Thoughts on Chapter 1, Mindfulness Solution to Pain

This is blog post number two about my journey reading The Mindfulness Solution to Pain by Dr. Jackie Gardner-Nix and Lucie Costin-Hall. In the first chapter the authors try to answer the question: why are some people more prone to disease, chronic pain or poor healing than others? The key take away from this chapter is that a combination of genetic predisposition and childhood stressors increase the probability that challenging life events in adulthood can activate illness or prolong healing. The underlying mechanism is the stress-response system, which is an important part of the mind-body connection.

Nature: Some of us are born with genes that predispose us to certain diseases, such as psoriasis or rheumatoid arthritis. However, we  may not “express” those genes unless adverse life experiences trigger them. Others may be born with a genetic makeup that makes them a “highly sensitive person”. This is based on the work of Elaine Aron, who has demonstrated a biological basis for a highly sensitive personality trait, which includes having a sensitive nervous system, being aware of subtleties in the environment and being overwhelmed in very stimulating surroundings.* Dr. Jackie Gardner-Nix argues that being highly sensitive can also mean being more sensitive to pain (supported by genetic research that shows that variations in the COMT gene can produce higher pain sensitivity in certain individuals). Furthermore, highly sensitive persons may be more negatively affected later in life by adverse events in their childhood. This discussion completely resonated with me – all my life people have told me that I’m too sensitive. Sensitive to too much light, too much noise, too many people, lack of sleep, lack of food, criticism, other people’s suffering, and now pain and touch… After I finish this book, I’d like to go on and read Elaine Aaron’s book, because I think it might explain a lot (I’m sure other chronic pain patients identify with this personality trait too).
Secondly, the authors talk about the negative physical effects of chronic stress. The stress response cycle includes increased heart rate, breathing, tensing muscles and increasing energy, while also slowing down the immune system and the gastrointestinal system. Stress can then slow healing, disrupt sleep and eventually disrupt your body’s ability to restore itself – leading to anxiety, depression, muscle tension, diarrhea and/or constipation, weight gain or loss, headaches, fatigue, and poor concentration, among other problems (Caudill, pg. 46). In turn, all these consequences of stress can worsen the perception of pain. In particular, I think that the stress – immune relationship is really important for fibromyalgia patients to keep in mind, in light of recent research that shows that people with fibromyalgia have immune depression at the cellular level.

Nurture: This book emphasizes that childhood stress is an important contributing factor to chronic pain in adulthood. This section was hard for me to read because it forced me to go back and re-examine difficult things that happened while I was young. The authors argue that childhood stressors can even affect gene expression, cause a weakened immune system or sensitize your nervous system to go on high alert “easily and frequently”. Challenging life events in childhood, parental deficiency, or poor parental role modeling can all affect a person’s ability to cope with stress as an adult. One of the core reasons is that negative emotional patterns or highly stressful thinking trigger the nervous system, and can cause a cascade of negative bodily effects through the stress response system. In my own childhood, my parents had an ugly divorce before I was five, which was characterized by loud,  angry fights, betrayals, and ultimately, nervous breakdowns. Although my parents each went on to recover and start over, the uncertainty and hostility left lasting scars. I thought I had left that all behind, and went on to become what Dr. Jackie calls the “superwoman high achiever”, determined never to make the same mistakes my parents made. Dr. Jackie says that a critical childhood caregiver can lead to this pattern of behavior. She says that the decreased function caused by an injury or disease in adulthood can, in turn, lead to anxiety about not getting ahead, causing greatly increased anxiety and heightened stress response, which can further prolong disability. This almost exactly describes my last year in which I went from starting a difficult graduate school program to crashing and burning because I tried to stick it out, even though my body was slowly falling apart due to my worsening fibromyalgia. I definitely made things worse by continuing, and causing more damage to my body – eventually getting to the point of having panic attacks because of the growing gap between what was expected and what I could do. Now I know that the high degree of anxiety was probably affecting my immune system, and impairing my ability to heal.

The book explains that mindfulness can help to repair the mind-body connection by helping you to manage stress and overcome negative emotional patterns of thought. I can’t wait to begin to learn these tools and a little bit more about what mindfulness means. Hopefully my blog post will be more about my personal experiences, and less about summarizing in the near future!

Caudill, Margaret A. (2009). Managing Pain Before it Manages You. TheGuilford Press: New York, New York.

Gardner-Nix, Jackie & Lucie Costin-Hall. (2009). The Mindfulness Solution to Pain. New Harbinger Publications: Oakland, CA.

Thoughts On the Intro to the ‘Mindfulness Solution To Pain’

Thoughts On the Intro to the ‘Mindfulness Solution To Pain’

This is my first blog post, so here we go! My first project for this blog is to track my journey towards living mindfully with chronic pain as I read a book called  the Mindfulness Solution to Pain (2009). In the introduction the authors tell us about how they came to facilitate mindfulness courses for chronic pain patients. A major theme that leaps out right away is the relationship between emotions and pain. ‘Dr. Jackie’ (Dr. Jackie Gardner-Nix) writes that in her practice she has noticed many patients whose pain improves because of positive emotional experiences like falling in love or going on vacation. ‘Lucie’ (Lucie Costin-Hall) describes how, during one terrible flare up, she read a book that made the connection for her between her own accumulated anger and her pain, which caused her pain to leave permanently. I found both of these observations to be alternately hopeful and alienating. On the one hand, I hope that this book will give me the tools to level out my volatile emotions and reduce my pain; but I am also skeptical that it could be as simple as making the connection between intense emotion and intense pain. I have already been in therapy for a few months, and have learned that tension in my relationships leads to the tension in my body – but my pain hasn’t gone away! I feel like most chronic pain patients already know that stress in their lives leads to increased pain in their bodies.

The key point in the introduction is that mindfulness offers a way to modify the emotional experience of chronic pain patients, which in turn can modify the pain experience. The authors are quick to point out that day in no way mean to suggest that chronic pain patients are psychologically deficient or less capable than normal people. However, in both Lucie’s story, and another example they give of a man who participated in one of their classes and was able to come off of his pain medications after practicing mindfulness regularly and doing some much needed soul-searching for a couple of years, the authors implicitly suggest that a core part of recovery involves dealing with your psychological baggage. This may be so, but what I find troubling about both examples is this suggestion that dealing with psychological issues will effectively cure you. Jon Kabat-Zin, the father of using mindfulness for chronic pain, is adamant that mindfulness is about finding a more helpful perspective on your situation, not about eliminating your pain. I’m sure the authors did not intend to suggest that mindfulness is a magic bullet approach, only to offer hope to people living in very frustrating circumstances. However, I think the examples are poorly chosen and even undermine the key message of the book. When I flip ahead through the rest of the book, though, it seems like the authors go on to tell a much more complicated story about the relationship between mind and body, which I’m looking forward to reading more about.

The introduction goes on to talk a little bit about the chemistry of thoughts. I thought this section was really interesting. The authors explain that your very thoughts are chemical reactions, which can trigger a cascade of biochemical responses in your body. For example, thinking very stressful thoughts can even weaken your immune system and make you more susceptible to you disease or impair your healing. This is very relevant for fibromyalgia patients because researchers recently discovered that fibromyalgia causes cellular immune depression (Behm et al. 2012). This makes me all the more eager to get going on my mindfulness journey! On to Chapter one!

Sources:

Behm et al. (2012). Unique immunologic patterns in fibromyalgia. http://www.biomedcentral.com/1472-6890/12/25