Mindfulness: imagination

Mindfulness and the Emergency Healthcare Professional

Chapter 7: it’s all in your imagination

The “meditation industry”

The transition into meditation is the hardest part for all of us at first, and because of this, a whole “meditation industry” of various types of meditation aids, devices, books and music has arisen to help us out. And, no doubt, to create commercial opportunities for the creators.  In the interests of transparency, I must declare myself as a participant in this, having written a book on the topic.

Once we have practised enough transitions from waking state to meditation state, we begin to build up our own library of ‘cues’ about our own individual transition process.  And then, we can tune into those cues – or lack of them if we are a bit “scrambled” – and by using our own biofeedback, we can “nut it out” for ourselves. There is a bit of stumbling around in the dark for a while, but persist, because the fog clears, and the whole thing then starts to motor along quite nicely.

Once we have experienced what it feels like we can steer the same route again when we have our next practice. Navigating by feelings sounds so corny, but that is how it seems to work.

I don’t really know why mindfulness has to be so difficult to achieve...

I don’t really know why mindfulness has to be so difficult for us to achieve in our fast-moving lives, but it seems to be the case.  At first.  But with repetition and trial and error we learn about our own inner signals  of what the different states feel like.  Let’s use an example.

What’s your favourite relaxation / holiday activity?  What is your absolute best experience you have ever had doing that?  What did it feel like when you were completely “in the zone” during that activity?

Now do a simple three mindful breaths exercise, and re-capture that “zone” feeling, focussing really hard on recalling the feeling.  You will probably notice after a few seconds that a part of you has “gone there” into that feeling, and your physiology may be shaping itself to exactly how it was, when you were undertaking that activity.  Breathe for a minute and explore that feeling of whatever that great moment was for you.  Then, slowly come back to now.

I have just tricked you into doing your first visualisation...

…or maybe not the first for many of you. Imagery creates a physiological response.  And the meditation industry realises this, with the proliferation of guided meditations, to music backing tracks often.  These aids help us to conjure a visualisation, with the brain falling into line, slowing our heart rate, slowing our breathing and letting muscle tension go.  And all because of the induced imagination imagery within the visualisation.

So, we can rely on an external trigger for visualisation, like someone else’s voice telling us what to imagine, or we can do it for ourselves.

Imagination came easily to us as children, as we delved into play and inventing stories effortlessly.

But, with the seriousness of school, and even more so, of medical school, it was easy for us to become unimaginative.  But we can build up this shrunken muscle with repetitions, just as we do in the gym with all of those biceps curls (well, this is me imagining here!).

Imagination and visualisation are certainly powerful in meditation practice, but as with Rome, meditation was certainly not built in a day (with only a few sessions before giving up), and there are many roads (techniques) which lead to the same destination.

Having a few techniques ‘dusted off’ for meditation transition is a bit like knowing a few sedation drug combinations for use in the ED.  If one doesn’t work, you just pivot to another technique.

And the repetition is reinforced further by using other aids such as:

  1. same time of day for mindfulness practice,
  2. same chair or room in the house,
  3. same simple dedication and preparation for the session, and
  4. allocating the same amount of time each time you practise.  

The brain gets the message that you are serious, and it complies

The exciting reinforcement of successful transition achievement comes when we experience our first cool meditation experience.  A completely new and different level of consciousness, which feels just great for those moments, and it was all our own work.

And while it is not the aim of mindfulness to clock up “experiences” per se, travelling through the levels of meditation gives us encouragement that we actually can be successful at transitioning into these states using our own reproducible, and ever quicker, methodology.

What about the biofeedback headsets and glasses?

As I said above, all of these tools support our entry into transition, and are useful.  But, thankfully, we can quickly go beyond the need to use these once we start to really build up our inner list of “index cards” about how each stage of mindfulness feels.  We write our own map.

So, you may have bought a Muse, or a pair of Deepak Chopra flashing light glasses, as I did, but I don’t use them now because I just don’t need to.  And you won’t either, and the music player will probably stay switched off once you really understand transition, your style.

To finish, with thanks to my friend James..

The haunting sound of a shakuhachi flute conjures up images of samurai warriors training, and Zen Buddhist monks meditating, in the forests or snow on a Japanese mountainside… Some sounds just have a magical ability, in most of us, to transport us to another level of “in the zone” awareness.  Some call this “touching on the infinite” within us.

As I said, there are many roads, along this very special journey  – which is, among other things, about re-establishing your inner calm and balance – despite the noise going on all around you.

Thanks for reading this, and take care of yourself.

Next time we will look at the idea of “signal to noise” and some concepts for how we can better focus on the real signal, and trim out the distracting noise.  Mindfulness comes into its own in busy and messy ED situations, and can reduce stress levels and burn-out.

Further reading

Waiver: These articles represent my own views and approach to mindfulness, and do not purport to be the official view of ACEM.  They are not intended to replace appropriate medical or mental health care, provided by professionals in these domains


A/Prof Andrew Dean, MBBS FACEM Grad Cert Clinical Simulation. Emergency Physician and DEMT at St John of God Hospital, Ballarat, Victoria, Australia. Head of Ballarat Rural Clinical School, School of Medicine Sydney, University of Notre Dame Australia.
Still searching for new and innovative teaching methods for emergency medicine education.  Also a committed advocate for mindfulness meditation, and the nurturing of emotionally intelligent clinical teams in health care.

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