A Mindful Approach to Pain

Every week or so, I go through the same set of symptoms. It starts with the familiar mid-day throb beneath my right eye. The ache intensifies throughout the day, graduating into a blazing sensation by the late-afternoon. In the evening, I’m completely mired in the pain, able to do little more than lie down. This is usually when I retreat to bed to endure a tormented night.

I have lived with headaches my entire life. My mother tells me about the time she had to pick me up early from kindergarten, laying on the floor, shielding my eyes from the harsh light of the classroom. As a high school and university student, I would sacrifice valuable studying time to nursing a headache. Today, my headaches are as bad as they have ever been, and it’s not unusual for me to take entire days off from work to recover from a headache.

I have been seeking treatment for this condition for years, but to no avail. I have taken pain medication, altered my diet, and sought out folk remedies from the internet. This year, I sought medical advice from my family doctor. He gave me some general advice and referred me for a sleep study to assess respiratory issues. When the sleep study showed no abnormalities, I underwent a CT scan as a final resort. Thankfully, the CT scan was normal, but this meant I had exhausted every diagnostic and medicinal tool within my means. It appeared that headaches were part of my life, and there was no reason or relief for this ailment.

Around the time of my CT scan, I began studying mindfulness and the therapeutic effects of meditation. I was interested in mindfulness for its psychological and emotional benefits, but I soon learned about several physical health advantages as well. According to research, mindfulness is beneficial to general physical health (Murphy et al. 2012), as well as specific issues related to cardiovascular health (Loucks et al. 2015), gastrointestinal health, (Ghandi et al. 2018) and sleep (Howell et al. 2008). There is even evidence that mindfulness can be used to reduce pain in severe conditions such as complex regional pain syndrome (Zeiden 2016). If mindfulness reaps the clinical benefits that these researchers suggest, perhaps it could be applied to my specific condition? I sought to understand what mindfulness is and how it could be used to better my own physical health.

Mindfulness is a technique that involves conscious and sustained focus on present surroundings. It is a cognitive skill that involves “deliberately bringing one's attention to the present moment with openness and without judgment” (Baer et al., 2006; Bishop et al., 2004). Mindfulness grew out of the Buddist meditative tradition, and is still very closely associated with this philosophy (Ahir 1999). In fact, mindfulness is sometimes used in conjunction with meditation, and many of its techniques involve attaining a meditative, judgement-free mindset. During the mid-twentieth century, mindfulness saw adoption in clinical settings as a way to manage emotions and well-being (Hofmann et al. 2010). Within the last few decades, mindfulness has increasingly gained cache in the medical world, and research into mindfulness-based intervention is now at an all time high. According to a 2015 finding, 80% of accredited U.S. medical schools incorporate mindfulness into their treatment, education, and research (Buchholz 2015). This number is surely expected to rise as more studies promoting the utility of mindfulness are published.

According to a review of mindfulness-based randomized control trials by Black and Slavich, mindfulness intervention has yielded benefits on a range of physiological issues, including “stress-related ailments, psychiatric disorders, and disease symptomatology” (Black and Slavich 2016). Further research suggests that mindfulness can improve sleep quality (Howell 2008), reduce risk of heart disease (Loucks et al. 2015), and could improve the human immune response (Black and Slavich 2016). There is even some promising findings on mindfulness as a suppressant for pain-related conditions. In a 2018 study, Ghandi et al. demonstrated that mindfulness-based stress reduction therapy helped decrease the pain associated with irritable bowel syndrome (IBS) and reduced the severity of symptoms for patients with this condition (Ghandi et al. 2018). The authors of the study explain that mindfulness allows patients to “experience pain … without any judgment” and therefore be “less controlled by pain, anxiety, and depression” (Ghandi et al. 2018). These researchers ultimately found that “mindfulness-based techniques lead to reduced stress and pain symptoms” in IBS patients (Ghandi et al. 2018).?

The findings from Ghandi et al. are consistent with other contemporary studies on the efficacy of mindfulness as a pain suppressant. Indeed, pain management has been a part of mindfulness ever since its inception. In the Buddist text known as the Sallatha Sutta, the author notes that a “a well-taught noble disciple … when he is touched by a painful feeling, he will not worry nor grieve and lament, he will not beat his breast and weep, nor will he be distraught” (Sallatha Sutta: The Dart). This is because, according to the author, the expert meditator will learn to let go of the mental pain associated with a pain stimulus, and will therefore be more prepared to accept bodily pain. This idea was assessed in a 2010 study by Grant et al., who observed lower pain sensitivity in zen meditators compared with novice meditators (Grant et al. 2010). Finally, in a 2016 talk, Zeiden consolidated these findings and discussed his own study into meditation and pain, which indicated that “meditation’s pain relieving effects do go beyond a placebo response” (Zeiden 2016). Zeiden even noticed pain reduction in patients with serious chronic pain conditions, who used a regimen of meditation to “let go” of their symptoms (Zeiden 2016).?

If mindfulness-based therapies can help patients with chronic pain conditions, perhaps it could also be used to treat the moderate pain of headaches? It appears that research into this regimen is nascent but has some promising early results. Andrasik et al. indicated evidence that supports mindfulness as a method of headache management (Andrasik et al. 2016). In another study by Wells et al., headache patients using mindfulness “had improvements in headache-related disability, quality of life, depression scores, self-efficacy, pain catastrophizing, and decreased experimentally induced pain intensity and unpleasantness” (Wells et al. 2020).

So, if mindfulness can have such a pronounced effect on chronic pain conditions, including headaches themselves, why not try it out myself? I have been experimenting with mindfulness meditation over the last few weeks, but I never considered it as a physical therapy for myself. I had noticed how even a couple minutes of mindfulness meditation had changed my perception and creativity, so I was eager to apply it to my physical health as well. After all, I had been through the gauntlet of every intervention and diagnostic for my headaches, so there was nothing to lose in attempting one last remedy.

I had my chance earlier this week when I was laid up with a burgeoning cluster headache. Relaxing on the couch, I turned off all distractions and closed my eyes. For this intervention, I practiced the body scan technique, a popular mindfulness exercise that involves paying attention to each part of their body, with a sustained focus on breathing rate. Deeply inhaling and exhaling, I gently interrogated every part of my body, starting with the toes, working my way up the torso, and settling on my head. At each body part, I paused to contemplate how that particular body part felt and used my focus to explore this feeling. If my mind wandered, I gently and without judgement guided it back to my breathing. It took some effort to get invested in the exercise, but after a few minutes I was able to shut away distractions, focus, and feel good about my body. When my body scan reached my head, I took the time to linger on the throbbing pain and really experience it. Although it may sound strange, I had a conversation with my brain, and asked why it was causing me pain? I treated the pain response with a kind of respect, not judging or forcing it away. Thinking back to the Sallatha Sutta, I accepted the physical pain, while letting the mental pain wander off. To my surprise, this dialogue dulled the pain in my head and provided moderate relief. As a side effect, I also experienced a boost in creativity and felt gratitude for the people in my life. After the session was complete, I was able to carry on with the rest of my evening, rather than being hampered by my headache.

To be clear, my body scan experience was not a cure all. I still experienced some pain, but I was able to manage it and carry on with my night. It didn’t completely relieve the negative sensation, but it worked better than any medicine or other technique I can remember. I know that meditation takes practice, and perhaps this activity will not be as successful for pain relief on my next session. But I now know that I can live with the pain, and there are more productive ways to confront this feeling. For the first time, I feel in control of my ailment.?

Sources

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Zeiden, F. (2016, 07 20). A Different Approach To Pain Management: Mindfulness Meditation [Video]. TEDx Conferences. https://www.youtube.com/watch?v=OLQJJDrbj6Q&ab_channel=TEDxTalks?