(Or the Power of Mindfulness)
When chronic pain flares we obviously want it to go away. And if it won’t go away we want to find a way to ignore it and move on with our lives. That’s why techniques like distraction can be so helpful. We engage our brains with another activity with the goal of having the pain fade to the background. I’m a big fan of distraction—it can be very helpful. However, at the risk of sounding like I’m totally contradicting myself, paying attention to your pain can also be helpful.
First, let’s start with the understanding that by talking about our brain’s role in managing pain, I am not ignoring the fact that chronic pain is very real, physical pain (nor saying that the pain is “all in your head”). However, over time, chronic pain increases our overall stress level, and negatively impacts our emotions, our thinking, and our ability to cope with stress. It wears us down. Tending to our thoughts and feelings is one way to reduce the impact of chronic pain on our lives. This is where mindfulness can come in.
Mindfulness is the awareness of what is happening in the present moment, and is a meaningful way to address the impact of chronic pain. Often our minds are caught up in the past (“I used to be able to do so many more activities before my pain started; I should have had more adventures”) or in the future (“What if my pain never gets better?”) rather than being in this present moment. And without the awareness of what is happening in the present moment, we miss out on a lot of important information. In the case of chronic pain, we have the potential to miss subtle clues our bodies can give us that it’s time to take a break, or that we need to get moving a bit and stretch our muscles. We may also be so intent on ignoring the feelings that chronic pain can generate in us (e.g. sadness, anger, frustration) that we never take time to understand our feelings and decide how we might want to respond to them. Practicing mindfulness on a regular basis in relation to your pain can help you find a new relationship with that pain, to get under the pain and relate to it from a new space within yourself.
To the uninitiated this may sound like a lot of psychobabble hooey but research has shown a positive link between mindfulness and anxiety, depression, stress, emotion regulation and cognitive control—all factors that can be important in managing pain and its effects on quality of life. Further, research that has emerged in recent years suggests there are some potentially meaningful changes in the brain associated with mindfulness meditation. And a 2015 study published in the Journal of Neuroscience reported that mindfulness meditation reduced pain intensity and unpleasantness ratings more than a placebo pain cream or a “sham”/placebo form of mindfulness. In addition, patterns of brain activity resulting from mindfulness meditation differed from those associated with the placebo cream. The “sham” mindfulness technique did not produce any neural activity--though it did produce greater respiration reduction. (Zelden, F., Emerson, N.M., Farris, S. R., Ray, J.N., Jung, Y., McHaffie, J.G., Coghill, R.C. (2015). Mindfulness Meditation-Based Pain Relief Employs Different Neural Mechanisms than Placebo and Sham Mindfulness Meditation-Induced Analgesia, The Journal of Neuroscience, 35(46), 15307-15325.)
What does all that mean for the chronic pain sufferer? It means there are good reasons to integrate mindfulness into your arsenal of ways to cope with chronic pain. Mindfulness asks you to notice your thoughts and feelings without judgment, and to then decide whether you want to engage with them or not. It is not about relaxing your mind, or thinking of nothing. It is about simply noticing what flows into your mind. Over time you may observe a pattern of thoughts that has significance to you. You may observe that there are times when you feel happier or sadder, or more irritable. All of this is helpful information that is not to be judged. Within mindfulness it’s neither good nor bad that you feel happy, sad, or irritable—it is just an observation. In regard to your pain, you may notice an ability to notice your pain and to accept the reality of its existence, letting go of some of the struggle that comes from fighting against it. This doesn’t mean you like the pain but you form a relationship with it that is different from struggling against it. In an article by Barry Boyce titled “The Healing Power of Mindfulness” and published on the website Mindful, the author interviews Jon Kabat-Zinn, a leading expert on mindfulness and health. In response to the question “What are some of the benefits of mindfulness—both the practice and the state of mind—for our health and healing?” Kabat-Zinn discusses the idea that we can be in relationship with what we are going through and discover “deep internal resources” to help us. He goes on to say:
“Appreciating this kind of awareness can have virtually immediate effects on health and well-being. As crazy as it sounds, it’s possible to befriend your pain or your fear—rather than feeling that you can’t get anywhere until this thing that bothers you is cut out or walled off or shut down. That’s a really profound realization for someone to come to. It’s very healing to realize, if only for a moment here and a moment there, that you can be in a wiser relationship with your interior experience than just being driven by liking it or hating it. We say to our patients…that there’s more right with them than wrong with them, no matter what their diagnosis is. We’re going to pour energy into what’s right with them and see what happens. It’s a great adventure and it’s very satisfying to be able to see people light up as they experience the knowledge that it’s okay to be where they are as they are.”
That’s the power of mindfulness.
There are many ways to begin to practice mindfulness. Listen to my podcast here for an overview, and consider exploring YouTube for videos that will lead you through mindfulness exercises. Mindfulness can be practiced throughout the day as well, simply by tuning into what you’re doing as you do it. If you’re washing dishes, notice what that experience looks, feels, and smells like. If you’re taking a walk, notice what you’re noticing along the way. Pay attention to how your body is moving. Notice-but don’t judge--pain, or thoughts about that pain, that you’re experiencing. Initially this may feel clunky and awkward. However, stick with it and over time you will be able to slip into mindfulness with greater ease and tap into your internal self. By doing so, you may find an ability to use thoughts, feelings, and acceptance to gain greater clarity and actually make peace with your chronic pain.
If you are interested in learning more about using mindfulness to help manage chronic pain or in engaging in therapy for coping with chronic pain, please contact Dr. Jana Drew at 512-960-5265 or contact her here. Dr. Drew offers a free 30-minute consultation and would welcome the chance to discuss your concerns with you.