Mindfulness in the Management of Pain

Dana C. Jack, EdD, Western Washington Universityhttp://www.wwu.edu/fairhaven/about/faculty/jack.shtml

What is mindfulness?

Focusing our attention in the present moment, on purpose, in a particular way –

With kindly, nonjudgmental awarenessRelating to oneself and thoughts with compassion

Waking up from automatic pilot; saying yes with an open heart.

Three dimensions of pain:

physical

emotional

cognitive.

What is pain?

Bringing awareness to pain with acceptance and kind curiosity

Trying to know your pain better, not to stop it or get rid of it or escape from it.

Going into the pain: In this moment, is it tolerable? Being with sensations moment by moment.

Learning to distinguish between the ‘first and second dart.’

Mindfulness and pain

Brought Buddhist meditation practices to the West in secularized form

Visit his website for many resources: guided meditation downloads, etc.

Supported by clinical trials research.

Jon Kabat-Zinn, MBSR

Body Scan - bringing awareness to each body part and instead of immediately reacting to your pain, the body scan teaches your brain the experience that it can actually be with what’s there. Videos available with a three-, five- and 10-minute body scan, but these not supported by research

Focus on the breath When pain arises, the brain reacts automatically, with thoughts, such as “I hate this, what am I going to do? You can calm your mind and ground your breath. When pain is intense, breathing in slowly and saying to yourself “In,” and breathing out slowly and saying “Out.”

Mindfulness and pain

Body Scan Meditation, a supine meditation

Gentle Yoga, practiced with mindful awareness of the body

Sitting Meditation mindfulness of breath, body, feelings, thoughts, emotions, and choiceless awareness

Walking Meditation

Mindfulness and pain, MBSR

“Informal” Mindfulness Meditation Practices (mindfulness in everyday life)Awareness of pleasant and unpleasant

events (RAIN) Awareness of breathing, Deliberate awareness of routine

activities and events such as: eating, driving, weather, interactions, thoughts, etc.

Mindfulness and pain, MBSR

Compassion meditation can result in greater altruistic behavior and related changes in neural systems underlying compassion

Self-compassion critical for caregivers and those who suffer chronic pain. See Thupten Jinpa, A Fearless Heart, presenting Stanford University program of compassion training.

Learning compassion for self and others

A wide range of studies support the use of mindful meditation for chronic pain.

Naturalistic, qualitative study of 27 older adults with chronic back pain. Eight-week mindfulness meditation program resulted in pain reduction, improved attention, improved sleep, and improved well-being. Morone et al., (2008) Journal of Pain.

What does the research say?

fMRI studies: Pain unpleasantness ratings were reduced by 57% after just one hour of mindfulness training. (Zeidan, F., 2011, J. of Neuroscience)

"You might not need extensive training [in meditation] to realize pain-relief benefits. Most people don't have time to spend months in a monastery." —Fadel Zeidan, neuroscientist

Also see Nakata, H., Sakamoto, K., & Kakigi (2014)

What does the research say?

Depression and pain in dialectical relationship; feed on each other.

MBCT for depression can cut risk of relapse by half – overcoming chronic unhappiness

What does the research say?

What we pay

attention to creates,

for the moment,

our reality

Blue dragonfly slumbering on a leaf at sunrise.