Abstract
Introduction
Cognitive ergonomics is concerned with mental processes such as perception, memory and reasoning [1]. Mental processes in the work place has become a serious concern with conditions like occupational stress and burnout emerging as major health problems. These conditions are associated with organizational inefficiency, high staff turnover, reduced job satisfaction and absenteeism [2].
Factors such as healthy physical environment, better salaries and recreational facilities may influence cognitive ergonomics in an occupational setting. Above all these, well trained internally stable minds help workers to offer a better service while leading a healthier life [3].
Mental processes related to work matters in health care settings as much as or more than anywhere else. This is because staff in health care settings needs to be well prepared to serve patients who need high quality attention than ordinary people in other settings. Readiness to serve and other soft skills like patience, compassion and caring attitude are essential pre-requisites among health care personnel.
It has been observed that spiritual wellbeing has a positive effect on work [4]. Hence, it is worth exploring how life style based mind development programs can be instituted to create ergonomically better-adjusted minds to bring about happiness in workplaces while keeping productivity and quality of services high.
This is a challenging task. This paper presents a series of attempts made in the past few years to find a solution to this problem. The training method used in these attempts could be considered for mind development in appropriate occupational settings in the future.
Objective
The objective of the present work was to test a body-mind technique to generate happiness, patience, contentment and caring attitude, and apply it in a health care work setting.
Methodology
A training exercise with the following four components were developed and tested to promote happiness, patience, contentment and caring attitude. Exploring different methods of training mind to choose a suitable method Mastering the chosen method Testing its usefulness among those who practice the method Applying it on occupational settings.
Initial work started in 2005 with considerable amount of self-study and practice of different methods of improving these selected ergonomic skills. These methods included mind training exercises from different origins. An attempt was made to design a method of training the mind to develop a re-charging mechanism to top up happiness and contentment and in generating skills such as patience, compassion and caring attitude with lasting changes withinindividuals [5].
Of the methods available one method originally discovered by the Buddha in the 5th century BC called “insight meditation” was chosen considering its exceptional features. This method of training mind is known to reduce the disturbances that an individual gets from the distressing memories, the physical body and the external environment substantially bringing down mental stress. Ability of this method to transform people who practice it to become more patient, caring and empathetic workers free from personal biases and prejudices were considered in choosing the method.
This method of “insight meditation” included the following essential steps. Sitting on the ground in cross legged position preferably using a suitable cushion. Determining a period of time for training. One can start with fifteen minutes twice daily. Scanning the body using the mind as a probe. A number of body parts should be identified to create a path for the scanning process (six body parts method includes head, right arm, front of the chest, left arm, right thigh and left thigh). Scanning the body using these body parts while contemplating the verse “may all be well, happy and peaceful” on each of the body parts before leaving it to the next part. Trainee lets the mind scan the body in circles along these body parts. While the mind is engaged in the body scan it is trained to let go thoughts generated from the external world through eyes, ears, nose and skin; pains and other sensations from the physical body and thoughts from the stored memories that interrupt the scan process [6].
This exercise trains the mind to stay focused every moment with no additional effort. It also imparts additional skills of self-reflection within the mind producing a unique ability of eliminating personal bias in thinking and decision making This ability, which is not seen in other methods of relaxation, facilitates happiness, patience, contentment and caring attitude and also has a positive effect on work performance. There are advantages that cannot be adequately described. Parallel experience by others is possible as the method is transferable. Training to achieve this parallel experience is the only successful way of teaching this unique method of health promotion that produces global positive effect on the health of individual and workplace community. Though it was not possible to measure every aspect of improvement some aspects were measured using the Primary Mental Health Questionnaire [7] which included questions on contentment, compassion, happiness and mental stress.
A research group, of which the principal investigator is a member, practiced this method and obtained experience to describe its scientific nature and the possibility of training others. A qualitative study was carried out among the members in this group using in-depth interviews as the method ofinquiry [8].
Later it was introduced to a convenient sample of health personnel in the western province who volunteered to learn the method with the idea of creating a rippling effect to transfer it to others. The aim of this activity was to train health workers of the District of Colombo in this method of insight meditation to establish a self-sustainable mental skills promotion program [9].
Medical Officers of Mental Health, Assistant Medical Officers, Dental Therapists, Public Health Midwives, Public Health Inspectors and other health personnel who volunteered were trained in small groups creating the first ripple. They were also educated on the interplay between the body, mind and consciousness and on how to experience it during meditation. Facilitation was made to incorporate this practice to their life styles as a twice daily meditation practice. After the initial training follow up sessions were also initiated. Those who obtained initial training were given the opportunity of further practice and taking part in experience sharingdiscussions.
Different individuals took up further practice at different frequencies and durations without much prompting from the first ripple centre. Each person who continued meditation practice after the first training was considered as the second level ripple centre. It is expected to identify those who continue the practice and trained them as trainers for the community initiating tertiary ripplecentres.
Results
Mastering the chosen method
Principal investigator practiced insight meditation under supervision for a period of five years, two hours each day and was able to master the approach. Nature of interplay between body (brain, nerves, muscles and all other systems), mind and consciousness was realized. This realization, though not complete yet, facilitated seeing subconscious internal noise leading to mental stress. Some freedom from previous attachments and conflicts stored in the memory were experienced [5].
The exercise also gave freedom from attachment to and conflicts with the physical body, mind and stored memory helping to stay focused on the job at hand. It also helped to reduce mental stress and improved the speed of work [5]. The changes in the body, mind and consciousness warranted introducing it tovolunteers.
Testing its usefulness among those who practice the method
The method was introduced to a group of medical students who volunteered to practice the method. It was found to be effective in improving professional and personal performance in terms of quantity and quality. It was also proved that it can be taught by a sufficiently experienced person to a group of others and the tool developed was useful in measuring change [10].
In a qualitative study on the group of professionals who practiced this method a rich collection of observations were made on the skills achieved. On these observations eight constructs were developed. They are that “Insight meditation method practiced: Gives the stability against emotional challenges Reduces conflicts in social and family life Reduces mental stress Reduces compelling desires Reduces internal noise Reduces pain and reaction to pain Changes the personality of the practitioner Improvements in the mental skills achieved are sustainable”
Out of the eight constructs achievement of stability against emotional challenges, reduction of conflicts in social and family life, reduction of stress levels, compelling desires and internal noise were confirmed by all. Pain and reaction to pain were reported to be reduced. There was evidence that personality of the individuals did not change. It was concluded that the method of insight meditation practiced had a favourable and sustainable effect on selected aspects of mental health in this group. This method of insight meditation can be recommended to promote relevant aspects of mental health among those who can take up this method as part oflifestyle [8].
Applying it in occupational settings
Five hundred members obtained training in the initial round in 11 training sessions in the auditorium of the Provincial Director of Health Services, Colombo and two sessions in the mental health directorate in the Ministry of Health (Table 1). An assessment is being done of the frequency and duration of daily practice to identify potential candidates who can be developed into re-trainers [9]. It has been observed that about 10 such candidates are currently existing.
Initial qualitative information indicated improvement of mental wellbeing among ‘normal’ people who were trained and emergence of secondary ripple centres. There was a universal agreement among those who continued practice that they experienced “relief from stress and had a sense of comfort” during the practice sessions which cannot be achieved by other means. Mental wellbeing was enhanced among the first group of trainees. Health workers’ interest and enthusiasm in the mind training exercise was reflected by the fact that they organized training sessions in their own workplaces.
Fifteen such training sessions were held in different work setting of the health department of the Western Province and outside. There is a continuous demand for training sessions. Initial assessment suggests long term viability of the program and benefits to the community.
Conclusions and recommendations
This method of Insight meditation has had a profound effect on many aspects of cognitive ergonomics as experienced by the self- study and on the results of the subsequent studies. The ideal approach to demonstrate the true effect of insight meditation on mental processes related to work is to use an experimental design. However, it was difficult to use a true experimental design as random allocation is not going to sustain due to differential continuity of meditation by individuals. A quasi-experimental study is underway to confirm the effects of insight meditation on selected aspects of cognitive ergonomics.
Details of the method used in Insight Meditation is difficult to describe and not quite visible to a reader without practice. It is recommended for interested researchers to initiate training with this method and the finer details will unfold in an experiential learning process. The author is ready to assist those who seek further details of the method used.
Conflict of interest
The author has no conflict of interest to report.
Footnotes
Acknowledgments
I acknowledge my teacher of meditation Ven. Arahath Lankapura Sariputta Thero for his valuable guidance.