The therapeutic approach of mindfulness
Joon Choi, Clinical Psychologist
Chronic pain is complex – it is often more than ‘just’ pain for many people. Trying to manage chronic pain on a daily basis often leads to frustration, anger, and distress. The way an individual experiences pain can be influenced by many factors in addition to pain intensity. Factors such as your emotional state (e.g., anger about the pain), beliefs related to pain (e.g., this pain is going to continue to worsen), self-expectations (e.g., this treatment or medication will not work), and environment (e.g., being socially isolated and detached from others).
What is mindfulness?
Mindfulness is about being present in the moment, accepting any thoughts and feelings you are having at that moment without worrying or attaching meaning to them (being non-judgmental). This, in turn, allows a person to achieve a sense of calm or peace.
Mindfulness is a therapeutic approach derived from Buddhism and other spiritual practices, which were initially incorporated into mainstream medicine in the late 1970s. Since then, there has been a wealth of research that have shown mindfulness as an effective therapy approach for a number of physical and psychological difficulties.
How can mindfulness help?
In the context of chronic pain, mindfulness can help by:
Decreasing repetitive thinking/reactivity about the pain or stressors
Increasing a sense of acceptance with unpleasant sensations
Improving emotional flexibility
Reducing rumination and avoidance behaviours
Enhancing self-compassion
Adding a sense of acceptance for the present moment
Facilitating a relaxation response and decreasing stress
Mindfulness is not intended to dull or eliminate pain. The goal of mindfulness is to change the relationship between a person and their pain, so that they can focus on more valuable aspects of life (and even enjoyment/positive feelings) while in pain.
In practice, this means that a person suffering from chronic pain can use mindfulness as a tool to stop their mind wandering to and focusing on their pain when they are trying to focus on something else (e.g., spending time with family/friends, completing a hobby). This will increase their ability to attend to the task at hand, increasing enjoyment and participation levels.
Techniques of mindfulness
There are a number of different forms of mindfulness, which means that it may require some experimenting to find out what work best for a particular person.
Individual mindfulness meditation
This can involve sitting alone in a quiet comfortable space, typically with your eyes closed or with your eyes relaxed and not focusing on anything specific. This is about connecting with yourself and focusing on the moment. You may also focus on your breathing, what you can hear, or on various areas of your body one at a time (known as a body scan). Most people find that their thoughts will continue to flow during this time – this is ok, as your mind does not have to be completely ‘quiet’; it’s about letting thoughts flow without any judgment or meaning.
Guided mindfulness meditation
This involves listening to someone (either in-person or via a recording), who will talk you through the meditation process and help you to reach a meditative state. This may involve techniques such as imagery (asking you to picture specific things in your mind) or specific thought exercises. Guided meditations will also focus on breathing techniques, helping you to slow down your breathing while visualising ‘breathing out’ of negative thoughts and ‘breathing in’ positive thoughts.
Mindful movement
Body movements can often be used in mindfulness practice. Typically this involves focusing on your breathing and how your body is moving during this type of mindfulness. For those who struggle to focus on meditation while sitting or lying down, mindful movement can be more helpful. This approach also has the added benefit of exercise – learning how to maintain a state of calm while exercising or engaging in activity can reduce fear/anxiety associated with movement in some individuals with chronic pain.
Overall, mindfulness can help reduce the distress associated with chronic pain without necessarily reducing the intensity of the pain. It allows a person to manage their pain with less fear and greater acceptance, which helps improve their overall quality of life.
Joon Choi practices from Advance Healthcare St Albans. He completed his Clinical Psychology training in New Zealand and has wide-ranging experience working in health, forensic and community settings across a number of different population groups.