Pain Is No Matter for the Meditative Mindby Stephen Dougherty, MS | October 23, 2011
Remove your opinion about that which appears to give you pain and you stand painless.
— Marcus Aurelius
Pain is inevitable. Suffering is optional.
— Dalai Lama
The insight of Marcus Aurelius and the Dalai Lama about the nature of pain alludes to the practical knowledge that physical pain can be managed effectively through proper training and mental discipline, neatly summarized by the popular phrase “mind over matter.”
In the West, the notion of “mind over matter” has been circulating for centuries (at least since Aurelius and previous Stoic philosophers), yet it has been relatively recently that a technique that puts this insight into practice became the subject of serious scientific examination, namely mindfulness meditation. Mindfulness meditation achieves this effect by cultivating a sense of equanimity through objective observation of the internal processes of the body. Over the past decade, the science of mindfulness meditation has revealed a wide range of cognitive and emotional benefits conferred on practitioners including enhanced attention, lower pain sensitivity, and reduced emotional reactivity. The evidence for these benefits has also been supported by brain imaging studies in long-term meditators showing that change occurs at the physiological level.
To date, the majority of mindfulness meditation studies have been conducted in individuals with long-term intensive meditation experience. In a study published earlier this year in the Journal of Neuroscience, researchers at Wake Forest University explored the impact of mindfulness meditation on pain after only a few days of meditation training.
A group of 15 healthy volunteers took part in four 20-minute sessions of mindfulness meditation instruction where they were trained to maintain awareness on their own breathing while acknowledging and letting go of distraction.
The study evaluated the effect of mindfulness meditation in two dimensions: 1) how the volunteers reported pain intensity and unpleasantness, and 2) how brain activation patterns changed as measured by functional MRI. To assess the volunteer’s pain response, a small thermal simulator heated to around 120°F was applied to the back of the leg.
Comparing responses to the heat before and after meditation training, volunteers reported a 40% reduction in pain intensity and a 57% reduction in unpleasantness associated with the heat stimulus. Brain imaging indicated increased activation in areas associated with awareness of the pain sensation and a reduced activation in areas associated with the emotional response to pain perception.
Interestingly, a decoupling of two brain areas, the dorsolateral prefrontal cortex and cingulate cortex, was observed. The prefrontal cortex is thought to control attention and other executive functions, whereas the cingulate cortex is associated with the emotional salience of a stimulus. The authors suggest that the beneficial effect of meditation may be due to a dissociation of the awareness of pain with the emotional evaluation of the pain attached to it. Accordingly, the meditators are aware of the pain sensation, but are not judging or focusing on the disturbing quality normally associated with the pain. Marcus Aurelius sums it up nicely,
If you are distressed by anything external, the pain is not due to the thing itself but to your own estimate of it; and this you have the power to revoke at any moment.
As a way to better understand the meditation experience, think about the mental focus a top endurance athlete exhibits in competition. The conviction to overcome excruciating muscle aches and pains enables world class cyclists to complete the Tour de France (a 2000 mile race over 21 days at altitude) and long distance runners to finish marathons in around 2 hours (averaging less than 5 min per mile). Of course, great endurance athletes are not necessarily meditators, but they are individuals who have cultivated mental discipline with years of training in which they have come to appreciate the essence of “mind over matter.”
This study hints at the fascinating implication that one need not pursue the path of a monk, adopt an extreme stoic philosophy or even engage in an intensive meditation retreat to experience substantial health benefits. It’s possible that intensive meditation may offer additional rewards, yet this study shows that even short-term meditation training yields a meaningful reduction in the suffering associated with common, everyday pain.
The National Institutes of Health (NIH) estimates that 70 million Americans suffer from chronic pain with an economic burden of at least $100 billion in the United States. The low cost and low risk of mindfulness meditation make it particularly attractive for chronic pain sufferers, though the value extends to anyone looking for a boost in concentration and a reduction in suffering. In a way, we all have become conditioned to react to the distractions in our environments like a dog conditioned to the sound of a bell. And so couldn’t we all use a bit of the calm, quiet mind lying dormant beneath the sound of the iPhone, the Blackberry, and Pavlov’s bell ringing in our ear?
Salomons TV, & Kucyi A (2011). Does Meditation Reduce Pain through a Unique Neural Mechanism? The Journal of neuroscience : the official journal of the Society for Neuroscience, 31 (36), 12705-7 PMID: 21900549
Zeidan F, Martucci KT, Kraft RA, Gordon NS, McHaffie JG, & Coghill RC (2011). Brain mechanisms supporting the modulation of pain by mindfulness meditation. The Journal of neuroscience : the official journal of the Society for Neuroscience, 31 (14), 5540-8 PMID: 21471390
Mental Context – A Delicate Subject
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