The Current

As health-care workers face 'soul-destroying' pandemic, Zen teacher offers tips for coping

An American Zen teacher and medical anthropologist says COVID-19 is revealing “profound cracks” within the culture of medicine.

But Roshi Joan Halifax sees an opportunity to improve clinician well-being

A health-care worker attends to a COVID-19 patient in an intensive care unit at the General University Hospital in Prague, Czech Republic, on April 7. One expert says front-line medical workers are feeling overwhelmed by the demands of the pandemic, and it's having an impact on both patients and caregivers. (Petr David Josek/Associated Press)

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COVID-19 is revealing "profound cracks" within the culture of medicine, an American Zen teacher and medical anthropologist says.

"I think we're in a real crisis in health-care culture right now," Roshi Joana Halifax told The Current's Matt Galloway.

"The suffering experienced by clinicians, by caregivers, has become untenable. And the outcome of this, of course, is to affect not only patients, but caregivers themselves."

More than eight months into the pandemic, front-line workers across the country are feeling the strain. In B.C., health-care professionals are sounding the alarm that they are teetering on the edge of burnout. In Toronto, front-line emergency workers are already at their breaking point, citing mental, physiological and emotional exhaustion.

Halifax, who is the founder of the Upaya Institute and Zen Center in Santa Fe, Calif., has spent decades teaching health-care workers practical ways to sustain themselves in the face of pain and suffering. Amid this difficult year, that work has become all the more important, she said.

"What we realized as the pandemic was ramping up was that health-care providers were suffering from many challenges, including challenges related to moral suffering, moral distress, moral injury," said Halifax.

Roshi Joan Halifax is the founder of the Upaya Institute and Zen Center in Santa Fe, Calif. She is helping health-care workers cope with the stress of trying to care for others during the COVID-19 pandemic. (Submitted by Joan Halifax)

Moral distress, for example, is the anguish health-care workers feel when an issue — that they feel responsible to address — arises, but ends in suffering because they are unable to act on it due to internal or external constraints, Halifax explained.

It's an issue health-care workers have raised throughout the pandemic as hospitals reach capacity and staff are forced to make decisions about who gets care.

To help health-care workers through such dilemmas, Halifax helped start Being with Suffering, a seminar series that offers clinicians the resources to deal with burnout and handle the challenges of caring for people during what she described as a "soul-destroying" pandemic.

Part of that work is to help people identify signs of "pathological altruism," Halifax said. 

Pathological altruism happens "when there's mental, physical, relational, social, [or] economic harm to ourselves as we engage in service to others," she said.

This pandemic is putting an enormous added pressure on clinicians, and so recognizing when moral distress is happening is important.- Roshi Joan Halifax

"One of the things that I think is really important to recognize is that moral suffering is very much a part of the life of any caregiver. That is, we do the best we can to alleviate pain and suffering, and yet the outcome is often not what we wish," Halifax told Galloway. 

"In the case of what's happening now, this pandemic is putting an enormous added pressure on clinicians, and so recognizing when moral distress is happening is important."

Halifax offered a few tips for anyone dealing with similar struggles: 

Be present when you feel anxious

When you're feeling a sense of anxiety or inadequacy, Halifax said it's important to track your emotional and cognitive experience so you can "reallocate your attention."

She suggested trying to ground yourself — or be present.

But how do you do that? 

"In a way, it has to do with withdrawing your attention for a very brief period, like, you know, one breath worth, and allocating your attention to the body, or to the sensation of your sitz [sitting] bones on the chair, or your feet on the floor, or bringing your attention to your breath just to take a moment to actually come into presence," Halifax explained.

ER doctor teaches how to practise mindfulness during self-isolation

1 year ago
2:30
Dr. James Maskalyk, ER doctor and meditation teacher, guides us through a breathing and mindfulness exercise. (Photo by James Maskalyk) 2:30

Remember your intention

"Another thing … that is really critical, which often gets lost in the fray, is that we lose the thread of why we are here in service to others," Halifax said.

That's why it's important to remember what your intention is in serving others, she explained.

Although most caregivers enter into their jobs out of a desire to help others, Halifax said that altruism can be "squeezed out" of people as they try to meet the demands of the job or the institution they serve in.

"So recalling your intention is really critical in this experience of serving others."

Look at things from a broader perspective

"It's a very poor use of our energy, and it's actually toxic for us, to spend time railing against the reality of any given situation that is putting pressure on us," Halifax said. 

Instead, she suggested trying to step out of the position of feeling victimized and look for a deeper perspective in the situation.

She said it can also help to let go of unrealistic expectations.

Watch your pain intake

Lastly, if we are constantly exposed to suffering and pain, without having any breaks from it, it can lead to burnout or feeling overwhelmed, Halifax said.

"It is very important to find a way to titrate our exposure to conditions that are characterized by extreme suffering," she said.

Halifax says that constant exposure to suffering can lead to burnout. (Massimo Pinca/Reuters)

Despite the difficult challenges health-care workers are facing in the pandemic — including the challenge of caring for themselves — Halifax sees an opportunity.

"We know that when systems break down, if they learn from the breakdown process, they can reorganize themselves at a … more functional level," said Halifax. 

"And I think we have an opportunity now to actually address issues in medical education that have been largely unaddressed in relation to clinician well-being."


Written by Kirsten Fenn. Produced by Julie Crysler

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