How to Work with Physical Pain
“Recognizing and accepting our physical pain”
We all experience physical pain from time to time. The first step in working with pain is to assess whether it’s acute or chronic.
Acute Pain, usually has a physical cause and is often associated with a recent injury or physical problem. It may require immediate medical attention.
Chronic Pain, may also have a physical cause, it’s likely to be associated with cognitive and emotional components, as well, such as despair, anger, fear, or confusion.
Mindfulness meditation has been shown to be helpful with chronic pain. There are three important steps in applying mindfulness to chronic pain.
- Recognizing – dropping into the body; feeling the tension and pain.
- Accepting- without judgment any emotional reactions to the pain and tension.
- Understanding- learning how to live with pain and emotions one moment at a time.
Step 1: Investigating Pain and Tension in the Body
It may sound counter-intuitive or even frightening to bring focused attention to the body and its sensations when you’re feeling pain. Isn’t it normal and natural to want to escape or distract yourself from pain? Why would you want to bring awareness to discomfort when it seems so much better to get rid of it? However, if you don’t know how you’re holding pain and tension in the body, you may be increasing it inadvertently. This is where mindfulness comes in.
A common knee-jerk reaction to pain is to clench and get tighter around it. Unfortunately, this can not only increase the physical pain, it may also begin a vicious cycle of reactions that lead to increased anger, fear, sadness, and confusion. Getting tight around pain further constricts the muscles and restricts blood flow, which may cause more spasms and pain, possibly even in other areas of the body. This cycle is difficult to stop, and in time you may discover that you’re constricted not just around the painful area, but throughout the body.
The body scan provides an opportunity for you to reorient toward living and working with tension and pain. As you re-educate yourself about your pain by distinguishing physical sensations from mental and emotional feelings, you can learn to recognize strong sensations in the body as just physical sensations. That said, living with physical tension and pain can be very difficult and cause high levels of stress and anxiety, so it’s important to learn some skills for both coping with pain and learning to reduce it.
Once you become aware of how you hold pain in the body, you can start figuring out how best to work with it. For example, you may have lower back pain and, using the body scan, discover that the tension and tightness expands up to the top of the head—that your entire upper body is a constricted mass of pain. Is there a need for the extra tension and tightness beyond the low back area? The truth is, you may be further exacerbating your pain by holding this musculoskeletal tension.
So how do you deal with this extensive area of constricted tension and pain? Mindful awareness will not only allow you to see where you’re holding unnecessary tension, but will also help you soften and possibly release tension in these areas where there’s no pain at all. Mindfulness also teaches that if you can’t release the tension, you can practice riding its waves, just observing them, letting them be, and allowing them to ripple wherever they need to go. Just like watching ripples in a pond extend out farther and farther, you can give space to sensations and let them go wherever they need to go. Learning to be with pain may feel counter-intuitive, but it’s a fundamental step in healing. Rather than investing your energy in fighting or resisting pain, learn to go with it. This is an ancient wisdom that goes back to the Buddha, who taught that whenever there is resistance to what is, there’s suffering.
Step 2: Working with the Emotions in Physical Pain
Why is it that we have such a hard time dealing with physical and emotional pain? Is it because of our upbringing? Do we live in a culture that prefers to deny the existence of pain? We certainly receive many cultural messages that encourage us to keep a stiff upper lip and suppress, repress, avoid, or deny our pain and other feelings.
Mindfulness, on the other hand, offers a pathway to working with the uncomfortable emotions that often arise when you have physical pain, such as anger, rage, sadness, confusion, despair, grief, anxiety, and fear. Bringing mindful awareness to emotions allows you to begin to acknowledge them, no matter what they are, validating and acknowledging them without censorship and without resistance. As with physical pain, resistance to difficult emotions often causes more pain, while learning to let be and go with them, rather than fighting them, can often diminish or change the suffering associated with them. Rather than fighting difficult emotions, simply allow and acknowledge whatever you feel, letting the waves of emotion go wherever they need to go.
As mentioned earlier, there are important distinctions between “acknowledgment” and “acceptance,” and between “letting be” and “letting go.” To “acknowledge” is to simply see things as they are, whether you like it or not. “Acceptance,” on the other hand, can be seen as being okay or at peace with things as they are. If you’re experiencing pain, it may be difficult to be okay with the pain, but you can acknowledge it even if you don’t accept it. Likewise, “letting be” is different from “letting go.” “Letting go” implies being able to release, whereas “letting be” simply provides space for things to be as they are. Just like the sky gives space to a storm, you can give space to your emotions.
Acknowledging emotional pain helps create the possibility for deeper understanding, compassion, and peace. As you gain more understanding of your physical pain, your emotional reactions to it, and the differences between them, you’ll begin to see that there’s a difference between physical pain and suffering. Even in times when you can’t change the physical sensations of pain, you can change your emotional responses to them and thereby reduce your suffering. In other words, physical pain is a reality, but suffering is optional. The body does have pain receptors and is designed to feel pain; in fact, in some cases it can help prevent injury. However, your emotional response to pain is in your hands. With time and practice, you can learn to feel the pain and suffer less.
Step 3: Living in the Present Moment
The third step is living in the present moment. The truth is, you can only live in the here and now. This is the only moment in which you can make any changes. When you identify with stress, tension, or chronic pain, you may think of it as a long-term problem or life sentence, and this attitude can take you out of the present moment and increase your suffering. Mindfulness teaches you to be here now. You don’t know what the future may bring, and you really don’t know if the stress and pain will last forever. Through mindfulness practice, you can learn to be with pain one moment at a time and develop an attitude of “Let’s see if I can be with pain in this moment. If pain arises in the next moment, I’ll deal with it then.”
As you deepen your practice of mindfulness, you’ll reconnect to yourself and discover new strategies to work with tension and pain. Rather than being held hostage by your discomfort, you can cultivate the attitude that it’s possible to learn from it. As you learn to let go of the past and not to cling to a specific vision of the future, you’ll be able to see things as they are in the moment, with a growing sense of freedom and the possibility of new options. This perspective transforms you, your pain, and your relationship to your pain.
Informal Practice: Minding Your Pain
When we experience stress, tension, emotional pain, or chronic physical pain, most of us have an immediate reaction to try to get away from the unpleasant feeling. However, you also have the option of choosing to relate to it in a different way by bringing attention to how you’re holding it in the body in the moment. If you can allow the area to soften, that’s fine. If not, see if you can adopt the attitude of mindfulness, just riding the waves of sensations and letting them be.
As an informal practice, throughout the next week bring attention to physical sensations or emotions in your body and just notice how you’re feeling. Bring beginner’s mind or gentle curiosity to the feeling, cradling it in your awareness and just letting it be. Allow yourself to experience these physical or emotional sensations and allow them to be as they are, without resistance or judgment. To help you remember to practice, you could schedule a pop-up reminder in an electronic calendar that says something like “How is my body?”
Source- A Mindfulness Based Stress Reduction Workbook, by Bob Stahl & Elisha Goldstein
Adapted by G Ross Clark