Saturday, June 12, 2010

3 Mindful Steps to Working With Chronic Pain

This morning, sitting, I was visited by various pains and aches. In the knees, in the shoulders, in the usual spot in my right lower back . . . There was frustration, and some anger also. Even breath was slipping away, making itself hard to follow. More than once, I was tempted to get up and walk away. I was glad I stuck with it however, as I got a chance to very clearly experience the cycle of pain - not liking - body tensing - more pain. In such moments, I was reminded of our very human tendency towards resisting physical pain, as expressed in reflexive recoil in our body. 

This is where mindfulness practice, along with wisdom, right effort, equanimity, and faith in proven process come into play. What kept me in my seat this morning, were the knowledge and prior experience, that there was much to be gained from not to fleeing, but sitting instead with the pain in a non reactive way. 

In their MBSR Workbook, Bob Stahl and Elisha Golstein, present a very helpful how-to three step approach to working with chronic pain in meditation:

1) Investigate the pain and tension in the body:
A common knee-jerk reaction to pain is to clench and get tighter around it. Unfortunately, this can not only increase the physical pain, it may also begin a vicious cycle of reactions that lead to increased anger, fear, sadness, and confusion. Getting tight around pain further constricts the muscles and restricts blood flow, which may cause more spasms and pain, possibly even in other areas of the body. This cycle is difficult to stop, and in time you may discover that you're constricted not just around the painful area, but throughout the body.
The body scan provides an opportunity for you to reorient toward living and working with tension and pain. As you reeducate yourself about your pain by distinguishing physical sensations from mental and emotional feelings, you can learn to recognize strong sensations in the body as just physical sensations . . . 
Once you become aware of how you hold pain in the body, you can start figuring out how best to work with it . . . Mindful awareness will not only allow you to see where you're holding unnecessary tension, but will also help you soften and possibly release tension in these areas where there's no pain at all. Mindfulness also teaches you that if you can't release the tension, you can practice riding its waves, just observing them, letting them be, and allowing them to ripple wherever they need to go.  
2) Working with the emotions in physical pain:
Bringing mindful awareness to emotions allows you to begin to acknowledge them, no matter what they are, validating and acknowledging them without censorship and without resistance. As with physical pain, resistance to difficult emotions often causes more pain while learning to let be and go with them, rather than fighting them, can often diminish or change the suffering associated with them . . . 
As you gain more understanding of your physical pain, your emotional reactions to it, and the differences between them, you'll begin to see that there's a difference between physical pain and suffering.  Even in times when you can't change the physical sensations of pain, you can change your emotional responses to them and thereby reduce your suffering. 
3) Living in the present moment:
When you identify with stress, tension, or chronic pain, you may think of it as a long-term problem or life sentence, and this attitude can take you out of the present moment and increase your suffering. Mindfulness teaches you to be here now. You don't know what the future may bring, and you really don't know if the stress and pain will last forever . . . 
Rather than being held hostage by your discomfort, you can cultivate the attitude that it's possible to learn from it. As you learn to let go of the past and not cling to a specific vision of the future, you'll be able to see things as they are in the moment, with a growing sense of freedom and the possibility of new options. This perspective transforms you, your pain, and your relationship to your pain.
Three proven steps that can change the way you live with your pain. Not easy, but well worth the effort. 


  1. It amazes me when I think of how much the fear of pain amplified what was actually there, and how much just coming back to the moment makes it more bearable.

  2. Thank you Sunim. Yes, the mind really does play dirty tricks on us when it comes to living with pain.

    Have you noticed how animals are so much more graceful than us, humans, when it comes to enduring physical pain? This says a lot about the mind created share of physical suffering.

    And of course, it also does not minimize the excruciating pains that sometimes besiege the sick, the crippled, or the wounded.