Mindfulness: Signal to Noise

Mindfulness and the Emergency Healthcare Professional

Chapter 8: Signal to Noise

An early compelling outcome from regular practice of mindfulness or meditation, call it whatever you prefer, is that we begin to sense that we have an unexpected executive capability to control the whole cacophony of our thoughts and emotions. By and large, our constant firing of neural impulses is shaped by our past.

Mindfulness reawakens a dim memory that we can affect the present, and that it doesn’t just randomly happen to us

The influences that shape our average brain activity include such predictable culprits as our childhood experiences, the emotional patterns of our early family life during our formative years, a few disasters or momentous events along the way, and of course the daily conditioning of the people we live or work with – they influence our reaction patterns simply because we spend time with them.  So, our family or friends are enormously influential on how we react to events, and how we instinctively dive down emotional rabbit holes, positive or negative, when an event or “trigger” happens to us. 

In audio technical talk, there is a term called “signal to noise ratio” which refers to the amount of fuzzy static that disrupts a clear signal.  Peter Gabriel described it in his brilliant song called “Signal to Noise”, from which these following lines come

All the while the world is turning to noise
Oh, the more that it’s surrounding us
The more that it destroys
Turn up the signal – wipe out the noise!

Peter Gabriel, Signal to Noise. 1995

So much noise, so much emotional reaction. There is a societal disapproval, certainly a mainstream media disapproval, of calmness, of quiet reflection, of equanimity amidst the noise and haste of “Desiderata” fame. 

Go placidly amid the noise and haste,
and remember what peace there may be in silence

Max Ehrmann. Desiderata. 1927

It is surprising how large an obstacle this fundamental belief seems to be: that we can actually take control back from the maelstrom of emotional reactions that forms the majority of our waking thoughts.

We can become quiet
We can return to calm clarity

The other element in the quote is the idea of going placidly (calmly) amidst the noise and haste.  Not escaping, not running away from our lives, but learning how to (1) reliably reach calmness in ourselves, using mindfulness or meditation techniques, and then (2) going right back out into the fray, moving calmly amidst day-to-day events that hitherto would have ‘triggered’ us emotionally. 

Our effectiveness now is enhanced, because our inner world is calmer; we can quietly hear the ‘signal’ from our intuition about the right thing to say, or do, in any situation.  And, the ‘noise’ is no longer dominating our awareness and dragging us along with it.

Fine words, but…

Part of the effect of watching our breathing, scanning our body and muscles, in the mindfulness exercises, is that we build a type of early warning radar for detecting ‘imbalance’.   When we recognise that we are tensing up, we are then more likely to immediately do the thing that restores us to balance.  The mindfulness solutions to stress in any moment are not complex.  By practising regularly, both in ‘scheduled’ sessions of mindfulness, and in ‘mindfulness on the run’ moments at work or during our other daily activities, we build the reflex ever stronger.  This stuff becomes a mostly automatic response to situations that previously would have us reacting with anger, irritation, anxiety or even reactive depression.

Let’s practice this mindfulness again …

Start with a familiar image…

It has been a massive day at work, with over-capacity waiting rooms, and bed-block stretching nerves and energy levels.  It is finally ‘go home time’, and you change out of PPE into civilian clothes, and make your way to the staff car park.  A busy home with all the issues of the day awaits you, and you are feeling like an over-tightened spring already. 

As you sit in your car, quite safely in the car park, let’s do a “reset” mindfulness exercise, a ‘time out’ just for you, before you drive home…

Close your eyes or keep them open if you like, and just stare at something and let your eyes rest from the constant movement of the shift in the ED. 

Keep all your muscles still. 

Follow your breath. 

Breathe in, then out. 

No need to force it; the smoothing and slowing of breathing happens automatically if we let it.

Just watch your breath, in a detached kind of way, as if you are standing in the shallows at the beach watching waves rolling in.

With each breath out release some aspect of the winding of your inner ‘spring’.  Perhaps identify a list of the day’s stresses, and work through the list as you breathe slowly.

Let them go.

Feel yourself moving towards the ‘calm you’, increment by increment, with each breath. Breathe out some tension from shoulders, or jaw muscles perhaps, or let your tension headache move out and away, with the breathing pattern.

If you get distracted, don’t worry; just recognise this, and simply recommence the pattern. 

Once you have done a few minutes of this, give yourself a break and just have some unscripted mindfulness time, not trying to focus on or do anything, and simply enjoy the ‘unwound’ feeling that you have just created.

Perhaps take 5 more minutes, or even 10 minutes if you feel comfortable, then ease your mind back into the mundane world of carparks and commuting, and another normal evening at home with your loved ones…

But you have changed, and you will go home different, with a new, mindful element awakened in you as you engage with the evening.

Next time we will look at mindfulness applied in the workplace, with some examples, and go over the concepts about how the hurdles to mindfulness are essentially transition zone problems, and the strategies are simple – if only we would remember to practise

Thanks for reading this, and take care of yourself.



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

Cite this article as: Andrew Dean, "Mindfulness: Signal to Noise," In: LITFL - Life in the FastLane, Accessed on December 1, 2021, https://litfl.com/mindfulness-signal-to-noise/.
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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