Sage Medicine

Mindfulness in Medicine: The Paradox

Mindfulness is often understood as simply being present, in the moment. This involves awareness of the senses, including breath, sound, vision, taste, smell, and all body sensations. This also includes awareness of the mind, observing thoughts and emotions.

Mindfulness can also refer to the state of single-pointed focus, or deeply paying attention to a specific activity. With this understanding, work and daily tasks become meditative experiences.

The practice of mindfulness is not limited to internal awareness, it also accounts for the awareness of one’s external surroundings, noticing one’s physical relationships in space. The term is sometimes even used to mean, being considerate of others. For example, I recently saw a sign in the men’s bathroom of a healing arts center that read, “Please be mindful of the next person, by wiping down the sink after you wash your hands.”

How does all of this relate to medicine? These are all qualities that we hope for in a medical practitioner: being present, deeply focused, aware of surroundings, and considerate of others. However, the undercurrent of all these practices is the concept of non-judgment, experiencing the moment without labeling or establishing value. Experiencing the moment without deciding whether the experience is good or bad, and whether it should change or stay the same. Non-judgment is the more elusive aspect of applying the practice of mindfulness to medicine.

Non-judgment does not simply refer to avoiding judgment of the individual patient based on character, appearance, life choices, etc. Hopefully, this is a given for healthcare providers. The more challenging practice is to not judge symptoms or disease. As medical practitioners, we are trained to assess, label, diagnose and treat. Essentially, our job is to decide which aspects of the patient are unhealthy (bad) and help to restore them to a state of health (good).

Our patients are also deeply invested in this process. The very fact that they are coming to us for treatment indicates they are judging some aspect of their present experience as unpleasant, undesirable, or unhealthy.

Here is the paradox. The practice of mindfulness does not include making judgments of good or bad, healthy or unhealthy. So how do we as practitioners remain in mindful non-judgment, while still supporting the patient in their intention for change and healing? Is mindfulness even helpful in the healing process? Is it necessary? Maybe the answer is simpler than it seems.

To be continued…

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