Physician Wellness, Episode 2: Mindfulness

January 25, 2024

In this episode, host Tony Passalacqua and guests Dr. Charlotte Howard and Dr. Tori Olds explore how the brain responds to stressors and how being more mindful can help us better handle overwhelming or stressful feelings and emotions. A mindfulness exercise is also offered to help you become more relaxed and refreshed. (39:37)
 



Also available on Apple, Google podcasts, and Spotify. A transcript of this podcast is found below.
 

Additional episodes in this series:

Episode 1: Physician wellness and burnout

Episode 3: The science of self-compassion

Episode 4: Physician healing and getting the most out of therapy
 


 

Transcript:
 

Tony Passalacqua: Welcome back to the series. Our special guests, Dr. Charlotte Howard and Dr. Tori Olds are sisters and licensed psychologists started Deep Eddy Psychotherapy, the second largest psychology practice in Texas. Deep Eddy helps thousands of clients work through such issues as anxiety, stress management, and relationship issues, depression, trauma, and grief.
 

Dr. Howard currently serves on the Deep Eddy board. And, Dr. Olds leads an international training group, and you can search for her on her YouTube channel by searching for Dr. Tori Olds, or you can access it by the link below. So, our next topic that we're going to cover today is mindfulness. Can one of you guide me through what mindfulness is? 
 

Tori Olds: Okay, so mindfulness. You, you've probably heard a lot of buzz about it because it's been researched death. Constantly. There's like thousands of studies on 20 years, really. Yeah. 
 

Charlotte Howard:  Um, but psychology kind of stole it from Buddhism and then, um, now it's, it's mainstream. It's mainstream and it's really sort of seen as the most healing factor in, in a lot of ways because it has so, so, so many positive outcomes in all the research consistently on all sorts of, um, but mindfulness is, um, uh, Non-judgmental awareness of what is.
 

So, it's being present in the moment, and then noticing what is without judgment. And a lot of this is physical awareness, like noticing your sensations. You might notice the light in the room, or what you're feeling inside, or the feeling of your chair under your bottom, or whatever it is. Your breath. your breath, the sensation of breath, um, but you're noticing what it's like to be you at the moment and then not judging that.
 

And actually, that's what therapy really helps you to do in a way because in therapy you're noticing what's going on inside of you and talking about it and exploring it and so it trains your brain to be both feeling in your sensations and also understanding what's going on inside you at the same time.
 

So, Tori's going to talk a little bit about why that's so helpful, but just very simply put, non-judgmental awareness in the moment. So, you have to be more present, not on autopilot, but actually noticing what's going on inside you, noticing what's around you, and then not judging it. 
 

Tori: You know when we're usually on autopilot, something called the default mode network in our brain takes over, and we all know what that feels like.
 

It's the, what Buddhists would call, monkey mind. It's just the inner chatter, and it's very, um, self-focused, like, what did I do wrong? You know, but it's also like comparing ourselves to others. It tends to orient to the past or the future versus the present. And we all know the default mode network because it's our mind wandering network, which we live in so often. You know, we, I think most of us know that we're not in the present moment, you know, we're thinking about the past, we're thinking about the future.
 

So, mindfulness really helps us, you know, return to the present because It shuts off our default mode network. But let me, let me actually backtrack a little bit. So, we're going to get into, you know, why mindfulness is so important in terms of wiring our brain toward resilience. But the first thing I want to just say is like, what is mental health?
 

Like what is resilience in the first place? And in my simple sort of very simplistic definition. Mental health is simply the ability to both think and feel at the same time. You see, our brain is wired that when our thinking, our neocortex comes on more dominantly, it often, it has like a dampening effect to our, you know, of our subcortical emotional brain.
 

Now that's great. We need our neocortex to regulate our emotions. But we can take that too far and actually overregulate our emotions to the point where we're not feeling at all. You know, we're just in our mind, we have trouble accessing what we feel. We can think, that's great, but we're having trouble feeling.
 

And for many people, the moment that emotion does come online, you know, it actually can trigger the neocortex to be less online. And that is a problem because then you can feel, but you're flooded, you can't have perspective, you can't think straight. So what I want to talk to you a little bit about is neural integration, and this comes out of the field of interpersonal neurobiology.
 

You might have heard the word, the, the man, the name Daniel Siegel, Dr. Daniel Siegel. He's a, probably the most famous psychiatrist right now, and he's kind of a rock star in our field. So, most of my clients come in knowing about him, and when I go hear him speak, people like Goldie Hawn, and you know, like are in the audience just following him around because he's so brilliant.
 

So, he's a big important person in just the field of medicine and science because he draws all sorts of sciences together to understand the mind. But his core concept is that meant all sorts of mental health and wellness rest on what's called integration and the type I'm going to talk about today is called vertical integration between our subcortical and cortical brain.
 

Before I say why that's important, just to quickly differentiate, you're a doctor, so you probably have this in your mind already. But you can think of the, the, you know, our neocortex is our thinking brain, and it is incredibly brilliant in the sophisticated things it can do. However, it can't deal with very much data at the same time.
 

You think about how much, you know, this is why we have, you know, phone numbers that are only seven, you know, like our working memory can hold about seven bits of information. So that's like pretty focused, narrow. It's great for novel situations, novel problem solving, where we need narrow focus. That's accuracy is important. 
 

But it can't be our workhorse for just moving throughout our day and surviving because it takes way too much glucose, and it takes too much time. So, we need a subcortical. We used to call it the limbic system, you know, when we talk about the emotional brain. We've sort of moved a little bit away from calling it the limbic system for various reasons because it's a little too narrow and not enough.
 

But anyway, subcortically, we have a different way of processing information. It's all about pattern recognition. So that part of our brain, basically what it does is unconscious statistical analysis all the time--saying given the data that's streaming through all of my senses together, like what's my best guess at what's going on here?
 

Like that's, I see some colors, I see some shapes, that's probably an apple. It makes that assessment so quickly. Because it doesn't rationally have to figure out that's a fruit and it's lying on a table and it's in a jar that would hold things that hold food. So I rationally can figure out it's an apple.
 

It just does a quick sort of assessment of what things are. But not just what things are. Also, what do they mean for me? Like, is that safe or dangerous? You know, our medulla does a lot of, you know, memory programming around things like that. What can I expect to happen next and how should I respond? So subcortical is brilliant because it works at lightning speed.
 

And it can take in an ocean's amount of data all at the same time and have broad awareness and be picking up stuff. So, if something, a little sound, like, reminds you, like, wait, that's a pattern that's similar to another sound that one time got me hurt, you know, it just, like, picks that up in a second, right?
 

It may not have a rational reason why that sound might be dangerous, but if in our previous experience that sound led to danger, our body's going to start activating, like, oh, I might have to do something in a millisecond. I'm not going to think about it, I'm not going to overthink it, I can't because I need to act now.
 

So that, this is where, um, if you've heard of like operant conditioning or classical conditioning, that's kind of those networks are, are, you know, in the more implicit memory systems. All right, so we have therefore both, uh, two really, really important overarching ways of processing information: cortical and subcortical.
 

We need both. Um, they have different kind of ways that they serve us. Um, different pros to them, but different cons as well. Um, again, I think I mentioned that our neocortex takes a lot of glucose and time. By the way, this is a little bit of an aside, but you know, so much of our psychological struggles, I think, comes down to the fact that our brain has to, like, exist on resources like time and energy. Glucose. That means we don't have the resources we need most of the time to think things through. So, we have to rest on old knowing and learnings and assumptions and automated ways of being. We can't like reinvent how to be ourselves every day, you know, and we wish we could because that would be personal growth.
 

But we, of course, we're not gonna, like, if that was how we were evolved, it would be too slow, it would be too cumbersome, it would be asking our brain to do too much. So, a lot of the reasons we have this, what we might think of as our more emotional brain or whatever, is really that we just have to automate things to make them efficient.
 

So, we have to rest on what happened last time. You know, if it happened last time that that was dangerous, I'm going to be afraid. You know, uh, okay. So, however, as I mentioned at the beginning, there can be kind of a seesaw relationship, where the more the neocortex is activated, it tends to dampen the lower brain.
 

But unfortunately, in reverse, the more the subcortical brain is activated and emotional, it tends to dampen the upper brain. And the reason for that is that if we were in fight or flight, we had to draw glucose and like we can't slow down and think things through. We have to act quickly. So, we can have, it's called a hijack, you know, where our neocortex, our brain gets hijacked by our emotional brain and says, this is not the time to be writing poetry, or having a conversation with a friend, or thinking about the meaning of life, or like, planning, like, is this really dangerous?
 

I don't know, are tigers dangerous? Like, I think they are, because they have teeth, that could bite me, you know, it's not, you can't think, you just have to go on instinct, and that's why we have this whole thing where our neocortex is evolved when we have a fight or flight response to get booted offline. 
 

And this is so frustrating, you know, this goes into things like test anxiety and like, you know, our, you know, we're like, this is really pressure, and we've evolved under pressure to think less well. Like that is really, really difficult, you know, and not a great, uh, you know, uh, situation for us. However, we can combat that by practicing making connections between the middle, our middle prefrontal cortex.
 

And our deeper brain, specifically all the way down to our amygdala, right? But anterior cingulate and all, you know, having, we, the more, those are upper and lower brain are connected. I think it was like neural architecture in place. Like the more we have highways of information, neural connections between the two, the more likely we are to be able to retain a state of integration where we can feel, but we can also think at the same time where our feelings don't boot our neocortex offline, we can maintain that state of integration if we practice it.
 

And mindfulness is actually the practice of maintaining a neurally integrated state. Why? Because the practice of mindfulness is inviting, it requires our thinking, conscious, uh, you know, executive kind of control, you know, focus part of our brain, our, uh, um, middle prefrontal cortex, it requires, it comes online. But instead of using it to solve a problem or focus on another person or focus on something else, we're purposely asking it to consciously turn inward and track signals from the lower brain.
 

In other words, to track our experience, like Charlotte described, to track our sensations, to track our breath, to track what we're feeling. You know, we can track our thoughts too. Any, any, any time the brain is paying attention to its own processes, it's requiring it to work in a way that's integrated.
 

Because if the brain is having to speak to itself, it's picking, it's purposefully picking up the signals. That is really important because it's Hebb's Law. Neurons that fire together, wire together. The more we do that, the more that's ingrained. That way, when we have a moment of stress and our, you know, subcortical brain is trying to, is now having a, you know, stress response and it's, it could have us, we call it "flip our lids" when our neocortex goes offline.
 

Um, that's Daniel Siegel's, you know, clever way of calling it. Um, it could compromise our integration because we did evolve to lose integration during stress. But if we've practiced staying integrated, then our networks will hold together, the lower and upper brain will communicate well, and we'll be able to emotionally regulate.
 

Because that's another thing the neocortex does beside thinking. It sends GABA down to our limbic system, what we used to call limbic system, so as to regulate it. It's our, only it's our neocortex that can soothe our emotions. That's the thing we were talking about in the last podcast.
 

So, this is hugely important for mental health, just, if nothing else, for the sake of emotion regulation. But there's also a lot of other things that come out of neural integration. And I just want to say, if you don't mind me just touching on them, this is getting a little bit science-y, but that's okay for you guys, I think.
 

You know, our brain is actually a complex system. So, the mathematics of complex systems applies to our brain functioning. Why is it a complex system? Because it has different ways of processing information that are integrated, that are connected. They create a whole system together, even though they have differentiated parts.
 

That's a complex system basically. And any time you have different, different elements, but they're linked, except they're linked together in that way. There's something that comes, it's called emergence. This is just like a scientific, that's actually like a mathematical term - emergence, which means that not only when our lower brain and thinking brain are working at the same time, can they balance each other? 
 

It's just great. You've got the seesaw where you got the right amount of feeling the right amount of thinking. But when those two ways of knowing come together. They can create something that neither has on their own. So that's the phenomenon of emergence. An obvious example would be like, if you take apart the parts of a car, they, you, and you add them together, it's not like, oh, now we have more metal than before.
 

No, you have something totally different, which is motion. You know? It's like, they can make something together they could not. It's not just more of the same. It adds together to make a completely different thing. So, when we have different ways of knowing and different ways of processing information all along lots of different neural networks, when they all can come together and integrate together and create a picture that has emotional wisdom, you know, knowledge plus intellectual knowledge plus memory, but you know, all of it together, then it can produce things that we couldn't produce on our own. 
 

I mean, one of the most obvious examples is wisdom. You can have an incredibly brilliant person and that person is not wise. Their neocortex is doing great, you know, in fact, they could even be like the evil doctor, you know, the evil scientist, you know, whatever, like, you know, you know, or programmer, hacker, or whatever, you know. So, we can have incredible genius and not be grounded into other truths, or you can have somebody who's very emotional, and that's great, they're very emotional, but if they're not thinking clearly, they're not wise, I mean, just raw emotion, I can tell you is also not wise, you know, a lot of the time. But when you combine thinking and feeling, they emerge to create wisdom, on top of morality, creativity, and there's all sorts of things that can emerge, um, and, as I mentioned, emotional balance and resiliency.
 

So, this is, I'm, I'm, I know I'm taking my time to describe this, if that's okay, because it's just so foundational. And it's such a cutting-edge way of thinking, thanks to Daniel Siegel's work. He's really someone, uh, in interpersonal neurobiology, who's really an interesting field. 
 

Charlotte: We can talk about chaos and rigidity in relation to this. 
 

Tori: Yeah, I mean, yeah, yeah. Well, this is another complexity theory thing that applies to mental health so much. There happens to be a thing where complex systems, if they're not properly integrated, speaking well, uh, across networks, they will either fall toward chaos or rigidity. And that's absolutely true of our own system.
 

And we've looked through every single disorder in the DSM and each one is a disorder of either chaos, rigidity, or both. So rigidity would be like OCD. I have to do this. I'm fixed in a thing. Um, I'm obsessive. I'm self-critical, you know, I'm not having my feelings. I'm over, I’m hyper controlled limited.
 

Yeah, you're hyper controlled. Yeah. Yeah, versus out of control You know, I'm just like raging and I can't you know, it's chaotic inside and I can't make sense of things and it's that...I love this one time, probably mid 2000- 2006, I had a chance to go see Dale Siegel, uh, live describing this stuff. And he brought down, I'm, I'm a singer.
 

And so, he said, any singers in the audience. And I came down and we're all on the stage demonstrating this point. He calls it the complexity choir. And the first thing he had us do is all sing the same note. Okay. So, we're all saying the same, uh, you know, it's fine. It's not like you want to hold your ears and, but you're not, it's not beautiful.
 

It's just very boring, you know? And then he said, okay, now I'll like close your ears and don't listen to each other. Just sing whatever. And then we kind of all closed our ears, and then we're all singing our own random tune, and it just was cacophony. That's chaos. And then the third example, he said, okay, now sing like “Row, Row, Row Your Boat” and harmonize. 
 

So we were, now we're listening to each other. We all had our own voice. In fact, we all sometimes had different notes we were playing. But we were being responsive to each other and listening, so that we could actually create harmony. And, and actually something more complex. Think of a symphony. All the different instruments.
 

Different instruments. Different, sometimes totally different melodies that they're playing. But it's creating something so sophisticated. It's not chaos. It's complexity. Actually, complexity is what we need mentally. That is what we're always going for. It's not chaos. It helps us organize all of it from chaos into complexity without having to simplify it because we're afraid of complexity, you know, chaos and just becoming rigidity.
 

So that's, that's resilience. That's again, like I said, all the emergent, beautiful, more sophisticated capacities like morality and all the creativity and wisdom and perspective and all that, uh, flexibility, you know, so we're not just rigidly always doing the same thing, but can really think and know, have all of our knowings come to every moment.
 

So, you can tell I'm excited about this because I think it's a real breakthrough through, uh, in our science. 
 

Charlotte: So, complexity and integration. And so that we don't get too rigid or too chaotic. We don't use our emotional brain. Overuse our emotional brain... 
 

Tori: Exactly, we're taking moments, and the practice we did in the last podcast is really a practice of it, we're saying, I'm going to keep my thinking brain on through using language, saying, I feel this, I'm bringing my awareness, I'm putting my focus, I'm keeping my neocortex on line purposely, and I'm turning into my body. I'm letting the data from my deeper mind be known and tracked. 
 

Charlotte: And you have to practice this a lot in order to, um, help your body go there automatically, even without your effort. 
 

Tori: I just want to, though, comment on the a lot piece because it really, yes, I mean, the more the better. The more the better. But they've done so many studies on mindfulness impacting the brain where they can tell if someone's been doing mindfulness, they put them in brain scans, you know, in the moment, but also over time, the enduring impact.
 

But really, you know, a lot of these studies, it's just five minutes a day for two months. This is not like you have to go, like, do a deep dive training center program of mindfulness, you know, and become a monk or something, you know. It's like, it's very doable, which is such good news that just, if you can actually just carve out five minutes a day and purposely focus on your breath. And, I will say the thing I, okay, one thing I do want to say about this is we're getting into the logistics of actually how to do it.
 

One thing I've noticed that people do when they're trying to do mindfulness is not think, which is true. We're not trying to like over attend to our thinking. Like, oh, I'm just, I'm just thinking and like letting my thoughts wander freely. That's the default mode network. You know, we, we do want to dampen that. If we're purposely trying to not think it's really hard and then people get frustrated and give up.
 

So, all you don't worry about whether you're thinking or not thinking. Just try to be aware. Just try, and you can, it can help by giving yourself something to focus on, like your breath, you know, something you're looking at, or the, you know, what you're feeling, or just what, tracking what's happening internally.
 

But just see if you can just, like, let awareness come into the picture of, like, what is it like right now? Like, with curiosity, like, what am, what is this experience of being human in this moment? And then when your mind wanders, which it will, you just kind of pull it back. It's not like now you've, you've done it wrong.
 

That actually is the practice. So like, I hope it does wander so you can gently practice bringing it back. You know, it's like the practice, like, oh, okay. My default mode never came. You know, I'm on. Okay. Let me come back to gentle awareness on my breath or whatever it is I'm focusing on. Even just could just be what's happening in the moment experientially for me. 
 

Okay. Okay. And then my mind wanders, and I just come back gently, you know, um, it's just too much pressure to try not to think. And if I could even say it in a, in a slightly different way than you usually hear mindfulness described, to me it's about just kind of showing up for ourselves in a friendly way and it's not really that different than when you have a friend who's having a difficulty. Maybe they just got broken up with or something and you go over to their house, and you sit down on the couch with them, and you just turn to them, and you just say like, "I'm here." And we don't do that enough for ourselves. 
 

We kind of know how to do it with friends sometimes, hopefully. You know, it's like we know they don't need our advice or for us to talk over them or overanalyze it or like that's probably not the most comforting thing even for another person. They just need us to say like, "Oh, I'm here. I'm listening."
 

Yeah. And just to gaze it, like give them our senses, you know, give like, we're looking at them, we're listening, we're, you know what I mean? We're maybe putting out a hand and touching them, you know, it's like just that is the most comforting thing just to feel like there's awareness on something. 
 

Charlotte: And it changes it, just the awareness, changes it in itself, you know, it evolves once, once we start paying attention to it, and we've been literally trained to ignore ourselves, and so, and that can be a lot through.
 

Um, like what Tori says, we're managing so much that we don't really have the resources to be paying attention all the time, but, but also it can happen through our childhood and our parents and our friends and everyone basically trying to help us focus outward and please everyone else and not, so we really are trained to ignore ourselves in so many levels.
 

But when we can be mindful, it's amazing the peace and fulfillment that can come because we're kind of undoing core aloneness. Right. And so that's such a healing, especially when we're bringing our awareness to our difficulties or to our emotions. Yeah. But it can be really to anything just to actually show up and be present in our lives so that we're not missing life.
 

You know, if we're just like a rat in a maze going for the cheese, you know, to do and going through the motions, life just passes by and its really kind of meaningless. 
 

Tori: Less rich than really showing up experience and feeling your experience. And I really appreciate what you said, Charlotte, about like.
 

It's undoing aloneness because I think we really do, we, we are, we'll talk about conditioning earlier. The reason I think so many people are having to do mindfulness practice in the first place is because we've been conditioned to be non-mindful. It's not like this extra thing. It's just literally we've been trained.
 

The moment as a child, we tried to notice our feelings. We were noticing something. It's like, you're too much. And they're like, oh, I guess I wasn't supposed to acknowledge that, or feel that, or have that experience, or pay attention to anyone else's pain. Uh, oh, I guess I'm not supposed to pay attention to what's happening internally for me.
 

It's too much. It's too difficult for someone. It's not appropriate. There's just not time. We're not, yeah, we're distracted. 
 

Charlotte: We're running to school. Did you do your thing? Did you go on a walk? Did you brush your teeth? Yeah, absolutely. It's kind of just like, okay, we've got to just jump through hoops what life is about.
 

Tori: Yeah, we're just like, okay, I guess we're not paying attention to ourselves. Yeah, exactly. So, I think that's why mindfulness like can be such an important thing and like I'm glad we could just talk about it philosophically a little bit beyond just the science and the brain and like you just have to focus inward and because it is really actually the deep relationship thing too, saying it's just like we would pay attention to a kid. I mean we always use the kid metaphor, but like it's like you would just sit down and, " Hey, tell me what's going on for you." Like why can't we just take that moment to say, "Hey self, what's going on for you and what's that like?" And maybe it's a positive thing like, "Oh is that so exciting like let me feel that."
 

Heaven forbid we actually let ourselves feel our joy, you know, we can also be mindful of that, you know. 
 

Tony: So that sounds amazing, but are there different ways that you can do mindfulness exercises? So, you were saying one could be maybe sitting and listening, what would be a good example of that? 
 

Tori: Yeah, you know, I guess in my general way of thinking about this, anytime you're listening to yourself, even if, even if it's not technically mindfulness, it's like maybe a moment of self-reflection or journaling.
 

Or just slowing down. So, there's many ways to slow down productively. You know, you could do it in a way it's like, huh, what's going on? And how would I like to solve that problem? So, you know, that may not be classic mindfulness, but it's very, it's in that theme of just like attending to ourselves. You know, journaling, um, it could be just like, I really just need a moment to just do pure mindfulness.
 

Like, just to settle my system and become present, I'm just going to focus on my breath. 
 

 Charlotte: Which could feel like a mindfulness meditation. It's like a meditation. But then you have to take time out of your day and just kind of pause and stop and get into a more meditative state to go and give yourself space to look at what you're feeling inside. Yeah. Whereas the other way... 
 

Tori: Yeah, I mean, you can do anything mindfully too. You can do mindful cooking if you're needing to cook, you know, or like mindful eating, like anything you do with like, well, it's like the purposeful intention. It's consciously choosing awareness. 
 

Charlotte: Of being aware nonjudgmentally with whatever you're doing. And the cool thing about that is you can practice it as you go about your day. So you're walking to work, and you feel your feet on the floor, yeah, you're feeling what it feels like to walk on the pavement, or you're looking around at the trees, and you're taking in, like, how does that make me feel, to look at those leaves, or what's going on inside me, or am I a little tired, am I a little this, or what's it smell like, and you're just showing up as you're going, instead of just letting your mind wander to the autopilot.
 

And you can do that with anything. You could do it even while you're talking to a coworker. Like, what am I feeling in my body? What's it like to, um, however, the, the, that is a great way because you don't have to spend extra time taking it out of your day and practicing, but it's just so darn hard to remember to do that


Tori: And we really do need practice. We just get five minutes a day, like get your brain, like. Get some of that neural architecture online, you know, that'll make it a lot easier to actually schedule. 
 

Charlotte: To take that time out to do something. It's easier because it's kind of like a little bit of an advanced skill to be able to practice mindfulness just while you're doing something else. 
 

You could set little reminders on your phone to go off and then okay, for the next one minute, do one minute as whatever else I'm doing, I'm also just noticing what it's like to be me doing this. Yeah. 
 

Tori: And, and next during the next podcast is me focused on self-compassion. And that's one of my favorite ways of doing mindfulness. That's like a mindfulness plus if you can add care with it. So we'll talk about that, and there, and there's something called the self-compassion break. We'll talk about how to do that. So, I'll add that in, but right now we'll just share a little just guide and just like a classic traditional, you know, maybe three minutes or something of mindfulness. Yeah. 
 

Tony: That'd be great. 
 

Charlotte: Yeah. Okay, just, you know, before we jump in, I just want to summarize that, um, mindfulness is incredibly important for so many aspects of health, but also of meaning, and so that we don't miss our lives, and we can show up to actually be present to feel what we feel. It doesn't really matter what, you know, when we're suffering, we're connected more to other humans, to the life experience.
 

And when we're in joy, we don't want to miss that either. Just, but all the complexity of human experiences to show up for that is what gives us meaning and fulfillment and allows us to connect with other people and to savor our lives and to enjoy them. Yeah, so mind, being mindful is such a core...um, beautiful way to engage in life, but it's also really, really important as Tori said with mental health and physical health and you know, as we said, all the research outcomes on it, almost everything, blood pressure and this and that, every aspect of health, every aspect of mental health, whether it's depression, anxiety. I mean the list, it's just almost every diagnosis, mindfulness really helps with, so that's why we took so much time for Tori to, to help you understand what happens in the brain and why this is not just, "Oh, meditate, everyone should meditate. This is kind of woo woo." This is actually changing the brain to be able to do something Tthat is the core of mental health. Which is handle the complexity in a way that's integrated so that you don't get too rigid or too chaotic and you can actually do both things at once. Think and feel. Which is huge to our life experience. So, hopefully you understood all that Tori was explaining about how that happens in the brain through this practice and the cool news that she shared that it really doesn't take that much practice. Just a few minutes a day can really change your ability to do this. 
 

So, all that said, to summarize, and then we'll just close with the, with the short practice, if that's okay? 
 

Tony: That'd be wonderful. 
 

Charlotte: Okay. So, let's slow it down a little bit here and close your eyes. If you're in the middle of doing something, you can try practicing the other way that we just talked about, which is to keep doing it, but also taking my cue simultaneously around orienting toward what you're experiencing. But if you're in a place where you can do this, we're going to close your eyes. There's just so much data from the outside that it'll help us with the practice to go internally if we have our eyes shut. And take a couple slow deep breaths. 
 

You can feel your diaphragm descending and ascending, massaging the organs. 
 

You might feel the air coming in through your nostril. 
 

You might notice the temperature in the room or anything touching your skin like your clothes or where your feet are on the ground or your bottom of the chair. Just noticing any physical sensation that you're having. 
 

Continuing to breathe deeply and bring your attention to that. 
 

You might also notice some feelings. At least check inside to see if there are some. 
 

You might notice physical feelings like you're tired. Or sad. Or tension in the chest or in the belly. Or maybe you notice openness. Relaxation. 
 

But whatever you're feeling, it's okay. And that's the key here. So, you can feel it. No matter what sensations you're feeling, it's okay with you. You're not judging them. They're not positive or negative. They just are. 
 

So, if you're a little cold or a little warm, a little too bright or too dark, or your tummy hurts or your shoulder hurts, or whatever you're feeling, or maybe you feel a positive or open, relaxing feeling, it doesn't matter. You're just noticing. Letting them be okay, it's just a sensation. You could even say, oh isn't that interesting, like, oh my back hurts, or, oh, oh, isn't that an interesting sensation, and you're just really okay with it, you're making space to just let it be. 
 

Continuing to breathe, letting your breath ground you and your body, bring you back to sensation. 
 

And you might notice your thoughts, and if they wander, or you're thinking quickly, or slowly, or whatever you're thinking, you just notice those thoughts, and notice how non-judgmental you can be with them. Oh, okay. Thoughts. Isn't that interesting? My mind wandered. And coming back to the breath, you're noticing sensation, non-judgmentally. 
 

And if you find yourself judging a sensation or a feeling, then you just notice that, oh, isn't that interesting, I was judging. And that's okay, you're just not judging the fact that you're judging. 
 

Take some time scanning your body, your heart, surrendering to whatever is in this moment. Embracing it, let it be, just noticing, no judgment.
 

This is the only moment that you'll be this age, in this day of the week, at this time of day, and you're just noticing, what's that like? 
 

No right or wrong way to be in this moment, all you have to be is exactly what it is. 
 

Taking a few more slow, deep breaths, noticing the sensation of breathing, being alive in this moment, what it's like to be you, knowing everything is okay. 
 

And continuing your attention in the present moment but opening your eyes. And ready to continue your day relaxed and refreshed. 
 

Tony: Mindfulness exercise. Do you guys have anything that you would like our listeners to leave with, with mindfulness? What's the main takeaways you think? 
 

Charlotte: I think that it's just so important to show up for our lives and not let them just pass by if you're going into autopilot. And, you know, it's our chance to really be with ourselves and not alone. 
 

Tori: Yeah. Yeah, it's a way of really saying, let me just be with you, self, and let me contact and witness what's happening for me. Yeah. Without immediately jumping into needing to manage it. 
 

Charlotte: And letting it be okay. Life is complicated. It's complex. It has all sorts of things that we normally put in the negative or positive and we're kind of playing a game, let's get more positives. 
 

Tori: Um, which is exhausting and anxiety inducing.
 

Charlotte: Exactly. But the safe shore is if we can just surrender to whatever it is and notice it, not be scared of it. It's just a set of sensations. 
 

Tori: At least in that moment, you know, and then you can feel if you want to do action, you know. Like act for solving problems, do positive action, of course. At least in that moment when you're just doing mindfulness. You're not jumping into the evaluated mind. You're just in the witnessing mind. For that point. 
 

Charlotte: Because then you can be at peace no matter what. Really deeply. Take it all the way. If you really are able to surrender and accept whatever is and notice it. You're in a really amazing place psychologically.
 

And I guess I would just close by saying that because we haven't touched on this which is the obvious, which is that we are in a huge epidemic of technology and social media and screens, and all of those things have made our attention span so incredibly short and made it so much easier to lose ourselves. I mean, when I was growing up, it was like you lose yourself in a movie, but at least you're having an experience of, you're like having a deep, meaningful journey over an hour and a half. 
 

Um, but you know, my kids watch TikToks that are 30 seconds or less and they're bored after five seconds of something, and they move on to the next.
 

So. You know, on top of everything else we've said for why this is so important, we're also combating an epidemic that really, really causes a lot of depression and anxiety and the research incredibly supports that. So, all the more reason that we need to take some time out from that. 
 

Tori:  Yeah, that's right. That would be the moment to cue you to do mindfulness. If you think, if you're about to pick up your phone, I mean, I know we have to check our things or whatever, but like if you're doing it as just self-soothing or just automatic, you don't actually have to live on autopilot. Let me take a moment and nod.
 

Charlotte: Our instinct is to disengage and numb to deal with feelings, but really the healing thing is to engage and come into a relationship with what actually is. So the total opposite of our instinct. 
 

Tony: Perfect. And then do you guys have any resources that we could send our listeners to? 
 

Tori: I mean, you know, for more about everything we've talked about, this is the kind of thing I cover on my YouTube channel. So, Dr. Tori Olds, and I go more in depth with how to do inner exploration and self-compassion and all the things we'll be talking about in this podcast, but that's certainly a place you can go and mindfulness is all over the place nowadays and all of it's good. You know, some of it, you know, it depends how advanced you want to get.
 

If you want to know about interpersonal neurobiology, I would suggest “Mindsight,” the book “Mindsight.”  And if you want to apply it to parenting, “The Whole Brain Child,” on how to raise children who are neurally-integrated and can think and feel at the same time. “The Whole Brain Child” is a great book. 
 

Tony: We'll leave some notes at the bottom of our page here. So, if you would like to look at some of those links, you'll be able to see those. 

And thank you for listening to this podcast. If you are a policyholder, please feel free to contact us with any questions by calling 1-800-580-8658 or check out our resources at tmlt.org and clicking on our Resource Hub.
 

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Physician wellness, Episode 1: Physician wellness and burnout
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