How to Ease Chronic Pain With Mindfulness

by Gina Simmons, Ph.D.

Kendra arrived at her therapy session with a furrowed brow and walked with a stiffness in her limbs. “My knees are acting up today,” she said, as she gingerly sat on a chair. Kendra, a young former athlete, suffered from an injury that left her in chronic pain and derailed her athletic career. She found temporary relief with pain medications, physical therapy, acupuncture and lifestyle changes, like an anti-inflammatory diet. She came to me for help for depression stemming from the pain.

Chronic pain impacts more than 100 million Americans, more than diabetes, heart disease and cancer combined. Globally, about 20% of the population suffers from chronic pain. The costs of chronic pain to our country range from $560 billion to $630 billion per year. That’s the equivalent of about $2000 per person living in the US. About 80% of chronic pain sufferers report feeling depressed. Chronic pain leads to poor concentration, lower productivity, sleep problems and low energy.

What is Pain?

We need physical pain to signal us that something is wrong, so that we won’t continue to injure ourselves. In fact, people with a congenital insensitivity to pain often unknowingly injure themselves and can develop serious illnesses and infections eventually leading to death. Pain is necessary for our survival because it motivates us to take care of the injury and change our behavior. Acute pain acts as a loud signal forcing us to take action to make us feel better. Chronic pain sends continuous signals to our brain that can drain us of energy and motivation. We can become hyper-sensitized to it so that even slight touch can stimulate the pain receptors of our brain.

Pain Vs. Suffering

According to Dr. Christiane Wolf, a physician and mindfulness teacher, pain does not inevitably lead to suffering and depression. The saying, “Pain is inevitable, suffering is optional,” can give you an easy to remember phrase to start you moving away from suffering and toward more of a feeling of control over your relationship to your pain. Dr. Wolf in an article in Mindfulness magazine shares an equation developed by meditation teacher Shinzen Young: “Suffering = Pain X Resistance.” It’s similar to some of the childbirth training approaches that teach you to relax into the contractions rather than to fight them. When we stiffen up to pain, it’s intensity increases along with our suffering.

The Three Components of Pain

Pain consists of three parts: the physical sensations of pain, the emotions we have about the pain, and the meaning the pain has for us and our life. The meaning is our interpretation of the pain. Kendra, the former athlete, told herself that the injury and subsequent pain, “ruined my life.” She felt bitter, depressed and defeated by the injury, pain and change to her lifestyle. She also felt like a failure, and no longer connected with her former athlete friends.

Mindfulness Can Help

It helps to start with Kindness Toward Yourself, or what Kristen Neff, Ph.D. and others call Self-Compassion. You can even take a self-compassion test to help you determine your level of compassion for yourself. Dr. Neff offers this simple technique:

• Acknowledge the pain:  “Yes this hurts right now.”
• Connect with others in pain: “This is what it feels like for a young athlete to feel pain.”
• Offer kindness to yourself:  “May I be kind to myself, may I not close down my heart.”

When we acknowledge that others feel pain too, and that we can connect with that common experience of human pain, it helps to divert us from the toxic feeling of alienation and separation that adds to our suffering.

Counter-intuitive Pain Management

It seems counter to our instinct to avoid pain, but one of the best ways to begin to manage pain is to pay attention to it, rather than try to avoid it. Do this in three steps:

• Sensations: Pay attention to the physical pain. Take deep breaths and notice where you feel it. Rank the intensity on a scale from one to ten. Notice what parts of your body are not in pain. Sometimes it helps to notice that most of your body might be pain free. Describe the pain to yourself. Is it sharp, burning, dull, aching? Notice how the pain can change over time in it’s feeling, intensity and location.
• Emotions: Name the emotions you have related to your pain. Meditation teachers use the acronym RAIN to help with this: Recognize, Acknowledge, Investigate with kindness, Non-identify. This means recognize your emotions and name them. Acknowledge that you feel these emotions. Be kind to yourself in your investigation. Don’t identify with the emotions. You can do this by saying to yourself, “this is what anger (sadness, fear)  feels like.” You are merely feeling normal human feelings, but you are not the anger, sadness or fear.
• Thoughts: What are your beliefs about the pain? Do you think you will never feel better? Like Kendra, do you believe that your life is ruined? Could you possibly change those thoughts, or recognize that thoughts come and go, and are not fixed truths? Perhaps your life is merely changed, not ruined. Perhaps there are gifts you have received in this suffering that you could share with others.

Sometimes we can never be free from pain, but with mindfulness, focusing on our pain, emotions, and thoughts, we can reduce our suffering and increase the meaning in our lives. I encourage you to read more by following the links in this post. Meditation can feel awkward at first, but with practice it can become one of the most kind things that you do for yourself.

Photo courtesy of Ryan Weisgerber.

Learn to relax and let go of anger and resentment with our Manage Anger Daily Meditation Vol. One. Available on CD or Mp3 download at Amazon and other online outlets.