GP Burnout Special:
How can we help ourselves and one
another using mindfulness?
A mini introduction
Dr Kamila Hortynska
Clinical Psychologist, CBT Therapist
Mindfulness Teacher and Trainer
27th April 2017
Definition and context
 The relevant findings and recommendations from of
the evidence base review of MBIs commissioned by
West CCG indicate that mindfulness can be a helpful
strategy preventing burnout and building resilience in
healthcare professionals.
 Mindfulness is a form of attention and awareness
training that helps people relate more effectively to
their experiences.
 Growing interest in mindfulness-based approaches
and growing evidence base for their effectiveness in
 physical health problems
 mental health problems
 work performance and employees stress reduction
What does it involve?
Mindfulness involves paying attention to thoughts,
feelings and body sensations in a way that increases
awareness, acceptance and self-compassion in order
to help manage difficult experiences, and create
space to make wiser choices.
It promotes self-regulation defined as individual’s
capacity to effectively manage their thoughts,
emotions, behaviours and to cope with adversity in
their environment
What mindfulness is not:
 Not a relaxation activity or just ‘sitting still’
 Not just focusing on breath as a distraction
from anything else that is present
 Not a trance experience or a manifestation of
religious faith
 Not about trying to be calm, relaxed, at
peace, etc
Practice example 1 Mindful Mintue
What benefits one can expect?
 To take time out, and get relief, from
preoccupations and worries
 To tolerate difficult feelings, physical sensations
or pain
 To experience life more directly and step out of
the relentless commentary of our thoughts
 To feel more alive, engaged and happy
 To feel less stuck and drained
 To be more compassionate
 To improve relationships with others
Key features of the training
 Attention and concentration training - exercising our
capacity for wide or narrow focus of attention
 Developing skills in mind and body awareness – noticing
and noticing that you are noticing
 Working with direct experience in the present moment
rather than thinking about the experience
 Developing acceptance and openness to experiences
 Letting go of the impulse to avoid, control or hold onto
thoughts and feelings
 Cultivating compassion and practicing a non-judgemental
attitude especially suspending self criticism
Mindfulness and healthcare
professionals
The recent meta-analysis of the effectiveness of
MBIs with healthy individuals found that among all
reviewed target populations, healthcare
professionals benefited the most. (Kohury et al,
2013). Specific benefits reported for: general wellbeing, better self care, higher job satisfaction, lower
experiences of burnout and reductions in perceived
stress
Doctors’ psychological well-being
Simone and Durand-Bush (2015) suggest that clinicians
should consider developing self-regulation skills in order to
maintain adequate level of health and well-being. They
found that the more physicians effectively managed
themselves and their environment the higher they scored
on all well-being dimensions.
The most recent systematic review of interventions to
improve psychological well-being of GPs (Murray, Murray &
Donnelly, 2016) found only 4 relevant studies (2 used CBT ,
1 MBI and 1 simply fed-back GHQ scores and self-help info).
The authors called for more high quality research and
changing the focus from mental illness prevention to
mental health promotion.
Mindfulness and GPs
Two recent studies on GPs:
 RCT of 42 Spanish physicians (Amutio et al, 2015) found
significant improvements on levels of relaxation and other
positive psychological states among those who completed an
8week mindfulness course with additional 10-month
maintenance period. Change magnitudes significantly
increased at 1 year follow up.
 Controlled pre-post mixed method study of 43 Dutch GPs
(Verweij et al, 2016) found that 8 week mindfulness course
resulted in fewer burnout symptoms and increased work
engagement and well-being. Qualitative data indicate that it
also increased compassion towards self and others (including
patients).
Local experiences
 So far 2 courses have been offered
 28 GPs completed the training
 No drop outs, and attendance was very high
 The evaluation of the first course showed
statistically significant improvements in 3
measures:
 Perceived Stress Scale
 Mindfulness Attention and Awareness Scale
 Brief Resilience Scale
 Feedback was super positive
Quotes from local GPs
 It has helped me appreciate my life so much more. To be able to recognize stress
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and manage that stress is amazing. My mood has lifted. I feel kinder to myself
and others.
This course has been life-changing. It has given me the tools and skills to be
more self-aware, to manage my personal stress and anxiety and to understand
myself better.
It has made me realize the very high stress levels I have been working at. Then it
has provided me with the skills I need to manage this stress, live happier and
enjoy each day.
The course has been very important to me as it has shown me another way of
looking at my life and dealing with stresses and difficulties. It has given
strategies which I can use and call upon in times of stress as well as making me
appreciate the joys of life.
It has opened my mind to lots of choices and possibilities for the future. I am
appreciating my family relationships and friends so much more and feel less
irritated by things that are really not important.
Quotes from local GPs 2
 It has made me more aware of my own feelings/thoughts. Allowed me to
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acknowledge my thoughts and also taught me not all my thoughts are
real. Allowed me to deal with my recurring thoughts and acknowledge
they are there and it’s OK.
Coming back to mindfulness has taught me new things that I didn’t know
– thoughts are not facts. This has helped with my mood better than
Sertraline ever has and has given me a sense of self-determination and
self-healing; it’s my choice.
I have realized that I am not alone in my anxieties re work and life. I have
gained practical experience of mindfulness.
A new way of life – slowing down, enjoying life in all aspects, recognizing
stress early on and taking positive steps to manage this.
I learnt that it is not a given that unpleasant feelings and physical
symptoms are there. I learnt to work with them and breathe into painful
feelings and miraculously they became less noticeable.
Quotes from local GPs 3
 I learned how to be more accepting of my own feelings and of the inevitable
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ups and downs of life. I also clearly learned the necessity of ‘weaving the
parachute before jumping out of the plane’.
I thought I was the only one and this has made it difficult to talk about it or
access help for the fear of stigma or GMC referral. Also that my own
reactions etc. have the greatest impact on my mood and well-being.
I am able to live better with uncertainty and have learned to relax, be there to
myself and confront difficult feelings which in turn have made them less
difficult.
I’ve learned so much about how to look after myself in a positive way. I will
promote this course to all my friends and colleagues.
Could not have predicted impact of using breathing and physical techniques
to increase awareness of self and the fact that I can use such techniques to
help how I feel.
I feel I am making better decisions as I am not stressed when seeing patients.
Quotes from local GPs 4
 This course has really helped me both professionally and personally. It has
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allowed me to accept certain things about myself and my life and helped me
find joy in the little things again
I have gained so much from this course. I’ve learnt how to be kind to myself
and recognize early on when I need to look after myself. I learnt how
recurring thoughts of self-doubt and criticism had impacted my confidence
levels and now I can recognize these as thoughts not facts and that is so
freeing.
Now I feel more able to cope with everyday stresses through self-care,
responding not reacting, remembering to breathe and being more aware of
small positive moments in life.
It has helped me to manage stress, make conscious choices and stop trying to
do everything myself.
My family says I’m calmer, that I seem happier.
I appreciate my family more and focus on happy/nourishing things for the
whole family.
Quotes from local GPs 5
 Meditation practices give a calming effect on body/mind. It partially reduced
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stress in home/work life.
It has allowed me to recognize all the ‘nourishing’ things/actions that I’m
already doing. I feel a lot calmer and more relaxed. I recognize thoughts as
just that.
It has changed the way I relate to my thoughts. I am no longer consumed
with worrying thoughts.
It has allowed me to understand how good my life is and how the bad parts
are something to allow and not avoid, as is in my learned behaviour.
I feel calmer, less stressed.
Very quick and easy techniques to help with worry, upset and stress.
Feel so much calmer, more relaxed. Feel more positive things are happening
to me.
Calmer in the face of stressful patients/days and also less worry about the
future.
Practice example 2 Mindfulness of Breath
& Body
Books to get you started
 Mindfulness: A Practical guide to finding peace in
frantic world. Williams & Penman
 Wherever you go there you are: Mindfulness
meditation in everyday life. Jon Kabat-Zinn
 Mindfulness for Dummies Shamash Alidina
 Stop Physician Burnout: What to Do When Working
Harder Isn't Working Dike Drummond
 Hardwiring Happiness or Buddha’s Brain. Rick
Hanson
Useful websites and apps
 The Mental Health Foundation’s website has information
about the clinical application of mindfulness. It also
provides links to mindfulness courses for common mental
health difficulties around the country as well as teachers
profiles www.bemindful.co.uk
 General information on mindfulness, along with
information on the neuroscience of mediation practice
www.mindfulnet.org
 Free mindfulness resources, guided mediations and
downloads www.freemindfulness.org
 Headspace, Insight Timer or visit www.mindful.org/freemindfulness-apps-worthy-of-your-attention
Thank you
Questions?
Comments?
Reflections?
[email protected]
www.leedscbt.co.uk