Clinical Aspects of Natural Health

How to flourish in today’s stressful work climate

Take a moment to find the stillness in the hurricane’s eye

Interview with Anne Formsma, MSc.

In today’s demanding society, more and more people suffer from work-related stress and stress-related pathology. Job stress has a detrimental impact on the individual and the organization.  It can undermine motivation, engagement and productivity, and increase absenteeism. It may trigger emotional states including irritability, anxiety, depression and behavioral changes such as aggression or withdrawal. In the long run, it can affect health dramatically by interfering with neuroendocrine, cardiovascular, autonomic and immune function and increase mortality by nearly 20 percent. To fight the harmful effects of work-related pressure, it is essential to develop appropriate strategies – either person or organization-orientated – to blow off steam and improve stress management.

Given the magnitude and urgency of the matter, it is surprising that less than 30 percent of all companies give specific attention to the development and/or implementation of stress-reducing policies. And yet, there is a growing intenti- on among executives to foster mental and physical wellness of their workers. The introduction of the Mindful2Work training – a combination of physical exercise, restorative yoga and mindfulness meditations – seems to serve this ambition. With its powerful impact, the training exceeds the expectations of its developers.  By recording the personal experiences of one of the developers directly, we hope to gain more insight into the philosophy and ambition that lies behind this effective stress reduction approach.

ANNE FORMSMA, As a (developmental) psychologist, Anne is associated with UvA minds (academic centre for the treatment of parents and children) and UvA minds You. She completed her Master of Child Development and Education at the University of Amsterdam. Anne is an established mindfulness teacher who has specialized in Mindfulness for Children and Mindful Parenting at UvA minds in Amsterdam, and Mindfulness-Based Stress Reduction at the International Center for Mindfulness at the University of Massachusetts. She obtained her qualification as Yoga teacher at Delight Yoga in Amsterdam. Anne is the co- author of the book Mindful2Work.

Anne Formsma


What is mindfulness?

‘Mindfulness   means   conscious   attention  to the present moment, without judgement. Often our attention is highly fragmented and not focused on the situation in which we are physically present. Instead we anticipate future events or rehash things that have happened already. We have a head full of thoughts so our attention is not focused on the current moment. The here and now inevitably escapes us. That is a pity because  the  present  moment  is  the  only  moment in which we are truly living. Only when we are fully attentive to this moment, do we become aware of what is happening around and inside us. When we learn to slow down and look at things from a distance, we create space and freedom to choose how to relate to situations and how to cope with them’.

Why  did  you  start  practicing Mindfulness yourself?

‘About ten years ago I started practicing mindfulness. I had a busy job and numerous leisure activities.  I felt increasingly overwhelmed by life, I missed tranquility, calmness  and  relaxation.  When  I  started  practicing yoga and mindfulness, I instantly noticed an increase in quietness and I was more capable of staying attentive to  the  present  moment.  I  could  relax  better  and enjoy more deeply. In my work as a (developmental) psychologist, I then specialized in providing mindfulness courses myself. Personally, I think it’s beautiful that I can transfer something to my clients and customers that I have experienced myself ’.

That led to the development of your own training – a highly effective mindfulness training aimed at stress reduction in work environments. Can you introduce it briefly?

Together with Esther de Bruin, researcher at the University of Amsterdam, and Susan Bögels, director of the training center where I am employed, I developed Mindful2Work training. It is aimed at adults with stress- related symptoms and comprises a six-week group training followed by a feedback session six weeks later. In this training we combine three disciplines: mindfulness, yoga and sport, all of which are addressed on a weekly basis. Besides practical exercises, we elaborate on relevant topics such as attention, body awareness, stress etcetera. We came up with the idea to integrate the disciplines into a single stress reduction training, while practicing all three ourselves and noticing the positive effects thereof. In line with our personal experiences, science repeatedly demonstrates the stress-reducing impact of yoga, mindfulness and sport. It is marvelous to observe the significant change we can generate again and again in so little time.

But how do you motivate people to stop and create a moment of silence when there is a culture of too little time and too much work? 

Often,  people  get  interested  in  mindfulness  when they  are  confronted  with  stories  about  its  efficacy. From a deep desire to change they start to investigate. However, a genuine internal motivation can only grow when people experience themselves what mindfulness has to offer them. And yet, with our busy lives it remains difficult to free  up  sufficient time. How do I inspire people to practice it nonetheless? Primarily by lowering the threshold. If it is really impossible to meditate for twenty  minutes,  then  try  ten  minutes  or  even  two minutes. A two-minute meditation session can be beneficial in itself, and in addition, there is always the possibility that it lasts just a little longer after the two minutes have passed. So I advise people to keep it small and simple and implement a routine. After all, we don’t think about how and where to brush our teeth. Setting a fixed moment in the day can be very helpful so that it becomes habitual.

‘When we learn to slow down and look at things from a distance, we create space and freedom to choose how to relate to situations and how to cope with them’

Do you expect prevention to play a bigger role in the future, whereby one won’t wait until health complaints emerge but act more preventatively?

I certainly expect that. I can already see that employers are becoming increasingly aware of the principle that it is better to prevent than to cure. Moreover, society in general is giving more prominence to a healthy lifestyle and self-care. Ever more people free up time to devote to sport, yoga and mindfulness, simply to feel healthy and good about themselves.

A recent proof of concept study shows that your program leads to significant improvements in sleep quality, physical and mental work ability, as well as reduced anxiety and depression. How do explain the impressive effects?

As I said, the Mindful2Work training comprises three individual  elements  (mindfulness,  yoga  and  sport), which- in themselves- have a scientifically proven stress- lowering effect. With this in mind, it was foreseeable that the fusion of elements would generate an effective training.  Nonetheless,  even  in  our  wildest  dreams we didn’t imagine that it would be that effective. We attribute the good results to a synergistic effect whereby the outcome is more than the sum of its parts.

Since we focus on the body and mind simultaneously, we are capable of addressing stress at multiple levels. By observing carefully what is going on in both body and mind in everything we do, we accumulate more insight, self-awareness and (self)knowledge. This leads to greater effectiveness than a purely mind-orientated or body-orientated approach.

There are numerous sources of stress that the individual is likely to perceive as outside his/her power  to  change. How can one reduce mental distress caused by external  events/the culture of an organization/management styles/organizational  climate (poor  relationships  with superiors, lack of trust among employees etc.)?

We have little control over what crosses our path, both externally (outside of ourselves) and internally (what crosses our minds), but we have control over how we relate to it and that freedom is the playground which mindfulness makes full and effective use of. We learn to take distance from the matters that preoccupy us, which allows us to make a more conscious decision about how to deal with a situation. Hence we are no longer forced to react unconsciously on automatic pilot, but become aware of the freedom to respond intentionally. For instance when we sense stress, we can face it in different ways.

If I judge the experience, feel  annoyed and decide to fight and resist it, I accumulate even more tension. In a way, I become stressed about the stress! However, if I sense the stress, connect with the feeling and become conscious of my breathing, I will certainly not add tension and may even find some relief.

‘We have little control over what crosses our path, both externally (outside of ourselves) and internally (what crosses our minds), but we have control over how we relate to it and that freedom is the playground which mindfulness makes full and effective use of’.

What are your recommendations for those that are on the edge of developing burn-out?

If  someone  suffers  from  stress-related  complaints, I would strongly urge him or her to take it seriously. The sooner one can deal with it, the better. After all, it requires energy to generate energy so if one finds oneself completely exhausted, it is a long way back. Most people are mainly living in their heads and lose all contact with their body. So by definition, they are less capable of picking up the signals of the body or are inclined to suppress them (for instance a feeling of tiredness or a headache). Though these sensations are a strong indicator of a need to take it easy, they are considered as inconvenient messages in our busy life. We refuse to become aware of our inner state and instead decide to drink another cup of coffee or take a paracetamol. It is okay to have this attitude every now and then, but if we permanently ignore bodily signals, the alarm will become increasingly loud and the symptoms will deteriorate. Eventually, this strategy undermines us. So if you find that you are really not doing well, it is important to recognize it. Acknowledge your condition and try to act upon it.


What can companies do to create more mindful workspaces where employees can flourish?

We know that one in seven employees suffers from burnout  symptoms-  an  incredibly  high  percentage! This is costly so it is in the interest of a company that employees are healthy and vital. One could start by engaging in a dialogue to find out how the employee is really doing. In this respect, it is important that there is a safe atmosphere in which an employee dares to be vulnerable. It is essential to break the taboo on talking about not feeling well. It’s an inevitable part of being human and should be discussed, especially in the demanding times we are living in.

A heavy workload can disturb the work-life balance dramatically, so if an employee indicates that he is not doing well, it is desirable that the company can offer support. For example, by providing mindfulness training, a coach, subscription for the gym or by facilitating yoga lessons. In addition, it is helpful to create a quiet space that allows employees to retreat for a little time by themselves, for a short meditation or yoga exercise, for example.

What is your experience of willingness among executives and managers to implement stress management programs?

That is very varied. More progressive/pioneering companies recognize that we live in demanding times, which takes a toll. They consider the need for stress management and vitality programs to be self- evident, a natural investment in their human capital. An international example of this is Google. In contrast, more traditional companies take the position that stress management is not the responsibility of the company. Hence there are large variations between organizations but overall I see a trend of increasing open-mindedness among executives.

What  are  the  challenges  you  face  when you bring mindfulness into the work field?

The first challenge is the fact that mindfulness training costs money. But it is an investment that pays itself. Hence it is important to outline a long-term vision: healthy employees show less absenteeism, are more productive, motivated and satisfied. A second challenge I face is the unfortunate ‘wooly’ or esoteric image of mindfulness. This is a pity. Mindfulness is a pure attention-training program, not some kind of wishy-washy technique. It is my experience that when I get the chance to explain what mindfulness entails, I can take away these prejudices. The method has a firm theoretical basis and is scien- tifically well-researched. We can provide hard numbers that offer ample support to justify the positive experiences from the field and companies are receptive to that.

How do you define leadership from a mindful perspective?

I would describe mindful leadership as offering guidance with conscious attention. Rather than being on automatic pilot, a mindful leader acts with full awareness. He will be more focused, have a better over- view and make more conscious decisions. A mindful manager has more personal resources and is more resilient. The manager plays an exemplary role and affects the entire corporate culture. When an executive has more rest and attention, this will be noted by others and reflect positively on working relationships.

Based on your training outcome, what is the main advice you have for managers who are interested in cultivating mindful leadership, creating  trust  and  reducing  stress-related  disease?

I would advise managers to follow a mindfulness training themselves.  Ideally, a mindful leadership training, but a ‘common’ mindfulness training is valuable as well. If there’s no opportunity to attend a course, I would re- commend to build in moments of rest, or meditation into the day. A day without quiet moments is like a sentence without punctuation marks. So it is not surprising that our brains are often overloaded! It can already make a huge difference if we meditate for just one minute, pay attention to our breath, and ask ourselves how we are doing at that particular moment and what we need.

What are the main lessons you have learned so far and where would you like to see mindfulness at work go next? 

The extent to which people suffer from stress these days is alarming. Rather than being the exception, it has become the norm to be busy and overburdened. I have experienced that mindfulness is of inestimable value in today’s demanding   world. Therefore  I hope that it becomes a natural component of everyone’s (working) life.