The Body Scan: Mindfulness Meets Anatomy

By Edgar Meyer (member of the AAA Committee for Early-Career Anatomists)

This article was originally published in the June 16, 2021 edition of the Anatomy Now newsletter.

Present Moment.  It’s morning!  Another day, and you are still living the dream.  You have donned your clothes, and you have arrived at work with intentionality and determination.  You finish chugging your coffee, and the roasted flavor lingers on the root of your tongue.  You set foot into the lab, and immediately, the LED lights mesmerize you, as if for the first time.  The fumes of formaldehyde cling to your nasal mucosae and pervade your lungs.  You can already hear the resonating clamor of dissection tables being opened and the metallic clangs of probes and forceps being placed upon the steel trays.  You caress the rubbery texture of the nylon gloves as you stretch them over your hands, reveling in the present moment just before the rest of the day’s journey begins.

Let’s face it; this routine is probably not exactly how you would experience or describe a typical day as an anatomist or an anatomy instructor.  I mean, how often do we ever really consider the present moment mindfully, with full awareness and appreciation of each observation with our senses?  Let alone, how often do we consider our very own bodies or the bodies of generous donors with an experience of perpetual gratitude and awe?  Perhaps some of us maintain a semblance of child-like wonder in our explorations of anatomical complexities.  But perhaps many of us take our encounters for granted as we have been conditioned by consistency and familiarity to the point that we fail to notice the uniqueness in each new present-moment experience. 

Awareness.  This westernized concept of mindfulness has its roots in the East Asian religious tradition of Buddhism.  The term mindfulness, or awareness, is the English translation of sati, a word in Pali, the language of early Buddhist writings (Frisk, 2012).  Mindfulness has been defined by Jon Kabat-Zinn, M.D., as “awareness that arises through paying attention, on purpose, in the present moment, non-judgmentally, […] in the service of self-understanding and wisdom” (Mindful, 2017).  The popularization of mindfulness practice in the United States is mainly due to the work of Dr. Jon Kabat-Zinn, Professor Emeritus of Medicine and founder of the Stress Reduction Clinic and the Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Memorial Medical Center and the University of Massachusetts Medical School (UMass MH, 2021).  Dr. Kabat-Zinn developed a more scientifically oriented program called Mindfulness-Based Stress Reduction (MBSR) (Wilson, 2014), drawing from the teachings of Zen Buddhist teachers like Thich Nhat Hanh and Seung Sahn (Fitzpatrick, 2019; Kabat-Zinn, 2017).  Since this program’s inception, Dr. Kabat-Zinn’s work has inspired the establishment of other organizations that utilize mindfulness practices, such as the Center for Mind-Body Medicine (CMBM, 2021) and the Center for Koru Mindfulness (CKM, 2021), and of the use of apps like Headspace (2021).

The Mindfulness Program at the University of Arkansas for Medical Sciences (UAMS, 2021) strives to encourage this same level of mindful awareness among the faculty, staff, students, and community members who participate in the thirty-minute mindfulness sessions offered every weekday at noon.  As a member of the team of faculty who facilitate these sessions, I have acquired just as much (if not more) meaning and purpose from offering these opportunities to others as I have from incorporating mindfulness practices into my own daily routine.  All teachers within the program are either certified or working toward certification in either Koru Mindfulness or Mindfulness-Based Stress Reduction (MBSR).  Both mindfulness approaches feature concepts of acceptance, non-judgmental attitude, and present-moment awareness as described in Dr. Kabat-Zinn’s book Full Catastrophe Living (Kabat-Zinn, 1990).

Why Mindfulness?  For three years, a combination of these two sets of mindfulness practices have been incorporated into the UAMS Physician Assistant (PA) Program with noticeable positive results among the students.  In a recent mindfulness session with the PA students, I guided them in the Koru Mindfulness body scan guided meditation, incorporating additional modifications focusing on specific muscles relevant to the students’ upcoming exam.  The body scan meditation invites students to allow their attention to settle on specific regions or parts of their bodies and to focus their awareness on the sensations in those parts or regions, using these sensations as anchors to their present-moment experience.  The body scan typically begins with their feet, and the facilitator gradually guides them in moving their attention up their bodies all the way to their heads.  At each point or region, the students are invited to notice any sensations they experience, if applicable, and to breathe out any tightness or tension they might be experiencing in that particular point or region.  Finally, the students are encouraged to perform one last scan of their entire body from head to toe, bring their awareness to any tight place, and breathe out any tightness or tension that might be present in that tight place.  In the subsequent debrief, students report relaxation, relief, and novel realizations about themselves.

Overall, in studies, the body scan mindfulness practice has been shown to confer to practitioners significant reductions in anxiety, depression, and perceived stress and significant advancements in present-moment awareness, observational skills, wellbeing, and overall mental health (Carmody & Baer, 2008; Lengacher et al., 2009; Dreeben et al., 2013).  In addition, mindfulness practices in general within the literature have shown improvements in adaptive body awareness and attention and emotional regulation (Hölzel et al., 2011), responses to stress and anxiety (Edenfield & Saeed, 2012), interoception (Gibson, 2019), and heart rate and blood pressure (HHP, 2021).

Gratitude.  Through the daily incorporation of the body scan meditation and other mindfulness practices, students are likely to have greater potential in dealing with the stress associated with balancing school and personal life, coping with anxiety associated with exams, and improving their mindful awareness of the humanity of the cadaveric donors with whom they interact.  Similarly, faculty who regularly practice mindfulness, and the body scan in particular, could have the same potential to increase their own awareness of their present-moment experiences in the anatomy lab.  Perhaps then, each day of work, though similar to the one before, could be encountered in an ever-increasingly novel way, enriched with sensations and observations more invigorating than the last.  Through this degree of openness, we can cultivate a continuous commitment to let go of judgment toward ourselves and others, embrace compassion for ourselves and others, and express gratitude for both the living and the dead who teach and inspire us every day.

References

Carmody, J., & Baer, R.A. (2008). Relationships between mindfulness practice and levels of mindfulness, medical and psychological symptoms and well-being in a mindfulness-based stress reduction program. Journal of Behavioral Medicine, 31(1), 23-33. doi: 10.1007/s10865-007-9130-7 URL: https://pubmed.ncbi.nlm.nih.gov/17899351/ [accessed 3 Jun 2021].

The Center for Koru Mindfulness (CKM). (2021). The Center for Koru Mindfulness, Durham, NC. URL: https://korumindfulness.org/ [accessed 3 Jun 2021].

The Center for Mind-Body Medicine (CMBM). (2021). The Center for Mind-Body Medicine, Washington, DC. URL: https://cmbm.org/ [accessed 3 Jun 2021].

Dreeben, S.J., Mamberg, M., & Salmon, P. (2013). The MBSR body scan in clinical practice. Mindfulness, 4(4):394-401. doi: 10.1007/s12671-013-0212-z URL: file:///C:/Users/Edgar%20Meyer/Downloads/DreebenMambergSalmon2013M44.pdf [accessed 3 Jun 2021].

Edenfield, T.M., & Saeed, S.A. (2012). An update on mindfulness meditation as a self-help treatment for anxiety and depression. Psychology Research and Behavior Management, 5, 131–141. doi: 10.2147/PRBM.S34937 URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3500142/ [accessed 3 Jun 2021].

Fitzpatrick, L. (2019). The monk who taught the world mindfulness awaits the end of this life. Time. January 24, 2019. URL: https://time.com/5511729/monk-mindfulness-art-of-dying/ [accessed 3 Jun 2021].

Frisk, L. (2012). The practice of mindfulness: From Buddhism to secular mainstream in a post-secular society. Scripta Instituti Donneriani Aboensis, 24:48-61. doi: 10.30674/scripta.67408 URL: file:///C:/Users/Edgar%20Meyer/Downloads/The_practice_of_mindfulness_from_Buddhism_to_secul.pdf [accessed from ResearchGate 3 Jun 2021].

Gibson, J. (2019). Mindfulness, interoception, and the body: A contemporary perspective. Frontiers in Psychology, 10:2012. doi: 10.3389/fpsyg.2019.02012 URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6753170/ [accessed 3 Jun 2021].

Harvard Health Publishing (HHP). (2018). Mindfulness can improve heart health. Harvard Health Publishing. Harvard Medical School. URL: https://www.health.harvard.edu/heart-health/mindfulness-can-improve-heart-health  [accessed 11 May 2021].

Headspace. (2021). Headspace. Headspace, Inc. URL: https://www.headspace.com/?gclid=Cj0KCQjw8IaGBhCHARIsAGIRRYpjZrbhlLeO_wAe9ljoDo7bA7C_Ydxr11W1tyqAtBoAE2LV2FGoU9gaAgg5EALw_wcB [accessed 10 Jun 2021].

Hölzel, B., Lazar, S., Gard, T., Schuman-Olivier, Z., Vago, D., & Ott U. (2011). How does mindfulness meditation work? Proposing mechanisms of action from a conceptual and neural perspective. Perspect Psychol Sci. 6, 537–559. doi: 10.1177/1745691611419671 URL: https://pubmed.ncbi.nlm.nih.gov/26168376/ [accessed 3 Jun 2021].

Kabat-Zinn, J. (1990). Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. New York, NY: Delta Trade Paperback.

Kabat-Zinn, J. (2017). Too early to tell: The potential impact and challenges—ethical and otherwise—inherent in the mainstreaming of dharma in an increasingly dystopian world. Mindfulness, 8(5):1125-1135. doi: 10.1007/s12671-017-0758-2 URL: https://www.mindfulnesscds.com/pages/too-soon-to-tell [accessed 3 Jun 2021].

Lengacher, C.A., Johnson-Mallard, V., Post-White, J., Moscoso, M.S., Jacobsen, P.B., Klein, T.W. (2009). Randomized controlled trial of mindfulness-based stress reduction (MBSR) for survivors of breast cancer. Psycho-Oncology, 18(12), 1261-1272. Doi: 10.1002/pon.1529 URL: https://pubmed.ncbi.nlm.nih.gov/19235193/ [accessed 3 Jun 2021].

Mindful. (2017). Jon Kabat-Zinn: Defining mindfulness. Mindful. Mindful Communications & Such, PBC. URL: https://www.mindful.org/jon-kabat-zinn-defining-mindfulness/ [accessed 10 Jun 2021].

Mindfulness Program (UAMS). (2021). Mindfulness Program, University of Arkansas for Medical Sciences. URL: https://mindfulness.uams.edu/ [accessed 3 Jun 2021].

University of Massachusetts Memorial Health (UMass MH). (2021). UMass Memorial Health Center for Mindfulness. URL: https://www.ummhealth.org/center-mindfulness [accessed 3 Jun 2021].

Wilson, J. (2014). Mindful America: The Mutual Transformation of Buddhist Meditation and American Culture. Oxford, UK: Oxford University Press. ISBN-13: 9780199827817. Published to Oxford Scholarship Online, 2014. doi: 10.1093/acprof:oso/9780199827817.0001