Pain management has been an important, necessary, and evolving strategy in my life for almost twenty years. Mindfulness training has become an increasingly important component in managing all areas of my life, including pain management, over the last several years. Recently I received formal training in Mindfulness Based Stress Reduction, a program devised by mindfulness teacher Jon Kabat-Zinn in 1990 and currently taught all over the world (I took my course through Mindfulness Northwest in Bellingham). According to Kabat-Zinn, mindfulness is: “the awareness that emerges through paying attention on purpose, in the present moment, and non-judgmentally to the unfolding experience, moment to moment.” Much can be said about applying these concepts to daily living, and the study of mindfulness is extensive in it’s very simplicity! For the purposes of this post, I will look at how the Seven Principles of Mindfulness, which are discussed in Kabat-Zinn’s book Full Catastrophe Living, can be helpful in the lives of those dealing with chronic pain and anxiety. I will most often reference pain; however, feel free to substitute anxiety or tightness or whatever description fits for you, as the concepts can be effectively applied to all physical manifestations of stress in our bodies.
THE SEVEN PRINCIPLES OF MINDFULNESS
1. NON-JUDGING — Not feeling caught up in our ideas and opinions, likes and dislikes.
I think it’s fair to say that most of us don’t like pain, would prefer to live without it, and desire to rid ourselves of it when it occurs. Holding that judgment about pain, however, that it is bad and must be gotten rid of, can sometimes exacerbate pain and even cause depression and anxiety when we focus excessively on it. The mindful intention here is to step away from the negative judgment of pain, and to see if we can neutrally approach it, by asking the question “What can I learn from this pain?” To the degree that we can take on an attitude of curiosity, asking “What is this pain trying to tell me?”, instead of approaching it as wrong or horribly undesirable, we can adopt a more open perspective that allows for a non-judgmental relationship to our pain. The best way I have been able to do this is to view pain as my friend, not my enemy, and to learn to align myself with pain from an investigative standpoint instead of doing battle with it.
2. PATIENCE — An understanding and acceptance that sometimes things must unfold in their own time.
How many times have we all heard that we can’t force a flower to bloom or a tree to bud any earlier than nature intends? The same can be said of the healing process, and waiting it out can be incredibly tedious sometimes. It’s admittedly difficult to be patient with pain, especially the acute style…because it’s painful! But what I have found over and over again, through surgeries, recoveries, and nearly twenty years of dealing with chronic pain, is that things do change! Our bodies do heal, pains do come and go, and vary in intensity. The more patiently I can hang in there with the process, the smoother and less stressful the recovery or painful episode is. I have recently enjoyed a particular guided meditation that asks the listener to focus on the most significant pain or discomfort present during the 45 minute meditation. What I have found each time is that the presenting pain, whether it’s post-surgical foot pain or a particularly bad headache, always fluctuates and moves in and out of intensity multiple times during my 45 minutes of focus. I realize that there are some types of pain that don’t let up, and the strategy of patience takes on a whole new meaning in the face of unrelenting pain. But for most of us, an awareness of the variance and fluctuating nature of pain can help us to be patient with the process of pain management.
3. BEGINNER’S MIND — Seeing things with fresh eyes, with a clear and uncluttered mind.
Having a Beginner’s Mind allows for the possibilities that things may unfold in new and unexpected ways. So often we expect that things will go a certain, predictable way, a way that they have always gone before. With Beginner’s Mind, we allow ourselves to open to the possibility that anything can happen, and people and events then have the freedom to show up as they do, unhindered by our expectations. This last foot surgery provided a perfect opportunity to practice Beginner’s Mind. Having just had foot surgery last January, eleven months prior, I initially expected the course of recovery to be just as difficult as the last round. I reminded myself to stay open to any outcome, and I soon discovered that this recovery was happening significantly faster than the previous one. I stayed open up to the possibility that I would be up and around sooner and experience much less pain….and that is what happened! Admittedly, I did this partly in the face of evidence to support…the real challenge comes in opening up to the possibility of new and unexpected outcomes without specific evidence to support. I am sure opportunities will come to practice that soon enough as new challenges arise.
4. TRUST — Trusting your intuition and your own authority.
I am fully on board with this principle…intuition doesn’t lie! When we dare to trust our bodily intuition and awareness as the course to follow, we get to influence certain aspects of our lives to a much greater degree. Sure, there will always be outside factors to influence us in our decisions, and these have their time and place. Often, however, the temptation is to follow some outside source or “authority”, at the expense of following our own intuition and inner guidance. I am certain we all have done that, sometimes with varying degrees of adversity or fall out. I know for certain that when I trust myself first and foremost — my feelings, experiences, and knowings — I am blessed with an enveloping inner peace. With regards to pain management, this has been indispensable. I can always remember my orthopedist father saying “Let pain be your guide.” When I honor and trust my experience of pain and physical sensations to guide me, I stay on course with surgery and injury recovery and pain management strategies.
5. NON-STRIVING — Trying less and being more.
Admittedly, the same father who wisely spoke of using pain as my guide also had an incredibly strong drive to accomplish… which he also passed onto his children. It has been a challenge to balance the ingrained need to push and excel at things with the quiet appreciation of trusting myself and living in the moment. While striving has it’s place, it also brings about higher stress and sometimes an increase in pain and anxiety. In non-striving, the intention is to step away from the stress and strain of always trying to get somewhere, because where we are now is where we are now! There is a lessening of expectations that takes place with non-striving, a trust that things will unfold moment by moment. When I come at pain from a striving place, my goal is to overcome it, surmount it, beat it into submission, or otherwise dominate it. This rarely works for me. But when I approach pain from a perspective of non-striving, I don’t feel the need to power through or otherwise “win” with my pain or discomfort.
6. ACCEPTANCE — Coming to terms with things as they are.
Of the seven principles of mindfulness, Trust and Acceptance are the two most deeply ingrained in my habits and psyche. If I had a nickel for every time I have said “It is what it is”, I would be retired and living on a desert island by now! Accepting oneself and life’s circumstances, regardless of how rough they may be, is sometimes tough…but is there really any alternative? Unquestionably, non-acceptance can manifest as an escape from reality by some means, but that never lasts. Further, stress is known to increase when the mind resists that which is. Ultimately, we all have to accept our lives as they are and as they continue to unfold, moment by moment. Doing so graciously and willingly is key, and does much to ease pain and anxiety as well. When I approach pain with open acceptance, it means I take it at face value. It is what it is — no more and no less. It doesn’t mean I deny it or avoid it, but I also don’t give it an overwhelming degree of attention or focus. It exists along with and as one part of all other aspects of my life. This approach, seeing pain as a part of my experience, but not as the entire experience, remains my best mechanism for coping with ongoing pain.
7. LETTING GO — Letting our experience be what it is.
Letting go is also known as non-attachment. It is human nature to desire to hold onto that which is pleasant and desire to get rid of or change that which is unpleasant. Letting go of and being non-attached to circumstances, outcomes, or goals allows for the existence of both “good” and “bad” — and the redefinition there of. It is possible to neutralize and be with both, and view them as equal parts of the human experience. Pain can be viewed in the same way. Pain and pleasure are part of a spectrum, but the intention doesn’t have to be pain avoidance and pleasure seeking. Both pain and pleasure can co-exist, simultaneously and peacefully, if approached from a different perspective. One isn’t better than the other…they are both valuable and inevitable, and both provide rich learning opportunities within the vast array of human experiences.
A footnote: After finishing this blog post, I went directly to my Mindfulness Meditation Group. For whatever reason, I was able to sit through an entire 40-minute seated meditation without back pain for the first time since beginning meditation. I am not sure why…perhaps it was after all the writing about mindfully approaching pain, but it was remarkable and noticeable that I experienced no pain or even discomfort. In the aftermath of this event, I have my work cut out for me. I can practice non-judgment about this meditation as being no better or worse than any other; I may have to be patient for it to happen again; I certainly will adopt beginner’s mind and stay open to the possibility that it could happen again; but I will not strive to make that happen; I will accept what happens in the next seated meditation as just what it should be, regardless; and I will make sure I don’t become attached to the outcome that each meditation should be pain free!