Mindfulness Meditation and Pain Management Recent Findings!

by Ram

Branches by Melina Meza

This is part one of two articles that focus on some of the latest findings on meditation and its an amazing variety of neurological benefits. Dhyana or meditation is a state of being where the mind stops wandering, is calmer, and maintains a period of stillness. In this state of mind, an individual no longer possess bodily awareness, the sense organs are not distracted, and the stillness produces few or no thoughts at all (see Yoga Meditation Techniques). One of the original goals of meditation was to quiet the mind. Because our minds are typically busy with thoughts and emotions—many of which disturb our equanimity—quieting the mind and letting go of these daily dramas of life allows us to experience feelings of peace and contentment. Meditation also fosters feelings of compassion, which improve relationships with others. And you can also use meditation to cultivate feelings of gratitude that in turn fosters contentment (Honesty and Contentment in the Yoga Room). There are many different kinds of meditation. Some are designed to help us relax; others are meant to produce altered states of consciousness. 

Mindfulness meditation is one of the techniques where your mind is not only fully aware of the stillness but also keeps observing when your attention starts to wander from the object of the meditation (in most cases the object of meditation is the repetitious breath, flow of thoughts, emotions or feelings). And as you observe these objects with a sense of detachment, you will notice familiar patterns that may seem irrelevant to harbor and you may want to let go these patterns. Detachment or letting go of these patterns helps in cultivating equanimity in your daily life (Meditation and Equanimity). Thus, mindfulness meditation allows you to observe your habitual thought patterns and emotional responses and provides the opportunity to change them to more positive ones. Mindfulness meditation helps us become aware of what is already true at every moment, providing us with an opportunity to become more present with ourselves just as we are. This, in turn, helps us to overcome the unnecessary suffering that results from trying to escape the discomfort and pain that we experience in our daily lives.

Today’s discussion is about mindfulness meditation and its role in alleviating the acute pain response. Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage and is part of the body’s inherent protective mechanism to motivate the individual to pull out from a damaging situation and prevent further damage to the tissue, allow the damaged tissue to rest and heal, and avoid similar encounters. Thus, the phenomenon of pain is beneficial in a true sense when, for example, your back sustains a blow and the injured tissues need care and protection (Understanding Pain). 

Just like inflammation, the phenomenon of pain is generally transient, and recedes when the stimulus is removed or the damaged tissue has healed (How and Why Yoga Helps with Pain). When your body encounters an acute pain stimulus, your brain releases a large number of pain reducing chemicals called opioids. Opioids act by attaching to specific proteins called opioid receptors, which are found in the brain, spinal cord, gastrointestinal tract, and other organs in the body. The binding of the endogenous opioids to their specific receptors results in reduction of the perception of pain. However, there are certain abnormal pathological conditions where pain is a constant feature and persists for a long time (chronic pain). While in some chronic cases the levels of the endogenous opioids are not sufficient to alleviate the pain response, in most cases the body becomes insensitive to the body’s levels of opioids. Chronic pain that lasts beyond the expected period of healing can interfere with a person's quality of life and general functioning. Unfortunately, chronic pain brings with it other health issues including constant fear, worry, anxiety, depression, and memory deficits and turns out to be the most common reason for individuals to visit their physician (Techniques for Managing Pain with Yoga). 

One of the methods of pain management is the external administration of opioids like vicodin, morphine, codeine, or oxycontin. These external opioids not only blunt the pain response, they also produce a euphoric response since they also affect the brain regions involved in reward. Regular or long-term use or abuse of opioids can lead to physical dependence and, in most cases, addiction. Naloxone is a drug that works as an antidote to the opioids and is mainly used to reverse an opioid overdose. Naloxone works by blocking the analgesic (anti-pain) and the euphoric response of the opioids in the system. Naloxone only works if a person has opioids in their system; the medication doesn't work on other drugs. 

Now what does all this have to do with mindfulness meditation? Well, we know that meditation produces relaxation and the lovely blissful feelings that result from release of tension. The question is: does meditation trigger the release of endogenous opioids which in turn produces the pain relief and the pleasant effects thereafter? This was the premise of a new study Mindfulness-Meditation-Based Pain Relief Is Not Mediated by Endogenous Opioids in which the researchers set out to ask a simple question, “does mindfulness meditation (MM) produce pain relief and if yes, then does it do so through the release of endogenous opioids”? 

The double blind randomized study involved 78 healthy, pain-free people who were randomly assigned to receive different interventions. The first group was trained in mindfulness meditation for 20 minutes a day for four days. And the second group, which served as a control group, spent the same amount of time listening to a book read aloud. The scientists then exposed all the participants to a pain stimulus by placing a hot probe on the back of their legs. The group that practiced mindfulness meditation experienced significantly reduced pain intensity and pain unpleasantness than the control group. 

The next thing to determine was if the pain reduction in the mindfulness meditation group was due to release of endogenous opioids. One way to test this was to block the release of endogenous opioids (if any) by administering the drug Naloxone, which would then reverse the beneficial analgesic effects of mindfulness meditation. (A control group was given simple saline as a placebo.) To the surprise of the researchers, the meditators who received the drug Naloxone before being subjected to the hot probe continued to experience significantly reduced pain intensity and pain unpleasantness than the control group, suggesting that Naloxone administration failed to reverse the meditation-induced pain relief. There were also no significant differences in pain intensity or pain unpleasantness reductions between the meditation + naloxone and the meditation + saline groups.

The findings clearly demonstrate that mindfulness meditation eases pain through some distinct pathways that are independent of the endogenous opioid mechanisms, suggesting that meditation-based pain relief does not require the role of endogenous opioids. The researchers do not have a clear explanation of the effect of mindfulness meditation on the brain that results in the pain relief. But based on their past results, they believe that meditation activates several regions of the brain that are associated with emotion regulation, focus, and cognitive control. At the same time, meditation also down-regulates the thalamic activity that transmits painful information from and to the body. Thus, the global effect of mindfulness meditation helps to prevent pain and painful information from spreading throughout the brain and body. 

It remains to be determined whether mindfulness meditation would be helpful in the treatment of chronic pain and also be effective in overcoming opiate drug abuse. For now though, mindfulness meditation seems to be a very attractive technique for acute pain relief and for those seeking a non-opiate pain therapy. And, if this is the case, getting hooked on meditation would also be a perfect panacea for pain and other pathological systems some of which we described earlier (Meditation: Effects on Gene Expression). 

This reminds me of an anecdotal report of a senior monk who underwent a complicated surgery without the use of any anesthetics. His years of meditation practice helped him to tide over the pain during and after the surgery. But based on the above-mentioned scientific study, it is also clear that you don’t need to be a monk to reap the benefits of mindfulness meditation. 

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Meditation and Equanimity

by Nina

Of course most of us realize that while meditation is an excellent stress management tool this is not its original goal nor its only benefit. But because I wanted to explain something to people who are newer to yoga about the relationship between meditation and equanimity, I’ve been delving a bit deeper into this subject. In general here’s what I’ve come up with so far. 

One of original goals of meditation was to quiet the mind. Because our minds are typically busy with thoughts, many of which disturb our equanimity—regrets about the past, worries about the future, and dissatisfaction with the present—quieting your mind allows you to experience feelings of peace and contentment. Meditation also fosters feelings of compassion, which improve your relationships with others. And you can use meditation to cultivate feelings of gratitude, which allows you to be more content with what you have and what you don’t have. In addition, the process of meditating allows you to observe your habitual thought patterns and emotional responses, which is the first step in changing them to more positive ones. 

Here are my thoughts about these four different aspects of meditation. If you have any of your own you’d like to contribute, I’d love to hear from you! 

Quieting the Mind

In the Yoga Sutras, Patanjali defines yoga as: 

1.2 “Yoga is the stilling of the changing states of mind.” —Edwin Bryant

Stilling the changing “states of mind”—also translated as the “whirls of consciousness”—means quieting the thoughts that cycle over and over in your mind. While not all our thoughts disturb our equanimity, when we are worried, anxious, sad, depressed, or even overly excited, we can be tormented by thoughts and emotions that whirl uncontrollably through us. What if I miss my deadline? What if the plane crashes? What if I can’t fall asleep tonight? If only my lover hadn’t left me. If only I wasn’t so helpless/afraid/overwhelmed. If only my parents had loved me more. I hate that person. I wish I had a different body. I suck at meditating. 

In classical yoga, quieting the mind is a necessary prerequisite for achieving the union with the divine that is yoga. But it is also recommended as the antidote to the kleshas, our reactions to life that disturb our equanimity and that are the source of our suffering. 

2.3 The five afflictions (klesas) which disturb the equilibrium of consciousness are: ignorance or lack of wisdom, ego, pride of the ego or the sense of ‘I,’ attachment to pleasure, aversion to pain, fear of death and clinging to life. —Edwin Bryant

The simple act of regular meditation quiets your mind, but you may find that certain techniques work more effectively for you than others, depending on your particular personality or even just your current circumstances. So you might wish to experiment with several different techniques, perhaps even keeping record of the state of your mind both before and after practice for several days in a row. See Yoga Meditation Techniques for information about how to meditate. See Thoughts About Quieting the Mind for more information about quieting the mind. 

Self-Study with Meditation 

By using our witness mind as we meditate, we can engage in self-study (svadhyaya) to learn about habitual thought patterns and emotional responses that we might not even be aware of. The witness mind is that part of our minds that allows us to observe ourselves in action while we are acting. The Sankrit word sākshī (saa-kshe), refers to the “pure awareness” that witnesses the world but is not affected by it or involved with it. The term is made up of two parts: "sa," which means "with" and "aksha," which means “senses" or "eyes.” So the sakshi is an awareness that can observe “with its own eyes.” Another meaning of the word aksha is “the center of a wheel.” As the wheel turns, its center remains still. So the witness mind remains steady while events turn around it.

In meditation, your witness mind observes when your attention has wandered from the object of your meditation—and to what. Rather than floating down the stream of your thoughts, you sit on the shore and impartially observe from a distance. And as you observe with detachment what’s happening within you—your sensations, thoughts, emotions, and feelings—you start to recognize patterns that you may later decide to change. Observing your habits can help you change the way you react to stress (see Changing the Brain's Stressful Habits). And it can help you in general to change your patterns of reactivity (see Meditation and Brain Strength). All of this will help you cultivate equanimity in your daily life. 

You can also use your witness mind during your asana practice by cultivating mindfulness. To do this, notice when your thoughts stray from being present with your physical sensations and your breath and where they tend to go. Do you notice any patterns in your thinking? And are your reactions and judgments in the yoga room similar to thoughts you have in other circumstances?  Eventually you can use on your witness mind during any activity. 

See The Power of Svadhyaya (Self Study) for more information about self study. See Yoga Meditation Techniques for information about how to meditate. 

Compassion 

1.33 By cultivating an attitude of friendship toward those who are happy, compassion toward those in distress, joy toward those who are virtuous, and equanimity toward those who are nonvirtuous, lucidity arises in the mind. —trans. by Edwin Bryant 

In addition to quieting your mind and teaching you its workings, meditation provides interpersonal benefits. Scientists have shown that the practice of meditation increases compassion. And becoming more compassionate clearly fosters better relationships with people in your life as well as strangers who are suffering.

In general, a regular meditation practices seems to have this effect. Scientists who studied this phenomenon speculated that there are two possible explanations for this. The first is that because meditation improves your ability to pay attention, this might improve your ability to notice what’s going on with someone else (as opposed to being lost in your own thoughts). Another explanation is that meditation helps us to experience the interconnectedness of all beings. Interestingly, a study showed that when people meditated on "non-referentail" compassion, the regions of their brains responsible for planned action were activated, as if they were preparing to aid people in distress. So you may find yourself with an urge to help others—always a good thing, both for them and you.

A regular meditation practice of any kind will foster compassion but if you wish to work on this intentionally, you could: 

1. Choose a person for whom you wish to cultivate compassion and before meditating set the intention that your practice will dedicated to them. Then check in again by thinking of that person after you finish. 
2. Use the word “compassion” as a mantra. 
3. Practice the Loving Kindness Meditation, a structured meditation designed to help you open your heart and cultivate compassion towards people close to you as well as strangers. Or practice any other formal meditation designed to foster compassion. 

See Meditation and Compassion for more information about meditation and compassion. See Yoga Meditation Techniques for information about how to meditate. 

Gratitude

Meditating on gratitude can have a profound effect on your mood and state of mind. In fact, scientists have actually identified the biochemical explanations for this. Feeling grateful activates the region of your brain stem that produces dopamine (your reward and pleasure center), and experiencing gratitude toward others increases activity in your social dopamine circuits, which makes social interactions more enjoyable. And even just trying to think of things you are grateful for forces you to focus on the positive aspects of your life. This boosts your serotonin levels, which increases happiness. 

To cultivate gratitude in your meditation practice, you can use the following techniques: 

1. Use the word “gratitude” as a mantra. 
2. Use one thing for which you are grateful as the object of your meditation, either as a mantra or an image. 
3. Set the intention that as you meditate you will notice things you are grateful for as they naturally arise in your mind. 
4. Practice any formal meditation practice designed to cultivate gratitude. 

Of course, when you are being harassed by negative thoughts, it often isn’t easy to find and focus on things you are grateful for. But apparently the effort of remembering to look for gratitude alone provides the benefits! And just like strengthening a muscle, a regular gratitude practice makes you stronger at being grateful over time. So you’ll be improving in your gratitude practice as you age. See The Biochemical Basis for a Gratitude Practice for more information on a gratitude practice. See Yoga Meditation Techniques for information about how to meditate. 

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Meditation A Bench Press for the Brain

by Nina

Two recent articles in the NY Times suggest that practicing meditation may increase our cognitive abilities. The first article, How Meditation Might Boost Your Test Scores, discussed a study published last month in the journal Psychological Science  by University of California, Santa Barbara researchers. The UCSB researchers found that after a group of undergraduates went through a two-week intensive mindfulness training program, their mind-wandering decreased and their working memory capacity improved. They also performed better on a GRE reading comprehension test. Students in the control group had no similar improvement.

Granted, this study was on young adults, but increasing memory capacity in general sounds real good to me! Richard J. Davidson, a professor of psychology and psychiatry at the University of Wisconsin-Madison, who has studied brain function in long-term and novice mindful meditators, explained it this way, “You can improve the signal-to-noise ratio by reducing the noise. Decreasing mind-wandering is doing just that.”

The second NY Times article, In Sitting Still, a Bench Press for the Brain, discussed the many possible benefits of meditation in older people, citing several different studies. One study that intrigued me was The unique brain anatomy of meditation practitioners: alterations in cortical gyrification published in the Frontiers in Human Neuroscience journal in February, which looked at how meditation may affect neuroplasticity (your brain’s ability to make physiological changes). Previous studies found that the brains of long-term meditators had more gray matter (which is believed to be involved in processing information) and white matter (which is believed to be the “wiring” of the brain’s communication system).

In the recent University of California, Los Angeles study, researches used M.R.I. scans to examine the meditators brains and compare them to those from a control group of non-meditators. The meditators had a median age of 51 and had all been practicing meditation of various types for an average of 20 years. The oldest subject was 71 and the longest practitioner had been meditating regularly for 46 years. The study concluded that “the degree of cortical gyrification appeared to increase as the number of years practicing meditation increased.” The Times quotes the lead scientist of the study:

“We used to believe that when you were born, your brain would grow and reach a peak in the early 20s and then start shrinking,” Dr. Luders said. “It was thought there was nothing we could do to change that.”

Now it appears that we can! Although this study does not provide  proof that meditation caused the brain adaptations or that the adaptations are what caused the improved cognitive performance, the results were certainly intriguing. And I’m sure there will be more research in this area to come.

I don’t know about you, but keeping my cognitive abilities in good shape as I age is pretty high on my priority list! And these two articles at least give me some hope that there is something that I can actually do about it—something completely free, with no dangerous side effects, mind you. 

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Meditation and Healthy Eating

by Nina

Cake and Photo by Brad Gibson (yeah, he bakes, too)

My friend Elizabeth told me that before I knew her she weighed 205 pounds, but that she was able to lose weight and keep it off by changing her eating habits. From my observations of people close to me who have weight problems and from what I’ve read, I understood how unusual this was. So I asked Elizabeth to share her story with us. Okay, fine, I admit it! I have an agenda. Because I know from our previous conversations that Elizabeth has a regular meditation practice as well as a regular yoga practice, and that she credits both with helping her stay focused on maintaining her healthy eating habits.

I also happen to be reading The Willpower Instinct by Kelley McGonigal, Ph.D. because I want to learn more about how to help people change their eating habits. That’s because—as I'm sure most of you know by now—maintaining a healthy weight and eating more nourishing foods is vital for healthy aging. And sure enough, in one of the early chapters in Dr. McGonigal’s book she tells us that one of the best ways to strengthen your self control (and don’t we all need that to help us resist the daily food temptations we’re exposed to, I mean, my own daughter is pastry chef!) is to meditate.

Here is what she says:

“Neuroscientists have discovered that when you ask the brain to meditate, it gets better not just at meditating, but at a wide range of self-control skills, including attention, focus, stress management, impulse control, and self awareness. People who meditate regularly aren’t just better at these things. Over time, their brains become finely tuned willpower machines. Regular meditators have more gray matter in the prefrontal cortex, as well as regions of the brain that support self-awareness."

And the good news is that it doesn’t take a lifetime of meditation to change the brain. Here’s another quote from The Willpower Instinct:

"One study found that just three hours of meditation practice led to improved attention and self control. The new meditators had increased neural connections between regions of the brain important for staying focused, ignoring distractions, and controlling impulses. Another study found that eight weeks of daily meditation practice led to increased self-awareness in everyday life, as well as increased gray matter in corresponding areas of the brain.

"It may seem incredible that incredible that our brains can reshape themselves so quickly, but meditation increases blood flow to the prefrontal cortex, in much the same way that lifting weights increases blood flow to your muscles The brain appears to adapt to exercise in the same way that muscles do, getting both bigger and faster in order to get better at what you ask of it."

I don’t know about you, but I find these results fascinating. Because while self control is important for healthy eating, it’s also helpful for many other ways of fostering of healthy aging, whether it is something you need to stop doing, such as smoking, or something you need to start, like exercising.

But enough about science! Let’s hear what Elizabeth says about putting theory into practice:

Nina: Can you tell us something about why you needed to change your eating habits?

Elizabeth: I was overweight (205 lbs) and unhealthy at 32. I also had Crohn's disease. The change started when I moved to California in 1999. Eventually, I lost 50 lbs and have kept it off for 12 years.

Nina: What changes were you able to make that led to the weight loss and helped you maintain it?

Elizabeth: I started by making small, realistic changes that I knew would be easy to maintain. For dietary changes, I started with milk. I went from regular to 2%, then 1%. If I had fat-I tried to make it a healthy one such as avocado or olive oil. I also created a cookbook of my favorite recipes, and revamped them so they are still flavorful but healthy. I'm a genius at the 30-minute healthy dinner. My favorite is Cuban Black Bean soup. I try to always make time in my day for exercise. If I couldn't go to the gym, I would make a point of taking the stairs or walking on my lunch break. I also changed my perspective by viewing eating healthy and exercising as a way to do something positive for myself, not something to dread. I have a nice variety of yoga and exercise DVDs at home, which is also very convenient.

Nina: What is your meditation practice like and how do you think it helps you maintain healthy eating habits?

Elizabeth: I practice Transcendental Meditation, which is typically done twice daily, for 20 minutes. I meditate in the morning—I feel it's a great start to my day. It helps me to get the rest and focus that I need. It also manages stress and helps me to be checked in with what's going on in my life. I'm more likely to defer my unhealthy snacks once I've checked in with myself.

Nina: What you said about meditation helping you get focus is very interesting. Kelly McGonigal says, “Meditation is not about getting rid of your thoughts; it’s learning not to get so lost in them you forget what your goal is.” So meditation is supposed to help you stay “focused” on your goals.

I know that you also practice yoga asana. Has this helped with you maintain healthy eating habits? If so, how?

Elizabeth: Yoga has been wonderful in many ways. I am more relaxed, have less back pain, and I am more aware of how I'm feeling. For example, for most of the time, when I'm hungry, I'm actually dehydrated or have low potassium. I'll have a glass of water and a banana and I'm fine. Yoga helps me to be quiet through an uncomfortable situation (there are many of those in my practice!). I've learned to just pay attention to my breath and it usually moves me through a situation feeling very safe and grounded.

Nina: What you just said is so important! I think self-awareness is vital for healthy eating. You need to learn, as you said, when you’re just dehydrated rather than hungry, when you’re full and should stop eating, and which foods make feel good rather than just tasting good. And the relationship between stress management and healthy eating is so key that you’ve given me an idea for a future post. Thank you so much, Lizzy!

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Who Uses Guided Meditation and Why

Have you tried to meditate and given up in frustration? Does this frustration make you feel more anxious than relaxed? If you feel frustrated by your inability to quiet your mind, try this guided meditation as a simple alternative to a more formal practice.

Learn More About [Guided Relaxation]

Guided meditation (often known as guided relaxation) is used for relaxation purposes, healing and sometimes spiritual development. It is a proven way to relax the mind and attain inner peace.... Or at least to help turn the volume down on the seemingly never ending noise that is in many people's minds. The importance of guided meditation is to help let go of the outside world, clearing the mind of any thoughts and simply following the spoken words and visualizations. Many people believe in the effectiveness of guided meditation and guided relaxation because even if you fall asleep during the process your subconscious mind can still benefit.

A meditation or relaxation program can help you to relax and release all the negative thoughts and energy that is stored in your body. Through deep relaxation you can be able to reach hidden parts of your mind that you haven't used or remembered for a long time. Sometimes we may not even know that that part of the mind existed. This experience can unleash the power of the subconscious mind to release positive energy. Remember, our mind is like a computer that can be programmed with the things that we want to happen. If you want to change your state of mind to become more productive in any aspect of your life, guided meditation can certainly be a solution. There are several guided meditation techniques that will suit your needs.

Go ahead and check out The Big List of Free Guided Meditations and follow the guided meditation videos for free ranging from tons of topics, and amounts of time. Make sure to leave a comment on the page too. I love to know my readers opinions on the videos and which are their favorites! Did you know that guided meditations are one of the greatest ways to get into the habit of meditating?

That is because they are straightforward to use, which is great if you're in need of constant relaxation after a hard day.The funny thing is most people find it hard to find the time to actually listen to them, even though they are stressed out! That may sound weird, but a lot of people tend to place the least importance on themselves. Most people look after others, help others and in general do their utmost to help others to lead a more enhanced way of living.

You can create your own mini-vacation and enjoy the physiological, emotional, and psychological benefits of meditating by travelling in your mind to your favorite space and allowing yourself to enjoy the warmth of the sun. Increase your happiness and sense of well-being by gifting yourself with time for yourself. Give yourself a break from your constant busyness and let your mind and body relax. After a few minutes, you can return to your everyday life feeling more relaxed, refreshed, and restored.

About the Author:   Danae A. Strub

Discover more about Guided Relaxation and other Meditation For Beginners , now.