Every physician I’ve coached this week has shared how much fear and worry they’re living with. An anesthesiologist fearful of COVID-19 exposure in the OR. A radiologist worried after hearing rumors of being deployed to the ICU. An internist with too many at-risk diabetics and COPD patients to safely manage them all. And each also fearful for their children, aging parents, and others. In a time like this, it’s natural for fear to run high. For physicians and for all of us. Our minds can flit from one worry to another, some grounded in reality and many not. We can find ourselves preoccupied with the latest news, worried about what the government will do next, and focusing on what the stock market crash will mean for our retirement.
Many of us are running in sympathetic overdrive—heart racing, breath shallow, body tight. Caught in a fight/flight/freeze response, it’s as if our foot is stuck on the gas pedal. In this state of activation, our ability to manage stress and challenge decreases. We become alarmist, reactive, and irritable, and our ability to cope and execute good decisions erodes. We forget that in this moment we are safe. That in this moment we’re healthy. That right now our loved ones are healthy and safe.
Staying in the present moment provides respite from all the worry and fear. This is not a Pollyanna endeavor; it’s respite grounded in reality. Particularly in difficult times, we need the clarity, focus, and balance that calm provides. It may actually be as essential as hand sanitizer!
There are a number of simple mindfulness-based strategies that can help keep us in the present. Here are three that you can try today.
Stay in the present with a purposeful pause
Intentionally pausing is the simplest yet most underutilized strategy for managing fear and anxiety. Simply pausing and taking three slow, deep breaths has a myriad of benefits. First, it brings you back to the present. And the present is typically a far safer place than the unknown future. In the present, you’re able to breathe, think, and gather yourself to meet the demands you face. In the present you are safe. In the present, fears of a catastrophic future are not the reality.
Second, with a pause, you’re interrupting the cycle of amygdala activation with its cascade of stress hormones. You’ve giving your system a chance to let these biochemicals wash away, removing the high level of distress and alarm. A pause clears your system for a state of calm. Third, pausing and taking three slow deep breaths engages the parasympathetic nervous system. In other words, you’re applying the brakes. Pausing brings almost immediate calm.
Remind yourself what you’re grateful for
In times like this, we can be swept away not only by fear but by a sense that we’ve been dealt a bad hand. That the situation we’re in is unfair. Our minds can be so focused on fear and what’s not going well that it can feel like we have nothing to be grateful for. Yet is that true? Or are there also many things that are going well? Again, this is not about being Pollyanna; it’s about maintaining a reality-based vantage point.
In case you’re struggling to think of things you’re grateful for, here are some options:
Grateful that your health is good right now.
Grateful that you’ve been able to stock up and be prepared.
Grateful that your loved ones are safe.
Grateful that it’s almost springtime so it’s possible to be outdoors in the fresh air.
Grateful that you have a cell phone and can stay in touch with others.
We can have a brief moment of gratitude and then find that our mind has been pulled to fear. The practice of gratitude is very much like meditation. We are reactive and our mind goes to fear and worry. We notice that this has occurred, and we come back to gratitude. Over and over and over, this is what we need to do. There’s no reason to expect ourselves to be perfect or get it right every time. The point is to keep practicing and building the muscle of intentional focus.
Lean into connection
In times like this, the natural impulse is to hunker down. With the need for social distancing, we avoid contact. And fear can also lead us to isolate from others. Maybe if I isolate, I’ll increase my chances of staying healthy. But when we isolate ourselves, it typically simply allows an opportunity for our fears to multiply. Connection is the antithesis of fear. Connection reminds us that we are not alone and that we are truly all in this together. It reminds us that we’re all struggling right now, so it helps put our fears in perspective. All of us are fearful and worried, so maybe I’m actually ok. When I see your smile, I realize that I can smile too. All of us need to remind one another to come back to the present and be grateful for what we have.
The good news is that we all have cell phones and thus there are many ways to stay connected. A video call with a friend. A text to check in on someone who may not have loved ones near. Even a smiley face emoji. In addition, with spring arriving, we can safely be outside with others.
In summary, I hope you’ll try one of the three strategies we’ve examined:
- When your fear temperature is rising, pause and take three slow deep breaths.
- Remind yourself what you’re grateful for.
- Reach out to someone.
Experiencing fear during this time is normal, so you don’t need to berate yourself when it arises. The key is managing it. And that takes practice. Just as important as social distancing, we can all play a role in containing the fear virus. We can all play a role in maintaining much-needed calm.
If you’ve missed any previous posts in our popular Mindfulness In Medicine Series, here’s a list of them for your convenience.
- Managing the difficult co-worker
- Patient satisfaction in healthcare and mindfulness
- Mindful parenting
- Self compassion mindfulness for physicians
- Mindfulness and non-physician healthcare administrators
- The top 10 common myths about meditation
- Doctor stress, overwhelm and physician burnout
- Being present with patients
- Mindfulness leadership for physicians
- How to prevent medical errors causes and physician burnout
- Beat imposter syndrome anxiety symptoms with mindfulness