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Pain and sensory management through mindfulness, Part 1

January 29, 2010

In a recent post, I mentioned wanting to write about some ways of dealing with chronic pain and sensory issues which have helped me, and I am getting around to it now. 🙂

At least in my case, the sensory sensitivity/disruption and chronic pain seem to be all tied up together, coming out of a nervous system which appears to be cranked up at least three notches above most people’s. This connection first became obvious to me in the context of pain amplification, but it would also explain why so many stimuli which wouldn’t be painful to most other people can become very painful indeed. Just as certain sounds can make my skull feel like it’s shattering into tiny fragments and unexpected light touch can make my skin crawl painfully and set off muscle spasms, a scratchy piece of clothing can make my auditory processing go screwier and physical pains will blend together and start into improv sessions, creating new and interesting patterns of pain and electrical sensations. Pain perception is just another sensory perception.

Acquire further difficulties with muscle tone so that your muscles will go into spasm, lots of accumulated muscle injuries (really easy with hypermobility and dyspraxia), and trigger points developing at the drop of a hat, and things can get interesting. It’s been years since I’ve had a pain-free day, and when stress and diabetes-related nutritional deficiencies temporarily made things much worse, pretty much my whole body went into painful spasm and twitches, so that it was almost impossible to sleep (lack of sleep then aggravated it further). Near-constant migraine/cluster headaches set in. Picking up other people’s pain in sympathy does not help. And, when this happened while I was back in the U.S., I had no access to pain relief (ah, “hillbilly heroin” hysteria!), even once one of the hospice nurses found a doctor who would see me without insurance*. Not too surprisingly, I kept getting suicidal urges just to escape. Thank goodness I could see them for what they were, and had a lot of clear responsibilities during the worst period.

I’m not mentioning all this for sympathy, or anything like that, just clarifying that I do know chronic pain well. Again, something Amanda wrote at Ballastexistenz came to mind: “I bet if the people who have trouble believing this is ongoing, had to live in my body for one hour, they wouldn’t be able to function. At all.” After a while, you get used to things, sometimes too used to things.

Though I’ve gotten it calmed down a lot since then–and the couple of months’ reprise I’m just coming out of–I still have pain every day. Along with the sensory weirdness inherent to the way my nervous system is set up. The big difference? Pain and suffering do not automatically have to go together. This still amazes me, considering how I used to live and have watched too many other people live.

A while back, I mentioned ordering in and reading Shinzen Young’s Break Through Pain. His central thesis is important here: “What people call “pain” is actually a combination of pain and resistance…The distortion in perception and behavior can be a big part of the horror of the pain” also expressed as “suffering equals pain multiplied by resistance”.

Just by applying basic mindfulness, I had already started using pretty much all the techniques he suggests. (Along with some others; going into what has worked will probably turn this into a multi-part post.) This book would be a pretty good introduction for people who need more of an introduction to mindfulness, and he emphasizes that these are techniques which work, without depending on any specific belief system. I like Shinzen Young’s work, anyway, for a lot of the same reasons C4Chaos expresses. He also strikes me as geeky in a very good way.

I may have figured out a lot of basics on my own, but sometimes a teacher does help. While reading this book, some things clicked in a way that they hadn’t before, and things are not flaring up so much that I’m needing to take pain meds every day.

I still haven’t listened to the CD, since I have found guided meditation distracting; it might be very useful for some people. I’ll probably listen anyway, just in case there’s more useful info on there.

One excellent point he reinforced for me? The trouble with begrudging downtime, and causing yourself further problems by trying to push yourself too hard based on expectations. “If Nature has given you so much pain that you cannot do anything else other than be with it, then there is a message here: you are not expected to be doing anything else!” Yeah, I kinda | knew that social programming was hurting me there, but having it pointed out explicitly in this context helped.

BTW, that’s another case in which my Papaw’s more traditional Tutelo/Cherokee family got it right: if you have a splitting headache or a leg trying to spasm out from under you, for goodness’ sake go and lie down! You’re not doing anybody else any good otherwise, much less yourself. I’ve been doing a little better with this, but still have a lot of habit energy behind bulling through.

While I’ve still got Break Through Pain in front of me, I’ll quote a couple of very relevant passages:

[W]hen those qualities would occur together, he now experienced them as merely adding to each other, rather than cross-multiplying. Let’s say that a person dying of cancer has ten units of exhaustion, ten units of tumor discomfort, ten units of nausea discomfort, ten units of anger discomfort and ten units of fear discomfort. By what mathematical formula do we compute their total suffering? Under ordinary circumstances, because the sensations reinforce each other, the formula would be something like ten times ten times ten times ten times ten, which equals one hundred thousand. No wonder people say, “Please let me die, I can’t stand another moment…” If they had perfect mindfulness skills, they would not say that. Their total experience of suffering would be exactly what is there: ten plus ten plus ten plus ten plus ten, which adds up to fifty…

Because each of these sensations was clear and distinct, and because Gene had worked hard for five years with his meditation practice, he was readily able to “deconstruct” his suffering.

You don’t have to be dying from cancer, as in Gene’s case. The same thing applies to any combination of sensory weirdness, pain sensations, and getting upset about/scared by them: pretty soon things can amplify to the point that you’ve got some serious sufferering going on, with more pain and sensory scrambling than you started out with. (Meltdown/shutdown time.) And it doesn’t take five years’ practice to get some relief from that, thank goodness. 🙂 Once your mind learns to notice each sensation separately, and not to catastrophize so much, things become much easier to handle. If you keep with it, things will get better.

From another case study:

With this kind of pain, there is often a high probability that people will take their own lives. I suspect that we are hardwired to move in this direction if there is nothing but pain day after day. The horrible part of chronic pain is that the more it hurts, the more sensitive you become to the pain. Your pain circuits become pain magnifiers, so that even ordinary sensations are experienced as painful.

I would not have thought it possible–indeed, was pretty skeptical going in–but this does seem to be yet another of the wonders of neuroplasticity: what is trained can be untrained, or more like trained in another direction. I suspect that this is what is happening when the pain/sensory scrambling amplification reduces over time. After just a few months of serious practice, mine has become much less troublesome. Just having some kind of reasonable hope that your life is not falling into some kind of pit of monotonous awfulness helps a lot!

One of the major points I needed to have reinforced? Working with a goal of making the pain go away is an obstacle–even when it’s just lurking in the back of your mind. It’s like fighting the tar baby, or even damming up a river without providing floodgates. What really helps is learning to recognize the sensations themselves for what they are, and recognizing your reactions to those sensations for what they are. If you can distinguish between these things, and recognize them as they’re happening, the whole experience is not so overwhelming.

The same thing applies to more clearly mental and emotional sufferering, which is not a separate thing. A recent article, Learning to Sit with Depression: The Boulder Center for Mindfulness Psychotherapy, presents some excellent points in an accessible and practical way:

We develop a plethora of secondary reactions of avoidance, resistance or plain resignation. We busy ourselves in activities, anything to avoid facing the inner reality…

Mindfulness of our emotions is not the same as acting out the emotion and it is not wallowing in feeling bad. It is the process of literally “sitting” with the emotion: nothing to do, nowhere to go, nothing to fix, just being 100% present with the emotion as an object to observe and investigate with care.

Since this is running long (surprise!), in the next part of this post, I will describe some of the practical techniques which have helped me so far.


* This time, I was uninsured because I have been living out of the country, and was lucky enough to be able to pay $120/visit out of pocket and still afford essentials. (That doctor kept me going off drug samples, or it would have been a different story.) They make you pay up front, anyway, so I find that disregard even more appalling. It had been years since I was uninsured thanks to parental job loss and poverty, and I was shocked at barely even being able to find a doctor who would see me. The problem before was figuring out how to pay them. Then people complain about poor people tying up emergency rooms…

5 Comments leave one →
  1. January 29, 2010 6:16 pm

    Then people complain about poor people tying up emergency rooms…

    Oh FFS yes. And the ER doctors look down on you even if your own after-hours on-call doctor told you to go to the ER.


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