Mindfulness-based stress reduction

Recent initiative to increase awareness of stress and mental health issues among members of our profession is well-founded. Studies show a suicide rate amongst veterinarians approaching 7 times the general population and high levels of anxiety and depression. I have worked with real veterinarians who have experienced what the statistics are telling us and I believe that the time has come to educate veterinarians about the wide range of proven individual self-care techniques that are available. This article will focus on mindfulness.

To be mindful is to be in the present moment, on purpose, non-judgementally. The present moment may be the only real moment we ever have. Rather than appreciating the present, common defaults are reliving the past or anticipating the future which may be associated with emotions such as regret or worry. As a result, living outside the present can be a great source of anxiety. The irony is we create suffering, thinking about an event long past or one that may never come. There are many ways to hone mindfulness, all intended to cultivate present moment awareness. These techniques include purposeful breathing, basic meditation, yoga, and learning to observe as events unfold.

Mindfulness-based stress reduction or MBSR began over 30 years ago at the University of Massachusetts Medical School as an 8-week course designed to manage mental health and chronic pain patients who were non-responsive to conventional therapy. Dr. Jon Kabat-Zinn, the founder of MBSR, developed a course that is still used today.

The course has 8 weekly classes teaching basic relaxation and breathing techniques, meditation and simple yoga, along with daily homework such as maintaining a gratitude journal and a positive events log. The MBSR groups were followed and compared to controls. The MBSR group scored significantly better on standardized psychological tests with lower pain scores. In every measure there was an increase in their quality of life. This work was published and MBSR began to gain traction as another tool to manage mental health.

Today, tens of thousands have taken MBSR training worldwide. There are over 1300 scientific papers chronicling the benefits to mental health, physical health, and mental acuity. There has been a strong link to the reduction of compassion fatigue with MBSR course participants reporting more empathy and less distress from the frequency of interactions surrounding death.

There are remarkable findings from Dr. Amishi Jha, an American neuroscientist working with the United States Marine Corps. Mindfulness-based stress reduction training was introduced in boot camp to troops prior to deployment in Iraq. These participants had better memory, better task performance, and better decision-making under stress as compared with the controls. Clearly these benefits would be an advantage to soldiers as well as any medical practitioner. Even more compelling is that MBSR participants had a higher likelihood of returning home alive and a lower incidence and severity of Post-Traumatic Stress Disorder (PTSD). I believe this is of particular significance to veterinarians. There is a paucity of data, yet few will argue that veterinarians are confronted with horrific situations under which they have no control: loud unrelenting noises, unpredictably dangerous animals, bloodshed and death, all precipitators of PTSD. This disorder is linked with higher levels of anxiety, insomnia, depression, and suicide.

Currently MBSR is part of the curriculum at over 100 North American medical schools. It is now taught as an elective at WCVM by my mindfulness colleague Dr. Patricia Dowling and at the Tennessee Veterinary school by a non-veterinarian. Mindfulness training has a tremendous potential to improve the quality of life for veterinarians.

Five simple mindfulness tips

1. Take 5 slow cycles of respiration, feeling the air enter and leave your body just prior to seeing a patient.

2. With closed eyes reach slowly to the sky while breathing in for 5 seconds then slowly return your arms to your side and exhale — repeat 5 times.

3. Try eating your lunch as slowly as you can, savoring every bite and body sensation; you may be surprised at the flavor and your sensation of fullness.

4. Choose a random object in your immediate environment such as a pen, a flower, or your stethoscope and observe it very carefully for 60 seconds; see what you can observe that you may never have seen before.

5. Take a slow 10-minute walk and synchronize your inspirations and expirations with your footfalls — amazingly relaxing.

Dr. Steve Noonan is a veterinarian, management consultant, counsellor, mindfulness instructor, and professional life coach living in Guelph.