Pain becomes chronic when it’s ongoing, whether it’s constant or frequently occurring.
Some definitions say it’s chronic if it lasts for more than three months, as in this 2014 research review, while others say six months.
Chronic pain is a major health problem, and high cost for insurance companies and personal.
Chronic pain can wear on you, mentally and physically. It can disrupt sleep and leave you exhausted and in a foul mood. It can make you unable to do things you enjoy, and it even costs some people their jobs.
For that reason, it’s no wonder that people who suffer from chronic pain also have recurrent clinical depression.
The brain has to process every pain signal that’s sent, which means it gets over-worked by chronic pain. Constantly processing pain signals can lead to dysregulation of certain neurotransmitters—the same neurotransmitters involved in depression.
On top of that, researchers have identified at least six regions of the brain that deal with both mood and pain processing.
However, some alternative holistic approach has been shown to help manage chronic pain.
An approach called cognitive-behavioral therapy (CBT) has been shown repeatedly to help people with chronic pain change their behavior and lifestyles in ways that help them manage and cope with their pain.
It can also help them become less fearful of and demoralized about their pain.
With stress playing a role in both chronic pain and depression, learning to manage it can make a big difference.
Methods that have been shown to help include:
- Mindfulness meditation
- Deep breathing
I will elaborate these books definition about pain in a common and simple way; having in mind the complexity of this matter.
Let’s start with a simple question: What is pain?
We could say pain is the body’s way to tell the brain “Pay attention! There is something wrong.” And, as such, the pain response is immensely helpful.
We actually couldn’t have survived as a species without this mechanism.
What about chronic pain?
My personal theory is that chronic pain could be seen as a malfunctioning side effect of evolution.
Think about it: Let’s say you tear your meniscus, the cartilage in your knee.
It’s painful. After a while you get surgery because it’s not healing. But after the surgery and healing phase your knee is still in pain.
Your doctor says, “Well, there isn’t really anything I can do now. I can give you another prescription for your meds but otherwise you’ll have learn how to live with that.”
Wouldn’t it be nice to be able to switch off the pain at this point? You know everything you need to know, so now pain’s job to alert you is done. But no such luck. Instead the pain keeps telling you over and over: “Pay attention! There is something wrong.” This constant alerting is exhausting to the nervous system, as anyone suffering from chronic pain will tell you.
And, if that’s not enough, research shows that the pain threshold is lowered over time: At the extreme, even slight touch can be felt by the alerted brain as pain.
Pain doesn’t seem to be something we can get used to, allowing it to fade into deep background, like sounds or sights.
Instead, we have to learn how to live with it.
And mindfulness practice is a wonderful opportunity to do just that.
It helps to shift the locus of control from the outside (“this is happening to me and there is nothing I can do about it”) to the inside (“this is happening to me but I can choose how I relate to it”).
We learn to attend to our experience in a kind, curious manner instead of fighting or denying it.
We learn to cope with the pain in new ways. Some studies on pain suggest that the greatest benefit from learning mindfulness meditation is the coping.
A regular meditation practice (which can include short and long sessions and everything in between) is the best ongoing foundation for working with pain.
It helps us to hone the skills we need to attend to pain—or any challenging experience we encounter for that matter.
Before we look at working with pain in more detail, let’s start out with a bigger picture perspective. You might have heard the saying, “Pain is inevitable, suffering is optional.” While this is an easy-to-remember phrase, most people still wonder “How exactly does that work?”
Unexamined pain often feels like it’s unchanging or always present.
Prove that wrong by paying attention.
Let me explain. Insight meditation teacher Shinzen Young came up with the following equation: “Suffering = Pain x Resistance.”
We can safely say that pain is a constant in life, whether it is physical or emotional pain. And during moments when it’s not affecting you, for sure somebody you care about is in pain.
When you’re in pain and you really hate it, what happens to your suffering? It goes up, doesn’t it?
And yet, at another time when you have the same or a similar pain but you don’t resist it or you don’t worry about it so much, what happens to suffering? Doesn’t it go down? Of course is does.
That’s common sense.
At this point I love to be a little provocative to really make the point: According to this equation, if there is zero resistance, what happens to suffering? … Right?? Suffering would turn out to be zero as well!
Do you believe that?
Can you give me an example where you had pain but zero suffering? When you were okay with it, even though it did hurt?
To understand this point of view, I will pick up the example of a women that is giving birth; “When I had my baby, it hurt like hell, but I didn’t care, I was so excited to be a mom soon.”
And more examples to come ; “When I lift weights that often really hurts, but it’s okay. That’s how I grow stronger.”
“I recently got a new tattoo on the inside of my arm. Super painful, but zero suffering, that’s what it takes.”
And even people with chronic pain have told me, “I can be in severe pain, but if my mind is not worried and I don’t fight it, I can feel deeply okay in that moment.”
It’s normal to resist pain or to worry about what’s wrong.
It’s normal to suffer when we’re in pain. But it feels so normal that we forget pain and suffering are NOT the same.
We could say pain and suffering are like twins—fraternal twins, not identical ones.
Armed with this equation, we can move into the exploration of pain in a very different manner.
Let me resume my thoughts about pain!
What we call pain is actually a conglomerate of three components: the actual physical sensations, the emotions we have about the pain, and the meaning the pain has for us and our life, which we call “the story.”
They are lumped together in our experience as if they only coexisted together in a box labeled PAIN.
Let’s imagine we give the sensations, the emotions, and the story each the value of 10.
This box and its confinement would be like multiplying the power of its content: 10 x 10 x 10 = 1,000.
Of course this is easily overwhelming and many people will try to never look into the box anymore. They just try to avoid the box at all costs.
Mindfulness—which you could also call loving awareness—gives us a different approach to work with the content of the box. It helps us to open it up and take what’s in there out into the light.
We take the contents of the box out into the open field that mindfulness provides. We turn toward the pain instead of away.
We stop either running away or fighting it. We open the door to acceptance in a kind and accessible way.
We can now look at each of the three components of pain separately:
The physical sensations are different from the emotions I have about the pain, which is different from the story I tell myself about it.
Of course they all intimately influence each other. But once I know that they’re not the same I can start working with them separately and they become much more manageable.
I can simply feel the sensations for what they are. How strong are the sensations? What are the main qualities right now? Stabbing? Tearing? Pressure? Heat?
I can feel what emotion I have about the pain in this moment, and once again in the next moment. Is it sadness or more frustration? Anger? Fear?
And I can see how the story, the meaning, deeply influences both how I feel about the pain and how I actually experience the unpleasant sensations.
Breaking down the components decreases the ping-ponging back and forth, with its dangerous potential to spiral out of control. It becomes more like a 10 + 10 + 10, which equals 30. I might not be able to handle 1,000, but I can handle 30.
Let me explain it in more details and let me talk about a client I had and I will call her X .
I asked X to place attention on (or “feel into”) the unpleasant sensations in her belly and asked, “If somebody who never had this pain before was feeling what you feel right now, what would they make of it?”
She closed her eyes and felt into her belly. She was silent for some time. Then we could see something change in her face and she started to softly cry. She said, “They would think they have an upset stomach.” In that moment X could see that the actual pain was just that: unpleasant, but not overwhelming.
And that the overwhelm she had felt came from her worries about what might happen in the next couple of days and even months ahead.
Her suffering was mostly from her fear, not from the pain in her belly. And with mindfulness and compassion, she was able to stay in the present moment. One moment at a time.
Harnessing the power of self-compassion with the wisdom of mindfulness practice we can approach pain in a new way and get to know it and befriend it in ways never thought possible. Suffering really can become optional. More and more moments at a time.
The good news is that you have a lot of treatment options to try.
Work closely with me to get a diagnosis and figure out the right treatment(s) to start with.
It may take time and experimentation, but you can learn to manage these conditions and improve your quality of life.