Stressing the Importance Managing Stress

How mindfulness makes a difference

“We used to think that whatever happens to the brain was immutable, that it was written in stone, that it couldn’t be changed.”

The World Health Organization has labelled stress the Health Epidemic of the 21st Century. Through mindfulness-based interventions and scientific research, Dr. Michael McIntyre and his colleagues are looking to fight the epidemic.

Their work is already making a difference in Manitoba and it is advancing the global dialogue about the role of mindfulness in health care. “Mindfulness,” says Dr. McIntyre, “really involves the capacity to take your mind where you want it to be in the present moment.” While it has deep roots in eastern philosophies, mindfulness made its way into mainstream discourse in the late 1970s when Jon Kabat-Zinn founded the mindfulness-based stress reduction (MBSR) program at the University of Massachusetts to offer treatment to chronically ill patients. It is a practice that involves meditation, self-awareness, self-compassion, and the ability to focus and calm the mind.

Through the Catholic Health Corporation of Manitoba’s (CHCM) “Compassion Project,” Dr. McIntyre and his colleagues are offering mindfulness training and programs to staff and volunteers of organizations governed and sponsored by the Corporation, including St. Boniface Hospital. They are closely monitoring the results of the work to understand potential impact of mindfulness on health care.

“There was already a large research base on mindfulness-based interventions,” explains Dr. McIntyre. “It showed reductions in stress levels and burnout. It showed changes in brain anatomy. It also showed changes in immune efficiency, among other things.”

Dr. McIntyre and his colleagues started to wonder what the potential impact of mindfulness could be on health care workers – people who typically endure higher stress levels and higher levels of burnout than the general population. When stress is high and employees are on the verge of burnout, patient care could be compromised. Mindfulness could help address the challenge.

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“What are the benefits that accrue to the workers themselves, to their families, to their coworkers, and to their patients? What happens with leaders? Can we reduce the stress level to the level that we see in the general population? The answer to that has been sometimes yes and sometimes no,” says Dr. McIntyre.

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For example, with health care leaders – like CEOs and Unit Managers – they are finding that stress can be reduced through mindfulness programs, but not yet to a level similar to the general population and not yet to a level where employees of these leaders would likely be able to feel the changes. So, less stress, but not yet low stress. The work and research in this area continue.

“As you can imagine, in a rigorous scientific community, mindfulness meditation and compassion cultivation are outliers,” says Dr. McIntyre in recognition of the novelty of his work. That said, he is finding growing acceptance for the work and growing curiosity from his colleagues at St. Boniface Hospital and among the CHCM agencies (known as communities of service). The use of biologically based data has been of central importance in the growing acceptance.

In fact, at the time of writing, Dr. McIntyre and Dr. Bram Ramjiawan, Director of Research for the Asper Clinical Research Institute at St. Boniface Hospital, are advancing the idea of using “mindful self-compassion” with cardiac patients to promote healing. “And at St.Amant, we offer mindful self-compassion courses to parents with deeply autistic children and children with pervasive developmental disability. At times, these parents endure the agonizing task of deciding that their child can’t be cared for within the home context. The support we offer is quite transformative for this particular group.”

Dr. McIntyre also points to earlier work about the relationship between stress and the immune system. Mindfulness pioneer Jon Kabat-Zinn and a colleague, Richard Davidson from the University of Wisconsin, put people through a mindfulness-based stress reduction course. Those people got flu shots along with a group of people who did not yet take the course. “People who went through a mindfulness course were much more immune efficient,” explains Dr. McIntyre. “There is good evidence that physical health improves as a consequence of stress reduction. Of course, when you’re physically healthy, you’re less depleted and better able to react to the stressors that will inevitably exist in your life.”

Dr. McIntyre and company are adding to that growing body of evidence through their work on the Compassion Project – through the programs they offer to health care workers and through analysis of both physiological and subjective responses and their correlation.

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“We used to think that whatever happens to the brain was immutable, that it was written in stone, that it couldn’t be changed,” he says. “One of the most exciting things that has occurred in the last 20 years is the recognition of how plastic the brain is. Neuroplasticity is an important topic. It’s central to the research that Dr. Jennifer Kornelsen and I are doing. She’s a professor in Radiology at Health Sciences Centre and an affiliated scientist with the St. Boniface Hospital Albrechtsen Research Centre. We’re looking at the brain changes that occur as a consequence of the exact programs that we offer and the exact groups that are employed here.”

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Above all, as we learn more about mindfulness techniques and strategies and gain an even better understanding of their impact, we can envision better lives for health care workers and leaders, and better outcomes for patients.

“We think that the capacity for mindfulness is huge. A lot of people are fond of using the label ‘alternative medicine’. I prefer to use the term ‘complementary medicine’ because I think it potentiates traditional medicine,” says Dr. McIntyre. The practice of mindfulness helps caregivers focus more keenly on the needs of patients as individuals. “Patients tell us again, and again, and again that their confidence goes up when they feel that people have paid attention to them.”

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