Don’t miss this important gathering! Mindful Healthcare Summit
Don’t miss this important gathering! Mindful Healthcare Summit
How do they apply to me and how can I use embodied awareness as a tool for understanding them?
Boundary. The word conjures up images of solidity, barriers, no trespassing . . . something impenetrable and off limits. And because I’m a rebel of the 60’s and 70’s, I’ve always had difficulty being told that I can’t get to where I want to go! I interpreted boundaries as an unhealthy protective device used out of fear or even laziness. By putting distance between themselves and others, they would not have to care. And a “healthy” boundary sounded like an oxymoron. My interpretation had contributed to a disdain for the topic.
Moving beyond that simplistic perspective, I began to understand that boundaries are an essential component in relationships and communication. And I wanted to learn more. Most interestingly, how might boundaries be applied in the context of embodied awareness? Can we create a practical tool for assessing and accessing our boundaries?
I’ve developed respect for the concept of boundaries and realize that it is a complex topic. This post is an overview and introduction to the topic from an embodied perspective.
So what is a boundary, anyway?
Though I’m still not a fan of the term, an embodied awareness of boundaries can be a useful tool for managing difficult situations and relationships. Because not all boundaries are positive, I’ll add a qualifier to a working definition:
This definition provides apt parameters for how to apply the concept, beginning with the term healthy. Healthy boundaries support your autonomy and your sense of connection, they lead to open communication without obligation or hurt, and they uphold your values while allowing you to remain curious about others’ perspectives. No wonder boundaries are such a complex subject!
Boundaries are unique. The boundaries of each individual are composed of a complex history including culture, experience, sexuality, race, socioeconomic status, geography, physical makeup, age . . . Resulting in a distinct personality and a concurrent distinct set of boundaries.
Boundaries are multipurpose. They apply to our physical space, to our emotional and intellectual lives, even to our time and possessions. They involve our personal physical space and extend to our emotional & intellectual lives. How much space do we need? Do we over share or find we’re stingy with sharing? Do we allow others to take over discussions or belittle our ideas? Do we allow our work to take too much of our time?
Boundaries are dynamic. Not only can they be porous, rigid, or somewhere between, they also take a particular shape and quality depending on the context and players. What might be a rigid boundary with a patient may turn porous with a friend and even non-existent with an intimate. You may find yourself using the concept of boundaries to guide you on topics that do/don’t work with particular people: you know you’ll always argue with Uncle Jasper when discussing politics!
By exploring boundaries through the practice of embodiment, you will begin to sense your limits and discover what feels most comfortable to you. We’ll begin by working with the idea of a boundary being either rigid, porous, or semi-permeable:
Take a moment to breathe in through your nose, feeling the air travel up from the base of your spine. Feel yourself lighten. Exhale slowly through your mouth and feel yourself expand beyond your physical body.
Imagine a solid wall surrounding you. How distant or near is it to your physical body? What color is it? What is it made of? Is it opaque or transparent? As you envision the wall around you, sense what is happening in your body, to your thoughts, your breathing, your body temperature . . . Do you feel more tight or loose? Are you breathing more slowly or quickly? What else do you notice?
Take another deep inhale and exhale, and let that image dissipate.
Now try to imagine that you have absolutely no limits, that your gaze and energy and attention go on forever, way beyond your space, the structure you’re in, your town, country . . . Beyond this planet, even. Sense into yourself. What do you notice? What types of thoughts are you having? Are you feeling settled, nervous, just right? How about your breathing and heart rate? How does this time compare to the first exercise?
Inhale deeply, exhale and lighten, letting that image recede.
This time imagine that you have a kind of bubble surrounding you, that is transparent yet defined. You can see outside the bubble and others can see in. Passing from one side of the bubble to the other requires an invitation of sorts, it is a kind of passage. The bubble wall has a tension to it, but is permeable. Notice how near or far you place the edge of your bubble. Are there particular people or things or events that are in the bubble with you? Who or what is on the outside? What do you notice about your thoughts, body temperature, breathing pattern, and heart rate?
By comparing and contrasting we can get a sense for where our systems feel most comfortable. Your comfort zone will likely shift depending on the situation. You can then begin applying that embodied awareness when you are curious about your boundaries in particular situations. You might notice that you have very rigid boundaries in certain circumstances even though you noticed that that isn’t comfortable when you did the exercise. Or the opposite: that you have created a porous boundary and that also gave you a sense of unease.
When you are aware of the physical sensation of your boundaries, you can play with shifting them. Imagining a boundary more opaque or rigid, describing a broad space around you or very narrow, allowing none to pass through, or all.
The skill of embodying concepts provides you with a practical tool that you can use in the moment, on demand. You can be curious and play with shifting how you literally, and figuratively, perceive the world around you. What your system enjoys, and what it finds uncomfortable.
References & resources:
You are a top performer. You’ve got this. You are an experienced physician, RN, or student killing it in med school. You hear the talk about burnout, resilience, self-care, work-life balance. You understand that it is important, but you are different. You don’t need to indulge yourself the way others do. At the end of the day, you feel good about yourself and your work. You can relax later, when you’re not so needed. You are looking forward to that vacation at the shore . . .
Nice! We are thrilled to have you in our midst! And that is not said with tongue in cheek. Thank you for your service and your ability to carry on in a way that most of us find untenable in the long run.
A lot of us in the “service” professions strive to be a top performer. We want to be “tough” enough to not need to figure out how to maintain balance in our lives. We lean toward perfectionism and attend to the details. We know that we need to leave work, but we just need to finish this one last thing . . . We imagine we can do it all. And to a degree, we can. But eventually we feel the confines of stress and succumb to our personal version of overload. And if that weren’t enough, we might then chastise ourselves for not being able to handle it all!
So how do we develop the ability to do what we need to do, even in the face of internal or external pressure?
We practice developing tools that we know will help us develop more resilience. Hone our ability to bounce back when we get off track, as we all do. It’s not about getting off track, it’s about getting back on with increasingly agility.
I hear you saying:
So try embodied awareness. You can work on it little by little, anywhere you are, with just the tools you have at hand: your body-mind system. By tuning in to your sympathetic nervous system in the moment, you will be able to get an immediate sense of your automated reactions. In this way, you can then learn to shift those reactions into desired responses. You can do this starting right now. It can take as little as 1 minute.
Breathe in. Feel your feet on the ground. Sense the inhale up through the top of your head. Exhale your breath out your front, to your left, right, and behind. Feel where the most tension is in your body. The most relaxation . . .
This practice builds your skill of embodied awareness. As you become more skillful, you will be able to engage your awareness during difficult interactions or when you are facing something unpleasant or challenging. You build your practice by taking only a minute or so of your time interspersed throughout your day. As your practice builds, you may notice yourself being able to shift to a more relaxed state, even in the face of discomfort. You may notice that you are more able to recognize your boundaries, follow-through with your intention to take a break, stop attending to the details that are impeding your time to connect with your loved ones.
As a foundation, yoga and tai chi, mindfulness, guided imagery, body scanning and qi gong — to name a few — are all invaluable tools. And by supplementing whatever mindfulness based practice you have with the ability to engage your embodied awareness in the moment, you will become increasingly skillful at navigating low-grade threats. We face low grade threats multiple times a day. They trigger our sympathetic nervous system: the flight, flight, fawn or freeze reaction. If even slightly or briefly. But these little t “traumas” build up in our system. They can create an untenable situation.
Wendy Palmer, pioneer and master of leadership embodiment and skilled mindfulness practitioner puts it this way in her new book Dragons and Power:
The nervous system is at the heart of our ability to be resilient in challenging environments. We are not able to fully engage our beautiful frontal lobe in all it’s glory when our nervous system is feeling threatened. That is when our sympathetic nervous system is activated. Interestingly, one person’s threat might be another’s no big deal. Our nervous systems are utterly unique, finely tuned from our personal history. When we are aware of what our system finds threatening, we are better able to calm it. If we remain unaware, our body tends to run us.
So are we not tough enough? Tough enough compared to what? Let’s work with what we have at hand, where we find ourselves in this particular moment in time. It is unhelpful and counterproductive to compare ourselves to some perfectionistic construct that has nothing to do with our own unique set of circumstances.
We got this.
Working for an organization interested in resilience training? Contact us at RISE | Resilience in Service.
Looking for a way to improve your personal resilience? Visit bodycomestomind.com
Kimberly Woodland is the founder the non-profit organization RISE | Resilience in Service. RISE uses embodied awareness as an adjunct to creating sustainable change in healthcare. Individual change powered by resilience to decrease burnout and moral injury, and improve the patient experience. The RISE approach complements existing programs. It also serves as a practical tool for developing organizational resilience training.
There is no silver bullet. Uprising, racial discord, implicit and explicit bias, unconscious bias, unintentional bias, prejudice, white privilege, discrimination, racism . . . These are complex and complicated situations, conditions and attitudes. There is discord and disagreement about what might work to mend the divide and who needs to be doing what.
What I know is that I have white skin and I am biased. If I had any other skin color, I would also be biased. “Us” versus “them” can be traced to the start of our existence; and has endured.
There is no question about whether we are biased, prejudiced, or — if we have white skin — have white privilege. The starting point is yes, we are, we do. The question is: How do we reduce the bias we have? How can I make a positive impact on systemic dysfunction?
Our unintentional prejudice conflicts with our values. It creates inner discord. It is uncomfortable. We have a cognitive recognition of how we want to behave. But it is not enough to have the thought that we want to be different. If thinking alone could create change, this world would be vastly different. But thinking something doesn’t make it so.
What does create lasting change? Self awareness. Having a cognitive sense of how we want to change. Creating intention. Engaging in repeated and endless practice.
Dr. Patricia Devine has been studying unintentional bias and discrimination for over 30 years. She, Dr. William Cox and their colleagues developed an intervention to break down prejudice. It is the only one that has been studied and shown to produce long-term change in bias.
In short, they provide strategies for disrupting and replacing bias.
“I see a black woman walking on an overpass with a lot of bags in her hands. She is wearing flip flops. I think: ‘Homeless. Drugs.’ I REFLECT on my own upbringing in a predominantly white town in the 70s. I have educated myself on the rampant stereotypes of that era and beyond. I then RECOGNIZE that I am repeating the mistake. I realize that are a million probable alternatives having nothing to do with homelessness or drugs. I REJECT that stereotype. I REPLACE it with: ‘I wonder where she’s going with all those bags?’”
“I then VISUALIZE the life this woman may be living. She is walking because her car is currently in the shop. She is carrying a lot of bags because she has picnic food and a few items she is going to donate along the way to her outing. She is finally out of the hard soled shoes she has to wear at the hospital and is enjoying the feeling of air on her feet. These are her favorite flip flops and she could walk in them forever! She is excited because she is meeting her eldest daughter in the park by the water. They haven’t had any alone time for weeks because her daughter is in college.
I INCLUDE the phrases ‘Hard working,’ ‘Enjoys nature,’ and ‘Role model doctor’ in an image I create. I access that image wherever I see anyone who doesn’t have the same skin color as I do. I’m disrupting my automatic thoughts and replacing them.”
“I SUBVERT my thinking by envisioning the details of the life I’ve constructed. I INDIVIDUALIZE by thinking about her role as a doctor and mother. How difficult it is to be a physician in a hospital right now, with the documentation and case loads. I notice when I’m reverting to group think such as ‘Oh, she must have had to work so hard to go to med school.’ I PAUSE and realize there is no way I can know anything about this woman’s upbringing!”
“I think about how good it must feel to be walking in the open air on a beautiful day. How I also enjoy the open air. I also enjoy getting my feel out of shoes. And I prefer not to be in my car at all if I can help it!”
“I continue to live in a predominantly white area, but I do work with a lot of people of color. I create opportunity to practice reducing my bias in the workplace. I am educating myself on implicit bias of any kind and the history of racism in the US. I SEEK OPPORTUNITIES to create connection.”
“When I witness bias in others or see it in the flow of the workplace, I address it. I may write an email. I take time to collect myself. I can then point out that the fact that the person is “black” is irrelevant to providing therapy, for instance.”
Each one of these steps requires the foundational skill of embodied self awareness: The ability to sense what is happening in your body in the present moment. The body reacts before the mind. As Wendy Palmer so aptly states: “My mind is the starting point . . . But it is my body that actually allows me to do [what I want to do] in difficult moments, in the face of low-grade threat.” We can only make alternative choices by first becoming aware of our automatic reactions. The body is the front line to developing lasting, behavioral change.
Consider the actions necessary to disrupt bias: recognize; reflect; reject; replace; visualize; include; subvert; pause; seek; find. How do we do these things?
First you become aware of what is happening in your body. What do you notice? Where do you find yourself more tight? What is happening to your breathing? Sense your body. Having done so, you can then practice settling your nervous system. That will give you the ability to pause your automatic reaction. From that place you will be able to reflect, and include the most salient information. You will have the opportunity to sort through your options and make different choices. And then you can act on your measured interpretation skillfully, remaining calm and composed in the face of pressure. Like when you need to speak out.
And speaking out is exactly what we need to do. Feel free to connect to continue the conversation!
Resilience begins with self-awareness. How am I feeling? What sensations am I experiencing and where in my body? Am I hot? Cold? Hungry? Tired? Numb? The first step to surviving and thriving under pressure begins with this basic analysis. Excess stress often goes unnoticed at the outset. Stress accumulates under the surface of things. It chips away at our resilience. It makes us less agile, less communicative and responsive. We tend not to be as helpful, kind or generous. Our capacity for compassion falters. In short, excess stress undermines our power to be who we want to be, for ourselves and for others. And it does so exponentially when we’re under pressure.
Checking in with sensations might sound so basic that it hardly needs to be pointed out. But think about it: How in touch are you with your body throughout the day? How aware are you of your basic sensations? Take this quiz to find out: Test Your Body Awareness The results might surprise you!
Knowing how connected you are to your body is important. Because the more aware you are of your body the more you will recognize when you are in need of . . . a short break, a hug, a quiet space, a dance move, a slice of pizza.
This cannot be stressed enough:
The more you are able to take care of yourself by providing yourself with what you need, the more you can help others.
What enables you to go forth and help others in a calm, thoughtful, balanced way? Well, it depends. It hinges on the intrinsic and extrinsic factors at play at that particular moment. By checking in and becoming aware of sensations, you get a better sense of what is happening within. You become aware of the stress points and sensitivities that take you off balance. Instead of stress building up under the surface, you are able to detect stress points and shift them.
In the long term this will help you to discover unhelpful patterns, adjust them, and stay connected to how you want to be in the world.
Take a moment right now to tense your entire body. You can do this without anyone noticing what you’re doing. Tighten all your muscles . . . See how your breathing stops, the pressure builds in your head and chest? Notice what happens to your thoughts.
Now take a moment to do the opposite, to soften and open. (Again, no one needs to know what’s happening.) Notice how your muscles feel and what happens with your breathing and your thoughts.
This is an exercise in embodied self awareness. It is useful as a tool for recognizing how the body + mind system works. For centuries the brain and body connection has been severed: “I think, therefore I am.” This has created a false interpretation of how the system unfolds. We now know that there are numerous, multi-directional connections between the brain and the rest of the system. Take the example of the connection between the nerves in the gut and perception. Gut disruption and anxiety and depression are inextricably linked. The phrase “It’s all in your head” is obsolete.
Conscious engagement with your body supports resilience. In the healthcare environment, conditions were rarely ideal pre-COVID-19. The need for self-awareness to support mental health is greater now than ever. Organizations must do everything they can to support healthcare workers. And we must do everything we can to help ourselves.
When you learn the skills to settle your nervous system through embodied self awareness, you expand your ability to sort through options and develop clear, concise information. You are able to work with your stress in a more skillful way and remain calm and composed when pressure increases. You become more available. Others can ask questions and convey their needs and wants completely. You are able to engage with yourself and others in a meaningful way.
The best part is that you already have everything you need! That is: your body and being willing to take a moment or two to sense what’s happening within. You do not need to go anywhere or have special props. You do not need extensive training or hours of cognitive learning. The concept is simple, but not necessarily easy. It does require repeated practice.
Start with 10-15 seconds of awareness. Take a deep breath. What part of your body are you breathing in to? Can you feel the weight of your body on the floor or the chair? Where is most of your attention? Are your muscles tight anywhere? If so, can you make more space there?
Want to learn more? Let’s connect!