When I return from my summer holidays, I often dread dealing with the deluge of email that awaits. But this time, my trepidation dissipated quickly as I opened several messages from people sharing the benefits of mindfulness in their lives. These messages are such a delight to read and help reenergize our commitment to teaching. I was particularly struck by the ones where there was a relationship between pain and anxiety, especially since I have been working quite a bit recently with people experiencing both.

The first email was from someone who had been trying to conceive, despite dealing with a fair bit of chronic pain from endometriosis and another painful condition. Two years after being in a mindfulness program, she wrote:

“I have a daughter! Using the meditation techniques, I managed to labor 18 hours drug-free! I am very proud of this.”

Very heartwarming indeed.

A second email related a participant’s recent experience with a root canal. Jen gave me permission to share this with you. She wrote:

“About two weeks ago, I had a root canal. There was some difficulty with freezing the nerves, so the procedure was a tiny bit painful, and I was super-stressed out and anxious about it to begin with. But what I learned in MBSR II really helped!!

For one thing, I was able to scan my whole body throughout the procedure, noticing more than just the pain. Secondly, I worked at paying attention to what the pain really felt like, the true sensations of it, noticing that it came and went.
But most of all, it helped with the anxiety, because while paying attention to my entire body, I was able to notice all the tightness I was creating in my neck and shoulder, even my hands, and was able to relax over and over again. The whole thing was actually done before I knew it and wasn’t so bad at all!”

Wow. We couldn’t have scripted her response any better. She really got it… And on so many levels. Right down to how she was relating to her experience both mentally and emotionally, as well as recognizing how her expectations and concepts didn’t match the actuality. No catastrophe ensued and the whole experience was impermanent.

Now, both these writers make their responses sound fairly simple – but, of course, the benefits of mindfulness are not instantaneous. Both women had participated in their first mindfulness course 1- 2 years before. And Jen had taken a second course. Although MBSR is usually given as an 8-week program, ongoing practice is needed (Basson, 2012). When researchers followed up with MBSR participants (of randomized clinical trials), they noted that evidence of stress reduction may not be seen until 2- 6 months later (Pradhan et al., 2007).

This is important to realize for people who have chronic pain and who might otherwise give up practice. With chronic pain, a kind of pain hypersensitivity occurs, called central sensitization. Functional changes happen within the brain and central nervous system that increase excitability of pain sensitive circuits (Woolf, 2011). It seems that the usual neural signals that serve to inhibit pain in most conditions, become dysfunctional where chronic pain is involved.

The thinking now is that higher excitability of pain sensitive circuits in some chronic pain conditions could not only maintain the chronicity of the pain but could even be the main causal factor (Woolf, 2011). In other words, we don’t necessarily need a painful stimulus to experience pain. If neurons in the pain pathways are sensitive enough, they will be activated by innocuous stimuli.
But what makes these pathways so excitable in the first place? It appears that chronic stress is a big culprit. Chronic pain is believed to develop due to accumulated stress that on its own can sometimes be enough to dysregulate the brain’s ability to modulate pain sensitivity (Black, 2002; Chapman, et al., 2008; McEwan & Kalia, 2010).

Some researchers have recognized that central sensitization plays a role in the pain of irritable bowel syndrome (Price et al, 2006) and fibromyalgia (Staud, 2007).

In the more than 30 years since the mindfulness-based stress reduction program was designed, it has been widely used to lessen the stress and pain of those living with chronic disease. Just how change takes place in participants is currently being clarified, and there is now empirical evidence that the practice of mindfulness lessens perceived stress and restores altered cortisol and other immune responses (Carlson et al., 2007).

Well-practiced mindfulness meditators experience analgesic effects and lower pain sensitivity than non-meditators in an experimental pain condition, when they adopt a mindful state (Grant & Rainville, 2009). Others studies of mindfulness report benefits in those with fibromyalgia and substantial symptom reduction in people with IBS (Grossman et al., 2007; Gaylord et al., 2011) as well as other pain conditions. It seems that ongoing practice decreases that hypersensitivity in the nervous system, but it takes time for this to happen.

Next time, I’ll write more on this and the relationship between pain, emotion and brain activity. In the meantime, I wanted to encourage you to keep up your practice, even if it’s only 10 minutes a day; so many health benefits are just percolating below the surface! As Jen shared with us in her email, “… as I suspected, the real usefulness/benefits of the course have only just begun.”

To learn more about the MBSR II course offering, please visit the Course Descriptions page.

Thank you and be well,

Marian

Sometimes we get caught in an intense emotion and it makes us miserable, to say nothing of the people around us… Last Sunday, I returned from an inspiring workshop and as I walked up the path to my front door, breathed in the unmistakably noxious smell of mothballs. It was coming from my next-door neighbour’s yard. Even when I sealed myself indoors, the fumes managed to creep into my home causing headaches and inflaming my whole respiratory system. But that’s not all that was inflamed; I was angry. The internal judgments were flying. “Who chooses to expose themselves–and others– to poison that mutates cells? What is wrong with this person?? And hadn’t I talked to her about the very same thing several years ago? Obviously, she doesn’t care about people, animals or the environment…. “ And so it went.

As psychologist Paul Ekman notes, when we are gripped by intense emotion, we interpret what is happening in a way that fits with how we are feeling and ignore information that doesn’t fit with our view. So, when I am angry about the mothballs, it isn’t easy for me to consider that my neighbour’s actions might have come out of ignorance. I will only selectively recall past knowledge about that person and perhaps remember similar instances of feeling intruded on or even unsafe, because underneath my anger, I was afraid. I was unnerved by my body’s intense reaction to the fumes.

Ekman has spent decades studying emotions across cultures and refers to the experience of being caught up in intense emotion as a “refractory state, during which time our thinking cannot incorporate information that does not fit, maintain or justify the emotion we are feeling.” This state can be very positive if it only lasts a couple of seconds. It can help focus our attention on a particular problem and help us access relevant information to help guide immediate and subsequent actions. (In my case, it got me moving indoors pretty quickly!) 
It becomes problematic when the refractory period lasts for minutes or even hours as it can give rise to inappropriate emotional behaviour, such as telling off my neighbour, or giving her the cold shoulder. An extended refractory period can end up having even more serious consequences by biasing our view of the world and of ourselves. In this instance, if my refractory state lasted longer, I could conclude that “people are selfish” and “the world isn’t safe.”

There are many factors that affect the power of an emotion trigger and the length of the refractory period, including individual personality differences. Although most of us won’t end up physically hurting ourselves or others, most of us will occasionally say or do things that are hurtful. Sometimes the harm is toward others, sometimes to ourselves, and sometimes both.

If we are to stop emotional behaviours that harm ourselves and our relationships, if we are to change how we are feeling, Ekman counsels that we need to be able to develop a different type of emotional consciousness. Even as we are feeling the emotion, we can question whether we want to go along with what our emotion is driving us to do or choose how we will act on our emotion.

My mindfulness practice helped me to observe the urge to write an angry email, complain to others or report my neighbour’s actions to the city (it’s actually illegal in Canada to use mothballs outdoors because of their toxicity– you gotta love this country!) It also helped rein in my urge to tiptoe over in the dark with a flashlight and pick up the mothballs on the sly!

Lucky for me (and my neighbours), mindfulness practice actually lessens both the intensity of the refractory period and its duration. (See Goleman’s Destructive Emotions.) Mindfulness really decreases our suffering and in this case, helped me to see the humour in my reactive fantasies.

I had to remind myself of that tonight as I returned from my evening walk to find that my other neighbour had scattered the darn things all over his garden…

Be well,

Marian & Brett

Well, now that we are well into January, many of us are probably finding that some of our New Year’s resolutions are beginning to wane. That kale-veggie-super-antioxidant smoothie I intended to have every morning is now down to five days a week …and the prospect of keeping that up beyond January is a little daunting!

So even though I’ve slipped a little– which I fully expected– I am gentle with myself and pretty pleased with my choices, so far. Of course, I still have chocolate every day! 🙂

I have to say that my uber motivation came out of glimpsing my future in my 89-year-old parents over Christmas, which had me placing the responsibility for my health squarely back on my own shoulders. Rather than expecting/hoping that my naturopath, GP or physio would anticipate what I needed– in the form of supplements, exercises, etc.– it hit me that that no one else is really going to take care of me. As Zauberman and Lynch (2005) deduced, I had fallen prey to thinking that I’d have more time at some future point than I do right now. I can start eating better, exercising more and meditating more next month.

That holiday was some kind of wake-up call. I could see all my parents’ health issues just waiting in the wings for me. (To my mother’s credit, she attends a three-times-a-week exercise class and is at least 20 years older than all the other participants!!)

At a retreat last year, meditation teacher Phillip Moffitt shared one of his tools for differentiating our values, intentions and goals. After choosing our five core values, he asked us to identify our essential intentions.

No surprise that as a meditator, values of inner authority, open-mindedness, creativity, kindness, health and equanimity would be at the top of the list.(Okay, that’s six and that’s not even counting relationships!)

According to Phillip, “an important distinction between values and intentions is that you can have values that lack commitment, whereas intentions are active in the moment and focused on being a certain way right now. Intentions are where the “rubber meets the road,” where your values are reconciled with your goals and where you give witness to what is essential to you as you dance with life.” (Life Balance Institute, 2012)

Huh, that’s interesting. Even though I knew I valued health, my commitment to consistently acting on it waxed and waned. Now, it seems that the good feelings I get from making those smoothies in fact arise precisely from acting out of my values; the intention to become more of an inner authority on my health, to value myself and be kind to my body, to be open-minded as to what my body needs and to be creative as I try ever-changing weird and wonderful combinations of superfoods. Our intentions help us to clarify our actions in each moment, making it more likely that we will act in accordance with our deeper values..

Ah well, it’s still only January and lucky for me, kale won’t always be in season!

(To see more on Phillip’s work, see www.lifebalanceinstitute.com)

Thanks and be well,

Marian & Brett

I just finished reading an interesting new study that reports that for “the first time, meditation training has been shown to affect emotional processing in the brain outside of a meditative state.” Collaborators on the study were from UMass General, Boston University and several other research centers.

When they looked at people’s brain activity after completing an eight-week meditation program, they found that activity in the amygdala changed in response to viewing emotional material– even when people were not actively meditating.

You may recall that the amygdala is a small but mighty area of the brain that is always on the alert for real — or imagined — danger and has a large role to play in processing our emotions, including whether or not we go into a state of panic.
Interestingly, the researchers found a difference in the amydala’s response to different types of meditation. In order to test this, they randomized volunteers to three different eight-week groups: health education, mindfulness training and compassion meditation training, which included lovingkindness practice. Three weeks before and after their courses, participants’ brains were scanned while viewing 108 images of people in situations with either positive, neutral or negative emotional content.

Those who attended the educational program showed no differences in the amygdala, 
Yet those who took part in the mindfulness course had decreased activation in the amygdala in response to all of the images, which supports the hypothesis that meditation can improve emotional stability and response to stress. Those in the compassion group also showed decreased activation in response to positive and neutral emotional images. However, in response to negative images that depicted human suffering, amygdala activation tended to increase.

Corresponding author Desbordes and his colleagues, like many Eastern and Western meditation teachers, believe that mindfulness and compassion meditation cultivate different aspects of mind. “Since compassion meditation is designed to enhance compassionate feelings, it makes sense that it could increase amygdala response to seeing people suffer.” He adds that, “increased amygdala activation was also correlated with decreased depression scores in the compassion meditation group, which suggests that having more compassion towards others may also be beneficial for oneself. Overall, these results are consistent with the overarching hypothesis that meditation may result in enduring, beneficial changes in brain function, especially in the area of emotional processing.”

Hijacked by your emotions?

Even with some meditation practice under your belt, you may find yourself feeling hijacked by certain emotions in particular situations. The amygdala picks up covert cues that resemble past stressful or traumatic interactions and situations– and can react with alarm. For example, if you are planning to visit relatives over the holidays, it is not uncommon for many to feel apprehensive if previous family holidays went sideways. You might be dismayed to find yourself feeling and behaving like a teenager again around your parents or siblings. When we are not aware of our triggers and in touch with the emotions that arise from them, we can find ourselves reacting in ways that cause us pain.

In MBSR II, we explore some of the more challenging emotions, such as frustration and anger, fear and anxiety, sadness and grief. Although our initial impulse is to try to shut down, deny or avoid difficult emotions, that strategy doesn’t work in the long run. Our emotions invariably seep through in one way or another, affecting our physical and mental health as well as our relationships.

Throughout this eight-session program, we invite you to become more intimate with these challenging states and with how they manifest in your body, mind and heart. Through this compassionate, experiential exploration you will learn skillful ways of responding to the full catastrophe of life, while decreasing the intensity and frequency of emotional reactivity.

Thanks and be well,

Marian & Brett