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Upcoming Mindfulness Talks

At Pacific Oaks College I am speaking about Mindfulness for Peace on Sept 21, sponsored by their student government.  It is a virtual event and open.  The flyer contains details on how to register.

Another event is for the National University of Health Sciences (NUHS) on Mindfulness as Mind-Body Medicine on Tuesday 27 at 1pm ET. This introduction to mindfulness in the context of Mind-Body Medicine.  This will be an experiential introduction and its approach to wellness and presented virtually to the NUHS community.

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Luann’s Interview with Unbound

UNBOUND Saybrook Insights: Mindfulness, Integrative Health, and Healthcare For The 21st Century

This podcast episode features Luann Fortune, Ph.D., faculty in Saybrook University’s mind-body medicine program and coordinator for the mindful leadership in healthcare specialization. Dr. Fortune has vast experience in systems, mindful leadership in health care settings, and complementary healthcare techniques that support whole health and healing. This episode explores how we can evolve systems and practices to support a more systems-based approach to health care, how to develop mindful approaches to leading and more. For the whole episode see

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“You Put Your Whole Self In” – Embodied Research, A new publication by Luann Fortune

Luann Fortune, PhD (MBM) has published a chapter (Fortune, 2021).   In an edited book on Transformative Phenomenology (Bentz & Marlatt, 2021), the movement in phenomenology meant to transform and heal the world. In her publication, Dr. Fortune presented a model for incorporating embodiment perspectives and mind-body methods into qualitative research.  Drawing from her own research and her years as an educator at Saybrook, she described using and teaching embodiment techniques to enrich questions, findings, and interpretations. Her examples include multiple Saybrook dissertations that she has guided over the past 10 years. 

Bentz, V. & Marlatt, J. (Ed.) (2021). Handbook of transformative phenomenology. Fielding University Press. 

Fortune, L. D. (2021). “You put your whole self in”:  Enacting embodiment in research. In V. M. Bentz & J. Marlatt (Ed.), Handbook of transformative phenomenology (pp. 161-180). Fielding University Press. 

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The power of meditation

By Luann Fortune, Ph.D.

This article was previously published on UnBound magazine at

Many think that meditation is simply closing your eyes, clearing your thoughts, and breathing for about five minutes. Many do not know about the plethora of options when it comes to meditation.

Maybe being home more during the pandemic has offered you the opportunity to welcome meditation into your life. Or maybe you are looking into meditation to help you deal with new anxiety that has arisen. Either way, meditation is free, easy to start, and has many benefits.

“Mindfulness and meditation—tools for wellness and self-care—can provide calm and restoration,” says Luann Fortune, Ph.D., a Mind-Body Medicine faculty member at Saybrook University. “Research shows that related practices contribute to improved immunity and mental well-being, as well as better quality of life. Evidence also has shown such practices can connect us as a community to support health and healing.”

Dr. Fortune has been instrumental in the start and continuation of Saybrook’s Mindful Moments, a program offered since March 2020. She has presented many different types of meditation, including progressive muscle relaxationguided meditationguided imageryabhyanga (self-massage), and loving kindness meditation.

To help others find peace during this stressful and chaotic year, Dr. Fortune offers further tips and explorations on how to practice meditation—and what kind might be best for you.

What is meditation?

According to The New York Times, meditation is a way to train the mind.

The origins of meditation can be traced back to as early as 5000 BCE, to ancient Egypt and China and tied to the religious practices of Judaism, Hinduism, Jainism, Sikhism, and Buddhism. Spread along the Silk Road, it moved throughout Asia. Before the 20th century, meditation spread from Asia into the west. In the past few decades, doctors and scientists started studying meditation for its medical and other health benefits.

Dr. Herbert Benson, a Harvard Medical School professor, found that people who meditated used 17% less oxygen, had lower heart rates, and produced increased brain waves found to help with sleep. Years later, he said the following about his research: “All I’ve done is to put a biological explanation on techniques that people have been utilizing for thousands of years.”

Who can practice meditation?

Meditation is available to all, requiring only a few minutes of quiet, an openness to try, and a willingness to let go. The mind is powerful—meditation is called a practice because its practitioners always have room to grow and try again. When you begin meditation, it is important to refrain from judgment of yourself and your process.

Before you meditate, find a quiet spot. You can either sit down in a chair or on the floor. You can even lay down if that is more comfortable to you. As you begin your practice, be patient. If your mind wanders, take a moment to pause and reflect and bring your attention back to center. And remember, the more you do it, the easier meditation becomes. With some commitment, you will be able to focus more deeply each time you practice meditation.

How do I start incorporating it into my daily routine?

Meditation draws from a vast array of traditions, histories, and methods. Selecting the “best” method depends on personal preference and background. Most practices are cultivated to bring emotional calm and mental clarity and involve setting aside time each day, from a few minutes to an hour for intentional practice.

Here are a few of the more common forms with an example of each.

Guided Meditation is the collection of techniques and practices that focus one’s thoughts on a particular object or invite suspension of thoughts, so it is often associated with our mental life. In guided meditation, a leader provides verbal prompts or instructions to direct the individual or group through the practice.

Progressive Muscle Relaxation (PMR) was developed to help people suffering from tension and stress and can provide many benefits. The practice, which can be considered muscle-body based, focuses on relaxing specific muscles in a directed protocol, tightening specific muscle groups and then releasing. Research shows that PMR can help reduce anxiety and reverse stress as well as help release tight muscles. In a recent study by Liu and colleagues (2020), PMR was found to improve anxiety levels and sleep in COVID-19 patients.

Guided Imagery, also called guided visualization, involves directing thoughts and sensations to engage positive mental images and sensory recall, meaning conjuring smells, tastes, sounds, and textures as well as visual images. Because it is multi-sensorial, it draws on our creative selves. Strong research supports many benefits, from invoking calm, improving performance, and healing trauma. Guided imagery can be conducted in individual or group settings. Multiple quality audio recordings are available that provide guided imagery, which makes it a suitable form for use in clinical settings where access may be restricted.

Abhyanga (Self-Massage) is one active form of mindfulness practice that draws on the ancient (ayurvedic) practice of self-massage. It is meant to be practiced daily to stimulate the immune system and promote circulation and body-mind awareness. It can also bring calm and vitality. It is especially helpful during times of sheltering and isolation.

Loving Kindness Meditation, a gentle guided meditation, is widely used to support emotional and mind-body wellness as well as prevent compassion fatigue and build mindful leadership. Based on supporting research, it has gained prominence in clinical settings, particularly to prevent burnout for health care workers. It involves sending out thoughts and intentions for unconditional love toward oneself, outward to others, and to bring peace and healing. It is sometimes considered a “heart-based” form, drawing on feelings and thoughts of pure love

Learn what meditation practice is best for you

The examples provided are appropriate for mindfulness experts as well as those who are new to meditation and mindfulness practices. You can explore more practices as well by listening to Saybrook’s Mindful Moments. Faculty from the Mind-Body Medicine program provide these live guided sessions during the week and are open to the public. They are recorded and available at Saybrook’s website or through Spotify.

Taking a few minutes from the stress of daily responsibilities through a structured mindfulness practice can support wellness and a stronger immune system and help restore balance in these challenging times.

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Self-Massage: Guided Instructions for Body & Mind

Here are the instructions to follow along for the May 2 workshop on self-massage.  Consider printing it out for future reference.

The recording of this offering is now available by clicking here.

Massage Series

Neck , Shoulders, Back                                                           

  • Stretch & Shrug: Gently nod head back and forth, up and down, side to side, letting chin drop to chest and then to neutral; shrug shoulders to ears and roll shoulders.
  • Neck cradle: Place flat of hands on either side of neck, placing fingertip at base of skull.
  • Occiput circles: Find the ridge at the base of your skull (occiput). Using fingertips, press fingertips into the ridge, make circles, work outward toward the ears.
  • Stroke neck sides: Using flat of hands, stroke down sides of neck to shoulders.
  • Knead shoulders: Place hands on shoulders (same side); using fingers and palms, squeeze and knead outwards to shoulder joint. One side at a time, place hand across onto opposite shoulder, kneading across, reaching fingertips to top of scapula.
  • Glide: Place flat of hands on same side of torso and stroke down to waist. Reach down and around lower back and use fingertips to make circles along back of pelvis.
  • Hug: Bring hands and arms across front of chest and give yourself a hug.
  • Self-massage tool: Lie supine and position tennis balls tool on either side of spine at neck. Gradually roll your body over the tennis balls, working the pressure points down along either side of the spine to reach the lower back. Pause over tender spots and allow your body to release into the tennis balls.  When done, roll to one side to release tennis balls and, when ready, use your hands to slowly push up to sitting.

T-Ball tool


  • Hold: Add a few drops of oil to hands and rub together, then hold one hand with the working hand. Take a moment to notice temperature, texture, weight.
  • Spread: With pad of thumb pressing into palm and fingertips around the top of the hand, spread open the hand.
  • Finger twirls: Using thumb and forefingers, gently massage each finger from base to tip.
  • Glide fingertips between hand bones (metacarpals) on top of hand, from knuckles to wrist.
  • Palm spread: Interlace fingers of both hands and stretch outward. Relax stretch, and keeping fingers interlaced, reach working thumb into palm, making circles. Release interlock, use fingers to support top of hand, and continue pressing thumbs into palm and base of thumb pad.
  • Knead wrist area with fingers and thumbs.
  • Glide up forearm to elbow, gently circle inside and outside of elbow, and continue gliding up upper arm to shoulder.
  • Stroke underarms (armpits).
  • Brush lightly down the arm with fingertips over the forearm and off ends of fingers.

Pause, breathe, and notice how the massaged hand feels.

Repeat series on the other hand.

When done, allow both hands to rest, take a few deep breaths.


Foot Self Massage                                                                            

  • Position your foot in your lap or in front of you; hold with both hands.
  • Place a small amount of oil on your hands.
  • Slide, with one hand on top and the other on the bottom of foot.
  • Spread, with thumbs side-by-side into sole and fingers wrapped around top.
  • Toe twists: using thumb and forefingers, gently pull and twist from base to tip. Weave fingers between toes.
  • Thumb press into entire sole of foot, working to cover the entire surface from base of the toes to the heel.
  • Ankle circles: Using fingertips and thumbs, circle around the bones. Then hold the foot with one hand and rotate the foot around the ankle.
  • Wringing: Wrap the foot with both hands and rotate back and forth around foot.
  • Tapping: Using fingertips, tap the entire bottom of foot and then lightly brush surface.

Reflexology points can be affected. See one foot reflexology chart at

Pause, breathe, and notice how the massaged foot feels.

Repeat series on the other foot.

When done, find a comfortable position, take a few deep breaths.


Integration: Abhyanga

  • Rub hands together and, one a time, use flat of hands and fingertips to brush down each arm.
  • Brush with fingertips down chest and torso. Tap fingertips on sternum (breastbone).
  • Flat hand brush down thighs and lower legs, front and back as you can reach.
  • Scalp massage with fingertips.
  • Rub hands together, place hands over eyes, allowing your head to gently rest on your palms.

Breathe.  Return your head to neutral, remove your hand, and take another dee

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Tilting Our Homeostatic Balance for COVID-19 Prevention (Part 1): Mechanisms from Mind-Body Medicine

By Luann Fortune, PhD & Shannon McLain Sims, PhD, MS


Not a person on the planet has been untouched by the COVID-19 pandemic.  In these articles (Parts 1 & 2), we explain evidence for using mind-body practices to help minimize risk to COVID-19. We also offer an extensive collection of resources in the references list.  For the discerning and inquiry reader, we provide a platform for an interdisciplinary, integrative strategy to fight COVID-19 and also come out stronger on the other side.

As of April 26, authorities had reported 2,962,915 cases globally of COVID-19 infections, with 961,969 cases confirmed in the U.S. (Johns Hopkins, 2020).  While the numbers sadly change each day, Johns Hopkins reported a total of 205,936 deaths globally, with 53,755 of those in the U.S. alone.  With limited testing, experts assume there are far greater numbers of persons infected than reported (Fitzpatrick et al., 2020).  Also, early evidence indicates many people are asymptomatic or contract sufficiently mild cases so that they do not even seek medical help.  It is still unclear whether those who have recovered from the virus develop immunity.  Scientists project that a vaccine is at least a year away (Ercolano, 2020).  With the duration and long-term impact of this outbreak so unpredictable, this situation demonstrates more than ever that our world is VUCA: volatile, uncertain, complex, and ambiguous.

While scientists and public health officials race for a cure and vaccine, it is clear that every person needs to adopt a strategy of prevention and to optimize their ability to recover.  To boost immunity and mitigate the ever-present inherent stress, myriad self-care practices can be customized and adopted to suit each individual (Fortune, 2019).  Amongst the self-care repertoire lie a spectrum of mind-body practices that are evidence based (Fortune, 2019).


Mind-body medicine (MBM) is based on an inherent connection between mind-body-spirit, and includes practices such as mindfulness, biofeedback, and imagery. When faced with the seemingly gargantuan challenges of negotiating a COVID-19 VUCA environment, deep breathing, mediation, or yoga might seem insignificant responses.  Yet the benefits associated with mind-body practices could be exactly what we need to tilt our homeostatic balance to fortify resistance to infection and, if needed, more readily cope with an infection.  There is some growing indication that mind-body practices can support recovery in those already infected with the virus (Liu et al., 2020).  The key mechanisms appear to relate to reducing systematic inflammation and managing the stress response.

Research on Stress & Immunity

 The word stress often carries a negative connotation, but the experience of stress is a familiar and unavoidable feature of life.  Stress is a constellation of events, including a stressor (i.e., stimulus) and our perception of that stressor (i.e., the reaction on our brain), that activates the body’s natural biological reaction: the fight-or-flight response.  While short-term stress (i.e., lasting minutes or hours) is helpful, motivating, and protective, long-term stress (i.e., lasting several hours per day, week, or months) throws the body out of balance and causes unwanted inflammation, which is damaging to both the mind and body (Dhabhar, 2014; Straub & Cutolo, 2018).  As it turns out, a prolonged episode of stress will disrupt a wide variety of immune functions (Sapolsky, 2004).

But the good news is that we can reverse, or even prevent, the damage caused by chronic stress by engaging in mind-body practices.  Researchers now think they have identified the mechanisms that allow such practices to minimize the harmful effects of stress. The stress response also increases harmful pro-inflammatory cytokines.  In re-orienting our stress response, we can enhance our immune system (Dhabhar, 2014), balance our body’s production of cytokines, and be better equipped to resist COVID-19.


Mechanisms to Fight COVID19 Using Mind-body Channels

As research continues to emerge, we are beginning to see the health effects this novel virus.  Data suggests that the major way in which the Corona Virus kills is by triggering a cytokine storm (Chen, Zhang, Ju, & He, 2020), a form of systemic inflammation that is triggered in the immune system.  In the case of COVID-19, this inflammatory response can attack the lungs and respiratory system leading to further, potentially lethal, complications (Prompetchara et al, 2020).  In most cases, this cytokine call to action is a healthy immune response, but a cytokine storm is a damaging overreaction by the immune system (Mau, 2020).

Given what we know about stress’ ability to increase harmful cytokines, one response to COVID-19 might be to use mind-body practices to help support the immune system.  Research suggests that mind-body therapies and practices can lower markers of inflammation and cytokine expression (Bower & Irwin, 2015; Creswell et al., 2016; McLain, 2019).  It is important to emphasize that such practices cannot replace conventional medical treatment.  Still, mind-body practices can prompt the body to respond in a more appropriate, balanced way.

Mind-Body Medicine for COVID-19

MBM focuses on the interactions between the mind and the body and the powerful ways in which you can participate in your own health and healing (NCCIH, 2018).  This occurs through the complex psycho-neuro-immunological system (PNI) where mind and body physiology mutually influence the whole (Litrell, 2008; Yan, 2016).  MBM remedies share a common function: they initiate a change in one realm to affect a positive change in equilibrium of the whole.  That is to say, thoughts, feelings, beliefs, and attitudes can affect and shape every aspect of our psychological and physiological functioning, and in turn, how we care for our bodies can affect how we think, feel and what we believe.  This means that we have many opportunities and can do many things to care for ourselves.

In Part 2 of “Tilting our Homeostatic Balance” we suggest specific mind-body practices to help manage the challenges of the COVID-19 pandemic.


Luann Fortune, PhD, LMT is on faculty at Saybrook University in the Department of Mind-Body Medicine, where she also coordinates the specialization in Mindful Leadership in Healthcare. Her research focuses on integrative health and wellness.

Shannon McLain Sims, PhD, MS holds degrees Mind-Body Medicine from Saybrook University’s College of Integrative Medicine and Health Sciences where she currently serves as a post-doctoral fellow.



Bower, J. E., & Irwin, M. R. (2016). Mind–body therapies and control of inflammatory biology: A descriptive review. Brain, Behavior, and Immunity, 51, 1-11. doi: 10.1016/j.bbi.2015.06.012

Chen, C., Zhang, X. R., Ju, Z. Y., & He, W. F. (2020). Advances in the research of cytokine storm mechanism induced by Corona Virus Disease 2019 and the corresponding immunotherapies. Zhonghua shao shang za zhi= Zhonghua shaoshang zazhi= Chinese journal of burns, 36, E005-E005.

Creswell, J. D., Taren, A. A., Lindsay, E. K., Greco, C. M., Gianaros, P. J., Fairgrieve, A., … &Ferris, J. L. (2016). Alterations in resting-state functional connectivity link mindfulness meditation with reduced interleukin-6: A randomized controlled trial. Biological Psychiatry, 80(1), 53-61. doi: 10.1016/j.biopsych.2016.01.008

Dhabhar, F. S. (2014). Effects of stress on immune function: The good, the bad, and the beautiful. Immunologic Research, 58(2-3), 193-210.

Ercolano, J. (2020, April 16).  A coronavirus vaccine is in the works – but it will not emerge overnight.  Johns Hopkins Coronavirus Resource Center.  Retrieved from

Fitzpatrick, S., Przybyla, H., De Luce, D., Strickler, L., & Kaplan, A, . (2020, April 17). Coronavirus testing must double or triple before U.S. can safely reopen, experts say. NBC News. Retrieved from

Fortune, L. (2019, September 13).  Self-care: Pursuing the ultimate path to optimal wellbeing.  UnBound. Retrieved from

Johns Hopkins University. (2020).COVID19 dashboard. Retrieved April 25, 2020, from

Littrell, J. (2008). The mind-body connection: not just a theory anymore. Social Work in Health Care, 46(4), 17-37.

Liu, K., Chen, Y., Wu, D., Lin, R., Wang, Z., & Pan, L. (2020). Effects of progressive muscle relaxation on anxiety and sleep quality in patients with COVID-19. Complementary Therapies in Clinical Practice, 39, 101132.

Mau, F. (2020). No need for a hammer A guided imagery process for patients suffering from COVID-19. Retrieved from

McLain, S. (2019). The impact of mind-body skills training on medical students: A mixed-methods research study (Doctoral dissertation). Available from ProQuest Dissertations & Theses Global database. (Accession Order No. 27738770).

National Center for Complementary and Integrative Health (NCCIH). (2018, July).  Complementary, alternative, or integrative health: What’s in a name? Retrieved from

Prompetchara, E., Ketloy, C., & Palaga, T. (2020). Immune responses in COVID-19 and potential vaccines: Lessons learned from SARS and MERS epidemic. Asian Pacific Journal Allergy Immunology, 38(1), 1-9.

Sapolsky, R. M. (2004). Why zebras don’t get ulcers: The acclaimed guide to stress, stress-related diseases, and coping-now revised and updated. Holt paperbacks.

Straub, R. H., & Cutolo, M. (2018). Psychoneuroimmunology—developments in stress research. Wiener Medizinische Wochenschrift, 168(3-4), 76-84.

Yan, Q. (2016). The translation of psychoneuroimmunology into mind–body medicine. In Psychoneuroimmunology: Systems biology approaches to mind-body medicine (pp. 121-129). Cham, SZ: Springer.

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COVID-19 Self Care Coping Strategies

By Luann Fortune, PhD & Shannon McLain Sims, PhD

Self-care is vital for wellness and quality of life in normal times and has special meaning in the context of the COVID-19 pandemic. While science races to find a cure, a vaccine, and better testing, self-care has never been so important.  First and foremost, we all need to take care and precautions to minimize infection.  The Center for Disease Control provides regularly updated guidelines on reducing risk.  In addition, self-care routines can help manage the increased burden of emotional trauma and avoid burnout, especially for front line workers.  In addition to adequate sleep, a balanced diet, and various supplements and vitamins, mind-body practices to mitigate stress can be beneficial (Alschuler et al., 2020).

COVID19 self care figure

What about the role of the mind in protecting the body? Healthcare workers and the many who provide us essential services in these challenging times suffer the added burden of perpetual fight-or-flight response.  Those on the front lines need to adopt vigilance, but also stay calm. The ever-present threat of infection results in increased anxiety.  Stress and anxiety not only affect the quality of daily life, but can impact immune response and result in weariness, and eventually, burnout.  Burnout, emotional exhaustion, and empathy depletion are all related.

Previous research indicates that integrative practices can support prevention and healing.  Early research specific to COVID-19 found that mind-body practices that promote stronger immunity can reduce infection risk and promote recovery in those who become infected (Liu et al., 2020). Many mind-body practices that have already been demonstrated to support wellness can be used to manage stress and calm body-mind-spirit.

With many being forced to self-isolate, either away from family or within their own homes, options are appearing to help support a calm and relaxed state through online offerings.  Mind-body techniques and practices offer a rich tool box of in-the-moment remedies for emergency relief.  Many online resources are available to help mitigate the strain of isolation.  Even a few minutes a day spent to reverse hyper-stress can have long term effects.  Some of these are also offered live, providing the added benefit of connection and community to help deal with the disruption in social support.

One such example is a daily program provided by Saybrook University as a free public service.  The faculty of the Department of Mind-Body Medicine offer live mindfulness meditation sessions each weekday at 12:15pm ET/9:15am PT. The audio podcasts are also available at  The 15 minute guided interludes are open to anyone globally and can be joined live at

Hopefully, the COVID-19 pandemic crisis will soon be a chapter in our personal and collective histories. Refining our self-care practices and strategies will remain important to our continued health and well-being.  Building a bigger ensemble of mind-body practices can become one reward we carry forward.



Alschuler, L., Weil, A., Horwitz, R., Stamets, P., Chiasson, A. M., Crocker, R., & Maizes, V. (2020). Integrative considerations during the COVID-19 pandemic. EXPLORE, 26.

Liu, K., Chen, Y., Wu, D., Lin, R., Wang, Z., & Pan, L. (2020). Effects of progressive muscle relaxation on anxiety and sleep quality in patients with COVID-19. Complementary Therapies in Clinical Practice, 39, 101132.


Luann Fortune, PhD, LMT is on faculty at Saybrook University in the Department of Mind-Body Medicine, where she also coordinates the specialization in Mindful Leadership in Healthcare. Her research focuses on integrative health and wellness.

Shannon McLain Sims, PhD holds degrees Mind-Body Medicine from Saybrook University’s College of Integrative Medicine and Health Sciences where she currently serves as a post-doctoral fellow.


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Spiritual Meditation and Health: Research published

At Saybrook University where I work and teach and research, in our Department of Mind-Body Medicine we are proud to contribute to evidence on the interconnectivity of mind-body and spirit for health and wellness.  Our latest research on meditation and health has just been published with @SpringerNature in Journal of Religion and Health (JORH).  “Spiritually focused meditation practices appear to increase the emotional, physical, and spiritual well-being of cancer survivors, which could translate into better physiological outcomes.”  Congratulations to new PhD Dr. Kanishtha Agarwal for taking the lead in this authorship and my colleagues Drs. Heintzman and Kelly for their contributions to this research and publication.  The entire peer-review article is available for all to ready via open-access. Read here:

Agarwal, K., Fortune, L., Heintzman, J., & Kelly, L. (2020). Spiritual experiences of long-term meditation practitioners diagnosed with breast cancer: An Interpretative Phenomenological Analysis pilot study. Journal of Religion and Health,(), 1-17. Advanced online publication.


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Unbound for Higher Ed Seekers

I am honored to be featured in hashtagSaybrooks blog hashtagUnbound article touting our mission and accomplishments. My work in hashtagintegrativehealth care hashtagmindbodymedicine and hashtagmindfulnessatwork in healthcare leadership inspires me each day. Thank you to my colleagues and students. To cite myself, at Saybrook hashtagCIMHS “.You might discover that, when you have finished your Saybrook work, the real work begins and in the process you have changed yourself.”

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Mindfulness for a VUCA Healthcare World

I am cautiously optimistic and also skeptical about the McMindfulness movement (Hyland, 2017; Purser & Loy, 2013).  Critics of proliferating mindfulness training in organizations point to challenges to the ethics (Wolverman, Schwartz, & Schoenberg, 2018) and over-capitalization of the movement (Hyland, 2017).  Plus, the tips provided by popular organizational gurus (e.g., Hougaard & Carter, 2018) sometimes strike me as simplistic, e.g. offer healthy food and drinks, control digital distractions, encourage boundary setting.  Perhaps each small change is meant to be a pebble in the pond towards shifting organizational culture.  Yet none of these tactics are novel, making me wonder why they have not worked up to this point to stem the volatile, uncertain, complex and ambiguous (VUCA) tide.

I teach a course in Reflective Leadership in Mindful Leadership in Healthcare at Saybrook University.  This course is experiential in that we are all doing the Mindful Leader app (Hougaard & Carter, 2018), practicing mindfulness meditation each day in addition to textbook readings and assessing original research.  As an educator and advocate of integrative healthcare, I am committed to integrative healthcare and envision myself as a “pebble in the pond”, creating large changes with small actions (Perlman, Horrigan, Goldblatt, Maizes, & Kligler, 2014). While our Mindful Leadership curriculum focuses on integrative healthcare and mind-body medicine, we have to do this in a VUCA world, where instability is the norm in fields and settings beyond healthcare.  Perlman et al.’s (2014) called for unique leadership to lead integrative healthcare systems, where mindfulness can serve as the connector between self-awareness, self-regulation, and the educated decision making needed to succeed.  They are not alone in suggesting that mindfulness is the answer, as evidenced by the volumes of readings, conferences, and apps readily available.

I admit to a slight mistrust of the panacea of mindful leadership tactics to reform VUCA environments. Turns out that my distrust is at least organic, a reflection of typical norms in the U.S.

Globalization of Trust

According to the Organisation for Economic Co-operation and Development (OECD, n.d.), the U.S. is lower than all but one of the European countries in the survey on trust and on a downward slide.  Generalized trust has declined steadily in the U.S. from 1972 to 2014.  More strikingly, trust in U.S government institutions declined from a rating near 80% trust in 1964 to <20% respondents expressing trust in 2015 (OECD, 2017). Based on this data, the U.S. is a global leader in the diminishment of trust in our institutions.

So, what is going on in the U.S.?  Deteriorating healthcare aside, was not the late 20th century a time of great solidarity, prosperity, and innovation lead by the U.S.?   I suspect a shadow side, the metaphor of the allegory of Plato’s Cave, and possible psychodynamics at play. “Human beings have a knack for getting trapped in webs of their own creation” (Morgan, 2006, p. 207).

Psychodynamics of Organizations and Mindfulness

We remember the Socratic teaching moment drawn in an ancient cave with three prisoners. They were shackled and tied so they could only see the outside world represented in shadows cast by firelight on a wall before them (Plato, VII, 514 a, 2 to 517 a, 7).  They never saw the world outside.  When one prisoner escaped and saw the other side of the cave wall, he was at first shocked but eventually realized that his former reality was false.  He returned to the cave and told his fellow prisoners.  But when he tried to set them free, they threatened to kill him.  Some philosophers argue this allegory shows the dangers of believing empirical evidence ensures knowledge, others claim it shows that people are afraid of higher truths, and others that we are psycho-dynamically predisposed to keeping ourselves trapped (Morgan, 2006).

Mindfulness consultants Hougaard and Carter (2018) admitted that organizational change is not easy and that influencing culture “goes deeper than articulating a set of values and posting them on the wall” (p. 163).  There are multiple practical and observable obstacles to implementing wide-spread change in any organization.  In addition, even in apparently well-functioning organizations, members experience normal psychological injuries, expected and normal hurts that people feel when collaborating with others to reach organizational goals in uncertain environments (Hirschhorn, 1999).

Hirschhorn is a global leader in training organizational consultants in psychodynamic structures (CFAR, n.d.).  I consulted Hirschhorn about his opinions on the current mindfulness movement and its potential to reach to the shadows of organizational prisons.  He positioned mindfulness as a useful tool, a “framework for knowing yourself and for being attuned to the tacit dimensions of organizational life around you.  A kind of tuning in to what is below the surface in yourself and in your setting” (L. Hirschhorn, personal communication, November 12, 2019).  Hirschhorn also pointed me to his blog site and a recent psychodynamic assessment of President Trump (Hirschhorn, 2019). In his post that examines psychological traits for larger organizational manifestations, one point involves the importance of considering how the role one occupies in an organization will describe potential contributions as well as the ability to successfully influence organizational change.  So, in affecting change, we need to remember our place.  In addition, Hirschhorn highlighted the importance of an effective leader marrying basic ideas to the entourage of organizational membership.  In a reframing of this consideration, I return to the challenge of shifting values and a recent personal experience (Donaldson-Feilder, Lewis, & Yarker, 2019).

Saga of an Orthopedic Surgeon: What Can and Cannot be Changed

I recently witnessed an illustration of the personal costs of unresponsive, unmindful leadership in a healthcare organization.  I share this story with the endorsement of the physician involved.  On Thanksgiving Day, I was visiting a hospitalized friend.  Overall, in her many weeks there, I observed the hospital operation was not entirely responsive, and I knew they had no competition in this community for the level of trauma care provided.  But I had several opportunities to observe the surgeon and his staff in this setting.  I was impressed by the level of patient-centered, compassionate care they provided my friend, and her level of trust in them.  On that morning, her surgeon visited her and delivered very unfortunate news.  This news was not about her condition, which improved steadily with his expert and abundant care. Rather, he came to tell her he had quit the hospital system, no longer able to work with inconsistent, unreliable, and inexpert support.

During the next minutes, he calmly explained to us the multiple issues with the organization, and the myriad issues tied to quality patient care that he repeatedly reported to administrators.  He explained he was hampered by so many incompetent systems and unresponsive management that he could not be the effective surgeon and healer he aspired to be.  He repeatedly said he was not burned out, at least not yet, but suffered on a moral level.  I suggested to him, “moral injury” and he concurred:  that was it.  Very soon, he would be returning to his place of residency, a nationally recognized leader in integrative healthcare, to pursue his surgery practice in a more compassionate, like-minded, supportive environment.  He hoped he could someday come back, when the climate of the organization had shifted to a more patient-centered and practitioner-supporting organization and system.

But he was not optimistic about changing the embedded mindset that was generating toxicity in this large, unmalleable organization.  This demonstrates the embeddedness of resistant thinking:  replacing a physician entails hundreds of thousands of dollars cost to an organization, plus loss of quality of care, safety, and patient satisfaction.  Yet this physician was aware of the larger risks of not leaving:  costs associated with burnout are escalating each day, physician suicide incidence is over three times the national average, and the associated costs are deep due to loss of skills, care quality, and sustainability (West, Dyrbye, & Shanafelt, 2018).

I propose that one possible strategy is decentralize, to diminish the size and power of the mega-organizations to smaller, collaborative entities.  Shifting the operations off the mothership onto smaller, innovative operations could be grounded in mindful-selfless-compassionate (MSC) principles, practices, and values.  By de-centralizing control, change makers can introduce the practices touted by Hougaard and Carter (2018) and cultivate MSC cultures.  Further, this could create a fertile ground for adopting integrative medicine models and components.

In an argument I never expected to make, for-profit healthcare does have advantages:  it could benefit from innovation if it leads to improved outcomes.  This approach should ultimately make for more satisfied customers, measurable outcomes, and provide competitive edge.  As I have seen in my association with IM4US (n.d.), we can also include the under-served.

According to Hirschhorn, there will always be psychodynamics to overcome:  These can be better overcome with awareness.  There will also be nay-sayers who prefer Plato’s Cave: leaving them behind requires decisive and hard actions.  At the heart of my proposed evacuate-and-rebuilt strategy are MSC-oriented leaders able to garner support and willing to take risks.  Even my sense of mistrust is optimistic.

Perlman et al. (2014) concluded in their argument for mindful, integrative leadership that each leader and each member should do what they can in the present moment and wait until the foundational support is stronger to do more.  In the meantime, we build up each other, which we can do with MSC practices. Donaldson-Feilder, Lewis, and Yarker (2019) found that mindfulness practices enhanced the leader’s well-being, resilience, leadership capabilities, and possibly their innovation.  The analysis failed to identify which type of mindfulness practice was most effective.  Also, the researchers found little evidence of benefits to the leaders’ direct reports.  Hence, the evidence indicates the leaders should first attend to self, in whatever mode best builds individual self-efficacy.  If we are each attending to self, we need to be less worried about bringing along the other:  they will bring along themselves and also become empowered in the process.

In conclusion, I argue for continuing our individual practices and sharing with members of our organizations and communities and the people we serve.  By cultivating our awareness and also our fortitude, we are preparing for the opportunity of each moment, as it unfolds.  MSC practices are endeavors that remind us we are solitary and concurrently interconnected.  We simultaneously operate at the systems level, joined by our underlying intention to transform healthcare based on shared values.  By taking an MSC approach, we have added tools to achieve sustainable transformation, and in the process, transform ourselves.

I welcome your comments here as we all continue with this important work.


CFAR. (n.d.). Dynamics of Consulting.  Retrieved from

Donaldson-Feilder, E., Lewis, R., & Yarker, J. (2019). What outcomes have mindfulness and meditation interventions for managers and leaders achieved? A systematic review. European Journal of Work and Organizational Psychology28(1), 11-29.

IM4US. (n.d.).  Mission and philosophy.  Retrieved from

Hirschhorn, L. (1999). The workplace within: Psychodynamics of organizational life (Vol. 8). Cambridge, MA: MIT Press.

Hirschhorn, L. (2019, July 22).  Trump’s style of executive functioning. Learning from experience: Larry Hirschhorn.  Retrieved from

Hougaard, R., & Carter, J. (2018). The mind of the leader: How to lead yourself, your people, and your organization for extraordinary results. Boston, MA: Harvard Business Review Press.

Hyland, T. (2017). McDonaldizing spirituality: Mindfulness, education, and consumerism. Journal of Transformative Education15(4), 334-356.

Morgan, G. (2006). Exploring Plato’s Cave: Organizations as psychic prisons. In Images of organzations (pp. 207-240). Thousand Oaks, CA:  Sage.

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OECD. (2017).  Guidelines on measuring trust. Paris: OECD Publishing.

Perlman, A., Horrigan, B., Goldblatt, E., Maizes, V., & Kligler, B. (2014). The pebble in the pond: How integrative leadership can bring about transformation. EXPLORE: The Journal of Science and Healing10(5), S1-S14.

Plato. Allegory of the cave.  Republic, VII, 514 a, 2 to 517 a, 7. (T. Sheehan, Trans.).  Retrieved from

Purser, R., & Loy, D. (2013). Beyond mcmindfulness. Huffington post1(7), 13.

West, C. P., Dyrbye, L. N., & Shanafelt, T. D. (2018). Physician burnout: contributors, consequences and solutions. Journal of internal medicine, 283(6), 516-529.

Wolever, R. Q., Schwartz, E. R., & Schoenberg, P. L. (2018). Mindfulness in corporate America: Is the Trojan Horse ethical?  The Journal of Alternative and Complementary Medicine,  24(5), 403-406.






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