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.