We’ve been looking at mindfulness in several past posts – now let’s look more closely at how mindfulness relates to our experiences of chronic pain. I’ve asked my pain management colleague Dr. David Kannerstein to say more about this connection. If you’d like to ask Dr. Kannerstein a question for a future post, click here.
Dr. Kannerstein: “Mindfulness can be understood in different ways. Fundamentally, it means focusing your attention on what you’re experiencing in the present moment, without judging it. This may seem simple, but it’s in fact a radical departure from our normal experience where we live much of the time “in our heads,” thinking about what’s going on rather than experiencing it in the moment.
In various Buddhist traditions, mindfulness is a form of meditation that’s used as part of one’s spiritual development, with the goal of reaching enlightenment, as Thubten Chodron discussed. In recent years, mindfulness has become widely used to help in treating those with chronic pain, as well as those suffering from emotional disorders such as depression.
How can focusing on what’s happening in the moment help the person suffering with chronic pain? Isn’t the goal to NOT notice what you’re feeling? As a psychologist who’s used it in my work with individuals with pain, I’ve found that it can be incredibly powerful as a tool to ease suffering.
I’ll generally begin by explaining briefly how I think it’ll help the patient. Then I’ll ask her to focus attention on her breath (or something else if breathing is painful), to be aware of each inhalation and exhalation, and to notice whenever she’s distracted. Whenever she notices she’s distracted, she’s to notice what she was distracted by – thoughts, emotions, sensations such as pain – and then to refocus on her breathing.
This approach was pioneered in helping those with pain by Jon Kabat-Zinn. You may also allow your attention to float over the whole range of your experience – sensations, thoughts, emotions – without becoming absorbed in any one aspect of things.
If my patient is so immersed in her pain that she’s unable to focus on anything else, I’ll use an approach I learned from the writings and recordings of Shinzen Young, an American who trained as a Buddhist monk in Japan, and who’s been a major force in using meditation for pain. I’ll suggest that the patient focus on the pain – it’s location, qualities, intensity – and just observe it with as much detachment as possible.
I’ve found that both of these approaches – focusing away from the pain and focusing on the pain – can be incredibly effective. Patients generally become more relaxed, but that’s not the most important result. The relaxation is part of breaking the circle:
negative sensations (pain) …
triggering negative thoughts and beliefs …
leading to negative emotions (fear, sadness, anger) …
leading to more pain, and so on.
By attending mindfully to what they’re experiencing, patients become less afraid of it, less depressed by it, and less angry about it – and their suffering diminishes greatly. As Shinzen Young puts it, meditating on pain lessens the resistance to the pain which causes the suffering.
Those interested in learning more about mindfulness approaches to pain may wish to read Full Catastrophe Living by Jon Kabat-Zinn (New York: Delta Books, 1990) or Break Through Pain by Shinzen Young (Boulder CO: Sounds True, 2004).
Thanks so much to Dr. Kannerstein. Dr. Kannerstein is a psychologist in private practice with Margolis Berman Byrne Health Psychology in Philadelphia and SRI Psychological Services in Jenkintown, PA. He specializes in helping individuals and their families manage chronic pain.
The beautiful picture above, Water Lily , is by Anna Coulter. Thanks!