The best way to capture moments is to pay attention. This is how we cultivate mindfulness. Mindfulness means being awake. It means knowing what you are doing.
—Jon Kabat‐Zinn, mindfulness teacher, professor, author, and creator of the Mindfulness‐Based Stress Reduction programme
Defined as paying attention to the present moment, with non‐judgment, mindfulness is our ability to know what is in our heads at any given moment, without getting lost in the story of our thoughts. Our mind is constant chatter of anxious thoughts about the future or thoughts ruminating about the past. Mindfulness allows us to react with our emotions and thoughts with kindness, equanimity, and intelligence, so we aren’t jerked around by those emotions and thoughts. This powerful tool also helps us hone all three components of emotional intelligence: self‐awareness, emotional regulation, and fostering positive emotions.
To be a mindful dental professional means consciously cultivating the nine attitudes of mindfulness: non‐judging, gratitude, patience, a beginner’s mind, trust, non‐striving, acceptance, letting go, and generosity (Kabat‐Zinn 1990). And just like any muscle of the body, mindfulness can be trained and strengthened, and no matter what your starting point is, you can become more mindful tomorrow. In this chapter, we explore in depth how in dentistry we can infuse mindfulness at work and outside the clinic, reaping benefits for ourselves, the dental team, and our patients and have downstream impacts on all of our wider relationships.
The experience of being on a rollercoaster is very different to observing a rollercoaster from a distance; similarly, mindfulness can give us distance to zoom out and gain perspective. Our minds are a constant chatter of thoughts of the past or future. When we are in the role of mindful observer, we have space to choose our words and actions rather than being reactive. We can step off the rollercoaster. We start noticing the beautiful details of our lives. Far from just a pain reliever, mindfulness is at its core an awakening of the senses. It is moving from autopilot mode, where we are doing things mindlessly, to being fully engaged with our reality.
Since anxiety and negative emotions are uncomfortable, we may have developed strategies to keep anxiety at bay. We try to control our emotions by resisting the negative emotions. This could be through the following strategies:
- Bottling worries: This takes a great deal of effort and can be very draining. It also brings an additional worry – that you will not be able to keep your emotions in.
- Distracting yourself: This prolongs the underlying problem and also may lead to other unhelpful coping strategies, such as excessive drinking, comfort eating, or scrolling on social media for prolonged periods of time.
- Toxic positivity: This is a belief that no matter how difficult the situation is, you should maintain a positive mindset. Toxic positivity can make people feel under pressure to pretend to be happy even if they are struggling. This is a harmful strategy, as it can lead to ignoring serious problems, a sense of isolation or stigma, and low self‐esteem.
However, none of these strategies are likely to succeed, because when we avoid feeling and processing our emotions, those emotions amplify and may cause us to feel disconnected from ourselves or implode at unexpected times. Mindfulness involves acceptance rather than control.
A Self‐Awareness Exercise: What’s My Internal Weather?
In many ways, our emotions are like the weather. Clouds float away and rain stops. The weather does not stay the same forever. Similarly, our emotions and thoughts come and go. Are you feeling great, like a clear sunny day? Or grumpy, like a sky full of black clouds? Thinking of our emotions and thoughts in this way can help us gain a little objectivity and stay with them longer, rather than pushing them away. When we better understand our inner world, we can engage with it with greater curiosity and confidence. We can say to ourselves; ‘I’m just feeling stormy, today. I’ll feel better soon’.
Myth versus Fact
There are numerous myths around mindfulness that can be obstacles to us engaging with this practice. Following are the four most common myths I find when teaching mindfulness to dental professionals.
Myth 1: Mindfulness Is a Religious Practice
Although mindfulness gets its roots from several religions, namely Buddhism, mindfulness is in fact a secular practice that involves no religious chanting. It was brought over by American professor Jon Kabat‐Zinn in 1979 as a way to help a very stressed population. He was inspired to formulate the Mindfulness‐Based Stress Reduction programme after attending a talk by author Philip Kapleau, which introduced Kabat‐Zinn to the concepts of mindfulness. Mindfulness focuses on breathing as a way of paying attention to the present moment.
Myth 2: Mindfulness Involves Not Having Thoughts
A common misconception of mindfulness is that this practice involves getting rid of thoughts. This is simply not possible, as our brains have a natural tendency to wander, and far from the practice of mindfulness. The mindfulness process involves paying attention to our breath, noticing our mind wander, and gently nudging our attention back to the breath with kind compassion.
Myth 3: Mindfulness Is the Same as Meditation
Mindfulness incorporates a wide range of activities, from meditations to mindful eating, mindful listening, and mindful movement. We can also apply mindfulness to every aspect of our lives, such as when we are with our patients, in a queue or driving to work, or brushing our teeth. With mindfulness, we are asking ourselves to pay attention to the present moment. Meditation, on the other hand, involves sitting down, often closing our eyes, and focusing our full attention inwards.
Myth 4: Mindfulness Can Only Be Practised in a Quiet Space
The wonderful aspect of mindfulness, specifically for busy dental professionals, is that it can be practised throughout our day, whatever the noise levels are, through integrating micro‐moments of mindfulness. This could be, for example, when we are drinking a cup of tea in the morning and taking three mindful breaths. Alternatively, it could be when we are at work, listening mindfully to our patients. We can also integrate mindfulness meditations, but this does not necessarily mean we need a quiet space to commit to it.
A Superpower in Dentistry
Practising mindfulness as dental professionals allows us to create space in our minds for joy, relaxation, peace, inspiration, ideas, creativity, and confidence to thrive in the workplace and outside. We can think of mindfulness as a tool to help us pay attention, with kindness, to the here and now. It can give us a whole novel approach to life that actively invites more positive emotions: self‐compassion, gratitude, curiosity, and acceptance.
There are numerous psychological, physical, and psychosocial benefits of practising mindfulness reported in the literature. These include an increase in positive well‐being states; for example, life satisfaction, engagement with health‐related behaviours, better sleep, improved thinking and memory, and a reduction in negative well‐being states, such as burnout and compassion fatigue. Mindfulness also helps our interpersonal relationships by nurturing our listening skills and our ability to empathise with our patients and loved ones.
Looking back at Chapter 1, and thinking about the mental health continuum, mindfulness is a protective factor that can boost our resilience levels and our mental well‐being.
Neuroscience of Mindfulness
Neuroscience research has also caught up with the increasing belief that mindfulness is beneficial. These studies validate over and over that mindfulness indeed can change the brain structure in positive ways.
Let us hone into the specific changes the brain makes in response to mindfulness practice:
- Amygdala: Mindfulness may reduce the grey matter of our amygdala. The functional connections between the amygdala and pre‐frontal cortex are also strengthened. This allows for less reactivity when it comes to our stress triggers.
- Hippocampus: Mindfulness improves the work of the hippocampus, our ‘librarian’, which strengthens our recall and storage for memories and important information.
- Pre‐frontal cortex: The grey matter of this region of the brain can increase with mindfulness practice (Gotink et al. 2016). This results in enhancing our executive function abilities, such as memory, attention, planning, and problem solving.
- Default mode network (DMN): Decreased activation of the DMN is associated with excessive worrying and commonly found in depression or anxiety. Mindfulness switches on the alternative brain network, known as the task positive network. It is associated with ‘flow state’, and much of the time, we are happier when we are using this network.
- Anterior cingulate cortex: Increased grey matter changes in this region allow for more thinking flexibility.
Clough and colleagues reported that relaxation modalities, such as mindfulness‐based interventions (MBIs), reduced physician stress, burnout, psychological distress, and self‐compassion (Clough et al. 2017; Krasner et al. 2009; Ospina‐Kammerer and Figley 2003; Shapiro et al. 1998). MBIs may help clinicians by fostering attitudes of acceptance, compassion, and non‐judgment in addition to a new relationship with difficult emotions at work, such as observing anxiety without interaction during a stressful procedure.
Managing Our Energy and Emotions
The circumplex model of emotions (see Figure 6.1) (Russell 1980) describes different zones we experience, along an axis of high or low energy and negative or positive emotions. Understanding which zone we are currently in by regular mindful check‐ins can help us better take care of our mental well‐being by thinking of steps, if needed, that can shift us towards the recovery zone.
Survival zone: This is characterised by negative emotions and high energy. This zone is where many of us may find ourselves spending a lot of time, trying to meet the demands of patients and our personal lives.
Burnout zone: The burnout zone is characterised by low energy and negative emotions. Dental professionals early on in their careers may be at increased susceptibility to depersonalisation and work–life conflicts (see Chapter 1 for an in‐depth look at burnout).
Recovery zone: This is characterised by low energy and positive emotions. Without recharging and carving out time for self‐care, it is very difficult to reach the performance or thriving zone, where many leaders find they do their optimal work.
Performance zone: The performance zone is characterised by high energy and positive emotions. The performance zone, otherwise known as the thriving zone, is a zone where we feel engaged, connected, optimistic, and challenged but not to the point of being burnt out. This is often the zone where we are personally motivated to do great work and enjoy the process of doing so.