A pilot study of 50 Dutch general practitioners (GPs) found that an 8-week mindfulness-based stress reduction (MBSR) course reduced depersonalization (a key burnout symptom) and increased dedication and mindfulness skills compared to a waiting-list control group. Empathy did not change significantly. Qualitative reports indicated the training improved wellbeing and compassion toward self, others, and patients. The authors conclude MBSR is feasible for GPs and may reduce burnout and improve work engagement, but call for a fully powered randomized trial to confirm the results.
Existential distress at the end of life, termed 'total pain,' involves psychological and spiritual suffering that often does not respond to strong opioid medications. This distress resembles mental health conditions linked to an overactive default mode network (DMN), which includes the medial prefrontal cortex, medial temporal lobe, and posterior cingulate cortex—brain regions associated with the ego and more developed in humans. Patients facing early mortality may experience a crisis of meaning, leading to uncontrolled pain that opioids fail to alleviate. The text suggests that understanding the neural basis of existential distress could inform more holistic approaches in palliative care.