More about Monument Health


Published October 2021 | In Fall 2021

Mindfulness is the ability to be fully present in the moment, while not being overly reactive or overwhelmed by what's happening around us.

Mindfulness Media

In practical terms, mindfulness is paying attention to what’s going on and responding in a measured way. It’s often tied to activities like yoga and meditation, but these exercises are simply a means to an end. Mindfulness is a state we can find and cultivate, regardless of location or activity.

Mary Kurniawan, CSW-PIP, is an Outpatient Social Worker at Monument Health’s Family Medicine Residency Clinic. She says, “Mindfulness consists of two concepts: focusing on the here and now versus the past or future, and then paying attention to the here and now with a non-judgmental stance. Mindful thinking doesn’t immediately judge what’s going on around us but accepts it as it is. Then we assess the information as useful or not useful, and respond appropriately.”

There are several easy ways to include mindfulness in our day, including breathing exercises and increased self-awareness, which can ultimately reduce stress and improve our overall health.

Instill calm with breathing

A powerful yet simple way to include mindfulness in our daily lives is to focus on something we already do: breathing. Mindful breathing is a simple stress-reduction practice that anyone can do, and it can help reduce physical, mental, emotional, behavioral and relationship stressors.

When we’re anxious or upset, we take in fast, shallow breaths. This speeds up heart rate and increases our overall feeling of stress. Our body enters a fight-or-flight state, which makes it hard to react to stressors in an appropriate or measured way. By taking a few deep breaths from our diaphragm, we allow our body a chance to slow down. This creates space to respond to whatever is causing stress rather than simply reacting.

Mary says, “Breathing can be helpful in a number of ways. It can be a short 2-3 breaths that give your mind time to calm down and remember the skills or strengths that you have to deal with a situation.”

When we’re relaxed, we naturally breathe through our nose in a slow, even way. By purposely taking deep, controlled breaths, we can mimic this state and signal to our nervous system that it’s okay to relax.

Mary says, “If mindful breathing is done on a more lengthy basis, like 5-10 minutes, it can provide a reset for your mind and body and allow for a full decompression of stress. It signals the brain that you’re safe, and that it can relax and stop signaling that you’re in danger.” Our body will respond by lowering heart rate, balancing oxygen and carbon dioxide levels, increasing levels of well-being and decreasing stress. This is called the relaxation response, and it’s the physical reaction we encourage
in our body by breathing deeply.

We’re taught to always think ahead or consider what’s coming next, which means many of us have trouble quieting our mind. We’re so
used to staying busy we can’t simply sit in silence and let go of the
world around us to meditate.

“People feel like meditation means you have to have an empty mind, which isn’t necessarily true,” Mary says. “It’s not about making your mind empty, it’s choosing to focus on something like your breath, and if it wanders, re-centering your mind to what you’re focusing on.”

Here are three short meditations to help start a new practice:

  • Morning check in: take one minute to slow down and get into a good frame of mind for the day using positive affirmations. This can be in the shower, while you drink your coffee or before starting a workout.
  • Body scan: with eyes closed, start at the top of your head and slowly scan your body. Notice how each part feels; are you tense or relaxed? Comfortable or uncomfortable? Continue to your toes and finish by checking in with your body overall.
  • End of day review: relax in a quiet place and take five minutes to reflect on your day. Think about how you felt throughout the day and how to approach tomorrow.

Go one step further

Breathing helps us calm our mind and body to a state that prepares us for the next key to mindfulness: self-awareness.

Self-awareness is the part of mindfulness that helps us differentiate between what is actually happening and what our mind is experiencing based on our own personal narrative. When faced with a stressful situation, many of us push our emotions down while reacting to the stress in an unproductive manner. Being aware of our feelings and emotions in the moment helps us respond to our stress in a measured way.

Being self-aware, like being mindful, takes practice. Self-awareness is something we can work on in small pieces throughout the day, and gradually build into a more routine practice. Mary says, “going for a walk is a great way to increase mindfulness and awareness in your day. Head outside and be aware of what’s around you, engage your senses and be present
in the moment.”

Mindfulness-based therapy

Beyond a personal practice, there are ways that mindfulness can be used in a more intensive way. Mindfulness-based therapy is a form of cognitive therapy that uses tools, such as breathing and self-awareness, to help patients break negative thought patterns.

“I teach these skills with almost every patient, but for people struggling with anxiety or chronic stress, mindfulness is one of the first things we talk about,” Mary says. “Part of mindfulness that I discuss with patients is being able to analyze your thoughts with a non-judgmental stance and ask yourself: Is this helpful? Is this useful? Is this true? Once you’ve done that, you get into the habit of being mindful and examining your thoughts before reacting.”

Originally conceived to help people with recurrent depression or anxiety disorders, mindfulness-based therapy has grown to treat a variety of conditions. While research is ongoing, its use has shown promise as an alternative to maintenance antidepressants in patients with recurrent depression. It has also been used to help relieve conditions such as chronic pain and post-traumatic stress.

  • Start walking at a natural pace; not too fast, but also not much slower than a casual gait.
  • Pay attention to the movement of your body. Notice how your feet lift from the ground and come back down, and how your body moves in sync with your legs.
  • If your mind wanders to other things, gently come back to focus on the sensation of walking. If you’re having trouble, you can count your steps up to 10 and back down to zero, taking deep breaths that last 2-3 steps each.
  • After a few minutes, expand your attention to what you experience around you. Focus on your breathing and what you smell, then listen to the sounds around you, and so on. Continue through all five senses: what do you smell, see, hear, feel and even taste. Savor each sensation and enjoy the world around you.
  • As your walk ends, refocus your attention on your body. Feel how your feet and legs work together, and how your body moves. At the end of your walk, stand still and take a few deep breaths to end your practice.

The effect of mindfulness on stress management

Stress is a normal part of life and is even necessary in some situations. When it becomes a chronic condition or not well managed, stress can be problematic. Fortunately, mindfulness is a great tool to help relieve unnecessary stress by helping us focus on what we can control and what we need to let go.

“Mindfulness helps us manage stress in so many ways,” Mary says. “It helps us relax instead of worrying about the future. It helps us recognize where we have power, where we don’t, and how to use resources wisely as far as where we spend time and energy.”

By managing our own stress, we have more energy for things that bring us happiness or provide meaning, rather than worrying about things out of our control. Reducing unnecessary stressors can also improve our physical health by lowering blood pressure, increasing sleep quality and improving our overall mood. We also contribute to the relief of stress throughout society: research shows mindfulness can help cope with stress and improve health, which makes us better able to serve others in need.

Mary says what’s most important about mindfulness is understanding it gets better with practice.

“Mindfulness will improve and get easier the more you do it, just like any other skill. It’s also attainable for anyone; it’s not something you have to have a certain level of focus or concentration to do effectively.”

Rapid City’s Care Campus is a nationally recognized program focused on substance abuse in our community. It's the collaborative effort of nearly 40 organizations, including Monument Health. Care Campus includes a Crisis Care Unit that focuses on mental health issues related to substance abuse. The unit teaches tools to cope with trauma, stress and other triggers that interfere with living a full and healthy life.

In 2021, over $4 million in funding was approved for a new 13,000 square foot building to house the current Crisis Care Unit and a new Stabilization Unit. The expanded facility will reduce health care costs and expand mental health services. Most importantly, it will provide world-class care in Rapid City, so those in need no longer have to travel across the state to receive help.

The Crisis Care Unit hosts classes such as Moral Reconation Therapy and Cognitive Behavioral Interventions for Substance Abuse. These classes help those struggling with addiction or substance abuse learn how to address problematic thoughts and beliefs, make conscious decisions rather than react to triggers and become aware of how their internal feelings affect their actions.

Many principles used at Care Campus and the Crisis Care Unit are similar to strategies for practicing mindfulness. Understanding the link between our thoughts, emotions and behaviors helps us be better able to respond in a measured and productive manner. Self-awareness and mindfulness are tools that can help with overcoming addiction, substance abuse, post-traumatic stress, trauma and more.

By focusing on the person as a whole and assisting in long-term recovery, the Crisis Care Unit is helping people in our community improve their quality of life based on their individual needs.

It can be hard to fully engage in any mindfulness practice or meditation at first. If your mind wanders, that’s okay. Recenter your thoughts by coming back to the movement of your body and start again. The more you practice, the easier you’ll be able to ignore distractions around you and focus on grounding yourself in the moment.