Working With Pain Instead Of Against It

By: Liz Gruber, Ph.D.

For those with chronic pain, the idea of bringing focused attention to the body and its sensations of pain likely sounds terrifying. Distractors and the thought of “getting rid” of pain might sound more appealing than bringing intentional awareness to overwhelming discomfort. However, with an avoidance or distraction seeking mindset, it is difficult to identify where you hold tension and emotions in the body, leading to inadvertently amplifying unnecessary physical and emotional pain (Stahl & Goldstein, 2010).

Mind body techniques and understandings of pain help foster a genuine, noncritical curiosity of one’s own bodily experience, assisting in changing your relationship to pain. Although overlapping in some ways, various mind-body frameworks use different paths/tools of altering this relationship. Pain Reprocessing Therapy emphasizes the importance of disrupting the pain-fear cycle through somatic tracking, which entails observing physical pain sensations while soothing yourself with messages of safety (Gordon & Ziv, 2021). Subsequently, corrective experiences with pain are created via somatic tracking or gradual exposure to fear and pain triggers. Avoidance behaviors are understandably common in those with chronic pain, but are used as opportunities to overcome fear related pain in Pain Reprocessing Therapy when done strategically (Gordon & Ziv).

Buzz words like “mindfulness” often used in the context of “being aware,” tend to miss other important parts of its meaning. Mindfulness extends to intentional, nonjudgmental, moment-to-moment observation of the mind-body (Stahl & Goldstein, 2010). You might be thinking “but what does that actually mean and how the heck does it help me with pain!?”

Let’s start with clarifying some misconceptions about mindfulness, as you continue to decide whether you want to test the mind-body waters or not. Mindfulness originated from Eastern tradition with Jon Kabat-Zinn considered a founding father of mindfulness in Western medicine. Mindfulness can have a spiritual component, but it is not necessary to its practice. Mindfulness extends beyond meditation to cultivate a particular state of consciousness; offering formal and informal mindfulness practices (Kabat-Zinn, 2013). Research has documented the benefits of mindfulness for both mental and physical well-being including anxiety, depression, addiction, heart disease, blood pressure issues, cancer, gastrointestinal issues, asthma, chronic pain, and more (Stahl & Goldstein, 2010).

As we initially notice pain, many of us have knee-jerk reactions that are judgements in response to discomfort such as “my day is ruined again” or “I’ll never stop being in pain”. We also are bombarded with ongoing cultural messages to avoid, deny, and suppress pain. Avoidance accompanied with harsh critical reactions trigger increased body tension, thereby intensifying and perpetuating the pain cycle.

Using mindful awareness with thoughts, feelings and emotions helps to acknowledge them without being consumed by or resisting them. Working toward acknowledgment can be an easier starting frame before embodying another important mindfulness principle, acceptance. It is important to clarify that neither of these mindfulness tenets involve “giving up.” Put simply, acknowledgement means being willing to see things as they are regardless if you like it or not whereas acceptance is being at peace with the way things are. It is likely hard to fathom the idea of “being at peace” with pain but you can still acknowledge pain without accepting it.

Congratulations for being open to learning how to work with rather than against chronic pain. As you continue to embark on this journey of befriending or re-befriending your body, I recommend setting aside a short amount of time each day to engage in a formal practice and consider using a mindfulness phone application, a book or therapist. Given that mind-body principles might sound foreign, it is helpful to have a guide while you familiarize and incorporate mindfulness into your routine. Intentionality is important, as you learn to change the suffering associated with your pain.

For example, Pain Reprocessing Therapy would recommend first starting somatic tracking at a time when your pain level is relatively low (Gordon & Ziv, 2021). Additionally, engaging in daily activities with intention are other opportunities to informally practice observing your moment-to-moment experience (Stahl & Goldstein, 2010). Depending on the Mindfulness approach utilized, some would encourage starting with a Body Scan meditation to facilitate bodily awareness (Kabat-Zinn, 2013). Notice when your mind is wandering; the scents, tastes, textures, and temperatures of your surroundings, and bodily sensations.

It will take time to explore which times of day, duration, and type of mindfulness practices work best for you. Becoming distracted is normal and can be considered a good thing because this means you’re recognizing when your mind is wandering, which takes a certain level of awareness. Just keep bringing your mind back to the breath when distractions come and go. Ride the waves of any unpleasant emotions, thoughts and sensations that may arise. With time and continued practice, you can learn to feel pain moment by moment but change your reactions to it, thereby suffering less.

References

Gordon, A. & Ziv, A. (2021). A revolutionary, scientifically proven approach to healing chronic pain: The way out. Penguin Random House.

Kabat-Zinn, J. (2013). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, & illness. Batman.

Stahl, B. & Goldstein, E. (2010). A mindfulness-based stress reduction workbook. New Harbinger Publications, Inc.

Disclaimer: These blogs are for informational and educational purposes only. They are not a substitute for medical or mental health assessment, diagnosis, or treatment.