Category: Reading ‘The Mindfulness Solution to Pain’

Meditation Journal

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I thought I would post some reflections on my attempts meditating in the last couple of weeks. So far, I’ve been able to meditate every day (except weekends), which is the longest period of time I have ever been able to keep it up. I’ve noticed a few subtle changes in that time. I was definitely able to focus on my breath without getting distracted for up to a few minutes. This is pretty good for me, because I am always jumping around to different thoughts in my mind. I think I was able to notice intervening thoughts more quickly, like evaluations of how I was doing, or thoughts about the past or future. When I notice them, though, I still have to work on just noting the content of the thought and then escorting my attention back to the breath, without being judgey on getting distracted the first place. The thoughts I find most slippery are thoughts about meditating while I am meditating – like thoughts about making a nice meditation corner in my apartment, thoughts about building my practice into a lifelong habit, thoughts about becoming less stressed and more Zen, etc. Of course, none of those nice things is going to happen if I’m thinking about them instead of actually meditating!

I like Jon Kabat-Zinn’s explanation on his disk (meditation for pain) – that meditation is a journey exploring yourself and your relationship to pain, with no destinations promised, such as ending up having less pain or becoming enlightened. Dr. Jackie Gardner-Nix promises more – less stress and reduced pain. I think that Dr. Jackie is probably trying to give hope to chronic pain patients, as well as feels supported by recent research, whereas Kabat-Zinn is coming from a more traditional meditation background which emphasizes nonattachment and impermanence/changeability. I think both perspectives give a good balance; the first gives you hope and reason to keep practicing, while the second reminds you that being judgmental or frustrated, because you aren’t where you want to be yet, defeats the purpose of the exercise. I think that over the last two weeks I got better at understanding that each day is different and that I can’t expect a certain result every time I meditate.

One of the phrases on my guided meditation track asks you to reflect on “accepting being in the here and now”. While I was meditating last week, I found a strong internal resistance to those words. When I looked around my living room, I felt sad and resigned to be there, then. I realized that these feelings came up because I feel unhappy with my current lot – being at home, on disability, without any concrete plans for the future. This week I made more of an effort to get out and spend my time doing the things that I enjoy. I went to an interesting talk at the library, watched lectures from my online course at a café, and went for lunch with my godmother (this is part of my philosophy of living like I am a retiree – don’t people wait all their lives for time to pursue their hobbies?). Then I had another, more interesting, revelation: I have been feeling guilty for enjoying my life again. Remember the superwoman overachiever tendencies? Part of me thinks that, until I have ‘solved’ the problem of my fibromyalgia, I have no right to have fun. Wouldn’t that be tantamount to shirking my responsibilities as a grown-up, and flaking out on life?

Wow, writing that down makes it seem even more crazy. It seems obvious that it would be hard to heal if I keep pulling myself down into a pit of despondency. So, this week I’ve been challenging that voice by saying that my life is pretty good, actually, thank you very much!

Mentally Mindful

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In the past two weeks I finally moved into my new apartment and it is starting to feel like home. The silence and the space are so much more conducive to learning mindful living then the construction zone I lived in before. I did not feel very Zen during the move or unpacking, but that’s what I’m working on now. No time like the present!

The second part of chapter 2 in The Mindfulness Solution To Pain by Dr. Jackie Gardner – Nix talks about mental attitudes related to mindfulness. (I’m going to keep summarizing the key points that jumped out at me, and connections I made to my own life; I don”t want to put citations everywhere). Attitudes can be enabling or harmful to our well-being, and awareness about these attitudes can help us to strengthen positive ones and change negative ones.

The first attitude associated with mindfulness is being nonjudgmental. This is something that I have a long way to go to achieve! On Monday I was listening to Dr. Jackie Gardner – Nix’ guided meditation (more on this in a moment) and my practice was not going as well as last week. Every other breath I caught myself thinking things like “my breathing is too fast and shallow”, “why can’t I stay focused today?”, “I don’t think I’m ever going to get this right”. In the book, the authors point out that judgments about whether something is positive or negative are very black and white, and often miss the ‘gray’ nuanced part of experiences. Bad experiences can have silver linings, and good things aren’t always what they seem. Negative judgments can begin a domino effect of reactive emotions, tension and increased pain. Given the changeability and impermanence of things, judgments can really be a waste of time. I’m going to have to work on this in meditation practice and in the rest of my life too! Being off work on disability leave, as I’ve mentioned before, definitely leads me to be very judgmental about the lack of accomplishment, purpose, etc. I think they called this the inserting “superwoman overachiever cycle” in the last chapter!I really liked the observation made in the book that it can be freeing to experience situations or encounters with people and not judge them.

The second attitude associated with mindfulness is the beginner’s mind. To achieve this mental stance, you have to try to overcome your own biases, prejudices and preconceived notions, and not bring them to present situations or encounters. This reminds me of what my anthropology professors called ‘reflexive thinking’. Anthropologists believe that it’s impossible to cultivate a purely objective stand point, but by being aware of your own subjective point of view, you can still produce valuable insights and new knowledge about the culture you are studying. So this mindful attitude sounds to me like being an anthropologist studying yourself!

The third and fourth attitudes to cultivate are trust and patience. Trust that developing awareness will lead to change over time, and patience regarding how long that will take.

The next chapter (chapter 3) is about beginning a formal meditation practice. The authors define this as “intentionally setting aside a specific period of time… In your day to systematically cultivate mindfulness by focusing your attention moment by moment on some particular aspect of your experience, and actively noting when your mind wanders – as it always will – and then bringing it back to the focus” (Gardner-Nix and Costin-Hall, 2009). Usually breathing is the focus of mindfulness practice. I decided to buy Dr. Gardner-Nix’ CD of guided meditations, called ‘meditations for the mindfulness solution to pain’, which is available on iTunes. I thought it would be best to go with this one because it is designed to specifically accompany the book. The authors also recommend Andrew Weil’s “meditation for optimum health”, available from Sounds True (Google for website).  I also really like John Kabat-Zinn’s disc of guided meditations called “mindfulness meditation for pain relief”.  I’m not going to give a detailed summary of how to meditate because I think these resources to a much better job than I ever could. I did just want to mention the advice given at the end of this chapter to pace yourself while incorporating meditation into your daily routine – start with 5 min., slowly work up to 10, then 20, and so on. I’m at 10 minutes right now. I’d like to work up to 20, eventually without the guide, but for now I like listening 😉 p.s. I don’t sit cross-legged in serene white while meditating. I have to lie down with pillows under my legs on the couch or on the floor – fibrostyle. My body wouldn’t put up with that kind of sitting!

image courtesy of photostock at FreeDigitalPhotos.net

Zen master, not so fast

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Hello again,
I was hoping to write a little bit sooner, but my plans were foiled by the construction zone that has sprung up outside of my apartment building. Thank God we are moving next week to an oasis of quiet – at least, I hope that’s what it will be! Maybe it’s just me, but since my fibromyalgia diagnosis I sometimes dream of living in a soundproof room. Barring that, hopefully some of this mindfulness work will make me Zen enough not to get woken up by every dripping tap, licking cat and snoring husband. On that note, on to chapter 2 of The Mindfulness Solution To Pain.

Dr. Jackie Gardner – Nix defines mindfulness as “the awareness that arises when we pay attention to what is happening in the present moment, nonjudgmentally”. I was struck by the poignant message made at the beginning of this chapter that many of the people who live mindfully, live with with a terminal illness. The authors say that it shouldn’t have to come to this extreme for you to pay attention to your life as it unfolds, rather than “realizing at some point that somehow you may have missed large swathes of life while it was passing you by”. Moreover, the chapter points out that mindfulness is not just about being aware of the pleasant moments. The authors claim that ignoring strong, negative feelings can deepen their affect on your health.

This really struck a chord with me. Although I haven’t really begun practicing mindfulness yet, the previous chapter (which was about the impact of childhood stressors on chronic pain in later adult hood) stayed in my mind during the week, and led to some interesting observations. I realized that every couple of hours I say something really negative to myself, and that a lot of these things relate to how my family operates. For example, I found myself saying things like “am I ever going to do anything with my life?” or “I haven’t done anything productive today!” In my family, personal worth is attached to accomplishment, and there is a lot of suspicion about long-term illness (that it is ‘all in your head’ and really about some kind of not yet dealt with emotional problem). I often struggle with feeling like my fibromyalgia is a failing rather than a misfortune and I guess I am repeating that daily by trying to accomplish things to make up for it. I think this is also why I was resistant at the beginning of the book when the authors gave some examples of people who were healed by realizing they had emotional issues. These examples repeat what I grew up with and cast doubt on the biological realness of my illness. In fact, the authors give a more complicated explanation for chronic pain. They claim that issues from your childhood (experiences, parental deficiency, or poor parental role modeling) might well be affecting you, but right down to your gene expression, immune function, nervous system reactivity and other biological operations. In that sense, it is both “all in your head,” in terms of negative patterns of feeling or thinking that elicit the body’s stress response, and real biological dysfunction (including slow healing, activating predisposed illness and pain signals), which can occur partly as a result. I think I’m starting to be aware of some of my own negative patterns.Dr. Jackie is reassuring though, when she says that “just seeing …[destructive habits] clearly is the first step by which they can change”. And also that “this too shall pass”.

I think that I will leave it there for this week. It has been pretty heavy stuff so far, so I may have to get some treats and watch some trashy reality TV tonight (I’ll confess that my guilty pleasure is watching keeping up with the Kardashians – don’t judge!). I’m looking forward to learning more about starting meditation in the next chapter. Have a great weekend!

Thoughts on Chapter 1, Mindfulness Solution to Pain

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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’

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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

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