The Mindful Psychiatrist: Being Present with Suffering

Abstract

In this chapter, the author illustrates how her personal practice of mindfulness meditation facilitated her work as a psychiatrist treating a patient suffering from trauma and severe chronic pain. Mindfulness practice cultivates the capacity to be present with the suffering of one’s patients and oneself with acceptance, patience, and compassion. The author describes how her personal mindfulness practice played an important role in overcoming the helplessness and frustration often inherent in working with complex, challenging patients for whom little can be done within the Western medical paradigm. Faced with such patients, health-care providers may unconsciously react by labeling them as “difficult,” demanding, or unhelpable. They may have difficulty tolerating their own sense of helplessness elicited by these patients; their aversion to these feelings may interfere with the doctor–patient relationship, resulting in a standstill in treatment and progress. The author illustrates several ways in which mindfulness can be integrated into clinical practice. She describes how empathic and compassionate attunement and understanding enabled her to form a therapeutic alliance with the patient, to the benefit of both patient and treatment team. She describes a mindfulness exercise in which one redirects the wandering mind back to the present moment, and how she patiently redirected the patient again and again to the topic at hand. A combination of mindfulness inside and outside the clinical hour resulted in gradual improvement in the patient, and renewed the author’s appreciation of the potential rewards of working with such patients.