Dr Amiee Vyas explores how practising yoga and meditation can benefit both aesthetic patients and your own personal wellbeing
In the world of aesthetic medicine, where our services focus on outward beauty, people often forget about the mind. With its origins more than 5,000 years old in Indian philosophy, yoga is an ancient practice for the unification of body and mind, combining physical postures, rhythmic breathing and meditation.1,2 Meditation is one of the modalities used in Ayurveda, the comprehensive natural healthcare system originating from the Vedic times of India, which is now commonly used as complementary healthcare in the western world.3 According to recent research by Bupa Global, meditation is the UK’s favourite form of wellbeing therapy, with over a quarter of adults (26%) using it to improve their mental wellbeing in the past five years.4 Meditation is also the most popular complementary health approach used in the US, with a report from the 2017 National Health Interview Survey finding that American adults’ use of meditation tripled from 2012-2017.2,5 In recent years, the World Health Organization (WHO) has recognised traditional and complementary medicine as an important and often underestimated part of healthcare, and that the demand for its services is increasing.6
I come from a family of healthcare professionals and, interestingly, many of these individuals are also teachers of meditation and yoga. It’s therefore unsurprising that I have known these techniques since childhood and I have seen first-hand the positive impact of incorporating daily meditation practices into your life, not only for personal wellbeing, but also with regards to how we can impact the lives of our patients and enrich their journeys with us in clinic.
The benefits of yoga on the body as a physical exercise is well established and there is now a growing body of evidence to support a positive effect on brain structure and function, particularly with regards to the mediation strand of the practice.7-10 There are many well-documented health benefits of meditation. These include deep relaxation through stimulating increased alpha and theta wave activity in the brain for stress reduction, improved mood including reduced anxiety, reduced depression and aggression, reduction in both physical and psychological pain, improved memory and increased efficiency and focus.3,11-15 One study involving 50 meditators and 10 controls looked at the effect of meditation on the executive attention network, finding meditators were faster on all tasks.14 Furthermore, physiological benefits include reduced blood pressure and heart rate, reduced lactate, symptomatic relief for pre-menstrual syndrome and menopausal symptoms, as well as others.3,12
Stress reduction is one of the most common reasons to take up meditation. A 2013 study by Rosenkranz et.al. showed meditation can also reduce post-stress inflammatory response.16 Physical and mental stress causes release of cortisol to provide the energy and substrate required to cope with stress-provoking stimuli as part of the body’s fight-or-flight response, and, in turn, an inflammatory response.17 Ongoing production of cortisol, if the stress signal is not switched off, can have detrimental effects on our physical and mental health causing issues from anxiety and depression, to heart disease.18
Meditation is often described as a skill as it improves with practice and takes consistency to get comfortable.19 As with any skill, practice gets you so far, but the guidance of someone who can teach you makes all the difference.19 Two of the notable techniques widely practised today are mindfulness and Vedic meditation. Mindfulness is a good starting point; it reflects the basic and fundamental human capacity to attend to relevant aspects of experience in a non-judgemental and non-reactive way, which in turn cultivates clear thinking, equanimity, compassion and openheartedness.20 Put simply, it is the ability to be present and fully engaged in whatever we’re doing in the moment.19 It is a stepping-stone into deeper forms of meditation like Vedic meditation, which connect you to your deep inner self or consciousness.3
In the same way we encourage our patients to only seek aesthetic treatment and advice from qualified medical professionals, the same can be said for meditation teachers. I personally believe it is important to seek guidance from those who are qualified, experienced and have expertise in the field. I recommend that you encourage patients to do the same, or you can even partner with a suitable teacher through your clinic as an added service.
As the aesthetic medicine industry moves towards wellness, with many patients seeking our services as part of their personal self-care, stress management is inevitably filtering into our work in clinics. Self-care is understood as peoples’ ability to care for themselves physically, emotionally and spiritually.21 Nurse prescriber and clinic owner Julie Scott recently stated in an interview with Aesthetics that emotional and physical wellness go hand in hand. If you are not emotionally and psychologically well, then you cannot be physically well and what we are doing then may become redundant.22 With the rise of pressure from social media to look perfect, individuals are speaking to themselves more negatively than ever before. Frequent selfie viewing on social media has been shown to have a negative association with self-esteem and decreased life satisfaction.23
Meditation programmes can result in reductions of multiple negative dimensions of psychological stress, as well as improve emotional resilience and a provide a greater sense of self-love by bringing about a restructuring of priorities and values, while reorienting the mind towards what is truly meaningful in life.24,25 Other forms address interpersonal relationships, nurturing pro-social qualities of kindness and compassion25 including towards one’s self.26 I feel this is particularly important to consider when patients aim to drastically change their appearance, leaning towards body dysmorphic disorder (BDD). BDD is a disorder of self-perception, characterised by an obsession with perfection, with an impairing preoccupation with non-existent or minimal flaws in appearance. It affects 0.7-2.4% of the general population, with a large percentage of those attempting to receive aesthetic treatments, meaning many cases are first picked up in our clinics.27
Accelerated skin ageing has been linked with poor sleep, which can result in increased signs of intrinsic ageing, as well as a worse perception of personal physical attractiveness.28 Meditation has been found to successfully improve sleep quality, helping individuals to both fall asleep faster and for longer than non-meditators.29 A pilot study on Sudarshan Kriya and Pranayama, which combines physical yoga, meditation and breath work, furthermore showed an improved antioxidant status both at the enzyme activity and ribonucleic acid (RNA) level in practitioners due to changes in expression of the relevant genes, which may translate into better response to environmental stress.30,31
As professionals in this industry, meditation is valuable on another level. Through its ability to nurture pro-social qualities it enables us to authentically connect with others and may improve our rapport with patients.25
Research shows that a Mind-Body (MB) skills course including meditation and mindfulness can strengthen the capacity for self-care and self-awareness, which are increasingly recognised as important competencies for future physicians and nurses.20,32 They form a cornerstone for patient-centred care in which a mutual, humanistic partnership between patient and healthcare provider is established.32-34 Self-awareness enables individuals to reflect on their own attitudes and emotions and can lead to increased understanding of the influence of their own attitudes and behaviour on the patient.32,35 Increasing self-awareness can thus generate healthcare professionals with conscious control to deeply attune to the patient when providing care or to step back if necessary.32,34 This is important because practitioner-patient relationship in aesthetics is guided by the patient’s desires, but relies on us as the practitioners to sign post when continued treatment may be damaging to their appearance and/or mental health in line with the GMC’s good medical practice principle to do no harm.36 Furthermore, MB programmes have been shown to have the potential to develop empathy.32 In practice, improved empathic capacities in patient care are related to improved satisfaction, better compliance to treatment, improved clinical outcomes and fewer medical errors.32,35 This increases patient trust in us as their treatment providers and will make for long lasting patient relationships.
One concept called Sri Sri's Pancha Kosha meditation is simple and easy enough for you or your patients to practice anytime. I like this meditation because even if the mind wanders, you can always come back to where you last remember and pick it back up. To do this, sit comfortably and relax with your eyes closed and take yourself through these five steps, breathing in and letting go after each one.
1) Become aware of all the sounds in your environment.
2) Become aware of the whole body, from the soles of your feet to the top of your head. Giving each part of your body individual attention and honouring it without judgement.
3) Become aware of your thoughts. There’s no need to engage the thoughts, but just watch them as they pass by, don’t resist or hold on to any thought (thoughts in general are not an obstacle to meditation).
4) Become aware of your emotions, whether pleasant or unpleasant. Again, don’t resist any feeling or emotion, but just observe them however they are.
5) Recognise the stillness and peace at the core of your being, beyond the outer layers (sounds, body, thoughts, emotions) of existence.
Incorporating meditation into our clinics can benefit both practitioners and enhance the patient experience. Choosing how to incorporate this depends on the patients we see and their individual needs and, as with other interventions, seeing the benefits of meditation varies with patient motivation. Especially in medical clinics, incorporating meditation must align with our other evidence-based treatments and be implemented under proper guidance from experts in the field. Current literature shows promising evidence of the benefits of meditation as a complementary therapy, but further studies including large randomised trials and longitudinal studies on practitioners will reveal scope for the future.
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