Pain and mindfulness – It is possible, through mindful exposure, to take the “hurt” out of pain. The idea that the experience of pain is subject to modification is a relatively novel idea in the medical field. For centuries, it was believed that the magnitude of the experience of pain was directly related to the magnitude of physical injury. Now we now that many perceptual, emotional, cognitive, contextual and motivational factors can influence the magnitude and quality of the pain experience. For example, a soldier, wounded on the battle field, will often show less pain behavior and require less narcotics than an equivalent injury in a civilian context. In a war situation, the injury has much different meaning and implications. It is recognized as a sacrifice for a noble cause and can be seen as a mark of valor. It can mean one’s ticket out of the battle or war. In the course of horsing around and roughhousing, kids can mutually inflict pain which is often accompanied by howls of laughter and obvious enjoyment. But a parent lightly spanking a kid ( a practice I don’t recommend) can elicit significant pain since it is associated with the emotions stemming from perceived parental rejection, (fear, loss, hurt, abandonment). Thus, how we feel about pain and the associated context, and how we talk to ourselves about pain will influence our subjective experience of pain as well as our pain behavior (grimacing, pain vocalizations, medication requests, activity levels etc.). This has terrific implications for treating pain. Notable clinicians and researchers such as Dr. John Kabat-Zin has shown how teaching mindfulness to people with chronic pain can greatly influence the patients response to pain. Thus, by teaching people to learn to pay attention to their mental responses to pain, can dramatically change their relationship with pain. The pain doesn’t go away. But nonetheless, they become less reactive to the pain.
Now in my mind, pain bears many similarities to emotions. In fact, in may ways, in a sense it is an emotion, or perhaps it is more accurate to say it is embedded with emotions. Like emotions, pain is a drive state in that it compels us to action; whether it is to move a hand from a hot iron or to seek medical evaluation or treatment. fear is an emotion that compels us to flee from danger. Thus, as with emotions, pain is subject to the laws of learning and conditioning. The experience of “hurt” can be viewed as a conditioned emotional response to pain. Thus, pain and hurt are not one and the same. Hurt is in many ways an emotional response to pain. Thus, it stands to reason, that by exposing an individual to the cues that create hurt in a mindful way, one can come to decrease the emotional reactivity to pain and thus diminish the hurt. The pain will still be there as long as the pain provoking stimulus (injury, illness, etc) are still active. So my approach is slightly different from a pure mindfulness orientation, in that it places more emphasis on exposing one to the emotional aspects of the pain experience.
The next blog will provide a guide to help with this process.
Please, as always, feel free to provide personal comments, experiences, anecdotes, or divergent views.