05 March 2014
This week, week seven, in our ten week mindfulness series by Dr Patricia (Trish) Lück, a palliative care physician and facilitator of mindfulness-based stress reduction (MBSR) programmes, we explore the theme of communication and working with difficulty.
During the course of this session the often complex and complicated area of communication can be engaged through use of different methods and tools. Some facilitators use the approach taught by Jon Kabat-Zinn and Saki Santorelli which is based on Aikido, a martial arts discipline that, when engaged with as a communication approach, embodies how we interface with ourselves, with our world and with those around us, and demands of us to notice our habitual and often unaware and unconscious communication patterns. This approach asks us to turn into and toward all that communicates with us, whether easy or difficult, stressful or not. I will be sharing more of how this approach has informed my own work within palliative medicine at the upcoming 12th Annual International Scientific Conference hosted by the Center for Mindfulness in Medicine, Health care, and Society at the University of Massachusetts Medical School.
Other facilitators share the work of Greg Kramer and his interpersonal meditative practice of Insight Dialogue. This interpersonal communication practice involves a deep listening to self and other, pausing, relaxing into what is here, opening up to what arises, trusting what emerges, listening deeply and then kindly and gently speaking one’s truth without any need to foreshadow the outcome. In our rush to talk, we often fail to communicate. In our rush to present our point of view, we risk shutting down that of the other. As healthcare professionals working in the most difficult of spaces with the very real suffering of people at their most vulnerable and raw, we are well served by a mindful capacity to listen deeply to what needs to emerge. It is especially important to allow time and space for the needs and questions that may not yet be known to emerge and to trust that these can be heard and gently spoken to.
In one of the very last teaching rounds I held before leaving South Africa, I was brought to visit a child with very difficult pain in one of the hospital wards. As often happened on these teaching rounds, we were a relatively large mass of people– doctors, nurse, social worker, students– all crowding into the room enquiring of the doctor there how she was addressing the patient’s pain. What may have been easily observable but also easily missed were the defensiveness and discomfort of the attending doctor on the ward. My practice of Insight Dialogue in action served me well and turned this situation from one in which much discord could have resulted with the needs of the patient not fully addressed, to one in which everyone’s attention turned toward ‘what was needed now’ and ‘how could we best serve this patient’.
The practice of pausing, observing the communication that was happening in terms of verbal and non-verbal cues, relaxing into what was being felt by the individuals and the group, opening up to my own ambivalence and enquiring nonjudgmentally of the doctor about her own thoughts, and trusting what emerged through this interface.
Without this deep listening, we might have missed that this doctor was a specialist in her own right from a foreign country, not recognised yet as one in this country where she was working. Her own resentment and ambivalence at not being trusted with care became part of what was present in speaking her truth. We were able to agree on a plan of action that worked even with the possible misunderstandings of care that existed, and were able to ensure that this patient died a peace-filled, pain-free death very shortly thereafter. All this was achieved through the simple capacity of turning toward the communication difficulty rather than away from it.
So as you go through this next week, in addition to continuing to attend mindfully to breathing, eating, sitting, walking, daily tasks, perhaps spend some time noticing how you communicate with others, and how you communicate with yourself. Communicating not just through verbal interaction, but also through body language, writing, texting, and how you present yourself in public and private spaces, inwardly and outwardly. Noticing if you rush to communicate what is uppermost on your mind or if you can perhaps pause, relax, open to what is here, listen deeply first and then only speak your truth that emerges for this very moment. Try it. Remain curious of what this way of communicating may present for you. As you do so I will be in the middle of a nine-day silent retreat, not communicating other than with myself silently alongside others, and wondering how you are in the midst of this moment.