Amit Sood, MD: Q&A About Finding Resilience to Chronic Stress Through Neuroscience

The creator of Mayo Clinic’s Resilient Mind is taking his program global, promoting well-being using gratitude, noticing novelty, not trying to improve the people you love, and forgiving yourself and others.

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Resilient people strive to help others, live by their values, and maintain a hopeful view of the world.Nicole Wilcox/Unsplash
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Amit Sood, MDPhoto Courtesy of The Mayo Clinic

Amit Sood, MD, is on a mission.

The creator of the Resilient Mind program at the Mayo Clinic in Rochester, Minnesota, is determined to bring neuroscience advances in resilience, presence, and well-being to 100 million people. And that’s just the start. Ultimately, he wants to reach the entire planet. In the process, Dr. Sood says he intends to help build a healthier, kinder, and better world.

Recently retired as a beloved Mayo Clinic internist and professor of medicine, Sood chaired the Mayo Mind-Body Initiative, where he created a wide-ranging program targeting chronically ill individuals who were also saddled with increasing isolation and despair.

Sood himself is no stranger to suffering. Born in India, he witnessed one of the worst man-made disasters in history as a medical student in Bhopal, when an industrial gas leak claimed at least 3,000 — and possibly as many as 10,000 — lives.

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Continuing his medical studies at Albert Einstein College of Medicine in the Bronx, New York, Sood joined the Mayo Clinic in 2005. But it was as an observer of the human spirit that he made an indelible mark, building a wellness program upon knowledge gleaned from thousands of workshops and more than 20 clinical trials. His philosophy of resilience, detailed in four books, is the backbone of a multipart teaching initiative that has reached one-half million people so far; a first step towards his ambitious objective.

Sood, now the executive director of the Global Center for Resiliency and Well-Being in Rochester, Minnesota, shared his approach and ideas in an Everyday Health interview.

Everyday Health: What do you hope to achieve with your wellness initiative?

Amit Sood: I want to make good on our evolutionary imperative to hand over a better world than the one we inherited. Sadly, at this point, we appear to be failing in this important task, largely because our brains still lag well behind our accomplishments.

If you go back thousands of years, people faced the constant threat of injury or starvation. To survive, they had to become selfish; to make everything about me, and the resources I — my group — required. But as the world shifted from brawn to brain, and we no longer needed to fear predators or hunger, we continued to behave as if nothing had changed. I believe this is not sustainable.

We cannot remain in this state of cognitive and emotional turmoil, with fatigue, negativity, and overload. We cannot maintain our addiction to short-term gratification, our inability to forgive, our struggle to feel compassion for those who are different. Our only choices in this fast-changing world are to slow things down, which is impossible, or to understand and upgrade our brains, and rise above our evolutionary baggage. That’s what I hope to accomplish.

EH: What led you to these conclusions?

AS: As an internist, I was surprised to find that probably 90 percent of my patients were aching for connection, for love, for more. They were struggling in relationships, lonely and deeply unhappy. This was quite a revelation for someone who, coming from India, had assumed that the material well-being here would equate to widespread emotional satisfaction.

But as I researched this, I began to appreciate that this was not under our individual control nor was it our fault. It resulted from a systematic design problem in the human mind — a relic from an earlier human era — that we have somehow held on to.

I remember wondering one day how Christ would view people if he walked through the Mayo Clinic lobby. Would he evaluate and criticize them, as we often do, or would he silently wish them well? That was an important and early realization, as I began developing my wellness initiative. I wanted to find a way to cultivate the kindness and compassion we lack; the comfort and validation we need.

EH: What do you mean by resilience and why do you focus on it?

AS: Resilience captures a wide variety of themes in a single cohesive concept; one that has excellent scientific support. It is about doing well even when it seems you shouldn’t.

When you are emotionally resilient, you withstand and bounce back from adversity, weathering life’s downturns. Resilient people strive to help others, live by their values, and maintain a hopeful view of the world. They don’t escape stress, but their stress does not lead them to a dark deep place — at least, not for long. They don’t succumb to chronic stress.

Resilience helps them become physically stronger, establish better relationships, and enjoy greater success at work.

EH: How does this fit with mindfulness, meditation, presence, and the other “new age” movements?

AS: These are all related concepts. However, if we wish to engage our millennials, it is important to avoid mysticism and esoteric philosophies. Practices that are cliché and impractical, such as asking us to “empty the mind” or always be “in the moment,” do not seem achievable or relevant in lives dominated by bills and mortgages and jobs.

And, ultimately, the purpose of meditation isn’t to become a good meditator. It is to become a kinder, more engaged human being.

I feel that we must democratize these approaches, so that you don’t have to spend a week on a mountain or practice an hour a day for the benefits. The basics of my program can be learned in two hours and reinforced with daily practice that takes no more than 5 to 10 minutes. And there is more available for people who want to go further.

EH: What are the program’s components?

AS: There are three parts. The Stress Management and Resiliency Training Workshops (SMART) offer a more structured approach to building self-awareness, incorporating principles of neuroscience through attention and interpretation. Participants develop a practical approach to experiencing their day with the five principles of gratitude, compassion, acceptance, meaning, and forgiveness. This approach helps to lower stress, increase well-being, and diminish the constant rumination that is our brain’s default. We actually spend almost two-thirds of our days in “dwell time,” with our minds wandering and revisiting events or worrying about the future. We need to address that.

The Transform course is more immersive, training people to engage the brain for better focus and creativity. It is a full two days of on-site classroom training that explores resilience from the cognitive, emotional, social, and spiritual perspective, with the objective of uncovering deeper meaning. That initial session is followed by six months of engagement through emails and teleconferences. At the very end, participants come back for a one-day sharing session.

The online components include a digital course, a series of meditation offerings, and online resources that integrate science with timeless principles. I also post some of these ideas on Twitter.

And finally, there is a Train the Trainer program for those who want to teach the techniques themselves.

EH: How can anyone, anywhere learn some of the principles of your program?

AS: I believe anyone can cultivate the basic qualities of gratitude, forgiveness, and kind attention that foster resilience and build happiness. Let me explain.

My first suggestion is to wake up in gratitude. Spend the first minutes of every day being thankful for the wonderful people and things in your life.

The second suggestion is to connect with your family or other loved ones as if you have not seen them in months. Spend time when you get home from work or when you see them in the morning sharing kind attention, not trying to improve them. Being a source of happiness helps lead others into happiness. And that cultivates the greatest joy in life — the satisfaction that comes from relationships.

Constantly notice novelty in the beautiful world around you and consistently focus on kind attention. Send people your silent good wishes throughout the day. When you do that, the little annoying things — the traffic jam, the line at the bank, the cranky boss — don’t affect you as much.

And learn to forgive. Even when things don’t go right, you will feel better.

Finally, cultivate a way of thinking that includes the principles of gratitude, forgiveness, and compassion.

This may seem like a lot, but I believe my approach to building these skills can take as little as 5 to 10 minutes of daily practice. Instead of adding more milk to life’s already full cup, I see this as adding chocolate powder to the milk. It doesn’t increase the volume, but it improves the whole flavor.

EH: Would you explore those first two concepts — gratitude and forgiveness — a bit more? For example, if people are going through a particularly difficult period in their lives because of someone else’s actions, how can you expect them to be forgiving? And for what should they be grateful?

AS: When people ask how I can suggest gratitude and forgiveness, even in the face of suffering or misfortune, I explain it as a way of taking care of yourself and not losing control to things that are beyond you.

Forgiveness, for example, is for you, not for the other person. When you allow yourself to get wrapped in emotion, you lose rationality. To regain it, you must begin by forgiving yourself for forgetting, if only for a moment, that you recognize the weakness of human beings.

Instead of forgiving them, you are reclaiming control for yourself. You are asserting that it is not okay for you to be treated like a doormat, even if that's something that others may naturally revert to.

In forgiving, you're acknowledging that people struggle to be kind to each other. And they struggle the most in situations where they are hurt, where there is miscommunication, or where there's perhaps some kind of innocent reason for acting irrationally.

By choosing to forgive, you are claiming command of the situation, giving the other person a second chance, and being kind to yourself. Because remaining angry and unforgiving hurts you, not the other person.

EH: And what of gratitude?

AS: The importance of expressing gratitude is related to forgiveness. It is very hard to find a way to show appreciation when things are going horribly, but when you do it, it minimizes the sting of misfortune.

I'm reminded of the guy who was robbed on the streets of London. Instead of acting indignant and upset, he said he was glad it was the first time he'd ever been robbed. And he went on to say that he was grateful that he was the one being robbed, rather than having the situation occur the other way around.

These kinds of arguments diffuse the anger and upset. And they tend to remind you that there's a bigger picture than today's problem. When you focus on what went right rather than what went wrong, you're creating a positive context that creates perspective and helps you feel better. It is very, very effective.

EH: To whom are you taking this message?

AS: The program is already offered to all Mayo clinic medical students, physicians, and nurses through the onboarding process. I am also working with government agencies to bring it to their employees; to educational institutions; and to teachers. In addition, I’m working with corporations, law firms, insurance companies, and some of the most prestigious hospitals and health systems in the nation. I’m training other medical professionals — physicians, nurses, wellness coaches — to teach the program. And, of course, I’m bringing it to general consumers.

I would estimate the program has already reached about half a million people; a first step towards my very ambitious goal.

EH: Why is this kind of knowledge essential now?

AS: We are in a dangerous period. Trust is at an all-time low, our teenagers are constantly absorbing toxic content from social media, and people have become divided, tribal, and unconnected. While we live reasonable lives, we do so while in a constant state of stress — chronic stress. And it’s not just true in the United States. I’ve met people from every continent dealing with the same problem.

EH: How is the program doing so far?

AS: About 30 to 40 percent of the people come to the program somewhat cynical. But once they complete it, the acceptance rate is extremely high. More than 95 percent say the ideas resonate with them.

If I can ultimately reach 7.5 billion people, a very ambitious “stretch” goal, I can help the world accomplish what I see eventually happening anyway: that we will one day arrive at a time when everyone will be Christ-like and Buddha-like. It’s unlikely this will occur in time for our kids or grandchildren. But this is a good way to start.

We just have to make sure we don’t destroy ourselves before reaching that state. That’s the reason I am a man in a hurry.