Mindfulness Techniques For Pain Management

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Introduction

Body-mindfulness can be defined as an individual’s ability to understand their “state of being” and not their “state of mind”. To define what “state of mind” is, it is the act of mindlessness; however, to assemble the effects of mindfulness for pain management, individuals want to be in tune with their “state of mind”. The state of being mindful of the body involves being aware of the different sensory and mental experiences that generate thoughts, emotions, and moods. This awareness allows less energy to be consumed in sustaining these experiences and more focus on the present moment as it unfolds.

Mindfulness Mechanisms:

Refocus thought

Eliminate negative thought

And, reduce tension and stress

Acceptance and Commitment Therapy (ACT)

ACT aims to incorporate psychological flexibility which involves emotional openness to confront and adapt one’s thoughts and feelings to better align them with their values and goals. Psychological flexibility involves six core processes:

1. Acceptance: Acknowledge and accept the full range of emotions and feelings from experiences without judging them or altering your thoughts.

2. Cognitive Defusion: Distance yourself from harmful ways of reacting to distressful thoughts and feelings. Observe a thought without judgment, repeat a negative thought out loud until it is only a sound, and break down an externally observed event by giving it a shape, color, speed, or form.

3. Flexible Attention to the present: Experience the present more directly by observing and interacting with the present without judgment.

4. Self as Context: Do not be controlled by your thoughts and feelings. You can be aware of thoughts without being attached to them.

5. Values: Choose personal values that are positive such as ones that are related to family, spirituality, and career rather than choosing values based on fear avoidance or adherence to societal pressures.

6. Committed Action: Take purposeful steps to incorporate changes that will lead to positive outcomes such as confronting negative thoughts, altering distress management, and goal setting.

Research has shown ACT to be effective when used for pain management, specifically chronic pain. The American Psychological Association’s division 12, the division of clinical psychology, has stated that ACT is a supported treatment for general chronic pain.

The Body Scan:

The body scan is a key component of mindfulness meditation that allows the patient to focus on each body part and how it’s feeling in the moment.

1. Lie comfortably, remove potential distractions

2. Notice body parts in contact with the surface laid upon. Search for lingering tension and relaxing those parts of your body

3. Let go of the past. Forget the future. Focus on the moment and let all other thoughts simply drift away.

4. Body scan from toe tips to cranium. For each body part, feel for any sensations. When your mind wanders, observe where it's gone and return focus to the body part. Don’t pass judgement on the feeling or your attention. Accept each feeling that comes, then move on.

5. Become aware of your body as a whole. Stay present in the moment feeling any feeling that comes up fully and completely.

One Randomized Control Trial found significant reductions in reports of pain distress from participants when the body scan was being performed in a clinical setting. There was also a reduction in pain severity, although this finding was nonsignificant when compared to the control group.

Integrating Mindfulness and Exercise:

1. Anchor attention via breathing - focus on inhalations and exhalations, observe the tempo of your breath

2. Anchor on components of the exercise - the rotation of pedals, ascent and descent of a dumbbell

3. Focus on the purpose of Mindfulness and Exercise - bring attention to how the body’s muscles and joints are moving

4. Avoid sensory overload - exercise without audio, phones, podcasts, music or videos

5. Tap into sensation - compare body parts to each other, and to previous sessions (the body scan techniques work well here)

6. Note surroundings - focus on the atmosphere, any noises, the temperature

7. Practice non-judgment - appreciate your current ability, speed, and endurance; if exercising in a group setting, practice avoiding comparisons

There is evidence to support the feasibility of mindfulness during physical activity and the technique's ability to decrease pain. A randomized control trial found that chronic pain patients who participated in a program where mindfulness was incorporated into their physical activity had significant reductions in pain at rest and with activity, pain catastrophizing, and fear of pain due to movement.

Exercises for mindful movement:

1. Dynamic mountains - Stand with feet hip-width apart - Inhale and reach both your arms forward and overhead. - As you exhale, reach your arms out to the sides and down. Repeat this movement for three breaths.

2. Side Sways - Bring arms overhead as you inhale. - Exhale and sway to your right, reaching over your head with your left hand. Inhale and come back to the center, - As you exhale, reach your right hand over to the left. - Inhale and reach both of your arms up together. Repeat this for three breaths.