Is Mindfulness the Answer?

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Mindfulness meditation is a practice that has been in existence for millennia.  Essentially, the practice can be considered to be comprised of either focus on a single object, such as the breath, or open contemplation, in which one recognizes and acknowledge thoughts as they enter awareness.  Another type of mindfulness practice, is loving kindness in which intentions of goodwill, wellbeing, and health are extended to oneself and others.  Other meditative practices, such as transcendental meditation, are not considered in this article. 

While these traditional practices have long been intertwined within many Eastern philosophies and cultures, they have more more recently become commonplace in Western culture.  Accompanying this emergence of mindfulness practice within Western communities, has been an implicit and, at times, explicitly stated expectation that mindfulness can address and effectively cure our response to stress and burnout.  Is this truly the case?

The benefits of mindfulness have been long known by traditional practitioners.  In large part this explains why the practice has been passed down across numerous generations.  While the Western perspective includes the belief that mindfulness decreases stress, this is not exactly the case.  The primary goal of developing a mindfulness practice is not stress reduction, although it may be a byproduct.  To unpack this further, it is first necessary to understand the primary purpose of the practice. 

The goal of mindfulness meditation is not to become an accomplished meditator.  The goal is also not to reduce stress or cure any other conditions, including burnout.  The primary goal of the practice is to develop awareness of our internal and external environment and do so without critique or judgement.  Irrespective of whether we are practicing single point focus on our breath, or any other object, or open contemplative practice, the skill that is being developed is awareness of thoughts, sensations, and feelings in the present moment.  Due to the large number of thoughts which are continuously arising in our minds, the process of noting these thoughts without judgement and letting them pass without pursuing any narratives or stories about them can lead to relaxation and decreased stress, although this is not the primary objective.

The primary direct benefit from mindfulness meditation is developing the skill of awareness.  This can also be considered to be the skill of attending, acknowledgment, and recognition, although for the sake of brevity it will be referred to in this article as awareness.  The additional key to full development of this ability of awareness, is to do so without critique or judgement.  The awareness that we develop through mindfulness practice applies equally to internal cues, including thoughts, feelings, sensations, and emotions, as it does to external stimuli, such as cues from other people and our surroundings.

The awareness skill that is developed is a key tool for managing our focus and attention.  Typically, we are able to choose what we want to pay attention to and focus on.  Due to the nature of the human brain, we may frequently become distracted and begin to focus our attention on a different object.  When this occurs and we want to refocus on the initial object, it is first necessary to be aware of where our focus actually is in the present moment.  Once we become aware of this, we can then choose to place our focus back on the initial object or any other object, however this will be on the basis of our conscious decision.  Without awareness of where our attention is placed, we can easily become distracted without knowing that we are no longer focusing on what we initially intended.  This concept and the related principles to improve our ability to place our attention upon the object we choose is well described by Amishi Jha, PhD in her book, Peak Mind: Find Your Focus, Own Your Attention, Invest 12 Minutes a Day.

Awareness is also a key tool in the management of our physiological states within the polyvagal informed paradigm that has been discussed in previous articles.  In order to ensure that our physiological state is optimized for our current task, as well as to shift our state to a preferred state if needed, it is first necessary to develop the ability to identify our current state.  Without this capability, it is not possible to adjust or maintain our state as needed for the current situation as we will not be aware of our starting point.  We can develop skills and habits to help us modulate our physiological state, however in order to make use of the skills it is first required that we have the ability to recognize our physiological state.  This process can be assisted through identification of the features, specific to us, of each state in conjunction with developing the skill of awareness to be able to rapidly identify our state, on the basis of the previously recognized features. 

From the above applications, it can be appreciated that awareness is a fundamental skill to living a polyvagal informed life and to being able to place our attention on a desired object and redirect our attention as needed when we become distracted.  Given this understanding, the next question becomes how best to develop awareness.  As described above, mindfulness meditation is a strategy that primarily develops the skill of awareness.  In fact, a formal mindfulness practice is arguably the most powerful method to develop the ability of awareness.  This is the primary mechanism by which mindfulness can improve our lives.  It is important to note, however, that this practice is not the only method to develop awareness and, for some people, it may not be an option.

Awareness is a skill that can be developed through any practice in which we acknowledge and identify our internal and external cues and stimuli.  While this certainly can be through formal mindfulness practice, it can also be performed in an informal fashion within the context of any activity.  By simply noting and identifying our internal sensations and external stimuli and doing so without judgement, we are developing the essential skill of awareness.  In fact, even if we have a regular mindfulness practice, it is important to continue the development and application of awareness outside of formal practice through the aforementioned recognition.  In order to fully realize the benefits of mindfulness meditation in our life, it must be applied in our everyday activities.  No matter how accomplished we may be in meditation, if we are not able to apply the skill of awareness outside of our formal practice, it would be reasonable to question the true benefit of our practice.

It is also the case, that it may not be possible for some individuals to participate in a formal mindfulness practice at certain times.  For people who have a history of dorsal vagal shutdown or are frequently experiencing dorsal vagal states, it may not be possible to meditate until an ability to modulate their physiological states is developed.  As the polyvagal informed skills of modifying physiological states are dependent upon an initial awareness of the state, it becomes necessary for these individuals to develop the skill of awareness through the informal practices described above.  Once they are able to do so, meditation may become possible.  The reason for this inability to meditate when there is a history of shutdown or concurrent dorsal vagal states is that a formal meditation practice requires the ability to be quiet and rest within the formal practice, which may resemble an element of a dorsal vagal state.  The nervous system of individuals with a history of shutdown may prevent their body from being able to rest in this state.  In this circumstance, the nervous system is attempting to protect the body from the previously experienced shutdown by effectively not allowing the person to rest in a quiet state.

Another application of a formal mindfulness practice is loving kindness meditation.  This can be briefly described as a practice in which wishes for health, wellbeing, and safety are extended towards oneself and others.  The intention of this practice is to not only state these wishes but to truly feel and intend the wishes.  While this does not primarily train awareness, it provides benefit in training compassion.  From a polyvagal perspective, it is possible that the mechanism through which this is beneficial is the development of a deeper sense of connection to self and others, which is a cue of safety to the nervous system thereby promoting ventral vagal stabilization and related increased compassion.

As can be understood from the above discussion, awareness is a key skill for the development of health, wellbeing, and sustainable high performance from a polyvagal perspective within The Practices of the Healthcare Athlete.  Mindfulness practice may be a powerful method through which to develop awareness, however it is not the only tool and, for some, may not be an option.  Awareness can be trained through informal practices as well.  For these reasons, while mindfulness is an important tool, it is not, in and of itself, the answer to developing health, wellbeing, and sustainable high performance.  As with each of the skills and strategies within The Practices of the Healthcare Athlete, incorporation of a formal mindfulness practice should be considered for each individual and, ultimately, a routine specific to the needs and goals of the individual selected.

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REFERENCE Jha, AP.  Peak Mind: Find Your Focus, Own Your Attention, Invest 12 Minutes a Day.  New York: HarperOne; 2021.

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