Psychological resilience refers to an individual’s ability to successfully adapt to and overcome adversity, and has garnered much enquiry since the earliest studies of the 1970s, this interest fuelled by the disparate responses of individuals to psychosocial stressors and trauma. Although resilience may not be a common topic of dialogue amongst health professionals, it is as important to medical staff as it is to the patients they treat; working in high-stress environments is not without its toll, with burnout commonly reported amongst medical professionals.
As such, being able to traverse work and life’s challenges, and perhaps more importantly, being able to channel these experiences towards personal growth, is of immense value. Fortunately, the notion of resilience as a rigid trait has been challenged by neuroplasticity and epigenetics, with more recent definitions opting to view it as a complex process open to therapeutic intervention. As we enter Mental Health Month, I’d like to introduce the practice of meditation and mindfulness as a preface to something that is powerful and accessible, in the hope that it may encourage interest and further enquiry.
Mindfulness is as much a trait, as it is a state and practice; put simply, it refers to the ability to silence the mind, and to exist wholly within the present moment. Throughout history, meditation has traversed a fine line between theism, philosophy, and science, and hence the term has attracted different meanings amidst different contexts. Some of the earliest references to it are in the Hindu texts of Vedantism from 1500 BC, with subsequent references found in Taoism, Buddhism, Judaism, Christianity, and Islam.
More recently, it has gained popularity within Western medicine owing to Jon Kabat-Zinn’s introduction of the Mindfulness-Based Stress Reduction (MBSR) program, which was lauded as secularizing meditation from its philosophical and religious roots; it is now incorporated into several psychological therapies, including dialectical-behavioural therapy (DBT), acceptance and commitment therapy (ACT), relapse-prevention therapy, and mindfulness-based cognitive therapy. Although an exhaustive exploration of meditation is beyond the scope of this article, 3 concepts central to meditation are discussed below.
Within meditation and mindfulness, particular importance is placed upon becoming the master of one’s mind, and gaining the ability to transcend thought at will. Although the mind is an amazing entity that has afforded human beings an unparalleled capacity to think, reason, question, and abstract far beyond any other species on earth, it is also seen as a pertinent source of suffering. As connoted in cognitive behavioural theory, it isn’t necessarily our external circumstances that dictate our psychological wellbeing, but it is rather our thoughts and interpretations of our experiences that engender emotional responses (whether good or bad). Without the mind, there would be no thought, and without thought, there would be no suffering.
We cannot necessarily be without our mind, and hence the challenge lies in taking control of it, and more specifically, our thoughts. If we take a moment to reflect upon the human condition, one appreciates the significant proportion of time people spend within their minds, whether it is traversing memories of their past, or mingling with their imagination. This mental noise precludes full immersion in the present moment, and often colours our experiences to shades that distort their true nature. The purpose of meditation is to enter a state of consciousness where the mind is silent and where the individual wholly exists in the now, whilst being able to use the thinking mind when required, albeit in a more focused and effective fashion.
Humans can only ever physically reside within the “eternal now”, although the mind provides avenues to live within the mental constructs of the past (through memory) and the future (through imagination). Within the now there is no suffering – it is via the vehicle of memory that individuals experience emotions such as bitterness, guilt, regret, resentment, and sadness, and likewise, it is through identification with the future that one experiences anxiety, stress, tension, unease, and worry. By dedicating our full attention to the very moment in which we live, we alleviate much of the psychological basis of our suffering, only attending to brief visits to the past and future for practical purposes.
Acceptance is another key aspect of mindfulness and meditation, as a significant source of suffering is seen to be derived from non-acceptance of the now. The mind is believed to be responsible for colouring experiences as good or bad based on limited inferences of the past and the future. When your attention is fully in the now, there are no problems, only situations that need to be dealt with or accepted.
The Taoist parable below demonstrates the power of acceptance.
A farmer had worked the land for many years.
His horse ran away one day.
Upon hearing the news, his neighbors came to visit; “Such bad luck,” they said sympathetically.
“Maybe,” the farmer replied.
The next morning the horse returned, bringing with it three other wild horses.
“How wonderful,” the neighbors exclaimed.
“Maybe,” replied the old man.
The following day, his son tried to ride one of the untamed horses, was thrown, and broke his leg.
The neighbors again came to offer their sympathy on his misfortune.
“Maybe,” answered the farmer.
The day after, military officials came to the village to draft young men into the army. Seeing that the son’s leg was broken, they passed him by.
The neighbors congratulated the farmer on how well things had turned out.
“Maybe,” said the farmer.
The parable emphasises that we are never fully able to comprehend whether our current circumstances represent opportunity or adversity – such labels are constructs of the mind, and are ultimately without value as they may not reflect the true nature of our circumstances.
Incorporating meditation into a busy lifestyle can be challenging, and people often cite this as the largest impediment to its practice, but things need not be so difficult. If we reflect on our daily routine, we realise that there are plenty of occasions that do not necessitate the active use of our minds, whether it be brushing our teeth in the morning, eating lunch, or waiting in between patients during ward-rounds – these are moments during which we can practice meditation.
Although clearing the mind may be challenging for the beginner, perhaps begin by concentrating wholly on the sensations of your body (also known as sensory awareness) – try to find and identify all 10 toes of your feet, feel the full weight of your body on your seat, and concentrate on the sounds around you; the list goes on. Think of meditation as a muscle. The more you exercise it, the stronger it will get, and the easier it will be to achieve mental stillness amidst the hustle and bustle of your daily lives.