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Mindfulness & Chronic Pain
Friday August 05th 2005, 11:00 am
Filed under: health / healing,politics
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I have been dealing with chronic back/ sciatic pain for a lot of months now, since about April last year, including chiropractic, massage, acupuncture, back surgery, physical therapy, disabled parking permits, a complete loss of hiking and backpacking, lots of whining and complaining and then learning how to be more mindful about pain. After good progress in my recovery, I had a setback after a couple of hikes involving some steepness, plunging me into one of my extremely rare depressions (having been depressed only twice before in my adult life). I offer this information to those of you with chronic pain or who are healers in hope that this information can help more people than just me.

The other day, one of my wonderful grad students brought me a chapter on chronic pain from a book he was reading on Mindfulness in Psychotherapy. Lo and behold, reading this chapter has made an incredible difference in my life. Did you know that “approximately 2/3 of people who have never suffered from serious back pain have the same kinds of ‘abnormal’ back structures that are often blamed for chronic back pain,” that “many people continue to have pain after ‘successful’ surgery,” and that there is little relation between the success of the surgery and whether or not a person is still in pain? Also “psychological stress, and particularly job dissatisfaction, predicts who will develop disabling back pain more reliably than do physical measures or the physical demands of one’s job.”

Ronald Siegel, the author of the chapter, identified fear as a major factor in continuing the pain cycle when there are no structural problems. Apparently, if we are afraid, then the pain is worse than when we are not afraid. It was amazing to read this chapter and find that my sciatic pain went down several notches after reading it, when I was unafraid. I began to understand how scared I’ve been that the pain would get worse, I’d never recover, I’d never hike or run rivers again. As I keep noticing the fear and staying in the moment things get better. Also, that fear makes us not notice that pain fluctuates: sometimes it can be really bad, but other times a person with chronic pain is not in great pain and may be pain-free at times. Amazing when you pay attention to your body!

The three elements that will help people recover from chronic pain are (a) cognitive restructuring (changing how you think about the pain), (b) resuming full physical activity (after being sure that there are not structural reasons to limit activity), and (c) working with negative emotions. Underpinning it all is mindfulness practice. I would recommend work by Jon Kabat-Zin, particularly his book Full Catastrophe Living. I have ordered Ronald Siegel’s book Back Sense ($4.50 used on Amazon). And if you are a healer, you might want to get the book from which this chapter came: Germer, C. K., Siegel, R. D., & Fulton, P. R. (2005). Mindfulness and Psychotherapy. New York: Guilford. Also, last year Andrei recommended to me the book The Life we are Given by George Leonard and Michael Murphy. It was a bit too structured for me to follow the whole program, but it has some awesome ideas.

Although I am far from blowing off the allopathic medical system, having been heavily socialized in the quick fix and the drug solution (my mom was a nurse), I feel like this chapter has given me some tools that make sense. I think our dependence on the medical system undermines our power and makes us dependent on procedures and medications that can actually harm us rather than help us. I would be interested in having more dialogue on DS about health and healing. Any takers? (Sherry, where are you??)

11 Comments so far
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Here I am! Great topic. Having been struggling myself for the last 10 years with chronic back, neck and hip pain, of course I have had alot of positive and negative experiences with both Western and Eastern practices and ideas. I have gone from a place of absolutely paralyzing fear, (when I was in Baltimore and facing losing my career in music), through to now, where my fear is sometimes present, but is more manageable because I now have a support network in place and I know that if I do have a crisis, I can get through it and on with it. I have also come to a place where I just accept that this is my body, I have these chronic injuries, I do my best to take care of them, come what may after that.

Several health care providers that I have worked with have mentioned that they notice a correlation with me between my emotional state and my experience of pain. Being a fairly emotional person (okay extremely emotional and quickly sequencing through emotions at times…) it is hard to know what comes first. Is my pain increased (for whatever reason), causing my depression or hopelessness (or fear) to increase? or am I in a funk of any kind, making me more susceptible to feeling my pain and not only that, but having that pain EFFECT me more negatively than it might if I’m feeling great and stable?

I am still searching for these answers which may never be found…potentially it’s not always the same cycle but different combinations of occurances. Damn-people are so complicated!

Certainly though, it is more and more recognized that the mind is a powerful tool to controlling or dealing with pain. Biofeedback, visual imagery, meditation, and other types of energy work show many people the way through their fear and out of parts of their pain.

Coming to terms with limitations is never easy and seems to be an ongoing process. This idea of noticing the fear, saying thanks but no thanks, and sending it on it’s way seems like a great tool to try.
Thanks to fearless Sue!

Comment by Sherry 08.05.05 @ 11:27 am


I’ll take it too! This is really good information. I had to cheer when I read that your pain decreased after you read how fear affects chronic pain! I am reminded again of Bill Moyer’s book Healing and the Mind, a companion to his PBS documentary of the same title that was published in 1993. He interviewed people (including Jon Kabat-Zinn) on the forefront of exploring the mind / body connections. The variety of detailed information on this field of study must be amazing ten years later.

In 1988 I underwent a rather scary operation to remove a small “non-cancerous” Cholesteatoma tumor from my right inner ear in 1988. The tumor was creating an environment conducive to chronic ear infections. After the operation I had random shooting pain and chronic high pitched ringing tinnitus in my ear for several years. I was able to “make peace” with this tyranny of sound in part by understanding the mind/body connections and later with guided imagery sessions that Christina (your omni-talented daughter) walked me through in 1994. In this process I was able to “absorb” the sound and see it as a part of my own body, instead of viewing it as an invasion of my consciousness. Once I was able to do this, the shooting pain all but disappeared.

I welcome any dialogue on health and healing; my mom was a nurse for 30 years and I worked in the Home Health Care field for ten years. I got to see first hand how the medical system “works.” One of the key issues with so many patients is how they originally delay care due to worry about what seeking medical care costs. That debilitating cycle of “fear” you mentioned often starts before the condition has become critical. The “price” we pay for “health care” today often goes beyond the shamefully inflated costs.

Comment by Tao 08.06.05 @ 12:00 am

That’s really inspiring, and supports an idea that at first I just carried in the back of my mind, then later read, and see reiterated here and which I truly believe: The human body heals itself. It is self-regulating and self-maintaining. Sure we need drugs to kill the really nasty stuff, but other than that it’s up to us.

I suffer chronic hand and arm pain. It often terrifies me because as a programmer my hands are my living. But the more I put mental depression aside the better I feel physically. You can’t ignore pain, but I just have to hold faith that you can overcome it, somehow.

Comment by eric 08.07.05 @ 12:32 am

Thank you for this post, Sue! I too have suffered through some painful episodes of a condition in my eye that is a mystery to those in the medical field. They can identify what it is, but not what causes it or how to cure it. Talk about scary!! Over the last 10 or so years I have eventually been able to surround myself with a team of individuals who help me through these episodes, so that I don’t feel so scared and helpless as I did before. And now, even when I’m experiencing the pain, it is so much more tolerable. Because I am not afraid. Good stuff!

Comment by shelby 08.08.05 @ 12:00 pm

So here I am again…this time full of fear. Just a couple of days after writing my first response to this post, I had a recurrance of a neck/upper back injury. It has not been as totally debilitating as in the past, but it has me mad, sad, and yes, scared. I have a big anniversary playday this weekend and am supposed to sing in two big concerts next week that are very important to me on my journey through dealing with the previous loss of my career I mentioned above. A day long kayaking trip in a few weeks as well as going to Costa Rica in a mere 4 weeks (a 10 hour plane ride each way). I’m scared this will get in my way of enjoying all of these things I’ve worked so hard for. I was doing so great, zooming along, now I’m “in the barrel” again, as my gram would say. Bluck!

Comment by Sherry 08.10.05 @ 8:00 pm

Ahhh, dearest Sherry, I ache for your struggles! I am going to send off the chapter that made such a difference in tomorrow’s mail if I can get out, otherwise Monday I will express it. What you wrote in your earlier blog about your colleagues noticing the relationship between your stress and your pain is so on target for me as well. I think letting go of the fear (right, Sue!) is crucial, yet I know how hard it is to stay in the moment. My precious goddess daughter, sit for a moment and just be observant of the fear. Notice it without judgment. Say, “Wow, I am really noticing right now how afraid I am! That is so interesting, like if I were a kitty, I would not be so scared. I would just hurt, sometimes more than others (like have you ever noticed that chronic pain fluctuates?! Amazing!). If my kitty gets its tail stepped on, it yowls and runs, but I notice that it doesn’t sit around wondering if it will prevent it from doing the important kitty things in its life. Isn’t it interesting that because I have the gift of looking into the future that I can get so scared?)
Love you, Sue

Comment by Sue 08.12.05 @ 5:27 pm

Your blog resonated with me. I have never had chronic back pain, (knock on wood) but I did have to go to a chiropractor for about a year after I was in a car accident.

The cost of the chiropractic work was paid for, but I didn’t feel like it was the solution for me.

I totally believe in the power of thought to cure many physical ailments. We often forget how connected our emotional and physical states are.

Although I am a teacher and I’m around germs all day long, my friends are often surprised that I rarely get sick. I have found that if I just don’t “allow it” into my body, it doesn’t come in. OK, diet and exercise help too.

Thank you for reminding us to keep our pain away by facing our emotional state and dealing with negative emotions. I think we are too quick to medicate or have surgery in this country.

It is impossible to have a pain-free life, but I wish you to come as close to that as possible.

Stay positive!!

Comment by laura 08.25.05 @ 1:37 pm

Oh I hadn’t been back to this blog until now. Thanks for the imagery Sue, the kitty idea is so true, pervasively about life. it’s interesting, I’ve gotten better about living in the moment and not thinking about the future too much and recently two people close to me were encouraging me to hurry up and think about my future! Ya can’t win, I tell ya! But either way, I’ll keep doing my kitty things and it’ll all work out. 🙂

Comment by Sherry 10.20.05 @ 1:05 pm

Tao, if you get back to this, I want to thank you for your post. My mom was a nurse as well, and my socialization to the medical model of health/illness still has a lot of influence in my thinking. I’m glad the medical system is there when I really need it, but also am so thankful for alternatives. Sometimes it’s hard to know where to turn when something’s not in synch, but that’s another one of those lifelong processes, I guess.

Comment by Sue 11.10.05 @ 8:56 am

Eric, thanks so much for your post. I think it is easy to go around the world not knowing how many people are dealing with pain an so many different ways. I send you lots of healing energy. I also don’t think you can ignore pain, and I think there are so many ways to approach it, mindfulness, etc., that we should never give up hope. I’d be interested in talking with people on DS about acupuncture–maybe I’ll start another health and healing blog soon to reinstate the conversation. Always glad to have ibuprofen as a backup!

Comment by Sue 11.10.05 @ 9:04 am

Hi, Shelby and Laura, as I said to Eric, I am stunned to hear how many of us have dealt with and continue to deal with chronic pain. Shelby, it sounds like you found the key when you surrounded yourself with people who love and support you and thus reduced the fear. I wonder how much of our fears about pain come from feeling so alone with it?

Laura, like you, I have used chiropractic, and as much as i liked it better than some of the traditional allopathic medical treatments I could have had, it also fell short. I think it’s because I was focused only on the body.

Comment by Sue 11.10.05 @ 9:22 am

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