"The Practice of Mindfulness: Being Present in this Moment" by Aneela Cox, MD - Integrative Family Medicine of Asheville

“Mindfulness helps you go home to the present.” – Thich Nhat Hanh 

While there are formal courses in mindfulness, it is a moment-to-moment practice. Even the awareness of when we are not mindful allows us to come back to the present moment. This practice invites constant attention and a gentle guiding back “home to the present.” 

My journey with meditation and mindfulness began with a Mindfulness Based Stress Reduction (MBSR) course offered in medical school. MBSR has both a formal practice (seated meditation, body scan, yoga, etc.) and an informal practice (awareness while brushing teeth, mindful eating, etc). After the 8-week course, I connected through the yoga community with my current mindfulness teacher who graciously offered to mentor me in this practice. 

Over the years, my meditation practice has evolved. Some days I practiced only a few minutes while working 80-hour work weeks in residency while other days I practiced for 30-40 minutes. Even now, some days I am very in tune with the present moment while other times I have to be reminded by my loved ones to be present. 

How do I apply mindfulness in my life? My mindfulness teacher says, “practicing in a low stakes environment allows us to show up for high stake situations.” In medical residency training, I experienced many high-stake situations, i.e. critically ill patients that needed emergent attention or a laboring mom who needed an emergent c-section. Because I had cultivated a practice over the years, my mindfulness—attention to the present moment—would show up so that I could respond in a meaningful way. Sometimes, it was a matter of recognizing difficult moments, which showed up in physical, mental and emotional cues. For me, those difficult moments looked like irritability or impulsivity (I like to get things done) or physically as migraines or abdominal pain. By allowing myself to be present, I was able to bring in self-compassion when moments of vulnerability arose.  At one point in my medical training, awareness of the present moment helped me recognize that I needed more sleep!

From a research standpoint, there are many studies regarding mindfulness based interventions like MBSR or Mindfulness Based Cognitive Therapy (MBCT). Studies show changes in areas of the brain—hippocampus (memory), prefrontal cortex (decision making), and amygdala (emotional center)—with eight weeks of practice. Other studies show improvement in depression and anxiety through pre and post survey analysis. Demonstrated results also show that the 8-week course is equivalent to medication management in patients with depression and compared to cognitive behavioral therapy. It is an incredibly potent practice that connects us to ourselves at a deeper level. 

My teacher, Maria, says to “show up for what is showing up.” It is this constant reminder to get in touch with the present moment no matter how difficult it may seem that can anchor a mindfulness practice. My offering to you is to be present…to show up right here and right now.  I invite you to check in with yourself: What physical sensations are you noticing? Emotions? Thoughts? Observe your surroundings, any smells in the air, the sensation of clothes against your skin and the earth beneath your feet. Then, when it is available to you, take an activity (i.e. eating a meal, jogging, driving to work) and show up with awareness in that activity. 

Thich Nhat Hanh said “mindfulness helps you go home to the present.” For me, it is an opportunity to pause, reflect and then act. My journey with mindfulness is an on-going process that unfolds through its practice. And it is readily available every moment!

Bibliography:

Khoury B, Lecomte T, Fortin G, et al. Mindfulness-based therapy: a comprehensive meta-analysis. Clin Psychol Rev. 2013;33(6):763–771.
Rinske et al. 8-week Mindfulness Based Stress Reduction induces brain changes similar to traditional long-term meditation practice. Brain and Cognition. 2016; 108: 32-41.
Strauss C, Cavanagh K, Oliver A, Pettman D. Mindfulness-based interventions for people diagnosed with a current episode of an anxiety or depressive disorder: a meta-analysis of randomized controlled trials. PLoS One. 2014;9(4):e96110.