MHM Magazine

Issue 2 | 2023 | MENTAL HEALTH MATTERS | 25 MHM With a nod of encouragement from her mother, Tina eventually looked at me with tears in her eyes. Very quietly she said, ‘I feel...like a man in a woman’s body. I am ashamed and I don’t know what to do.’ I took her hand. For five minutes nobody said a word. While she settled, I continued to give her my full attention, ‘listening’ to the resonant field we’d created between us. ‘Congratulations! I’m so proud of you. You just took a tremendous step.’ I assured her that we were on this journey together and could assemble a team to find the best route forward. Her whole posture had changed. The slumped, awkward teenager was now sitting up straight in her chair, her gaze penetrating, her voice deeper. When I asked her how many of her symptoms she attributed to feeling this way, she didn’t miss a beat. ‘All of them, Dr Bonhoeffer.’ Every cell in my body knew she was right. Yet if I had followed my familiar training and not listened deeply, my initial list of suspected diagnoses would have included chronic gastritis, juvenile arthritis, atopic dermatitis, anorexia and many more, followed up by extensive lab tests, an MRI and gastroscopy. I could also have prescribed antibiotics, antacids and anti-inflammatories to treat her symptoms. Instead, I suggested she listen intently to her body and her feelings, inviting her body to realign with this new perspective. Rather than making suggestions for her treatment, I decided to ask her what the best next step might be for her. She responded immediately, advocating rest, eating lightly and taking walks in nature. I encouraged her to sketch her thoughts and feelings as they arose and recommended a series of soothing massages and Feldenkrais movement exercises to help her inhabit her body with more confidence. By now my teenaged patient was smiling broadly. As I reflected later, Tina had taught me a valuable lesson. Exploring traditional diagnostic pathways and employing active listening techniques would have only given us a partial picture of what was really going on. Only by taking the time to build a more heart-centered relationship, engaging her trust by listening deeply without judgment and inviting her to co-create her own treatment plan was I able to support her with my knowledge and experience. Deep listening is a skill that can be learned, but only with the sincere intention of practicing it from the heart. It cannot be faked. When you have a profound desire to fully understand the other person, deep listening becomes second nature. How can you practice deep listening? When you’re with a patient, colleague or loved one, first practice noticing every single detail around them and paying undivided attention, not only to the words they are speaking, but also their expressed and implied emotions and their body language. Notice how this contributes to your understanding of your patient and their current condition. Second, allow yourself to become deeply absorbed in the person in front of you and adopt an attitude of genuine curiosity. This is a precious opportunity to shift into seeing the world through your patient’s eyes. Which means taking the risk of relinquishing your medical interpretation and daring to let the insight change you and how you relate to the patient. Third, if emotions surface in you, check in with yourself to see if they belong to you or your patient. If you suspect you might be mirroring emotions, you can gently verify how it feels for them. If you become aware that your feelings are personal and reactive, you were just gifted a tremendous opportunity for growth! Make a note and embrace it in your reflective practice. Fourth, when judgments or divisive emotions threaten to separate you, you can step forward with compassion without letting go of your centre. Here, compassion is the key to moving from judgment to understanding. You can become aware of both your own and your patient’s over-identification and dissolve the illusion of separation. In practice, this may feel like seeing the situation from above with loving kindness for both. By practicing deep listening in this way we can be fully present, returning to our sense of wonder and exploration and learning to trust in the innate wisdom of our patients and their own journey towards greater health. It’s my sincere desire that the field of medicine embraces this heart- based approach as we move forward into a co-creative future. About the Author: Dr. Jan Bonhoeffer is founder of Heart Based Medicine, a non-profit foundation that promotes and supports the wellbeing of health professionals with heart-centered training, tools and resources. He cares for patients and teaches pediatrics at the University Children’s Hospital in Basel, Switzerland. He has built and led large global research networks to improve child health, has published over 100 scientific papers and book chapters on infectious diseases and vaccines, and worked with the World Health Organization to shape global health programs. He is the author of the new book “Dare to Care — How to Survive and Thrive in Today’s Medical World. Learn more at heartbasedmedicine.org . Email: contact@heartbasedmedicine.org. References available on request.