Mindfulness & Chronic Pain: Can We Befriend Our Pain?

Chronic pain can negatively impact a person’s quality of life on many levels. There is of course, the constant physical pain and then there is the mental anguish that comes from what can feel like relentless discomfort. This can often lead to depressive and/or anxiety symptoms due to feelings of helplessness and worry that the pain will not subside or that even small tasks will cause more pain. Chronic pain can lead to isolation as the sufferer often fears that they will have to abruptly leave a social outing or that others will not understand, or may even judge, their limitations. Loss of income often follows, as increased activity can worsen pain, resulting in individuals needing to take time off or use disability benefits. Isolation and loss of income can exacerbate the depressive and anxiety symptoms as well, that can in turn, make it harder to cope with the constant pain. It is a cyclical pattern that can feel never ending.So, with chronic pain being a difficult and multi-dimensional issue, how does one cope when there isn’t necessarily a cure or end to the pain in sight?

MIndfulness has been found to significantly improve the distress caused by chronic pain. Although not a quick fix, mindfulness works well as it is also multi-dimensional in its scope for healing. 

Mindfulness-Based Stress Reduction

One form of mindfulness-based treatment called MIndfulness-Based Stress Reduction (MBSR), has been found to be the “gold standard” program for stress-related illness and chronic pain. Created by Jon Kabat-Zinn in 1979, MBSR is an 8 week program consisting of daily meditation and yoga practice as well as lessons on basic mindfulness concepts. It has been found to be clinically significantly effective for chronic pain, as well as for the secondary symptoms of anxiety and depression. 

Befriending Your Pain

One of the basic tenets of mindfulness is to work toward accepting “what is”, rather than constantly seeking out something “better” or “different”, whether it be wanting the nicer car or wanting to feel happier in the moment. It is about accepting whatever comes, no matter how painful or uncomfortable it may be. In a way, it is like, making friends with the pain and discomfort. When we do not accept what we are currently feeling, we are rejecting, or fighting against reality. When we fight against reality, we add more strain and suffering to what is already painful. In MBSR, we learn that, “Suffering = Pain X Resistance”. Pain is inevitable, suffering is optional. By accepting the pain that we feel, we are reducing our suffering. Can we then turn toward our pain as if it is a friend and be kind to it, nurture it a bit? Is it possible to manage our pain better with this mindset? According to many mindfulness teachings, including MBSR, the answer is yes.

You Are Not Your Pain

Mindfulness teaches us that we don’t have to identify with our pain. When pain or illness becomes chronic, it can seep into all areas of our lives and feel as though it is us. However, it is one piece of a very large puzzle that encompasses one’s life. Mindfulness can help us to put some emotional and even physical distance from our pain so that we can observe it as more of an objective bystander. 

If you are suffering with chronic pain, starting a mindfulness practice may be a helpful supplement to your treatment. If you are not ready to take the 8 week MBSR course, trying some audio of mindfulness meditations is a great way to start. Even if you cannot start a daily meditation practice, finding some regularity with the practice is still beneficial. Some great meditation apps are Insight Timer, Buddhify, Calm and Headspace.

Dr. Christina Barber-Addis is the founder of New Awakenings Therapy and is a mindfulness-based, licensed psychologist in private practice in Woodland Hills, California. She specializes in treating adults with anxiety by incorporating mindfulness meditation into her therapy practice.

Clinging to Happiness Leads to More Anxiety

Christina Barber-Addis, Psy.D.

I recently visited the island of Kauai for a vacation. It was my first trip to Hawaii and the first vacation I had taken in a few years. I remember throughout those five months after booking the trip, I would think about the trip constantly, dreaming about the fun and relaxation that I would experience. When things would get stressful or overwhelming, I would remind myself that more happiness was on the way, in the form of an awesome vacation. And especially as the vacation neared, I found myself becoming more and more impatient with my current workload and daily tasks, dreaming for my vacation to take me away from it. 

Then I went on my vacation and had a wonderful time. But I noticed, underneath the joy, there was this underlying anxiety and agitation that my vacation experience didn’t compare to my expectation of how I thought it would be. In fact, the first few days of the vacation, I actually felt more anxious than prior to arriving. This puzzled me, but in looking back, I think it was because of my unrealistic expectation of the vacation transporting me away from my problems. My expectation was that my time in Kauai would be life-altering and take all my cares away. Of course, this wasn’t the case. All of my troubles and challenges that I had prior to my vacation, travelled on that plane along with me. 

After returning home, the disappointment continued because life threw its many wrenches at me almost as soon as the plane landed. Work was slow, leading to financial woes and the stress of our bathroom remodel reared it’s ugly head. I remember thinking, “Great, I guess all the good from the vacation is cancelled out since I can’t savor the moment. I’m thrown back into the real world again.” But, is this how it should be? Should we expect the joy from a vacation to last beyond our returning home? Are we then clinging to happiness well past its expiration date?

My biggest realization in all of this was that I wasn’t being present in my experience. The expectations and constant comparisons between “real life” and my time on vacation pulled me away from being fully immersed and present in my experience, before, during and after the vacation. What might my experience have been like if I were to allow it all in, the challenges and the joys, equally? What if I had little expectation, but rather, curiosity about my vacation and allow the joy and fun to rise and pass without judgment? All I know is that clinging to happiness only added to my anxiety. 

So how do we do this? How do we not cling to happiness? It is natural to be excited about an upcoming exciting event or vacation. But perhaps when we notice ourselves pulling away from our present experience, even when it is unpleasant, we can notice this and come back to the task at hand. Although not as exciting as the dreamy expectation of the future excitement, we are potentially preventing the anxiety that will come from the expectation that we will be saved from our present challenges. In turn, we can notice when we are being pulled away from joy by the thought of its inevitable end and just feel it, giving ourselves the gift of being present in our lives, right now, in this moment. 

Dr. Christina Barber-Addis is the founder of New Awakenings Therapy and is a mindfulness-based, licensed psychologist in private practice in Woodland Hills, California. She specializes in treating adults with anxiety by incorporating mindfulness meditation into her therapy practice.

Reflections on the Death of Michael Stone, a Beloved Meditation Teacher

Christina Barber-Addis, Psy.D.

I didn’t know Michael Stone personally. Nor had I ever been in his physical or cyber presence through teachings or classes. I had only known of him from a few audio meditations that I had found on my favorite meditation app. When I heard the first meditation, I was immediately hooked. I was struck by his clarity of voice, his impeccable pacing and uncanny ability to cut right to the chase. He had a way of teaching each part of the meditation in such a way that was mind-altering. I remember after that first meditation thinking, Whoa. This guy really knows what he is doing and has lived the meditation experience. He would say things like, Let your legs experience themselves. What the heck does that mean?? He was essentially instructing to feel the sensations of the legs without thinking about the legs. But, who would think to describe it like that? Again, mind blown! By describing it in this way, it helped me to understand meditation on a deeper level. I knew I wanted to learn more from him. I quickly learned that he was a well-known meditation teacher and devoted student of Buddhism who converted an old garage into a meditation gathering place in Toronto, Canada. He had an ever-growing following of students all over the world who flocked to take classes from him in person an on-line. He was a passionate activist, writing and speaking about social, environmental and economic challenges in our world.

What I didn’t know about Michael, and what I learned just after his death, was that he suffered with severe Bipolar Disorder. At one time in his illness he thought that if only he could deepen his meditation and spiritual practice, perhaps it would bring him relief from his symptoms. He is not alone in thinking this. Many in the meditation community think that if you meditate enough and deepen your practice enough, it can heal anything. This is of course a trap, and an understandable one, as meditation can have far-reaching benefits for people with a regular practice. However, those of us in the psychological and psychiatric community know that for people with mental disorders, it is often about changes in brain chemistry. And although meditation and other healthy activities like yoga and exercise can cause significant changes in brain chemistry, and can help us cope with symptoms, it is not always enough. Bipolar Disorder, especially the more severe Bipolar 1 Disorder, usually needs medication in order to stabilize the intense mood swings between the sometimes seductively pleasant highs of mania and the often suicidal lows of depression. Many who have been diagnosed with Bipolar Disorder don’t want to remain on medication because it can dampen the creativity and productivity that can come with manic episodes. 

Michael was receiving treatment and taking medication for his illness. However, it seemed that even this wasn’t enough to relieve his suffering. On the day of his death, he had a typical day full of errands in Victoria, Canada, near his home. He also tried to acquire a medication at an addictions pharmacy (like a methadone clinic) as he had heard that a low dose of opiates may be beneficial. He found that he was not a candidate for this treatment, so then acquired opiates on the street. He was found later that day, unresponsive, apparently having overdosed on a mixture of opiates that included the drug Fentanyl. He died a few days later after falling into a coma. 

The news of Michael’s death stirred up so much within me. First, the wave of shock came. It felt close to home, being a part of Michael’s community, even never having met him. What followed the shock were many questions: How could this have happened? Why would he take opiates? How could he do this with a family and a baby on the way? I found my questions starting to have a slant of judgment, when truly I didn’t know this person or his suffering at all. And clearly he was suffering greatly to have taken such a risk.

I realized that what surfaced next for me was another kind of judgment. It was a sense of shock that someone so experienced in meditation, self-compassion and loving kindness could be also going through such intense turmoil. In some ways it mirrored the trap of believing that meditation can be a cure-all for mental distress and illness. In the meditation community and also in the therapy community, our teachers and therapists are often idolized. We have a tendency to put them on a pedestal, somehow believing them to be all-knowing and having surpassed all of the obstacles that we still face. I found in my grief over Michael Stone’s death that I had done the same with him. I had created a story in my mind of him having risen above our earthly difficulties, perhaps finding enlightenment after years of practice. It is such a humbling reminder that we are all just human beings trying to find our way through our suffering. We are all just trying to breathe through it all, moment to moment. 

Even though I will never meet Michael Stone or have the honor of learning from him in his presence, I have learned so much from his final days on earth. I have been touched by his devotion to cultivating a culture of compassion and wisdom amidst his own personal struggles. Michael, may you be free from suffering. May we all be free from suffering.

If you’d like to learn more about Michael Stone and his teachings, 

visit his website at : https://michaelstoneteaching.com/

Dr. Christina Barber-Addis is the founder of New Awakenings Therapy and is a mindfulness-based, licensed psychologist in private practice in Woodland Hills, California. She specializes in treating adults with anxiety by incorporating mindfulness meditation into her therapy practice. 

How to Stop Your Anxious Thoughts

By the time people reach out to see me for therapy, they have been plagued by anxiety that is so severe, it feels as if it is running their lives. They report sometimes having obsessive thoughts that seem to never stop or nagging worrisome thoughts that elevate their heart rate and keep them in an almost constant state of fear. This can sometimes not only cause emotional distress but also physical symptoms such as high blood pressure, dizziness, nausea, digestive issues, and the list goes on and on.

What if I told you that almost 100% of the time, it is our thoughts that are the culprit? Most of our anxiety, even at it’s most severe, begins with one anxious thoughts that builds and builds until it feels as if our mind is filled with them. So then the answer must be that we just need to figure out what that first thought is and get rid of it! Right? Wrong.

Unfortunately, there is no way to get rid of these anxious thoughts completely. I know, that would have been the best, simplest solution possible but it is just not the case. We really don’t have complete control over what thoughts are coming into our mind. I’m sure you have tried to tell yourself, “okay, mind, just have positive thoughts now” or “stop thinking negative thoughts”. How did this work out for you? Not very well, right? It’s just not that simple. A meditation teacher once told me, “our minds create thoughts like our mouths create saliva.” Thoughts are streaming into our minds like a continuously moving conveyer belt, dropping sometimes random thoughts, images, stories and memories into our consciousness. And, as you have probably noticed, they are being dropped into our minds at an alarmingly fast rate. So it is virtually impossible to stop thoughts from dropping. 

Although this isn’t great news, it doesn’t mean that there is nothing we can do to feel better. Our control lives in what we do with the thoughts once they arrive.

So what can we do with these anxious thoughts?

1.  Don’t Believe Everything Your Mind Tells You

We can start with an awareness that we don’t have to believe everything that comes up in our minds, that we don’t have to take it all to heart or allow it to change our moods. As humans, we have the tendency to believe all of the thoughts that come into our heads. But I have to tell you, not all of your thoughts are real or accurate. Sometimes, they are flat-out lies. It’s true, your mind sometimes lies to you! Even our own memories can become distorted or seem to be more negative when we are already in a bad mood. Often, our minds will randomly drop images or thoughts that are incredibly scary or disturbing and again, aren’t really based in reality. But I know from experience, these thoughts and images can stick with me and set off a spiral of anxiety or even depression.

There may be times where it seems impossible not to believe our thoughts. But perhaps if we can remember this just 10% of the time, we can notice an improvement in our anxiety or low-mood levels.

2.  You Are Not Your Thoughts

By putting some distance between ourselves and our thoughts, we begin to realize that we are not what we think. What I mean by this is that we can begin to identify with our thoughts. A good example are unkind thoughts that we all have about ourselves, such as “I am stupid” or “I am ugly”. We can believe these thoughts so much so that it becomes a part of who we are. But actually, these are just thoughts. Just because they come up in our minds, doesn’t make them true, as I explain above.

3.  Come Back to the Moment

Anxious thoughts are always directed toward the future and often begin with “what if…” or are full of possible scenarios, usually of a catastrophic nature. Most of us are not able to predict the future, and yet we try to do it all the time. We have amazing, vivid imaginations, which can be helpful in many creative ways. However, this hurts us when we begin worrying about the endless and sometimes horrific scenarios that may come to be. And in actuality, I have found that 99% of the time, the things that I’m sure will happen, never do. 

When we begin to try our hand at predicting the future, it is possible to disrupt the thought loop by coming back to the moment. Again, we are in the future when these anxious thoughts come up, so it is possible to shift our minds back to the task at hand, which may be our work, time with our loved ones, etc. When caught in these anxious thoughts, our minds often pull us away from our present moment experience which is all that truly exists. The past is gone and the future hasn’t happened yet, thus, the present moment is precious and filled with possibility.

Dr. Christina Barber-Addis is the founder of New Awakenings Therapy and is a mindfulness-based, licensed psychologist in private practice in Encino, California. She specializes in treating adults with anxiety by incorporating mindfulness meditation into her therapy practice.