Breathworks Co-Founder, Vidyamala, shares from her 40 years of exploration into how mindfulness can help with pain management.
This blog post originally featured on Breathworks
Reason 1: Mindfulness helps us distinguish between primary pain (which is given) and secondary pain (which is optional)
The experience of physical pain can be divided into two elements when we are aware, or mindful.
The first is the basic unpleasant sensations in the body—the primary suffering which is a ‘given’ in the moment it arises. The secondary pain is what quickly arises when we resist or fight that pain. This includes automatically holding our breath, getting tense, experiencing anxiety and negative thinking. This secondary pain is optional—we can learn to minimise it with mindfulness skills.
Through mindfulness we learn to accept the primary pain with a kind, gentle attitude. And through doing this we reduce, sometimes massively, the secondary pain.
Secondary pain is only created when we’re fighting and resisting primary pain.
Put simply: when we allow tension to arise, our pain increases. When we drop our awareness down into the body with a soft attitude, the physical pain doesn’t escalate. We’re aware of the pain, but we neither fixate on it in a rigid tense way; or split off from it. We gently hold it in our awareness simply as primary sensation, free of contraction, resistance and secondary suffering.
Primary pain is clean. Sure, it hurts, but it can be a relatively simple experience. Secondary pain on the other hand is sticky and complicated.
It’s often the secondary pain that ruins our life.
Reason 2: Mindfulness helps us to use breath awareness to release tension
Many people live with chronic breath holding—especially when they’re experiencing physical or emotional pain. It’s like a clenched fist—tight and contracted. When we experience pain plus breath holding, we create more tension which inevitably increases the experience of pain.
Every time we notice we’re holding our breath, we can intentionally pause, pay attention to breathing, and make sure we allow the next exhalation to flow all the way out. The in-breath will then quite naturally flow back in.
Each time we interrupt the habit of breath-holding in this way, we effectively soften that fist of tension. It’s impossible to have soft breathing and contracting states at the same time.
Instead of living life with a tight fist, live life with an open hand.
A good slogan to help remember to do this is “when in doubt, breath out”.
This can be used when we’re in pain, having doubts, or even when we don’t quite know what to do. Befriend your breath—taking it with you through life with awareness.
Reason 3: Mindfulness helps us get perspective on our thoughts with a kind and positive attitude
Many people are completely identified with the content of the mind and not aware that they can have perspective on their thoughts.
The average person has about 30-70 thousand thoughts each day. When we haven’t learned to train our minds, about 75% of these thoughts are negative and we’ve had at least 95% of them before. That’s a lot of repetitive negative thinking!
The good news is that we can train our minds, so we aren’t captive to the tyranny of thoughts (and all the associated emotions). One of the easiest ways we can do this is to repeatedly bring awareness back to the sensations of breathing in the body, which acts as an anchor for the mind.
We can’t be present to sensations in the body and lost in thought within the same moment. Once we’re connected with our direct physical sensations we’re present—rather than worrying about the past or future. So, we can gradually train ourselves to use breath and body-awareness as a ‘home-base’ for the mind.
We can learn to look at our thoughts, not from our thoughts.
The analogy of clouds in the sky is helpful here. The blue sky represents awareness and the clouds represent thoughts. We can rest in the blue sky rather than being completely identified with the clouds. Much of our thinking is repetitive inconsequential nonsense and it’s true that most of our thoughts aren’t objectively true!
Thoughts are not facts—even those that say they are.
When living with pain we can have a lot of disturbed thoughts and emotions. This is completely understandable. But by bringing awareness back to our present direct experience again and again, we can stop our thoughts escalating in destructive cycles. Kindness and self-empathy are crucial qualities to bring to this.
Reason 4: Mindfulness helps us in daily life to overcome boom and bust with pacing
Living in ‘boom and bust’ modes is very common when experiencing regular pain or illness. It means we tend to ‘over-do’ things whilst we’re feeling well/having a good day (boom); but this means we exhaust ourselves, our pain or illness flares up, and we find we can’t do as much as we’d like (bust).
Mindful awareness allows us to pace our activities. There’s a great little book called “The Art of Mindfulness: Mindfulness of Daily Life” available for free as an e-book that helps with this. It involves keeping a seven-day diary and scoring pain at the end of every activity. Then, by analysing the data and identifying activities that are triggers, e. g. sitting for too long, we can set a baseline for how long we can undertake an activity safely, without tipping into booming and busting.
My quality of life has greatly improved with pacing, or Mindfulness in Daily Life. This has the acronym MIDL which also points to finding the middle way between extremes. I use a timer when sitting and take a break every 20 minutes, taking time out to stretch my back. When exercising, I know my limits, so I’m able to exercise regularly to maintain strength and fitness as much as possible without tipping into flare-up.
Learning to pace may well transform our lives more than meditation—it’s a profound behaviour change enabling us to take a break before we break-down, rather than being trapped in boom and bust modes.
Reason 5: Mindfulness helps us to make choices—the behavioural outcome of mindfulness is choice
During life, we usually crave and want more of what we like and push away what we don’t like. This is normal but doesn’t often lead to happiness or ease. Through mindfulness, rather than living life reactively, we learn to respond skilfully.
We learn to enjoy pleasurable things and then let them go. We learn to acknowledge unpleasant things like pain in the body with kindness and grace—with a gentle acceptance. Crucially, we also realise that ‘pain’ isn’t a concrete or static thing but it’s an experience that is more fluid than we think. It is always changing, and we only ever experience it one moment at a time.
With this kind of awareness comes choice. Rather than being a victim to impulses we can choose how we respond to experience, living with flow rather than an edgy, jagged sense of life.
Through mindfulness we can befriend our mind, getting it to work with us rather than against us.
Mindfulness Enhances our Life Experience
The skilful choices we make through being mindful will enhance our life experience and help reduce our pain. We can creatively choose what we can do to help reduce our pain by changing our behaviours, thoughts and how we care for our body.
To summarise, here are the five reasons why mindfulness is helpful for living well with pain…
Mindfulness helps us distinguish between primary pain (which is given) and secondary pain (which is optional).
Mindfulness helps us to use breath awareness to release tension: “when in doubt, breath out.”
Mindfulness helps us get perspective on our thoughts with a kindly and positive attitude: “learn to look at your thoughts/emotions rather than from them.”
Mindfulness helps us in daily life to overcome boom and bust with pacing: “take a break before you break-down!”
Mindfulness helps us make choices—the behavioural outcome of mindfulness is choice: “learn to respond rather than react”
You can hear the content of this article in an interview here