Your body – it’s strong, resilient, and capable of incredible things! However, it can feel like you are battling your body when it is not functioning the way you think it should, especially when dealing with chronic pain. Pain can switch the roles of mind and body, so that the body’s pain begins to dictate your thoughts and actions instead of the mind telling the body what it needs. Mindfulness is a method to reassert the mind over the body to better manage chronic pain.
Mindfulness can be described as bringing awareness to your present state while non-judgmentally accepting your emotions, thoughts, and your body’s sensations. There are several ideologies that support using mindfulness to reduce pain, with Mindfulness-Based Stress Reduction (MBSR) being well supported by research literature (Banth & Ardebil, 2015; Cherkin et al., 2014; Veehof, Oskam, Schreurs & Bohlmeijer, 2011). Jon Kabat-Zinn, the founder of Mindfulness-Based Stress Reduction (MBSR), described mindfulness as “the awareness that emerges through paying attention on purpose, in the present moment, and non-judgmentally, to the unfolding experience moment to moment” (2003). MBSR uses formal group-based and individual meditation that includes breathing practice and body scanning, yoga, and practicing mindfulness in daily situations.
Modern medicine has studied the influence of thoughts on pain perception for several decades. In 1977, Engel proposed the gate control theory, which theorized that the brain actively participates in pain perception rather than passively responding to the body’s pain signals (Banth & Ardebil, 2015). The gate control theory suggests that the way the brain perceives pain signals from the body’s nervous system can be inhibited or enhanced by psychological factors. Thus, inhibiting pain signals by practicing mindfulness has the potential to change the way that we experience pain.
Mindfulness cultivates an experience of detached observation toward the pain, whereby the participant is aware of the pain but is detached from the cognitive associations that label the sensation as hurt and disabling. This uncouples bodily sensation from the emotional experience of pain, reducing the brain’s cognitive perception of the pain (Banth & Ardebil, 2015). Disassociating pain from the patient’s emotional experience enables the patient to identify maladaptive thoughts and behaviors that were previously based around pain avoidance. The participant then works toward changing these maladaptive thoughts and behaviors to align more closely with their body’s needs.
Implementing mindfulness as a pain reduction strategy can dramatically change the way we approach our patients’ pain. Physical therapists can facilitate mindfulness by suggesting that patients bring awareness to their body’s sensation of pain without fear or judgment. Examples of guided mindfulness exercises and information on certification in MBSR can be found online at http://www.mbsrtraining.com.
Lindsay Weston, PT, DPT
References:
Banth, S., & Ardebil, M. (2015, June 1). Effectiveness of mindfulness meditation on pain and quality of life of
patients with chronic low back pain. Retrieved September 20, 2015, from
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4479890/
Cherkin, D., Sherman, K., Balderson, B., Turner, J., Cook, A., Stoelb, B., . . . Hawkes, R. (2014, June 7).
Comparison of complementary and alternative medicine with conventional mind–body therapies for
chronic back pain: Protocol for the Mind–body Approaches to Pain (MAP) randomized controlled trial. Retrieved September 20, 2015, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4052284
Kabat-Zinn, J. (2003). Mindfulness-Based Interventions in Context: Past, Present, and Future. Clinical
Psychology: Science and Practice, 144-156. doi:10.1093/clipsy/bpg016
Veehof, M., Oskam, M., Schreurs, K., & Bohlmeijer, E. (2011, March 1). Acceptance-based interventions for the
treatment of chronic pain: A systematic review and meta-analysis. Retrieved September 20, 2015, from http://www.sciencedirect.com/science/article/pii/S0304395910006871
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