Teaching mindfulness at Harvard Medical School

When I first arrived at Harvard Med as a student, I was quite intimidated… and even more so when I returned as a faculty member!  So many emotions – wanting to do a good job, remembering what it was like when I was a student, a certain level of “imposter syndrome” regarding my own capacities.  Of course, these are all emotions that I identify as associated with my ego, or my historical sense of self in time.  It is very different from the sense of universal inspiration, from that sense of love, joy and bliss that inspires these pages!

It is not that I am two different people – sharing here versus teaching there – but that my capacity to live in the spontaneous bliss that arises in meditation varies in part depending on environmental triggers.  That sense of “fight or flight” – jitteriness, wobbly legs, anxiety – is much heightened when in front of a classroom full of a skeptical audience.  Fortunately, with more experience and also through intentionally breathing and using the imagery practices of the Fern Hill Center (which I developed but continue to learn from), I have learned how to more easily relax into the teaching role.

My students at Harvard Med come from very diverse backgrounds.  From these, the perceptions of meditation and relaxation skills vary.  The ability to learn the techniques also varies – including being able to learn simple diaphragmatic breathing.  For some, it arouses tension that breathing exercises have always left them with – a sense of unease or anxiety that is perhaps related to trauma, or perhaps an aspect of their character and how their own “fight or flight” system is wired.  For others, the techniques seem to make no difference – at least immediately.  For others, they can truly relax into the techniques and gain a tremendous amount in a short period of time.

While it is understandable that some might have different responses, I believe this also points for a need for us to better understand how to teach beginners mindfulness techniques.  Our best research literature shows that some people naturally respond better to others to mindfulness.  There is no one size fits all.  Yet for those who are able to do them, the benefits are vast.  The next step, in my view, is to innovate in the medical education setting by identifying those for whom mindfulness training has not been immediately successful, and to provide them with different kinds of relaxation skills learning – perhaps technology augmented – to see what appears to make the most difference for them.

Because burnout in the profession of medicine is increasing, and doctors are at even higher risk than the general population of committing suicide, figuring out how to best teach these techniques to boost resilience and coping skills to future physicians is critically important.  My friends in the profession would note that changing the systems that cause physician burnout are also pressing – and I believe that as well.  In my view, they are the two wings that will enable physicians not only to experience job satisfaction, but to thrive – and even to know bliss.