Responding to Your Pain with Self-Compassion

Image by Julien Tromeur

Have you ever had a bad back? I’m guessing that, as you are human, have a spine and do all the things that 21st-century humans do (sitting too much, being overly stressed, being hunched over a computer screen all day) the answer is yes. And if you are a fellow bad-back sufferer, you will know that when your back pain flares up, it’s not much fun.

As I write this, I am a few days into a flare-up. Despite doing everything possible to manage it – first ice, then heat; help from a brilliant osteopath; frequent yoga, stretching and mobilisation; anti-inflammatory gel, and so on – I’m in a fair amount of pain.

And when you are suffering from pain, your natural reaction might be to get frustrated and impatient. ‘Why me?’ you ask, stooped over and clutching your lower back. ‘It’s so unfair!’ Or, ‘I hate being in pain so much!’ Or, ‘I’m sick to death of this – I just cannot stand it.’

Trust me, these thoughts – accompanied by various expletives – have passed through my mind and out of my mouth in the last few days. Chronic pain is a real struggle. It just grinds you down and makes it hard to be positive, upbeat or optimistic that the episode will ever end.

Why negative thinking makes pain worse

But I am lucky enough to work in a profession that has helped me understand a great deal about pain, both physical and emotional, and how best to deal with it. When my back was really bad, a couple of years ago, I read a life-changing book by Vidyamala Burch and Danny Penman: Mindfulness for Health: A Practical Guide to Relieving Pain, Reducing Stress and Restoring Wellbeing. The authors explain that there are two types of physical pain: primary and secondary. Primary pain comprises the signals from your nerves at the site of the injury or illness in your body – like a broken leg or gash on your knee.

This information travels up the nerves until it reaches your brain. At which point, your brain interprets the information from your nervous system, as well as the thoughts you are having about the pain, to decide whether it’s serious/threatening or not. If your brain thinks it’s serious – that broken leg, for example – it then turns up the ‘pain volume’, making the pain worse.

This is secondary pain, which is often far worse and more distressing for us than the primary version. It’s important to stress that both forms of pain are real – it’s not ‘all in your mind’. We are talking about actual, physical pain and discomfort here.

But the fascinating – and revolutionary, for me – discovery here is that we can control the level of our pain by adjusting our response to it. And the key to reducing your pain, whether it’s physical or emotional, is responding with self-compassion.

The miracle of self-compassion

Let’s circle back to those (totally understandable) responses to being in pain. In Buddhism, these are known as ‘second darts’ – the first dart is the pain itself. But the second dart is the anger, frustration, stress and upset we feel when we respond to that pain with negative, blaming, hostile thoughts and words. Instead, the Buddha taught us to respond with acceptance, kindness and compassion, however alien or difficult that might seem at moments of discomfort and distress.

What helps me respond to my pain, and tight back muscles, with compassion is that I know from experience that this will both reduce my pain and accelerate the healing process. I do my level best to say/think things like, ‘Oh man, this is hard. But I know it won’t last forever and I will get better soon.’ Or, ‘Poor back. I know you’re really suffering right now. But it’s OK, nothing is wrong, you can just relax.’ Or, ‘Dan, I know you’re in a lot of pain right now and that is hard to bear. But remember that you’re not alone. I’m here for you, I care about you, and we will get through this together.’

If I keep responding in this way, my pain is significantly less. My back gets better much more quickly, as I’m not bracing and tensing up, which keeps the muscles tight and in spasm. And I spare myself a great deal of unhappiness, because accepting that I’m going through a tough time helps reduce the frustration, irritation and upset that those negative responses cause.

Of course, everything you’re reading here applies just as much to psychological and emotional pain, as it does physical, somatic pain. And that’s why my next Heal Your Trauma webinar – The Healing Power of Self-Compassion – will teach you all about being kind and compassionate, rather than unkind or harsh with yourself.

I will teach you some simple, powerful self-compassion practices that you can use right away. And the webinar will feature a 15-minute Q&A, allowing you to ask me anything you want about how to manage your pain, mental health and wellbeing.

This 90-minute Zoom webinar takes place at 3pm on Saturday 28th May 2022 – and costs just £39, including exclusive access to a recording of the event.

I look forward to seeing you there – find out more about this event by watching the video and book your place now using the button below.

And sending you love and healing thoughts, whatever you might be struggling with right now.

Warm wishes,

Dan

How Chronic Pain and Illness Affect Your Mood

Image by Toa Heftiba

As I sit writing this, I am in a moderate amount of pain. Like millions of people around the world, I suffer from chronic musculoskeletal (back and hip) problems, so most days come with either a small or large dose of pain, depending on how well I am looking after myself, how stressed I am, how much sitting I do that day, and various other factors.

Having been in some degree of daily pain for almost two years now, I have learned a few things about the relationship between physical pain and mental suffering:

• It's important to distinguish between 'primary' and 'secondary' pain. I learned this from Vidyamala Burch, founder of the excellent Breathworks. This organisation provides the Mindfulness-Based Pain Management programme, which has a strong research base behind it and helps many people in the UK and beyond deal with chronic pain and illness.

• Burch also co-wrote Mindfulness for Health: A Practical Guide to Relieving Pain, Reducing Stress and Restoring Wellbeing with Danny Penman. In this superb book the authors explain that primary pain is the actual raw data caused by, say, a gash in your leg. Intriguingly, the majority of the pain you end up experiencing is secondary – the pain created by your brain as it amplifies that raw data, depending on the way you think about and respond to your primary pain.

• This only became clear to me recently when I visited my osteopath during a bad patch physically, feeling down and hopeless about resolving my problems. He reminded me that the pain was significantly better now than when I first came to see him; and that it was crucial to remain as positive as possible, because my negative thoughts ('I will never get over this'; 'Nothing will help'; 'I can't stand the pain any more') were undoubtedly making the pain worse (this is essentially what the Buddha taught – that human life inevitably involves pain, but we create suffering by our response to that pain. But that's a topic for another day).

Managing the pain

I think it's important to note here just how hard it is to maintain a positive, optimistic mood in the face of chronic pain or illness. As anyone with a long-term condition knows, it grinds you down, especially when it flares up or your symptoms get worse for whatever reason. Please don't think I underestimate the impact of physical ailments on your mood – it is a struggle and gets everyone down from time to time, as well as causing stress and worry/anxiety about the future.

I couldn't understand that vicious cycle any better. But once you understand the relationship between pain sensations in the body and the way that your brain either amplifies or minimises those sensations, it seems crucial to me that you do all you can to use your brain/mind to help your body.

 When I first hurt my back and was really struggling, Vidyamala Burch's guided meditations really helped pull me through. Visit her website (www.vidyamala-burch.com) to find out more. And if you are dealing with chronic pain or illness, my thoughts and well wishes go out to you – I hope you get the medical help you need and manage to overcome your problem soon.

Warm wishes,

Dan

How Mindfulness Can Help with Chronic Pain

Image by Joyce McCown

If you suffer from a medical condition that causes you chronic pain, life can be gruelling. Nobody likes being in pain, so over time it can really grind you down. Musculoskeletal problems like hip, knee or lower-back pain, arthritis and other ongoing, hard-to-treat conditions can sap your strength and energy over time, making it hard to stay positive or hopeful that a solution will eventually be found. Dealing with pain can make you stressed or depressed, as the ongoing struggle – unsurprisingly – causes sadness and low mood.

But if you or someone you care about is struggling with a painful condition, it's important to know that there is very good evidence for the impact that psychological treatments can have – in particular, cognitive therapy and mindfulness meditation.

Of course, thinking differently about your problem, the core strategy in cognitive therapy, will not take away the pain (although it can significantly decrease the amount of pain you are in). Instead, it will help you stop thinking so negatively about the problem, which will boost your mood and stave off the risk of depression. 

The mindful approach to stress

Since the 1970s, mindfulness – in particular, mindfulness-based stress reduction, or MBSR – has been used to help people with a wide range of psychological and physical ailments. MBSR's founder, Jon Kabat-Zinn, developed his revolutionary approach to help people who had been failed by traditional Western medicine.

He worked with patients suffering from treatment-resistant spinal problems and even terminal illness – and had a remarkable success rate at lowering their stress levels and improving the quality of their daily lives.

As with all forms of suffering, whether emotional or physical, the mindful approach is to change our relationship to the thoughts, feelings and physical sensations, enabling us to stop fighting or resisting them and – counterintuitively – accept them, even if we do not want them to be there.

Over time, we find that this stance of acceptance is an extremely powerful one, allowing the 'aversive' experiences to come and go, so they don't get stuck or morph into other forms of suffering like self-criticism or anger.

I want to be clear: I am not minimising how hard or upsetting it can be to live with chronic pain (as someone with ongoing back, hip and other musculoskeletal problems, I know that only too well). But being human inevitably means dealing with stressors, large or small; and, if we cannot free ourselves from them, we must find the best possible way to live with them.

Warm wishes,

Dan