Mindfulness-Based Pain Management uses ancient meditations that were largely unknown in the West until recently. A typical meditation involves focusing on the breath as it flows into and out of the body (see box on page Q). This allows you to see your mind and body in action, to observe painful sensations as they arise and to let go of struggling with them. 41\94eiallitl.ness teaches you that pain naturally waxes and wanes. You learn to gently observe it, rather than be caught up in it, and when you do so, something remarkable happens: it begins to melt away of its own accord. After a while you come to the profound realisation that pain comes in two forms: Primary and Secondary. Each of these has very different causes — and understanding this gives you far greater control over your suffering.

Through aging, pain tends to arise from illness, injury or damage to the body or nervous system. You could see it as raw information being sent by the body to the brain. Secondary pain follows on close behind, but is often far more powerful and distressing. Secondary pain can be seen as the

mind’s reaction to Primary pain. The mind has however tremendous control over the
sensations of pain that you consciously feel and how unpleasant they are. It has a ‘volume’
control that governs both the intensity and duration of the sensations of pain.

This process happens in an instant, before you’re consciously aware of it. Each thought builds on the last and quickly turns into a vicious cycle that ends up further amplifying your pain. And it can be worse than this because such stresses and fears feed back into the body to create even more tension and stress. This can aggravate illnesses and injuries, leading to even more pain. It also dampens down the immune system, so impairing healing. So you can all too easily become trapped in a vicious downward spiral that leads to ever greater suffering.

But even worse, such negative spirals can begin wearing tracks in the mind so that you become primed to suffer. Your brain begins fine-tuning itself to sense pain more quickly — and with greater intensity — in a futile bid to try to avoid the worst of it. Over time, the brain actually becomes better at sensing pain. Brain scans confirm that people who suffer from chronic pain have more brain tissue dedicated to feeling the conscious sensations of

pain. It’s almost as if the brain has turned up the volume to maximum and doesn’t know how to turn it down again.

It’s very impoprtant to emphasise that Secondary pain is real. And it’s the mind’s reaction to

Primary pain and has been heavily processed before you consciously feel it. But this same processing also gives you a way out; it means you can learn to gain control over your pain. For this reason, Secondary pain is best described as suffering.

In practice, you can be in pain but you need not suffer.

Once you realise this, deep in your heart, then you can learn to step aside from your suffering and begin to handle pain very differently indeed. In effect, mindfulness hands back to you the volume control for your pain.

The benefits of mindfulness on overall mental and physical health have been demonstrated in a wide range of scientific studies. Despite this, you might still be a little sceptical about meditation. When the word is mentioned a whole cascade of stereotypes can spring to mind: Buddhist monks, yoga classes, lentils, brown rice … So, before we proceed, we’d like to dispel some myths:

• Meditation is not a religion. It is simply a form of mental training that has been proven in countless scientific trials to help people cope with pain, illness, anxiety, stress, depression, irritability and exhaustion.

• Meditation will not trick you into passivity or resign you to your fate. On the contrary, mindfulness boosts mental and physical resilience.

• Meditation will not seduce you into adopting a fake `positive’ attitude to life. It simply creates a form of mental clarity that helps you to enjoy life and achieve your goals.

• Meditation does not take a lot of time. The programme in this book takes around twenty minutes per day. In fact, many people fmd that it liberates more time than it consumes because they spend far less time having to cope with chronic pain, illness and stress.

• Meditation is not difficult or complicated, although it does require some effort and persistence. You can meditate on more or less anything (see the Coffee Meditation in Chapter Three). You can also do it virtually anywhere — on buses, trains, aircraft or even in the busiest office.

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