Mindfulness Mindful medical practice MUDr. Rastislav Šumec, Ph.D. Department of Psychology and Psychosomatics, 2019 „Brain‘s Dark Energy“ ̶ Task – surprisingly ↓ energy (E) -10 0 0 + 10 Deactivation during task Activation during task Raichle 2006 ̶ „Doing nothing“ – 20x more E ̶ => brain seems to use most of its energy for functions irrelevant to the task at hand ̶ Regions active during this proces => Default Mode Network (DMN) A wandering mind is an unhappy mind ̶ „Mind-wandering“ Killingsworth et Gilbert 2010 ̶ Mind wanders 47% of time ̶ Associated with unhappiness ̶ => Ability to think about what is not happening comes at an emotional cost Andrews-Hanna et al. 2014 (Not) living in a present moment Doing vs. Being Mode of Mind 1. Automatic pilot VS conscious awareness 2. Experiencing through thoughts VS directly through senses 3. Dwelling in past/future VS being in present moment 4. Needing to avoid unpleasant VS approaching it with interest 5. Needing things to be different VS allowing things to be just as they are 6. Seeing thoughts as true VS as mental events 7. Prioritizing goal attainment VS sensitivity to wider needs Teasdale et al. 2014 - The Mindful Way Workbook Doing Mode Being Mode? Mindfulness ̶ A way of cultivating the being mode ̶ Ability to be aware of what is going on in and out of ourselves, non-judgementally and without an impulsive need to change it ̶ Mental training Teasdale et al. 2014 - The Mindful Way Workbook Neuroscience of mindfulness Tang et al. 2015 1. Attention control 2. Self-awareness 3. Emotion regulation Mindfulness in health care Mindful practice Quality of caring Clinician resilience Quality of care • Safe • Up-to-date • Effective • Accessible • ↑ emotional stability • ↑ mood • ↑ empathy (Dean 2007) • ↑ interest in pacient (Fernando 2017) • ↑ conscientiousness (Krasner 2009) Epstein 2017 – Attending: Medicine, Mindfulness, Humanity • ↓ burnout • ↓ depression • ↓ anxiety (Lomas 2018, Krasner 2009) • ↓ medical mistakes due mind-wandering (Berner 2011, Hilton 2011) • ↑ working memory (Lao 2016) • ↑ learning (Ramsburg 2014) 4. Presence • Full engagement • Patient as a human being • ↓ auto-pilot 3. Beginner‘s mind “In the beginner’s mind the possibilities are many, in the expert’s mind they are few” (Suzuki, 2011) 2. Curiosity • ↑ interest in patient • ↓ over-investigation, inefficient time-management, poor clinical thinking 1. Attentive observation • Ability to recognize: • cognitive bias, mistakes, emotional reactions, distractions, auto-pilot 4 mindful habits of mind Mindful medical practice Epstein 2017 20 min – Body scan 10 min – Meditace v sedě3 min – Návrat k dechu Best rated mindfulness-based application (Mani et al. 2015) Mark Williams, Danny Penman John Kabat-Zinn Applications a books John Teasdale, Mark Williams, Zindel Segal Mindfulness-Based Cognitive Therapy Oxford MBCT: https://mbctapp.oxfordmindfulness.org/ Thank you for your attention