from harm, and many moments of respite and calm.

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Covid SunsetLoving Kindness for Ourselves and Our Patients

This nine-minute meditation teaches a practice that helps clinicians renew our compassion and presence for ourselves and others.

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Meditation for CalmMeditation for Calm in a Time of Uncertainty (5 minutes)

COVID-19 brings so much worry, fear, and uncertainty, as well as so many responsibilities, professionally and personally. For many, it’s go, go, go, and it can be hard to take time to pause or rest. With all the uncertainty, many are in a state of sympathetic overdrive (a painful state that contributes to exhaustion), which can take us further into worry and distress. To be most resourceful, we need to find moments of calm. This brief meditation will help you access calm and disengage the sympathetic state, de-escalating stress in a powerful way and helping you weather this storm.

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HandwashingMindful Handwashing in between Caring in Different Patients

The extra stress and responsibility caused by the pandemic is affecting our ability to be totally present with our patients. As clinicians, we wash our hands all day long in between caring for many types of patients. This three-minute mindful handwashing practice helps us connect with the body, reset, and get ready to move on to our next patient.

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Letting GoMeditation for Letting Go (10 minutes)

Health care providers generally carry a lot, but even more so in the time of COVID-19. Yet, if we can loosen the reins and let go of what we don’t need to carry, we can build more steadiness and calm. This meditation helps you utilize your breath and awareness to practice letting go.

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BreatheUsing Breathing to Recharge in between Caring for Different Patients

With the COVID-19 pandemic, we are caring for sicker patients and many of us find ourselves in personal protective equipment all day. Having our faces covered can get in the way of connecting with our patients and cause more stress. Taking a few minutes to breathe and reset can be helpful for clinicians caring for patients. This three-minute breathing practice helps us connect our body, our focus, and our patients.

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Open SkyMind like Open Sky (10 minutes)

Our minds produce tens of thousands of thoughts a day. We get tugged and pulled about by the cascade of thoughts and this contributes to exhaustion and provider burnout. This meditation helps you see your thoughts as clouds that pass by in the open sky, providing a calming structure that promotes your well-being.

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MountainMountain Meditation (12 minutes)

Our minds are very busy places, sometimes generating much instability in worry, fear, and thoughts about the past and future. Mountains remain stable no matter what occurs around them. We can use the image of the mountain as a centering presence that reminds us that all our thoughts, feelings, and physical sensations are temporary and that they all pass, no matter how weighty they can seem. In this meditation, we will learn to support our ability to encounter each moment of our lives with growing equanimity, clarity, and calm. Much like the mountain, we can develop the ability to be with whatever occurs in our lives.

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Pausing The Importance of Pausing

You may be used to a very busy pace, sometimes without even noticing it. If you tune in and notice, you may find that your day is spent almost continuously rushing about. With the advent of COVID-19, this may be even more true.

The days can be so busy that, by the end, it all seems like a big blur. You may not recall what you did or what you ate for lunch. It can be like spinning in constant motion, leaving you feeling disconnected — from yourself, from the people you interact with, and from a sense of fulfillment. Mindfulness helps strengthen our sense of connection with the moments of our lives. One key mindfulness technique, pausing, allows us to see that there’s a space between what was and what’s next. That space is the present moment.

Listen to audio »


Emotions Working with Difficult Emotions

With all the challenge and uncertainty of COVID, there are many emotions that can arise within us. We may feel joyful about a smile from a loved one, sad about a sick patient, angry at something someone has said to us. Some emotions feel tame, and others overwhelming. Some are pleasant and some are not.

We get little training in how to be with all of these emotions and little modeling of how to comfortably ride these waves. We may believe that instead of experiencing an emotion, we’ll do better to push it away. But does it truly go away? Many times, the answer is no. Unprocessed emotions can hit when we least expect them and when that happens, we can get derailed, taken off course by these seemingly surprise visits the emotion has made.

With mindfulness, we gain practice simply being with whatever arises. We also begin to see that all states pass and feeling them is truly the path to their passing smoothly and easily.

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Thoughts Managing the Stream of Thoughts

The human mind produces thousands of thoughts a day. Some are vitally important, yet many are not. Especially during challenging times, it can feel as if the mind is a great servant but a poor master. Mindfulness offers the possibility of looking more critically at our thoughts. In doing so, we realize we can choose which ones we give attention to and how much.

The fact is that we can decide how we relate to our thoughts. Mindful awareness leads to curiosity, which makes us see we have more choices than we may have realized. We gradually become the master of our mind.

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Befriending Your Body Befriending Your Body

As health care providers, we’re in the business of caring for the human body; however, many of us have learned to tune out our bodies, ignoring areas of discomfort and pangs of hunger. We tend to power through our days, ignoring physical sensations that arise, and assuming that our body will cooperate with whatever we ask of it.

However, it may help us though to pay greater attention to bodily sensations. After all, the body is always in the present, even if the mind time travels away. Being more present with bodily sensations can have a grounding and centering effect. We may, however, be at war with our body, unhappy with how it looks or how it’s behaving. We may compare it to what it might’ve been like in the past or to an idealized societal standard of youth and beauty. The awareness we cultivate with mindfulness can help us become acquainted, familiar, and perhaps even kinder to our body.

Listen to audio »


ObserverBecoming the Observer

The multitude of thoughts created each day by the human mind can overwhelm us, and in times of crisis it can be hard to maintain an objective stance on our circumstances.

From the stance of the observer, we can gain a healthy degree of detachment from our thoughts and emotions, helping us to see things much more clearly. Once we develop this habit of becoming the observer, we can make better choices and develop more autonomy over our experience. This autonomy helps us become more resilient.

Listen to audio »


Massachusetts Physicians Risk Management Study
According to the Massachusetts Board of Registration in Medicine’s (MA BORIM) Policy 19-06 (click here), risk management study also includes education and awareness around physician burnout and wellness. Every hour spent on the topic of physician burnout or mindfulness will count for one hour of risk management study. To record these credits, you should note the amount of time spent, the website, and the date.


FACULTY


Gail Gazelle

Gail Gazelle, MD, MCC, is a part-time Assistant Professor of Medicine at Harvard Medical School, a former hospice physician, and a current master coach for physicians and health care leaders. Having coached over 500 physicians and physician leaders, she is a master certified coach with the International Coach Federation. She is the author of Mindfulness Support for Alzheimer’s Caregivers (2013), a Harvard Medical School Guide, and Building Your Resilient Self: 52 Tips to Move from Burnout to Balance (2014). Deeply committed to helping everyone in health care thrive, she developed the free 14-day mindfulness series Daily Dose of Calm to help those working in health care learn about mindfulness and access steadiness, compassion, and calm.

Dr. Gazelle has completed an intensive two-year mindfulness meditation teacher training with world-renowned educators Tara Brach and Jack Kornfield. She is the author of Everyday Resilience. A Practical Guide to Build Inner Strength and Weather Life’s Challenges. Download a free chapter.


Paula Gardiner

Paula Gardiner, MD, MPH, is associate professor at the University of Massachusetts Medical School and associate director of research in the Department of Family Medicine. She has more than 20 years of experience as a family medicine and integrative medicine clinician and mindfulness research. She is the director of medical group visits in the Center for Integrated Primary Care at the University of Massachusetts Medical School. Her research concentration is patient-oriented research regarding chronic conditions, depression, chronic pain, and non-pharmacological evidence-based medicine. Her research is focused on the adaptive role of technology, such as online video groups and telehealth, to support health behavior change and reducing pain and opioid use using group visit models. Additionally, her research focuses on innovative technologies such as embodied conversational agents and Our Whole Lives, a holistic online toolkit that provides online groups to teach mind-body techniques to low-health literacy patients. She is a certified meditation teacher after completing a two-year training with Tara Brach and Jack Kornfield and has her certification in the Mindful Practice program with Ron Epstein and Mick Krasner. Additionally, she has completed training in Mindful Self Compassion and Mindful Self-Compassion for Health Care Providers. She also teaches classes in mindfulness-based stress reduction.

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