Iowa Alumni Magazine | February 2005 | Features

Doing Nothing

By Tina Owen
When pills, surgery, and high-tech approaches alone can't provide relief for the physical and mental problems that ail us, a UIHC program suggests the succor of doing nothing.

The pain began for Walter Wiese when shrapnel from so-called “friendly fire” during the Vietnam War tore into his body, lacerating his left leg so completely that military surgeons had no choice but to amputate. Thirty-five years later, the pain continues to throb like a spike in his leg stump.

Dr. Ann Broderick faced a different stress. Pulled both by her profession and her family, she felt caught in the middle of a horrendous crunch between the things that mattered most to her. As she raced from one commitment to the next, she worried over everything that still needed to be done. The harder she worked, the more stress she felt.

Meanwhile, Bonnie Murphy fought a darkness that could overwhelm her spirit. Her mother was weakening from congestive heart failure, and, with her youngest daughter moving away, a middle-age empty nest loomed. These and other stresses brought deep sadness, an unwelcome companion that sapped her energy and stole the pleasure from life’s activities.

Like hundreds of other people suffering from physical or psychological pain or the hectic pace of modern living, Wiese, Broderick, and Murphy turned to the Mindfulness-Based Stress Reduction (MBSR) program offered through the University of Iowa Hospitals and Clinics. Based on a program developed at the University of Massachusetts medical school in 1979, MBSR helps people reduce their stress levels or cope with pain and/or illness through a combination of meditation, yoga, and other simple exercises.

Instead of being helplessly caught up in the non-stop doing of their lives—eat, work, drop off the dry cleaning, pick up the kids, cook dinner, exercise, walk the dog, pay the bills, floss, throw a load in the laundry, sleep, start all over again—mindfulness practitioners aim to experience simply being. They relate to their problems in an unusual way, by doing nothing. And that takes a disciplined focus that is difficult to attain.

Sitting still and doing nothing doesn’t come easily to many Americans. “It is such a contrast with how we’re used to living our lives in this country,” says Bev Klug, 74BS, 85MA, director of Iowa’s mindfulness program. “We’re not used to stopping each day just to be and not to do. The contrast is often startling, and it helps people recognize how crazy their lives have become—and how they have some choice about that.”

Unlike other forms of meditation that aim for a transcendent experience, mindfulness calls for being present. At its heart lies the belief that this moment—right here, right now—is all the life we have, and too often we miss it. As we rehash the past or fret about the future, the moments of our lives slip by unnoticed. Paying mindful attention helps us appreciate joyful experiences, put the less-enjoyable parts of our lives (including pain) into perspective, and make skillful choices rather than knee-jerk reactions. “MBSR is about being right here in our lives rather than somewhere else,” says Klug. “It empowers people to recognize their strengths and encourages them to tap into their internal resources.”

Jon Kabat-Zinn, who developed MBSR, defines mindfulness as “paying attention in a particular way, on purpose, in the present moment, non-judgmentally.” Klug adds that, “Mindfulness isn’t about learning to levitate. It’s not another way of saying ‘relax,’ and it’s not only for New Age people or Buddhists. It’s a way of integrating our physical problems or psychological struggles into our lives.”

Murphy, 79MA, says that it helps her feel “settled, grounded in who I am, so that I can bring that person authentically to the world.”

While her words may sound like vague, New Age mumbo-jumbo to skeptics, rigorous clinical studies over the last two decades have shown that meditation can affect both our minds and our bodies. In one study that demonstrated the effects of meditation on the immune system, mindfulness practitioners produced more antibodies in response to a flu shot. Another study showed that psoriasis patients undergoing ultraviolet light therapy healed four times faster if they listened to meditation tapes.

Regular meditation can actually change the way our brains work, increasing the amount of activity in the left prefrontal cortex, which is associated with positive emotions such as happiness and optimism. Mindfulness complements other health care approaches such as medication and psychotherapies, and it’s being used to help treat problems including binge eating, obsessive-compulsive disorder, and depression. An approach that melds mindfulness with cognitive therapy has been shown to reduce by half the number of relapses in people with major depression.

Dr. Nicole Nisly, 93R, director of the UI’s Complementary and Alternative Medicine Clinic has taken the MBSR program and recommends it to many patients. “MBSR is a key resource,” she says. “Data is pouring in on the benefits of mind-body techniques to help treat more difficult conditions such as pain and mood disorders.”

Once they learn to practice mindfulness, Klug’s students often report improvement in their health problems—including chronic pain, eating disorders, cancer, stress, headaches, fibromyalgia, high blood pressure, and anxiety attacks. They have more energy, an increased ability to focus and concentrate, and a greater sense of control, plus their relationships with family members, friends, and colleagues frequently improve. “People often say after the program that they realize pain and anxiety isn’t the whole story,” says Klug. “They’re aware of all the things that are working well in their lives.”

Wiese, who took the program in the summer of 2003 and still practices mindfulness exercises, found that MBSR alleviated his chronic pain and post-traumatic stress syndrome in a way that transcendental meditation, a TENS (transcutaneous electronic nerve stimulation) pain control device, and prescribed painkillers could not. He no longer sees himself as a victim of the pain that gave him sleepless nights and a short temper.

“With MBSR, I’ve become a scientist, investigating in finer detail the source of my pain and what I’m actually experiencing in my body,” he says. “The pain becomes like someone I’m familiar with but am seeing in a new way, transforming it from an enemy to an ally.

Walter Wiese Walter Wiese practices mindfulness to cope with his chronic pain, but also, he says, "as a means to investigate and uncover finer levels of my humanity."

“My experience used to be ‘Ow, it hurts! Take a pain pill, make it go away!’ That’s the kind of programming we receive in our culture, but the pain—and the source of the pain—is still there. I’ve discovered a more delicious, enjoyable way of living in the midst of this distressing, overwhelming experience.”

Wiese personifies one of the basic tenets of mindfulness: that ignoring or trying to avoid the painful aspects of our lives simply doesn’t work. Instead, we have to acknowledge and examine the things that hurt us.

“People in the MBSR class have to deal with some tough things—stepping up close to physical or emotional pain. But mindfulness practice shows us how to be here with these things—and that often takes away a lot of their power to hurt or scare us,” says Klug.

Klug set up the program in the family medicine department’s counseling and health promotions clinic in 1996 (she and the program moved to the psychiatry department last year). Since then, she’s instructed more than 600 people—doctors, construction workers, stay-at-home moms, teachers, high school students, and 80-year-olds—in how to live in the moment. An estimated 15,000 people have completed MBSR programs at UMass, while even more have benefited from classes offered by hospitals, clinics, and academic medical centers across the nation. UIHC was the first and remains the only hospital in Iowa to offer the program.

Klug teaches two or three classes up to four times a year, with about 25 people in each session. Participants are referred by doctors or mental health workers, recommended by friends, or inspired by the increasing amount of media coverage about MBSR and similar programs. While many are ill or in pain, others see the course as a way of maintaining and safeguarding their good health.

For some, it’s their last hope—and they’re more than willing to travel long distances and pay the $380 program fee that isn’t covered by insurance. (Under a pilot wellness program running from 2002 to summer 2005, the UI has subsidized 75 percent of the cost of the MBSR program for 205 eligible staff. In follow-up surveys, those staff reported both a high level of satisfaction with the program and improvements in their
health.)

Mindfulness can work—if you work at it. Klug warns her students that they have to commit a lot of time and effort. Besides attending eight weekly two-hour sessions at the hospital and a day-long retreat at a meditation center, they must find time for “homework”—45 minutes daily of meditation, yoga, or the body scan exercise, which aims to familiarize them with the physical sensations of their bodies. Every day, they carry out informal practices such as bringing mindful attention to routine tasks and keeping track of how they react to pleasant or unpleasant events.

To open participants’ minds to the possibilities of mindfulness, Klug begins each course with an unusual exercise. She gives each person two raisins and tells them to examine the dried fruit carefully, to hold it up to the light and look at all the colors, then to feel, smell, and finally to eat it, paying precise attention to what they notice. Chances are that most people in the room have eaten raisins before, but never like this, self-consciously devoting such attention to every aspect of a mundane experience that proves surprisingly rich. It’s a fundamental lesson in mindfulness: stop and smell the raisins—or whatever comes your way.

Novice mindfulness practitioners soon discover, however, that being is a lot harder than doing. They get frustrated when unwelcome thoughts sneak in during meditation or when physical aches or drowsiness hijack their body scans. When they bemoan perceived failures in these exercises, Klug patiently repeats: “That’s why we call it a practice.” She hands out a sheet with this advice from mindfulness teacher and author Larry Rosenberg: “1) When possible, just do one thing at a time; 2) Pay full attention to what you are doing; 3) When the mind wanders from what you are doing, bring it back; 4) Repeat step three several billion times.”

Even with all this effort, can mindfulness actually help people cope with the nitty-gritty of the real world? Broderick thinks so. Since taking the course two years ago, she’s noticed changes beyond a reduction in her stress levels. “When I’m with a patient, I’m much more focused and rarely distracted—I hardly even remember that I have children,” she says. “As soon as I leave the patient room, I’m multitasking again. We might do well to market this to primary caregivers, as we could all use the focus on the present.”

Broderick, 86MD, 89R, 91MS, regards mindfulness as another tool to use alongside medication. She’s referred about 15 patients suffering from stress, high blood pressure, depression, and anxiety to the MBSR program, and she knows of five who have done the course.

At the end of each program, Klug’s students decide how—or whether—to use what they’ve learned. Murphy had experimented with other forms of meditation both as a spiritual practice and as a healing technique when she faced breast cancer several years ago. Mindfulness enabled her to cope better with her feelings of depression and anxiety.

“I gained a new perspective,” she says. “The concept of consciously responding to life instead of reacting to it has been enormously freeing. I take things less personally, am less self-critical and more compassionate with others, and I realize that I can choose skillful ways of acting in difficult situations. I find myself drawn to it, almost hungering for the ‘coming home’ feeling of being completely myself for even a few minutes.”

Most of Klug’s students continue with the practice in some form or another, often attending follow-up weekend or evening sessions. Like Murphy, they fit mindfulness into their daily routines, along with working, traveling, caring for their families, and all the other incessant demands on their time. They simply get on with living their lives—one moment at a time.