Monday, June 21, 2010

The 5 Step Model of Mindfulness for Pain

I have to share these pearls of wisdom from Vidyamala Burch, regarding 5 mindful steps of living with chronic pain:
1. Awareness:
I noticed that it was essential to be willing to engage with my actual experience of pain rather than block it or resist it and I noticed, paradoxically, that if I was locked into avoidance and blocking, then I also numbed myself to beauty and subtle positive emotions. When blocking I didn’t experience the pain so much, but then I only felt half alive, which was in itself unpleasant.
2. Moving towards the unpleasant:
So I realized that, after the first step of becoming broadly aware in a general sense, the next step for becoming mindful when living with pain is to find ways to very gently turn towards the pain and allow layers of resistance, avoidance and blocking to soften with tenderness and gentleness so one can begin to feel more fully alive. This is the second step – moving towards the difficulty.
3. Seeking out the pleasant in the moment:
I also knew that this was not the whole story and that, after having become more tender and open by turning towards pain and softening resistance, the next step was to be like an explorer seeking hidden treasure and to learn to pay attention to pleasurable states. So this is the third step – seeking the pleasant in the knowledge that it is always possible to find something pleasant if you learn how to pay subtle attention to your experience.
4. Holding both pleasant and unpleasant in broad awareness
The fourth step grows out of the previous steps and is a broadening of awareness to hold both the unpleasant and the pleasant within a very stable field of awareness that is infused with equanimity. You can see steps two and three as being like looking through a close-up lens of a camera to examine the details of experience, and then step four is like pulling back to a wide-angle lens that contains great variety within the same frame. Another important aspect of the fourth step is to see into the impermanent, fluid nature of experience and to allow both the unpleasant and pleasant to rise and fall without either resisting unpleasant experience on the one hand or grasping onto pleasant experience on the other.
5. Responding rather than reacting
The fifth step is the behavioural outcome of the previous four steps and is ‘choice’ – it is learning to live with creative choice in every single moment rather than being driven by habitual reactions. 
Simple. And also very powerful.


  1. Lovely -- and very lucid.

    I have been practicing for six years or so, and I have to say that I feel as though I am just beginning to really understand what not-resisting looks like. Intellectually, I choose not to resist and prefer not to react, but it seems as though, at least for me, the change has to come on a cellular level, and I can really feel how my cellular response has changed/is changing -- I am creating new ways of responding. What a wonderful realization, what a wonderful opportunity!

  2. Clear and direct, as ever. I find it compelling that you are able to put the individual in the driver seat, moving towards a solution, rather than a helpless victim at the mercy of circumstances. The "awareness," that you mention is the path of the open-hearted way of heart-mind.

    With Gassho,


  3. Stacy, I totally know what you mean. From head to embodied realization, there can be quite some time . . . Of course, mindfulness practice is the key.

  4. Thank you Seiho. I really don't like to suffer, you know, and am rather practical about this whole Buddhist path. I am on it, because, it is the only way I have found to effectively deal with the unavoidable problem of primary suffering, including physical pain. I am on it, because it is well worth it to sacrifice a string of conditioned, short-lived happiness for unconditioned, long-term happiness. Kind of like going to the dentist to take care of rotten tooth, rather than postponing and trying all kinds of diversion to not feel the tooth ache.