Mindfulness tools for dealing with emotional and physical pain

Like many women and quite a few meditators (including a young S.N. Goenka), I suffer from migraines. These severe headaches are not all that well understood in the medical community and are often extremely difficult to treat through either allopathic or homeopathic means. Fortunately, through the practice, I have found that mindfulness meditation offers some insight into the causes at the same time as it provides significant relief.

As any meditator knows, one of the biggest obstacles we face in the beginning (and sometimes in perpetuity) is the physical discomfort experienced in formal sitting meditation practice. Regardless of whether you’re seated in a chair, kneeling on the floor, or in half-lotus – the body is not accustomed to remaining in one position for extended periods of time. Even when practicing lying-down meditation, we experience pressure and eventual pain if we stay in the same posture for too long. At the same time, the discipline of formal practice, particularly in community, asks us to sit a little longer and to explore what physical pain is all about. When we develop some stability of mind in our meditation, it can be pretty interesting to investigate what really constitutes pain.

Yesterday I spent the day with Ajahn Amaro at the New York City Insight Meditation Center. The day was dedicated to the Spiritual Faculties or indriya, a favorite topic of mine thanks to my Burmese teacher, Sayadaw U Tejaniya. I won’t entirely side-track this discussion, but Ajahn Amaro described the five indriya as akin to a bird, with mindfulness being the heart of the bird, and the partner qualities of energy and samadhi representing the wings, and with the elements of faith and wisdom — also a pair — representing the base and the head of the bird, respectively. In our practice, keeping these faculties in balance is an ongoing act of minor adjustments made possible only through our remembering to be aware (sati or mindfulness).

As part of his response to one of the retreatant’s questions regarding difficult emotions, Ajahn Amaro talked about how we are able to see concepts of pleasant and unpleasant in a broader perspective through mindfulness. Specifically, when we refrain from getting involved in the story line that produces difficult emotion and instead just bring our attention to the physical sensations associated with that emotion, we find that even seemingly pleasant emotions result in discomfort in the body (e.g., excitement). On the other hand, those emotions that we associate as unpleasant such as anger or fear, when we see them for the sensations that they are, aren’t really all that bad. In fact, the physical response to both strong positive and negative emotions is pretty similar. It’s the thoughts about the emotion, the thought content itself, or the fixed ideas (shoulds, etc.) that color our perception of these passing phenomena…

Particularly from my experience with migraines while on intensive retreat, I would argue that the same principle can be applied to physical pain to a large extent. While I can’t say that I know the pain of childbirth or of a terminal illness, migraines have been very debilitating and generally the only way that I have been able to cope with them is to sleep as much as possible. In discussing the quality of energy (viriya), Ajahn Amaro talked about the mind’s tendency to either have too much or too little energy. If too much, the mind is restless and racing around discursively, if too little, we are constantly nodding off and unable to maintain interest in meditation. Often, this is a kind of “mental numbness” or shutting off to something we don’t want to deal with – like physical or emotional pain. Unconsciousness is nature’s anaesthesia, Ajahn Amaro says.

When we experience chronic pain like this, the mind develops a pattern of relationship with the pain. Obviously, we don’t want the pain. We want to shut it out. We want it to go away. We don’t want to be aware of what’s happening. We want to wake from a deep sleep feeling refreshed and totally recovered. So to then try and practice mindfulness meditation while experiencing intense pain can be extraordinarily difficult. While I was in Burma, I had several migraines and was unable to go to the meditation hall. But rather than fall asleep, I wanted to understand the nature of these headaches, so tried in earnest to practice lying-down meditation. What I found was that the object of the meditation – the pain, and to a certain extent the mind’s reaction to the pain – was so gross as to be virtually impossible to be at peace with. But I began to see improvements in the way the mind was relating to the pain over time, because I wasn’t vomiting from the sheer exhaustion of the pain anymore. I also began to recognize the mental states that contributed to a migraine’s appearance, and was able to stop them ahead of time (as long as they didn’t come in my sleep!). Still, the pain was real and challenging, but there was definitely a change under foot.

Three days ago I woke with a headache. I sensed that it might turn into a bad one. And it did. Try as I might have to divert it. We were going to a family wedding and the last thing I wanted to do was get in a hot car in the middle of the day where the sunlight would be moving in and out of my view and the sounds of the highway would constantly be droning. I brought a pillow and an ice pack, covered my eyes and dropped into my body. I felt the migraine. I didn’t think about the migraine. And in the feeling, in the just being really present in my body, an extraordinary peacefulness emerged. An acceptance of the way things were and, in that, a significant relief.

When pain is constant and unrelenting, it is very hard not to identify with it, “MY pain”, “MY back hurts”, etc., and it seems to defy the law of impermanence while we are experiencing it so a tremendous amount of aversion or resistance arises in the mind. But when we can create some distance between the mind that is aware of the pain and the body that is experiencing the pain, when we can truly observe objectively, it changes the whole equation. The more I think about how much my head hurts, the more it hurts, but if instead I’m just experiencing sensation, the intensity goes away, and then suddenly I find myself virtually headache-free. It seems almost a miracle.

It is in this way that we begin to redefine the mind’s relationship to that old pain. And it’s not in shutting ourselves off to it or trying to push it away, but rather in opening up to it and allowing it to be that we find freedom.

For a long time I have looked at the practice of meditation as a way of learning to live so that we can learn to die. Death often is accompanied with physical pain, and clearly represents the ultimate letting go, which if we are not prepared for will then be accompanied with significant mental pain as well. And, if my experience with migraines is any indication of what we are capable of through cultivating the mind, I can’t imagine anything more important to help us to both live and die well.

…

For more reading on the Five Spiritual Faculties, refer to Ayya Khema’s description here, or to Thanissaro Bhikku’s commentary and translations here. Also, you can listen to Ajahn Amaro speak about Faith and the Spiritual Faculties here.

—

For more reading on vipassanā and pain management, see below.

• UPDATE 8/17/10: Using meditation to get acquainted with pain – are you serious?
• Open Practice: How Vipassana Meditation Relieves My Migraine Headaches
• Mindfulness and Pain, Part 3: Untangling the Threads, Part 1 (Pain & Sensory Management), and Part 2 (Body Awareness)
• Perlman D.M., Salomons T.V., Davidson R.J., and Lutz A. Differential Effects on Pain Intensity and Unpleasantness of Two Meditation Practices. Emotion, Vol. 10, No. 1, 65–71
• Johns Hopkins School of Medicine, Dept of Medicine ( Madhav Goyal, Assistant Professor). Intensive Meditation and Migraines: Effects on Health and Well Being – research under way
• Patil SG. Effectiveness of mindfulness meditation (Vipassana) in the management of chronic low back pain. Indian J Anaesth [serial online] 2009 [cited 2010 May 24];53:158-63.
• Rosenzweig S, Greeson JM, Reibel DK, Green JS, Jasser SA, Beasley D. Mindfulness-based stress reduction for chronic pain conditions: variation in treatment outcomes and role of home meditation practice. J Psychosom Res. 2010 Jan;68(1):29-36.

Posted by sharanam on May 24, 2010

https://sharanam.wordpress.com/2010/05/24/mindfulness-tools-for-dealing-with-emotional-and-physical-pain/