Facing the COVID-19 pandemic is challenging for all. Countries around the world have imposed unprecedented controls, including social distancing, travel restriction, self-isolation, gathering ban, and business restriction to contain the exponentially increasing spread. Although there are signs of slowing down of the infection rate in many countries due to these lock-down measures, the threat of COVID-19 is still on-going. The World Health Organization warned of an “immediate second peak” if the current rules to halt the outbreak were letting up too soon [1].
While persisting the current lock-down can lower the immediate risk of community infections, there are long-term costs to health and economic wellbeing. Already, many countries are expected to enter recession this year. Singapore is forecasting a worst-ever recession with an expected shrinkage of the gross domestic product between 4 and 7 per cent this year [2]. No doubt, COVID-19 will continue to impact not only the health but also the livelihoods of people for a long time. It is in time like this that practising mindfulness can help everyone to face the immediate and forthcoming challenges in this crisis.
What is mindfulness?
Mindfulness is often considered a form of meditation. Many people may conjure up a stereotype image of meditation as one sitting cross-legged quietly, with the hands forming some special mudras to achieve transcendental experiences. In truth, meditation is simply any form of mind and body practices that involve emotional and attentional regulation and not restricted to any posture [3]. Therefore, Yoga, Tai Chi, and Qigong are also meditation, and they all incorporate mindfulness as an integral element. Mindfulness is a mental state achieved by focusing one’s awareness on the present moment, while calmly acknowledging and accepting one’s bodily sensations, feelings, and thoughts [4]. As such, mindfulness can be applied anytime, anywhere, with no restriction to posture and activity.
Mindfulness reduces stress and anxiety
Mindfulness begins with awareness of the body. Traditionally, the practice starts by observing the breaths. By merely bringing the mind back from external engagement to feel the in and out breaths, calmness and relaxation will naturally develop. However, it takes training and experience to continuous hold the attention at the breaths without being distracted. Hence, sitting in a quiet and peaceful environment can be helpful.
One immediate benefit of breath watching is stress reduction through the activation of the parasympathetic nervous system and reduction of cortisol production. The body goes into a resting mode. The breaths become slow and rhythmic, heart rates reduced, and muscles relaxed [5–7]. Continuing this practice also can help to lower anxiety, improve memory and attention, and thus increase performance in a range of tasks [8]. For this reason, mindfulness practice is especially useful for healthcare professionals and all frontline workers currently fighting COVID-19 infections [9]. Also, for those who work from home during this period, spending 10-20 minutes to practise mindfulness of breathing can be very refreshing and rejuvenating after hours of staring at the computer screen. The mindfulness-based technique is well known to be a useful tool for stress management [10].
Mindfulness for pain and sickness
With the familiarisation of mindfulness with breathing, one can start to apply the awareness of the body during sitting, standing, walking, and even lying down. Always aware of the postures and bodily sensations with an accepting mind. An essential skill to master as it can be beneficial when one is facing with physical discomfort and pain, such as complications from the COVID-19 infection. Research has shown that even a single session of mindfulness training on acceptance of bodily sensations can alleviate pain [11]. In one study, hospital patients were able to be more accepting of the unpleasantness of pain and reduce the desire for pain medications. They became more relax and experienced an increase in pleasurable body sensations [11]. Mindfulness meditation is also known to improve symptom and quality of life in chronic pain patients [12]. Such patients, especially the older cohort, can find relief with mindfulness when they are confined at home with other care facilities shutdown during this period.
Mindfulness and self-regulation
As one practise mindfulness of the body, one will naturally become more sensitive to feelings and emotions. Such ability can be a great help during this uncertain time when fear, insecurity, confusion, and emotional isolation abound. Issues and conflicts often surface when family members living closely for an extended period, which is unavoidable when movement restrictions for COVID-19 protection are in place. Sadly, the escalation of domestic violence is an unintended negative consequence during this time [13]. Through growing awareness, the practice of mindfulness helps to avert reaction to negative feelings and emotions and promote actions that are constructive and positive. Mindfulness improves the activation and connectivity in brain areas related to self-regulation, as shown in a study using neuroimaging techniques [14]. Therefore, mindfulness is an effective means to overcome conflicts [15] and reduce aggression [10]. Individual practising mindfulness in the family further improves relationships, child outcomes, and overall wellbeing [16].
Mindfulness and mental health
The Covid-19 pandemic is causing many major stressors that can contribute to widespread emotional distress and increased risk for mental health conditions [17]. For patients and carers, the lack of effective treatment and potential complications and mortality are frightening. For healthcare professionals, the overstretching resources, constant risk of close contact, and the sense of helplessness in losing patients can all lead to burnout. For businesses, the growing financial losses suffered, and the groom economic prospect is worrying. For workers, there are fears for their job and financial security. For those who have lost their jobs, stress and anxiety are mounting.
With mindfulness, one can become aware of the negative emotions and associated thoughts. By being non-judgemental, it will become easier for one to move on with negative experiences without the mind repetitively evaluating the situation encountered [18]. Such skilful means of emotion regulation can increase tolerance to negative affect and improve mental wellbeing. One can become more equanimous in the face of difficulties. Hence, mindfulness is a preventive strategy against the development of disordered conditions due to fear, anxiety, obsessiveness, depressive mood, and stress experienced in the current climate [19].
Mindfulness build resilience
Resilience is the quality to persevere in the time of hardships and failures. It is the quality that enables one to “be knocked down by life and come back stronger and ever” [20]. Resilience is needed not only for individuals but also for businesses, communities, and nations to steer through this COVID-19 storm. For healthcare workers, prolonged exposure to the pain and suffering of others may take a toll on the phycological wellbeing and functioning, leading to compassion fatigue and burnout. Mindfulness-based training has demonstrated effectiveness in improving resilience among them [21]. Improvement in resilience has also been should in students [22], office workers [23], and professionals [24]. Hence, faced with the uncertain future, mindfulness is a vital skill to be harnessed.
Mindfulness and compassion
One result of the practice of mindfulness is the increasing awareness of the suffering of self and others. As such, mindfulness practice often accompanied by the generation of thoughts of loving-kindness and compassion. These positive emotions activate the neuro circuitries linked to empathy [25] and encourage more prosocial altruistic behaviours [26]. One becomes more willing to render a helping hand to those in needs and make financial contributions to alleviate others’ difficulties [26]. Mindfulness practice can promote kindness in the community and a more compassionate society, one that is in dire need in the time of crisis.
Conclusion
Mindfulness can help to reduce stress, alleviate pain, enhance self-regulation, and promote mental wellbeing. The practice will be of great help to everyone during this challenging time when COVID-19 wreak havoc on earth, impacting not only the health but also the livelihoods of many people. Mindfulness practice can improve resilience for all to weather through this hardship and lead to a kinder and more helping society.
.jpg)
References
[1] WHO warns of “second peak” in areas where COVID-19 declining, Channel News Asia. (2020). https://www.channelnewsasia.com/news/world/who-warns-second-peak-covid-19-coronavirus-declining-12768450 (accessed May 26, 2020).
[2] S.K. Tang, Singapore’s GDP expected to shrink between 4% and 7% as growth forecast cut again on COVID-19 impact – CNA, Channel News Asia. (2020). https://www.channelnewsasia.com/news/singapore/worst-recession-gdp-forecast-cut-again-covid-19-12767948 (accessed May 26, 2020).
[3] S.L. Ooi, S.C. Pak, The Landscape of Current Meditation Research: An Overview to the Special Issue on “Health Benefits of Meditation,” OBM Integr. Complement. Med. 4 (2019) 8. doi:10.21926/obm.icm.1902033.
[4] Mindfulness, Lexico.Com. (n.d.). https://www.lexico.com/en/definition/mindfulness (accessed May 26, 2020).
[5] X. Ma, Z.-Q. Yue, Z.-Q. Gong, H. Zhang, N.-Y. Duan, Y.-T. Shi, G.-X. Wei, Y.-F. Li, The Effect of Diaphragmatic Breathing on Attention, Negative Affect and Stress in Healthy Adults, Front. Psychol. 8 (2017) 874. doi:10.3389/fpsyg.2017.00874.
[6] C.-K. Peng, I.C. Henry, J.E. Mietus, J.M. Hausdorff, G. Khalsa, H. Benson, A.L. Goldberger, Heart rate dynamics during three forms of meditation., Int. J. Cardiol. 95 (2004) 19–27. doi:10.1016/j.ijcard.2003.02.006.
[7] M.A. Russo, D.M. Santarelli, D. O’Rourke, The physiological effects of slow breathing in the healthy human, Breathe (Sheffield, England). 13 (2017) 298–309. doi:10.1183/20734735.009817.
[8] K.S. Carter, R. Carter 3rd, Breath-based meditation: A mechanism to restore the physiological and cognitive reserves for optimal human performance, World J. Clin. Cases. 4 (2016) 99–102. doi:10.12998/wjcc.v4.i4.99.
[9] C. Behan, The benefits of Meditation and Mindfulness practices during times of crisis such as Covid-19, Ir. J. Psychol. Med. (2020) 1–8. doi:10.1017/ipm.2020.38.
[10] A. Gillions, R. Cheang, R. Duarte, The effect of mindfulness practice on aggression and violence levels in adults: A systematic review, Aggress. Violent Behav. 48 (2019) 104–115. doi:10.1016/j.avb.2019.08.012.
[11] E.L. Garland, A.K. Baker, P. Larsen, M.R. Riquino, S.E. Priddy, E. Thomas, A.W. Hanley, P. Galbraith, N. Wanner, Y. Nakamura, Randomized Controlled Trial of Brief Mindfulness Training and Hypnotic Suggestion for Acute Pain Relief in the Hospital Setting, J. Gen. Intern. Med. 32 (2017) 1106–1113. doi:10.1007/s11606-017-4116-9.
[12] L. Hilton, S. Hempel, B.A. Ewing, E. Apaydin, L. Xenakis, S. Newberry, B. Colaiaco, A.R. Maher, R.M. Shanman, M.E. Sorbero, M.A. Maglione, Mindfulness meditation for chronic pain: Systematic review and meta-analysis, Ann. Behav. Med. A Publ. Soc. Behav. Med. 51 (2017) 199–213. doi:10.1007/s12160-016-9844-2.
[13] C. Bradbury-Jones, L. Isham, The pandemic paradox: The consequences of COVID-19 on domestic violence, J. Clin. Nurs. n/a (2020). doi:10.1111/jocn.15296.
[14] Y.-Y. Tang, M.I. Posner, M.K. Rothbart, Meditation improves self-regulation over the life span, Ann. N. Y. Acad. Sci. 1307 (2014) 104–111. doi:10.1111/nyas.12227.
[15] S.L. Horton-Deutsch, J.M. Horton, Mindfulness: overcoming intractable conflict., Arch. Psychiatr. Nurs. 17 (2003) 186–193. doi:10.1016/s0883-9417(03)00089-x.
[16] S.M. Bögels, L.-M. Emerson, The mindful family: a systemic approach to mindfulness, relational functioning, and somatic and mental health., Curr. Opin. Psychol. 28 (2019) 138–142. doi:10.1016/j.copsyc.2018.12.001.
[17] B. Pfefferbaum, C.S. North, Mental health and the Covid-19 pandemic, N. Engl. J. Med. (2020). doi:10.1056/NEJMp2008017.
[18] N.A.S. Farb, A.K. Anderson, Z. V Segal, The mindful brain and emotion regulation in mood disorders, Can. J. Psychiatry. 57 (2012) 70–77. doi:10.1177/070674371205700203.
[19] M.F. Rodrigues, A.E. Nardi, M. Levitan, Mindfulness in mood and anxiety disorders: a review of the literature., Trends Psychiatry Psychother. 39 (2017) 207–215. doi:10.1590/2237-6089-2016-0051.
[20] C.E. Ackerman, What is Resilience and Why is It Important to Bounce Back?, PositivePsychology.Com. (2020). https://positivepsychology.com/what-is-resilience/ (accessed May 28, 2020).
[21] D.D. Colgan, M. Christopher, S. Bowen, C. Brems, M. Hunsinger, B. Tucker, E. Dapolonia, Mindfulness-based Wellness and Resilience intervention among interdisciplinary primary care teams: a mixed-methods feasibility and acceptability trial, Prim. Health Care Res. Dev. 20 (2019) e91. doi:10.1017/S1463423619000173.
[22] F. L. E. Fisher, A. M. Pidgeon, The Four-Facet Model of Eudaimonic Resilience and Its Relationships with Mindfulness, Perceived Stress and Resilience, OBM Integr. Complement. Med. 3 (2018) 15. doi:10.21926/obm.icm.1803015.
[23] L.G. Hilton, N.J. Marshall, A. Motala, S.L. Taylor, I.M. Miake-Lye, S. Baxi, R.M. Shanman, M.R. Solloway, J.M. Beroesand, S. Hempel, Mindfulness meditation for workplace wellness: An evidence map, Work. 63 (2019) 205–218. doi:10.3233/WOR-192922.
[24] A. Hanna, A.M. Pidgeon, Leveraging Mindfulness to Build Resilience and Professional Quality of Life in Human Service Professionals, OBM Integr. Complement. Med. 3 (2018) 7. doi:10.21926/obm.icm.1802007.
[25] A. Lutz, J. Brefczynski-Lewis, T. Johnstone, R.J. Davidson, Regulation of the Neural Circuitry of Emotion by Compassion Meditation: Effects of Meditative Expertise, PLoS One. 3 (2008) e1897. doi:10.1371/journal.pone.0001897.
[26] D. Lim, P. Condon, D. DeSteno, Mindfulness and compassion: an examination of mechanism and scalability, PLoS One. 10 (2015) e0118221–e0118221. doi:10.1371/journal.pone.0118221.