THR_Feb_2016_pp48_01-280x300Successfully coping with chronic pain is a multi-faceted, complicated subject. How mind/body medicine and specifically how mindfulness meditation can be helpful is vast and varied terrain as well. Just a segment of this subject is addressed in the following – ways that practicing mindfulness can help to remediate chronic pain. Mindbody interventions for pain, particularly mindfulness practices, and more specifically MBSR, have gained increasing attention and acceptance over the years as an extensive supportive evidence base continues to grow.

Consider this: Nearly 50 million American adults have significant chronic pain or severe pain, according to a 2015 study prepared by National Institutes of Health’s National Center for Complementary and Integrative Health (NCCIH). Some report statistics that are double that number. The Journal of Pain reported the annual cost of chronic pain is as high as $635 billion a year, which is more than the yearly costs for cancer, heart disease and diabetes. The National Safety Council recently reported that,  “Prescription opioid overdose kills 52 people every day.  In 2014, nearly 19,000 people died as a result of prescription opioid overdose. It is the most fatal drug crisis in U.S. history.” These astounding statistics scream how crucial it is to employ low risk, economical, effectual strategies for pain management. The costs of conventional western medicine pain management are unsustainable and fraught with risk.

While the goal of mindfulness meditation is be more present more often with less reactivity to what is, relaxation is a common helpful side effect. What are we when not relaxed? Uptight, anxious, worried, agitated – stressed? Yes, quite often! Stress increases pain perception, pain exacerbates stress and we find ourselves in a cycle of pain and stress endlessly feeding back upon itself.  Breaking this  looping receptive cycle is a practical and logical step towards effective pain management. Emotions like fear, anger, worry and depression can feed into the mind’s perception of pain.  Other feelings, too, can have an incredibly strong effect.  Feeling exhausted and overwhelmed, stressed and anxious, fragile and broken, can all amplify suffering and incline us toward a downward trajectory. These emotions act like amplifiers in the mind’s pain circuits – preparing the mind to sense pain quickly and intensely. The oppositie is also true, by reducing the stress and anxiety, fatigue – we can dimiinsh the perception of pain.,

Of course, it is natural to want to fight to obliterate pain. Yet When are struggling against what is happening, waging war with the body, we create more tension and frustration.  One step toward making peace with what is, is opening to accept what is happening in this moment. Acceptance is a foundational aspect of mindfulness– accepting what is here right now as best we can instead of resisting it.  When we can observe sensations and thoughts as they arise and let go of struggling with them, the suffering itself begins to melt. In doing so, it becomes possible to soften and be more receptive to the next moment and what happens in the next.  Additionally, observing sensations as they take place helps us to notice that pain is not a solid, coherent thing but is comprised of various sensations like tingling, throbbing, twisting, burning, aching, etc. This insight, in itself, can make the sensations experienced easier to bear.

Meeting pain with Beginner’s mind, can lead to improved mental flexibility and greater acceptance. Approaching our experience with curiosity, interest and open-hearted awareness helps us to see through fresh eyes, without all the back story and overlay of angst that has brewing, stewing and settling in the mind over time. Beginner’s mind helps us to see thoughts as merely thoughts and not necessarily facts. If we can clearly see the the mind’s stories about the pain are just that, stories (i.e., what it means, how it will impact our lives long term, we not as apt to get caught up in current of the thought stream as it flows across the mental landscape.)

Compassion, another aspect in developing mindfulness awareness is essential in dealing with discomfort. Cultivating compassion for ourselves helps us to be kinder and more understanding when we fail or experience pain rather than becoming frustrated and critical of ourselves.  When we are kind and caring for ourselves our bodies respond in a way that increases the likelihood that the body will be able to unwind. Treat pain with the tenderness that you might bring to an injured child versus judgment or the disdain you may bring to the voice of the catastrophizer or the incessant whiner.

It seems incongruous to many that accepting pain, softening around it and meeting it with openhearted awareness could be helpful…it may seem even masochistic. Yet,  it is consciously changing our relationship to pain in this way that makes mindfulness / meditation a powerful tool in its management.

Next issue, Part ll of Easing the Suffering of Chronic Pain.