Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

Meditation to Manage Stress


Stress can cause us to be impatient with patients and colleagues. Noticing this and refocusing our attention toward the patient can help us continue to give excellent care.

If you’re like me, you can feel it in your body when your “to-do” list gets longer than your “can-do” list—shoulders tense, heart rate rises, stomach tightens—it’s off to the cortisol races. Add on a client in crisis and it’s a perfect storm. How can we de-escalate our fight-or-flight system and regain composure?


We can handle occasional bouts of stress, but if they hit too often or intensely they wear us down, compromising our immune systems, digestion, hearts, and minds. We may become preoccupied during patient interactions, internally distracted, impatient, or even depressed. Our neural circuits that facilitate empathy and compassion compete with “vigilance-to-threat” networks, like the amygdala, and can easily be dominated if fear and distress steal our focus. When this happens, the level of care we’re able to give patients may not be our very best.


It can help to notice when stress and worry start to intrude on your ability to stay focused. You can then take steps to self-regulate and refocus your attention on patient care. Try taking time for a short walk during lunch, a chat with a colleague, or a stretching break. The main point is to try to restore equilibrium when stress becomes overwhelming. Once calm is regained, it’s good to take a few moments to reboot empathy and compassion before interacting with patients.


Empathy and compassion are crucial for strong patient-clinician relationships. You’ll do your best work when you’re calm, fully engaged, and empathically attuned. To calm your mind and body, try a one to three minute meditation (perhaps using an app like “headspace” or “Calm”) between patients. If you don’t have an app, focus on your breath and imagining breathing in well-being and then exhaling well-being to your next patient. Each morning, when preparing for the day, try practicing a series of brief contemplations to kindle a compassionate motivation for the day ahead. Here’s how to do this:


1. Start with mindfulness of breathing while releasing tension in your body, calming ruffled emotions, focusing awareness, and becoming a passive observer of thoughts that come and go, like clouds passing overhead.


2. Remind yourself that just like you want to be happy and avoid suffering, the same is true of everyone. We’re all the same in this regard.


3. Recall people who’ve helped you both directly and indirectly, which may help you move from emotional depletion to gratitude and a wish to pay it forward.


4. Wish well-being for yourself and then for others, which builds feelings of kindness. Couple this wish with visualization, breathing in well-being as soothing light and breathing out well-being as light to others.


5. Move your compassion from a passive wish to an engaged motivation by resolving to do your best to directly help patients and others throughout the day.


6. Once your compassion is activated, set your goals for the day, reminding yourself of them from time to time.


This sequence of contemplations will become natural and familiar through regular practice. The compassion you generate will become resilient and steady, even when stress comes to visit.