It’s not often that a keynote speaker will ask his audience to close their eyes and tune him out, but that’s what Aviad “Adi” Haramati, PhD, did when delivering the 2018 John E. Chapman Lecture.
Haramati’s address, which took place April 23 in Light Hall, touched on the topic of physician well-being and the important role that mindfulness can play in decreasing stress and increasing resiliency and empathy.
Neil Osheroff, PhD, John G. Coniglio Professor of Biochemistry, introduced Haramati, who spoke on “Managing Stress, Building Resilience: The Imperative for Self Care for Faculty, Staff and Students in the Health Professions.”
Haramati is professor of Physiology and Medicine and co-director of the Graduate Program in Complementary and Alternative Medicine (CAM) at Georgetown University School of Medicine, with research interests in renal and electrolyte physiology.
“I am going to talk about the imperative of self care. I am a basic scientist, and one of the things I’m going to be championing in this talk is the use of mindfulness training. I want you to think about the connection of mindfulness and urine,” joked the renal specialist.
Haramati’s current interests are more centered on medical education and rethinking how health professionals are trained. His interests in integrative medicine focus on the use of mind-body medicine skills for stress management and in health professions education. He is one of the national leaders in the movement to promote resilience in health care professionals, faculty and learners.
Haramati cited several published articles that indicate physician stress and burnout cause a decline in empathy and can affect patient care, and the problem begins in medical school. Educators must prepare medical students for the rigors of the profession and help them manage stress, foster empathy and build resilience.
“There is something not right about how we train, and we have to own up to it,” he said.
Excessive workload, inefficient work environment, lack of work-life integration, loss of control and autonomy and a resulting loss of meaning in work all contribute to burnout, which can be marked by chronic stress, a sense of dread when reporting to work and low personal accomplishment.
“There are national strategies, work strategies, organizational strategies and individual strategies, but I’m going to focus on individual strategy,” for dealing with stress, he said, adding this caveat: “You can be the most mindful individual, but if you are in a toxic environment, you will not thrive.”
A key way to cope with stress and burnout is to build resilience, “the ability of an individual to respond to stress in a healthy, adaptive way such that personal goals can be achieved at minimal psychological and physical loss.
“Resilient individuals not only bounce back, but grow stronger in the process,” Haramati added.
Skills to build resilience can be taught and practiced, and mindfulness can help. Haramati conducted an exercise with the audience in which he asked them to close their eyes and imagine being in their kitchens, which were very clean and sparse, save for a lemon on a counter. He talked them through approaching the lemon, slicing it, taking in its aroma, and finally asked them to take a bite of the juicy lemon. At the conclusion of the three-minute exercise, several people shared they had begun to salivate when they “bit into it.”
“There’s no lemon in this room. Did it matter? It didn’t matter to your brain. The awareness was there. What we just demonstrated is very simple: the mind and the body are connected.”
Mindfulness can be achieved by focusing on the present through meditation, imagery, biofeedback, breathing techniques and exercise, and has been shown to decrease hypertension and one’s heart rate and make those who practice it feel less anxious, Haramati said. By practicing mindfulness, among other self-care strategies, health care providers can be better prepared to deal with the stressors that inevitably accompany their work.
Haramati was principal investigator of a five-year National Institutes of Health grant that supported a broad educational initiative to incorporate complementary and alternative medicine and integrative medicine into the four-year medical curriculum at Georgetown. He co-leads the faculty training program in Mind-Body Medicine with Nancy Harazduk at Georgetown University and at The Institute for Integrative Health.