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ATD Blog

Mindfulness in Coaching and Healthcare

Thursday, December 12, 2019
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Mindfulness is beneficial for many reasons including stress relief and improved general health, but one of the most positive benefits of partaking in this practice is an increased presence. For the L&D industry, being present allows coaches to take more risks in the conversation, speak directly, and make requests that are bolder and more aligned with the work and contributions of those we coach. Emotional attunement also emerges in this hyper state of partnering with others in a thinking and creative process. It allows us to create safety, and from there, listening, questioning, and direct communication more naturally occur.

Mindfulness is a practiced way of cultivating presence and of setting an intention and focusing attention so our thinking and doing are observable to self and others. Being mindful occurs in a series of “now moments” that expand our awareness of our thoughts and feelings so we consciously choose our responses. This practice invites us to more easily navigate chaos and uncertainty and find that “still-point” for accessing wisdom to better lead and care for others. In leadership, we notice this quality as executive presence, a sense we have of being intimate and trustworthy.

Mindfulness is an important element for successful coaching. The International Coach Federation (ICF) has identified core competencies that must be mastered by all certified coaches. Mindfulness influences many of these core competencies in three ways:

  • Mindfulness strengthens presence, creates empathy, and improves equanimity. Coaches are more sensitive to the needs of others and keep the emotional balance to be able to assist the client in a positive and unattached way.
  • Mindfulness enhances active listening skills. Coaches who are active listeners can explore the client’s use of language and expression of emotion. Mindfulness will help the coach focus on the present moment and use heart-centered listening so the client can feel well-heard and cared for.
  • Mindfulness will create clarity and focus by cutting down on the mind chatter, so the coach can become more present, alert, and able to encourage the client to take new actions and keep moving toward the desired outcomes.

Mindfulness for Healthcare Providers

In healthcare, a state of mindfulness becomes more than a winning bedside manner. Early research indicates mindfulness is becoming a lifeline for thriving in a field with exorbitant levels of burnout.

Research at the Mayo Clinic and the University of Rochester have shown that mindfulness helps build resilience and prevent burnout in provider populations. TD Shanafelt published his research about the rate of burnout for physicians, up to 55 percent in certain specialties, and how a program of mindfulness has improved mental and emotional balance and sustained improvement in physician’s well-being and quality of patient’s care.

The program consisted of eight weekly 2 1/2 hour sessions on mindfulness plus an all-day (seven-hour) silent retreat, and a maintenance phase (10 monthly 2 1/2 hour sessions).

Participants engaged in mindful meditations, awareness of thoughts and feelings, self-care exploration, reflecting on meaningful experiences in their practice, and bringing their values to their daily practice.

The results were promising and the conclusion was that mindfulness practice is a means for health professionals to:

  • Enhance their self-awareness, wellness, and resilience.
  • Improve their relationships with patients and colleagues.
  • Advance the quality of medical care they provide.

Cultivating the practice of mindfulness first requires we become aware of where our attention and intentions go throughout the day. Tapping into our internal voice of wisdom, or observer-learner, we can intentionally watch ourselves and our thinking. A relatively new label for presence, mindfulness was brought to our attention by Jon Kabat-Zinn, one of the first to describe mindfulness as “the awareness that arises out of paying attention on purpose, in the present moment, without judgment.” Kabat-Zinn is an American professor emeritus of medicine and the creator of the Stress Reduction Clinic and the Center for Mindfulness in Medicine, at the University of Massachusetts Medical School.

Mindfulness comes from Buddhism, where it was originally taught, and has three components (or higher training elements): ethics, concentration, and wisdom. It is much more than concentrating on the present moment; it is the ability to bring mindfulness to our everyday life, and choose moment-to-moment experiences that lead to genuine happiness and a meaningful life.

The Dalai Lama, when asked what surprised him most about humanity, replied: “Man. Because he sacrifices his health in order to make money. Then he sacrifices money to recuperate his health.” He expanded this notion recently: “Those who are not well have one focus—their health. Those who are healthy can focus on many things.”

Granted, his holiness lives in a world where he is somewhat isolated, yet he spends his life in practice of mindfulness in ways that have him serve others by noticing the collective of humanity as we go about our evolutionary practices. And his mirror is one that most people on the planet recognize as wise counsel.

How Does It Work? Mindfulness, Neuroscience, and Neuroplasticity

Mindfulness works because it changes our brain. It creates new neural pathways and new connections. It follows the Hebbian theory that, “Neurons that fire together, wire together, and neurons that fire out of sync, fail to link.”

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Research from Harvard (Sara Lazar) showed that mindfulness could produce thickening and increased activity in important areas of the brain. Functional MRI revealed that experienced meditators had a thicker cortex than non-meditators. This was particularly true for brain areas associated with attention, introspection, and sensory processing. One of the important areas is the temporo-parietal junction, which is associated with empathy, compassion, self-awareness, adaptability, self-motivation, emotional balance, and social grace—the great qualities of emotional intelligence.

Another area that lit up on MRI was the prefrontal cortex which is the center of awareness, concentration, and decision-making. This was the part of the brain highly developed in Einstein. Increased thickness in this "king of all brain regions" means many great things: far less anxiety and depression, stronger willpower, more success, more processing power, and better health.

Neuroplasticity allows the neurons (nerve cells) in the brain to compensate for injury and disease and to adjust their activities in response to new situations or to changes in their environment.

The studies by Lazar also showed a reduction in volume of the amygdala. Participants reported reduction in stress which was also correlated with decreased gray-matter density in the amygdala which is known to play an important role in anxiety and stress.

Davidson described increase in emotional resilience by strengthening the left PFC so it sends stronger, longer-lasting inhibitory signals to the amygdalae. One way to do this, Davidson says, is mindfulness meditation, in which you observe your thoughts and feelings with the objectivity of a disinterested, nonjudgmental witness. Davidson discovered that people who are resilient—those able to regain their emotional balance after a setback rather than wallow in anxiety, anger, depression, or another negative emotion—have strong connections between the left prefrontal cortex (PFC) and the amygdalae. The left PFC sends inhibitory signals to the amygdalae, basically telling them to quiet down.

In conclusion, by practicing regular meditation, neural networks in the medial prefrontal cortex and the temporo-parietal junction are strengthened and stabilized. People who are experiencing high levels of stress, such as those with post-traumatic stress disorder, have an overactive amygdala and an underactive prefrontal cortex. Mindfulness meditation improves prefrontal cortex functioning and increases its activity.

Richard Davidson is popularizing the idea that based on what is known about the plasticity of the brain— that one can learn happiness and compassion as skills just as one learns to play a musical instrument, or train in golf or tennis. Happiness, like any skill, requires practice and time, and because one knows that the brain is built to change in response to mental training, it is possible to train a mind to be happy.

Three Ways to Cultivate Mindfulness

It is imperative that we recognize the importance of this research and provide an effective way for people to deal more effectively with chronic stress to build resilience and prevent burnout.

1. Start your day sitting and breathing for a few minutes. Deep breaths where you draw in what you most want and breath out gratitude for that experience, as if it has already happened.

2. Download an app. Insights, Calm, and others are tools to help guide you to a peaceful place regardless of where you are located.

3. Meditate and practice mindfulness while walking. So, you feel like your world moves faster than the speed of sound? Take a five- or ten-minute walk. Notice each step from the parking lot and into your work space. Or go outside for a break in activity when needed and as possible to ground yourself. Imagine a silver chord of light moving from the sky down through your skull, into your heart space, your gut, your core, down through your legs and into the soles of your feet, filling you with light. Feel your feet in motion. Take nothing for granted. Recall each event of your day in segments until you arrive and settle into your body and still point for the next activity.

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Mindfulness is not a quick fix, as if there is such a thing. It is a slowing down to learn and breathe and be here now. It is a process and a lifestyle change to build resilience on all levels, physical, mental, emotional, and spiritual. It requires discipline, daily practice, and developing the ability to see clearly, consciously discerning who we are and what we most want into our daily activity.

The program described by the University of Rochester is a great way to initiate mindfulness in every hospital, every organization and every business setting. Mindfulness now has also a great role in schools, and colleges to enhance mental and emotional balance, improve attention and productivity, and promote well-being.

Coaches are purveyors of hope and possibility. And it is easy for those in the learning and healing fields to sympathize with those we serve. Part of our discernment is self-care so that we can speak directly to those who most need our partnership and the highest and best we have to offer in our roles as leaders, practitioners, and coaches. The practice of mindfulness is a great place to begin again.

Editor's Note: The Healthcare Coaching Institute faculty contributors include Cindi Ackrill, Mark Greenawald, Assaad Mounzer, and Dael Waxman.

References

Shanafelt, TD. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med. 2012; 172(18):1377-1385. Oct 8, 2012.

Shanafelt, TD. Changes in Burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014. Mayo clinic proceedings, Dec 2015, Vol. 90, Issue 12, pages 1600-1613.

West, CP, Dyrbye, LN, Erwin, PJ, and Shanafelt, TD. Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis. Lancet. 2016 (published online, Sep. 28, 2016)

4. Krasner, MS, Epstein, RM, Beckman, H. Association of an educational program in Mindful communication with burnout, empathy, and attitudes among primary care physicians. JAMA. 2009; 302 (12):1284-1293.

Epstein, RM, Krasner, MS. Physician resilience: what it means, why it matters, and how to promote it. Academic Medicine: Journal of the Association of American Medical Colleges 88(3):301-3 · March 2013.

Bruna, J. The Wisdom of a Meaningful Life, the Essence of Mindfulness. Central Recovery Press, 2016. Las Vegas, NV.

Fortney L, Luchterband C, Zakletskaia L. Abbreviated mindfulness intervention for job satisfaction, quality of life, and compassion in primary care clinicians. Ann Fam. Med 2013; 412-420.

Lazar, S, Kerr, C, Wasserman, R. Meditation experience is associated with increased cortical thickness. Neuroreport. 2005, Nov 28, 16 (17): 1893-1897.

Davidson, R. J.; Kabat-Zinn, J.; D.; Santorelli, S.; Sheridan, J. F. (2003). "Alterations in Brain and Immune Function Produced by Mindfulness meditation". Psychosomatic Medicine. 65 (4): 564–570.

About the Author

Darelyn “DJ” Mitsch’s personal mission is to rehumanize work with a specific focus in the healthcare industry. DJ is an award-winning game changer, pioneer of the coaching profession, and president of the Pyramid Resource Group, which partners with leaders and healthcare providers to ignite genius and unleash full potential in their organizations. The sixth president of the International Coach Federation (ICF) and a founding global board member, DJ helped drive ICF chapter development across borders. She founded the Healthcare Coaching Institute (HCI) in 2013 to advance coaching as a key leadership capability for life sciences. HCI is now partnering with Virginia Tech’s international outreach and healthcare innovation programs. Combining her leadership experience in broadcasting and love of sports, DJ designed the first corporate team-coaching process around a strategic game plan. Team Advantage guides teams to transcend habitual ways of working and create new ways of working.

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Darelyn Mitsch, Thank you for reinforcing my Idea for introducing Mindfulness Programs in DFW. Would love to connect with you to keep you updated on my progress. Hopefully, I can find you on Linkedin.
Thank you for being the Leader you are!
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