The value of contemplative practices in mental health nursing: Let's get contemplating!
By Dr Susan Sumskis, RN, CMHN, FACMHN
Monday 4 April 2022
From deep listening to yoga, Chair of the new Australian College of Mental Health Nurses Contemplative Practices Special Interest Group (ConSIG) Susan Sumskis discusses the importance of contemplative practices for caring professions and talks about why it is worthwhile joining the new SIG.
The relentless pressure in the role of a modern healthcare professional has led to disembodiment. We have learned to override and even ignore our innate bodily signalling. We can ignore the most basic needs like thirst, hunger or arising feelings and emotions. Not surprisingly, lack of awareness and the care that should routinely result, leads to burnout, physiological and psychological, in the nursing role.
Restorative practices of both mind and body are needed to reset our ways of being and attending in not only our work, but often our lives. There are many attitudes and practices that can restore us. A useful umbrella term for these is 'contemplative practices'.
To contemplate is to gaze attentively within (Cigrand 2020). Contemplative practices originated from ancient wisdom traditions and have recently been gaining increasing recognition for their capacity to reduce suffering, build resilience and support wellbeing.
Contemplation is an individual activity and a personal practice that requires immersion in, and reflection on an object or experience. Contemplation can be on a present moment experience, an idea, a thought, a feeling, or another aspect of conscious experience (Cigrand 2020). At the simplest end, we reconnect with and learn to pay attention to our bodily signals that a physiological need must be met. At the more complex end we can reconnect with our higher self, our aspirations, meaning, purpose, ethical beliefs, and intentions.
Contemplative practices that can help to restore our compromised connections include things like deep listening, meditation, yoga, storytelling, music, and more (Cigrand 2020; Fiske 2017). Many of the things we love to do can be contemplative in nature, for example, things that bring us into a state of flow, like dancing, creative art or playing a musical instrument.
To contemplate is to move beyond thinking and the associations that are bound to the object being thought about to change the viewer’s understanding of what is beyond the physical properties (Hansen 2005). I may look at an object, apply a judgement and immediately move on. For example, that is an egg. I eat eggs. End of. Contemplating an egg, I see its shape, its colour, feel its form and temperature, and think about its journey into the world and onto my plate, I think about the life of the chicken who laid it, and then personal values might arise. Have we not learned to use the same principles in thinking about a person who is recovering? In the act of contemplation, limits are transcended, and perception is transformed.
Transformation occurs through taking the mind off autopilot to reduce the habitual, reactive, and unregulated thinking associated with the brain’s Default Mode Network, which unregulated, can lead to suffering and disease (Killingsworth & Gilbert 2010). You may have heard the term ‘monkey mind’? We are not our thoughts, we have thoughts. We have consciousness and from that perspective, we can learn to watch our thoughts, giving us an immensely valuable distance between arising thought and action. Through becoming the watcher of our own thinking and conceptualising, we can increase our ability to regulate reactivity and to choose how we respond.
Can you recall a moment when you were so immediately overcome by an experience that you were lost for words? This is an example of space between stimulus and response. A spontaneously arising state of awe can momentarily leave us standing there with our mind, and often our mouth, wide open. For a moment, we are taken to a place outside of our conceptual mind and there, from that place, we can formulate whatever response we desire. We can intentionally capture, practice, and grow that pause.
Contemplative practices are essential for the caring professions. Regular contemplative practice supports deeply therapeutic mental health nursing practice, having presence of body and mind, turning up awake and aware, listening deeply, hearing and responding.
Emerging research findings of inclusion of practices in undergraduate nursing curriculum identified practices are associated with deep reflectivity, connectedness, respect, and gratitude (Charoensuk et al. 2016; Fiske 2017; Sable 2014). Studies in nursing leadership show reduced burnout (Cunningham & Çayir 2021). Practice brings a lasting impact, not only for self but for those we connect with daily (Sharts-Hopko 2007). Research is also associating the use of contemplative practices in recovery with ongoing therapeutic effect for living with mental health conditions (Davis, Schwartz & Cefus 2017; Larrivee & Echarte 2018).
Contemplative practices reconnect us more deeply with ourselves and with others and need to be essential training for healthcare professionals who want to care for themselves while they care for others. Knowing this, contemplative teaching and learning is the pedagogical foundation in the postgraduate mental health programs at the Nan Tien Institute. The College has recently accredited Nan Tien’s programs and represent a unique offering of an evidence-based scientific mental health education that is underpinned by Buddhist values and contemplative practices.
Together with the ACMHN, I'm convening an innovative Contemplative Practices Special Interest Group (ConSIG) to explore the value of contemplative practices within the mental health nursing profession. ConSIG members will work together to practice and consider how to guide the translation of contemplative practices, with the aim of supporting practitioner wellbeing, revitalising the use of contemplative and restorative therapeutic arts, and in the longer term, introducing and supporting these practices as meaningful elements within people’s recovery. I warmly invite you be part of this collaborative movement to reduce suffering, build resilience and support wellbeing for all.
Charoensuk, S, Naksrisang, W, Suapumee, N & Plodpluang, U 2016, 'The Development of desirable characteristics of nursing students using extra-curriculum activities program based on the contemplative education', Ramathibodi Nursing Journal, vol. 22, no. 2, pp. 192-205.
Cigrand, CB 2020, Contemplative Pedagogy: A Grounded Theory of the Integration of Contemplative Practices and Perspectives Within Counselor Training, University of Northern Colorado, Cunningham, T & Çayir, E 2021, 'Nurse leaders employ contemplative practices to promote healthcare professional well-being and decrease anxiety', JONA: The Journal of Nursing Administration, vol. 51, no. 3, pp. 156-161.
Davis, AJ, Schwartz, RC & Cefus, JM 2017, 'A Relational-contemplative model of counselor practice with schizophrenia', Journal of Counselor Practice, vol. 8, no. 1, pp. 1-21.
Fiske, EA 2017, 'Contemplative activities in undergraduate nursing courses', Journal of Nursing Education, vol. 56, no. 6, pp. 378-382.
Hansen, LK 2005, Contemplative interaction: alternating between immersion and reflection, Proceedings of the 4th decennial conference on Critical computing: between sense and sensibility Keator, M 2018, Lectio Divina as Contemplative Pedagogy: Re-appropriating Monastic Practice for the Humanities, Routledge, New York.
Killingsworth, MA & Gilbert, DT 2010, 'A wandering mind is an unhappy mind', Science, vol. 330, no. 6006, pp. 932-932.
Larrivee, D & Echarte, L 2018, 'Contemplative meditation and neuroscience: Prospects for mental health', Journal of religion and health, vol. 57, no. 3, pp. 960-978.
Miller, J 2014, The contemplative practitioner: Meditation in education and the workplace, 2nd, University of Toronto Press, Toronto, CA.
Sable, D 2014, 'Reason in the service of the heart: The impacts of contemplative practices on critical thinking', The Journal of Contemplative Inquiry, vol. 1, no. 1,
Sharts-Hopko, NC 2007, 'Personal and professional impact of a course on contemplative practices in health and illness', Holistic Nursing Practice, vol. 21, no. 1, pp. 3-9.
Sue Sumskis’ work as a CMHN has spanned two decades, across mental health clinical settings and academic roles in undergraduate and postgraduate education, including completing a PhD investigating the meaning of resilience for people who experience schizophrenia. Sue's role as Head of Mental Health programs at the Nan Tien Institute draws together western science-based health evidence with Eastern wisdom traditions to produce a model of contemplative learning that incorporates care for self through wellbeing practices within mental health education. Sue’s role as a member of the Australian Compassion Council supports her current focus on reducing burnout, empathic distress and trauma in first-responder workforces and creation of the Contemplative Practices SIG aims to bring this knowledge and these practices to the mental health nursing workforce for personal and professional use.
Dr Susan Sumskis