Can Mindfulness Fix Medicine?

The science behind using the brain to beat burnout

Elizabeth Knight, PhD

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Published in

BeingWell

4 min readOct 11, 2021

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five matchsticks agains a purple background; the fourth is burned and the fifth is sprouting a green leaf — tangerine newt via unsplash

Trauma and burnout are common in the healthcare workforce during the COVID-19 pandemic, perhaps unsurprisingly¹. Even before the pandemic, though, trouble was brewing. Burnout, defined as emotional, mental, and physical exhaustion caused by excessive and prolonged stress, is on the rise. Overwork, the increasing demands of electronic documentation, and moral injury that stems from being unable to provide optimal care due to system constraints are a few of the contributing factors. With the added disruption of COVID, we are staring down a serious problem that is likely to impact both individuals and the entire healthcare system for years to come.

There is plenty of debate over how burnout in clinicians should be addressed; many people point to the role of health systems and institutions and believe that solutions must stem from this level²,³. It is clear that health systems need to make some changes to support struggling clinicians. Still, organizational change is slow, and individuals need to work to improve their own wellbeing even as they press for systemic change. The answer, as usual, is not either/or, but both/and. This article will examine the evidence for how mindfulness practices can help nurses, physicians, and other healthcare workers mitigate symptoms of burnout.

Mindfulness explored

Mindfulness is defined as “awareness that arises through paying attention, on purpose, in the present moment, non-judgementally”. Mindfulness training has been shown to reduce symptoms of burnout such as emotional exhaustion⁴. One of the best-studied approaches is mindfulness-based stress reduction or MBSR. Jon Kabat-Zinn, Ph.D. founded MBSR in 1979. It’s a structured, eight-week program, and this specificity has allowed for studies to measure its impact in different populations and environments. As a result, there is now a significant body of evidence suggesting that MBSR improves a wide variety of problems, including symptoms of burnout. Through MBSR is only one approach (and one that’s measurable and repeatable), the underlying theory is likely more broadly applicable. Shorter mindfulness training courses, and even internet-delivered sessions, may be effective. A simple introductory practice like this one might be a place for the curious to start exploring the potential benefits.

In recent years, the field of “contemplative neuroscience” has emerged. Researchers use fMRI and similar techniques to examine how mindfulness practices can alter both structure and function of the brain. The effects on both structure and function, it turns out, can be profound⁵. One potential mechanism for the impact of mindfulness interventions on health and disease outcomes is modulation of the stress response⁶. For healthcare workers facing high levels of stress, this is a promising approach. The stress of working in healthcare won’t disappear, but clinicians’ responses to it can change. Mindfulness, it seems, can help.

For the skeptics. . .

For healthcare workers experiencing burnout, existing evidence is promising for MBSR specifically⁷ and mindfulness in general⁸.

Mindfulness training interventions are effective, safe, and inexpensive, but they are not universally embraced⁹. While some are eager to try mindfulness practices, others meet this information with skepticism — yeah, right, they say, give me a real intervention. Why does mindfulness inspire so much resistance?

It’s hard. Anyone who has ever tried to sit quietly and meditate for ten minutes can tell you that mindfulness practices take work and willingness to sit in discomfort.
It’s soft. Healthcare professionals have a scientific education, and many have an inherent bias towards clearly understood biomedical interventions. We can see the biochemical role of a drug, but can’t quite grasp how changing thoughts can be related to outcomes.
It’s slow. The impact of mindfulness interventions isn’t always immediately felt, and shifts away from burnout can resemble a gentle slope more than a sudden spike. It’s harder to appreciate the value of a gradual improvement.

Mindfulness training won’t appeal to everyone. It doesn’t work without buy-in, both individual and institutional¹⁰. When people feel safe and supported sharing with their colleagues and their work environment allows for the integration of mindfulness practices, such as having time and space provided, they are most effective in improving burnout-related symptoms.

Mindfulness is not a panacea for the ailing healthcare system or the crises precipitated by the pandemic. For clinicians seeking relief from the immediate distress of burnout, however, mindfulness practices can offer a very real lifeline.

Elizabeth Knight is a scientist, nurse practitioner, educator, and coach. You can find her at www.flowerpower.health.

References

Can Mindfulness Fix Medicine?

The science behind using the brain to beat burnout

Mindfulness explored

For the skeptics. . .

Written by Elizabeth Knight, PhD