The Mindfulness and Chronic Pain Paradox

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The Paradox

• If you bring attention to your mild to moderate chronic pain with open curiosity, it will often ease. (And sometimes the same will occur with severe pain)

• If you bring attention to chronic pain with the hope of repeating that same ease and relief, it will often stay the same or worsen.

A client describes to me how they reached to get something out of the fridge and got a familiar and unwelcome slight twinge in their back. It’s not “off the charts” pain, but it’s one that comes often and that brings them to feel vigilant about what may come next. If they try to ignore it, it often sticks around and they end up feeling a bit more on edge as well. Thoughts come at a rapid pace about why they still feel this pain, will they ever be free from it, maybe they’ll need surgery. It’s the type of chattering negative thought patterns that the Buddha referred to as, “monkey-mind.” As you notice yourself going into monkey-mind, you can make the choice to really make a study of what you’re sensing and feeling. Bring attention to your chronic pain with open curiosity, and it will often ease. Pain is neuroplastic — meaning the experience of pain in the nervous system is not fixed, but changeable.

The paradox many of us hit up against is that when you try to repeat that process, this time looking for the same relief like last time, it doesn’t work nearly as well when we’re fixated on the goal of pain relief. In his new book, The Way Out, Alan Gordon suggests a framework for navigating this puzzle. He suggests that we think about bringing mindful attention to our chronic pain with two arcs of time in mind: one long and the other short. 

In the long arc, we hope for relief from pain. We acknowledge our wish that we will feel less pain, less often, and that we’ll learn to recover quickly from the pain we do experience. In the long arc, we know that there will be ups and downs, but we hope that in the big picture, our pain will be much less of a common presence in our lives. 

The long arc gives us the permission and capacity for the short arc to be more open and curious. The short arc is the present moment in which we’re feeling pain. In that moment, we bring open attention to our pain — studying how we experience it and watching how it changes. We do our best to staying open to the possibility that the pain may decrease, stay the same, increase in intensity.

When we know that making a study of our pain this way will bring us a welcome change in the long term, it allows us to put aside some of our goal oriented thinking in the short term. Some moments of mindfully noticing our pain will bring relief and others won’t. But in the long term, the practice is building towards less pain.

I’ve found this long and short arc thinking is helpful to share with many of my clients. It gives them a framework for allowing themselves the curiosity to study their experience of pain without willing it to go away each and every time. 

Feldenkrais and SE sessions can go many layers deeper than the basic approach presented in Gordon’s book, and can help us establish the level of neurological safety necessary to be able to track pain without getting overwhelmed. For the client reaching in the fridge, this means that we take in not just the mechanics of reaching into the fridge, but the quality of it as well (the ease or effort experienced) and how all of these influence our experience of pain. We make space and give equal importance to noticing associations that come up around that twinge of pain – sometimes those include strong emotions, difficult memories or intrusive thoughts like self-judgements or catastrophizing. 

Feldenkrais and SE work to allow you to feel safe and ready to track your pain signals in the present moment. (The “short-arc” above). After many such experiences we can even welcome moderate pain as a chance to practice! With each practice, we take another step towards breaking free of our old story of the pain. Instead we can move towards seeing chronic pain for the cluster of changing sensations, thoughts, emotions and nervous system responses which it is.  And in the long arc, that can have a significant effect on bringing relief and healing.