The Daily Dose • Wednesday, May 12, 2021

Weathering the Storm: Mindfulness and Wellness in Academic Anesthesia

Allison M. Janda, MD

This past year has brought additional stress to everyone and the experience of this year was described as “being caught in the storm” by Heather Poupore-King, PhD, the presenter of the session, Creating Mindfulness and Wellness in Academic Anesthesia, held during the IARS, AUA, SOCCA and eSAS 2021 Scholars’ Program on May 8. The ambiguity, confusion, uncertainty, and unpredictability in these novel times adds to the stress we experience on a standard workday and elicits additional emotions as we cope with these challenging times, according to Dr. Poupore-King. Introduced by her colleague, Vivianne Tawfik, MD, PhD, Dr. Poupore-King presented on mindfulness and wellness in academic anesthesia.

Dr. Poupore-King is an Associate Professor of Anesthesiology and Perioperative Pain Medicine at Stanford University, serves as the Director of the Pain Psychology Fellowship and runs the Medical Fellowship and Wellness Program at Stanford University. In her clinical roles, she specializes in the development of novel interdisciplinary treatments, such as cognitive behavioral therapy and acceptance and commitment therapy and spoke during this session about mindfulness and wellness in academic anesthesia in the context of additional stressors inflicted by the COVID-19 pandemic.

During her presentation, she explained how emotions are experienced can also be challenging, with guilt, irritability, anger, sadness, hopelessness, helplessness, fear, worry, anxiety, loneliness, and restlessness permeating our minds, and described how all of these emotions can accumulate in the “worry chain” as the stressful situation continues. While some anxiety or worry can be helpful for motivation to meet deadlines, for example, excessive worry can cause feelings of demoralization, upset, exhaustion and can get in the way of job performance. To address the potential negative consequences of excess worry or stress, Dr. Poupore-King shared techniques, skills and resources that can be applied in any stressful scenario. As burnout and stress can cause intense cognitive symptoms, emotional symptoms, physical symptoms (aches and pains, diarrhea/constipation, nausea/dizziness, chest pain, loss of sex drive, frequent colds/flu), and behavioral symptoms (eating more/less, sleep changes, drugs/alcohol, nervous habits), it is incredibly important to focus on mind-body health and a personal wellness plan to help counter this stress.

Dr. Poupore-King discussed the components of a personal wellness plan: nutrition, sleep, exercise, and mind-body health. She focused on mind-body health and provided the following tips to help improve it. The first tip she shared was to make a list of items that are, “under our control” and a separate list for items, “not under our control.” She explained how wasting a lot of time ruminating on items that are not under our control can be detrimental to our mental health. To manage things not under our control, trying to suppress, ignore or deny something can become part of the problem and perpetuate a cycle of frustration and defeat. Instead, she recommended acknowledging what is not under our control, and addressing the actionable items that are under our control. She explained that if we aren’t chasing an item not under our control, it is less likely to emotionally hijack us.

Her second tip was to “drop an anchor,” or in other words, to focus on the present instead of worrying about past or future events. She then led the group in a grounding exercise during which we focused on our breath since it connects to the present moment. She provided the image of chocolate ice cream and challenged participants to not think about chocolate ice cream while focusing on breathing, illustrating how difficult it is to stay in the present moment. She also emphasized that, when it’s hard to grant ourselves the compassion to acknowledge that we are doing our best despite challenging circumstances, think of telling this to a loved one and imagine what we would say to them. If we can give compassion to others, we can cultivate this for ourselves.

The third tip Dr. Poupore-King suggested was to create connection. She explained the concept of “conspiracy of silence,” meaning, if the room is quiet, we are inclined to think that everyone else has it all figured out, which is not always true. This belief can be detrimental. Instead of sitting in silence, we should cultivate professional relationships. She discussed how it is extremely important to create a safe space so we can show up in a genuine and authentic way to get support and effective mentorship. She also suggested returning to the foundational aspects which first drew us to medicine on particularly challenging days.

Dr. Poupore-King closed her talk by emphasizing focusing on finding peace in the storm and, although we have no control over the storm, we do have control over finding peace with the uncontrollable. She also shared a variety of mindfulness and self-compassion resources including, applications Headspace, Calm and InsightTimer, as well as websites: https://self-compassion.org, https://chrisgermer.com/meditations/, https://www.tarabrach.com/rain/, and https://nam.edu/coronavirus-resources/.

Encourage, stimulate, and fund ongoing anesthesia-related research projects that will enhance and advance the specialty, and to disseminate current, state-of-the-art, basic and clinical research data in all areas of clinical anesthesia, including perioperative medicine, critical care, and pain management. The IARS is focused solely on the advancement and support of education and scientific research related to anesthesiology.

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This award is intended to support investigations that will further the understanding of clinical practice in anesthesiology and related sciences. Up to four research projects are selected annually, with a maximum award of $175,000 each, payable over two years.

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