“It won’t be long before they find out that I am a fraud, or that I do not belong; they must have made a mistake when they sent me that acceptance letter. Should I throw in the towel now instead of dragging out the inevitable? Sure, I passed the exams necessary to keep up this deception, but if I will be challenged on something I did not anticipate I will unravel like the string that unravels the entire sweater…”
My mind is not frequently occupied with this dialogue of unpleasant thoughts; they tend to creep up when I am feeling depleted emotionally and mentally. Such thoughts are surprisingly insidious. If left unchecked they can masterfully intertwine themselves with my identity. They are like weeds that seemingly sprout overnight and unexpectedly overtake a garden by suffocating the rest of the flora.
“How did these thoughts appear and prevail in my mind” I wondered, ignorant to the fact that I had not taken the time to tend to my mind. It does not take much effort to address a few weeds in a well-tended garden, but a garden overtaken by deep-rooted visitors requires tremendous effort and time to clear out – a task that is overwhelming to anyone. This analogy led me to contemplate “How do I tend to my mental garden”?
I recognized that before I could tend to my garden I first needed to observe its state. I found the practice of mindfulness meditation paramount in allowing me to bring the mental weeds to my awareness. Mindfulness meditation means purposefully bringing one’s attention to the present moment and observing any thoughts, feelings or sensations that arise non-judgmentally. I was surprisingly oblivious of my mind’s resident toxic thoughts until I sat down to meditate and realized that my thoughts were predominantly suggesting to me that I am an imposter and do not belong in medical school. Mindfulness, therefore, was the first step in tending to my mental garden as I became aware of the unwelcome residents. As I observed these thoughts, I saw clearly how destructive they were. I was bewildered at how pervasive the thoughts were and how they undermined every other thought. I witnessed the suffocating of the healthy flora of my mind.
Thankfully through mindfulness training, I learned to be a more self-compassionate and non-judgmental observer of my thoughts. I noted that with more practice I was no longer associating or identifying with my thoughts. As my Mindfulness in Medicine mentor, Dr. Dzung Vo, told me “Thoughts are just thoughts, thoughts are not facts… don’t believe everything you think”.
For example, during a clinical training session a thought came into my awareness that suggested that “I did not belong and was accepted into medal school due to a clerical error”. Rather than identifying with and accepting the thought as fact, I observed the thought without any judgement as if it were a curious wasp passing through a garden. The thought lingered in my awareness for a few moments, I acknowledged it, and then returned my focus to the task at hand. Directing my full attention to the immediate moment allowed me to better engage with the training, which in turn developed my confidence as a medical student. Shortly after a similar thought entered my mind again, however, this time I saw that it was nothing more than the creation of an unsettled mind. It became apparent to me that intrusive and toxic thoughts were bogging down my mind causing me to lose sight of the simple truth that not having all the answers is acceptable given that I am here to learn. I began to appreciate that I was where I belonged, which was ironically directly contrary to the thought “I do not belong”.
Realizing that my thoughts are not necessarily representative of me I deduced that my mind was merely a “thought generating tool”; a tool can produce substandard products when left unregulated. I inferred that the longer a mind operates unchecked, the more undesirable thoughts it can produce. Therefore, intentionally observing my mind on a regular basis allows me to avoid the need for an overhaul of a mind polluted with substandard thoughts. My daily mindfulness practice, which serves as the quality assurance of my mind, is comprised of a formal session where I typically sit and observe my breathing and thoughts for 20-30 minutes and an informal component of being fully present and engaged in routine tasks.
Having a daily mindfulness practice is crucial as it allows me to observe the state of my mental garden. If I detect noxious thoughts arising in my mind I know that it needs some extra compassion and loving-care, as it is merely acting out to draw my attention. I found that routinely practicing mindfulness prevents unwanted thoughts from consuming my very being, and it enables me to optimally receive unwanted mental visitors. Subsequently, by not identifying with the visitors’ stupefying messages I can allow them to egress organically out of my mental garden. To sum it all up succinctly: regularly practicing mindfulness with purposeful presence and self-compassion helps me avert potential mental catastrophes while increasing my ability to fully engage with the present moment, which can vary from immersing myself in a lesson or giving my full and undivided attention to a patient.