Thursday, October 14, 2010

MINDFULNESS MEDITATION AND PAIN MANAGEMENT


Mindfulness and Mindfulness Meditation have been proven to assist in the management of both acute and chronic pain conditions.
By its very nature, the practice of meditation itself reveals the in-built potential for pain relief, for it is not uncommon to experience pain, both physical and emotional, when engaged for long periods of time in what may be described as “intensive meditation”.

For example, there is or may be a certain amount of pain associated with sitting in a fixed position for a fairly long period of time, especially if one is sitting in a cross-legged, half-lotus or full-lotus position.

Any experienced meditator knows that the experience of pain is an opportunity to bring one’s awareness - bare attention, and detached observation - to the pain sensations … that is, to apply the practice of mindfulness itself to the sensations of pain.

When we observe, in a detached but otherwise focused way, the sensations of pain, what do we experience? Well, for starters, we begin to see that the primary sensations of pain are not immutable but rather are constantly changing in intensity from moment to moment … and mindfulness means living in the moment, from one moment to the next. If we move one step further - still working with the insight already gained from observation – we begin to appreciate that the sensations of pain are entirely separate from the psychological interpretations that we may commonly attribute to them.

Over time, with practice - for that is what it is … practice - Mindfulness Meditation enables us to develop the ability to dwell in a supramundane - I didn’t say supernatural - state of heightened but otherwise bare awareness to bodily sensations, without going to the unnecessary, and self-destructive, path of engaging in constant psychological interpretations of our sensations of pain. All the latter does is lead to suffering. Mindfulness enables us to investigate the process of “pain”, the latter being only a mass of sensations, and not a “thing-in-itself”. We can then learn to discern between "pain" and "suffering”.

Several important reported studies, especially those of Dr Jon Kabat-Zinn, have shown that Mindfulness Meditation can greatly assist in cultivating (I love that word, for all meditation practice is mental cultivation) a state of “detached observation” during the perception of pain.

Other clinical studies have shown that regular meditation practice results in thicker brain tissue in two regions of the human brain, namely the “insula” and the “prefrontal cortex”.




The bottom line is this … meditation, especially Mindfulness Meditation, leads to “thicker” [no, not in that sense!] brains, and thicker brains help lessen pain (or, more accurately, our sensations of pain).

There are two essential “ingredients” involved in using Mindfulness Meditation for pain relief (especially relief from chronic pain).

First, observe, always with choiceless awareness and bare attention - that is, in a detached and non-judgmental manner - the sensations of pain … from moment to moment. Don’t judge those sensations or attempt to analyse or interpret them. Simply pay attention to whatever arises in the present moment, which, as Kabat-Zinn always reminds us, is the only moment.

Secondly, mentally “note” the primary sensation of pain and see it for what it is, namely, something entirely separate from the thoughts and other psychological interpretations that may occur about the pain.

NOTE. This blog sets out a simple form of mindfulness sitting meditation.

For those who are interested, the following scholarly articles are worth reading:

Kabat-Zinn, J, Lipworth, L, & Burney, R  1985. “The clinical use of mindfulness meditation for the self-regulation of chronic pain”, Journal of Behavioral Medicine, 8(2), 163-190.
Kabat-Zinn, J, Lipworth, L, Burnery, R, & Sellers, W  1986. “Four year follow-up of a meditation-based program for the self-regulation of chronic pain: Treatment outcomes and compliance”, Clinical Journal of Pain, 2, 159-173.
Morone, N, Weiner, D, & Greco, C  2005. “Randomized trial of mindfulness meditation for the treatment of chronic low back pain in older adults: A randomized controlled pilot study”, Journal of General Internal Medicine, 20 (Supplement 1), 58.
Plews-Ogan, M, Owens, M, Goodman, M, Wolfe, P, & Schorling, J  2005. “Brief report: A pilot study evaluating mindfulness-based stress reduction and massage for the management of chronic pain”, Journal of General Internal Medicine, 20(12), 1136-1138.
Rosenzweig, S, Greeson, J, Reibel, D, Green, J, Jasser, S A, and Beasley, D  2010.   Mindfulness-Based Stress Reduction for Chronic Pain Conditions: Variation in Treatment Outcomes and Role of Home Meditation Practice, 68:1 Journal of Psychosomatic Research, January 2010, 29-36.

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