After 30 years of conducting hundreds of assertiveness training workshops with nurses across the country, the relationship between thinking and feeling-the yin and yang of behavior-continues to fascinate me. Yin-yang is a useful model for examining the thinking and feeling dynamics, because it asserts the importance of balance and integration of thinking and feeling in producing healthy behavior and positive communication outcomes.
I recall working with a nurse who experienced great anxiety in telephone communications with managers and physicians. If she could not provide what she considered the "correct response," immediately during the phone call, she would break into a sweat, hyperventilate, and occasionally hang up. Her feelings seemed to completely obliterate any thinking processes that she might employ to appropriately get through the call. Once she learned how to focus on thinking about feeling and use simple relaxation techniques to control the anxiety, the nurse gained confidence and was able to handle difficult phone calls with success after a period of time.
This issue of Holistic Nursing Practice begins a series of 3 articles on Mindfulness-based Stress Reduction (MBSR), a program used successfully with hospital-based nurses. The literature illustrates that nursing and MBSR share some core values, and, more importantly, that MBSR might offer nurses tremendous help in dealing with stress and the emotional exhaustion, cynicism, and lack of a sense of accomplishment that accompany burnout.
Mindfulness is reminiscent of the Buddhist tradition of introspection and living in the moment. It is a way of training the mind to experience the body and its responses to the environment fully and without judgment. It also involves slowing the pace of thinking and feeling so that we can either delay responding or make more effective responses, particularly in pressured situations. I like to think of mindfulness as a form of calm detachment in which I observe my own and others' behavior in situations that are much like what a Martian scientist might encounter during a visit to this planet.
Neuroscientists are becoming much more interested in the introspective techniques used in the Tibetan tradition. In a recent meeting at the Massachusetts Institute of Technology, Western neuroscientists met with Buddhist monks to discuss the dynamics of attention, mental imagery, and emotion. They also shed new perspective on meditation as not only a form of relaxation, but also a "rigorous system of mind training and observation of mental processes"1 that could lead to the control of certain bodily processes such as blood pressure, anxiety responses, and other forms of brain activity that have beneficial health implications.
Intently focusing on the mind's activity and consciously slowing the pace of thoughts while simultaneously observing the body's responses to situations in the environment is the beginning of mindfulness. Becoming more introspective and less reactive might go a long way in preserving a nurse's health and in engendering a calmer, more focused environment in which to deliver high-quality patient care.
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