30 July 2010

Managing Pain and Practicing Presence


Today's Post:

How Practicing Presence Helps to Manage Pain


In my previous post, I wrote about my own methods for practicing presence, including deep and measured breathing, use of mantras, meditation, prayer, etc. I realize that it might not be obvious how these methods help someone in pain, so I want to be more specific, and I would also like to add a few other methods that have served me well when I am in pain.

How Breathing and Deep Relaxation Help Pain

I think the Lamaze folks could answer this better than I: that method has been taught to mothers about to give birth for decades. Even though the Lamaze breathing technique is taught for the acute pain of childbirth, the concept still applies: focus on and control of the breath is a very effective pain management tool. So the point is not to go find the Lamaze site and learn to practice - although I have checked out some sites and found them helpful in the broader sense of explaining the reasons for using the breath for pain management - but it is to point out the well-understood benefits of pain management through breathing technique.

For chronic pain, using the breath as a tool helps in two main ways:
* it helps to focus the mind away from obsessing about pain
* it promotes relaxation of the body.

Focusing the mind away from the pain has clear benefits. When I direct my thoughts to my breath, then my thoughts are not circling frantically around the pain and the distress it causes me physically and mentally.

Relaxing the body releases the tension I unconsciously hold when in pain: I am regularly surprised at how my muscles tense in response to a migraine - and not only the muscles in my neck and shoulders. I also carry the tension of pain in my hands, lower back, abdomen, and jaw. Additionally, there's a symbiotic exchange happening in that relaxing the body helps to relax and focus the mind while relaxing and focusing the mind (by concentrating on a breathing practice) helps to relax the body and all those muscles I didn't even know I was tensing.

The use of mantras enhances these benefits: adding a simple phrase that is meaningful to me increases the focus of my mind on the breath.

How Prayer and Meditation Help Pain

This seems obvious, yet I know that not all of us have the kind of faith that turns us to a personal God or sacred figure in whom we trust and who we believe will heal us. Even as my own spiritual life has progressed and changed to the point that I can no longer say that I believe in the standard, traditional Christian view of God, I have continued to find my prayer life to be rich, healing and essential to my well-being, the more so when I am in pain. However we term it - reflection, meditation, prayer, centering, yoga, etc. - our practice can be a help whether we envision or speak to a traditional God or not.

Here's how it works for me: meditative prayer connects me to a sacred reality beyond my small self and my small concerns (not that I am able to call the pain of a migraine "small" when I am in its clutches) that is so peaceful and still, broad and deep that it seems to dwarf the pain and thus change my relationship to it. For me, there is also a quality of boundless, compassionate beauty in meditation that defies attempts to describe it. (That I am writing a description of this practice that insists it's indescribable highlights the inherent paradox of talking about the sacred.)

Here I want to underscore a point I have made before: what really makes this pain management effective is that the tools I use and the skills I have developed come out of my daily, prayerful practice. One cannot learn breathing and meditation in the midst of great pain.

Tools that Help the Focus

MUSIC, of course, is number one on the list. My preference is piano, instrumental or vocal music that is quiet and slow. I love CD's that include nature sounds - water, rain, ocean, birds, tree frogs - below the music, because I find them most soothing. I have several CD's by Sister Kathleen Deignan, whose lovely voice and sacred subject matter is healing to me.

DISTRACTIONS, like DVD's I know and love (I probably have all nine seasons of Seinfeld memorized), or NPR radio programs (Car Talk, or Wait, Wait, Don't Tell Me, or This American Life, or The Moth, for example) provide distracting amusement or intellectual interest for me. And, since I cannot read when I have a migriane, books on CD are an immense help, too.

TREATS can make a difference in quality of life, and I will say more about that next week, when my topic is, "Quality of Life and Chronic Pain".


I'd love to hear from you. Click on Comment, below, or email me at carold.marsh@gmail.com.


  1. Today's NPR program, "Speaking of Faith," featured Dr. Rachel Naomi Remen, Author of "Kitchen Table Wisdom." She spoke of her life with her own chronic illness and how she found meaning in it. I think you and your readers would love this wonderful interview, http://speakingoffaith.publicradio.org/programs/2010/listening-generously/.

  2. Thank you, Carolyn. This speaks to the subject of next week's posts about gratitude. Very timely!