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Mindfulness for Chronic Pain: A 5 Step Practice | MyLifeStages
An estimated 80 million people in the U.S. experience chronic pain at some point in their lives, and treating ongoing pain is usually a multi-pronged approach.
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Pinterest Pin ItMindfulness for Chronic Pain: A 5 Step Practice

Mindfulness for Chronic Pain: A 5 Step Practice

Posted on 06/17/2013  by  Healthy Living Blog 

Mindfulness for chronic pain: Image of balancing rocksAn estimated 80 million people in the U.S. experience chronic pain at some point in their lives, and treating ongoing pain is usually a multi-pronged approach. Treatments for pain management may include things like medication, medical treatments, positive visualization, relaxation techniques, hypnosis, cognitive therapy, exercise, and many others. But the prospect of mindfulness for chronic pain is relatively new on the scene, at least in the context of healthcare.

Grounded in the spiritual traditions of India and Asia, mindfulness techniques have been around for more than 2,500 years as a way to attain greater equanimity and peace. For several decades now, however, scientists have been looking at mindfulness to address issues in health. In the late 70s, the now famous Dr. Jon Kabat-Zinn, Ph.D., founded a groundbreaking 8 week program at the University of Massachusetts called Mindfulness-Based Stress Reduction (MBSR) -- a program designed to help people turn their health around and experience greater well-being, regardless of  life circumstances, including chronic pain. Dr. Kabat-Zinn also led one of the first studies conducted using MBSR focused on chronic pain, and it has stood the test of time.


MBSR Today

Today, Sutter Health offers MBSR programs throughout Northern California (see our calendar of upcoming classes) along with medical centers across the country.

MBSR is suggested to many pain patients looking to manage pain and improve their quality of life. Mindfulness doesn't have to be a replacement for other pain management methods. Instead, it can be a complement to traditional medicine, or a recourse when current methods are not working. Mindfulness is a simple practice that can deepen and enrich a connection to our own wholeness. During times of pain it can make all the difference in the world. 

What Exactly is Mindfulness?
Mindfulness means having open and receptive attention and awareness of one's present moment awareness. We can be aware of our own responsiveness to our experience. This is different than being absorbed in our experience. During stress, which chronic pain will cause, we are often so immersed in our experience that we're more likely to be swept away by our stress reaction and the various thoughts that are generated. The practice is simple, but it's not easy. The key word is "practice," because it takes just that.

How to Practice Mindfulness for Chronic Pain in Five Steps

1. Invite mindfulness and choose to be aware. Rather than analyze or judge, experience the present moment with the curiosity of an explorer. 

Choosing to be aware: Commonly, we are operating on automatic pilot in our reactions. We base our reactivity on assumptions we are making about how things are going to work out. When under stress, we tend to imagine the worst. For example, "This is going to wreck my day." That's just an example but we all know what it's like to predict a negative outcome of events and we do this during many other situations, not just when experiencing pain.

Inviting mindful attention, we can essentially, appraise our experience and notice that many times things are much more manageable, in this moment, than what our mind is imaging as a worst case scenario. In fact, our future self will be much better poised to take care of what arises because of all the factors that are unknown to us now. Think of your teenage self imagining a potential crisis of the future and then how it either never manifested or if it did you were in a better position to handle it.

2. Check in with yourself and get a sense of your emotions, mood and state of mind.

Mindfulness of Emotions: We may not be aware that a large part of our experience of pain is actually the experience of our emotions related to pain. Identify the emotion being experienced. Feel it and be open to the fact that it may dissipate or pass completely in a very short period of time. An emotion lasts approximately 90 seconds unless it is fed by our thoughts, according to Jill Bolte Taylor, neuroanatomist and author of A Stroke of Insight.) What we call an emotion is really a 90 second chemical reaction in the body. With practice, even during very difficult times, we can gain a sense of spaciousness and perhaps a sense of freedom from the inner tyranny of difficult emotions. Honoring our emotions we can also acknowledge them and ask ourselves, "What is the kindest way we can respond to this right now?"

3. Check in with your body, experience it as it is, neither pushing yourself to feel less or more. Hold sensations in awareness like a neutral observer. (This is best practiced when pain is not at its most severe.)

Mindfulness of Sensations: It is best to practice mindfulness of sensations when not in a state of pain crisis. If things get rough we have some new skills at the ready! Sensations are essentially changing events. If we observe them, taking into account the thoughts and emotions that go with them, we may start to untangle the ball of yarn that is our suffering. We may even start to notice how we can influence them. The sensations we call "pain" may in the moment be experienced as heat, tingling, sharpness, dullness, pressure -or whatever we discover. We may see how they can change or come in waves. Sometimes there may even be a break in the waves, missed by us if we are on autopilot. Noticing sensations we can take action, in the moment. This might involve stopping what we are doing, slowing down, taking a deep breath and relaxing the muscles around the pain or somewhere unrelated to the pain (even if this doesn't change the pain itself.) If there are times the pain is not present or has reduced, let yourself be mindful of this as well. Awareness of the ebb and flow of sensations in the moment can be empowering and inspire us for more mindfulness practice.

4. Notice thoughts and assumptions arising. Our thoughts about pain are not the pain itself, which is a constellation of sensations. A thought might be something like, “I can’t handle this.”

Mindfulness of Thoughts: We are so immersed in thoughts that we are not really present for what is happening. For example, feeling our pain level rising we may have thoughts like, "I can't handle this," or "This is only going to get worse!" In actuality, the experience is influenced by a number of factors, some of which are in our control. Our fears are often based on past experiences and predictions for the future. Moment to moment we can notice options for responding that can have a positive influence on our situation and potentially change the outcome. In some ways we are actually reclaiming our lives and are more likely to make healthy choices that lead to better overall health and well-being. Additionally, anxiety about our experience and predicted outcomes can influence things like tension, circulation, inflammation, which are likely to increase pain.

5. Mindfully respond to the pain rather than reacting on auto-pilot, balancing awareness of pain with awareness of the big picture.

New Options for Mindful Responding
One of the things that can confuse people about using mindfulness for chronic pain is that usually we would like to feel our pain less, and when we are mindful we may actually feel our pain, at least temporarily, more acutely. However, consider that whatever we are noticing is already here. We now are able to respond with options that can take us to greater equanimity, meaning, balancing awareness of pain with awareness of what is happening that is not painful. We may even experience the surprise of noticing things that are pleasant or neutral.

We may also be more able to access a sense of our own wholeness. We naturally start paying attention the the cues that may not even be entirely conscious but lead us to make choices that result in greater health, well-being, improved relationships and generally more enjoyment of life. All this from paying attention! Even the simple act of a couple of minutes of mindful breathing, such as when we focus on the exhale, can be like a reset button for greater clarity, peace of mind, and ease of being.

Our minds are immensely capable and with mindfulness we are harnessing the power of awareness and paying attention to bring us greater peace and healing. Modern scientists are gaining more and more understanding of how we can use the power of our mind to positively enhance our physiology and even gene expression. The recent International Conference for Mindfulness in Medicine, Healthcare and Society was attended by people from six continents and 24 countries, many of them mindfulness researchers and neuroscientists. Expect more understanding and advances coming soon!

Recommended Mindfulness Reading:
Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness by Jon Kabat-Zinn

Mindfulness Meditation for Pain Relief: Guided Practices for Reclaiming Your Body and Your Life [Audio CD], Jon Kabat-Zinn

The Mindful Path to Self-Compassion, Christopher K. Germer;

Mindsight, Daniel J. Siegel

My Stroke of Insight, Jill Bolte Taylor

Self-Compassion, Kristin Neff

Additional Resources

Sutter Medical Resource Library
Many books and audio recordings related to mindfulness and chronic pain are available on loan from the Sutter Medical Resource Library , 2800 L St., Suite 600, Sacramento. Stop by to take a look or give them a call at (916) 207-3880 to ask about a title.


Denise Dempsey, CMT and Mindfulness InstructorBy Denise Dempsey, CMT, MBSR instructor with Sutter Center for  Integrative Holistic Health in greater Sacramento.

If you are interested in taking a Mindfulness Based Stress Reduction course you can contact Sutter instructor Denise Dempsey for the Davis and Sacramento region (530) 304-4341 or see Sutter Health's full listing of MBSR classes in the Bay Area and other Northern California locations.


DeniseDempsey wrote on 08/15/2013

For the person looking for a North Bay class, try a search through the University of Massachusetts Center for Mindfulness "Other MBSR Programs World Wide" search engine. It's at umassmed.edu/cfm.

smithclaire wrote on 08/01/2013

Hey, there's a health conference going on this Tuesday and Wednesday titled "Lessons for Healthy Living 2.0", and they are just asking for any donation to attend online. Check it out: www.LessonsForHealthyLiving.com Looks great, I'm going!

earthdog wrote on 07/19/2013

No classes offered in the North Bay...Why?

Blitherer wrote on 06/26/2013

So much excellent info, worth printing and re-reading. Thanks