Cultivating Meaningful Work: Letting go of Self-Doubt and “Supposed To”.
So you may not have noticed, but this past month of October went past without my Engaging the Whole Heart Project post materialising. For some reason it has been difficult writing post, even though I am fully submersed at the moment in cultivating meaningful work, continuing my mindfulness in palliative care work, and working toward a Masters in Medical Humanities. Lots of cultivating going on and pursuing of my passions fully. Letting go of the self doubt and the supposed to’s, listening deeply to my inner voice.
So to honour the October post I am circulating an article that was published to day on ehospice.com on a meeting I attended this past week in parliament to give a very brief submission on mindfulness in palliative medicine.
Hopefully the next post for November will follow shortly. The last of the ten points from Brené Brown’s Daring Greatly.
Members of Parliament from all three main UK political parties have initiated and co-chaired an All Party Parliamentary Group (APPG) on Mindfulness to investigate mindfulness-based interventions in all aspects of UK society.
The aim of the APPG is: “To review research evidence, current best practice and potential developments in the application of mindfulness to a range of policy areas and to develop policy recommendations for government, based on these findings.”
The UK parliament has been holding mindfulness classes for its parliamentary members since 2013. These have been held by the Mindfulness Initiative, a group of mindfulness teachers supported by a coalition of the Oxford, Exeter, Bangor and Sussex University Mindfulness Centres. The Mindfulness Initiative advocacy project aims to increase awareness of how mindfulness can benefit society as a whole.
With the help of the Mindfulness Initiative, the APPG on Mindfulness is conducting an inquiry into how mindfulness could be incorporated in UK services and institutions and to advocate for a better understanding of mindfulness as a low cost intervention and its potential in a range of public services.
At one of the group’s previous meetings, Rebecca Crane, Director of the Centre for Mindfulness Research and Practice at Bangor University, commented: “There is an expanding interest in the societal applications of mindfulness training in a range of settings, including the health service, education, the military and the justice system.
“The APPG offers an exciting opportunity to bring policy makers together in conversation with academics and practitioners to consider how the evidence for mindfulness can inform policy.”
Palliative Medicine and the Physical Health and NHS Staff Roundtable
At the APPG, the founder of Breathworks gave a presentation which was followed by an overview given of the evidence base by the Oxford Mindfulness Centre. The group discussed mindfulness and practical implementations within health settings, including chronic pain, palliative care, oncology and paediatric services.
NHS Staff reported on their experience of mindfulness training courses within two NHS Trusts, The King’s Fund, and the Bristol and Exeter University Mindfulness Network.
As the palliative care representative invited to present my personal experience of mindfulness within palliative care, perhaps a brief summary may capture some thoughts on why mindfulness might be an essential skill for all involved in the arena of caring for persons with life limiting and life threatening illness, and end of life care.
I have worked in palliative medicine in Johannesburg, South Africa, first in adult palliative care and these past years, before moving to London, in paediatric palliative care. I have had ample opportunity to incorporate my mindfulness training, which has developed at the same time, into my work.
This happened for no other reason than that my patients, to whom I was teaching some simple breath awareness mindfulness tools I had been exposed to on a short course, urged me to learn more.
Mindfulness interested me from a clinical perspective, wondering what it had to offer my practice of medicine as a clinician, to my patients in alleviating their suffering, and to healthcare workers, especially my co-workers in palliative care, to deal with their own levels of stress, burnout and compassion fatigue.
This symbiotic journey I have embarked on, of mindfulness and palliative care, these past thirteen years, has convinced me that mindfulness practice supports the experience of delivering palliative care in very practical ways.
This is especially so at a time of facing significant loss, death and dying – times perhaps of greatest distress for patients, families, and the professionals involved.
Mindfulness training offers palliative care workers a strengthening of the capacity of stable presence in the face of great suffering, deeply patient and self aware listening skills, open curiosity with less tendency to seek the least complex answers, unconditional regard, kindness and compassion for patients, families, and fellow clinicians.
It also fosters the capacity to allow curiosity, complexity and ambivalence to exist at times when answers are being sought, while being open and unattached to any pre-determined outcome. This ability to hold conflicting tensions of denial, anger, hope and hopelessness is crucial to compassionate care.
My journey has been informed by a small pilot research project I did with terminally ill cancer patients who reported increased quality of life scores, improved role function, and social and physical functioning through being part of an eight week mindfulness based stress reduction programme.
Since then, I have been offering the programme for palliative care teams and encouraging staff in engaging with a self care program which recognises that developing the capacity of self care with awareness, compassion, and greater presence can offer our patients a growing capacity that is less prone to turn away from their distress and difficulties due to our own unrecognised distress patterns.
Children respond readily to this approach and in my anecdotal experience, they show less anxiety, increased desire to engage with the experience they are facing, greater capacity to engage with ambivalence and denial that may be present, and even teach their own families the breath exercises and brief body scan practices they have learned.
The APPG on Mindfulness will wrap up its inquiry next month and all presentations, findings, and recommendations will be collated into a report: ‘The Mindful Nation’, due out in March 2015.
You can find further information on the Mindfulness Initiative website.