Mindfulness, In Miniature

As they care for the sickest of coronavirus patients, hundreds if not thousands of U.S. medical workers have contracted the resulting COVID-19 disease themselves.

“They are literally putting their own lives at risk,” says Santa Clara University Professor Shauna Shapiro, a clinical psychologist and internationally recognized expert in mindfulness and self-compassion.

And on top of confronting the possibility of catching a highly contagious, potentially lethal virus, healthcare professionals are also facing a sky-high stack of other profoundly distressing issues.

For example, Shapiro says, “relatively soon, they may be making decisions they have never had to make before, such as choosing which patients get resources, and which do not.” It’s the kind of ethical dilemma doctors in Italy have recently faced as they prioritize who receives quick treatment in their overburdened hospital system.

More than ever, Shapiro and other mental health experts agree frontline medical responders must force themselves to step back from the exhausting battle and pay attention to what is going on inside their heads.

New research in the Journal of the American Medical Association Network points to the mental toll coronavirus has taken on health care providers in China. “A considerable portion” of 1,257 health care workers involved in the study who had been exposed to the virus in COVID-19 fever clinics or wards in 34 Chinese hospitals reported high rates of depression and anxiety.

That is why practicing mindfulness—even for only a few minutes a day—is crucial for first-responders. “When we get stressed, we become disconnected from our prefrontal cortex. We go into a fight-or-flight response,” says Shapiro. “Mindfulness brings us back into a state of calm. It regulates our nervous system, and we can see things more clearly, and make wise choices.”

Three-minute Pick-Me-Up

In the midst of the pandemic, Shapiro has volunteered her time with Sausalito-based VectorCare, a medical transportation and logistics company, to create a free Smartphone app featuring a series of bite-sized mindfulness videos aimed at healthcare workers. For now, they can be accessed on her Instagram account @drshaunashapiro.

Two of the meditations debuted last week, and Shapiro is sharing them with the SCU alumni, faculty, staff, and students, who are also working through their own trauma.

In the videos which run just under three minutes, Shapiro welcomes viewers to her softly-lit, monochromatic bedroom, where she is seated on the floor. (Quarantined at home with her husband and their four children, she says she does not have much space to retreat for quiet meditation, except in the bedroom.)

With a gentle, relaxing voice, Shapiro asks viewers to close their eyes, soften their jaws, and notice their breathing. She suggests they place one hand over their heart, something she calls “a gesture of self-care,” while calmly telling themselves they are not alone, and that “we are all in this together.”

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A post shared by Dr. Shauna Shapiro (@drshaunashapiro) on Apr 8, 2020 at 12:32pm PDT

For healthcare workers, Shapiro says each meditation has two goals: prepare first-responders to be in difficult situations, and remind them to maintain an attitude of kindness and compassion—not just towards their patients, but themselves. “They’re in incredibly difficult situations, and to even pause for a moment to allow themselves to say, ‘This is hard, and scary, and I’m afraid,’ is important,” says Shapiro.

Practicing kindness and compassion bathes us in oxytocin, often called the “feel-good” hormone, and dopamine, which activates our brain’s motivation center, and “nourishes us and also prepares us for the difficult task at hand.”

That dilemma speaks directly to what she is teaching her graduate students in SCU’s Marriage and Family Therapy class about how to learn to take care of yourself while taking care of others.

Keeping Burnout at Bay

“When we are completely consumed by stress, it limits our capacity to see and respond,” says Shapiro. “This is why learning to ‘pendulate’ from the negative to the positive is essential.”

Shapiro has spent more than two decades studying the clinical applications of mindfulness meditation in psychotherapy and healthcare. Her research involving physicians and nurses shows mindfulness training can prevent burnout, depression, and anxiety. Dozens of medical schools now have incorporated such training into their curriculum.

In addition to writing more than 150 papers, she has published are three books, including The Art and Science of Mindfulness: Integrating Mindfulness into Psychology and the Helping Professions, which describes neuroscience research about mindfulness and how it inspires greater well-being in clinicians and their patients.

If there is one thing Shapiro believes we can all learn from the pandemic, it is that “we are remembering what is truly important now.” She quotes former Disney executive turned life coach Dave Hollis who recently advised: “In the rush to return to normal, use this time to consider which parts of normal are worth rushing back to.”

The virus, Shapiro says, has forced us to think about what matters most, from families and loved ones to slowing down, taking time to listen deeply. And then asking ourselves: “How do we want to live our best lives going forward?”