Psychophysiology of slow breathing exercises using heart rate variability measurements for stress reduction

Slow breathing exercises, associated with meditation and other eastern style modalities like tai chi and hatha yoga, are now increasingly employed in mainstream medicine to reduce stress, attenuate moderate hypertension, and alleviate symptoms of lifestyle-related illnesses. The clinical literature on slow breathing exercises includes studies employing various physiological measurements, including heart rate variability (HRV), galvanic skin response, and changes in skin temperature. HRV has been increasingly used to measure the activity of the autonomic nervous system in various human studies employing healthy and chronically ill subjects. 1. Objective: To understand the effects of slow breathing exercises on heart rate variability as a complementary intervention for stress reduction. 2. Method: Four subjects, through repetitive trials, were instructed to slow down their breathing following a metronome at 10 breaths per minute or 6 breaths per minute or spontaneously relax to slow down their respiratory rate. The ECG, heart rate, and respiratory rate were recorded using a Powerlab set-up (ADI). 3. Key Results:  Results showed an increase in amplitude of heart rate variability during these slow breathing exercises, either through the metronome-guided or spontaneous slow-breathing exercises, especially around a breathing frequency of 6 breaths per minute. The increased amplitude of heart rate variability can be seen as a positive sign, a marker for sympathovagal balance. 4. Conclusion: HRV measurements have shown that slow breathing exercises can increase heart rate variability.  Future protocols for clinical trials are being projected using the HRV technique and other physiological measurements for studying effects of yoga-based complementary interventions for stress reduction

Uncovering freedom: a story of empowerment

This article tells the story of a woman suffering from food anxiety and unintentional weight loss and how shifting to an empowerment-based model of care led her onto a path of health and healing

Touching the compassionate heart: the ground of healing

I am a psychiatrist, psychotherapist, secular mindfulness teacher and former university lecturer. Having conducted research in fields varying from laboratory molecular medicine to clinical applications of mindfulness, I took a two year sabbatical to focus on an inner search and healing. It was spent mostly spent in Plum Village: a Buddhist monastery in France in the tradition of Thich Nhat Hanh. I have recently returned to clinical work.I found that it was not until I took a compassionate view of myself that I truly began to heal; and that following my heart was the only way I could negotiate the uncertainties of the path

Healing in western medicine

NON

Healing environments that facilitate medical student training: from urban to rural settings

NON

On Africa, children, and the mutual dimension of healing

Non

Incorporation of spiritual care as a component of healthcare and medical education: comparison of Sub-Saharan African and Northern European viewpoints

This study addresses cultural differences regarding views on the place for spirituality within healthcare training and delivery. A questionnaire was devised using a 5-point ordinal scale, with additional free text comments assessed by thematic analysis, to compare the views of Ugandan healthcare staff and students with those of (1) visiting international colleagues at the same hospital; (2) medical faculty and students in United Kingdom. Ugandan healthcare personnel were more favourably disposed towards addressing spiritual issues, their incorporation within compulsory healthcare training, and were more willing to contribute themselves to delivery than their European counterparts. Those from a nursing background also attached a greater importance to spiritual health and provision of spiritual care than their medical colleagues. Although those from a medical background recognised that a patient’s religiosity and spirituality can affect their response to their diagnosis and prognosis, they were more reticent to become directly involved in provision of such care, preferring to delegate this to others with greater expertise. Thus, differences in background, culture and healthcare organisation are important, and indicate that the wide range of views expressed in the current literature, the majority of which has originated in North America, are not necessarily transferable between locations; assessment of these issues locally may be the best way to plan such training and incorporation of spiritual care into clinical practice

Finding My Voice in Residency: Reflections on Integrative Family Medicine

The author discusses how self awareness and healing play a key role within the evolving field of integrative family medicine

On Teaching the Sum While Paying Attention to the Parts: Whole Person Care through Ethnography in Medical Education

Objective—This article provides a reflection on medical teaching opportunities for whole person care based on our experiences mentoring 2nd-year medical students through an Ethnography Practicum at a Canadian university.                                                                  Background—The Ethnography Practicum is a new addition to the Family Medicine Transition to Clinical Practice (TCP) curriculum introduced in the second year of medical school at McGill University. It involves 30 hours of instruction (6 hours in lectures with an instructor, and 24 hours in small-group tutorials with the authors), and 9 hours of fieldwork observations in various community health settings across Montreal, QC. The primary aims of the Practicum converge with those of the TCP generally in two important ways: to inculcate in students the concepts of patient centered care, and to promote family medicine as both an academic discipline and career option.                    Results and Discussion— Our experiences illustrate two tensions that shape students’ expectations and experiences throughout their involvement in the Practicum and, in turn, highlight the implications for teaching whole-person care. First, ethnography as a combination of different methods has itself been the locus of tensions between positivist and critical traditions in the three last decades. Second, the Practicum is situated precisely at the crossroads of key moments on the professional identity formation continuum for our students. Such a crossroads is disruptive to the status quo of medical traineeship characteristic of the first two years in medical school, and thus reorients professional identity formation. The above tensions reveal how ethnography is not only a revered research tradition in the humanities, but can also be a conduit to whole person care-inspired clinical practice.Conclusion—As instructors and mentors involved in this Ethnography Practicum, we are continually forging a new relevance for organizational ethnography in medical training, where medical students can reflect and act on competencies beyond clinical ones. The Practicum provides a space for students to wrestle with alternative epistemologies to understanding the social world in which medicine is embedded. We lastly provide pragmatic ways to better address these tensions in an effort to support students as they proceed through the (multifaceted) development of their professional identities as future physicians

Transformative Learning as the Basis for Teaching Healing

The author describes the nature of transformative education, and highlights the potential importance of its implementation in creating physician-healers and propagating whole person care. The author proposes that teaching courses in healing are integral to the professional identity formation of “doctors as healers”. The teaching of Healing in workshop format for medical students is used as a template to suggest innovative teaching models (after Mezirow, Boyd and Myers, Daloz and Dirkx) which may be used to  engender  personal transformation in doctors and medical students, many of whom are trained as applied scientists in health