Story: Ekkapop Sittiwantana
Many people associate the word mindfulness with monks and strict buddhists but in actual fact, mindfulness should be a subject of interest for patients and their caregivers. Mindfulness is very effective in helping patients overcome their suffering and even peacefully reconcile themselves to death. This article outlines the process of introducing teachings from the Sangha for Patient Care Foundation’s training workshop and discussion seminar along with material on mindfulness to the spiritual healing of patients in different circumstances.
Mindfulness is Integral to Patient-Centered Care
We often hear that patient-centered care is important, that caregivers should be attuned to the feelings and needs of their patient, and provide them with appropriate care. The caregiver does not serve their own interests. The reality, however, is that patient-centered care is not easily realized, because patients are often in a fragile state and are vested with less power than their caregiver. Therefore, caregivers — whether relatives or healthcare professionals — must be mindful. They must be sensitive to the extent their own thinking and behavior aligns with their patient’s needs, and whether they are respecting their patient’s dignity.
Be in the Present
As monks, volunteers, nurses, and those who have had the experience of tending to patients’ spirits, have all reflected: “There is no perfect formula to follow from step 1, to step 2, to step 3; rather, we must be present with the state of the patient before us”. Healing patients is an art that is served by a compassionate spirit, the mindfulness to receive the entirety of the situation of the patient sitting before us, and the ability to respond to what unfolds.
For example, there was a monk who was invited to talk to a patient with depression. However, when he arrived at the patient’s bedside, he found that the patient did not want to speak to him, saying that they were tired and wanted to rest. Therefore, he decided to tell the patient, “Please close your eyes, I’ll keep you company”. On his second visit, the patient gave him a warm welcome. The patient’s responsiveness in the second visit arose from their feeling that the monk was there as a friend, rather than to cram in teachings.
Listen from the Heart
One of the concrete ways of holding space in the present with the patient is to listen from the heart. Rather than merely comprehending what the patient is saying, the interlocutor listens for the patient’s deeply-held feelings, needs and values that are important to them. They do not hasten to solve the patient’s problems for them. Listening from the heart will signal to the patient that they have a friend who understands. The patient can voice what they have long repressed. Sometimes, the patient may find the solution to their problem in the process of describing it. To listen from the heart is only possible if the caregiver listens mindfully.
Mindfully touching the patient — carefully holding their hand, massaging their hands, feet or forehead, gently rubbing their stomach — can give that touch warmth, clarity and even have the power to bring patients out of spiralling thoughts and return them to the present. Touching with care can also create a connection between the patient and their caregiver, and sometimes reduce the patient’s pain and suffering. There was a terminally-ill child who was in pain and wanted nothing else but to hold the hand of a trusted nurse. After holding the nurse’s hand for half an hour, the child’s pain lessened and they told the nurse to continue with her work.
Encouraging Patients to Practice Mindfulness and Be with Pain
The suffering of the spirit is derived from the fictions of the self, feelings of regret and anger towards the past and anxieties about the future. A spirit mired in these distractions often aggravates its suffering. Caregivers can encourage patients to detach from them by creating a “grounding tool” that provides their spirit with an anchor, so that it does not drift towards distraction and suffering.
The caregiver might invite their patient to focus on their breath, meditate, turn their palms towards the ceiling and then to the floor, pray, practice compassion meditation, recite passages on meditation, or even listen to their favorite songs — these can all be tools for grounding the spirit. Once the spirit is occupied, then it will not become distracted and lost in the past or the future. The patient’s suffering often decreases; their physical discomfort is also assuaged. That being said, when employing various techniques to guide the patient to mindfulness, the caregiver must be mindful, confident and well-practiced. They must also have experienced the merit of applying these techniques to their own suffering.
Mindfully caring for the spiritual well-being of patients is of boundless virtue. It is not only the patient who receives care, but the caregiver themselves that is also healed from their own compassion. The caregiver also practices their own mindfulness, their ability to stay with the present and sensitivity to their own spirit. They also have the opportunity to examine the truth of life. Mindfully caring for patients is a path that illuminates the caregiver’s life and gives the patient a peaceful death.