Aware: The Science and Practice of Presence

2019 AMWA Alvarez Award

By Dean Celia

One of the best feelings I get as a medical writer is the moment when I turn in an assignment. I'm relieved to have completed it on time, usually proud of the effort, and maybe a little exhausted, especially if I just finished a massive project. I usually allow myself a bit of an indulgence, which might include some pleasurable reading, listening to music while sitting in my favorite chair, or - if I am feeling especially deserving - a drive to Wawa for a cup of their incredible coffee!

Then it's onto the next project. Rinse. Repeat. I am not complaining, mind you. I love medical writing, and I suspect most of you love it as well. But I have to admit that last year while reviewing the meeting program for the 2019 American Medical Writers Association annual meeting in San Diego, I found myself drawn to the "softer" health- and wellness-related talks:

• Can Fitting in Fun Make Us Better Medical Writers?
• Career Burnout: We Didn't Start the Fire...or Did We?
• The ABCs of Stress Management
• It's YOUR Time: A Nonjudgmental Approach to Time Management
• Dealing with Life and Stress Using Emotional Granularity

There were other sessions in this vein as well. Many more, in fact, than were included in the 2018 meeting. Moreover, these sessions were well attended, leading me to conclude that just because we love what we do, that does not mean that we aren't looking for more.

More of what exactly? That's a question we have to answer individually. For me, it's maintaining the feeling of satisfaction that I get after turning in an assignment-even after I am knee-deep into the next job. Less stressed. More satisfied about the meaning of my work. Better connected to my existence beyond medical writing. But how on earth do I even begin to try to get there? 

Daniel J. Siegel, MD, says he has the answer, and it involves guided meditation. The clinical professor of psychiatry at the UCLA School of Medicine and Executive Director of the Mindsight Institute has extensively explored the power of the mind to integrate the brain and promote well-being. He delivered the 2019 Alvarez Award Address entitled, "Aware: The Science and Practice of Presence."

"There's No Time for Tears!"

Dr Siegel's interest in this area was forged by an experience he had in medical school. One day while attending rounds he learned that one of his patients had died. "My resident came to get me and we went and sat with the nurse who had helped care for him, and we cried. Later on the attending physician asked me why I left rounds." After hearing Dr Siegel's explanation, this physician, the chief of oncology at Harvard Medical School, said, "There's no time for tears!"

"So, for the next 6 weeks of this very important rotation," explained Dr Siegel, "my emotional life disappeared from my awareness. I learned how to be a robot like him. I received the highest mark in the rotation, which was useful for my resume and horrible for my psyche."

 Dr Siegel was mortified by the realization that the medical profession was largely built on the idea that a person should not be aware of their internal world of subjective experience, including emotion and meaning. He couldn't help but think this led to faster burnout, depression, anxiety, and suicidal tendencies. Over time, research confirmed his suspicions. 

"We have a serious problem," he said. "Not only is it bad for physicians, but think about how bad it is for their patients."

Out of this concern, the Mindsight Institute was born. According to the organization's website, the educational center uses a scientific approach to the mind and well-being to promote "insight, compassion, and empathy" to "nurture a kinder society." Dr Siegel's approach involves guided meditation that employs a "Wheel of Awareness" (see accompanying graphic). The hub of the wheel represents our awareness. At the outer rim are four quadrants comprising the things we can be aware of, including:

• the five senses
• bodily sensations
• mental activities
• interconnection with others

Connect to Your Inner Awareness

Dr Siegel found that individuals who regularly and purposefully connected their inner awareness with the senses that exist at the outer rim of the wheel experienced reduced anxiety and lower levels of mild to moderate depression. Moreover, issues related to their unresolved trauma were more easily resolved. "If you start doing this on a regular basis, like brushing your teeth, you will reduce stress, enhance immune function, and improve your cardiovascular risk factors." The cumulative effect, he noted, will be a slowing of the aging process. Medical writers are naturally skeptical. Dr. Siegel said his findings are based on work with more than 10,000 individuals. References backing up his work can be found here.

If nothing else, explained Dr Siegel, employing guided meditation using the Wheel of Awareness will

• strengthen your capacity to focus attention
• open your awareness
• build kind attention

Dr Siegel takes you through his guided meditation approach here. The key is repetition: "The wheel is just one example of many forms of guided meditation. Whatever you decide to do, make a daily practice of it."

Dean Celia is a medical editor, writer, and product developer with specific expertise in CME publishing. He is based in Downingtown, PA. For more articles like this, visit https://www.amwa-dvc.org/