There is no doubt that the stress of the COVID-19 pandemic is causing a high level of stress and distress, particularly among health care workers due to our unique role in fighting the COVID-19 pandemic. During a pandemic like this, our capacity to stay calm, present, and compassionate is more important than ever. The Zen Master Thich Nhat Hanh, describing the Vietnamese refugee crisis of the 1970s and early 80s, said “When the crowded Vietnamese refugee boats met with storms or pirates, if everyone panicked all would be lost. But if even one person on the boat remained calm and centered, it was enough. It showed the way for everyone to survive.”

Recently, a pediatric colleague asked me what my “top 5” mindfulness practices are during this time. While I don’t pretend to have all of the answers, here are the practices that I’m finding most helpful right now:

1. Coming back to the present moment. With so much uncertainty in the future days, weeks, and months ahead, all we truly have is the present moment. A simple way of coming back to the present is by using my breathing as an anchor. When I breathe in, I say silently to myself, “Here.” When I breathe out, I say “Now.” Breathing in, breathing out… “Here … Now….” It doesn’t meant that my mind doesn’t wander into worries about the future and uncertainties about what is to come. But, even when that is happening, I can continually return my attention to the present moment, using my breathing as my “home base.”
2. Gratitude. It’s important to acknowledge and accept the grief and sadness of what has been cancelled and lost during this time. Even while doing so, I also find it immensely helpful to train myself to bring awareness to the conditions that are still available to nourish my wellness in the present moment. Inspired by a poem I heard, I’ve invented the “This is not cancelled” practice: I make a list out loud or in writing of what I’ve noticed in the last day or so that has not been cancelled during the pandemic. For example, this morning for me it would be: “The morning sunlight reflecting on the skyline and mountains of Vancouver has not been cancelled.” Sometimes I will practice this with others, either out loud (phone / online) or on social media, and it becomes a wonderful group practice and sharing!
3. Walking Meditation. Walking meditation has long been one of my favorite practices, especially when I’m feeling too stressed to sit still. During the pandemic, I find it deeply rewarding to spend some time outside walking, as long as it is still recommended by public health as safe to do so, using appropriate safe physical distancing away from other people. I walk with the primary intention of just enjoying the walk. With each step and each breath, I bring my primary attention to the present moment. I notice the signs of spring, the flower buds coming up, the warmer air against my face…. This practice helps me to get “out of my head,” and into my body, connected to the earth.
4. Mindfulness of Media Consumption. Right now it is important to stay up to date with what is happening in the world, in our communities, and in medicine as the COVID-19 situation evolves so rapidly. At the same time, I’m finding that there is such a thing as “too much information.” I’m trying to find a balance of getting enough information to help me make informed and wise decisions at home and at work, while avoiding getting to the point where I’m going down the “rabbit hole” of news, clicking on one story after another past the point of usefulness. When I get to that point, I find that I’m just ruminating, over-thinking, and increasing my stress about the situation, without actually accomplishing anything useful in terms of being able to take better care of myself or others. Given that those of us in health care already saturated with COVID-related discussion and activities at our workplaces all day long, we need to be particularly cautious about getting oversaturated with COVID-19 talk and news outside of work. Mindfulness helps me to find that balance by being aware of what is happening for me moment-to-moment for me as I “consume” news and media. Mindfulness helps me to stop and make an intentional choice about my media consumption – which, in many cases, means that I decide to put down the phone or turn off the computer for the night so I can get a good night’s sleep! I know that the important information will be there for me the next morning.
5. Daily formal meditation. During uncertain and unpredictable times, maintaining some kind of daily routine is helpful. For me, maintaining a daily formal meditation practice gives me a short period every day to allow myself to “just be,” and not have to “do,” even if just for a few minutes. As health care workers we have so much to do in this pandemic situation, it can seem overwhelming. At the same time, I’ve found that the quality my doing is determined by the quality of my being. If I want to stay kind and stay calm during this time, I need to continue to intentionally practice and train myself to do so. Right now the quality of being that is most helpful for me is self-compassion, and one of the practices that I am finding the most useful is the Self-Compassion Break. This is a three-step practice that includes 1) Mindfulness and awareness of the suffering that I’m experiencing; 2) Connecting with my common humanity and others around the globe who are also having a hard time in this moment; and 3) Offering myself kind words, as I would say to a good friend who was having a hard time. For more information on this practice, see Kristen Neff’s website. Another formal practice that I am finding helpful in coping with COVID-19-related stress is called RAIN, by Tara Brach, which helps me to work with stress and difficulty by Recognizing that it’s here, Allowing it to be here (since resisting it doesn’t help), Investigating how it feels in my body, and Nuturing myself with self-compassion.

May we all stay kind, stay calm, stay safe, and take good care of ourselves and each other during these trying times.