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3 Ways Mindfulness Can Reduce Chronic Pain

3 Ways Mindfulness Can Reduce Chronic Pain

Reduce Chronic Pain

Research has established that mindfulness meditation is an effective medical intervention for chronic pain sufferers.

How Does Mindfulness Possibly Reduce Chronic Pain?

By Maryjane Osa, Ph.D.

 

 

In the two years since Time Magazine proclaimed the “Mindfulness Revolution” on its cover, meditation has caught on. But few realize mindfulness meditation as an effective medical intervention was established with research on chronic pain sufferers.

Back pain, neck pain, and shoulder pain are challenging conditions for conventional medicine to treat. Treatment of chronic pain with drugs or surgery comes with substantial negatives. Drugs are expensive, often ineffective, and have side effects. Surgery risks infection or complications and may not alleviate the pain. The problem is that pain is a complex phenomenon, and medical science has only recently developed models to explain this complexity.

Normal pain is an adaptive response. If someone touches a hot iron and burns a finger, the resulting pain signals to the brain that skin cells are damaged. The neurological process triggers a motor response: the person immediately removes her hand from the hot iron. Chronic pain, on the other hand, is pathological. The pain of a long duration causes stress and is of no physical benefit.

In the 1970s, medical researchers began understanding the difference between normal and chronic pain. Ronald Melzack and his colleagues developed a psycho-physiological model that explained why chronic pain tended to intensify over time. They discovered additional second-order cognitive and affective-motivational effects that prolonged the pain cycle. For example, a person’s thoughts about the pain, such as “this is unbearable,” added a cognitive dimension. This added an affective dimension when angry or helpless feelings were generated by such thoughts. These added effects could heighten and sustain the experience of pain. This complex mind-body interaction explains why pain persists, even after the initial stimulus is removed.

University of Massachusetts Medical School Professor Jon Kabat-Zinn realized that chronic pain sufferers had something in common with serious meditators: the experience of extreme pain. Although meditation is often relaxing, when a meditator sits motionless for hours, for example, when on retreat, muscles and joints ache intensely. However, traditional meditation instruction offers a coping mechanism. Meditators learn a habit of non-judgmental observation that allows them to detach the physical sensation of pain from the cognitive and emotional reactions to it. Recognizing that this process fits with the scientific theory of pain complexity, Kabat-Zinn reasoned that meditation might be an effective medical intervention.

 

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Mindfulness was taught to chronic pain sufferers in an outpatient program at the University of Massachusetts Medical Center as part of Kabat-Zinn’s carefully designed research study (published in 1982). As a result, two-thirds of the patients reported reduced pain by at least one-third. In addition, half of the patients reported reduced their symptoms by 50 percent or more. This research justified continuing to develop mindfulness as a medical intervention. In the last three decades, mindfulness has been applied in many different settings, and thousands of research studies have been published.

Chronic pain sufferers can follow the same path today. There are many resources available for mindfulness training. (Some are listed at the end of this article.) The basic process is not difficult to learn, but the positive effects are not experienced unless a person practices consistently. The Mindfulness-Based Stress Reduction (MBSR) course developed by Professor Kabat-Zinn unfolds over eight weeks, with weekly meetings and daily homework. Participants move through various mindfulness practices: the body-scan, sitting and walking meditations, and hatha yoga exercises. But the basic set of instructions remains the same across these different forms. Participants are instructed to:

  1. Consider the primary object of observation, for example, the breath.
  2. Be aware of the in-breath and the out-breath from moment to moment.
  3. When the mind wanders into thought, recognize that your attention has wandered. Rather than getting involved in the contents of the thought, label it: “thinking, thinking,” or “thought form.”
  4. Return to your anchor in the breath. Observe the inhalation. Observe the exhalation.

Participants are told to observe everything–thoughts, feelings, body sensations–without judgment. Even a judgmental thought can be observed in a detached fashion. People thinking, “This is a stupid waste of time,” may realize they have mentally wandered off. Then the mindfulness training kicks in. They say to themselves, “judging, judging,” and return their attention to the in-breath, the out-breath. The purpose is to develop an awareness of the transient nature of sensations, thoughts, and feelings. Through this method, individuals learn how to let go of obsessive thinking and focus attention deliberately on objects of their choosing.

Mindfulness, then, is a skill. And it is a skill that can be used to combat chronic pain. Here are the three ways that this works:

 

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Desensitization to primary pain stimulus

We are always seeking to avoid intense, chronic pain is natural. Consequently, chronic pain sufferers often curtail activities they fear might trigger pain. In some cases, chronic pain leads to depression and self-medication attempts, leading to substance abuse. This pain-avoidance behavior is counterproductive. Mindfulness techniques, on the contrary, instruct the individual to treat the pain as a sensory experience and to observe it. The person watches as the pain modulates, perhaps becoming stronger or weaker; he observes as the wave of sensation ebbs and flows. Scientists consider this to be prolonged exposure, which can help desensitize the patient to the primary pain stimulus in the absence of traumatic consequences.

 

Interrupt Pain Reactivity Cycle

The practice of non-judgmental observation interrupts the alarm/reaction spiral that causes the most suffering. Obsessive thinking about the pain, and the emotional charge added to these thoughts, heightens and prolongs distress. The mindfulness techniques of labeling cognition and emotions (e.g., “judging,” “complaining,” “frustration,” “anger”) and then returning attention to the breath interrupts the sequence of pain-alarm-reaction. Thus, the second-order effects are eliminated, reducing the duration and intensity of pain.

 

Strengthen Coping Responses

The individual develops her higher brain centers by uncoupling the second-order effects (thoughts and feelings) from the primary pain stimulus through mindfulness. In addition, the process of self-observation practiced in mindfulness training helps strengthen the individual’s ability to cope with stressors in general–including chronic pain.

 

Resources:

Book: Jon Kabbat-Zinn, Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness, Rev. ed. New York: Bantam, 2013.

Article: Ruth A. Baer, “Mindfulness Training as a Clinical Intervention: A Conceptual and Empirical Review,” Clinical Psychology: Science and Practice, Vol. 10, No. 2, (Summer 2003): 125-143.

MBSR online course: http://www.soundstrue.com/store/the-mbsr-online-course-3226.html

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About the Author

Maryjane Osa, Ph.D., is a sociologist, speaker, and educator. She is writing a book about American society’s “spiritual but not religious” cultural trend. Maryjane is a spiritual practitioner working in the New Thought tradition. Connect with Maryjane on Facebook at: www.facebook.com/dr.maryjane.osa or check out her website and blog at: www.maryjaneosa.com.

 

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