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mhallett

Just because it’s virtual doesn’t mean it’s not real

Published by Maggie Hallett on February 2, 2012.

As a psychotherapist, I’ve generally been of the mindset that a good ol’ face-to-face conversation is the most effective way to connect with another human being on an emotional level.  Like many therapists, I’ve been wary of the way communication has changed throughout the digital era, which is to say I’ve been mindful of what I perceived to be surface-level connections through 140-character text limits, or time taken away from connecting with the people who really matter—those sitting next to you on the couch—as you check out a friend of a friend’s trip to Hawaii on Facebook.  I found myself judging those whose online personas completely outshine their in-person personalities, assuming it’s easier for them to be sparkly, witty, and overly opinionated when they don’t have to see the faces of the people with whom they are communicating.  I thought about how empty their lives must be, not being able to connect in the flesh.  I patted myself on the back for being able to have real conversations with people.  And for not joining Twitter…

Well, I was knocked off my high horse pretty swiftly this week.

I sit on the board of directors for a fantastic non-profit organization called POEM, which helps new mothers suffering from postpartum depression and other perinatal mood disorders.  Our board meetings start and end with a “mission moment,” during which the executive director shares how moms using POEM’s services have been helped since our last meeting.  This week, the mission moment was about the increase in attendance of the monthly support group meetings.  I, of course, felt smug; this is how moms should be seeking help—in a face-to-face setting so they can see, hear, and feel, firsthand, others going through similar difficulties.

Then she shared the reason for the increase in attendance…

Facebook.

The support group leaders have recently created a closed group on Facebook for the moms seeking help from POEM to connect and chat in between meetings.  What they weren’t expecting was for it to be a major catalyst for real relationships.  Women were joining in droves, and they weren’t just writing encouraging posts of support and understanding; they were making lunch and play dates with one another.  Thanks to this online group, they all felt more compelled to go to the actual support group meeting because they had “tested the waters” and felt comfortable with the other women in attendance.  Plus, they were going shopping afterward!

Also, thanks to the online group, there were not only more moms in attendance at the support group, there were more moms being helped by POEM.  Women who were unable to make it to the group because of physical distance, transportation, or babysitter issues were still able to get the support they were seeking through the Facebook conversations.  And the online group has become so popular that the support group leaders now have a bimonthly moderated online chat—a virtual support group in real time.

In an e-mail to the support group leader, one mom noted (paraphrased), “Although I don’t post on the boards, just reading the other posts and knowing others are experiencing what I am experiencing is enough to get me through the day.”

So, a big lesson learned.  It’s time for me to embrace the inevitable and allow myself to see the emotional benefits that can come from connecting virtually.  Though I still believe that online connections cannot fully replace face-to-face connections, they certainly can enhance and enable them.

Categories: Health and wellness marketing and New ideas and approaches
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leigh.householder

Slideshare highlights iQ’s 2012 predictions

Published by Leigh Householder on January 5, 2012.

Our crazy-talented innovation team here at GSW (iQ) spends a lot of time looking ahead at the technology and trends that will change our industry. Their work includes analyzing specific categories, emerging technologies, best-in-practice strategies and publishing monthly perspectives that our core teams leverage when creating their next great campaign.

Back in November, iQ collected all our best content and insight and started to formulate what 2012 will look like for the healthcare marketing world.

The result was a presentation highlighting the first moves that healthcare is making to embrace the latest trends and the changes that iQ sees ahead. We were honored when Slideshare recognized the presentation as a Top 12 for 2012 presentation and recently highlighted it on their own blog.

2012 Digital Trends For Healthcare Marketing

We look forward to see if our predictions are correct–to keep up with all the latest in digital healthcare marketing check out www.whatsyourdigitaliq.com.

Categories: Healthcare marketing innovations and New ideas and approaches
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mnelson

Every time an Rx is written, it’s another New Year’s Day.

Published by Marcee Nelson on January 3, 2012.

Right now we’re all thinking about starting a brand new year, ready to put our good intentions into action—you know, our plans to work out more, eat less.  Form new good habits.  Break the bad ones.  It seems to be human nature to need—or at least like—a trigger point for change.  So every January 1, we declare our intentions to make daily wellness choices in the new year.  And we all know what happens next.  By June a few of us are still at it, but many of us are back where we started.

That 6-month mark is a familiar theme for pharmaceutical marketers.  Because that’s the time the average persistence curve takes a dramatic dive south, especially for chronic conditions. If we think like Advertisers, we rely on mass media DTC campaigns to tell people “ask your doctor” and we consider the box checked. But when our consumers walk out of the doctor’s office with a new Rx and some good intentions in hand, it’s like another New Year’s Day.  Six months later, where will they be?

Advocate brand-builders understand that ROI for long term commitment is return on involvement. So they focus more of their time, attention and investment post-script—they ask themselves not “how can we get consumers to adhere?” but “how can we stick with our consumers?”  The Advocate definition of DTC is Do, Teach, Connect.

Here’s why:

1) Because mass media offers no utility to us as consumers except to make us aware, and awareness is the most superficial level of involvement.

Do means taking action vs. sending messages:

  • Adding utility to media –making it somehow useful, not just interruptive
  • Creating tools and personalized support systems
  • Showing up to solve problems where and when it matters most
  • Using mass media instead as a mass invitation to an involving, personalized experience

2) Because, as we learned in Pink Tank’s 2010 She Says Survey of 1300 women, consumers want more transparency from pharma companies when it comes to risks and benefits.

Teach means empowering choice, not preaching information:

  • Improving their “health literacy” about therapies and procedures
  • Tying rewards and risks together in a complete, logical and honest story
  • Giving them ways to visualize what’s happening inside, especially in chronic and preventive conditions where they may feel no cause/effect

3) Because now a physician’s opinion is a lesser part of the equation.  Over 40% of She Says Survey respondents told us that before filling a prescription they gather consensus through their Circle of Influencers both online and off.  Consumers are now taking a bigger role in their own care and self-navigating their way, armed with knowledge and community.

Connect means finding new ways to bridge disconnects and dead-ends healthcare consumers meet as they try to self-navigate:

  • Correcting misalignments or gaps in their Circle of Influencers
  • Helping to start or facilitate conversations between influencers
  • Thinking outside the industry for innovative partnerships to form new continuums of self-care

So how about this:  On January 1, 2012, let’s resolve to involve healthcare consumers more by redefining and redesigning our DTC efforts with the goals of Do, Teach, Connect.  The result could be a happier and more involving New Year for all of us.

*For more information on health and wellness visit thewellatgsw.com

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dmarinacci

Med Ad News Asks: To iPad or Not to iPad?

Published by Dawn Marinacci on December 7, 2011.

Leigh Householder, the Managing Director of our innovation lab (iQ), recently was asked by Med Ad News editor Chris Truelove about her thoughts on the iPad and the adoption by pharmaceutical industry.

“The teams most intrigued with using the iPad are those wanting to create experiences that could not be produced with paper detail aids, Ms. Householder says. “How can we pull apart and explore a medical device together? How can we go inside the brain to look at how a therapeutic effects those tissues? These are things that they (pharma companies/sales reps) never could have done before.”

To read the entire article, click here

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mark.stinson

Could “recommendation algorithms” have a greater role in pharma marketing?

Published by Mark Stinson on November 23, 2011.

Recommendation algorithms are best known for their use on e-commerce Web sites, where they generate a list of recommended items based on input about a customer’s interests.

One of the best known examples is Amazon.com, which uses recommendation algorithms to personalize the online store for each customer. The online store radically changed based on customer interests, searches, wish lists, and purchases. It shows programming books to a software engineer, and baby toys to a new mother.

No wonder that when you compare two important measures of Web-based and email advertising effectiveness – click-through and conversion rates – these personalized suggestions perform vastly better compared to untargeted content (such as banner ads and top-seller lists).

Now the framework is so commonplace that even new fall TV shows are being publicized based on “what you like.”

  • Like The Big Bang Theory? Try New Girl.
  • People like you who watch The Mentalist have also watched Unforgettable.
  • You have Modern Family on your DVR, so why not try Man Up!
  • You ordered every season of Mad Men on iTunes, so you should watch Pan Am.

We have seen the retail industry more broadly apply recommendation algorithms for targeted marketing, both online and offline. While e-commerce businesses may have the easiest vehicles for personalization, the technology is also compelling to offline marketers for use in postal mailings, coupons, and other forms of customer communication.

In healthcare, one example similar to Amazon’s is the Web site for Edward Hospital & Health Services in Naperville, Illinois.  Last year, Edwards started using real-time behavioral targeting to tailor its Web content to current and prospective patients based on individual health needs.  It uses consumer and patient data stored in the hospital’s CRM database to interactively and incrementally customize the content presented to individuals to enhance and personalize the consumer “conversation.”

From our pharma marketing viewpoint, I’ve been pondering the health, medical, and wellness applications of such recommendations:

  • If you have this condition, you should pay attention to these associated risk factors.
  • If you’re taking this prescription, you might consider this companion product/food to make it more tolerable.
  • If you are seeing this kind of doctor, you could also benefit from these supportive healthcare services.

These CRM-enabled Web messages could be displayed as dynamically created, real-time content that contains customized copy, imagery and offers for individual visitors.

Most of all, these relevant health messages would create a more personalized experience that could improve patient engagement.

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brooke

It’s Time “DTC” Stood for Something Else

Published by Bruce Rooke on November 3, 2011.

By Bruce Rooke, Chief Creative Officer, GSW Worldwide

If change is the Grandmother of Invention (after all, who do you think begot Necessity?), then the current world of DTC is like ladies night at the nursing home. There’s a huge mosh pit of change all around us:

  • Almost 75% of the biggest DTC spenders will go generic by the end of 2013. Think about it: Lipitor, Crestor, Plavix, Cymbalta, Viagra, Advair, Boniva, etc. (IMS, 2010)
  • There’s been a dramatic shift from mass media to targeted audience, (eg, a 23% swing from network to cable (MM&M 2010)
  • And, miracle of all miracles, there’s finally a government agency that admits DTC plays a beneficial role in both public health and in lowering healthcare costs (The Congressional Budget Committee, May 2011)

Which means DTC is due for some big Invention.

In fact, it’d be a shame if we just stood there and kept putting out the same Beauty and the Beast formula of disease-stricken patient magically transformed into a walking grin, interrupted by 32 seconds of fake doctor-patient interaction while fair balance is read. We have the chance– and responsibility– to respond to the changing landscape with a whole new vocabulary of action.

What DTC Could Mean.

“Direct to Consumer” says what it is and where it plays. But effective brands today are built on what they do than what they are. So imagine if DTC stood for:

D = Do. Do something for consumers beyond disseminating information. Don’t just stand there at the pulpit and preach. Add value to your communications by adding utility to your media. A mobile app (“mHealth”) that empowers a consumer to do something about their disease, or their care, can be much more effective in building your brand. Some other good examples:

1) Is an app that alerts me to when my epinephrine pen needs replacing worth more than another print ad? It shows that the brand is actively engaged in my life, proving its understanding—not just passively claiming it.

2). The AllergyManager app (from Omnaris) gives sufferers an allergy forecast in their area, along with information on Omnaris. (But don’t cheat. Your app has to be more than just the mobile version of your Web site.).

3) GoMeals (from Sanofi-Aventis) instantly guides diabetics in the real world to what they should eat, where they can eat, and helps them watch what they eat.

4) The Tamiflu campaign* for Roche where, beyond the “Happy Feet” dancing penguins, we gave consumers a simple mnemonic to tell the difference between cold and flu– the F.A.C.T.S. of flu: Fever, Aches, Chills, Tiredness, and Sudden Symptoms. It gave caregivers a free diagnostic tool that made them, well, better caregivers. That’s doing, not just telling.

T = Teach. Equip your consumers to be smarter patients or more astute caregivers. We love to hide behind the veil of educating consumers about their health—and then we proceed to sell in the traditional manner. Let’s truly educate. What if we walked them through a procedure, step-by-step, fears and hopes, using a celebrity not as borrowed interest but as the real consumer? (realitylasik.com)? What if we taught men how to be conversant in controlling uric acid versus medicating gout pain (Takeda, Uloric DTC campaign)*? Designer Jacob Heberlie found the perfect touch in his multiple sclerosis (MS) animated video series for Dr. Singer’s MS Clinic (mslivingwell.org) in taking the complex science and therapies and creating motivating “I get it now” moments for consumers and caregivers. The year-old GE healthymagination and Howcast online videos do much of the same (see the case study at howcast.com). And the healthymagination/MedHelp app, “I’m Expecting,” teaches a mom what is going on with her baby at any given time along the journey. In all of these examples, smarter consumers equaled more active consumers. And that teaching leaps over the hurdles and can lead directly to the brand.

C = Connect. Connect the conversation. Healthcare decisions are no longer made unilaterally. They include the consumer (patient), the caregiver(s), the physician, the nurse, the payer, and the invite list goes on. Plus, under healthcare reform, team health management will be standard of care (SOC) at the doctor’s office. So it will take multiple influencers to get to one decision. Which makes connecting that conversation even more crucial. This doesn’t mean you have to have the same campaign across all audiences. But it does mean that somehow in your campaign, you need to inspire and incentivize a connected conversation. (Yes, beyond the ol’ “ask your doctor about…”) Besides, you want people talking about your brand, influencing each other, filling in each other’s blanks, completing the story– with your brand front and center. For example, Eisai realized with Aloxi that the cancer patient may never speak up about their nausea (for fear of getting reduced, less effective chemo), and the doctor may never hear the patient complain. So they expanded their campaign to reach both caregivers and nurses, knowing if they could connect them, they could create that vital conversation, and Aloxi would be an important part of the dialogue. The customizable e-postcards of Gardasil’s “Tell Someone” campaign* helped boost awareness from 5% to 50%. And just imagine how a Zeo Personal Sleep Coach (www.myzeo.com), with all its tracking data and  “ZQ” score, could create a connected conversation for a branded sleep aid. (Sorry, you have to imagine it. Hasn’t happened yet).

So, as you can see, the necessity of change (and the endless opportunity of digital) has given all of us the chance to make DTC mean so much more than “Direct to Consumer” (or “Dull Television Commercials” or even “Diarrhea to Come”). By redefining DTC to mean Do, Teach, Connect, we can truly realize the potential of DTC to responsibly change consumer healthcare and Deliver the Coveted: improved outcomes.

*Denotes campaigns developed by GSW Worldwide.

**content previously published in DTC Perspectives magazine, October 2011 issue

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leigh.householder

Inspired By TedMed: How 14 Leaders Would Change Healthcare

Published by Leigh Householder on October 27, 2011.

This week is the annual TEDMED conference in San Diego. It’s where the world’s most creative minds meet healthcare’s most innovative science. Where public health meets personal care, and where today’s theory meets tomorrow’s technologies.

We’ve been watching the tweets and snippets from the floor of the conference and they’re inspiring a lot of great conversations around our hallways for how we could fundamentally improve healthcare – what are the barriers to take down, what has great promise, and what could we rethink – and recreate – to bring better health to more people:

“When we think ‘patient,’ we picture a person in a gown being shepherded through the system by healthcare authority figures. Newsflash: Patients are consumers–more demanding, more informed, more unified than ever before. Today, the physician’s opinion is only part of the decision. With less authority, we must find new ways to influence.” – Marcee Nelson, The Well

“Inspire and reward wellness through people’s wallets: have insurance companies create quantified wellness structures that deduct cost from premiums. Clearly outline attainable goals and associate a cost deduction with each accomplishment– i.e., hit the gym three days a week, $x off; no smoking $x off; BMI in check, $x off; plant based diet, $x off; and so on. Enroll in the program and get validation/documentation through annual check-ups at the MD. Maybe this way we can start having positive conversations with physicians and payers instead of arguments, trepidation, confusion and avoidance. Better behavior. Better healthcare.” – Christina Blosser, Accounts

“I see a vicious circle that involves healthcare, co-morbidity, and digital behavior. As pressure for productivity on healthcare providers increases, the result is less time to provide ‘whole body assessments.’ All while non-infectious diseases (such as diabetes, hypertension, etc.) continue to rise and are now coupled with depression, obesity, and anxiety. The result is an under served patient. In addition, most healthcare materials provided to healthcare professionals are wordy and time consuming and do not reflect the manner in which people consume information in a digital age.” – Leah McDougald, Engagement

“Make it mandatory for food/beverage industry to make/market their retail products following stricter nutritional guidelines (i.e. must not exceed 500 mg of sodium, 10 g of sugar, 20 g of carbs). What if we could dedicate more than one aisle to health/organic foods in grocery stores like Kroger, Giant Eagle?  Model all grocery stores to be more like Whole Foods, Trader Joes.” – Dawn Marinacci, Communications

“Focus more attention to healthy food education and access. Something like fair balance on food packaging. I know, it seems a bit socialist but right now the packaged food industry is out of control.” – Sean Cowan, Digital

“Adopt a European approach by offering and mandating 8 weeks of vacation time annually to all full-time employees, which will help to relieve stress, foster better well-being and overall happiness, and lead to a more energized and more positive society. Make cigarettes illegal. Provide a “well-being credit” on your annual tax return for having an annual check-up and receive additional credits for staying within all specified laboratory ranges for diabetes, hypertension, and hypercholesterolemia.” – Kevin Stone, Accounts

“Coin operated elevators, escalators, and moving walkways (with passes for those in need of assistance).” – Joe Daley, Leadership

“A simple change that we can make to dramatically improve the health of our nation is to shift the nation’s paradigm in regards to healthy eating. One example is to develop more “farm to dinner table” support initiatives to provide affordable natural/organic alternatives to fast food. Food is the new pharma!”  – Jude Divierte, Innovation

“Expanding health care options while reducing the red tape generated by payer groups. Some HMOs/PPOs do recognize the benefits of traditional eastern medicine, but aren’t structured to accommodate their holistic, long-term approach. And ease up on denying newer treatments and calling them out as “unproven” – if the doctor feels it could benefit their patient (especially when it comes to life-threatening illnesses) then they should be able to move forward with it.” – Alex Bragg, Planning

“I think one of the biggest challenges facing healthcare will be reducing cost. Hospitals, physicians, and other providers will have to squeeze every penny out of their operations, including renegotiating contracts with suppliers on everything from food to medical devices and pharmaceuticals. This will mean increasing reimbursement pressure, with physician practice models beginning to adapt and Pharma will be more intensely restricted in its marketing activities.” – Christine Crooks, The Well

“Incentivize good health through lower taxes, for example; the rationale being that healthier citizens are less of a burden to the resources of the community and so should be rewarded for the decisions they are making that not only help them but also the health of the greater good.” – Todd Hodgman, Strategy

“Our disengaging use of language. For example, patient, compliance, adherence. Tape adheres; prisoners comply. From the moment a person is diagnosed with a chronic illness, healers and the people they treat must persevere: steady persistence to create a state of well-being, especially in spite of stigma, barriers, or low health literacy.”         – Kathryn Bernish-Fisher, Engagement

“I would incorporate shorter work weeks to allow a third day off. This country’s current state of 50, 60, 70 hour work weeks is coming at a price. We spend less and less time with our families in order to put in our time at work and make our money. Life is too short to have work be the central part of our lives. Our friends and families are ultimately what we’d all love to have more of. I believe this re-shifting of priorities will make us and our children healthier…physically and emotionally.” – Cheryl Foley, Medical Director

“The labeling we’re putting on processed foods is good – more transparency from the companies and an incredibly simplified way for consumers to weigh their options. I hold a processed food next to a natural food and can easily answer the question: is it worth it?” – Ben Harben, Innovation

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mtscott

The Eternal Sunshine of Protein Synthesis Inhibition

Published by Michael Scott on October 6, 2011.

Why do people dwell on bad memories? We talk of memories being “scorched” or “branded” into our brains. The phrase “there are just some things you can’t unsee” has gone from being a joke to part of the lexicon

This phenomenon drove Freud, who had written The Pleasure Principle, to write one of his darkest books, in which he moved the furthest from his neurologist roots: Beyond the Pleasure Principle. He considered it “uncanny” (unheimlich) that people would continue to scratch a psychic wound, and speculated about a “deathly” instinct. There seemed to be little he could do for these patients.

An article published in The Best American Science and Nature Writing 2010 looked at recent research on “memory reconsolidation” and sent me in search of the original sources. In short, in remembering something, you (or proteins in your brain) “rewrite” the memory.

Consolidation of memory

For more than 100 years, we’ve known that memories move through an unstable phase to a stable phase, at which time they are said to be consolidated. During the unstable phase, memories can be impaired by distraction or new learning. (They can also be impaired by protein synthesis inhibitors—we’ll get to that in a moment.)

For example, think of trying to remember a phone number. If someone just told you the number and then begins to recite other phone numbers, rattle off random series of numbers, or the phone rings, you’re less likely to remember it. However, if the same reciting, rattling, or ringing occurs the next day, you’ll probably still remember that phone number.

For a long time, that was believed to be that. Memories went through a stabilization or consolidation period, after which they could be “retrieved.” The analogies were always filing cabinets or computers.

Reconsolidation: the present in the past

Then a researcher named Karim Nader conducted a brilliant experiment, published in a letter to the editor of Nature in 2000. Basically, Nader and her group looked at rats that had been trained to associate a tone with a foot shock. When the tone was played, the rats froze in fear.

The next day, the tone was played, and a protein synthesis inhibitor into the amygdala, a part of the brain associated with learned fear. No foot shock followed. The day after that, the tone was played again, and the rats no longer froze in fear. The memory of the initial training was cleared.

Turns out that both the original consolidation of memories and the reconsolidation of memories require protein synthesis. As Nader put it, “Our data show that consolidated fear memories, when reactivated, return to a labile state that requires de novo protein synthesis for reconsolidation.”

Eternal Sunshine of the Spotless Mind? Total Recall? One of those “flashy memory erasing things” from Men in Black?

Not so fast.

But a decade of studies has shown that new learning and other distractions can lead to altered or forgotten memories, but only within a certain window after the memory is brought up. Your mind then lays down a “new” memory, based on current experiences, thoughts, personality, fears, hopes, and dreams.

New hope in post-traumatic stress disorder

Protein synthesis inhibitors used in rat studies are highly toxic, but propanolol (a beta-blocker) may interfere with protein synthesis in the amygdala. That may be why some people report feeling “foggy” when taking this drug.

However, based on the model laid out by Nader, a group looked at what happened if people with post-traumatic stress disorder (PTSD) were asked to recall the traumatic event in detail and then given propanolol. A week later, when asked to remember the traumatic event once more—without propanolol—the researchers measured heart rate, skin conductance (a measure of stress), and the electrical impulses in the “facial frowning” muscle (the left corrugator). All were much, much lower than a group that had received placebo the previous week.

So we’re not in a brave new world of designer memories, memory erasure, or vacations by memory implants. Not just yet. But Freud has been demonstrated wrong (yet again). People with PTSD have been helped. And who knows where this research will lead next?

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brizzo

The healthcare dating game–finding the right doctor

Published by Brenda Rizzo on October 4, 2011.

I was recently reading an article in JAMA entitled “Do nice patients receive better care?” and was appalled at the title. How can we suggest that there are different types of care in the health care delivery system based on “niceness”? Could those differences be based on how a patient “behaves”? How do clinicians define “nice”?

The article went on to state that each healthcare provider defines “nice” differently, but when asked they definitely can identify patients in their practice as “nice” patients. Some prefer patients who come to their appointment well informed, others like patients who always comply with the treatment, while others find patients who are challenging medically but willing to discuss options as “nice.” Healthcare providers are human too, so they have human responses to their patients. In fact this article wondered if the relationship between patient and healthcare provider affect the level of care they receive.

Often in my job I get asked for healthcare provider referrals by my colleagues. When they ask for a referral, I ask them a series of questions: do you prefer female or male healthcare providers, are you looking for someone for you or your whole family, do you have any language needs (family members that are non-English speaking), do you have geographic needs, etc. As I make referrals I share things like, “this healthcare provider is not warm and fuzzy, but very matter of fact,” or “this healthcare provider will take the time you need,” or “this practice is very responsive,” etc. People have preferences for what type of healthcare provider they want. Then I have a list of healthcare providers that I tell people about either from personal experience, from having worked with them, I know health care provider colleagues that work in the practice, or based on other co-workers experiences.

Sometimes the physician works out, and sometimes it doesn’t but the bottom line is, if you don’t like the healthcare provider then you should stop going to them. The healthcare provider you see to coordinate your care must fit with your personality type; they must meet your expectations. If the office staff is not responsive this too could disrupt the satisfaction with his or her practice. Don’t be afraid to change healthcare providers. I tell people, if you have a plumber to your house and they didn’t do the job you wouldn’t ask them to come back. If you go to a healthcare provider and they don’t meet your needs then don’t go back.

And based on this article in JAMA, the relationship with your clinician and how you connect could affect the level of care you are receiving. Patients should seek out clinicians they prefer just as clinicians seek out patients that they prefer. Some clinicians like working with young people, so they go into pediatrics, some like the elderly so they focus their practice on that population. The article in JAMA even stated that some healthcare providers like to interview the patient before they decide if they are going to be their healthcare provider. This seems extreme, but it brings home the point that you need to connect to your healthcare provider to get the most out of your health care. In the article they conclude, “Nice patients and patients with nice families probably do receive a level of care that is perhaps at times well above the professional standard. Pretending that this phenomenon is not so is probably not helpful, and raises the next question―is it wrong?” What do you think?

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mhallett

The Art of Mindfulness

Published by Maggie Hallett on September 23, 2011.

There has been a lot of talk recently about information overload, the downsides to multitasking, and how focus and concentration have become novel ideas. In earlier posts, Dawn shared suggestions about dealing with distractions at work, and Bob talked about the hazards of being too connected and the negative effects of not being able to remain focused. At the end of his post, Bob asked for solutions. I have a suggestion…

It’s called being mindful.

On Tuesdays, my work is very different from the Account Service work I do the rest of the week, because I work as a therapist specializing in Dialectical Behavioral Therapy (DBT) for the treatment of Borderline Personality Disorder. DBT is a wonderful mixture of traditional Cognitive Behavioral Therapy (recognizing unhealthy thought patterns and working to change them, thus changing responses to them) and Mindfulness (living in the present moment with awareness). Mindfulness is the basis and foundation of DBT skills. The other skills—interpersonal effectiveness, distress tolerance, and emotion regulation—are difficult to master without the ability to be mindful.

So what exactly is mindfulness, and how do we become more mindful? I think the easiest way to explain mindfulness is through examples of when we are not being mindful (which is most of the time).

Example 1

You are driving home after work and you are replaying the last conversation you had with a client or co-worker. You felt it was unfinished, so you are planning how you’d like to continue it tomorrow, and you actually preview how the conversation will go in your mind. Meanwhile, you’ve pulled into your driveway, having no recollection of the actual drive home because you were so wrapped up in your thoughts about the past and the future.

Example 2

You’re having a good day. It’s nice outside and you actually get to go out to lunch. Right before lunch, you are emptying out some old personal e-mails and you come across one from a family member with whom you’ve been having some issues. It immediately stirs up all of the feelings of anger, hurt, and anxiety that surround the relationship, even though nothing in the moment has happened or changed. Your fine day just became a lot darker because you can’t stop thinking about that e-mail and the issues you are having.

Example 3

You are reading this blog, listening to your co-worker’s conversation next to you, designing a Web site, and thinking about dinner.

Mindfulness involves conscious awareness of your current thoughts, feelings, and surroundings. Raising awareness of the present can ultimately help to control concentration and impulses. So when you are driving, you are focused only on driving, and when you are building a Web site, you are focused only on building a Web site. And when a thought comes into your mind that triggers a negative emotion, you are aware of the thought (and the feelings that come with it) but let it pass without holding on to it and allowing it to spiral into unhealthy rumination. This last example is probably the most difficult to master.

In DBT, we teach mindfulness in two parts: the “what” skills and the “how” skills. The “what” skills are what to do to become mindful, and the “how” skills are how to do it.

What Skills

Observe your thoughts and feelings: Notice what you are experiencing without getting caught up in the experience. Step inside yourself and watch your thoughts coming and going, but do not hold on to any of them. Notice what comes through your senses—sight, smell, taste, etc. Notice the actions and expressions of others.

Describe your thoughts and feelings: Put words on experiences; this tends to keep you honest. Name your feelings. Make sure to call a thought a thought and a feeling a feeling. “I feel like no one listens to me” is NOT a feeling. “I feel lonely” or “I feel ignored” are feelings.

Participate in each moment: Enter into your experiences, forgetting yourself. Attempt to lose self-consciousness. Act intuitively, trust yourself, and accept both yourself and the situation as they are.

How Skills

Non-Judgmentally: See, but do not evaluate. Focus on “just the facts” and attempt to unglue your opinions from the facts. Acknowledge the good and the bad, but don’t judge any of it.

One-Mindfully: Do one thing at a time. If you find yourself distracted (either by others or your own mind), go back to what you are doing again and again and again.

Effectively: Focus on what works. Attempt to stay away from right or wrong, fair and unfair, etc. Play by the rules; try not to cut off your nose to spite your face. Act as best as you can to meet the needs of the real situation you are in. Keep an eye on your objectives, and do your best to let go of anger, vengeance, and righteousness.

Mindfulness, in concept, seems pretty simple. But it’s one of the hardest things to do in practice, especially in recent times.  Like any other skill you are trying to master, mindfulness takes practice, practice, and more practice. And the best way to practice mindfulness is to become aware of when you are not being mindful and bring yourself back to the present moment.

I could write forever about mindfulness–the benefits are endless. However, since good blog etiquette doesn’t recommend that, I’ll leave you with this:

Mindfulness can be life-altering because it gives you the opportunity to control your thoughts instead of allowing your thoughts to control you.

*For more information on health and wellness visit thewellatgsw.com

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