Mindfulness and chronic pain

Mindfulness is the ability to pay attention to the present moment both purposefully and non-judgmentally. It is the act of knowing what is happening in your thought, emotions, body or senses, without “getting carried away by it”. Mindfulness has increasingly gained attention over the past few decades, as it is gradually implemented in medical care, hospitals, schools, and businesses. 

One of the first applications of mindfulness has been for patients with chronic pain. Dr. Jon Kabat-Zinn, a scientist, writer, and teacher internationally recognized for bringing mindfulness to the West as a psychological intervention, found that mindfulness can meaningfully be helpful in reducing pain, negative body image, emotional distress, and mood disturbance associated with pain. 

While chronic pain is a complex and multidimensional phenomenon, mindfulness can aid by grounding people to their own experience, whether it is positive or negative. When pain arises, we often try to push it away, get rid of it, and attach to it a variety of negative judgments. We tend to ruminate on our pain, “fight” it and have “catastrophic” thoughts about it, which can make our experience worse. 

Such experiences often result in avoidance and reduced engagement in valued life activity. This can, in turn, worsen mood and exacerbate disability. Mindfulness can help break this negative cycle by allowing individuals to be present with and accepting of their momentary experiences, even if unpleasant, without being consumed by them. In this way, it can improve our ability to tolerate pain and other unpleasant states, and can enable us to get back to our lives and activities even though some pain may be there. 

Mindfulness for coping

Hence, mindfulness can be a useful coping strategy for dealing with chronic pain. It can help people construct more accurate perceptions of pain. It can help people remain open and curious to their thoughts, emotions, and reactions to their pain, and can help people manage their pain-related symptoms, rather than merely avoiding them. While it may seem counter-productive to open up to our pain, it may provide individuals with more control over their condition, and, in turn, facilitate physical function, psychological well being, and overall health.

So, how can people suffering from chronic pain cultivate mindfulness in their own lives? 

1. Practice mindfulness daily. A good place to start is by following guided audio and video meditations. Examples can be found in this link as well as the resources list found below. 

2. Implement “mini-meditations” throughout your day. Between tasks at home or at work, can you briefly close your eyes, take a few breaths and check in with how your body is feeling right now? 

3. Try to develop curiosity and openness towards whatever you are experiencing, even if painful or unpleasant. Can you notice how these experiences are temporary and change over time?

4. Try to apply mindfulness “in action”, throughout your day (e.g., when eating, brushing your teeth, at work, while doing chores). Can you focus on what is in front of you right now, notice how your body and mind react to what is happening, and allow it to be?

5. Read mindfulness-related books. A list can be found below in the resources list. 

6. Try to cultivate gratitude to the positive things and people in your life every day. 

Content provided by Jonathan Greenberg, PhD & Anya Ragnhildstveit

Mindfulness-related Resources

Smartphone apps 

Headspace 

A set of free brief meditations focused on stress reduction and walking at home, along with resources for employers and an extensive library of articles on meditation, managing stress and anxiety, healthy living and mental health.

Calm 

Curated free recordings include: soothing meditations for mindfulness and self-compassion; sleep meditations; calm music; relaxing soundscapes; mindful movement exercises; mindfulness for kids; daily mindfulness activity calendars; journaling resources; ideas for social connection

Stop, Breathe & Think 

Free app to help notice feelings and reactions, practice mindful breathing, and broaden perspectives via guided meditations

Mentalization-Based Guided Imagery and Mindfulness Practices

Guided imagery and mindfulness resources from HMS/MGH-affiliated faculty Dr. Felipe Jain and colleagues, that rely on principles of mentalization, i.e., how we understand our own minds and that of others. Registration required to access free recordings

Prezence 

Free app with guided mindfulness and relaxation resources, designed to support stress reduction, healthy habits, sleep, and being present in the midst of life stressors. Developed by a Boston-based company, with Dr. Blaire Aguirre from McLean as Chief Clinical Officer

Books 

• Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness by Jon Kabat-Zinn
• The Mindfulness Solution to Pain by Jackie Gardner-Nix
• You Are Not Your Pain by Vidyamala Burch
• The Mindful Path to Self-Compassion: Freeing Yourself from Destructive Thoughts and Emotions by Christopher Germer
• Self-Compassion Step by Step: The Proven Power of Being Kind to Yourself by Kristen Neff
• 10% Happier: How I Tamed the Voice in My Head, Reduced Stress Without Losing My Edge, and Self-Help That Actually Works-A True Story by Dan Harris