Pain is a tricky beast. We can struggle through the most crippling agony for fear of losing a job or letting someone down, or even through sheer determination, but the moment we get home and relax… bam! It hits you like a freight train.
How is it that we can cope with such intolerable discomfort by will power alone? Without realising it, we are modulating our perceptions and increasing our tolerance to pain thresholds. It’s not an easy way to get through the day, but I’m sure we can all think of occasions when we’ve held ourselves together in times of crisis.
What if we could suppress the level of pain without having to endure the freight train at the end of the day? This is where long-term meditation practitioners have the upper hand. Recent research has shown that even a few sessions of mindful meditation can drastically alter our perceptions and reactions to pain.
Let’s consider how our bodies react.
The problem with physical pain is that it triggers conscious and sub-conscious evaluation, tipping the mind into worry. What if it’s something serious? What if it never gets better? I wonder if I’ll get any sleep tonight? How will I manage to fulfil my duties and obligations? What started out as physical pain, rapidly descends into secondary suffering. When the pain becomes a chronic issue, lasting for some time, the mental anguish can fall into serious conditions such as depression and acute anxiety.
As we dwell on these insurmountable problems, we strengthen the neural pathways related to fear. We begin to anticipate pain, priming our senses for the onset until we have created a hair trigger response.
Our mind receives this sensory data and immediately begins to evaluate the symptoms. The brain has an inbuilt compulsion to find systems to protect us. It is looking for ways to avoid future episodes. By comparing the current levels of pain to how we reacted to similar conditions in the past, it can streamline the entire process for efficiency. In effect, we have increased our sensitivity to pain reception. With each cycle of pain detection and reaction, we spiral into a loop of suffering.
The result is to amplify the pain we experience and package it up with a range of debilitating worries and fears.
More often than not, people react to pain by holding their breath, gasping or shallow breathing to cope. It’s a natural response to have, but our bodies interpret this as a warning sign, releasing stress hormones and altering the body chemistry to add to your suffering. Before you know it, your heart is pounding, your blood pressure has spiked and your anxiety is pushed into overdrive.
Rather than helping, our brain’s response works against us by reacting negatively to any source of pain, no matter the intensity, as a defence mechanism. This feedback loop becomes so finely tuned, that it’s hard to imagine that it could ever be reset back to tolerable limits.
Reversing the Feedback Loop
This is where meditation comes into play. Through mindful practices of Focused Attention combined with elements of Open Monitoring, we can teach our brain to handle the sensory data in a different way.
Instead of evaluating and judging pain, triggering the negative feedback loop, you can encourage your mind to observe the pain objectively. In doing so, you can lessen the tendency to gasp, shallow breathe or hold the breath, by-passing the warning sign that sets off the release of stress hormones from the adrenal glands.
The practice involves mentally scanning the body for aches, pains and tension and observing aspects about those sensations. Is it sharp and sporadic or dull and continuous? Does it ebb and flow or move about specific regions of the body? Once pinpointed, you are encouraged to label the emotions that accompany the condition, whether it’s anger, fear. sorrow, or commonly depression, anxiousness and stress.
Despite having all these feelings, you are taking a dispassionate look at the data as though you were an outsider, observing the suffering from a distance. The final part of the body scan exercise is to observe your breath, making sure that it is steady and rhythmic. There are good reasons why mid-wives tell pregnant women to breathe through the pain while they are giving birth. Although panting is not required, taking control of the breath does provide some relief.
Evidence that it works
Studies from the 1980’s right through to the present day, have focused on isolating the common factors involved in meditation practices and how it helps patients in acute and chronic pain. The problem with many of those research methodologies is that they are difficult to standardise and therefore even harder to compare.
Most have small sample sizes and are unable to take into account the different levels of experience in the subjects who are considered masters. Other factors such as distraction, belief systems, expectations, current mood and innate pain tolerance should also be taken into account when analysing results.
Despite this, we can generalise from the brain scans conducted on volunteers before and after meditation courses, and even from those who have spent years practicing techniques. Functional MRI scans of patients with no experience of meditation showed massive blood flow and activity in the regions related to pain reception, fear, stress and anxiety. After only eight weeks of mindful meditation, the scans showed vastly reduced activation in those areas. Anecdotal reports were incredibly positive, with subjects claiming a reduction in pain intensity and a general improvement in emotional reactions and stress.
While some scientists used actual patients with conditions such as lower back pain (Kabat-Zinn) or Irritable Bowel Syndrome (Garland and colleagues), others used cold, electrical stimulus or heat to induce pain in volunteers.
Kingston and colleagues found that six, hour long mindful meditation sessions, twice weekly, was enough to increase the pain tolerance in subjects compared to that of a control group of volunteers who were exposed to a similar length of visual imagery training. The meditators were taught both body awareness (Focused Attention- FA) and aspects of Open Monitoring (OM).
Zeidan and colleagues attempted to dispel the notion that relaxation or distraction could account for this new-found pain tolerance. In his study, he found that just three days of twenty-minute mindfulness sessions, incorporating FA and OM methods was sufficient to reduce the perception of pain, compared to those undergoing relaxation training, which had no impact on pain regulation at all.
How does it work?
The authors of these studies, such as Zeidan, conclude that the reasons why mindfulness meditation is successful at reducing pain perception is that by activating different regions of the brain, meditation enhances cognitive and emotional control by ‘cultivating an attitude of acceptance towards impending stimuli.’
I suppose it can be likened to when the nurse warns you that you’ll feel a sharp scratch just before jabbing a wide bore needle into your arm. You are prepared for the momentary pain and override the impulse to snatch your arm away, just by knowing in advance of what you will feel.
It’s also interesting to note that the studies on the most advanced meditation practitioners reported the greatest tolerance of pain, with associated brain scans to back up subjective reports. They also showed evidence of thicker grey matter in pain related regions which overlapped with functional effects. The longer the subject had been practicing meditation, the more structural changes were observed in the brain.
While a short course of mindfulness appears to be a quick fix for those in temporary pain, it seems that nothing compares to the lasting effects of long-term, regular meditation. Those with mastery of Open Monitoring practices, such as Zen, have the greatest control over their responses to all noxious sensory input. While they are aware that pain is present, their perception and reactions towards it are purely observational.
Sadly, few of us can devote such a huge proportion of our time to becoming Zen masters. Until then, regular short bursts of mindfulness can keep the negative feedback loops of pain in check. It may not be as quick as popping a few pain-killers, but it’s kinder to your liver and costs nothing but time.
If you are feeling stressed right now and need a few minutes to clear your mind, why not listen to the short session recorded at the bottom of this post?