Do you ever wonder how the body heals itself; how pain resolves and wounds heal; how broken bones mend? The mission of the National Institutes of Health (NIH) is “to seek fundamental knowledge about the nature and behavior of living systems and the application of that knowledge to enhance health, lengthen life, and reduce illness and disability.” The Ransdell Act establishing the NIH specifically indicated that it was for “ascertaining the cause, prevention and cure of disease …” Recently, the NIH has been funding studies exploring the role of the mind and more specifically the brain in relieving pain. NIH researcher Catherine Bushnell, Ph.D. points out that the brain can modulate pain, and that these self-regulating processes can be accessed through mind-body therapies such as meditation and yoga.¹ Other NIH-funded researchers have also found that mind-body practices can tap into the neurobehavioral mechanisms that help us to coordinate the healthy functioning of our body to relieve pain, inflammation, and to reverse the disease processes.
There are many different types of mind-body practices, and different ways of teaching and practicing meditation, yoga and related therapies such as qigong. Researchers and practitioners are beginning to explore the active ingredients of these practices; what it is about mind-body therapies that enable healing to occur. One of the key ingredients has been identified as letting the focus of awareness be on the sensations of the body. We call this focus on self “interoceptive awareness”. Interoceptive awareness, or focusing on body sensations allows the higher regions of the conscious brain known as the sensory cortex to access the far reaches of the body and coordinate the healthy function of the body.
When you sense pain, my own research and others have shown that attending to the pain can help it to resolve.² Pain exists for a reason. It is the body’s way of sending a message to the brain to inform it of a problem. Usually we try to ignore it, or mask it with drugs that block the pain. We now find that meditation practitioners who gradually explore the felt sensations of pain are experiencing significant relief within several weeks of beginning their practice.
Another key ingredient that I find in my practice is the use of the exhale to deepen the relaxation response and let go of tension in the body. The build-up of carbon dioxide can activate the stress-response, while exhaling and releasing carbon dioxide can elicit the relaxation response. Each time that we exhale deeply, there is a corresponding cascade of shifting hormones that reduce inflammation and associated pain. This may explain why we call a deep exhale “the sigh of relief”. This type of emotion regulation supports both the neural and emotional changes associated with relief of pain. Taken together, interoceptive awareness, particularly of the exhale and related relief may explain what scientists are discovering, that “..new experimental studies show that interventions such as meditation not only decrease pain but also have powerful protective effects on brain grey matter”.³
From our studies, we can identify at least six steps in the practice that may make mindfulness an effective therapy for relieving pain:
1. Take the time. Begin by agreeing to set aside the time to do the practices. As with any practice, you want to begin gently and proceed gradually. You might start by committing to 5 or 10 minutes a day to exploring the practice of meditation or yoga. Most research explores the benefits of one one-hour class a week over 8-12 weeks. Gradually, you will find yourself enjoying this time more and more, and may naturally choose to give yourself more time for practice.
2. Be patient with yourself. All kinds of emotional experiences can arise when you begin the practice, including frustration, boredom, self-doubt, and even pain itself. These are familiar obstacles that are a part of the process of self-exploration. Be patient and accepting of these experiences and continue the practice. (If you need assistance, seek a trained expert to guide you through your practice until you are able to or choose to practice on your own.)
3. Make yourself comfortable. Since the overall goal of this practice is to become more comfortable in your skin, it makes sense to begin here. Mindfulness is not about enduring pain for the sake of proving that we can tough it out. Our ability to tough it out and ignore pain has a place, but it does not have a place in the curative powers of the mind. Begin by making yourself comfortable, and continue to do so throughout your practice. Eventually the adjustments that you make will become subtle, and perhaps unnoticed by others, such a relaxing your shoulders or unclenching your jaw. Continue with this until you recognize comfort throughout.
4. Focus on your breathing. Once you are comfortable, spend some of your mindfulness time practicing a deep sigh of relief. Become familiar with exploring the sensations of breathing. Once you know how to elicit the relaxation response with your exhale, you are ready for the next step.
5. Listen to the pain. Pain exists for a reason. It is your body’s way of communicating with you. Let the messages of your body into your consciousness. Use curious awareness to explore any pain. Remember, you are in a safe place allowing existing sensations into your consciousness.
6. Visualize the breath moving through the area of your pain. Imagination and intention are powerful tools. Everything that humankind has ever built was first imagined in someone’s mind. Every action that we take stems from an intention formulated in the brain. Slow down the process and practice by visualizing a sense of the breath moving through and around any area of pain.
My next article in this series on the Science of Mindful Awareness will explore how mind-body practices affect the brain and our emotions, thus enabling our brain to modulate pain.
¹ Bushnell, M.C., Ceko, M., Low, LA, Cognitive and emotional control of pain and its disruption in chronic pain, Nat Rev Neuroscience, 2013, 14(7):502-511.
² Nassif, TH, Norris, DO, Soltes, KL, Blackman, MR, Chapman, JC, Sandbrink, F., Mindfulness Meditation and Chronic Pain Management in Iraq and Afghanistan Veterans with Traumatic Brain Injury: A Pilot Study, Journal Military Behavioral Health, Nov 17, 2015.
³ Bushnell, M.C., Ceko, M., Low, LA, Cognitive and emotional control of pain and its disruption in chronic pain, Nat Rev Neuroscience, 2013, 14(7):502-511.
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