Mindfulness and pain

Pain is lessened through mindfulness which reduces our resistance to the pain
Eastern therapies practitioner Olivier Lejus continues his exploration of the power of mindfulness.

In my previous article, I introduced the Buddhist concept of mindfulness. This is an ancient meditation practice to train oneself to live in the present moment, and to become totally aware of what is around us and inside us at all times. All too often we are unaware of the mechanisms that condition us to react the way we do. We have little control over our behaviour, and struggle to alleviate well developed negative patterns that have been with us for many years.

Mindfulness allows us to withdraw and observe our emotional response, and change the way we react. This is only possible if we are aware of what is happening at all times. The practice of mindfulness can also help people with conditions such as depression, anxiety or cancer. This has been demonstrated in research using brain imaging which shows that meditation increases both the level of antibodies and left sided brain activity, which is associated with positive emotional states. It is a model of meditation, which has been adopted with great success by chronic pain sufferers.

Thousands of years ago, Buddha first told the story of the two arrows to explain the different response of a wise person and an ordinary person when confronted with pain. The onset of pain was akin to being hit by an arrow, he said. This first arrow represented the primary pain and then, as our response to the pain kicked in, we inflicted ourself with a second arrow by responding to the initial onset with distressing emotions such as fear, anxiety, grief or anger, which just caused a mass of additional suffering.

According to the Buddha, a wise person experiencing a painful feeling didn't agonise or feel distraught. So while the physical pain remained, the mental pain didn't follow, and the suffering was greatly reduced.

Trying to cope by resisting pain or seeking distraction from it was doomed to fail, the Buddha said. Instead, the solution lay in accepting the fact that suffering was a part of our existence, and thus in observing the physical experience without trying to change it.

While to us, these emotional responses often seem appropriate and understandable, these reactions become more problematic once they start to dominate us. It becomes the secondary arrow that we inflict on ourselves. In other words, the resistance to pain becomes the major cause of suffering and distress, not the pain itself.

This is especially true in the case of chronic pain sufferers, who can be confronted with a lifetime of suffering.

While at first this may sound like an unrealistic concept to somebody who is in constant pain, training workshops with chronic pain sufferers have shown that by dispelling the fear, by avoiding being locked into a pattern of aversion and distraction, by changing our approach and instead, concentrating on the quality of the pain, its texture and location, we can see it for what it is, instead of what we imagine it to be.

As a result, we can significantly diminish its impact and improve our quality of life.

The first stage of mindfulness is becoming more aware of what is happening at the moment. It is concentrating our attention on the myriads of pleasurable sensations that we are experiencing at the same time - the smells, the sounds, and the tactile sensations of the clothes on our skin. It is looking at life with a wide lens vision, instead of being narrowly focused on our suffering. We soon realise that inside our world of pain, they are still many wonderful sensations for us to discover. The sun still rises every day, the birds are still singing ...

Nevertheless, learning to face our pain is an essential step. It is common for long term sufferers to resist it by blocking it or drowning it with diversions. One needs to overcome this resistance which is often greater than the pain itself. This is where breathing exercises become useful. A normal reaction when confronted with lasting aches is to alter our breathing pattern, so we take shallow breaths to protect ourselves.

In the case of chronic pain, this gradually becomes a habit which causes muscular tension in our chest, and aggravates our suffering. Instead, one is encouraged to direct the full breath towards the source of the pain, while relaxing into the out breath.

While this exercise will not change the primary pain, the secondary layers of tension and resistance that have been building up will soon start to dissolve. In addition, other physical exercises based on yoga or tai chi can be gradually incorporated, according to the person's capabilities.

Also, as we become more aware of the way we respond to pleasant and not so pleasant sensations, it becomes easier to broaden our horizon and identify with other people's experience. This can be especially useful for chronic pain or illness sufferers, since it is easy to believe that one's pain is unique. The very thing which tends to isolate us can then become a source of connection with others. After all, everyone has experienced some degree of pain, to a greater or lesser extent.

The final article on this topic will appear in next month's issue.

Olivier Lejus (MHSc. (TCM), BHsc.(Acup.)is an accredited acupuncturist practising in Sydney.